Davis Edge Psychopharmacology CH 4 Questions

A client is prescribed zolpidem 5 mg by mouth; however, only 10 mg tablets of zolpidem are currently available. How many tablets will the nurse administer? Enter the numeral only.

0.5

Based on a 2015 Food and Drug Administration (FDA) law, which is required to be placed on a label for psychotropic medications to protect women of childbearing age? Select all that apply. 1. Pregnancy-associated risks 2. Dietary interactions 3. Risks of cancer 4. Lactation considerations 5. Reproductive potential

1, 4, 5

The nurse is teaching a client with attention-deficit-hyperactivity disorder (ADHD) taking atomoxetine about lifestyle changes. Which statement indicates a need for further teaching? 1. "I am going to take my medication in the morning so I am not awake all night." 2. "I am switching from diet cola to tea since it is better for me." 3. "I am taking oral contraceptives so I don't get pregnant while taking this medication." 4. "I am checking my blood pressure and heart rate before and after working out to make sure it doesn't get too high."

2 (This statement requires further teaching. Both diet cola and tea have caffeine, and caffeine should be avoided)

The nurse is caring for a client who is receiving venlafaxine and begins to develop restlessness, confusion, rapid heart rate, and muscle rigidity. Which additional medication can the nurse expect to find in the client's medication history? 1. Methylphenidate 2. Trazodone 3. Lithium 4. Zolpidem

2 (Venlafaxine, when taken concurrently with trazodone, can lead to serotonin syndrome)

Which medications from other classes have been known to relieve anxiety? Select all that apply. 1. ACE inhibitors 2. Antidepressants 3. Antihistamines 4. Narcotics 5. Antipsychotics

2, 3

Which statements made by the client indicate effectiveness of sedative-hypnotic therapy? Select all that apply. 1. "I am able to fall asleep within 2 hours of taking my medication and stay asleep for 5 hours." 2. "I have not experienced any periods of confusion while taking the medication." 3. "I feel more energized during the day since I've been taking this medication." 4. "I fell asleep in class this morning, so I may need to cut back on my medication." 5. "I was able to participate in my intramural football game this afternoon."

2, 3, 5

Which topics would the nurse include when educating the client about antipsychotics? Select all that apply. 1. Avoiding weight gain 2. Avoiding alcohol 3. Smoking cessation 4. Avoiding dressing too warmly in cool weather 5. Notifying the health-care provider of all medications taken

2, 3, 5

The nurse is administering sedative-hypnotics to a group of clients. For which clients would the nurse question the administration of this class of medications? Select all that apply. 1. A client with diabetes 2. A client with asthma 3. A client with anxiety 4. A client with cirrhosis 5. A client with congestive heart failure

2, 4, 5

The nurse is reviewing the laboratory results for a client who has been taking lithium for the past year. The nurse notes the lithium levels are 1.6 mEq/L. Which action should the nurse take? 1. Administer half of the scheduled dose 2. Document the result and administer the dose 3. Hold the dose and notify the health-care provider 4. Administer an additional dose of the lithium

3 (This is a correct action for the nurse to take; the nurse should hold the dose and notify the health-care provider. Normal maintenance lithium levels are 0.6 to 1.2 mEq/L. A level of 1.6mEq/L is too high)

Which statement made by the student nurse indicates a need for further teaching regarding psychotropic medications? 1. "Psychotropic medications can help reduce physical symptoms." 2. "Mental health practitioners prescribe psychotropic medications in adjunct to therapy." 3. "Psychotropic medications are prescribed to completely eliminate mental illness." 4. "Behavioral symptoms are minimized with psychotropic medications."

3 (This statement is inaccurate and indicates a need for further teaching. There is no cure for mental illness)

Which are symptoms of central nervous system (CNS) stimulants? Select all that apply. 1. Constricted pupils 2. Mental sluggishness 3. Increased energy 4. Respiratory stimulation 5. Increased motor activity

3, 4, 5

The nurse is reviewing laboratory values for a client receiving clozapine. Which absolute neutrophil count (ANC) value would be of most concern to the nurse? 1. 4000 µL 2. 1500 µL 3. 800 µL 4. 300 µL

4 (An ANC less than 500 µL is indicative of neutropenia, which can be fatal. This ANC level is most concerning)

The nurse is caring for a client who has been receiving treatment for anxiety for 6 months. Which medication can the nurse expect to administer to the client? 1. Clonazepam 2. Buspirone 3. Alprazolam 4. Sertraline

