psych rx quiz 1&2

A client with bipolar disorder, having experienced a depressive episode, is prescribed lamotrigine. After educating the client on this medication, the nurse determines that the education was successful when the client states which of the following?

"I need to notify my physician if I develop a skin rash"

Research has shown that risk of suicide increases within which time frame for initiation of antidepressant therapy?

14 days

The prescription of clozapine (Clozaril) requires weekly blood samples for which of the following time frames?

6 months

The nurse is caring for a client who has been taking clozapine (Clozaril) for two weeks. The client tells the nurse, "My throat is sore, and I feel weak." The nurse assesses the client's vital signs and finds that the client has a fever. The nurse notifies the physician, expecting an order to obtain which laboratory test?

a white blood cell count

A client who has been taking clozapine for six weeks visits the clinic complaining of fever, sore throat, and mouth sores. The nurse notifies the client's physician because the nurse suspects which of the following?

agranulocytosis

A client is seen in the clinic with clinical manifestations of an inability to sit still and a rigid posture. As the nurse performs the assessment, which of these side effects would be correctly identified?

akathisia

The nurse is teaching on the effects of antipsychotic medications to the client and family. Which disorders are extrapyramidal symptoms that may be caused by antipsychotic drugs?

akathisia pseudoparkonsonism dystonia

A major difference between the atypical antipsychotics (such as Clozapine) and the typical antipsychotics (such as Haldol) is what?

atypical antipsychotics block both serotonin and dopaminergic receptors

A client is diagnosed with neuroleptic malignant syndrome and is prescribed medication. Which agent would the nurse anticipate being prescribed?

benzodiazepine

The nurse is caring for a client receiving a tricyclic antidepressant and is monitoring for anticholinergic side effects. Anticholinergic effects include which of the following?

blurred vision

Extrapyramidal side effects are characterized by a triad of symptoms, including which of the following?

dystonia, akathisia, psuedoparkinsonism

A client is being released from the inpatient psychiatric unit with a diagnosis of schizophrenia and treatment with antipsychotic medications. After teaching the client and family about managing the disorder, the nurse determines that the education was effective when they state that which should be reported immediately?

elevated temperature

Which of the following is considered a first-generation antipsychotic drug used to treat psychosis in the United States?

fluphenazine

The nurse knows that long-acting antipsychotics can increase adherence but also knows that certain precautions in administering these drugs must be taken. What are some nursing interventions for the administration of 25 mg (1mL) of Fluphenzaine Decanoate, IM.

give medication by the z track method using a dry needle document rotation sites in the clients chart

A client with schizoaffective disorder is prescribed lithium. The nurse is reviewing the client's medication history. Which of the following, if noted by the nurse, would alert the nurse to a potential problem?

haloperidol ibuprofen furosemide quinipril

An elderly female resident in the nursing home has begun to suspect that her food is poisoned and no amount of reasoning has been able to get her to believe otherwise. The nurse notes that the resident is losing weight and has become combative. The nurse is concerned about her nutritional status and increasing safety issues regarding other residents and staff. After talking with the physician about this situation, which antipsychotic medication might be prescribed.

quietapine(seroquel) 5mg/day

A client is being seen in the mental health clinic. The client has been on haloperidol for 8 months and is now exhibiting tongue protrusion, lip smacking, and rapid eye blinking. A nurse would document this chronic syndrome as:

tardive dyskinesia

The psychiatric nurse is preparing to provide a client newly diagnosed with schizophrenia with information regarding his atypical antipsychotic medication, risperidone (Risperdal). The nurse includes which information?

the status of his liver function will need to be evaluated regularly while he is on the medication the medication will help with both positive and negative symptoms he is experiencing avoid changing position quickly, especially in the first weeks of treatment- you may feel dizzy

A client will be discharged on lithium carbonate 600 mg three times daily. When teaching the client and his family about lithium therapy, the nurse determines that teaching has been effective if the client and family state that they will notify the prescribing health care provider (HCP) immediately which symptoms?

muscle weakness vertigo vomiting

A client with schizoaffective disorder is prescribed clozapine. The nurse understands that in addition to the drug's antipsychotic effects, it is also effective in which of the following

reducing the risk for suicide

A client with a long history of schizophrenia has managed well on trifluoperazine (Stelazine). She calls her case manager to report that she keeps feeling like she wants to stick out her tongue and stare up at the ceiling. The nurse interprets the client's comments to mean she has which of the following?

signs of tardive dyskinesia associated with neuroleptic medication

A client is in the acute phase of mania and is receiving lithium. Which of the following blood levels of lithium is within the therapeutic range for acute mania?

