Psych Pharmacology

Fluoxetine (Prozac) is prescribed for the client, and the nurse reinforces instructions to the client regarding the administration of the medication. Which statement by the client indicates an understanding about administration of the medication?

1."I should take the medication with my evening meal." 2."I should take the medication at noon with an antacid." 3."I should take the medication in the morning when I first arise." 4."I should take the medication right before bedtime with a snack." 3."I should take the medication in the morning when I first arise."

Fluoxetine hydrochloride (Prozac) is prescribed for a client being treated for depression, and the nurse reinforces instructions to the client regarding the medication. Which statement by the client would indicate that the client understands this medication therapy?

1."If my mouth becomes dry, I should stop the medication." 2."If I don't feel better in 1 week, I should stop the medication." 3."I will need a stronger dose if I don't feel results in a few days." 4."It takes approximately 2 to 4 weeks before improvement is noted." 4."It takes approximately 2 to 4 weeks before improvement is noted."

A client diagnosed with depression is starting therapy with imipramine hydrochloride (Tofranil). The nurse is concerned that the client will not comply with the medication regimen. To encourage the client to continue taking the medication, the nurse tells the client that it is normal not to feel beneficial effects of the medication for which amount of time?

1.3 to 5 days 2.5 to 7 days 3.1 to 2 weeks 4.2 to 3 weeks 4. 2-3 weeks -Imipramine hydrochloride is an antidepressant. The client may not experience the therapeutic effects of administration of imipramine hydrochloride for 2 to 3 weeks after the antidepressant therapy has been initiated. It is important for clients to understand this at the beginning of therapy so that they do not become discouraged and stop taking the medication. The other options are incorrect.

The nurse is reinforcing medication discharge instructions for a client who has just begun taking isocarboxazid (Marplan) for depression and knows that the client needs further teaching after stating that which foods are safe to eat? Select all that apply.

1.Avocado 2.Apple 3.Bologna 4.Tomato 5.Broccoli Avocado and bologna

A client admitted to the hospital gives the nurse a bottle of clomipramine (Anafranil). The nurse notes that the medication has not been taken by the client in 2 months. Which behavior observed in the client would validate noncompliance with this medication?

1.Complaints of hunger 2.Complaints of insomnia 3.A pulse rate less than 60 beats per minute 4.Frequent hand washing with hot, soapy water 4.hand washing with hot soapy water -Clomipramine is commonly used in the treatment of obsessive-compulsive disorder. Hand washing is a common obsessive-compulsive behavior. Weight gain is a common side effect of this medication. Tachycardia and sedation are also side effects. Insomnia may occur but is seldom a side effect.

A client has a history of seizures. The health care provider has prescribed amitriptyline three times daily. The nurse seeks clarification of the prescription, knowing that the client is at risk for injury because of which adverse effect of the amitriptyline?

1.Decreased mental acuity 2.Decreased seizure threshold 3.Decreased platelet aggregation 4.Depressed immunological system decreased seizure threshold Amitriptyline, a tricyclic antidepressant, lowers the seizure threshold, increasing the risk of seizures. This may not be the medication of choice for a client who is already at risk for seizure activity. Options 1, 3, and 4 are unrelated to the use of this medication.

The nurse is collecting data from a client, and the client's spouse reports that the client is taking donepezil hydrochloride (Aricept). Which disorder should the nurse suspect that this client may have based on the use of this medication?

1.Dementia 2.Schizophrenia 3.Seizure disorder 4.Obsessive-compulsive disorder 1. Dementia

The nurse is monitoring a client taking an antipsychotic medication for signs of neuroleptic malignant syndrome (NMS). The nurse should expect to note which sign/symptom if NMS occurred?

1.Dysphagia 2.Bradycardia 3.Hypotension 4.Hyperpyrexia Hyperpyrexia -Hyperpyrexia up to 107° F may be present in neuroleptic malignant syndrome. Symptoms develop suddenly and may include respiratory distress and muscle rigidity. As the condition progresses, there is evidence of tachycardia, hypertension, increasing respiratory distress, confusion, and delirium. The presence and severity of symptoms are compounded when two or more antipsychotics are taken concomitantly.

