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NCLEX QUESTION TYPE TUTORIAL
The nurse is creating a plan of care for clients diagnosed with schizophrenia. There are several medication administration options. For which client does the nurse plan to administer long-acting, injectable antipsychotics?
“I have four patients with schizophrenia, a condition that makes it difficult to differentiate reality from delusions. I am planning their care. For which of those clients would long-acting, injectable antipsychotic medications be the best fit?”
Tip: Ask yourself: Which piece of knowledge is the question trying to test for? This question aims at the test-taker needing to know the rationale behind choosing long-acting, injectable antipsychotics, and matching this up with the client that fits that rationale best.
Schizophrenia is a spectrum of chronic thought disorders characterized by a serious lack of organized thoughts and insight. The literal definition of the word schizophrenia is “fragmented mind.” Affected persons experience hallucinations, delusions, and various impairments in psychosocial functioning.
Routes of administration for antipsychotic medications:
Note that not all medications can be administered via all routes.
Long-acting, injectable antipsychotic medications…
If a client often travels, not having to take medication that often would probably be helpful. For now, don’t eliminate this one.
There are lots of programs, so this is a complicated one – let’s not eliminate it and move on.
This one can be immediately eliminated. Injectable medications are given in a physician’s office, so a client with transportation issues would not be a good rationale to choose injectables.
Giving a long-acting injectable to a client who frequently loses medications sounds helpful, so don’t eliminate in this first pass either.
In the first pass for the answer options, only one of the answer choices was immediately and clearly eliminated. That’s okay: This method can sometimes already leave you with a single correct answer; if not, we move onto the next step.
Look at the remaining answer choices and really understand how you would justify each one as the correct answer:
An important reason why long-acting, injectable medications might be a good choice for a patient is that it takes the responsibility of taking the medication away from the client. The patient comes into the office with an appointment, and the medication is administered there.
While you could probably come up with rationales that justify each of the three answers above as an answer, answer D (the client who frequently loses medications) would have the strongest, clearest benefit of the main thing that is unique about injectable antipsychotics: They are administered in fixed appointments in the office, so the control does not lie with the client who is unable to stay on top of it, and we ensure that the patient receives the treatment they need. D is the correct answer.
It can be easy to talk yourself into multiple different answers when several of them seem plausible. The best way to tackle questions that ask for one correct answer but have several plausible choices is to be systematic when looking at the different choices. Make sure you’re clear on what the question is aiming at.
What you can learn from this sample question:
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