Pharmacology: Mental Health Drugs Test- Prep U Questions

Which drug used to treat anxiety would be appropriate for a client who is a school teacher and is concerned about feeling sedated at work? a. Lorazepam b. Buspirone c. Diazepam d. Alprazolam

b. Buspirone

What adverse effect could be related to a fall experienced by an older client prescribed amitriptyline? a. orthostatic hypotension b. visual disturbances c. urinary frequency d. urinary retention

a. orthostatic hypotension

A group of nursing students are reviewing information about CNS stimulants. The students demonstrate understanding of the information when they identify which drug as being used to treat obesity? a. Modafinil b. Methylphenidate c. Dexmethylphenidate d. Phentermine

d. Phentermine

The nurse is caring for an older adult in the long-term care facility who has begun to display signs of anxiety and insomnia. What is the priority nursing action? a. Increase the client's social time, encouraging interaction with others. b. Assess the client for physical problems. c. Call the provider and request an antianxiety drug order. d. Suggest the family visit more often to reduce the resident's stress level.

b. Assess the client for physical problems.

After administering an antianxiety drug, the nurse obtains the client's blood pressure. The nurse withholds the next dose if the client's systolic blood pressure has dropped by which value? a. 5 mm Hg. b. 20 mm Hg. c. 10 mm Hg. d. 15 mm Hg.

b. 20 mm Hg.

The nurse is assessing a client who has been prescribed lorazepam. Which of the client's current signs and symptoms should cause the nurse to suspect that the client is experiencing withdrawal? a. current mood is described as "depressed" b. severe insomnia for the past several nights c. unstable blood sugars in recent days d. uncharacteristic memory lapses

b. severe insomnia for the past several nights

A client received lorazepam intravenously at 0900. The nurse should maintain the client on bedrest until approximately what time? a. 1330 b. 1500 c. 1030 d. 1200

d. 1200

What drug should the nurse consider contraindicated for the client taking a monoamine oxidase inhibitor (MAOI)? a. acetaminophen b. docusate c. insulin d. escitalopram

d. escitalopram

A client's medication regimen for treatment of anxiety has been changed from a benzodiazepine. The client asks the nurse what likely prompted the health care provider to change the medication. What is the nurse's best response? a. "Long-term use of benzodiazepines can result in dependency." b. "Your provider may have been worried about the possibility of convulsions." c. "Long-term use of benzodiazepines can cause insomnia." d. "Your provider may have been concerned about causing depression."

a. "Long-term use of benzodiazepines can result in dependency."

An 11-year-old client has been hospitalized on the adolescent psychiatry unit with severe depression. For the past several weeks, the client has been prescribed a selective serotonin reuptake inhibitor (SSRI). What is the priority nursing action? a. Implement suicide precautions. b. Monitor the client for migraines. c. Monitor food intake and eliminate potential sources of tyramine. d. Assess for weight loss and difficulty sleeping.

a. Implement suicide precautions.

A nurse is caring for a client with reports of constipation after the administration of antianxiety drugs. Which would be appropriate for the nurse to include in the client's plan of care? Select all that apply. a. Increase the intake of fruits b. Offer meals rich in fiber c. Reduce the dosage. d. Suggest use of antacid e. Encourage increased fluid intake

a. Increase the intake of fruits b. Offer meals rich in fiber e. Encourage increased fluid intake

The client has been depressed since the client's father died 6 months ago and the health care provider has prescribed amitriptyline. What aspect of this client's health history should prompt the nurse to contact the health care provider? a. Ischemic heart disease b. Gastresophageal reflux disease (GERD) c. Osteoporosis d. Concussion 10 months ago

a. Ischemic heart disease

The nurse is providing health education for a client who has been prescribed a benzodiazepine. What adverse effect should the nurse discuss in the teaching? a. dependence b. personality changes c. suicide d. persistent insomnia

a. dependence

After teaching a group of nursing students about antianxiety drugs, the instructor determines that the teaching was successful when the students identify which as an example of a nonbenzodiazepine? Select all that apply. a. doxepin b. diazepam c. hydroxyzine d. lorazepam e. buspirone

a. doxepin c. hydroxyzine e. buspirone

The nurse is caring for an 8-year-old client who takes imipramine. The nurse should assess this child for a history of which health problem? a. enuresis (bed-wetting) b. obsessive-compulsive disorder (OCD) c. oppositional defiant disorder d. psoriasis

a. enuresis (bed-wetting)