A hospitalized client is started on phenelzine sulfate (Nardil) for the treatment of depression. The nurse reinforces instructions to the client and tells the client to avoid consuming which foods while taking this medication? Select all that apply.

1.Figs 2.Yogurt 3.Crackers 4.Aged cheese 5.Tossed salad 6.Oatmeal cookies Figs,yogurt,aged cheese

The nurse is caring for a client who has been prescribed citalopram (Celexa) and checks the client for which signs/symptoms of serotonin syndrome? Select all that apply.

1.Lethargy 2.Diarrhea 3.Bradycardia 4.Abdominal pain 5.Increased blood pressure diarrhea abdominal pain increased BP -Serotonin syndrome signs/symptoms include hyperactivity (not lethargy), tachycardia (not bradycardia), fever, elevated blood pressure, altered mental status, irrationality, seizures, myoclonus, abdominal pain, diarrhea, bloating, and apnea.

A tricyclic antidepressant is administered to a client daily. The nurse plans to alleviate the common side effects of the medication and includes which in the plan of care?

1.Offer hard candy or gum periodically. 2.Offer a nutritious snack between meals. 3.Monitor the blood pressure every 2 hours. 4.Review the white blood cell (WBC) count results daily. 1.offer hard candy or gum periodically -Dry mouth is a common side effect of tricyclic antidepressants. Frequent mouth rinsing with water, sucking on hard candy, and chewing gum will alleviate this common side effect.

A client receiving an anxiolytic medication complains that he feels very "faint" when he tries to get out of bed in the morning. The nurse explains to the client that which is a side effect of this type of medication?

1.Postural hypotension 2.Cardiac dysrhythmias 3.Psychosomatic symptoms 4. Respiratory insufficiency 1.postural hypertension

A client in the mental health unit is administered haloperidol (Haldol). What should the nurse check to determine medication effectiveness?

1.The client's vital signs 2.The client's nutritional intake 3.The physical safety of other unit clients 4.The client's orientation and delusional status 4. the clients orientation and delusional status -Haloperidol is used to treat clients exhibiting psychotic features. Therefore, to determine medication effectiveness, the nurse would check the client's orientation and delusional status. Vital signs are routine and not specific to this situation. The physical safety of other clients is not a direct assessment of this client. Monitoring nutritional intake is not related to this situation.

A client taking lithium carbonate (Lithobid) reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus, and tremors. The lithium level is checked as a part of the routine follow-up, and the level is 3.0 mEq/L. The nurse knows that this level is which?

1.Toxic 2.Normal 3.Slightly above normal 4.Excessively below normal 1.Insomnia 2.Weight gain 3.Seizure activity 4.Orthostatic hypotension

The nurse is caring for a client who is receiving lithium carbonate (Lithobid) for the treatment of bipolar disorder and monitors the client for signs of lithium toxicity. Which sign should alert the nurse to the potential for toxicity?

1.Vomiting 2.Headaches 3.Constipation 4.Increased urination vomitting One of the most common early signs of lithium toxicity is the presence of gastrointestinal (GI) disturbances, such as nausea, vomiting, and diarrhea. Options 2, 3, and 4 are unrelated to lithium toxicity.

Disulfiram (Antabuse) is prescribed for a client seen in the psychiatric health care clinic. The nurse is collecting data on the client and is reinforcing instructions regarding the use of this medication. Which is most important for the nurse to determine before administration of this medication?

1.A history of hyperthyroidism 2.A history of diabetes insipidus 3.When the last full meal was consumed 4.When the last alcoholic drink was consumed 4.When the last alcoholic drink was consumed

A client's medication sheet contains a prescription for sertraline hydrochloride (Zoloft). To ensure safe administration of the medication, which action should the nurse take?

1.Administer on an empty stomach. 2.Administer at the same time each evening. 3.Administer evenly spaced around the clock. 4.Administer on an as-needed basis when the client complains of depression. 2.administer at same time each evening -Sertraline is classified as an antidepressant and a selective serotonin reuptake inhibitor. It is generally administered once every 24 hours. It may be administered in the morning or evening, but evening may be preferable because drowsiness is a side effect.