4 (Antidepressants should be administered for long-term treatment of anxiety. Sertraline is an antidepressant)

The nurse is reviewing orders for a client with depression who smokes and wants to quit. Which medication can the nurse expect to administer? 1. Sertraline 2. Amitriptyline 3. Venlafaxine 4. Bupropion

4 (Bupropion is used for depression and smoking cessation)

Which client is at greatest risk for side effects associated with antipsychotic agents? 1. A 26-year-old 2. A 37-year-old 3. A 52-year-old 4. A 74-year-old

4 (Elderly clients are at highest risk for side effects associated with antipsychotic agents)

The nurse is reviewing orders for a client with hallucinations associated with Parkinson disease psychosis. Which medication can the nurse expect to administer? 1. Clozapine 2. Risperidone 3. Haloperidol 4. Pimavanserin

4 (Pimavanserin is indicated for the treatment of hallucinations and delusions associated with Parkinson disease psychosis)

Which medication is prescribed as the first line of treatment for depression? 1. Bupropion 2. Phenelzine 3. Amitriptyline 4. Sertraline

4 (Selective serotonin reuptake inhibitors and serotonin/norepinephrine reuptake inhibitors are the preferred first-line treatments for depression)

Which statement made by the client taking sedative-hypnotics would be of most concern to the nurse? 1. "I picked up my colleague and we attended a retirement party for my boss last night." 2. "I prepared a new seafood recipe for my family for dinner last night." 3. "I called my mom yesterday, and she is planning to come for a visit." 4. "I woke up to find multiple bags of groceries on my table, but I have no memory of going to the store."

4 (This behavior requires careful and immediate evaluation. The nurse should notify the health-care provider immediately)

Which statement made by the student nurse indicates an appropriate understanding of diet restrictions in clients receiving monoamine oxidase inhibitors (MAOI)? 1. "A glass of red wine each evening is good for my client." 2. "My client should eat a lot of bananas since they take furosemide." 3. "I have instructed my client to eat a lot of yogurt to reduce the risk of yeast infections." 4. "My client is upset they can only drink coffee occasionally."

4 (This statement indicates an understanding of dietary restrictions while on MAOI therapy; coffee, tea, and soda can only be consumed occasionally)

The nurse is preparing to administer 0.25 mg triazolam by mouth to a client; however, only 0.125 mg tablets of triazolam are available. How many tablets will the nurse administer? Enter the numeral only.

2

The nurse should monitor for which side effect in the client who recently began taking an antidepressant? 1. Diarrhea 2. Increase in energy 3. Increased salivation 4. Polyphagia

2 (As antidepressants begin to take effect, the client may have an increase in energy with which to implement a plan of suicide. The nurse should monitor the client for this increase of energy)

The nurse is teaching a parent of a child about antidepressants. Which is most important to include in the teaching? 1. Monitoring their child for statements or thoughts of suicidal ideation 2. Sucking on hard candy to eliminate dry mouth and nausea 3. Drinking plenty of water to reduce risk of constipation 4. Taking medication at night to decrease risk of daytime sedation

1 (Antidepressants carry a black-box warning for an increased risk of suicidal ideation in children and adolescents. It is important to notify the parents of this warning)

The nurse is caring for an older adult who is not responding to treatment with an antidepressant. Which medication can the nurse expect the health-care provider to prescribe? 1. Quetiapine 2. Bupropion 3. Fluoxetine 4. Imipramine

1 (Aripiprazole and quetiapine are used as adjunct therapy to antidepressants, especially for older adults who do not typically respond to antidepressants alone)

For which client would the nurse question an order for haloperidol? 1. A client with congestive heart failure 2. A client with hallucinations 3. A client with hypothyroidism 4. A client with sinusitis

1 (Haloperidol is contraindicated in a client with cardiac insufficiency)

The nurse is caring for a client with schizophrenia who is receiving risperidone. Which symptom, if developed by the client, would warrant immediate notification of the health-care provider? 1. Jerking of the head 2. Dry mouth 3. Fatigue 4. Nausea

1 (Jerking of the head is an extrapyramidal effect, which can last long after discontinuing the medication. This is a priority concern and requires immediate notification of the HCP)

The nurse is evaluating the effectiveness of therapy of mood-stabilizing agents. Which criterion indicates therapy has been effective? 1. The client reports no harm of self or others. 2. The client has a blood pressure of 86/42. 3. The client has gained 4 pounds. 4. The client reports excessive hyperactivity.

