Psych final

A nurse is caring for a client receiving thioridazine. Drug therapy with thioridazine shouldn't exceed a daily dose of 800 mg to prevent which adverse reaction? a) Tourette syndrome b) Retinal pigmentation c) Respiratory arrest d) Hypertension

Retinal pigmentation

Which effects do most antipsychotic medications exert on the central nervous system (CNS)? a) They sedate the CNS by stimulating serotonin at the synaptic cleft. b) They depress the CNS by stimulating the release of acetylcholine. c) They stimulate the CNS by blocking postsynaptic dopamine, norepinephrine, and serotonin receptors. d) They depress the CNS by blocking the postsynaptic transmission of dopamine, serotonin, and norepinephrine.

They depress the CNS by blocking the postsynaptic transmission of dopamine, serotonin, and norepinephrine.

A client with a tentative diagnosis of psychosis is admitted to the psychiatric unit. A physician orders the phenothiazine thioridazine 50 mg by mouth three times per day. Phenothiazines differ from central nervous system (CNS) depressants in their sedative effects by producing:

You selected: a calming effect from which the client is easily aroused.

One of the advantages of the antipsychotic medication APO-risperidone is: a) no incidence of neuroleptic malignant syndrome. b) a lower incidence of extrapyramidal effects. c) the absence of anticholinergic effects. d) photosensitivity and sedation.

a lower incidence of extrapyramidal effects. Explanation: Risperidone has a lower incidence of extrapyramidal effects than the typical antipsychotics. Risperidone does produce anticholinergic effects, and neuroleptic malignant syndrome can occur. Photosensitivity is not an advantage.

After 3 days of taking haloperidol , the client shows an inability to sit still, is restless and fidgety, and paces around the unit. The client is showing signs of which extrapyramidal adverse reactions? a) akathisia b) tardive dyskinesia c) parkinsonism d) dystonia

a) akathisia

A client admitted to the alcohol detoxification program asks the nurse if there's anything he can take to "stop me from wanting a drink so badly." The nurse should teach the client about: a) naltrexone. b) magnesium sulfate. c) haloperidol. d) chlordiazepoxide.

a) naltrexone.

A client on a psychiatric care unit has muscle spasms in the neck, stiffness in other muscles, and the eyes rolling upward. The client had two PRN doses of haloperidol in the last 6 hours. Of the drugs that have been prescribed for the client as needed (see chart), the nurse should administer: a) diphenhydramine. b) benztropine. c) lorazepam. d) amantadine.

b) benztropine.

A man with a 5-year history of multiple psychiatric admissions is brought to the emergency department by the police. This client was found wandering the streets disheveled, shoeless, and confused. Based on his previous medical records and current behavior, he is diagnosed with schizophrenia. The nurse should assign highest priority to which nursing diagnosis? a) Disturbed thought processes b) Dressing or grooming self-care deficit c) Risk for injury d) Impaired verbal communication

c) Risk for injury

Flumazenil has been ordered for a client who has overdosed on oxazepam. Before administering the medication, the nurse should be prepared for which common adverse effect? a) Chest pain b) Anxiety c) Seizures d) Shivering

c) Seizures

Which outcome criterion is appropriate for a child diagnosed with oppositional defiant disorder? a) The child will ask the nurses permission to sleep late. b) The child will verbalize his own needs and assert his rights. c) The child will establish his own limits and boundaries. d) The child will recognize responsibility for own behaviors.

d) The child will recognize responsibility for own behaviors.

Which medication is appropriate to administer, if prescribed, to a client experiencing symptoms of early alcohol withdrawal? a) disulfiram b) quetiapine c) temazepam d) lorazepam

d) lorazepam

A client was discharged from an alcohol rehabilitation program on clonazepam 0.5 mg three times a day. Several months later he reports having insomnia, shakiness, sweating, and one seizure. The nurse should first ask the client if he: a) has increased his clonazepam without consulting his health care provider (HCP). b) has stopped taking the clonazepam suddenly. c) has developed tolerance to the clonazepam and needs to increase the dose. d) has been drinking alcohol with the clonazepam.

has stopped taking the clonazepam suddenly. Explanation: The nurse should first confirm that the client has stopped taking the clonazepam because the client is reporting symptoms of benzodiazepine withdrawal from stopping the clonazepam abruptly. The client would report symptoms of being sedated if he took alcohol with the clonazepam. Tolerance symptoms would be increased anxiety, not these physical symptoms. The client symptoms are consistent with clonazepam withdrawal, not excess, so asking about increased use is not relevant.

