Pharmacology Ch. 22 Psychotherapeutic Agents

Monitoring of patients taking lithium includes periodically obtaining a serum lithium level; at what level may toxic reactions occur? Greater than 0.5 mEq/mL Greater than 1.5 mEq/mL Greater than 1.25 mEq/mL Greater than 1 mEq/mL

Greater than 1.5 mEq/mL

The nurse is aware that CNS stimulants are prescribed for clients with ADHD because these medications have what effect on behavior and attention? Contravening Deteriorating Improving Restoring

Improving

A client with schizophrenia is prescribed clozapine. For which information in the medical record will the nurse question giving this medication to the client? treatment for rheumatoid arthritis remote work in customer service history of seizure disorder vegetarian eating plan

history of seizure disorder

A psychiatric nurse is reviewing various antipsychotic agents. The nurse should identify what drug as having the highest potency? Thioridazine Chlorpromazine Fluphenazine Prochlorperazine

Fluphenazine

A nurse who is providing care on a pediatric client has conducted a medication reconciliation. In light of the fact that the client takes methylphenidate, the nurse is justified in considering a history of what health problem? Hyperactivity Respiratory depression Anxiety Obesity

Hyperactivity

For which adverse reactions should the nurse monitor the patient who has been administered antipsychotic drugs? Hypertension Skin eruptions Bradycardia Dry mouth

dry mouth

The nurse would monitor a patient closely for lithium toxicity if the patient is also receiving: tromethamine. psyllium. indomethacin. antacids.

indomethacin.

A female client's physician orders a low-dose antipsychotic to manage her acute agitation. Her daughter states that her mother is improved but her cognitive functions are the same, if not worse, than last month. What is the best explanation for this development? Antipsychotics cause a gradual return of cognitive ability. Antipsychotics do not improve memory loss and may further impair cognitive functioning. Antipsychotics reduce memory loss. Antipsychotics increase the risk of long-term memory loss.

Antipsychotics do not improve memory loss and may further impair cognitive functioning.

The wife of a client who is taking haloperidol calls the clinic and reports that her husband has taken the first dose of the drug and it is not having a therapeutic effect. An appropriate response by the nurse would be which? "I'll ask the nurse practitioner if the dosage can be increased." "Continue the prescribed dose. It may take several days to work." "I'll report this to the nurse practitioner and see if he will add another drug to enhance the effects of the haloperidol." "I'll ask the nurse practitioner if the haloperidol can be discontinued and another drug started."

"Continue the prescribed dose. It may take several days to work."

A client receiving outpatient therapy with antipsychotic therapy experiences dizziness from time to time. Which suggestion by the nurse would be appropriate? "Try taking sips of water frequently." "Get up slowly from the bed or chair." "Limit your salt intake." "Take the drug with meals."

"Get up slowly from the bed or chair."

A client asks to have a year's worth of prescription refills for methylphenidate, explaining that it is very hard to leave work for clinic appointments. How should the nurse respond to that request to best assure client safety? "The prescription dose is always started as low as possible, and the refills are monitored to prevent abuse." "It would be very costly to purchase a years' worth of medication at one time." "I will speak with your health care provider about increasing the size of each refill." "I understand the inconvenience, but you have to come in at least every month to have blood work done."

"The prescription dose is always started as low as possible, and the refills are monitored to prevent abuse."

The nurse expects to monitor a client's white blood count weekly when the client is prescribed: Quetiapine Olanzapine Clozapine Aripiprazole

Clozapine

Dexmethylphenidate has been prescribed to Scott, a 7-year-old boy who was diagnosed with ADHD. The mother asks how this medication will help her son. Which would be the most accurate description of the purpose of this medication? Dexmethylphenidate will increase Scott's ability to understand information better. Dexmethylphenidate will stabilize Scott's mood so that he can concentrate. Dexmethylphenidate will improve Scott's attention span so that he will be able to complete a task. Dexmethylphenidate will improve Scott's memory.

Dexmethylphenidate will improve Scott's attention span so that he will be able to complete a task.

The nursing instructor is discussing psychosis with the nursing students. What behavior would the instructor explain people with psychosis exhibit? Slowed reaction time and poor coordination Short manic episodes followed by long depressive episodes Short- and long-term-memory deficits Disorganized and often bizarre thinking

Disorganized and often bizarre thinking

A client, prescribed dextroamphetamine for attention deficit hyperactivity disorder (ADHD) has developed a common adverse effect of the medication since beginning therapy. Which initial intervention should the client be encouraged to implement? Take metronidazole. Take diphenoxylate hydrochloride. Increase fiber intake. Take an over-the-counter (OTC) laxative daily.

Increase fiber intake.

