Published - Thu, 23 Feb 2023

NCLEX-RN Exam Questions - Part 96

1. A 15-year-old client is admitted to the adolescent unit. The nurse recognizes that encouraging a client to speak openly depends on how clearly questions are phrased. Which of the following statements is most desirable in eliciting information from an adolescent client?

A) 'Do you get along well with your family?'
B) 'Do you communicate with your parents?'
C) 'You don - t hate your family, do you?'
D) 'What is it like between you and your family?'

2. A 37-year-old client has been taking antipsychotic medication for the past 10 days. The nurse observes her walking with a shuffling gait and postural rigidity and notes a masklike expression on her face. Which side effect is this client exhibiting?

A) Dystonia
B) Parkinsonism
C) Tardive dyskinesia
D) Akathesia

3. Clients receiving antipsychotic drug therapy will often exhibit extrapyramidal side effects that are reversible with which of the following agents ordered by the physician?

A) Phenothiazines
B) Anticholinergics
C) Anti-Parkinsonian drugs
D) Tricyclic agents

4. A client who was started on antipsychotic medication 2 weeks ago is preparing for discharge from the hospital. Compliance with the medication regimen is important despite the mild side effects encountered. In order to increase the likelihood of medication compliance, the nurse would:

A) Discuss the disease process and the importance of the medication in prevention of symptoms.
B) Inform the client that additional side effects are to be expected and need not be reported.
C) Discuss the importance of getting blood drawn weekly to determine medication therapeutics.
D) Inform the client to cease taking the medication when all psychotic symptoms have cleared.

5. A depressed client is seen at the mental health center for follow-up after an attempted suicide 1 week ago. She has taken phenelzine sulfate (Nardil), a monoamine oxidase (MAO) inhibitor, for 7 straight days. She states that she is not feeling any better. The nurse explains that the drug must accumulate to an effective level before symptoms are totally relieved. Symptom relief is expected to occur within:

A) 10 days
B) 2 - 4 weeks
C) 2 months
D) 3 months

1. Right Answer: D
Explanation: (A, B) This statement can be answered with a simple yes or no. (C) This statement is asked in a negative manner and therefore has a negative connotation. (D)This statement is open ended and positively stated.

2. Right Answer: B
Explanation: (A) This answer is incorrect. Dystonia refers to severe, painful muscle contractions. (B) This answer is correct. Parkinsonism commonly occurs approximately 12 weeks after initiation of antipsychotic drug therapy. Traditional signs are masklike facies, postural rigidity, shuffling gait, and resting tremor. (C) This answer is incorrect. Tardive dyskinesia is characterized by involuntary muscle movements of the face, jaw, and tongue. (D) This answer is incorrect. Akathesia is motor restlessness.

3. Right Answer: B
Explanation: (A) This answer is incorrect. Phenothiazines are antipsychotic drugs and produce the symptoms. (B) This answer is correct. Anticholinergic agents are often used prophylactically for extrapyramidal symptoms. They balance cholinergic activity in the basal ganglia of the brain. (C) This answer is incorrect. Anti- Parkinsonian drugs would increase the symptoms. (D) This answer is incorrect. Tricyclic agents are used for symptoms of depression.

4. Right Answer: A
Explanation: (A) This answer is correct. If the client is well informed about what reactions to expect from her medication, she is more likely to follow the treatment regimen. (B)This answer is incorrect. There are many side effects that are reversible by medication, and these must be reported to the nurse or physician. There are also more severe side effects, such as neuroleptic malignant syndrome, characterized by fever, tachycardia, and diaphoresis, which can be life threatening. (C) This answer is incorrect. There is no need for weekly blood tests if the drug regimen has been followed properly. (D) This answer is incorrect. The client should continue the medicationuntil the physician recommends any change in the drug regimen. Symptoms will usually reappear if medication is discontinued.

5. Right Answer: B
Explanation: (A) This answer is incorrect. It can take up to 1 month for therapeutic effect of the medication. (B) This answer is correct. Because MAO inhibitors are slow to act, it takes 24 weeks before improvement of symptoms is noted. (C) This answer is incorrect. It can take up to 1 month for therapeutic effect of the medication. (D)This answer is incorrect. Therapeutic effects of the medication are noted within 1 month of drug therapy.

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