A patient prescribed a muscarinic-receptor blocker will require assessment for what side effect?

Dry mouth

Orthostatic hypotension

Pseudoparkinsonism

Gynecomastia

Answer and Explanation

The Correct Answer is A

Choice A reason: Muscarinic receptor blockers inhibit parasympathetic activity, reducing salivary gland secretion via acetylcholine pathways. This causes dry mouth, as muscarinic receptors in salivary glands are blocked, decreasing saliva production. This anticholinergic effect is common in drugs like benztropine, requiring assessment to manage discomfort and prevent oral health issues.

Choice B reason: Orthostatic hypotension is linked to alpha-1 adrenergic blockade, not muscarinic receptors. Muscarinic blockers affect cholinergic pathways, not vascular tone regulated by norepinephrine. While autonomic effects occur, hypotension is not a primary consequence, making this side effect unrelated to muscarinic receptor antagonism.

Choice C reason: Pseudoparkinsonism results from dopamine receptor blockade, common in antipsychotics, not muscarinic blockers. Muscarinic receptors regulate parasympathetic functions like salivation, not motor control. Blocking muscarinic receptors may alleviate parkinsonism by balancing cholinergic-dopaminergic activity, making this an incorrect side effect for assessment.

Choice D reason: Gynecomastia is associated with hormonal imbalances or dopamine blockade, not muscarinic receptors. Muscarinic blockers affect cholinergic systems, not prolactin or estrogen pathways. This side effect is unrelated to muscarinic antagonism, which primarily causes anticholinergic effects like dry mouth, not endocrine changes.

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Correct Answer is B

Explanation

Choice A reason: Suppressing anger ignores countertransference, which can impair therapeutic neutrality. Anger may stem from patient behaviors linked to dopamine-driven paranoia, but suppression risks unconscious bias affecting care. Addressing feelings through supervision maintains professionalism, making this response less effective for managing emotions.

Choice B reason: Discussing anger with a manager addresses countertransference, a reaction to patient behaviors like suspicion from dopamine dysregulation. This allows reflection, reducing bias and maintaining therapeutic neutrality. It supports professional care by processing emotions, aligning with evidence-based psychiatric nursing practices for managing countertransference.

Choice C reason: Expressing anger directly risks damaging the therapeutic alliance. Suspicion, tied to mesolimbic dopamine excess, may escalate with confrontation, increasing patient anxiety. This approach disregards professional boundaries and neurobiological sensitivities, making it inappropriate for maintaining effective psychiatric care.

Choice D reason: Reassigning the patient avoids addressing countertransference, neglecting professional growth. Suspicion, linked to neurobiological paranoia, requires consistent care. Reassignment disrupts continuity, potentially worsening patient trust and outcomes, making this an ineffective response compared to processing feelings through supervision.

A. One who spent yesterday in the 24-hour supervised crisis care center and continues to be actively suicidal B. One who is experiencing agoraphobia and panic episodes and who would benefit from psychoeducation for relaxation therapy C. One who has a therapeutic lithium level and reports regularly for blood tests and clinic follow-up D. One who states, “I’m not sure I can avoid using alcohol when my spouse goes to work every morning.”

Correct Answer is B

Explanation

Choice A reason: Active suicidality, linked to severe serotonin deficits, requires inpatient hospitalization for constant monitoring to ensure safety. Partial hospitalization is insufficient for acute risk, as it lacks 24-hour supervision, making this patient inappropriate for this less intensive care setting.

Choice B reason: Agoraphobia and panic episodes, driven by norepinephrine surges, benefit from partial hospitalization’s structured psychoeducation and therapy. Relaxation techniques reduce amygdala hyperactivity, supporting outpatient management with daily support, making this patient suitable for partial hospitalization’s intensive, non-residential treatment.

Choice C reason: Stable lithium levels indicate controlled bipolar disorder, not requiring partial hospitalization. Regular follow-up manages neurotransmitter balance, suitable for outpatient care. Partial hospitalization is for active symptoms, not stable patients, making this an incorrect referral choice.

Choice D reason: Alcohol use concerns suggest outpatient substance abuse programs, not partial hospitalization. While dopamine reward pathways are involved, partial hospitalization targets acute psychiatric symptoms, not substance issues alone, making this patient unsuitable for this level of care.

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A patient prescribed a muscarinic-receptor blocker will require assessment for what side effect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse caring for a withdrawn, suspicious patient recognizes the development of feelings of anger toward the patient. What is the nurse’s best response to these feelings?

Correct Answer is B

Explanation

Which patient would a nurse refer to partial hospitalization?

Correct Answer is B

Explanation

Several nurses are concerned that agency policies related to restraint and seclusion are inadequate. Which statement about the relationship of substandard institutional policies and individual nursing practice should guide nursing practice?

A patient says to the nurse, “I dreamed I was pusillanimous. When I woke up, I felt emotionally drained, as though I hadn’t rested well.” Which comment would be appropriate if the nurse seeks clarification?

A nurse uses Maslow’s hierarchy of needs to plan care for a psychotic patient. Which problem will receive priority?

Which statement shows a nurse has empathy for a patient who made a suicide attempt?

A patient prescribed a muscarinic-receptor blocker will require assessment for what side effect?

A nurse works with a patient to establish goals/outcomes. The nurse believes that one outcome suggested by the patient is not in the patient’s best interest. What is the nurse’s best action?

A client is newly prescribed a medication that will block the effects of histamine for the treatment of a mental health disorder. The client asks, “What side effects should I anticipate with this new medication?” Which response by the nurse is accurate?

Which neurotransmitter has both muscarinic and nicotinic receptor subtypes?