1 (Report of no harm of self or others indicates effectiveness of therapy)

Which statement made by the client indicates further teaching about buspirone is required? 1. "I will feel much better within 2 days." 2. "I won't be as groggy as I was on the alprazolam." 3. "This drug is a good choice for me since I used to be an addict." 4. "I can take this for short-term relief of anxiety."

1 (This statement requires further teaching. This medication takes 7 to 10 days to achieve a full therapeutic effect)

The nurse should teach the client to expect which side effect while taking lithium for a mood disorder? 1. Weight gain 2. Nausea 3. Sedation 4. Dizziness

1 (Weight gain is an undesirable side effect of lithium which should be monitored. The nurse should teach the client about low-calorie diets while educating the client about not making changes in sodium intake due to its effect on lithium levels)

The nurse is caring for a client who takes a monoamine oxidase inhibitor (MAOI). Which foods that appear in the client's 24-hour dietary recall indicate a need for further nutritional teaching? Select all that apply. 1. Blue cheese 2. Raisins 3. Pepperoni 4. Caviar 5. Grilled chicken

1, 2, 3, 4 (Each contains tyramine, which is contraindicated in MAOI use)

For which symptoms should the nurse monitor the older adult while taking clonazepam? Select all that apply. 1. Difficulty dressing 2. Slurred speech 3. Increase in cognitive function 4. Paradoxical increase in anxiety 5. Difficulty walking

1, 2, 4, 5 (All A/E of benzodiazepines)

The nurse is caring for a client receiving clozapine. Which symptoms, if reported by the client, would be of concern to the nurse? Select all that apply. 1. Sore throat 2. Dry mouth 3. Weight gain 4. Fever 5. Malaise

1, 4, 5

The nurse is assessing a client who is receiving haloperidol for symptoms of schizophrenia. Which effects would be of most concern to the nurse? Select all that apply. 1. Lip smacking 2. Dry mouth 3. Nausea 4. Tremor 5. Dystonia

1, 4, 5 (Tardive dyskinesia is a side effect that can be permanent and is a priority for the nurse, Parkinsonian symptoms are side effects which can be permanent and should be a priority for the nurse, Extrapyramidal side effects can be permanent and are a priority for the nurse)

A client is prescribed temazepam 15 mg. Only 7.5 mg tablets are available. How many tablets will the nurse administer? Enter the numeral only.

2

The nurse is assessing a client who develops tardive dyskinesia. Which medication does the nurse expect this client to be receiving? 1. Alprazolam 2. Haloperidol 3. Zolpidem 4. Dexmethylphenidate

2 (Haloperidol causes EPS)

Which is most likely to affect the client's ability to adhere to a medication regimen? 1. Effectiveness of medication 2. Side effects 3. Client's Schedule 4. Family support

2 (If a medication has side effects, this could affect a client's likelihood of adhering to the medication regime. A client may discontinue the medication with or without telling the health-care provider)

The nurse is reviewing orders for a client receiving zolpidem for sleep. Which order is most important for the nurse to clarify with the health-care provider? 1. Flumazenil 2. Amiodarone 3. Rifampin 4. Ritonavir

2 (Life-threatening arrhythmias can occur with concomitant use of amiodarone with zolpidem. The nurse should seek clarification with the health-care provider as soon as possible)

Methylphenidate would be contraindicated for a client with which condition? 1. A client with hypothyroidism 2. A client with hypertension 3. A client with diabetes 4. A client with arthritis

2 (Methylphenidate is contraindicated in clients with hypertension because it can cause an elevation in blood pressure and heart rate)

The nurse is reviewing orders for a client who has been prescribed a medication that is used to treat anxiety. The medication is also used to treat hypertension. Which medication has the client been prescribed? 1. Topiramate 2. Propranolol 3. Hydroxyzine 4. Disulfiram

2 (Propranolol is a beta blocker used to treat hypertension and also prescribed to treat anxiety)

Which sedative-hypnotic would be a preferred option for individuals at risk for developing physical dependence? 1. Zolpidem 2. Ramelteon 3. Triazolam 4. Temazepam

2 (Ramelteon is not a controlled substance and does not produce tolerance of physical dependence)

A client receiving alprazolam calls the clinic and reports a temperature of 102.6°F, sore throat, and bruising. Which action should the nurse take? 1. Instruct the client to take the medication as ordered 2. Tell the client to hold the medication and come to the clinic 3. Instruct the client to drink plenty of fluids and rest 4. Call an antibiotic in for the client

2 (The client is likely experiencing blood dyscrasias; the nurse should instruct the client to hold the medication and come to the clinic to see the health-care provider to treat the underlying cause).

