MH Psychopharmacology Questions

The nurse refers a client with severe anxiety to a psychiatrist for medication evaluation. The physician is most likely to prescribe which psychotropic drug regimen on a short-term basis?

a. Alprazolam 0.25 mg orally three times per day

The nurse reinforces teaching for a client who will begin taking fluoxetine. Which of the following should be included in the teaching?

a. Expect to start feeling better in about 2-4 weeks.

Fluoxetine is prescribed for a client with depression. The nurse recognizes that what is the advantage to using fluoxetine rather than a tricyclic antidepressant?

a. Fluoxetine does not have cardiotoxicity as a side effect.

An elderly client's lithium level is 1.4 mEq/L. She complains of diarrhea, tremors, and nausea. Which action should the nurse take FIRST?

a. Hold the lithium and notify the physician.

A client is brought to the crisis intervention center by his wife, who states that he has been increasingly listless and less involved with his family recently. She reports that he sleeps poorly, eats little, and can barely perform basic self-care activities. She also reveals that 3 months ago he was in a car accident in which his best friend was killed. After the physician diagnoses acute depression, the nurse should anticipate administering which medication?

a. Paroxetine, 20 mg by mouth (P.O.) every morning.

A client diagnosed with major depression has started taking amitriptyline. What are common adverse effects of this drug? SELECT ALL THAT APPLY

a. Tachycardia b. Dry mouth e. Constipation

A client taking lithium carbonate reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus, and tremors. The lithium level is 2.7 mEq/L. This level is indicative of which finding?

a. Toxic

A male client with schizophrenia who is taking fluphenazine is being discharged in the morning. A repeat dose of medication is scheduled for 20 days after discharge. The client tells the nurse that he is going on vacation in the Bahamas and will return in 18 days. Which statement by the client indicates a need for further teaching?

a. When I return from my tropical island vacation, I will go to the clinic to get my fluphenazine injection.

To treat acute mania in a client with bipolar disorder, the physician prescribes lithium. During lithium therapy, this client's serum lithium level should be maintained within which range?

b. 0.8 to 1.4 mEq/L

A client receiving haloperidol (Haldol) complains of a stiff jaw and difficulty swallowing. Which action should the nurse take FIRST?

b. Administer as needed dose of benztropine I.M. as ordered.

A client diagnosed with major depression has started taking amitriptyline. What are common adverse effects of this drug? SELECT ALL THAT APPLY.

b. Dry mouth c. Trouble urinating

The nurse is reinforcing teaching for a client who is to be discharged with a prescription for lithium carbonate. Which of the following should the nurse include in the teaching?

b. Keep your dietary salt intake consistent.

While shopping at a mall, a woman experiences an episode of extreme terror accompanied by anxiety, tachycardia, trembling, and fear of going crazy. A friend drives her to the emergency department, where a physician rules out physiological causes and refers her to the psychiatric resident on call. To control the client's anxiety, the nurse caring for this client expects the resident to prescribe which medication?

b. Lorazepam

nurse is assessing a male client who recently began taking haloperidol. Which of the following findings is the highest priority to report to the provider?

b. Neck spasms

Which of the following would be a priority component of the teaching plan for a client prescribed phenelzine for treatment of depression?

b. Read labels of food and over-the-counter (OTC) drugs.

A client with manic episodes is taking lithium. Which electrolyte level should the nurse check before administering this medication?

b. Sodium

A nurse performs an Abnormal Involuntary Movement Scale (AIMS) assessment on a client who began taking chlorpromazine 2 years ago for the treatment of schizophrenia. Findings include lip smacking, tongue protrusion, and facial grimacing. The nurse should suspect which of the following?

b. Tardive dyskinesia

The nurse notes that a client with schizophrenia and receiving an antipsychotic medication is moving her mouth, protruding her tongue, and grimacing as she watches television. The nurse determines that the client is experiencing which medication complication?

b. Tardive dyskinesia

A client with bipolar disorder has been taking lithium, as prescribed, for the past 3 years. Today, family members brought the client to the hospital. The client hasn't slept, bathed, or changed clothes for 4 days; has lost 10 lb in the last month; and woke the entire family at 4 a.m. with plans to fly them to Hawaii for a vacation. Based on this information, what can the nurse assume?

b. The client has stopped taking the prescribed medication.

The nurse notices that a depressed client taking amitriptyline for 2 weeks has become very outgoing, cheerful, and talkative. The nurse suspects which of the following?

b. The client may be experiencing increased energy and is at an increased risk for suicide.

A client receiving tricyclic antidepressants arrives at the mental health clinic. Which observation would indicate that the client is following the medication plan correctly?

c. Client arrives at the clinic neat and appropriate in appearance.

The nurse reviews the client's lithium serum drug level, noting that it is 0.95 mEq/L. What is the appropriate nursing action?

c. File the lab result in the medical record.

A client is receiving haloperidol to reduce psychotic symptoms. As he watches television with other clients, the nurse notes that he has trouble sitting still. He seems restless, constantly moving his hands and feet and changing position. When the nurse asks what is wrong, he says he feels jittery. How should the nurse manage this situation?

c. Give an as needed dose of a prescribed anticholinergic agent to control akathisia.

The physician orders a tricyclic antidepressant for a client who has suffered an acute myocardial infarction (MI) within the past 6 months. The nurse should take which action?

c. Question the order with the physician.

A client has been receiving chlorpromazine, an antipsychotic, to treat his psychosis. Which findings should alert the nurse that the client is experiencing parkinsonism?

c. Tremors, shuffling gait, and masklike face

The nurse reinforces teaching for a client taking a MAOI to avoid foods containing which substance and for what reason?

c. Tyramine: due to the risk of hypertensive crisis.

The nurse reinforces teaching for a client who will begin taking lithium. Which statement by the client indicates understanding of the teaching?

d. "I should drink 2 to 3 liters of fluid each day."

A client begins taking haloperidol. After a few days, he experiences severe tonic contractures of muscles in the neck, mouth, and tongue. The nurse should recognize that the client is experiencing which adverse reaction to haloperidol?

d. Dystonia

The nurse is administering risperidone to a client who is scheduled to be discharged. Before discharge, which instruction should the nurse reinforce to the client?

d. Get up slowly when changing positions

The physician orders lithium carbonate for a client who is in the manic phase of bipolar disorder. During lithium therapy, the nurse should watch for which adverse reactions?

d. Nausea, diarrhea, tremor, and lethargy

Which diet selection by a client who is depressed and taking phenelzine sulfate indicates to the nurse that the client understands the dietary restrictions imposed by this medication regimen?

d. Roast beef, baked potato with butter, and Sprite.

A confused client has recently been prescribed sertraline. The client's spouse is taking paroxetine. The client presents with restlessness, tachycardia, diaphoresis, and tremors. What complication does a nurse suspect and what could be its possible cause?

d. Serotonin syndrome caused by ingestion of two different SSRIs

Which classification of drugs is the most potentially fatal if the client takes an overdose?

d. Tricyclic antidepressants