NU473 Week 4: Evolve Elsevier EAQ Psychiatric Drugs
Which statement by the client indicates to the nurse that the teaching about taking an antidepressant medication has been understood? o "I need to take every dose of my medication as prescribed." o "I need to discontinue the medication if I have side effects." o "I don't have to be concerned about taking my medications." o "I can double the dose of the medication if I still feel depressed."
o "I need to take every dose of my medication as prescribed." · The client should be encouraged to follow the medical regimen to maximize response to medication therapy. The client needs further teaching after stating medication should be discontinued for side effects. The primary health care provider should be notified of side effects. The medication should not be discontinued without the primary health care provider's supervision. The client should be concerned about taking the medication as prescribed. The primary health care provider should make the decision to increase the dosage.
The nurse teaches a client about the side effects and precautions associated with the antipsychotic haloperidol. The nurse concludes that the teaching has been understood when the client makes which statement? o "I'll call my health care provider right away if I have any diarrhea or vomiting." o "I won't eat anything containing tyramine while I'm taking this medication." o "I'll avoid direct sunlight and make sure to use sunscreen when I go outside." o "I'll be sure to drink enough fluids."
o "I'll avoid direct sunlight and make sure to use sunscreen when I go outside." Photosensitivity is a side effect of many antipsychotic medications. Diarrhea and vomiting are side effects of lithium, not haloperidol. Avoiding foods that contain tyramine is a precaution associated with monoamine oxidase inhibitors, not haloperidol. Adequate fluid intake is a precaution associated with lithium, not haloperidol.
A client with a diagnosis of bipolar I disorder, manic episode, is started on a regimen of an antipsychotic agent and lithium carbonate. Which purpose does the antipsychotic serve? o Potentiates the action of lithium for more effective results o Interacts with lithium to prevent progression to the depressive phase o Helps decrease the risk of lithium toxicity in the first week of therapy o Acts to calm the client while allowing time for the lithium to reach a therapeutic level
o Acts to calm the client while allowing time for the lithium to reach a therapeutic level · Antipsychotics usually are prescribed to calm agitated clients during the 3-week period it takes for the lithium to become effective. Antipsychotic medications have a different, not a potentiating, mechanism of action. The medications are used to control symptoms of mania, not prevent depression. The neuroleptic medication has no effect on lithium toxicity.
A client reports to the nurse becoming panicked and having an irrational fear of talking in public. Which medication would the nurse anticipate developing a teaching plan for? o Buspirone o Alprazolam o Diazepam o Lorazepam
o Alprazolam · Alprazolam (a benzodiazepine) is a short-acting anxiolytic medication used to treat those clients with panic disorders and the irrational fear of talking openly in public (agoraphobia). Buspirone, an anxiolytic medication that is different both chemically and pharmacologically from the benzodiazepines, is always administered on a scheduled basis (not on an as-needed basis) for the treatment of anxiety. Diazepam is an anxiolytic medication commonly prescribed for the treatment of anxiety but has generally been replaced by short-acting benzodiazepines. Lorazepam is an intermediate-acting anxiolytic medication used in the treatment of acutely agitated clients.
A male client diagnosed with bipolar disorder is prescribed medication that has caused reduced libido. The nurse understands that which of these medications would be most appropriate to treat this condition? Select all that apply. o Asenapine o Quetiapine o Haloperidol o Aripiprazole o Chlorpromazine
o Asenapine o Quetiapine o Aripiprazole · In men, first-generation antipsychotics can suppress the libido. The primary health care provider would prescribe second-generation antipsychotics such as asenapine, quetiapine, or aripiprazole. Haloperidol and chlorpromazine are first-generation antipsychotics that may suppress the libido and cause erectile and ejaculatory dysfunction.
An adolescent with a major depressive disorder is prescribed venlafaxine. Which signs or symptoms related to the medication will the nurse communicate immediately to the prescribing provider? Select all that apply. o Blurred vision o Suicidal ideation o Difficult urination o Tardive dyskinesia o Transient hypoglycemia
o Blurred vision o Suicidal ideation o Difficult urination · Abnormal vision (e.g., blurred or double vision) is a side effect of venlafaxine. Central nervous system effects such as emotional lability, vertigo, anxiety, insomnia, and suicidal ideation in children and adolescents are side effects of venlafaxine. Difficult or painful urination is a serious side effect of venlafaxine; impairment of urine flow can lead to urinary tract infection and renal failure. Extrapyramidal side effects such as tardive dyskinesia do not occur with venlafaxine. Transient hypoglycemia is not a side effect of venlafaxine.