Who is responsible for evaluating the effectiveness of psychotropic medications? 1. The client 2. The nurse 3. The social worker 4. The therapist

2 (The nurse is responsible for evaluating the effectiveness of psychotropic medications)

The nurse would prepare to administer a selective serotonin reuptake inhibitor (SSRI) to a client with which condition? 1. Schizophrenia 2. Bulimia 3. Attention-deficit-hyperactivity disorder (ADHD) 4. Post-traumatic stress disorder (PTSD)

2 (The nurse would administer an SSRI to a client with an eating disorder)

The nurse notes a client receiving risperidone is exhibiting dystonia. Which medication would the nurse prepare to administer? 1. Levodopa 2. Benztropine 3. Valbenazine 4. Deutetrabenazine

2 (This medication is used to treat dystonia and is given through intramuscular or intravenous routes)

Which statement made by the student nurse indicates the need for further teaching regarding monoamine oxidase inhibitors (MAOI)? 1. "MAOIs were the first medication used to treat depression." 2. "There are few drug interactions with MAOIs, making them very safe." 3. "MAOIs were first used to treat tuberculosis." 4. "Clients should avoid eating aged cheese while taking MAOIs."

2 (This statement requires further teaching. MAOIs were found to have several serious interactions with other drugs)

Which method most effectively determines the efficacy of dexmethylphenidate and the need to continue its use? 1. Review of symptoms 2. Assessment from a teacher 3. A drug holiday 4. Observing the client for an hour

3 (A drug holiday should be attempted periodically to determine the effectiveness and need to continue a medication. This method is most effective to watch a child without the medication to see if he or she truly needs to be on the medication and if it was effective)

Which classification of medications is used to treat narcolepsy and exogenous obesity? 1. Antipsychotics 2. Tricyclic Antidepressants 3. Amphetamines 4. Sedative-hypnotics

3 (Amphetamines are used to treat narcolepsy, exogenous obesity, and attention-deficit-hyperactivity disorder)

The nurse is reviewing orders for a client who is prescribed sertraline for depression and an atypical antipsychotic medication as adjunct therapy. Which medication can the nurse expect to administer? 1. Lithium 2. Alprazolam 3. Aripiprazole 4. Methylphenidate

3 (Aripiprazole and quetiapine are prescribed as adjunctive therapy to antidepressants)

The nurse is preparing to administer bupropion to a client. Which disorder would cause the nurse to hold the medication and notify the health-care provider? 1. Diabetes 2. Anxiety 3. Epilepsy 4. Asthma

3 (Bupropion is contraindicated in clients with seizure disorders; the nurse should not administer the medication and would notify the health-care provider)

The nurse is monitoring ANC levels in a client receiving clozapine. Which client would the nurse expect to have lower than normal ANC levels? 1. A Caucasian male 2. An Asian male 3. An African American male 4. A Hispanic male

3 (Dark-skinned individuals have lower than normal ANC levels. This makes it difficult to identify clinically significant neutropenia)

The nurse would question which order for a 13-year-old client? 1. Methylphenidate 2. Sertraline 3. Flurazepam 4. Lithium

3 (Flurazepam is a sedative hypnotic, and it is contraindicated in clients younger than 15)

The nurse should educate the client receiving lithium about maintaining intake of which electrolyte? 1. Potassium 2. Calcium 3. Sodium 4. Magnesium

3 (Lithium is a salt and is affected by a change in sodium intake. The client should be instructed to maintain normal sodium intake)

The nurse is evaluating the effectiveness of antidepressant therapy for a male client with depression. How does the nurse know therapy has been effective? 1. The client avoids making decisions. 2. The client expresses that he thinks therapy will never help. 3. The client plays bingo twice per week with his friends. 4. The client does not brush his teeth.