A nurse is administering a prescribed dose of chlordiazepoxide to a client. The nurse should closely assess the client for what adverse reaction? a. respiratory depression b. urinary retention c. esophageal bleeding d. idiopathic thrombocytopenic purpura (ITP)

a. respiratory depression

The nurse is caring for a client who experiences anxiety and insomnia and is prescribed lorazepam. When developing the plan of care, what would be an appropriate nursing diagnosis related to potential adverse effects of the drug? a. risk for injury related to central nervous system (CNS) effects b. fear related to rebound effects following therapy c. chronic confusion related to decreased arousal d. ineffective tissue perfusion related to vasoconstriction

a. risk for injury related to central nervous system (CNS) effects

The nurse is aware that which medication taken by a client for treatment of mood disorder requires a diet that restricts the amount of tyramine eaten? a. Diazepam b. Phenelzine c. Paroxetine d. Triazolam

b. Phenelzine

A client with attention deficit hyperactivity disorder (ADHD) has not had an adequate response to behavioral therapy. All these medications would be acceptable except: a. Methylphenidate (Ritalin). b. Phentermine (Ionamin). c. Atomoxetine (Strattera). d. Amphetamine (Adderall).

b. Phentermine (lonamin)

A nurse is caring for a client with suicidal tendencies and severe depression. Which would the nurse be alert for when monitoring the client's condition? a. Urinary retention b. Signs of insomnia c. Photosensitivity d. Visual disturbances

b. Signs of insomnia

The nurse is administering a benzodiazepine IV push. The monitor shows the client's heart rate decreased to 52 beats per minute. What is the nurse's priority action? a. Call the provider and inform of the client's reaction to the drug. b. Slow the rate of administration of the benzodiazepine c. Do not give the rest of the benzodiazepine and flush the line d. Document the client's allergic response to the medication.

b. Slow the rate of administration of the benzodiazepine

A client's medication history includes a long-term prescription for modafinil. Which assessment question should the nurse ask the client to confirm why the medication was prescribed? a. "Do you have a history of depression?" b. "Do you have a problem with sleepwalking?" c. "Do you have trouble falling asleep?" d. "Have you ever been diagnosed with narcolepsy?"

d. "Have you ever been diagnosed with narcolepsy?"

The nurse working in a gerontology office is preparing for the next client. She notes that it is for a dementia assessment. What would likely happen during this appointment? a. a complete eye exam b. lab work to see if the client's cholesterol is elevated c. tests such as a 12-lead EKG d. a cognitive ability and functioning assessment

d. a cognitive ability and functioning assessment

A client with a history of coronary artery disease has been diagnosed with depression and has been prescribed escitalopram 10 mg PO daily. The client's current drug regimen includes clopidogrel. The nurse recognizes that this combination creates a need to monitor the client closely for signs of: a. cerebral ischemia. b. renal failure. c. jaundice. d. bleeding.

d. bleeding

A client who is experiencing acute alcohol withdrawal is being treated with intravenous lorazepam (Ativan). This drug achieves a therapeutic effect by: a. increasing the amount of serotonin available in the synapses. b. affecting the regulation of serotonin and norepinephrine in the brain. c. inhibiting the action of monoamine oxidase. d. increasing the effects of the neurotransmitter GABA.

d. increasing the effects of the neurotransmitter GABA.

A mother brings her child to the clinic and informs the health care provider that the child is having a difficult time paying attention in school, seems to be getting in trouble several times a day, and is acting very impulsively. The nurse can expect the provider to order which drugs for this child? a. diethylpropion b. modafinil c. armodafinil d. methylphenidate

d. methylphenidate

A client is being prescribed dextroamphetamine for the treatment of attention deficit hyperactivity disorder (ADHD). During health education, the nurse should make the client aware of the black box warning relating to what potential risk issue? a. Stroke with excessive doses b. Kidney failure c. Unstable blood glucose levels d. Potential for abuse

d. potential for abuse

A nurse is planning teaching with a client who has had an anti-anxiety medication prescribed. A priority action for would be to: a. try to avoid factors that make you go to sleep. b. take the medication 30 minutes prior to going to bed. c. take the medication just as you go to bed. d. try to identify and avoid factors that cause nervousness or insomnia.

d. try to identify and avoid factors that cause nervousness or insomnia.

Doxapram (Dopram) is given to a pediatric client who weighs 4000 g. The maximum dose for this client is 250 mcg/kg. How many times can an IV infusion of 0.5 mg be given to this client?

2

A client with a known seizure disorder is admitted to the intensive care unit with a diagnosis of septic shock. The client is being sedated with midazolam (Versed). Following discontinuation of the medication, the client remains sedated for several days. Based on the client's history, what is the rationale for not treating with flumazenil (Romazicon)?

