NCLEX Psychiatric/Mental Health Drugs

A young adult with a history of cognitive impairment and tonic-clonic seizures is admitted to a group home. Among the client's medications is a prescription for 125 mg of phenytoin by mouth three times a day. Phenytoin is supplied as an oral suspension of 25 mg/5 mL. How many milliliters of solution will the nurse administer for each dose? Record your answer as a whole number. ___ mL

25

A healthcare provider prescribes aripiprazole 15 mg by mouth once a day for a client with the diagnosis of schizophrenia. The hospital pharmacy sends aripiprazole 5 mg/tablet. How many tablets will the nurse administer? Record your answer as a whole number. ____ tablet(s)

3

Which drug is contraindicated in clients with eating and seizure disorders? A. Bupropion B. Trazodone C. Amitriptyline D. Lithium citrate

A. Bupropion

Which statement is true regarding antipsychotic drugs? A. All first- and second-generation antipsychotics are equally effective. B. Second-generation antipsychotics pose a risk of extrapyramidal symptoms. C. First-generation antipsychotics pose a significant risk of metabolic side effects. D. Clozapine is more effective than other second-generation antipsychotics.

D. Clozapine is more effective than other second-generation antipsychotics.

Imipramine, 75 mg three times per day, is prescribed for a client. What nursing action is appropriate when this medication is being administered? A. Telling the client that barbiturates and steroids will not be prescribed B. Warning the client not to eat cheese, fermented products, and chicken liver C. Monitoring the client for increased tolerance and reporting when the dosage is no longer effective D. Having the client checked for increased intraocular pressure and teaching about glaucoma symptoms

D. Having the client checked for increased intraocular pressure and teaching about glaucoma symptoms

A client is receiving haloperidol for agitation, and the nurse is monitoring the client for side effects. Which response identified by the nurse is unrelated to an extrapyramidal tract effect? A. Akathisia B. Opisthotonos C. Oculogyric crisis D. Hypertensive crisis

D. Hypertensive crisis

Which toxic effect would the nurse find in a client who has overdosed on isocarboxazid? A. Mydriasis B. Bradycardia C. Hypothermia D. Circulatory collapse

D. Circulatory collapse

What is the best drug of choice for treating obsessive-compulsive disorder? A. Imipramine B. Lithium salts C. Amitriptyline D. Clomipramine

D. Clomipramine

A 45-year-old client who recently completed alcohol detoxification reports plans to begin using disulfiram (Antabuse) as part of the alcoholism treatment regimen. What important client teaching does the nurse share regarding this drug? A. Voluntary compliance with the disulfiram regimen is very high. B. A single dose of oral disulfiram will be effective for up to 72 hours. C. Disulfiram may be taken intramuscularly and will be effective for as long as 7 days. D. Foods, medications, and any topical preparation containing alcohol should be avoided.

D. Foods, medications, and any topical preparation containing alcohol should be avoided.

Which is the adverse effect of haloperidol? A. Ataxia B. Asthenia C. Insomnia D. Gynecomastia

D. Gynecomastia4

Which drug would the nurse administer transdermally to treat a client with major depression? A. Selegiline B. Phenelzine C. Isocarboxazid D. Tranylcypromine

A. Selegiline

A nurse is counseling a client who abuses cocaine. The nurse recognizes that this drug is representative of which drug category? A. An opioid B. A stimulant C. A barbiturate D. A hallucinogen

B. A stimulant

A client with schizophrenia who is receiving an antipsychotic medication begins to exhibit a shuffling gait and tremors. The primary healthcare provider prescribes the anticholinergic medication benztropine, 2 mg daily. What will the nurse assess the client for daily when administering these medications together? A. Constipation B. Hypertension C. Increased salivation D. Excessive perspiration

A. Constipation

Which atypical antipsychotics are approved for long-term use to prevent the recurrence of mood episodes in clients with bipolar disease? Select all that apply. A. Olanzapine B. Quetiapine C. Ziprasidone D. Risperidone E. Aripiprazole

A. Olanzapine C. Ziprasidone E. Aripiprazole

Which monoamine oxidase inhibitor is used to treat Parkinson disease? A. Selegiline B. Phenelzine C. Isocarboxazid D. Tranylcypromine

A. Selegiline

A client who has been taking the prescribed dose of zolpidem for 5 days returns to the clinic for a follow-up visit. When interviewing the client, the nurse identifies that the medication has been effective when the client makes which statement? A. "I have less pain." B. "I have been sleeping better." C. "My blood glucose is under control." D. "My blood pressure is coming down."

