Psych
32. Which of the following symptoms are seen when a patient abruptly stops taking diazepam (Valium)? Select all that apply. A. Insomnia B. Tremor C. Delirium D. Dry mouth
AB
24. Which teaching point by the nurse takes priority for a client newly prescribed lithium carbonate (lithium)? A. "Increase your salt and fluid intake." B. "Limit your fluid intake to 2000 mL/day." C. "Monitor your caloric intake because of potential weight gain." D. "Limit your salt intake."
A
31. A nurse is taking a history from a patient in an outpatient clinic. The patient has been prescribed lorazepam for 6 months. Which of the following is the most likely side effect that the nurse would expect to see as a result of the client using Ativan for this time period? A. Excessive appetite. B. Physical dependence. C. Suicidal ideation. D. Seizure activity.
B
14. The nurse is conducting discharge teaching for a patient taking tranylcypromine (Parnate). The nurse determines that the patient understands the instructions given if the patient says not to eat which food while taking the medication? A. Potatoes B. Salami C. Baked chicken D. Apples
B
27. An individual who is admitted to an alcohol detoxification unit has had no alcohol intake for 3 days. On admission the patient is noted to have tremors, anxiety, insomnia and disorientation accompanied by tachycardia and diaphoresis. These signs and symptoms are characteristic of: A. Alcoholic hallucinosis. B. Alcohol withdrawal delirium. C. Alcohol seizure disorder D. Dementia
B
41. Benzodiazepines increase the level of A. Serotonin B. Norepinephrine C. GABA D. Acetylcholine
C
11. A patient who has refused to take the regular prescribed dose of clonazepam (Klonopin) reports irritability, insomnia, tremors, and sweating. The nurse concludes that the patient is mostly likely experiencing symptoms associated with which of the following? A. Anxiety B. Manipulation C. Overdose D. Withdrawal
D
1. A patient is taking antipsychotic medications for treatment of schizophrenia reports feeling nervous. The nurse notes that the patient is pacing the ling hallway and is unable to remain still, even when in conversation with other patients. What term should the nurse use to document this occurrence? A. Akathisia B. Akinesia C. Dystonia D. Tardive dyskinesia
A
15. A patient has bipolar I disorder. Lithium carbonate (Eskalith) 300 mg four times daily has been prescribed. After three days of lithium therapy, the patient says, "What's wrong? My hands are shaking a little. "What is the best response by the nurse? A. "Minor hand trembling often happens for a few days after lithium is started. It usually stops in one to two weeks." B. "There is no reason to worry about that. We won't, unless it lasts longer than a couple of weeks." C. "Just in case your blood level is too high. I am not going to give you your next dose of lithium." D. "I wouldn't worry about it if I were you. It is a small tremor that doesn't interfere with your functioning."
A
16. A nurse needs to teach a patient about newly prescribed sertraline (Zoloft) Which information is essential to include in the teaching? Select all that apply. A. Sertraline is most often taken as a morning dose. B. Constipation is a common side effect of sertraline. C. Fever and flu-like symptoms are bothersome but not dangerous side effects of sertraline. D. Patients taking sertraline will usually recognize improvement within one week. E. It is possible that sexual side effects will occur.
A
28. When designing a teaching plan for a patient taking disulfiram (Antabuse), a nurse should include an explanation on the importance of avoiding certain over-the-counter substances. With appropriate instruction, which substance could the patient identify as being safe to use? A. Antacids. B. Mouthwash C. Cough syrups D. Cold medications
A
29. In the emergency room a nurse learns that a patient has recently taken a large amount of the drug PCP. The nurse should be ready to provide interventions for: A. Acute psychosis, agitation and violence. B. Hypotension, sedation and respiratory depression. C. Heightened sensory perceptions, dizziness and ataxia. D. Paranoid thinking, hyperthermia, hyperactivity, and arrhythmias.