Increased risk for seizures

A client with depression has been taking citalopram for several months and has presented for a follow-up assessment. The client tells the nurse, "I've been reading a lot online about the benefits of St. John's wort for depression, so I've started taking it once per day." In addition to referring the client to the provider, what is the nurse's best response? a. "There can be an unsafe reaction between your antidepressant and St. John's wort, which is why taking them both is discouraged." b. "It's very important that you not take the St. John's wort at the same time of day as your antidepressant." c. "Herbal remedies often contain unknown doses of the desired ingredient, which can be dangerous." d. "It's very important that you comply with your prescribed treatment."

a. "There can be an unsafe reaction between your antidepressant and St. John's wort, which is why taking them both is discouraged."

A 28-year-old client asks his nurse how phenelzine therapy will help him. Which would be an appropriate response by the nurse? a. "This therapy will improve your overall mood and increase your social activity." c. "The drug will help increase your attention level." d. "The drug will enable you to gain the appropriate weight."

a. "This therapy will improve your overall mood and increase your social activity."

What assessment question would be most appropriate when providing care for a client newly prescribed chlordiazepoxide? a. "When did you have your last drink of alcohol?" b. "How much alcohol have you ingested in the last 8 hours?" c. "What is motivating you to stop drinking alcohol?" d. "How has your alcohol use affected your quality of life?"

a. "When did you have your last drink of alcohol?"

A nurse works at a weight management clinic. To which overweight client could the nurse safely administer dextroamphetamine? a. A 48-year-old Caucasian man who has adult-onset diabetes b. A 28-year-old African-American woman with hyperthyroidism c. A 60-year-old African-American man who experiences angina d. A 38-year-old Caucasian woman with glaucoma

a. A 48-year-old Caucasian man who has adult-onset diabetes

The nursing student learned in pharmacology class that drugs that affect the CNS do which of the following? (Check all that apply.) a. Alter sensation b. Lower glucose levels c. Alter mood d. Alter the interpretation of information in the brain e. Decrease K+

a. Alter sensation c. Alter mood d. Alter the interpretation of the information in the brain

A 25-year-old client is being prescribed buspirone (BuSpar) for a general anxiety disorder. The client asks why she cannot take Ativan, which was prescribed to her last year for this disorder. What statement would provide the best explanation to the client? a. Buspirone has been shown not to cause withdrawal when the medication is stopped. b. Ativan is used only for short-term treatment of anxiety. c. Buspirone will start to relieve the symptoms of anxiety after the first dose. d. Buspirone will be more effective than Ativan at treating the symptoms of anxiety.

a. Buspirone has been shown not to cause withdrawal when the medication is stopped.

The nursing instructor is teaching students about Alzheimer's disease. The instructor informs the students that clients with this illness experience problems with memory and thinking. The reason that this happens is which? a. Degeneration of cholinergic pathways b. Regeneration of cholinergic pathways c. Increased level of acetylcholine d. Lack of neural destruction

a. Degeneration of cholinergic pathways

A client with Alzheimer's disease asks the nurse what the common adverse reactions to cholinesterase inhibitors are. What common side effects could the nurse provide? Select all that apply. a. Dizziness b. Flatulence c. Headache d. Seizures e. Diarrhea

a. Dizziness c. Headache e. Diarrhea

Which medication would the nurse expect to administer orally once a day to a client with Alzheimer disease (AD)? a. Donepezil b. Galantamine c. Memantine d. Rivastigmine

a. Donepezil

Benzodiazepines can cause severe respiratory depression but is not common. When it does the nurse knows that this reaction can be reversed by which specific benzodiazepine antagonist? a. Flumazenil (Romazicon) b. Hydroxyzine (Vistaril) c. Doxepin (Sinequan) d. Lorazepam (Ativan)

a. Flumazenil (Romazicon)

Which agent would a nurse identify as a selective serotonin reuptake inhibitor? a. Fluvoxamine b. Selegiline c. Nefazodone d. Mirtazapine

a. Fluvoxamine

The herbal preparation ginkgo has long been thought to enhance memory, and thus might be used by some clients with Alzheimer's disease to support memory. The nurse knows that which statements regarding ginkgo is correct? a. Ginkgo must be used with caution in clients who are taking anticoagulant drugs. b. Ginkgo has no adverse effects. c. Ginkgo may be combined with a monoamine oxidase inhibitor. d. The effects of ginkgo will be evident within 2 days.

a. Ginkgo must be used with caution in clients who are taking anticoagulant drugs.

