Question 737 the physician orders haloperidol 5 mg im

Question 737
The physician orders haloperidol 5 mg IM stat for a client and tells the nurse that the dose can be
repeated in 12 hours if needed. The most likely
rationale for this order is:
A. The client will settle down more quickly if he thinks the staff is medicating him
B. The medication will sedate the client until the physician arrives
C. Haloperidol is a minor tranquilizer and will not oversedate the client
D. Rapid neuroleptization is the most effective approach to care for the violent or potentially violent
client
Correct Answer: D
(A) If the client could think logically, he would not be paranoid. In fact, he is probably suspicious of the
staff, too. Newly admitted clients
frequently experience high levels of anxiety, which can contribute to delusions. (B) The goal of
pharmacological intervention is to calm the
client and assist with reality-based thinking, not to sedate him. (C) Haloperidol is a neuroleptic and
antipsychotic drug, not a minor tranquilizer.
(D) Haloperidol is a high-potency neuroleptic and first-line choice for rapid neuroleptization, with low
potential for sedation.
Question 738
Two hours after the second injection of haloperidol, a client complains to the nurse of a stiff neck and
inability to sit still. He is experiencing
symptoms consistent with:
A. Parkinsonism and dystonia
B. Dystonia and akathisia
C. Akathisia and parkinsonism
D. Neuroleptic malignant syndrome
Correct Answer: B
(A) Stiff neck is consistent with a dystonic reaction, but the client has no symptoms of drooling, shuffling
gait, or pill-rolling movements
characteristic of parkinsonism. (B) Stiff neck is consistent with a dystonic reaction, and inability to sit still
with varying degrees of psychomotor
agitation is characteristic of akathisia. (C) The client has symptoms of dystonia but not of parkinsonism.
(D) The client has none of the
characteristic symptoms of neuroleptic malignant syndrome: hyperpyrexia, generalized muscle rigidity,
mutism, obtundation, agitation,
sweating, increased blood pressure and pulse.

Question 739
The physician orders medication for a client’s unpleasant side effects from the haloperidol. The most
appropriate drug at this time is:
A. Lorazepam
B. Triazolam (Halcion)
C. Benztropine
D. Thiothixene
Correct Answer: C
(A) Lorazepam is a benzodiazepine, or antianxiety agent, that potentiates the effects of _-aminobutyric
acid in the CNS, which is not the CNS
Neurotransmitter EPS. (B) Triazolam is a benzodiazepine sedative-hypnotic whose action is mediated in
the limbic, thalamic, and hypothalamic levels of the CNS
by - aminobutyric acid. (C) Benztropine is an anticholinergic agent, and the drug of choice for blocking
CNS synaptic response, which causes EPS. (D) Thiothixene is an antipsychotic and neuroleptic drug that
blocks dopamine neurotransmission at the CNS synapses, thereby causing
EPS.