Pharmacology

Front

A 42-year-old client with schizophrenia is stable on haloperidol and recently started oxycodone for chronic pain. During a session, you notice:

• Drowsiness and slow responses
• Occasional drifting off mid-sentence
• Mild dizziness when standing
• Occasional diphenhydramine use at night
• No fever, rigidity, or sweating

What is the likely cause of these symptoms?

Back

Additive CNS depressant effects.

Front

A 34-year-old client with schizophrenia has prominent hallucinations and delusions as well as social withdrawal and flat affect. He has been prescribed a first-generation antipsychotic. Which of the following is most likely regarding treatment response?

Back

Positive symptoms will respond better than negative symptoms

Front

A client is prescribed haloperidol for schizophrenia. Which of the following best describes the primary mechanism by which haloperidol exerts its antipsychotic effects? Options: Serotonin 5-HT2A receptor antagonism, Norepinephrine reuptake inhibition, GABA receptor agonism.

Back

Dopamine D2 receptor blockade

Front

A client on chlorpromazine complains of dry mouth, constipation, blurred vision, and urinary retention. From a pharmacological perspective, which side effect category do these symptoms represent?

Back

Anticholinergic side effects

Front

A 29-year-old client taking haloperidol for schizophrenia presents with severe muscle rigidity, a temperature of 104°F (40°C), tachycardia, and labile blood pressure. Which of the following is the most likely diagnosis?

Back

Neuroleptic malignant syndrome (NMS)

Front

A client is diagnosed with NMS after showing muscle rigidity, fever, and autonomic instability while taking a high-potency antipsychotic. What is the first-line management strategy?

Back

Immediately discontinue the antipsychotic and provide supportive care (hydration, cooling, vital sign monitoring)

Front

A 35-year-old client taking haloperidol for schizophrenia develops resting tremor, muscle rigidity, and slowed movements. Which of the following is the most appropriate management strategy for these drug-induced Parkinsonism symptoms?

Back

Reduce the antipsychotic dose or add an anticholinergic medication (e.g., benztropine)

Front

A 28-year-old client taking fluphenazine for schizophrenia develops involuntary facial grimacing, lip-smacking, and repetitive tongue movements after several years of treatment. The symptoms are persistent and do not improve when the antipsychotic dose is temporarily reduced. Which of the following is the most appropriate next step to manage these symptoms?

Back

Gradually withdraw the current antipsychotic, consider switching to a second-generation antipsychotic, or administer a benzodiazepine.

Front

A 32-year-old client with schizophrenia has auditory hallucinations, delusions, and social withdrawal with flat affect. He is prescribed Seroquel. Which of the following is most accurate regarding expected symptom response?

Back

Positive symptoms will improve, and may also reduce negative symptoms.

Front

A client with schizophrenia has not responded adequately to multiple trials of other antipsychotics. Which medication is considered most effective for treatment-resistant schizophrenia?

Back

Clozapine