A
34.A patient being treated for depression reports experiencing nausea, palpitations, and "a terrible headache." When the patient is diaphoretic and hypertensive on assessment, the nurse suspects the effects of which of the following medications? A. Phenelzine (Nardil) B. Amitriptyline (Elavil) C. Advil D. Nortriptyline (Pamelor)
A
35.A patient diagnosed with schizophrenia tells a nurse, "I'm going to stop going to the clinic for my fluphenazine decanoate (Prolixin) shots because I think I'm okay now." Which of the following statements is therapeutic? A. "Let's discuss the reasons you've decided to stop taking your medication." B. "Your doctor knows what's best. Look at how well you're feeling now." C. "Our philosophy is to use the least amount of medicine. Why do you think you are okay now?" D. "You are going to be sick again very soon."
A
36. A patient who is prescribed lithium tells the nurse, "I'm planning to breast-feed my baby who is due to be born in 2 months." Which statement shows an understanding of the effects of lithium on breast-feeding? A. "Your medication will be excreted in your breast milk, let's discuss a safer option for your baby." B. "Your medication will cause the breast milk to have an unpleasant taste for your infant." C. "This medication will affect your ability to lactate." D. "This medication causes extreme mood fluctuations."
A
46. A client admitted to the acute care unit with complaints of depression and suicidal ideation is prescribed citalopram (Celelxa). Four days later, the client experienced pressured speech, euphoria, restlessness and is noted to wear heavy makeup. A potential reason for this client's behavior may be that the client is: A. Experiencing manic symptoms related to the citalopram (Celexa) B. Showing improvement and is ready for discharge C. Masking a depression in an attempt to be discharged from the hospital D. Anxious with an anticipated discharge
A
13. The inpatient mental health patient is being treated for major depression. The patient has psychomotor retardation, speaks very little and is extremely inactive physically. The patient takes an antidepressant that causes anticholinergic side effects. The nurse should conclude that this patient is at particular risk for developing which of the following? Select all that apply. A. Dry mouth B. Vomiting C. Constipation D. Diarrhea E. Weight loss
AC
19. A patient is admitted to the inpatient unit with a new diagnosis of bipolar disorder, most recent episode mania. The patient's history indicates she recently experienced an unresolved crisis; her sister died from a heroin overdose three months ago. The patient has been so busy raising her children by herself, ad working full time, that she repressed feelings related to the event. The patient currently manifests delusions, severe anxiety, and suicidal ideation. The nurse would anticipate which of the following becoming part of her treatment plan? Select all that apply. The patient will be places on A. One to one observation B. A serotonin selective reuptake inhibitor (SSRI) C. A mood stabilizer D. An antipsychotic E. An anxiolytic ordered as needed (prn)
ACD
10. A patient who is receiving an anxiolytic medication is reluctant to participate in group therapy. The patient states, "The pills I am taking will take care of my stress. I don't need to talk about my problems." In response to the patient's statement which of the following should the nurse explain? A. Many anxiolytics are habituating B. Medications relieve symptoms but do not change the source of the anxiety C. The patient will need to attend group therapy only until the medication becomes effective. D. The medications will not work unless the patient participates in group therapy.
B
17. An adolescent patient is depressed. The patient's ordered medication is fluoxetine (Prozac). What is the best response by the nurse when the patient says, "What will this medicine do inside my brain?" A. "It will help you feel less depressed." B. "It will regulate a neurotransmitter called serotonin. C. "It will raise your level of the brain hormone norepinephrine." D. "It will balance blood glucose and dopamine levels."
B
21. A patient prescribed clozapine (Clozaril) for 9 months complains to a clinic nurse of flulike symptoms which include sore throat, fever, and tiredness. Which of the nurse's responses shows the best understanding of these symptoms? A. "Drink lots of fluids, go to bed and then call next week to reschedule." B. "I want you to keep your appointment today; blood work will be done while you are here." C. "It's flu season, get better soon and reschedule when you're feeling better." D. "This may not be anything more serious than the flu."
B
25. A client recently prescribed fluphenazine (Prolixin) complains to the nurse of severe muscle spasms. On examination, heart rate is 108, blood pressure 160/96 mm Hg, and temperature is 101.5-degree F. Which nursing intervention takes priority? A. Check orders for PRN benztropine (Cogentin) due to increased extrapyramidal symptoms B. Hold next dose of fluphenazine (Prolixin), and call physician immediately to report findings C. Schedule an examination with the client's physician to evaluate cardiac function D. Ask client about recreational drug use and ask physician to order a drug screen
B
4. A patient reports having blurred vision that began after beginning drug therapy with a traditional antipsychotic. What would be the beset response by the nurse? A. "You need to schedule an appointment with your eye doctor to bet a new prescription for your eyeglasses." B. "Blurred vision is a temporary side effect of your medication that usually resolves within a few weeks." C. "You need to stop taking your antipsychotic medications and notify your doctor immediately." D. "Blurred vision is a permanent condition as a result of your medication."
