A nurse sits with a patient diagnosed with disorganized ...

[tingc95]

A nurse sits with a patient diagnosed with disorganized schizophrenia. The patient starts to laugh uncontrollably, although the nurse has not said anything funny. Select the nurse's best response.
 
  a. Why are you laughing?
  b. Please share the joke with me.
  c. I don't think I said anything funny.
  d. You're laughing. Tell me what's happening.

Question 2

A patient has taken trifluoperazine (Stelazine) 30 mg/day orally for 3 years. The clinic nurse notes that the patient grimaces and constantly smacks both lips. The patient's neck and shoulders twist in a slow, snakelike motion.
 
  Which problem would the nurse suspect?
 
  a. Agranulocytosis
  b. Tardive dyskinesia
  c. Tourette syndrome
  d. Anticholinergic effects

[ultraflyy23]

Answer to Question 1

ANS: D
The patient is likely laughing in response to inner stimuli such as hallucinations or fantasy. Focusing on the hallucinatory clue (i.e., the patient's laughter) and then eliciting the patient's observation is best. The incorrect options are less useful in eliciting a response; no joke may be involved, Why questions are difficult to answer, and the patient is probably not focusing on what the nurse has said in the first place.

Answer to Question 2

ANS: B
Tardive dyskinesia is a neuroleptic-induced condition involving the face, trunk, and limbs. Involuntary movements such as tongue thrusting; licking; blowing; irregular movements of the arms, neck, and shoulders; rocking; hip jerks; and pelvic thrusts are observed. These symptoms are frequently not reversible, even when the drug is discontinued. The scenario does not present evidence consistent with the other disorders mentioned. Agranulocytosis is a blood disorder. Tourette syndrome is a condition in which tics are present. Anticholinergic effects include dry mouth, blurred vision, flushing, constipation, and dry eyes.

[tingc95]

TYSM

[mjenn52]

Excellent