A diabetic patient being treated for obesity tells the nurse that the patient is having adverse effects from the drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which adverse effects would need the nurse's immediate attention? Increased blood glucose Dry eyes Jittery feeling Decreased libido

Increased blood glucose

Anticonvulsive medications are sometimes used in the treatment of bipolar disorder. What other drug is used to treat bipolar disorder? Flexeril Lithium Valium Restoril

Lithium

The nurse is caring for a client who takes clozapine. The nurse would be most concerned if this client displays what symptom? Temperature of 102°F Blood pressure of 98/64 Blood sugar of 108 Weight gain of 1 lb in the last week

Temperature of 102°F

A young client has been prescribed an antipsychotic agent to relieve psychotic symptoms. Which goal of care is the priority? The client will remain safe. The client will interact therapeutically with peers. The client will demonstrate independent health maintenance. The client will participate in activities of daily living (ADL).

The client will remain safe.

A nurse has administered the first dose of Didrex to a client for weight loss. The nurse should be monitoring for which side effects? Select all that apply. low blood glucose level apprehension disorientation excessive CNS stimulation headache nervousness

apprehension disorientation excessive CNS stimulation headache nervousness

A client, who has been diagnosed with schizophrenia and is taking an antipsychotic medication, reports constant thirst, frequent urination, and feeling nauseous. The nurse knows that the client may: have a urinary tract infection. be making up the symptoms simply to get attention. have the flu. have undiagnosed diabetes.

have undiagnosed diabetes.

A bipolar client is being discharged home in 48 hours. What statement by the client indicates an understanding of treatment with lithium? "I will increase my salt intake." "I will decrease my fluid intake." "I will increase my fluid intake." "I will decrease my salt intake."

"I will increase my fluid intake."

A female client 25 years of age has begun taking lithium for treatment of bipolar disorder. Which statement indicates that the client needs further instruction? "I will need to stop taking my birth control pills while I take lithium." "I will need to come to the clinic regularly for blood tests." "My lithium dose may change depending on the results of my blood tests." "I will call the health care provider if I experience diarrhea."

"I will need to stop taking my birth control pills while I take lithium."

The parents of a child receiving a central nervous system stimulant for treatment of attention deficit disorder asks the nurse why they are stopping the drug for a time. Which statement by the nurse would be most appropriate? "He probably doesn't need the medication anymore since he is getting older." "He is prone to developing severe adverse effects if he stays on it any longer." "The drug should be used for a specified period of time and then switched to another." "We need to check and see if he still has symptoms that require drug therapy."

"We need to check and see if he still has symptoms that require drug therapy."

The nursing student is reviewing information learned in anatomy and physiology class about the nervous system. The student recalls that the nervous system has how many divisions? 1 4 3 2

2

What would the nurse's pre-administration assessment of a client receiving a CNS stimulant for the treatment of obesity include? (Select all that apply.) Respiratory rate Review recent lab work Pulse Blood pressure Weight

Blood pressure Pulse Weight Respiratory rate

A high-school-age client, brought to the emergency department (ED) by friends after taking a "whole handful of dextroamphetamine," is now lapsing in and out of consciousness. The ED nurse should prioritize what assessment related to dextroamphetamine overdose? Lung function testing Blood glucose monitoring Cardiac monitoring Cognitive assessment

Cardiac monitoring

The nurse is providing education to a client who has been prescribed clozapine. During teaching, the nurse should inform the client of the need for regular monitoring of what laboratory test during the initial months of therapy and periodically thereafter? partial thromboplastin time (PTT) Prothrombin time (PT) blood urea nitrogen (BUN) Complete blood count (CBC)

Complete blood count (CBC)

Parents bring a 15-year-old male into the clinic. The parents tell the nurse that there is a family history of schizophrenia and they fear their son has developed the disease. What is an appropriate question to ask the parents? Which of your family members did not have schizophrenia? How long has your son been exhibiting symptoms? What health care providers have you taken your son to? What symptoms should he have?

How long has your son been exhibiting symptoms?

A nurse is reviewing a bipolar client's serum lithium level, which is 1.8 mEq/L. What is the nurse's best action? Inform the prescriber and perform a focused respiratory assessment Facilitate a transfer to the intensive care unit Inform the prescriber and monitor for GI and CNS effects Contact the prescriber and request a supplementary dose of lithium

Inform the prescriber and monitor for GI and CNS effects

When teaching about the action of conventional antipsychotic medications to a group of nursing students, which would the instructor include? Stimulating the release of dopamine in the brain Stimulating GABA receptors in the brain Inhibiting the release of dopamine in the brain Inhibiting the release of serotonin in the brain

Inhibiting the release of dopamine in the brain

A male client is diagnosed with narcolepsy by his physician. He asks the physician to prescribe modafinil, because it works so well for his friend. The physician will not prescribe the medication because of what aspect of the client's history? Ischemic changes on his electrocardiograms Gout and a history of tophi Cirrhosis of the liver Pancreatitis

Ischemic changes on his electrocardiograms

A child with attention deficit hyperactivity disorder has been receiving methylphenidate for several years. The prescriber has explained a plan to temporarily discontinue the drug. What rationale for this action should the nurse explain? The risk for cumulative adverse effects is greater if the child doesn't have a break. It needs to be determined if the child still has symptoms that require treatment. The drug likely needs to be switched to another agent that is less toxic. The drug must be occasionally stopped to prevent anticholinergic effects

It needs to be determined if the child still has symptoms that require treatment.

