👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Pharmacological Therapies🔖 Free to read, print, and share
Also known as: Risperdal · atypical antipsychotic · second-generation antipsychotic
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Use this quick-reference guide to spot, treat, and prevent Risperidone on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Use
Schizophrenia, bipolar mania
Blocks D2 + 5-HT2
🩺 Signs
↑Prolactin → galactorrhea
Gynecomastia, amenorrhea
Weight gain, metabolic synd
🧪 Labs
Monitor glucose, lipids, A1C
Baseline + serial weight
🚩 Report
EPS, less than typicals
NMS: fever, rigidity
Orthostatic hypotension
📚 Risperidone — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Risperidone is an atypical (second-generation) antipsychotic used for schizophrenia, bipolar mania, and irritability associated with autism. It treats both positive and negative symptoms with fewer EPS than typical antipsychotics, but at higher doses EPS and elevated prolactin can occur. A long-acting injectable form supports adherence.
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Key points
Understand these first
Treats positive and negative symptoms of schizophrenia with a lower EPS rate than haloperidol.
Of the atypicals, it most commonly raises prolactin (causing galactorrhea, gynecomastia, menstrual changes, sexual dysfunction).
Causes metabolic effects: weight gain, hyperglycemia, and dyslipidemia (less than olanzapine/clozapine).
Higher doses increase EPS risk; can still cause tardive dyskinesia and NMS.
Causes orthostatic hypotension and sedation, especially at initiation.
Available as a long-acting injectable to improve adherence.
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Nursing priorities
What to do, in order
Monitor weight, fasting glucose, and lipids for metabolic syndrome.
Assess for EPS, tardive dyskinesia (AIMS), and signs of NMS.
Monitor for prolactin-related effects and report bothersome symptoms.
Check for orthostatic hypotension; teach slow position changes.
Promote adherence and assess therapeutic response to psychotic symptoms.
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Red flags — report now
Escalate immediately
Neuroleptic malignant syndrome: high fever, rigidity, altered mental status - stop drug, emergency.
Report breast enlargement or discharge, menstrual changes, or sexual side effects.
Monitor your weight; report increased thirst, urination, or hunger (high blood sugar).
Rise slowly to avoid dizziness and falls.
Report any uncontrolled movements, muscle stiffness, or high fever immediately.
❓ Risperidone: NCLEX FAQs
What are the priority nursing interventions for Risperidone?
Monitor weight, fasting glucose, and lipids for metabolic syndrome. Assess for EPS, tardive dyskinesia (AIMS), and signs of NMS. Monitor for prolactin-related effects and report bothersome symptoms. Check for orthostatic hypotension; teach slow position changes.
What are the warning signs of Risperidone a nurse must report?
Neuroleptic malignant syndrome: high fever, rigidity, altered mental status - stop drug, emergency. Involuntary movements suggesting tardive dyskinesia. Marked hyperglycemia/new diabetes symptoms (polyuria, polydipsia). Severe orthostatic hypotension with falls.
What do I need to know about Risperidone for the NCLEX?
Treats positive and negative symptoms of schizophrenia with a lower EPS rate than haloperidol. Of the atypicals, it most commonly raises prolactin (causing galactorrhea, gynecomastia, menstrual changes, sexual dysfunction). Causes metabolic effects: weight gain, hyperglycemia, and dyslipidemia (less than olanzapine/clozapine). Higher doses increase EPS risk; can still cause tardive dyskinesia and NMS.
What patient teaching is important for Risperidone?
Report breast enlargement or discharge, menstrual changes, or sexual side effects. Monitor your weight; report increased thirst, urination, or hunger (high blood sugar). Rise slowly to avoid dizziness and falls. Report any uncontrolled movements, muscle stiffness, or high fever immediately.
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Quick Tip
Treats positive and negative symptoms of schizophrenia with a lower EPS rate than haloperidol.