B. "I have been sleeping better."

A client with schizophrenia is started on a regimen of chlorpromazine. After 10 days a shuffling gait, tremors, and some rigidity are apparent. Benztropine mesylate 2 mg by mouth daily is prescribed. What does the nurse remember when administering these medications together? A. Both medications are cholinesterase inhibitors. B. Both medications have a cholinergic-blocking action. C. The antipsychotic effects of chlorpromazine will be decreased. D. The synergistic effect of these medications will cause drooling.

B. Both medications have a cholinergic-blocking action.

A client asks the nurse how psychotropic medications work. How does the nurse reply? A. "These medications decrease the metabolic needs of your brain." B. "These medications increase the production of healthy nervous tissue." C. "These medications affect the chemicals used in communication between nerve cells." D. "These medications regulate the sensory input received from the external environment."

C. "These medications affect the chemicals used in communication between nerve cells."

Which condition is contraindicated for St. John's wort herbal therapy? A. Anxiety B. Seizures C. Dementia D. Cardiac disease

C. Dementia

Which drug is used to treat both generalized anxiety disorder and depression? A. Fluoxetine B. Bupropion C. Duloxetine D. Mirtazapine

C. Duloxetine

Which drug is a high-potency medication used to treat schizophrenia? A. Loxapine B. Thioridazine C. Fluphenazine D. Perphenazine

C. Fluphenazine

A client with a history of methamphetamine use is admitted to the medical unit. What clinical manifestation does the nurse expect when assessing the client? A. Constricted pupils B. Intractable diarrhea C. Increased heart rate D. Decreased respirations

C. Increased heart rate

A client has been receiving lithium for the past 2 weeks for the treatment of bipolar disorder, manic phase. What will the nurse include in the teaching plan for this client? A. A diuretic is necessary for anyone taking lithium. B. Lithium must be taken for the rest of the client's life. C. The blood level of lithium must be checked every month. D. A low-sodium diet must be followed while lithium is being taken.

C. The blood level of lithium must be checked every month.

A healthcare provider prescribes disulfiram for a client who abuses alcohol. The nurse teaches the client that disulfiram will have which action? A. Affect short-term memory B. Permit a healthier lifestyle C. Allow the client to tolerate small amounts of alcohol D. Cause a severe adverse reaction if alcohol is consumed

D. Cause a severe adverse reaction if alcohol is consumed

Which drug is contraindicated in clients with blood dyscrasias? A. Duloxetine B. Bupropion C. Mirtazapine D. Chlorpromazine

D. Chlorpromazine

Which drugs are considered typical antipsychotics? Select all that apply. A. Asenapine B. Lurasidone C. Aripiprazole D. Thioridazine E. Chlorpromazine

D. Thioridazine E. Chlorpromazine

Which medications are used to treat generalized anxiety disorder (GAD)? Select all that apply. A. Duloxetine B. Venlafaxine C. Clonazepam D. Escitalopram E. Clomipramine

A. Duloxetine B. Venlafaxine D. Escitalopram

Which antipsychotic drugs have the higher risk of causing tardive dyskinesia? Select all that apply. A. Loxapine B. Quetiapine C. Haloperidol D. Ziprasidone E. Olanzapine

A. Loxapine C. Haloperidol

An older adult living in a long-term care facility has been receiving 600 mg of lithium twice a day for 3 weeks to ease manic behavior. The client is experiencing nausea and vomiting, diarrhea, thirst, polyuria, slurred speech, and muscle weakness. What is the most appropriate nursing intervention? A. Withholding the next dose of lithium and drawing blood to test it for toxicity B. Obtaining a prescription for the antidote to lithium and administering it immediately C. Suggesting that the primary healthcare provider replace the lithium for an antiepileptic that will control the mania D. Assessing the client for coarse hand tremor and, if it is present, giving the daily dose of lithium with a bit of water

A. Withholding the next dose of lithium and drawing blood to test it for toxicity

Which drug is contraindicated in a pregnant client diagnosed with bipolar disorder? A. Sertraline B. Paroxetine C. Venlafaxine D. Despramine

B. Paroxetine

Which medication is the first choice drug for the treatment of attention deficit hyperactivity disorder (ADHD)? A. Clonidine B. Guanfacine C. Atomoxetine D. Methylphenidate

D. Methylphenidate

A client with the diagnosis of schizophrenia, paranoid type, has been receiving a phenothiazine drug. When the psychiatric daycare center plans a fishing trip, it will be important for the nurse to take which action? A. Provide the client with sunscreen. B. Caution the client to limit exertion during the trip. C. Give the client an extra dose of medication to take after lunch. D. Take the client's blood pressure before allowing participation in the outing.