Diphenhydramine hydrochloride (Benadryl) is used in the treatment of allergic rhinitis for a hospitalized client with a chronic psychotic disorder. The client asks the nurse why the medication is being discontinued before hospital discharge. How should the nurse respond correctly to this question?

1.Allergic symptoms are short in duration. 2.This medication promotes long-term extrapyramidal symptoms. 3.Addictive properties are enhanced in the presence of psychotropic medications. 4.Poor compliance causes this medication to fail to reach its therapeutic blood level. 3.Addictive properties are enhanced in the presence of psychotropic medications. -The addictive properties of diphenhydramine hydrochloride are enhanced when used with psychotropic medications. Allergic symptoms may not be short term and will occur if allergens are present in the environment. Poor compliance may be a problem with psychotic clients but is not the subject of the question. Diphenhydramine hydrochloride may be used for extrapyramidal symptoms and mild medication-induced movement disorders.

The nurse is caring for a client who has been admitted for alcohol abuse and knows that which medications may be prescribed in the treatment of this disorder? Select all that apply.

1.Diazepam (Valium) 2.Bupropion (Zyban) 3.Disulfiram (Antabuse) 4.Chlordiazepoxide (Librium) 5.Methadone hydrochloride (Methadone) diazepam, disulfiram , chlordiazepoxide -Medications used in the treatment of alcohol abuse include disulfiram (Antabuse), carbamazepine (Tegretol), acamprosate calcium (Campral), chlordiazepoxide (Librium), phenobarbital (Luminal), quetiapine fumarate (Seroquel), diazepam (Valium), and naltrexone (ReVia). Bupropion (Zyban) is used in the treatment of nicotine addiction and methadone hydrochloride (Methadone) is used in the treatment of opiate addiction.

A client with fibromyalgia has not achieved pain relief with opioid pain medication. The client has a history of diabetes mellitus and atherosclerosis. The nurse anticipates that which single medications may be selected by the health care provider to be given in conjunction with the opioid pain medication? Select all that apply.

1.Duloxetine (Cymbalta) 2.Pregabalin (Lyrica) 3.Alprazolam (Xanax) 4.Imipramine (Tofranil) 5.Amitriptyline (Elavil) Cymbalta, Lyrica, Xanax -Serotonin-norepinephrine reuptake inhibitors (duloxetine) are used for chronic pain disorders, as are certain anticonvulsants (pregabalin) and benzodiazepines (alprazolam). Each of these is used as an adjunct to the opioid medication. Tricyclic antidepressants are also used as adjuncts for chronic pain. However, in this case, the tricyclic antidepressants (imipramine and amitriptyline) are contraindicated because the client has atherosclerosis.

A client with a history of simple partial seizures is taking clorazepate (Tranxene). The client asks the nurse whether there is a risk of addiction. The nurse's response is based on which understanding of clorazepate?

1.Is not habit forming either physically or psychologically 2.Leads to physical tolerance, but only after 10 or more years of therapy 3.Can result in psychological dependence only because of the nature of the medication 4.Leads to physical and psychological dependence with prolonged, high-dose therapy 4.Leads to physical and psychological dependence with prolonged, high-dose therapy -Clorazepate is classified as an anticonvulsant, antianxiety agent, and sedative-hypnotic (benzodiazepine). The medication can lead to physical or psychological dependence when there is prolonged therapy at high doses. For this reason, the amount of medication that is readily available to the client at any one time is restricted. Options 1, 2, and 3 are incorrect.

A client with a psychotic disorder is being treated with haloperidol (Haldol). Which data would indicate the presence of a toxic effect of this medication?

1.Nausea 2.Hypotension 3.Blurred vision 4.Excessive salivation 4.excessive salivation

The nurse is caring for a hospitalized client who has been taking clozapine (Clozaril) for the treatment of a schizophrenic disorder. Which laboratory study prescribed for the client should the nurse specifically review to monitor for an adverse effect associated with the use of this medication?

1.Platelet count 2.Cholesterol level 3.White blood cell count 4.Blood urea nitrogen level White blood cell count

A client receiving a tricyclic antidepressant arrives at the mental health clinic. Which observation indicates that the client is correctly following the medication plan?

