LVN Mental Health Nursing 3 — Questions and Answers
Question 1: A patient taking haloperidol (Haldol) develops severe muscle rigidity, high fever (104°F), and altered mental status. The LVN recognizes this as?
- Tardive dyskinesia
- Neuroleptic malignant syndrome (NMS) (Correct answer)
- Akathisia
- Acute extrapyramidal reaction
Correct answer: Neuroleptic malignant syndrome (NMS)
NMS is a life-threatening emergency characterized by hyperthermia, muscle rigidity, autonomic instability, and altered consciousness.
Question 2: Which dietary restriction is ESSENTIAL for a patient prescribed phenelzine (Nardil), an MAOI antidepressant?
- Avoid high-potassium foods such as bananas.
- Avoid tyramine-rich foods such as aged cheese and red wine. (Correct answer)
- Avoid high-fat meals to prevent drug absorption issues.
- Avoid all caffeine to prevent hypertension.
Correct answer: Avoid tyramine-rich foods such as aged cheese and red wine.
Tyramine combined with MAOIs causes a hypertensive crisis, which can be life-threatening.
Question 3: A patient taking lithium carbonate has a serum lithium level of 1.8 mEq/L. The LVN's BEST action is?
- Administer the next scheduled dose as ordered.
- Withhold the dose and notify the RN immediately. (Correct answer)
- Encourage the patient to increase fluid intake.
- Document the result and reassess in 4 hours.
Correct answer: Withhold the dose and notify the RN immediately.
The therapeutic lithium range is 0.6–1.2 mEq/L; a level of 1.8 mEq/L indicates early toxicity requiring immediate notification.
Question 4: Which side effect of benzodiazepines causes the MOST concern when prescribed to older adult patients?
- Increased alertness and restlessness
- Fall risk secondary to excessive sedation (Correct answer)
- Elevated blood pressure
- Increased appetite and weight gain
Correct answer: Fall risk secondary to excessive sedation
Benzodiazepines cause sedation and impaired coordination in older adults, significantly increasing their risk of falls and fractures.
Question 5: A patient taking clozapine (Clozaril) reports a sore throat and fever. The LVN's PRIORITY action is?
- Administer acetaminophen and monitor vital signs.
- Withhold the medication and notify the RN immediately. (Correct answer)
- Document the symptoms and continue the medication.
- Reassure the patient that mild infection is a common side effect.
Correct answer: Withhold the medication and notify the RN immediately.
Sore throat and fever in a clozapine patient may indicate agranulocytosis, a life-threatening drop in white blood cells requiring immediate evaluation.
Question 6: Which patient statement indicates a need for FURTHER TEACHING about their newly prescribed SSRI?
- 'It may take 2 to 4 weeks before I notice improvement in my mood.'
- 'I should take this medication with food to help with nausea.'
- 'I can stop taking this medication as soon as I feel better.' (Correct answer)
- 'I should call my doctor if I have any thoughts of harming myself.'
Correct answer: 'I can stop taking this medication as soon as I feel better.'
SSRIs must be tapered gradually under medical supervision; abrupt discontinuation causes withdrawal syndrome and risks relapse.
Question 7: The LVN administers lorazepam (Ativan) to a patient experiencing acute alcohol withdrawal. What is the PRIMARY purpose of this medication?
- Prevent withdrawal seizures (Correct answer)
- Stimulate appetite to reverse malnutrition
- Reduce auditory hallucinations permanently
- Lower dangerously elevated blood pressure
Correct answer: Prevent withdrawal seizures
Benzodiazepines like lorazepam are the first-line treatment for alcohol withdrawal because they prevent life-threatening withdrawal seizures.
LVN Mental Health Nursing 3
A patient taking haloperidol (Haldol) develops severe muscle rigidity, high fever (104°F), and altered mental status.
The LVN recognizes this as?