The nurse is preparing a teaching plan for a client who is taking rivastigmine. What precaution should the nurse teach the client and family to minimize the risk of adverse GI effects? a. Having small, frequent meals b. Monitoring weight throughout the therapy c. Establishing appropriate sleep and rest patterns d. Eating nutrient and calorie rich foods

a. Having small, frequent meals

The nurse is reviewing signs and symptoms of benzodiazepine withdrawal with a client who has taken diazepam daily for several years. The nurse should include which possible effects of benzodiazepine withdrawal? Select all that apply. a. Headache b. Urinary retention c. Depression d. Nausea e. Nightmares

a. Headache d. Nausea e. Nightmares

A nurse is caring for a client who is taking a monoamine oxidase (MAO) inhibitor for treatment of a depressive disorder. What is a potentially serious side effect of MAO inhibitors? a. Hypertension b. Anemia c. Decreased urinary output d. Respiratory congestion

a. Hypertension

The nurse is admitting a client who has a possible diagnosis of mood disorder. The nurse assesses the client for symptoms of what medical condition that may be mistaken for a mood disorder? a. Hypothyroidism b. Congestive heart failure c. Bell's palsy d. Crohn's disease

a. Hypothyroidism

The nurse is assessing an adolescent client diagnosed with attention deficit hyperactivity disorder (ADHD) for therapeutic effects of methylphenidate. The nurse should focus on improvement associated with what client functions? Select all that apply. a. cognitive task performance b. stamina c. motor task performance d. behavior e. endurance

a. cognitive task performance c. motor task performance d. behavior

A client with Alzheimer's disease will take donepezil (Aricept). What must the client's family or caregiver be taught to do? Select all that apply. a. Keep all medical appointments. b. Vary the dosage of medication each day depending on how the client feels. c. Understand that over-the-counter drugs can be taken without the physician's approval. d. Report adverse effects such as severe vomiting and dehydration. e. Devise a method to ensure that medication is taken every day.

a. Keep all medical appointments. d. Report adverse effects such as severe vomiting and dehydration. e. Devise a method to ensure that medication is taken every day.

Diazepam (Valium) is prescribed for a patient. The nurse knows that contraindications to administration of benzodiazepines such as diazepam include which of the following? Select all that apply. a. Narrow-angle glaucoma b. Pregnancy c. Hypertension d. Lactation e. Acute alcohol withdrawal

a. Narrow-angle glaucoma b. Pregnancy d. Lactation

A pediatric client has been admitted to the floor and started on Ritalin therapy for ADHD. The nurse knows that an important daily intervention for this client would be which? a. Record a daily summary of client's behavior. b. Perform ROM exercises daily. c. Weigh the client daily. d. Suction the client daily.

a. Record a daily summary of client's behavior.

A middle-aged client was diagnosed with major depression after a suicide attempt several months ago and has failed to respond appreciably to treatment with SSRIs. As a result, the client was prescribed phenelzine. When planning this client's subsequent care, what nursing diagnosis should the nurse prioritize? a. Risk for Injury related to drug-drug interactions or drug-nutrient interactions b. Risk for Ineffective Peripheral Tissue Perfusion related to cardiovascular effects of phenelzine c. Risk for Constipation related to decreased gastrointestinal peristalsis d. Risk for Infection related to immunosuppressive effects of phenelzine

a. Risk for Injury related to drug-drug interactions or drug-nutrient interactions

A client with Alzheimer's disease has difficulty swallowing tablets and capsules. The nurse knows that transdermal patches are available for which medication? a. Rivastigmine (Exelon) b. Donepezil (Aricept) c. Tacrine (Cognex) d. Galantamine (Razadyne)

a. Rivastigmine (Exelon)

A client has been taking a selective serotonin reuptake inhibitor (SSRI) for the treatment of depression. Which represents the action of the medication? a. SSRIs prevent serotonin from being reabsorbed. b. SSRIs increase serotonin synthesis. c. SSRIs increase the number of serotonin binding sites. d. SSRIs block GABA function.

a. SSRIs prevent serotonin from being reabsorbed.

After teaching a group of nursing students about antidepressants, the instructor determines that the teaching was successful when the students identify which as inhibiting the reuptake of serotonin? a. Selective serotonin reuptake inhibitors b. Monoamine oxidase inhibitors c. Atypical antidepressants d. Tricyclic antidepressants

a. Selective serotonin reuptake inhibitors

The nurse is doing a physical assessment on admission of a client diagnosed with elevated blood pressure due to anxiety. What are the most important physical assessments for a nurse to perform? Select all that apply. a. Skin temperature and color b. Hair texture c. Bowel sounds d. Respiratory rate e. Blood pressure

a. Skin temperature and color d. Respiratory rate e. Blood pressure

The nurse has learned that there is a high incidence of suicidal ideation in children and adolescents when using which of the following drugs? a. Strattera b. Nuvigil c. Provigil d. Dopram

a. Strattera

Three days after discontinuing diazepam with medical guidance, an older adult continues to demonstrate impaired memory and confusion. The nurse should consider what possible explanation for the client's current status? a. The adverse effects of benzodiazepines can persist for several days after stopping the drug. b. The client may have been experiencing a hypersensitivity to the drug, rather than an adverse effect. c. The client may have decreased liver function. d. Benzodiazepines can occasionally cause permanent alterations in personality and level of consciousness.

a. The adverse effects of benzodiazepines can persist for several days after stopping the drug.

