Psychiatric Medications

The nurse is caring for a mental health client who has been prescribed a benzodiazepine called chlorazapate. Which are the principal indications for this medication? Select all that apply.

1.Anxiety 2.Insomnia 3.Seizure disorders 4.Alcohol withdrawal

The nurse is reinforcing medication discharge instructions for a client who has just begun taking isocarboxazid 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 3.Bologna

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

1.Dementia

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 primary health care provider to be given in conjunction with the opioid pain medication? Select all that apply.

1.Duloxetine 2.Pregabalin 3.Alprazolam

A hospitalized client is prescribed phenelzine sulfate 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 4.Aged cheese

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

1.No rapid heartbeats or anxiety

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.

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 side effect is associated with this type of medication?

1.Postural hypotension

A client receiving long-term therapy with lithium carbonate has a toxic serum lithium level of 1.5 and 2 mEq/L. Which organ functions are the major long-term risk factors? Select all that apply.

1.Renal function 3.Thyroid function

A client is receiving lithium carbonate. The client's lithium carbonate level is 1.5 mEq/L, which indicates an early sign of toxicity. Which are some early signs/symptoms of toxicity? Select all that apply.

1.Slurred speech 2.Muscle weakness 3.Lethargy 0.7 mEq/L 4.Diarrhea 1.0 mEq/L

A client taking lithium carbonate 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 (3.0 mmol/L). The nurse knows that this is which level?

1.Toxic

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

1.Vomiting

A hospitalized client is started on phenelzine sulfate for the treatment of depression. At lunchtime, a tray is delivered to the client. Which food item on the tray should the nurse remove?

1.Yogurt

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?

2.Absence of delusional statements

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

2.Administer at the same time each evening.

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

2.Desired effects do not occur for 2 to 3 weeks of administration.

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

2.Diarrhea 4.Abdominal pain 5.Increased blood pressure

An older mental health client diagnosed with chronic neuropathic pain is starting therapy with a tricyclic antidepressant called imipramine hydrochloride. The client is complaining of constipation. The nurse knows that which signs/symptoms are other adverse effects of this medication? Select all that apply.

2.Dry mouth 3.Drowsiness 5.Acute confusion 6.Urinary retention

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

2.Gastrointestinal dysfunctions

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

3."I should take the medication in the morning when I first arise."

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

3.Arrives at the clinic neat and appropriate in appearance

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

3.Carrots, sweet potatoes, and squash

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

3.Getting baseline postural blood pressures before administering the medication and each time the medication is administered

A client taking buspirone hydrochloride 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 sign/symptom?

3.Palpitations and anxiety

A client arrives at the health care clinic and tells the nurse that they have been doubling their daily dosage of bupropion hydrochloride to help them get better faster. The nurse understands that the client is now at risk for which problem?

3.Seizure activity

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

3.Symptomatology of MAO toxicity includes headache, hypertension, and nausea and vomiting.

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

3.The medication will be discontinued 1 to 2 days before the surgery and resumed as soon as full oral intake is allowed.

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?

3.Use hard, sour candy or sugarless gum.

A hospitalized client is taking clozapine 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?

3.White blood cell count

Fluoxetine hydrochloride 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?

4."It takes approximately 2 to 4 weeks before improvement is noted."

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

4.Check with the psychiatrist before using any over-the-counter (OTC) medications or prescription medications.

A client admitted to the hospital gives the nurse a bottle of clomipramine. 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?

4.Frequent hand washing with hot, soapy water

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

4.Hyperpyrexia

A nursing student is assigned to care for a client with a diagnosis of schizophrenia. Haloperidol 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?

4.It blocks the binding of dopamine to the postsynaptic dopamine receptors in the brain.

A client has been started on medication therapy with alprazolam. 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?

4.Rebound central nervous system (CNS) excitation could occur, including seizure activity.

A client in the mental health unit is administered haloperidol. What should the nurse check to determine its effectiveness?

4.The client's orientation and delusional status

Disulfiram is prescribed for a client and 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?

4.When the last alcoholic drink was consumed

The nurse is caring for a client on the mental health unit who has been declared incompetent through a formal legal proceeding. A guardian has been appointed. The nurse knows that guardians are typically selected from among family members. From the list of family members, what is the order of selection of a guardian for this client? List in descending order of importance from the first to the last choice. All options must be used.

Spouse Adult children or grandchildren Parents Adult siblings Adult nieces and nephews

A client has a history of seizures. The primary 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?

2.Decreased seizure threshold

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 3.Disulfiram 4.Chlordiazepoxide