A. Provide the client with sunscreen.

An antianxiety medication is prescribed for an extremely anxious client. The client says, "I'm afraid to take this medication because I heard they're addictive." The nurse teaches the client that antianxiety medications have what properties? A. Rarely cause dependence when the dosage is controlled B. May require increases in dosage but rarely cause dependence C. Usually result in psychological but not physiologic dependence D. Have the potential for physiologic and psychological dependence

D. Have the potential for physiologic and psychological dependence

A client receiving the medication buspirone is admitted to the hospital with the diagnosis of possible hepatitis. The nurse identifies that the client's sclerae look yellow. What will be the nurse's initial action? A. Withhold the medication. B. Give the buspirone with milk. C. Reduce the dosage of the medication. D. Ensure that the medication can be given parenterally.

A. Withhold the medication.

Which drug may lead to bruxism (a condition in which you grind, gnash or clench your teeth)? A. Vilazodone B. Isocarboxazid C. Clomipramine D. Levomilnacipran

D. Levomilnacipran

A nurse notes that haloperidol is most effective for clients who exhibit which type of behavior? A. Depressed B. Overactive C. Withdrawn D. Manipulative

B. Overactive

A healthcare provider diagnoses attention deficit hyperactivity disorder (ADHD) in a 7-year-old child and prescribes methylphenidate. The nurse discusses the child's treatment with the parents. What does the nurse emphasize as important for the parents to do? A. Monitor the effect of the medication on their child's behavior. B. Increase or decrease the dosage, depending on the child's behavior. C. Avoid imposing too many rules, because this will frustrate the child. D. Point out to their child that behavior can be controlled.

A. Monitor the effect of the medication on their child's behavior.

A client has been receiving fluphenazine for several months. The nurse will assess the client for which side effects? Select all that apply. A. Tremors B. Excess salivation C. Rambling speech D. Reluctance to converse E. Uncoordinated movement of extremities

A. Tremors E. Uncoordinated movement of extremities

The primary healthcare provider prescribes a neuroleptic drug to a client diagnosed with schizophrenia. On what basis would the primary healthcare provider choose the drug? A. Symptoms B. Side effects C. Therapeutic effects D. Underlying pathology

B. Side effects

The nurse is teaching a client who is receiving a monoamine oxidase inhibitor about dietary restrictions. The nurse plans to caution the client to avoid which foods? A. Pork, spinach, and fresh oysters B. Milk, grapes, and meat tenderizers C. Cheese, beer, and products with chocolate D. Leafy green vegetables, fresh apples, and ice cream

C. Cheese, beer, and products with chocolate

A client is started on chlorpromazine. To prevent life-threatening complications from the administration of this medication to an anxious, restless client, it is important that the nurse take which action? A. Provide adequate restraint. B. Monitor the client's vital signs. C. Protect against exposure to direct sunlight. D. Watch the client for extrapyramidal side effects.

B. Monitor the client's vital signs.

Which drug worsens uncontrolled angle-closure glaucoma when used for the treatment of generalized anxiety disorder? A. Buspirone B. Duloxetine C. Chlorpromazine D. Lithium carbonate

B. Duloxetine

Which drug most commonly causes extrapyramidal side effects (EPS)? A. Clozapine B. Haloperidol C. Risperidone D. Aripiprazole

B. Haloperidol

After assessing a client, the nurse suspects that the client has shift-work sleep disorder (SWSD). Which medication would be prescribed to the client? A. Caffeine B. Modafinil C. Atomoxetine D. Methylphenidate

B. Modafinil

A client has been taking 3 mg of risperidone twice a day for the past 8 days. At the follow-up appointment, the client reports tremors, shortness of breath, a fever, and sweating. What will the nurse do? A. Call 911 and have the client transported to the nearest psychiatric unit. B. Take the client's vital signs and arrange for immediate transfer to a hospital. C. Check the number of risperidone tablets left in the prescription bottle to see whether there was an overdose. D. Request a prescription for 2 mg of intramuscular benztropine stat and assess the client in 10 to 15 minutes for symptom relief.

B. Take the client's vital signs and arrange for immediate transfer to a hospital.

A nurse is administering medications to clients on a psychiatric unit. What does the nurse identify as the reason that so many psychiatric clients are given the drug benztropine or trihexyphenidyl in conjunction with the phenothiazine-derivative neuroleptic medications? A. They reduce postural hypotension. B. They potentiate the effects of the neuroleptic drug. C. They combat the extrapyramidal side effects of the neuroleptic drug. D. They ameliorate the depression that may accompany schizophrenia.

C. They combat the extrapyramidal side effects of the neuroleptic drug.

Which statement about psychotherapeutic drugs in elderly clients requires correction? A. Tricyclic antidepressants may increase anxiety in elderly clients. B. Normal dosage of lithium may result in lithium toxicity in elderly clients. C. Elderly clients on antipsychotic drugs are susceptible to orthostatic hypotension. D. Low serum levels of the drug are reported in elderly clients on psychotherapeutic drugs.

D. Low serum levels of the drug are reported in elderly clients on psychotherapeutic drugs.