To best assure client safety, what information should the nurse provide to a client whose fluoxetine therapy has been discontinued? a. The dosage of the medication will be gradually reduced over a period of 6 to 8 weeks. b. It will be important that the client avoid stressful situations until another selective serotonin reuptake inhibitor (SSRI) can be prescribed. c. Electroconvulsive therapy (ECT) will be prescribed 2 to 3 weeks before stopping the fluoxetine. d. A monoamine oxidase (MAO) inhibitor will be prescribed concurrently with the fluoxetine for 2 to 3 weeks.

a. The dosage of the medication will be gradually reduced over a period of 6 to 8 weeks.

A client diagnosed with an anxiety disorder has expressed dissatisfaction with lorazepam therapy and wants to discontinue the drug. What is the most important information the nurse expects the health care provider to give the client? a. The drug should be tapered gradually to prevent severe symptoms of withdrawal. b. Discontinuing the drug is unwise. c. Symptoms will only improve with medication therapy. d. It will take a minimum of 2 weeks for the drug to leave the system.

a. The drug should be tapered gradually to prevent severe symptoms of withdrawal.

A female client has been diagnosed with depression. She also has a history of alcoholism. She has been sober now for 4 months, but at her last physical examination, the health care provider noted right-upper-quadrant tenderness and elevated liver enzyme levels. The provider has prescribed sertraline to treat the client's depression. Which factor would need to be considered prior to administering this medication? a. The medication should be started at a lower dose due to liver dysfunction, and the client should be monitored for side effects. b. The client should not take any medications because of her liver dysfunction. c. The client should have monthly evaluation of liver function to monitor the disease progression. d. She should have an ultrasound of the liver to check for disease.

a. The medication should be started at a lower dose due to liver dysfunction, and the client should be monitored for side effects.

The nursing student has learned that caffeine is a drug with many different effects on the body. The student realizes that caffeine can be found in many different foods including which? Select all that apply. a. Coffee b. Chocolate c. Pasta d. Tea e. Red meats

a. coffee b. chocolate d. tea

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

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

The nurse must be aware of drug interactions when administering medications. Which medications are known to negatively interact with cholinesterase inhibitors? Select all that apply. a. theophylline b. nonsteroidal anti-inflammatory drugs (NSAIDs) c. anticholinergics d. ace inhibitors e. beta blockers

a. theophylline b. nonsteroidal anti-inflammatory drugs (NSAIDs) c. anticholinergics

The nurse must be aware of drug interactions when administering medications. Which medications are known to negatively interact with cholinesterase inhibitors? Select all that apply. a. theophylline b. ace inhibitors c. nonsteroidal anti-inflammatory drugs (NSAIDs) d. anticholinergics e. beta blockers

a. theophylline c. nonsteroidal anti-inflammatory drugs (NSAIDs) d. anticholinergics

A client has recently received a diagnosis of depression and has been prescribed citalopram. The nurse is providing health education and the client states, "I'm relieved to have some medication to help with my mood, because it's my daughter's wedding next weekend and I'll be feeling better." What is the nurse's best response? a. "You'll likely be feeling significantly better by the weekend, but remember to avoid drinking alcohol at the wedding." b. "Antidepressants will help your mood but it usually takes a few weeks to experience the benefits." c. "This is very good timing for you, but remember that you might have some side effects, especially for the first couple of weeks." d. "Antidepressants help relieve the lack of energy and concentration during depression but your mood might not be affected."

b. "Antidepressants will help your mood but it usually takes a few weeks to experience the benefits."

The nurse is reviewing a new client's current medication regimen, which includes a ten-week course of bupropion 150 mg PO b.i.d. The nurse has assessed the client for any history of depression, which the client denies. What assessment question should the nurse ask next? a. "Have you ever been diagnosed with obsessive-compulsive disorder?" b. "Are you in the process of quitting smoking?" c. "Are you receiving treatment for anxiety right now?" d. "Are you certain that you've never had depression?"

b. "Are you in the process of quitting smoking?"

The client is taking the medication fluvoxamine 150 mg PO daily. The nurse is assessing the clients medication regimen. The client denies a history of depression. What assessment question should the nurse subsequently ask? a. "Does anyone else in your family have a history of depression?" b. "Do you have any history of obsessive thoughts of compulsive habits?" c. "Have you ever had a Mini-Mental Status Exam performed?" d. "Have you ever had any thoughts about deliberately harming yourself?"

b. "Do you have any history of obsessive thoughts of compulsive habits?"