A client admitted to the alcohol detoxification program asks the nurse if there's anything he can take to "stop me from wanting a drink so badly." The nurse should teach the client about: a) naltrexone. b) haloperidol. c) magnesium sulfate. d) chlordiazepoxide.

naltrexone

A client is ordered sertraline, a selective serotonin reuptake inhibitor (SSRI). Which adverse effects should the nurse include when creating a medication teaching plan? Select all that apply. a) Dry mouth b) Intermittent tachycardia c) Agitation d) Seizures e) Agranulocytosis f) Sleep disturbance

• Agitation • Sleep disturbance • Dry mouth Explanation: Common adverse effects of sertraline are agitation, sleep disturbance, and dry mouth. Agranulocytosis, intermittent tachycardia, and seizures are adverse effects of clozapine.

A client is admitted to the emergency department having just used cocaine. The nurse should assess this client for which factors? Select all that apply. a) increased blood pressure b) tachycardia c) constricted pupils d) mood swings e) feeling of euphoria

• mood swings • feeling of euphoria • increased blood pressure • tachycardia

The nurse observes that a client on a psychiatric unit is looking around the room with eyes darting to a chair in the corner. The client grimaces and then states, "Bastard," under his breath. Which nursing action is most appropriate? a) Approach the client to interrupt the hallucinations. b) Suggest the client spend some time in his room. c) Remind the client that vulgar language is not appropriate in the hospital. d) Ignore the client because he appears to be hallucinating.

a) Approach the client to interrupt the hallucinations.

When teaching a client with bulimia nervosa about possible complications, which condition should the nurse emphasize? a) Allergies b) Diabetes mellitus c) Hepatitis A d) Lung cancer

b) Diabetes mellitus

A nurse knows that a physician has ordered the liquid form of the drug chlorpromazine rather than the tablet form because the liquid: a) produces fewer anticholinergic effects. b) has a more predictable onset of action. c) produces fewer drug interactions. d) has a longer duration of action.

b) has a more predictable onset of action

A nurse is assessing a 15-year-old female who's being admitted for treatment of anorexia nervosa. Which clinical manifestation is the nurse most likely to find? a) Coarse hair growth b) Tachycardia c) Muscle weakness d) Warm, flushed extremities

c) Muscle weakness

A nurse is evaluating a client for probable amphetamine overdose. Which assessment finding supports this diagnosis? a) Hot, dry skin b) Constricted pupils c) Tachycardia d) Hypotension

c) Tachycardia

A client is being admitted to the substance abuse unit for alcohol detoxification. As part of his intake interview, a nurse asks when he had his last alcoholic drink. He says that he had his last drink 6 hours before admission. Based on this response, the nurse should expect early withdrawal symptoms to peak: a) immediately. b) after 7 days. c) in 1 to 2 days. d) within 2 to 7 days.

c) in 1 to 2 days.

A physician orders lithium carbonate for a client who's in the manic phase of bipolar disorder. During lithium therapy, the nurse should watch for which adverse reactions? a) Anxiety, restlessness, and sleep disturbance b) Constipation, lethargy, and ataxia c) Weakness, tremor, and urine retention d) Nausea, diarrhea, tremor, and lethargy

d) Nausea, diarrhea, tremor, and lethargy

A client walks into the clinic and tells the nurse she has run out of money for crack, has crashed, and wants something to help her feel better. Which factor is most important for the nurse to assess? a) suicidal ideation b) suspiciousness c) drug craving d) loss of appetite

a) suicidal ideation

Important teaching for a client receiving risperidone should include advising the client to: a) discontinue the drug if he gains weight. b) maintain a therapeutic level by doubling a dose if he misses a dose. c) notify the physician if he notices an increase in bruising. d) be sure to take the drug with a meal because it can severely irritate the stomach.

c) notify the physician if he notices an increase in bruising.

A client is beginning to participate in the alcohol treatment program. Which nursing approach would be most effective in decreasing his denial about his alcoholism? a) Point out concrete problems that are a direct consequence of his alcoholism. b) Give him reading materials about the disease of alcoholism. c) Explain the physiologic effects of alcohol on the body. d) Teach him assertiveness techniques.

a) Point out concrete problems that are a direct consequence of his alcoholism.

When discharging a client after treatment for a dystonic reaction, an emergency department nurse must ensure that the client understands: a) the client must take benztropine as ordered to prevent a return of symptoms. b) the client shouldn't buy drugs on the street. c) results of treatment are rapid and dramatic but may not last. d) although uncomfortable, this reaction isn't serious.

a) the client must take benztropine as ordered to prevent a return of symptoms.

Benztropine is used to treat the extrapyramidal effects induced by antipsychotics. This drug exerts its effect by: a) increasing the level of acetylcholine in the CNS. b) increasing norepinephrine in the CNS. c) decreasing the anxiety causing muscle rigidity. d) blocking cholinergic activity in the central nervous system (CNS).

d) blocking cholinergic activity in the central nervous system (CNS).

The primary care provider prescribes risperidone 1 mg orally, two times a day for a client from a group home admitted to the hospital with severe anti-social behavior.The nurse determines that this dose is: a) Typical when initiating therapy. b) Typical when initiating therapy but it should be tapered down in 1 week. c) Too high for the client. d) Too low for the client.

a) Typical when initiating therapy.