B
42. Amitriptyline (Elavil), doxepin (Sinequan) and imipramine (Tofranil) are examples of A. Selective serotonin uptake inhibitors B. Tricyclic antidepressants C. Selective serotonin norepinephrine reuptake inhibitors D. Atypical antipsychotics
B
45. A client recently prescribed fluphenazine (Prolixin) complains to the nurse of severe muscle spasms. On examination, heart rate is 108, blood pressure 160/96 mm Hg, and temperature is 101.5-degree F. Which nursing intervention takes priority? A. Check orders for PRN benztropine (Cogentin) due to increased extrapyramidal symptoms B. Hold next dose of fluphenazine (Prolixin), and call physician immediately to report findings C. Schedule an examination with the client's physician to evaluate cardiac function D. Ask client about recreational drug use and ask physician to order a drug screen
B
20. A nurse has explained to a patient the biologic theories of depression. The nurse concludes that the teaching has been effective if the patient states that depression may be caused from which of the following? Select all that apply. A. Excessive serotonin activity in the central nervous system (CNS) B. Insufficient serotonin activity in the CNS C. Excessive acetylcholine in the CNS D. Insufficient acetylcholine activity in the CNS E. A genetic mutation on chromosome 6
BC
7. A make patient is taking a second-generation antipsychotic drug. The patient's spouse tells the nurse that she read that the drug is effective A. Abnormal thought B. Diminished pleasure C. Blunted affect D. Hallucinations E. Difficulty making decisions
BCE
6. A patient with chronic schizophrenia has been receiving an atypical antipsychotic for three months. The nurse concludes that the patient is experiencing a reduction in negative symptoms of schizophrenia if a family member says which of the following? Select all that apply. A. "We walked together for 15 minutes and I could see no evidence he was hearing voices." B. "For the past week, he has gotten up, dressed and taken a walk early each morning." C. "It has been more than a month since he said that he is a Martian prince." D. "We went to a musical concert, and he smiled and applauded the musicians." E. "I've noticed that his thoughts are better organized."
BD
2. A patient who has schizoaffective disorder takes both haloperidol (Haldol) and valproic acid (Depakote). When the patient asks the nurse to explain what this particular combination of drugs is expected to do, what would be the best response by the nurse? A. "Haloperidol (Haldol) makes your moods calmer and valproic acid prevents tight muscles." B. "This combination is good or people who have problems like yours." C. "Haloperidol improves your thinking and valproic acid stabilizes your moods." D. "This is an old combination of drugs that helps people to keep thinking and feelings in balance."
C
22. Which interventions should a nurse select to help a patient cope more effectively with chronic pain disorder? A. Mild opioids B. Benzodiazepines C. Relaxation techniques D. Response prevention
C
23. A nurse would be expected to administer which of the following medications when observing a patient being treated for schizophrenia is fidgety, with motor restlessness, and jiggling both legs when asked to sit down? A. Olanzapine (Zyprexa) B. Amitriptyline (Elavil) C. Benztropine mesylate (Cogentin) D. Thioridazine (Mellaril)
C
3. The nurse is to complete an AIMS assessment of the patient. When explaining this test to the patient, the nurse should say that this test will help to identify if the patient is beginning to have which of the following? A. Weak muscles B. Shaking hands and feet C. Uncontrollable motions in the body D. Slowed body movements
C
30. A nurse observes a patient diagnosed with schizophrenia tapping both feet, smacking both lips, and making contorted faces while speaking to another patient. These behaviors prompt the nurse to suspect the patient is experiencing: A. Neuroleptic malignant syndrome. B. Parkinson syndrome C. Tardive dyskinesia D. Torticollis
C
33. A nurse would be expected to administer which of the following medications when observing a patient being treated for schizophrenia is fidgety, with motor restlessness, and jiggling both legs when asked to sit down? A. Olanzapine (Zyprexa) B. Amitriptyline (Elavil) C. Benztropine mesylate (Cogentin) D. Thioridazine (Mellaril)
C
38. Which of the following statements by a client indicate successful teaching on benztropine mesylate (Cogentin)? A. "I may expect to urinate more frequently." B "This medication may make my eyes tear excessively." C. "I will probably experience a dry mouth and constipation." D. "I may experience a low energy level and fatigue."