1.Reports not going to work for the past week 2.Complains of not being able to "do anything" anymore 3.Arrives at the clinic neat and appropriate in appearance 4.Reports sleeping 12 hours per night and 3 to 4 hours during the day Arrives at the clinic neat and appropriate in appearance

A client has been started on medication therapy with alprazolam (Xanax). When the nurse teaches the client that the medication should not be discontinued abruptly, the client asks why. The nurse should incorporate which information in formulating a reply?

1.The client is likely to suffer irreversible kidney damage. 2.The client is likely to become resistant to medication effects. 3.It will make the medication much less effective if it must be restarted. 4.Rebound central nervous system (CNS) excitation could occur, including seizure activity. Rebound central nervous system (CNS) excitation could occur, including seizure activity. -Alprazolam is a benzodiazepine anxiolytic. The abrupt withdrawal of alprazolam could result in seizure activity from CNS excitation. All clients receiving this medication should be warned of this danger. The other options are incorrect and unrelated to this medication.

A client who is taking lithium carbonate (Lithobid) is scheduled for surgery. The nurse should reinforce what information in the preoperative teaching about this medication?

1.The medication will be discontinued a week before the surgery and resumed 1 week postoperatively. 2.The medication is to be taken until the day of surgery and resumed by injection immediately postoperatively. 3.The medication will be discontinued 1 to 2 days before the surgery and resumed as soon as full oral intake is allowed. 4.The medication will be discontinued several days before surgery and resumed by injection in the immediate postoperative period. The medication will be discontinued 1 to 2 days before the surgery and resumed as soon as full oral intake is allowed.

A client receiving lithium carbonate (Lithobid) complains of loose, watery stools and difficulty walking. The nurse should expect the serum lithium level to be which?

1.0.7 mEq/L 2.1.0 mEq/L 3.1.1 mEq/L 4.1.7 mEq/L 4. 1.7meq/L

A client has begun taking phenelzine (Nardil). At the initiation of therapy, the nurse teaches the client that which items are allowed in the diet?

1.Avocados, figs, and raisins 2.Red wines such as Chianti or sherry 3.Carrots, sweet potatoes, and squash 4.Lunch meats such as bologna or salami carrots sweet potatoes and squash

A client who is on lithium carbonate (Lithobid) will be discharged at the end of the week. In reinforcing a discharge teaching plan, the nurse should include which instructions?

1.Avoid soy sauce, wine, and aged cheese. 2.Have the lithium level checked every week. 3.Take medication only as prescribed because it can become addicting. 4.Check with the psychiatrist before using any over-the-counter (OTC) medications or prescription medications. 4.Check with the psychiatrist before using any over-the-counter (OTC) medications or prescription medications. Lithium is the medication of choice to treat manic-depressive illness. Many OTC medications interact with lithium, and the client is instructed to avoid OTC medications while taking lithium. Lithium is not addicting, and although serum lithium levels need to be monitored, it is not necessary to check these levels every week. A tyramine-free diet is associated with monoamine oxidase inhibitors.

The nurse is performing a follow-up teaching session with a client discharged 1 month ago who is taking fluoxetine (Prozac). Which information should be important for the nurse to gather regarding the adverse effects related to the medication?

1.Cardiovascular symptoms 2.Gastrointestinal dysfunctions 3.Problems with mouth dryness 4.Problems with excessive sweating gastrointestinal dysfunction

A client taking buspirone hydrochloride (BuSpar) for 1 month is scheduled for a follow-up appointment. The nurse gathers data from the client and interprets that the medication is effective if the client reports an absence of which symptom?

1.Delusions 2.Paranoid thoughts 3.Palpitations and anxiety 4.Alcohol withdrawal symptoms Palpitations and anxiety -Buspirone hydrochloride is indicated most often for the treatment of anxiety and aggression. It is not recommended for the treatment of thought disorders (option 1), schizophrenia (option 2), or drug or alcohol withdrawal (option 4).

When teaching a client who is being started on imipramine hydrochloride (Tofranil), when should the nurse tell the client that the medication should have the desired effects?