A nurse is describing the three stages of Alzheimer's disease to a family. The nurse knows that the family understands the stages when they make what statement? a. "Grandma is in the dementia due to AD stage, which means she might get better if she slows down and takes all of her medications." b. "Grandma is in the mild cognitive impairment (MCI) stage, so we will give her medications to slow her progression of dementia." c. "Grandma is in the preclinical stage, so no matter what we do she will always be very confused and unable to live by herself." d. "Grandma is in the mild cognitive impairment stage, and will get better if we give her medications and time."

b. "Grandma is in the mild cognitive impairment (MCI) stage, so we will give her medications to slow her progression of dementia."

What instructions should a nurse include when teaching a client who has depression about the use of amitriptyline? a. "Be sure to eat a low fiber diet to prevent diarrhea." b. "Use sugarless hard candies and gum to deal with dry mouth." c. "Take the drug daily in the morning for maximum benefit." d. "Limit your fluid intake so you don't have to urinate during the night."

b. "Use sugarless hard candies and gum to deal with dry mouth."

A 12-year-old has been prescribed dextroamphetamine therapy, and the nurse is now reviewing the correct schedule for taking the drug. The child should most likely take the initial daily dose of dextroamphetamine at what times? a. 09:00, 14:00, and 19:00 b. 7:00 and 11:30 c. 08:00 and 20:00 d. 07:30, 11:30, 16:30, and 20:00

b. 7:00 and 11:30

A client has been admitted to the emergency department in convulsions and been prescribed 200 mg amobarbital (Amytal sodium) IV STAT. What is the nurse's best action? a. Question the provider about the route of the medication b. Administer the medication and monitor the client's status closely c. Establish central IV access and administer the medication d. Confirm the dose with the prescriber or a pharmacist

b. Administer the medication and monitor the client's status closely

A nursing student is conducting a class presentation about cholinesterase inhibitors. Which would the student identify as the primary indication for use? a. Myasthenia gravis b. Alzheimer disease c. Glaucoma d. Urinary retention

b. Alzheimer disease

A client experiencing depression is reluctant to start on antidepressant medication. What information should be the basis for the nurse's best response? a. Depression is best treated naturally with rest, exercise, and nutritional supplements. b. Antidepressant therapy may be indicated if depressive symptoms impair social relationships or work performance and occur independently of life events. c. Antidepressant medications should not be used unless the client cannot function without them. d. If the depression has been present for more than 6 months, medication may be indicated

b. Antidepressant therapy may be indicated if depressive symptoms impair social relationships or work performance and occur independently of life events.

An infant born at 31 weeks' gestation is admitted to the neonatal intensive care unit (NICU). The infant's heart rate is 70 bpm; oxygen saturation is between 80% to 85%. The infant is also having periodic apnea lasting longer than 20 seconds. Of the following, which would be part of the treatment plan for this infant? a. Dextroamphetamine (Dexedrine) b. Caffeine c. Anorectics d. Atomoxetine (Strattera)

b. Caffeine

A nurse is reviewing information about anorexiants. The nurse would expect to find that most of these drugs are classified as which pregnancy category? a. Category B b. Category X c. Category C d. Category A

b. Category X

Besides being prescribed as an antidepressant, imipramine helps treat which disorder in children? a. Attention deficit hyperactivity disorder b. Enuresis c. Weight loss d. Night terrors

b. Enuresis

An older adult client diagnosed with generalized anxiety disorder is prescribed a benzodiazepine. The nurse caring for the client knows to include what intervention in the client's care plan? a. Seizure precautions b. Falls risk assessment c. Frequent dysrhythmias monitoring d. Education regarding sexual dysfunction

b. Falls risk assessment

A daughter brings her mother, who has Alzheimer's disease, to the clinic. The client has been taking a cholinesterase inhibitor medication for 1 month. When assessing the client, the nurse would be alert for the possibility of which side effect? a. Hypersomnia b. Gastrointestinal distress c. Muscle tics d. Hypotension

b. Gastrointestinal distress

A client who has taken diazepam for several months has developed physical dependence. The nurse has set up a schedule to taper drug doses to avoid a withdrawal syndrome. Which symptom would indicate that a withdrawal syndrome has occurred? Select all that apply. a. Constipation b. Headache c. Dry skin d. Tremor e. Increased anxiety

b. Headache d. Tremor e. Increased anxiety

A nurse is caring for a client who is taking rivastigmine. The client's nursing care plan will prioritize which nursing diagnosis? a. Risk for Fluid and Electrolyte Imbalance and Hyperglycemia related to adverse effects of medication b. Imbalanced Nutrition: Less Than Body Requirements related to decreased desire to eat secondary to nausea and vomiting from drug therapy c. Imbalanced Nutrition: More Than Body Requirements related to increased appetite and secondary to the drug therapy d. Risk for Injury related to extrapyramidal symptoms

b. Imbalanced Nutrition: Less Than Body Requirements related to decreased desire to eat secondary to nausea and vomiting from drug therapy

