Pharmacology Prep U Chapter 22 Psychotherapeutic Agents

The community health nurse is conducting a class for parents of preschoolers. One of the parents asks if a child with ADHD will always have problems with hyperactivity. What is the nurse's best response?

"ADHD usually starts in childhood and may persist through adulthood."

A male client tells the nurse he is going to stop taking his medication because he is always having fine tremors and slurred speech. These reactions are preventing him from teaching art classes like he used to do. The nurse knows that what action could help him?

He could talk with his health care provider and ask to have his medication dosage decreased, or change his medication to a second-generation antipsychotic.

A client, prescribed dextroamphetamine for attention deficit hyperactivity disorder (ADHD), has developed a common adverse effect of the medication since beginning therapy. Which initial intervention should the client be encouraged to implement?

Increase fiber intake

A client is being treated with clozapine. What should the nurse monitor most closely?

White blood cell count

What medication is an example of a phenothiazine antipsychotic?

chlorpromazine

What should the nurse assess regarding a client's reports of insomnia?

daily intake of caffeine-containing products

A patient is undergoing lithium therapy at a health care facility. The patient informs the nurse that he is taking antacids for heartburn. Which is a possible effect of the interaction of lithium with antacids?

decreased effectiveness of lithium

A client is prescribed olanzapine for the treatment of schizophrenia. The client is voiding three times each night and is always thirsty. Based on the adverse effects of olanzapine, what should the nurse suspect is triggering the client's reported polyuria and polydipsia?

diabetes mellitus

For clients taking clozapine (Clozaril), it is necessary to monitor what lab test for the first 6 months?

White blood cells

The wife of a client who is taking haloperidol calls the clinic and reports that her husband has taken the first dose of the drug and it is not having a therapeutic effect. An appropriate response by the nurse would be which?

"Continue the prescribed dose. It may take several days to work."

A client is taking antipsychotic medication and asks the nurse what dopamine is. What is a correct response by the nurse?

"Dopamine is a neurotransmitter that deals with pleasure and reward in the brain."

The nurse is teaching a client who is prescribed fluphenazine about the drug. Which client statement indicates that the client has understood the instructions?

"I shouldn't be alarmed if my urine turns pink or reddish brown."

A female client asks why it is not legal to have a year's worth of prescription refills for Ritalin, since she has been on it for more than a year. She would also like to have the largest dose possible, so she can use the prescription for 2 months, instead of one. She explains that it is very hard to get off work and come in for appointments. The nurse's best response would be:

"The prescription dose is always started as low as possible and the refills are monitored to prevent abuse."

An adult client, diagnosed with narcolepsy, admits being embarrassed to receive this diagnosis and is adamant that no one find out about it. The nurse should respond to the client by explaining what aspect of the etiology?

"This is the result of neurological factors over which you have no direct control."

An African American male client routinely takes haloperidol to manage his psychosis. Recently, he presented to the physician's office with signs of tardive dyskinesia, and his physician modified the drug regimen over time. The client will now take the drug olanzapine and discontinue the haloperidol. What will the nurse tell the client to help decrease his anxiety about the new drug regimen?

"When compared with haloperidol, olanzapine has been associated with fewer extrapyramidal reactions in African Americans."

The nursing student is reviewing information learned in anatomy and physiology class about the nervous system. The student recalls that the nervous system has how many divisions?

2

The classification of central nervous system (CNS) stimulants frequently prescribed for exogenous obesity is:

Amphetamines

What client is being treated with a typical antipsychotic?

An agitated client who was given haloperidol during acute psychosis

Moderate CNS depression is characterized by:

Drowsiness or sleep; decreased muscle tone; decreased ability to move; and decreased perception of sensations such as pain, heat, and cold.

A client calls the clinic reporting only being able to get a 1-month supply of pills for the client's son, who takes a CNS stimulant for ADHD. The nurse understands that these medications are given in limited numbers for what reason?