3 (Participation in social activities indicates therapy has been effective)

The nurse is caring for a client who is being treated with a tricyclic antidepressant. For which symptom should the nurse monitor the client 1. Weight loss 2. Bradycardia 3. Postural hypotension 4. Diarrhea

3 (Postural hypotension is a commonly seen in clients being treated with tricyclic antidepressants)

A client receiving a selective serotonin reuptake inhibitor for depression reports sedation. When should the nurse instruct the client to take the medication to prevent this side effect? 1. Before breakfast 2. After lunch 3. At bedtime 4. After a late-morning snack

3 (Taking this medication at bedtime will prevent the somnolent effects that occur when taken during the day)

The nurse is caring for a client who is taking risperidone and begins to develop oculogyric crisis. Which action should the nurse take? 1. Document the finding as normal 2. Administer the risperidone 3. Notify the health-care provider 4. Prepare to administer valbenazine

3 (The health-care provider should be notified immediately)

The client tells the nurse he is experiencing impotence while taking an antidepressant. Which statement by the nurse is appropriate? 1. "Stop taking the medication since it is interfering with your sex life." 2. "It is your decision, but you should probably keep taking the medication so you do not become depressed." 3. "Keep taking the medication for now, and I will talk to the health-care provider about trying a different medication." 4. "The health-care provider would want you to stop taking the medication immediately; once it is out of your system, we can try something else."

3 (This response is appropriate; the client should not stop taking the medication abruptly to avoid worsening depression symptoms. This statement also addresses the client's concern over experiencing impotence)

Which statement made by the client indicates a need for further teaching regarding lithium? 1. "I may not notice a change in my mood for at least 7 to 10 days." 2. "I will need to have blood testing periodically while taking this medication." 3. "I should increase my sodium intake while taking lithium." 4. "I need to let my doctor know of any other medications I am taking."

3 (This statement indicates a need for further teaching; sodium intake should be maintained as normal. If sodium intake is increased, lithium effectiveness will be reduced)

The nurse is teaching a client about clozapine. Which statement indicates a need for further teaching? 1. "I should chew sugar-free gum because I may experience excessive salivation." 2. "I will need to stop smoking because it can decrease the effect of the clozapine." 3. "Clozapine is safe to take during pregnancy, so it is OK for me to continue to try to get pregnant." 4. "I told my doctor every over-the-counter medication I am taking to be sure it doesn't interact with clozapine."

3 (This statement requires further teaching. Safe use during pregnancy has not been established. Clozapine is thought to affect the fetus, so clients are advised of risk during pregnancy)

The nurse is assessing a client who is receiving dexmethylphenidate. Which statement made by the client would be of most concern to the nurse? 1. "I can tell you what the movie I watched last night was about." 2. "I take the medication in the morning so I can sleep better at night." 3. "I haven't been hungry since I started taking this medication." 4. "I am sucking on hard candy because sometimes I get a little nauseated."

3 (This statement should cause the nurse concern; the client may not be eating since he or she is not hungry)

The nurse is providing education to a client who will be discharged with a prescription for methylphenidate. Which information should the nurse include in the teaching? Select all that apply. 1. Take the medication before meals 2. Administer the last dose at least 1 hour before bedtime 3. Keep stimuli low and environment quiet 4. Do not stop taking medication abruptly 5. Avoid consumption of large amounts of caffeine

3, 4, 5

Which atypical third-generation antipsychotic is prescribed because of minimal risk of extrapyramidal effects? 1. Haloperidol 2. Clozapine 3. Pimozide 4. Aripiprazole

4 (Aripiprazole is a third-generation atypical antipsychotic prescribed because it has minimal risk of extrapyramidal effects)

A client is receiving atomoxetine to treat attention-deficit-hyperactivity disorder. Which symptom should be reported to the health-care provider immediately? 1. Constipation 2. Dilated pupils 3. Nausea 4. Dark urine

4 (Dark urine is a sign of liver damage in a client taking atomoxetine and should be reported immediately)

The nurse is reviewing laboratory values for a client with acute mania receiving lithium. The lithium levels are 1.3 mEq/L. Which action should the nurse take based on these values? 1. Administer half of the ordered dose of lithium 2. Administer an additional dose of lithium 3. Hold the lithium and notify the health-care provider 4. Document the laboratory values and administer the lithiumThe nurse is reviewing orders for a client with hallucinations associated with Parkinson disease psychosis. Which medication can the nurse expect to administer?

4 (The normal range of lithium levels for a client in acute mania is 1.0 to 1.5 mEq/L. A level of 1.3 mEq/L is within normal range, so the nurse should document the laboratory values and administer the lithium as ordered)