0.9 mEq/L

A client has been taking olanzapine (Zyprexa) for a year, and is seen for follow-up in the doctor's office. He has experienced a weight gain of 20 (twenty) pounds and gained 3 inches on his waist circumference. What would the nurse anticipate that the primary care provider would do?

client will be started on a typical(conventional) antipsychotic medication

A client who is taking lithium carbonate is going home on a 3-day pass. What is the best health teaching the nurse should provide for this client?

continue to maintain normal sodium intake while at home

A client hospitalized for treatment of schizophrenia has been receiving olanzapine (Zyprexa) for the past two months. The nurse would be especially alert for which of the following?

diabetes

A client is receiving lithium carbonate for a bipolar disorder. The nurse is aware that early signs of lithium toxicity include which of the following?

diarrhea

The nurse is reviewing the laboratory report with the client's lithium level prior to administering the 1700 hours dose. The lithium level is 1.8 mEq/L (1.8 mmol/L). The nurse should:

hold the 1700 dose of lithium

A client taking an antipsychotic is exhibiting manifestations of neuroleptic malignant syndrome (NMS). Which area of the brain is involved with the increased temperature noted with NMS?

hypothalamus

Which psychotropic medication is administered based on an individualized dosage according to blood levels of the drug?

lithium carbonate

When administering an antipsychotic medication to a female client diagnosed with schizophrenia, the nurse should do which of the following? Select all that apply.

monitors the client for neuroleptic malignant syndrome for up to 2 months after initiating treatment encourages the client to use an effective form of birth contol advises the clinet to report skin rashes to he physician immediately use the abnormal involuntary movement scale to collect baseline information

A client is being seen in the health clinic. The nurse observes a shuffling gait, drooling, and slowness of movement. The client is currently taking an antipsychotic for treatment of schizophrenia. The nurse knows that which of the following side effects is occurring?

pseudoparkinsonism

A client with depression is prescribed fluoxetine. On a return visit to the clinic, the client tells the nurse that he also just started taking St. John's wort to feel better. The nurse assesses the client for which of the following?

serotonin syndrome

A client is taking paroxetine 20 mg PO every morning. The nurse should monitor the client for which adverse effect?

sexual problems

A client who has been discharged home on Celexa (citalopram) calls the nurse complaining that the medication causes her to feel too drowsy. The nurse should make which of the following suggestions?

try taking the medication at night

It is important for the client in acute mania, receiving lithium, to obtain blood levels within which time frame?

twice weekly

Which of the following side effects of lithium are frequent causes of noncompliance? Select all that apply.

weight gain lethargy

A client comes to the emergency department complaining of a severe pounding headache in the temples and a stiff neck. The client is flushed and diaphoretic, and his pulse is racing. The client states that he is being treated for depression with Selegiline (Anaprynyl). Which question by the nurse would be most important to ask at this time?

what have you had to eat or drink today?

A client has been prescribed clozapine for treatment of schizophrenia. Which of the following would the nurse include in the education plan for this client and family?

"you may experience noticeable weight gain while taking this medication"

A client receiving an antipsychotic agent develops acute extrapyramidal symptoms. Which response by the nurse would be most appropriate?

"these are results of the drug that can be treated; your illness is not getting worse"

Which of the following is an anticonvulsant that is often used as a mood stabilizer?

divalproex(depakote)

After administering 25 mg Risperdal Consta in the upper right quadrant of the gluteous, during a home visit , what does the nurse remind the client to do before leaving the home?

don't forget to walk around so that your medication is well absorbed

Antipsychotics work by blocking receptors of which neurotransmitter?

dopamine

Medications are not often used for a person with delusional disorder, but which of the following medication classifications are helpful during exacerbations?

antipsychotics benzodiazepines

A client with paranoid delusions and aggressive behavior has been administered Haloperidol (Haldol). The nurse finds that after administering the drug, the client has started having jerky and involuntary movements of the head and arms. Which drug should the nurse expect to be ordered for this client?

benztropine mesylate(cogentin)

A client is receiving lithium carbonate for a bipolar disorder. Assessment reveals dry mouth, nausea, thirst, and mild hand tremor. Based on analysis of these findings, what should the nurse do next?

continue the lithium and reassure the client that these temporary side effects will subside

A nurse knows that which of the following statements are true about atypical antipsychotic medications?

incidence of EPS are reduced with atypical antipsychotics, however they may still occur atypical antipsychotics can contribute to seizures and hyperprolactimia atypicals antipsychotics have marked decreased risk of long term irreversible side effects

A female client at the community center has been taking an Haloperidol (Haldol) 10 mg, bid for over ten years. A report from the lab shows that her Haldol blood level is 10 ng/mL. She shows the nurse some spots on her face that appear to be deep orange, but she doesn't seem concerned about them because they are painless. What intervention is best?

reinforce teaching about sun exposure and encourage her to get an eye examination

A female client is brought to the emergency department by her brother, who reports that she became very agitated and "started hallucinating." Further assessment reveals tachycardia, incoordination, vomiting, and diarrhea. The brother states that his sister is taking paroxetine for depression. Which of the following would the nurse most likely suspect?

serotonin syndrome

Fluoxetine includes a black box warning concerning which of the following?

suicidality in children

in planning for a client's discharge, the nurse must know that the most serious risk for the client taking a tricyclic antidepressant is which of the following?

suicide by overdose

A nurse administers an antiparkinson agent (benztropine 1-2 mg QID) to a client who has been taking an antipsychotic medication. What indications from the client, led the nurse to take this action?

the client said, "nurse, look at this twitching in my face"