Walkthrough: Pharmacological and Parenteral Therapies Q9 – NCLEX-RN®

by Rhonda Lawes, PhD, RN

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    00:01 The nurse who is creating a plan of care for clients with a diagnosis of schizophrenia has several medication administration options.

    00:10 For which client would the nurse plan to administer long acting injectable antipsychotics? All right, let's break it down.

    00:18 Remember one sentence at a time.

    00:21 We're looking for diagnoses or numbers, because we know what to do with those.

    00:25 But let's look at this one.

    00:27 I'm the nurse.

    00:28 I'm creating a plan of care for clients with a diagnosis of schizophrenia.

    00:34 So when I'm thinking about schizophrenia, that's a diagnosis what I remember.

    00:38 Oh, that's right, they have a hard time recognizing the difference between reality and their delusions.

    00:45 Now, this nurse has several medication administration options.

    00:49 So, so far, that's what we know.

    00:51 I'm a nurse, planning care for patients with schizophrenia.

    00:54 And I have several medication options as far as administration.

    00:58 Now for which client would the nurse plan to administer long acting injectable antipsychotics? Okay, we know that somebody with schizophrenia has a hard time knowing reality from delusions.

    01:13 We're thinking about what type of medication they're going to be on our anti-psychotics.

    01:17 So who is going to require look at what's specific about those anti-psychotics? Long acting injectable.

    01:26 Okay, now, when we bring the answer choices in, you're going to see four options.

    01:31 But before we do, don't click through that question stem too quickly.

    01:36 We're looking at this for something is unique about long acting, injectable antipsychotics.

    01:44 What are the rationale that we would choose this type of medication? Now, when you see the four patient options, what I want you to do after you pause the video and work through this on your own, I want you to think client number one, would this make sense for them to have long acting and injectable antipsychotics? Think through each answer. Eliminate them. And say why? Remember, we always ask you to use your scratch paper that has the numbers only not the answer choices, the number 1, 2, 3, and 4, written down before you start eliminating answers.

    02:20 So, pause the video.

    02:22 Do the work take as much time as it takes you.

    02:24 Remember, this is not timed.

    02:26 We're just practicing and learning how to rip apart those test questions.

    02:39 Welcome back.

    02:40 Let's take a look at this.

    02:41 Yep, you saw that we had for clients just like we knew that you would.

    02:46 We know we're looking at an injectable long acting antipsychotic.

    02:51 Now, would that make sense for a client who often travels? Well, I guess it would because you know, you're going to need to take it very often.

    03:00 So I can't get rid of one right away.

    03:03 What about number two? A client without health insurance.

    03:09 Well, we do have lots of programs for providing things, but I'm not really sure about that one either.

    03:15 What about number three? A client without access to transportation.

    03:21 Oh, so they could get injectables? Wait a minute.

    03:25 These medications are given in a physician's office.

    03:28 So this probably isn't going to be a good one.

    03:31 I can get rid of number three.

    03:33 Now what about number four? A client who frequently loses medications? Ah, okay.

    03:41 I see, while long acting injectable medication might be a good idea.

    03:47 But remember, I didn't eliminate number one, or number two.

    03:51 That's okay.

    03:52 Sometimes through the first time through the answer choices, you're not very clear.

    03:57 Just keep moving through the answer choices.

    03:59 Sometimes you have to go through them multiple times before you find the best one.

    04:04 So I have to think, would it be better for someone who often travels to have an injectable? Someone who doesn't have health insurance to have an injectable or somebody who frequently loses medications? Well, the reason we give long acting injectable antipsychotics is that the responsibility for taking the medication doesn't lie with the patient.

    04:25 Right, the health care provider or the nurse assist the client with getting their medications on a routine basis.

    04:32 Now they have to come in to get that medication, so no access to transportation. That's not a good idea.

    04:38 That's why that one was eliminated.

    04:40 But someone who often travels and they might be hard to get an appointment.

    04:45 Just because they travel a lot doesn't mean that they don't take their medications regularly on their own.

    04:51 A client without health insurance.

    04:53 Hey, this is a funding thing and we can work with social workers try to get them coverage for their antipsychotic medications.

    05:01 But a client who frequently loses their medication is not going to take them consistently.

    05:07 And an antipsychotic needs to be taken consistently, especially for something as significant as a diagnosis of schizophrenia.

    05:16 So, out of these four, the best answer for this question is who should have a long acting, injectable antipsychotic is number four.

    05:27 A client who frequently loses their medication.

    05:30 Why? Because they are the one that is most likely to not take their medication consistently.

    05:37 And that's why that is the best answer for this question.

    05:42 Okay, let's talk about it.

    05:43 I want you to think about, how you work through these answer choices.

    05:47 Now, you may be saying, well, wouldn't it be nice for somebody who travels to have it? Or what about health insurance? Then we know they would get it.

    05:53 Or what are some I can't -- I hear all those arguments and debates going on in your head.

    06:00 It's okay.

    06:01 Remember, when you're taking the NCLEX exam, when you're taking passing level questions, you're above that passing standard, you can miss up to 50% of them, and you are still fine.

    06:14 Just be sure that you're answering the questions one at a time, and taking your time.

    06:20 Because you've got to be answering levels that questions with a level of difficulty that is above the passing standard.

    06:28 All right. Now, with that said, Can you sometimes talk yourself into multiple different answers? I know I can.

    06:37 And you may feel that way about this question.

    06:40 All you can do is be systematic on every question.

    06:44 Make sure you're clear what you think the topic of the question is.

    06:48 And then when you have four options, you need to keep eliminating them.

    06:52 Say why? And then you'll eventually eliminate it down to your best answer.

    06:58 - Will it always be correct? No. Nobody gets 100% on the NCLEX.

    07:04 But know that what you learned from this question, let's see what you can take to another question.

    07:10 Keep in mind, an injectable antipsychotic is going to be a healthcare assisted administration.

    07:17 So we would likely do this for people who are not consistent in taking their medication.

    07:22 Of these four options, it's most likely that a client who loses the medication will be the most inconsistent, and therefore will benefit from a long acting injectable antipsychotic.

    07:35 All right, whether you got it right or whether you got it wrong, you know the drill.

    07:39 Reflect for a minute.

    07:41 Think about why you chose your answer.

    07:43 If you had a solid rationale, if you felt like, "Hey, I think that a client who doesn't have health insurance would more likely be inconsistent with their medications.

    07:54 And that's why I picked it. Don't change your answer.

    07:56 Don't change your thought process. Right? That was a solid thought process.

    08:01 Just know, you're not always going to be right.

    08:04 You have to learn to be uncomfortable and be okay with it.

    08:08 Because you're just gonna give your best effort.

    08:10 Remember, it's one question.

    08:13 Do your best. Pick your answer. And then let it go.

    08:18 Move on to the next one, when you're taking an exam.

    08:21 When you're studying with us, take the time to reflect see what notes need to go in your notebook.

    08:26 And I promise you, you're going to get stronger at answering test questions correctly.

    About the Lecture

    The lecture Walkthrough: Pharmacological and Parenteral Therapies Q9 – NCLEX-RN® by Rhonda Lawes, PhD, RN is from the course NCLEX-RN® Question Walkthrough: Pharmacological and Parenteral Therapies.

    Included Quiz Questions

    1. Schizophrenia
    2. Depression
    3. Dementia
    4. Autism
    1. Injectable
    2. Oral
    3. Sublingual
    4. Intranasal

    Author of lecture Walkthrough: Pharmacological and Parenteral Therapies Q9 – NCLEX-RN®

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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