1.Desired effects start during the first week of administration. 2.Desired effects do not occur for 2 to 3 weeks of administration. 3.Desired effects start immediately following initial administration. 4.Desired effects do not occur until after 2 months of administration. 2.Desired effects do not occur for 2 to 3 weeks of administration.

A client is being treated for depression with amitriptyline hydrochloride. During the initial phases of treatment, which is the most important nursing intervention?

1.Prescribing the client a tyramine-free diet 2.Checking the client for anticholinergic effects 3.Getting baseline postural blood pressures before administering the medication and each time the medication is administered 4.Monitoring blood levels frequently because there is a narrow range between therapeutic and toxic blood levels of this medication 3.Getting baseline postural blood pressures before administering the medication and each time the medication is administered -Amitriptyline hydrochloride is a tricyclic antidepressant often used to treat depression. It causes orthostatic changes and can produce hypotension and tachycardia. This can be frightening to the client and dangerous because it can result in dizziness and client falls.

A client with schizophrenia has been started on medication therapy with loxapine. The nurse determines that the client is experiencing the intended effects of the medication if which client behavior is observed?

1.Presence of fixed stare 2.Absence of delusional statements 3.Decreased appetite and food intake 4.Taking sips of water for dry mouth absence of delusional statements -Loxapine is an antipsychotic medication used to treat psychotic symptoms in clients. Hallucinations, delusions, and altered thought processes are characteristic of this disorder and should decrease with effective treatment. Fixed stare (option 1) and dry mouth (option 4) are side effects of therapy. Option 3 is unrelated to the question.

A client is taking a monoamine oxidase (MAO) inhibitor. The nurse plans care, knowing which information?

1.This classification of medications increases the amount of MAO in the liver. 2.Hypotensive crisis may be precipitated by foods that contain tyramine and tryptophan. 3.Symptomatology of drug toxicity includes headache, hypertension, and nausea and vomiting. 4.Increased salivation, bradycardia, constipation, and mild insomnia are expected side effects. 3.Symptomatology of drug toxicity includes headache, hypertension, and nausea and vomiting. -Headache, hypertension, tachycardia, and nausea and vomiting are precursors to hypertensive crisis. Hypertensive crisis is caused by the ingestion of foods that contain tyramine and tryptophan while a client is taking monoamine oxidase inhibitors. These medications act by decreasing the amount of monoamine oxidase in the liver, which is necessary for the breakdown and utilization of tyramine and tryptophan. Hypertensive crisis may lead to circulatory collapse, intracranial hemorrhage, and death. The identified side effects do not relate to the classification of medications.

A nursing student is assigned to care for a client with a diagnosis of schizophrenia. Haloperidol (Haldol) is prescribed for the client, and the nursing instructor asks the student to describe the action of the medication. Which statement by the nursing student indicates an understanding of the action of this medication?

1.It is a serotonin reuptake blocker. 2.It inhibits the breakdown of released acetylcholine. 3.It blocks the uptake of norepinephrine and serotonin. 4.It blocks the binding of dopamine to the postsynaptic dopamine receptors in the brain. It blocks the binding of dopamine to the postsynaptic dopamine receptors in the brain.

A client is receiving a daily dose of oral fluphenazine. The nurse should reinforce instructions to the client to practice which intervention to minimize common side effects of this medication?

1.Monitor pulse daily. 2.Eat snacks at mid morning and bedtime. 3.Use hard, sour candy or sugarless gum. 4.Have blood pressure checked once a week. use hard,sour candy or sugarless gum -Fluphenazine is classified as an antidepressant and a selective serotonin reuptake inhibitor. Dry mouth is a common side effect. Frequent mouth rinsing with water, sucking on hard candy, and chewing sugarless gum will alleviate this common side effect

A client taking buspirone (BuSpar) for 1 month returns to the clinic for a follow-up visit. Which should indicate medication effectiveness?

1.No rapid heartbeats or anxiety 2.No paranoid thought processes 3.No thought broadcasting or delusions 4.No reports of alcohol withdrawal symptoms 4.No reports of alcohol withdrawal symptoms