An older adult client has been diagnosed with early-stage Alzheimer's disease and has begun treatment with donepezil. When providing health education to the client and the client's spouse, the nurse should identify what goal of treatment? a. Cure of Alzheimer's disease b. Improvement of cognition and function c. Remission of Alzheimer's disease d. Resolution of memory and cognitive deficits

b. Improvement of cognition and function

The etiology of anxiety involves which physiologic process? a. Adrenocortical suppression b. Increased activation of the autonomic nervous system c. Stimulation of the parasympathetic nervous system d. Stimulating effects of somatotropin

b. Increased activation of the autonomic nervous system

A nurse is preparing a teaching plan for the family of a client diagnosed with Alzheimer disease (AD) who is receiving cholinesterase inhibitor therapy. Which would be appropriate for the nurse to include? a. Increasing the dose if the symptoms seem to increase. b. Keeping all appointments with the primary health care provider. c. Taking the dose at any time during the day. d. Reporting the first evidence of any nausea or diarrhea.

b. Keeping all appointments with the primary health care provider.

Cholinesterase inhibitors should not be administered to clients in which stage of Alzheimer's disease? a. Middle b. Late c. Pre d. Early

b. Late

After teaching a class on antianxiety drugs, the instructor determines that the teaching was successful when the class identifies which as a controlled substance by DEA regulations? a. Doxepin b. Lorazepam c. Buspirone d. Hydroxyzine

b. Lorazepam

A group of nursing students are reviewing the actions of drugs used to treat Alzheimer disease. The students demonstrate understanding when they identify that which drug works by decreasing the excitability of neurotransmission caused by an excess of the amino acid glutamate? a. Rivastigmine b. Memantine c. Donepezil d. Galantamine

b. Memantine

A tricyclic antidepressant has been prescribed to a 77-year-old client whose current medication regimen includes omeprazole, captopril, calcium carbonate, alendronate, and warfarin. What assessment should the nurse prioritize when monitoring the client for drug-drug interactions? a. Assess the client's blood pressure every six hours for the first week of therapy. b. Monitor the client closely for bleeding and review coagulation indices when available. c. Monitor the client for tetany and review serum calcium levels when available. d. Ask the client at each meal about any episodes of gastresophageal reflux.

b. Monitor the client closely for bleeding and review coagulation indices when available.

A client with advanced-stage Alzheimer's disease is seen by a health care provider who prescribes a newer drug that is not a cholinesterase inhibitor. This drug is a N-methyl-D-asparate (NMDA) receptor antagonist. This drug is better known as: a. Aricept. b. Namenda. c. Exelon. d. Cognex.

b. Namenda.

Prior to administering a CNS stimulant to reverse respiratory depression, which would the nurse need to ensure about the client? a. Normal blood pressure b. Patent airway c. Respiration greater than 24 breaths per minute d. Pulse less than 100 beats per minute

b. Patent airway

Ms. Keller has been prescribed sertraline for depression and anxiety. She has been taking the medication for 3 months now. After completing her health history, the nurse notes that she is having difficulty sleeping since starting this medication. What would be the best goal for Ms. Keller based on the assessment of her sleep dysfunction? a. The client will have no difficulty falling asleep at night. b. The client will sleep 8 hours each night. c. The client will take a nap each day to prevent fatigue. d. The client will drink two glasses of wine before bedtime each night.

b. The client will sleep 8 hours each night.

When a nurse is educating a client taking anorexiants for weight management, which teaching should be included? Select all that apply. a. Once you begin this medication, you will have to remain on it for several years. b. You may experience some side effects of this medication, including agitation, dizziness, and restlessness. c. You should not deviate from the prescribed dosage unless your provider instructs you to do so. d. You should take your medication before you eat dinner. e. You may take this medication in lieu of diet and exercise modifications to manage your weight.

b. You may experience some side effects of this medication, dizziness, and restlessness c. You should not deviate from the prescribed dosage unless your provider instructs you to do so

For which client would the black box warning that is present on all antidepressants be most relevant? a. a 32 year-old client who uses oral contraceptives and who has depression b. a 12 year-old child who has been diagnosed with depression by a pediatric psychiatrist c. a 62 year-old client who has depression and ischemic heart disease d. an 89-year-old client who is distraught after the recent death of their spouse

b. a 12 year-old child who has been diagnosed with depression by a pediatric psychiatrist