A friend asks the student nurse whether there is a medication marketed for smoking cessation. Which antidepressant medication would the student nurse identify for this clinical application? o Diazepam o Bupropion o Fluvoxamine o Chlordiazepoxide
o Bupropion · Bupropion is marketed expressly for smoking cessation because it decreases cravings. Diazepam is an antianxiety medication, and it is not used for smoking cessation. Fluvoxamine, a selective serotonin reuptake inhibitor antidepressant, is most often prescribed for individuals with obsessive-compulsive disorder; it is not used for smoking cessation because nicotine may decrease its effectiveness. Chlordiazepoxide is an antianxiety medication used to diminish alcohol withdrawal symptoms.
A client is admitted to the acute medical unit for severe amphetamine intoxication. Which medications are indicated to counteract the effects of stimulant intoxication? Select all that apply. o Diazepam o Propranolol o Benztropine o Bupropion o Amitriptyline
o Diazepam o Propranolol · Because stimulants act by increasing both adrenaline and dopamine, seizures may occur. Diazepam can reduce the chance of seizures. Because amphetamines act by increasing adrenaline, which can stimulate the heart, propranolol, a beta-blocker, will decrease this adrenergic stimulation. Benztropine, a cholinergic blocker, is not indicated as a treatment for stimulant intoxication. Bupropion is contraindicated because it increases dopamine and adrenaline, which will exacerbate stimulant intoxication. Amitriptyline is contraindicated because it increases dopamine and adrenaline, which will exacerbate stimulant intoxication.
Which food can cause a hypotensive crisis in clients taking monoamine oxidase inhibitors (MAOIs)? Select all that apply. o Figs o Apples o Yogurt o Pepperoni o Cheddar cheese
o Figs o Pepperoni o Cheddar cheese · MAOIs can cause a life-threatening hypertensive crisis when combined with tyramine. Clients will be instructed to avoid foods that contain tyramine including figs, fermented meats such as pepperoni, and aged cheeses such as cheddar cheese. Apples and yogurt do not contain tyramine.
A client on antidepressant therapy develops hyperthermia, seizures, and a heart rate of 200 beats per minute. Which medication would the nurse suspect is responsible for the condition? o Sertraline o Asenapine o Risperidone o Fluphenazine
o Sertraline · A heart rate of 200 beats per minute indicates cardiac dysrhythmias. Hyperthermia, seizures, and cardiac dysrhythmias in a client on antidepressant therapy indicate serotonin syndrome. Serotonin syndrome is an adverse effect of selective serotonin reuptake inhibitors such as sertraline. Asenapine, risperidone, and fluphenazine are antipsychotics that may cause drowsiness, neuroleptic malignant syndrome, extrapyramidal symptoms, and tardive dyskinesia as adverse effects.
A client with schizophrenia, paranoid type, demonstrates a shuffling gait and tilts the head toward one shoulder. Which detail would the nurse conclude about these clinical manifestations? o They are expected characteristics of this illness. o They are consistent with an acute exacerbation of the illness. o They are possible adverse effects of the antipsychotic medication. o They are life threatening and require immediate intervention.
o They are possible adverse effects of the antipsychotic medication. · Shuffling gait and torticollis are symptoms of pseudo parkinsonism that are caused by antipsychotic medications, particularly the typical antipsychotics. Expected characteristics of schizophrenia, paranoid type, include delusions, hallucinations, suspiciousness, anger, hostility, and paranoia. An acute exacerbation of the illness reflects an increased intensity of the expected characteristics associated with paranoid schizophrenia that include pressured speech; suicidal ideation; and aggressive, agitated behavior. Although these physical manifestations require intervention, they are not life threatening.
Which information would the nurse give to a client interested in kava and valerian supplements for the treatment of anxiety and insomnia? Select all that apply. o Valerian can cause restlessness and insomnia. o Both kava and valerian are contraindicated with liver disease. o Kava is contraindicated with Parkinson disease or depression. o Kava can cause temporary yellow discoloration of the skin, hair, and nails. o Both kava and valerian can have adverse effects on the central nervous system.
o Valerian can cause restlessness and insomnia. o Both kava and valerian are contraindicated with liver disease. o Kava is contraindicated with Parkinson disease or depression. o Kava can cause temporary yellow discoloration of the skin, hair, and nails. · It is true that valerian can cause restlessness and insomnia. Both kava and valerian can cause liver toxicity and liver injury; both are contraindicated with liver disease. Kava is also contraindicated with Parkinson disease or depression and can worsen symptoms of both. Kava can cause temporary yellow discoloration of the skin, hair, and nails. It is not true that both kava and valerian have adverse effects on the central nervous system; only valerian does, including depression, nausea, and vomiting.