It reduces the likelihood of drug dependence or diversion.

The nurse is caring for a client who takes clozapine. The nurse would be most concerned if this client displays what symptom?

Temperature of 102°F

The nurse is caring for a patient who is receiving drug therapy for a psychotic disorder. Which goals should the nurse include in a care plan for the patient following discharge from the hospital?

The patient will take medications as prescribed.

A 10-year-old boy is taking dextroamphetamine (Dexedrine) daily for ADHD. At each clinic visit, the nurse must assess the child. The priority assessment since he is on this medication would be which?

height and weight

What assessment finding should lead the nurse to suspect that a client receiving antipsychotic therapy is developing tardive dyskinesia?

lip smacking

A psychiatric nurse is discussing the advantages of atypical antipsychotics with the parents of a teenager who has been diagnosed with schizophrenia. When comparing these drugs with the older, typical antipsychotics, what advantage should the nurse cite?

reduced adverse effects

During health education with the nurse, what subject should be the primary focus for a client newly diagnosed with schizophrenia?

the importance of adherence to prescribed treatment

A 72-year-old man is taking Adderall XR for the treatment of narcolepsy. He is currently having problems with not being able to swallow large tablets or capsules. The man also wears dentures, which makes it even more difficult for him to swallow medication. He is in the clinic to talk to the nurse about his problem. The nurse will instruct him to

open the capsule and sprinkle the beads in applesauce.

The main goal of therapy when using CNS stimulants is to:

relieve the symptoms for which they were prescribed.

The client is ordered didrex 25 mg PO BID. The drug comes from the pharmacy to the floor in 50-mg tablets. How much should the nurse administer to the client per dose?

1/2 tablet

A female client is diagnosed with renal insufficiency. The nurse develops a teaching plan based on the diagnosis and antipsychotic drug usage. The client asks the nurse why it is so important to have renal function tests routinely. The nurse replies that if renal function test results become abnormal, what may be a consequence?

The drug may need to be lowered in dosage or discontinued.

The nurse is aware that CNS stimulants are prescribed for clients with ADHD because these medications have what effect on behavior and attention?

Improving

The nurse expects to monitor a client's white blood count weekly when the client is prescribed:

Clozapine

Serotonin abnormalities are thought to be involved in the following disorders:

Mental depression and sleep disorders.

A male client's health care provider orders antipsychotic medications for him. He experiences little or no side effects from the medications and is able to function successfully in both his home and work environments. Six weeks later, he is diagnosed with hepatitis B. He begins to experience adverse reactions to his medications. A possible reason for the adverse reactions might be that, in the presence of liver disease, what may happen?

Metabolism may be slowed and drug elimination half-lives prolonged, with resultant accumulation and increased risk of adverse effects.

A group of nursing students are reviewing information about CNS stimulants. The students demonstrate understanding of the information when they identify which drug as being used to treat obesity?

Phentermine

Which test should be scheduled every week for a patient taking clozapine?

WBC count

A client, who has been diagnosed with schizophrenia and is taking an antipsychotic medication, reports constant thirst, frequent urination, and feeling nauseous. The nurse knows that the client may:

have undiagnosed diabetes.

A nurse is caring for a patient who is taking haloperidol. The patient has orders for a new drug, and the nurse notes that it is highly protein bound. The nurse will plan care based on a(n):

increased risk for toxic effects of haloperidol therapy.

A 13-year-old has been prescribed dextroamphetamine for the treatment of attention deficit hyperactivity disorder (ADHD) since age 10, achieving significant improvements in behavior and mood. When assessing the child during a scheduled follow-up appointment, the nurse should prioritize what physical assessment to monitor for a potential adverse reaction to the therapy?

measurement of height and body weight

What goal would be appropriate for a client during the first week of treatment for acute psychosis? Select all that apply.

• decreasing the client's symptoms • normalizing the patterns of sleeping and eating