A nurse is assessing a client who has schizophrenia which has been treated with fluphenazine for several years. Which of the following findings should the nurse document as manifestations of tardive dyskinesia (TD)?
Shuffling gait
Sudden onset of high fever
Constant tapping of feet when sitting
Twisting tongue movements
The Correct Answer is D
A. A shuffling gait is more commonly associated with parkinsonism, a side effect of antipsychotic medications, rather than tardive dyskinesia.
B. A sudden onset of high fever could indicate neuroleptic malignant syndrome (NMS), which is a serious reaction to antipsychotic medications, not tardive dyskinesia.
C. Constant tapping of feet when sitting can indicate restlessness or akathisia, but it does not specifically represent tardive dyskinesia.
D. Twisting tongue movements are a classic manifestation of tardive dyskinesia, characterized by involuntary, repetitive movements of the face, tongue, and extremities, which may develop after long-term use of antipsychotic medications like fluphenazine.
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Correct Answer is C
Explanation
A. Monitoring heart rate for bradycardia is not a primary concern with cyclobenzaprine; instead, it can cause drowsiness and sedation.
B. Naloxone is not necessary for cyclobenzaprine overdose, as it is not an opioid.
C. Cyclobenzaprine can cause sedation and impair cognitive function, so the nurse should emphasize that clients should not operate heavy machinery or motor vehicles until they know how the medication affects them.
D. Excessive salivation is not a common side effect of cyclobenzaprine; instead, dry mouth is more frequently reported.
Correct Answer is B
Explanation
A. Discontinuing metformin 24 hours before a CT scan is longer than necessary and not standard practice.
B. It is generally recommended that metformin be held for at least 12 hours before the administration of IV contrast to reduce the risk of lactic acidosis, especially in clients with renal impairment.
C. Six hours is insufficient time to ensure the medication is cleared from the system, considering the potential risks.
D. Discontinuing metformin for 48 hours is overly cautious and not necessary unless there are complications that arise after the contrast is administered.