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Neuroleptic malignant syndrome

A case report

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doi: 10.1097/01.NURSE.0000659224.56124.78
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INSTRUCTIONS Neuroleptic malignant syndrome: A case report


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  • Registration deadline is March 4, 2022.


Lippincott Professional Development will award 1.5 contact hours and 0.5 pharmacology credits for this continuing nursing education activity. Lippincott Professional Development is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 1.5 contact hours, and the District of Columbia, Georgia, and Florida CE Broker #50-1223.

Payment: The registration fee for this test is $17.95.

Neuroleptic malignant syndrome: A case report

GENERAL PURPOSE: To provide information on the identification and treatment of NMS. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Identify the clinical manifestations of NMS. 2. List the risk factors for NMS. 3. Summarize treatment options for patients with NMS.

  1. Which statement regarding NMS is accurate?
    1. It is a serious but non-life-threatening disorder.
    2. It may affect individuals of all ages.
    3. It occurs in women more frequently than in men.
  2. With early recognition and prompt treatment, most patients will recover completely from NMS within
    1. 1 to 2 days.
    2. 1 to 2 weeks.
    3. 1 to 2 months.
  3. Mortality associated with NMS ranges from
    1. 1% to 2%.
    2. 10% to 20%.
    3. 40% to 50%.
  4. NMS can be caused by a sudden change in medications that block dopamine, including
    1. metoclopramide.
    2. diphenhydramine.
    3. ondansetron.
  5. Muscle damage from tremors and prolonged rigidity leads to the release of what into the bloodstream?
    1. cold agglutinins
    2. cholinesterase
    3. CK
  6. NMS may share pathophysiologic similarities with
    1. malignant hyperthermia.
    2. tardive dyskinesia.
    3. chemically induced agranulocytosis.
  7. NMS may be more likely in patients with
    1. slowly progressive disorders.
    2. chronic disorders.
    3. acute disorders.
  8. Following patient exposure to a dopamine antagonist, the major criteria for an NMS diagnosis include muscle rigidity and
    1. changes in mental status.
    2. seizures.
    3. hyperthermia.
  9. Other criteria that may be included in an NMS diagnosis include
    1. bradycardia.
    2. labile BP.
    3. excessively dry skin.
  10. Which is consistent with a diagnosis of NMS?
    1. leukocytosis
    2. neutropenia
    3. lymphocytosis
  11. What drugs indirectly increase dopaminergic activity and can enhance patient recovery from NMS?
    1. barbiturates
    2. central nervous system stimulants
    3. benzodiazepines
  12. Nurses should assess patients with NMS for complications, including
    1. VTE.
    2. respiratory alkalosis.
    3. disseminated intravascular coagulation.
  13. A typical course of ECT may consist of up to how many individualized treatments?
    1. 1 to 2
    2. 3 to 5
    3. 6 to 12
  14. Contraindications to ECT include
    1. hypothyroidism.
    2. retinal detachment.
    3. obesity.
  15. NMS is considered a(n)
    1. idiosyncratic reaction.
    2. time-related reaction.
    3. dose-related reaction.
  16. After ECT, patients may experience lingering effects such as
    1. tinnitus.
    2. memory loss.
    3. dysgeusia.
  17. Many medications are typically discontinued the evening before ECT, especially
    1. antireflux medications.
    2. antihypertensive medications.
    3. antiepileptic drugs.
  18. The standard agent for muscle relaxation during ECT is
    1. cisatracurium.
    2. succinylcholine.
    3. rocuronium.
  19. Clinical manifestations of NMS are related to
    1. sympathetic hyperactivity.
    2. parasympathetic hyperactivity.
    3. sympathetic hypoactivity.
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