C
39. Which of the following symptoms are seen when a client abruptly stops taking diazepam (Valium)? A. Dry mouth and lethargy B. Euphoria and dysphoria C. Insomnia and tremor D. Fever and tinnitus
C
40. Mr. M. presents in the clinic after being prescribed a Selective Serotonin Reuptake Inhibitor (SSRI). Which of the following symptoms alert the nurse to take immediate action? A. Weight gain B. Insomnia and depression C. Hyperthermia, restlessness, tachycardia, D. Serum glucose 156 mg/dL
C
44. Which atypical antipsychotic medication has the most potential for a client to experience sedation, weight gain and increased serum glucose? A. Haloperidol (Haldol) B. Chlorpromazine (Thorazine) C. Risperidone (Risperdal). D. Clozapine (Clozaril)
C
8. A nurse is assessing a patient who recently began taking a typical antipsychotic medication. The patient says. "All of a sudden I can't breathe right." The nurse observes generalized body rigidity and diaphoresis. The body temperature is 103 °F and the pulse is 130. What should the nurse do next? A. Administer the ordered prn anticholinergic medication B. Assess the patient for indications of orthostatic hypotension. C. Begin preparing the patient for immediate transfer to an emergency department D. Arrange for an additional physician's visit later in the day.
C
9. The patient is to begin taking olanzapine (Zyprexa). The nurse makes it a priority to assess which of the following before administering the first dose? A. Usual sleep pattern B. Food and fluid preferences C. Body weight D. History of indigestion
C
18. A five- year- old patient has been diagnosed with attention deficit hyperactivity disorder (ADHD). The child's parents report that a friend told them that the child will likely receive "lots of drugs." The nurse should reply that the child will most likely be prescribed which of the following drugs? Select all that apply. A. Amitriptyline (Elavil) B. Paroxetine (Paxil) C. Amphetamine and dextroamphetamine (Adderall) D. Haloperidol (Haldol) E. Atomoxetine (Strattera)
CE
26. A nurse caring for a patient with Alzheimer disease can anticipate that the family may need information about: A. Antimetabolites. B. Benzodiazepines. C. Immuno-suppressants. D. Acetylcholinesterase inhibitors.
D
37.In which situations would benzodiazepines be appropriately prescribed? A. Long-term treatment of posttraumatic stress disorder, convulsive disorder and alcohol Withdrawal B. Short-term treatment of obsessive compulsive disorder, skeletal muscle spasms and essential hypertension C. Long-term treatment of panic disorder, alcohol dependence, and bipolar affective disorder: manic episode D. Short-term treatment of generalized anxiety disorder, alcohol withdrawal, and preoperative sedation
D
43. The client prescribed clozapine (Clozaril) 25 mg daily has the following lab results: RBC 4.7 million/mcL, WBC 2000/mcL, and TSH 1.3 mc-IU. Based on these values which order would the nurse expect from the physician? A. Levothyroxine sodium (Synthroid) 150 mcg P.O. every day. B. Ferrous sulfate (Feosol) 100 mg three times a day C. Discontinue clozapine (Clozaril) D. Discontinue clozapine (Clozaril) and start levothyroxine sodium (Synthroid) 150 mcg daily.
D
5. A patient is planning to be discharged from the hospital. It is the nurse's responsibility to educate this patient regarding clozapine (Clozaril). The nurse makes it a priority to teach the patient to notify the physician immediately for which of the following? A. Feelings of increased energy and interest in the environment. B. Unusual reactions to exposures to the sun C. Interferences with normal sleep pattern D. Indications of any sort of infection
D
12. A patient asks why a beta blocker medication has been prescribed for anxiety. When answering this question, the nurse should explain that this medication class is effective for treatment of which symptoms associated with anxiety? Select all that apply. A. Confusion B. Suicidal ideations C. Insomnia D. Palpitations E. Rapid heart rate
DE
