Nur205

A patient who is taking Doxepin(Sinequan) 10 mg PO at bedtime has dizziness on arising. Which of the following suggestions is most appropriate?

"Get up slowly and dangle your feet before standing."

Which patient complaint should receive priority from a patient who is taking tranylcypromine(Parnate)?

"I've had a headache ever since i drank some coffee."

Which statement by a patient who will be maintained on lithium following discharge should the nurse evaluate as evidence of a need for further instruction?

"When I get home, I may go on salt-free diet."

A patients is taking Sertraline(Zoloft). The nurse explains to the patient that how much time will pass before the onset of the medication occurs?

1-2 weeks

You are instructed to infuse 800 mL of IV fat emulsion over 6 hours. The nurse would program the electric infusion device at what rate in mL?

133.4

Convert 342 pounds to Kilograms

155.4

YOu are instructed to give cephalexin monohydrate (Keflex) 0.5 g. The drug comes as 250 mg per capsule. How many capsules would the nurse give?

2

The patient is to receive 1000mL of fluid over 10 hours. The calibration set is 15 gtt/mL. How many drops per minute would the nurse give?

25

Am patient diagnosed with schizophrenia is admitted to the hospital and haloperidol (haldol) is started. The nurse would assess for neuroleptic malignant syndrome if the patient had a? Select all that apply

30mmHg decrease in blood pressure Temperature reading of 104 degree fahrenheit Diaphoresis

If the patient is to receive insulin at 3 units/hr with a solution of 50 units per 100 ml is normal saline (NS)the rate of infusion in milliliters would be?

6

In explaining alternative therapies to a patient, the nurse may correctly say that these therapies?

Are more effective if used as preventive measures than if used for cure.

A patient who is taking SSRIs mention to the nurse that his current medication causes fewer side effects than the TCA he took several years earlier. THe nurse understands that SSRIs advantage is due to?

Blocking only serotonin

The nurse entered the room of a patient who has been diagnosed with terminal cancer and found the patient and her husband laughing loudly at the returns of The Three Stooges. The nurse left the room and postponed a planned treatment, knowing that humor?

Can affect positive changes on several physiologic systems and functions

A patient taking fluphenazine (Prolixin) complains of dry mouth and blurred vision. What would the nurse assess as the likely cause of these symptoms?

Cholinergic blockage

When a patient for whom haloperidol has prescribed tells the nurse, "I'm burning up and my muscles are stiff and sore," the nurse suspects neuroleptic malignant syndrome and recognizes the possibility that the physician may order?

Dantrolene (Dantrium)

The nurse planning care for an Asian American patient who plans to use oriental medicinal dietary principles will need to understand that hot and cold substances are an integral part of therapy. The substance used are?

Determined by yin and yang characteristics

When a patient askes for an example of an alternative or com[;entary therapy, the nurse would correctly reply? Select all that apply

Detoxing foot pads Acupuncture

What would be a priority nursing diagnosis for a patient taking zolpidem(Ambien)?

Disturbed Sleep pattern

The primary healthcare provider prescribed fluoxetine(prozac) orally every morning for a 72 year old patient with depression. Which transient adverse effect of this drug requires immediate action?

Dizziness

To understand what to expect following administration of a benzodiazepine, the nurse must understand that benzodiazepine?

Enhances the activity of GABA

The primary healthcare provider prescribes mirtazapine (Remeron) 30 mg PO at bedtime for a depressed patient. The nurse should?

Give medication as prescribed

Sertraline(Zoloft) has been prescribed for a patient with symptoms of major depression. which factor was probably most important in the physician's decision to use an SSRI?

Good side effect profile

Which patient receiving typical antipsychotic medication would be assessed as displaying behavior characteristic of tardive dyskinesia? Select all that apply

Grimaces and smacks her lips Is experiencing muscle rigidity and tremors

To evaluate outcomes for a patient with schizophrenia receiving typical antidepressant drug therapy, the nurse would look for improvement in?

Hallucinations

Which statement made by the patient about a half hour before a scheduled ECT treatment would result in cancellation of the treatment?

I just had some crackers and milk since I'll miss breakfast.

The nurse is leading a medication management group for patients who are being discharged from the hospital. Which of these statements made by a patient taking phenelzine(Nardil) would warrant further instructions?

I usually order liver and onions when my wife and i eat out.

During a medication management class for nurses, the pharmacist discussing tricyclic antidepressants asks how these medications affect neurotransmitter activity

Increasing availability of norepinephrine and serotonin

The patient who has been taking venlafaxine (effexor) 25 mg PO three times a day for the past 2 days states, "I'm still so depressed." which of the following responses by the nurse is most appropriate? Select all that apply

It takes about 2 to 4 weeks to receive the full effects. Its's too soon to tell if your medication will help you.

