Neuroleptic malignant syndrome

Question 1

What is Neuroleptic Malignant Syndrome (NMS)?

Answer 1

A life-threatening reaction to antipsychotic medications characterized by muscle rigidity, fever, and autonomic instability.

Question 2

Which medications are most commonly associated with NMS?

Answer 2

Antipsychotic medications, particularly first-generation antipsychotics.

Question 3

True or False: NMS can occur after the first dose of antipsychotic medication.

Answer 3

True

Question 4

What is the hallmark symptom of Neuroleptic Malignant Syndrome?

Answer 4

Severe muscle rigidity.

Question 5

Fill in the blank: NMS typically presents with hyperthermia, altered mental status, autonomic dysregulation, and _______.

Answer 5

muscle rigidity

Question 6

What temperature is considered indicative of hyperthermia in NMS?

Answer 6

A body temperature greater than 38°C (100.4°F).

Question 7

Which autonomic signs may be present in NMS?

Answer 7

Tachycardia, hypertension, diaphoresis, and labile blood pressure.

Question 8

What is the first step in the management of suspected NMS?

Answer 8

Immediate discontinuation of the offending antipsychotic medication.

Question 9

True or False: Cooling measures are important in the management of NMS.

Answer 9

True

Question 10

What role do muscle relaxants play in the treatment of NMS?

Answer 10

They may be used to alleviate muscle rigidity.

Question 11

Which medication is often used as a first-line treatment for NMS?

Answer 11

Dantrolene.

Question 12

What is the recommended fluid management for patients with NMS?

Answer 12

Aggressive hydration, often intravenously.

Question 13

What laboratory findings are commonly associated with NMS?

Answer 13

Elevated creatine kinase (CK), leukocytosis, and metabolic acidosis.

Question 14

True or False: NMS can occur in patients taking atypical antipsychotics.

Answer 14

True

Question 15

What is the incidence rate of NMS in patients treated with antipsychotics?

Answer 15

Approximately 0.2% to 1%.

Question 16

Fill in the blank: NMS is more common in _______ patients.

Answer 16

younger

Question 17

What is the typical duration of NMS symptoms after withdrawal of the offending drug?

Answer 17

Symptoms may last from days to weeks.

Question 18

What is the role of bromocriptine in the treatment of NMS?

Answer 18

It is a dopamine agonist that can be used to alleviate symptoms.

Question 19

What should be monitored closely in a patient with NMS?

Answer 19

Vital signs and neurological status.

Question 20

True or False: NMS is a reversible condition.

Answer 20

True

Question 21

Which age group is at higher risk for developing NMS?

Answer 21

Younger adults, particularly males.

Question 22

What is one of the long-term complications of NMS?

Answer 22

Possible neurological damage or sequelae.

Question 23

Fill in the blank: The pathophysiology of NMS is believed to involve _______ dysregulation.

Answer 23

dopamine

Question 24

What is the primary nursing action when a patient presents with symptoms of NMS?

Answer 24

Assess the patient’s vital signs and neurological status.

Question 25

How is the diagnosis of NMS primarily made?

Answer 25

Clinically, based on symptoms and recent medication history.

Question 26

True or False: NMS can develop after dose increases of antipsychotic medications.

Answer 26

True

Question 27

What is the role of supportive care in the management of NMS?

Answer 27

To stabilize the patient and manage symptoms while the condition resolves.

Question 28

Name one potential risk factor for developing NMS.

Answer 28

Rapid dose escalation of antipsychotics.

Question 29

What should be done if a patient has a history of NMS when prescribing antipsychotics?

Answer 29

Avoid using antipsychotics or use with extreme caution.

Question 30

What is the significance of elevated creatine kinase in NMS?

Answer 30

It indicates muscle breakdown and rhabdomyolysis.

Question 31

Fill in the blank: NMS may present with _______ changes in mental status.

Answer 31

altered

Question 32

What is the recommended action for patients with severe NMS?

Answer 32

Transfer to an intensive care unit (ICU) for close monitoring.

Question 33

What is one way to help prevent NMS in at-risk patients?

Answer 33

Use the lowest effective dose of antipsychotic medications.

Question 34

True or False: NMS can occur after the discontinuation of antipsychotic medications.

Answer 34

False

Question 35

What is the typical age of onset for NMS?

Answer 35

Most commonly in young adults, typically between 18 and 30 years old.

Question 36

Fill in the blank: The presence of _______ can complicate the diagnosis of NMS.

Answer 36

other medical conditions

Question 37

What is one potential complication of untreated NMS?

Answer 37

Acute renal failure.

Question 38

What is the expected recovery time for most patients after NMS treatment?

Answer 38

Most patients recover within 1 to 2 weeks.

Question 39

True or False: All patients who develop NMS will have elevated temperature.

Answer 39

False

Question 40

What should be included in the education of patients taking antipsychotics to prevent NMS?

Answer 40

Awareness of symptoms of NMS and the importance of reporting them immediately.

Question 41

What is the most critical factor in managing NMS?

Answer 41

Early recognition and prompt treatment.

Question 42

Fill in the blank: _______ therapy can be beneficial in managing muscle rigidity in NMS.

Answer 42

Physical

Question 43

What is a common misconception about NMS?

Answer 43

That it only occurs with high doses of antipsychotics.

Question 44

What should be assessed in a patient with NMS to evaluate for complications?

Answer 44

Renal function and electrolyte levels.