A female client relates that she is taking diazepam for a muscle relaxant and modafinil for treatment of narcolepsy. Additionally, she informs you that she takes a contraceptive. As part of client education, the nurse would include: Modafinil may decrease the effects of diazepam. Modafinil should not be taken if the client is on a contraceptive. Modafinil may decrease the effects of her contraceptive, and she may need to use other protection. Modafinil will not interfere with any of the medications she is taking.

Modafinil may decrease the effects of her contraceptive, and she may need to use other protection.

A psychiatric nurse is discussing the advantages of atypical antipsychotics with the parents of a teenager who has been diagnosed with schizophrenia. When comparing these drugs with the older, typical antipsychotics, what advantage should the nurse cite? Absence of black box warnings Reduced adverse effects Lower cost The possibility of oral administration

Reduced adverse effects

A nurse is planning the care of a client who has been diagnosed with schizophrenia and who will begin treatment with a typical antipsychotic. The nurse should identify what nursing diagnosis? Risk for injury related to central nervous system depression Risk for impaired liver function related to hepatotoxicity Risk for imbalanced body temperature related to hypothalamic suppression Bowel incontinence related to gastrointestinal adverse effects

Risk for injury related to central nervous system depression

A client who was diagnosed with schizophrenia in 1962 was prescribed chlorpromazine. The client has been taking the medication for more than 40 years. What adverse effect will the client most likely experience? Tardive dyskinesia Urinary frequency Central nervous system agitation Hypertension

Tardive dyskinesia

A nurse is caring for a patient who is taking haloperidol. The patient has orders for a new drug, and the nurse notes that it is highly protein bound. The nurse will plan care based on a(n): decreased risk for muscular contractions and spasms. increased risk for toxic effects of haloperidol therapy. high drug efficacy of haloperidol. decreased risk for toxic effects of haloperidol therapy.

increased risk for toxic effects of haloperidol therapy.

The nurse is planning care for a client who has been prescribed a CNS stimulant. What should the nurse establish as the primary goal of therapy? increase the ability to study for long periods of time. increase productivity and work longer hours. use the drugs as they are ordered. relieve the symptoms for which they were prescribed.

relieve the symptoms for which they were prescribed.

A black, male client routinely takes haloperidol to manage his psychosis. Recently, he presented to the health care provider's (HCP's) office with signs of tardive dyskinesia, and his HCP modified the drug regimen over time. The client will now take the drug olanzapine and discontinue the haloperidol. What will the nurse tell the client to help decrease his anxiety about the new drug regimen? "Black clients always experience tardive dyskinesia with antipsychotics." "The olanzapine does not produce side effects in black males." "The signs of tardive dyskinesia will diminish over time." "When compared with haloperidol, olanzapine has been associated with fewer extrapyramidal reactions in black clients."

"When compared with haloperidol, olanzapine has been associated with fewer extrapyramidal reactions in black clients."

The nurse is preparing to provide education to a client who has been prescribed clozapine for schizophrenia. What is the most important aspect of client teaching? Reporting signs of neuralgia Stopping medications if weight gain occurs Limiting alcohol to two drinks per day Maintaining medication regimen

Maintaining medication regimen

A nurse is teaching the client about CNS medications and how they are addictive. What is primary reason CNS medications are addictive? The medication decreases the amount of dopamine released into the body, causing feelings of euphoria. The medication stimulates the brain's pleasure centers with enhanced neurotransmission of dopamine. The medication stimulates the brain's visual centers, so the client sees everything more clearly. The medication stimulates the brain's sleep centers, so the client can sleep more soundly.

The medication stimulates the brain's pleasure centers with enhanced neurotransmission of dopamine.

An adult client diagnosed with narcolepsy admits being embarrassed to receive this diagnosis and is adamant that no one find out about it. The nurse should respond to the client by explaining what aspect of the etiology? "This is the result of neurologic factors over which you have no direct control." "This is something that runs in certain families, and it's not your fault that this has happened." "This usually stems from suppressed emotions, so counseling usually helps greatly." "In a lot of cases, making improvements to your sleep habits can resolve narcolepsy."

"This is the result of neurologic factors over which you have no direct control."

A male client tells the nurse he is going to stop taking his medication because he is always having fine tremors and slurred speech. These reactions are preventing him from teaching art classes like he used to do. The nurse knows that what action could help him? He could tell his health care provider that the antipsychotics are not working and he needs a larger dose, or another medication added. He could learn to teach other classes via online education so that he wouldn't have to talk out loud. He could stop taking his medication and see if he still has schizophrenia. He could talk with his health care provider and ask to have his medication dosage decreased, or change his medication to a second-generation antipsychotic.

He could talk with his health care provider and ask to have his medication dosage decreased, or change his medication to a second-generation antipsychotic.