The patient with depression who is taking imipramine(Tofranil) states to the nurse, "My doctor wants me to have an ECG in 2 weeks, but my heart is fine." Which response by the nurse is most appropriate?

It's routine practice to have ECGs periodically because there is a slight chance that the drug may affect the heart.

Which statement by a patient who has given informed consent for ECT confirms the patient understanding of the side effects of this treatment?

Memory loss will be temporary

Which off the following statements by a patient taking trazodone (Desyrel) as prescribed by the primary healthcare provider indicated to the nurse that further teaching about the medication is needed?

My depression will be gone in about 5 to 7 days.

An impact about the popularity of alternative therapy has on nurse application of therapeutic interventions is that nurses?

Need to understand herbal-drug interactions

A patient who has received lithium for 3 weeks to control acute mania has the following symptoms: Coarse hand tremors, diarrhea, vomiting, lethargy and mild confusion. The priority nursing action should be to?

Obtain a stat lithium level: hold lithium pending results

An individual with post stroke depression is receiving a CNS stimulant. What is the rationale for giving the medication at breakfast and again at midday?

Prevent Insomnia

When a patient asks the nurse, "How can jolting me with an electrical shock possibly do me any good?, " The answer most reflective of current theory would be, "ECT?

Produces a change in brain chemistry that results in improved mood."

The nurse is explaining the differences in typical and atypical antipsychotics. She correctly states that atypical antipsychotics?

Produces fewer extrapyramidal effects

A patient was prescribed alprazolam(Xanax) for symptoms of anxiety related to a recent divorce and relocation She stated to the nurse, "A little while after I take the medication , I feel out of it and spacey." What is the likely cause of this feeling?

Rapid absorption and distribution to brain cells

Immediately after ECT, nursing care of the patient is most similar to care for patient?

Recovering from general anesthesia

A patient has been taking #0 mg of duloxetine hydrochloride (Cymbalta)twice daily for 2 months because of depression and vague aches and pains. While interacting with the nurse, the patient disclosed a pattern of drinking a six pack of beer daily for the past 10 years to help with sleep. What should the nurse do first?

Report the patient's beer consumption to the primary healthcare provider.

The patient is taking 50 mg of lamotrigine (Lamictal) daily for bipolar depression. The patient shows the nurse a rash on his arm. What should the nurse do?

Report the rash to the primary healthcare provider.

A patient who has an anxiety disorder fears having panic attacks when he is alone at home. The nurse teaches the client to use meditation techniques when he feels anxious. THe techniques can be evaluated as having proved useful when the patient explains to a friend that meditation?

Results in positive physical and mental effects

The nurse can anticipate that a patient who has shown little response to atypical antipsychotic medication therapy will be given a medication that produces a favorable response to both positive and negative symptoms such as?

Risperidone (Risperdal)

The nurse notes that a patient who has been receiving paroxetine(paxil) for symptoms of major depression and whose sensorium had been clear, begins to behave as though somewhat confused and elated. The nurse also notes the presence of restlessness, muscle jerking and diaphoresis. The nurse should assess these symptoms as probable?

Serotonin Syndrome

When following up on ssri medication side effects, the nurse will need to make specific inquires about?

Sexual dysfunction

The patient diagnosed with major depression has been taking Lexapro (Escitalopram) 10 mg daily for the past 2 weeks. Which of the following parameters should the nurse monitor most closely at this time?

Suicidal ideation

The patient with major depression and suicidal ideation has been taking bupropion(wellbutrin) 100 mg PO four times daily for 5 days. Assessment reveals the patient to be somewhat less withdrawn, able to perform activities daily living with minimal assistance and eating 50% of each meal. At this time, the nurse should monitor the patient specifically for which of the following behaviors? Select all that apply

Suicide attempts Decrease in reports of sadness

A patient has been taking chlorpromazine (Thorazine) for the past two weeks. He drools, has hand tremors and walks with a shuffling gait. The nurse would correctly attribute these behaviors to?

Tardive Dyskinesia

A patient was admitted to the inpatient unit 3 days ago with a flat affect ,psychomotor retardation, anorexia, hopelessness and suicidal ideation. The primary healthcare provider prescribed 75mg of venlafaxine extended release (Effexor XR) to be given every morning. The patient interacted minimally with the staff and spent most of the day in his room. As the nurse enters the unit at the beginning of the evening shift, the patient is smiling and cheerful and appears to be relaxed. What should the nurse interpret as the most likely cause of the patients behavior?

The patient's sudden improvement calls for close observation by the staff

Which alternative therapy could the nurse incorporate into the plan of care of an anxious patient receiving antidepressant medication without being concerned about untoward interactions?

Yoga

A patient is seen in the emergency department in an acutely agitated state due to threatening auditory hallucinations. The patient's medical record indicates he has had severe dystonic reactions to parenteral administration of typical antipsychotic medication. THe nurse can anticipate that the physician will order?

Ziprasidone (Geodon) IM