# Stage 6 — Evaluate outcomes. Review the trend and identify the best interpretation and ongoing priority.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=568881&lang=en  
> language: en  
> subject: Psychosocial Integrity  
> category: PSI

## Question

Stage 6 — Evaluate outcomes. Review the trend and identify the best interpretation and ongoing priority.

| Time | Data |
| --- | --- |
| Recognition | Temperature 40.2 C; HR 132; CK 6,800; potassium 5.6; creatinine 1.7; confused with severe rigidity |
| 8 hours | Temperature 38.9 C; HR 112; potassium 4.9; urine output improves with prescribed fluid |
| 24 hours | Temperature 37.8 C; CK 3,400; creatinine 1.3; follows commands; rigidity reduced |
| 48 hours | Temperature 37.1 C; HR 82; CK 780; potassium 4.2; creatinine 1.0; alert with minimal stiffness |

Q1. Which interpretation is best supported by the 48-hour trend?

NMS is worsening despite treatment
A new serotonergic syndrome is developing
The client is ready for immediate haloperidol re-exposure
NMS and associated muscle and kidney injury are resolving

Q2. Which action remains appropriate?

Stop all monitoring because the temperature is normal
Continue prescribed cardiac, renal, electrolyte, temperature, and neurologic surveillance
Restart the prior haloperidol regimen without consultation
Encourage strenuous activity to test muscle recovery

## Explanation

Falling temperature, heart rate, creatine kinase, potassium, and creatinine with improved consciousness and rigidity support resolving NMS and muscle injury. Continued renal, electrolyte, rhythm, temperature, and neurologic monitoring remains necessary until recovery is stable.

## In-depth explanation

Quick answer
The syndrome is resolving across several systems, but monitoring and cautious future medication planning must continue.

Why this is correct
Improvement in both bedside findings and injury markers demonstrates response more reliably than temperature alone.

Easy analogy or mental picture
The heat, muscle, kidney, and rhythm gauges are all returning toward baseline together.

Memory hook
NMS recovery is clinical plus CK plus kidney plus electrolytes.

NCLEX decision rule
Evaluate multisystem complications until stable; normal temperature alone is not the endpoint.

Why the other choices are wrong
Immediate re-exposure risks recurrence, and ending monitoring or stressing injured muscles ignores ongoing recovery needs.

References
1Haloperidol Prescribing InformationNMS manifestations, rhabdomyolysis and kidney injury, immediate discontinuation, intensive supportive treatment, and recurrence precautions

## Clinical scenario

Case update
Haloperidol remains discontinued while intensive supportive treatment continues.

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