The nurse working with the family of the child prescribed methylphenidate should implement what strategy to address possible adverse reactions? a. A strategy to ensure that the child maintains normal bladder function b. A plan to address the child's loss of appetite c. plan to address the child's loss of self-esteem d. A strategy to regularly monitor the child's blood glucose levels

b. a plan to address the child's loss of appetite

What statement should a nurse use to plan a client assessment for the characterizations associated with major depression? a. a quantifiable deficiency of epinephrine b. an impaired ability to function in activities and relationships c. negative thoughts that are unresponsive to reason d. a diagnosable lack of self-efficacy and self-advocacy

b. an impaired ability to function in activities and relationships

A client is given hydroxyzine (Vistaril) in combination with an opioid in the preoperative phase before a laparoscopic cholecystectomy. What does the administration of hydroxyzine (Vistaril) assist in minimizing? a. oral secretions b. anxiety c. hypotension d. confusion

b. anxiety

A truck driver has been diagnosed with a generalized anxiety disorder (GAD) and lorazepam has been prescribed. The client asked the nurse how this medication will affect his job. The nurse would advise him how? a. drive only 2 hours after consuming the drug and stop when it's time for the subsequent dose. b. avoid driving until he is aware of the adverse effects. c. avoid driving at night, because lorazepam affects the wake-sleep cycle and can lead to drowsiness. d. change his profession, because the drug has long-term effects after cessation of therapy.

b. avoid driving until he is aware of the adverse effects.

Which should a nurse report to the healthcare provider prior to the client being prescribed a medication for Alzheimer's disease? Select all that apply. a. glaucoma b. bladder obstruction c. hypocalcemia d. seizure disorder e. fungal infections

b. bladder obstruction d. seizure disorder

A client is diagnosed with early-stage Alzheimer's disease. The nurse will anticipate that the client will be given a(n): a. antihistamine. b. cholinesterase inhibitor. c. cholinergic antagonist. d. acetylcholine.

b. cholinesterase inhibitor.

The nurse practitioner knows not to prescribe an anorexiant for weight loss to a client with: a. diverticulosis who takes a fiber supplement. b. depression who takes an antidepressant. c. a history of kidney stones. d. diabetes who takes insulin.

b. depression who takes an antidepressant

The nurse works in a mental health clinic. When a new adult client arrives reporting feelings of depression, what conditions should be screened for before the client is prescribed antidepressants? Select all that apply. a. diabetes mellitus b. hormonal imbalance c. cardiovascular disorders d. thyroid disease e. Parkinson disease

b. hormonal imbalance c. cardiovascular disorders d. thyroid disease

The nurse is caring for a resident in a long-term care facility who is African American with a history of an anxiety disorder. The client is receiving oral lorazepam 2 mg t.i.d. What assessment should the nurse prioritize? a. mucous membrane integrity b. level of consciousness c. suicidal ideation d. sleep quality

b. level of consciousness

A mother brings her child to the clinic and informs the health care provider that the child is having a difficult time paying attention in school, seems to be getting in trouble several times a day, and is acting very impulsively. The nurse can expect the provider to order which drugs for this child? a. modafinil b. methylphenidate c. diethylpropion d. armodafinil

b. methylphenidate

What adverse effect could be related to a fall experienced by an older client prescribed amitriptyline? a. urinary frequency b. orthostatic hypotension c. urinary retention d. visual disturbances

b. orthostatic hypotension

The nurse is caring for a client who was referred to a psychiatrist for treatment of a severe anxiety disorder. What medication would the nurse consider appropriate for this client? a. clozapine 200 mg twice daily orally b. paroxetine 10 mg once daily orally c. chlorpromazine 25 mg three times daily orally d. benztropine 2 mg twice daily orally

b. paroxetine 10 mg once daily orally

An adult client with a diagnosis of alcoholism is to be treated with chlordiazepoxide on an in-client basis. When administering chlordiazepoxide, the nurse should implement which client-focused intervention? a. Assessing the client's cardiac status prior to administering each dose b. Promptly stopping the medication once status improvements are noted c. Monitoring vital signs closely during intravenous (IV) administration d. Administering the oral form of the medication if the client is combative

c. Monitoring vital signs closely during intravenous (IV) administration

A client comes to the mental health clinic for a regular appointment. The client tells the nurse he has been taking oral fluoxetine 20 mg daily for the past 3 weeks and that he has lost 3 lb during that time due to a loss of appetite. What action should the nurse take? a. reassuring the client that the weight loss is due to diuresis and will resolve once fluid balance is restored b. reassuring the client that this is a common adverse effect with this medication c. encouraging the client to increase fat intake to avoid further weight loss d. recommending the use of over-the-counter multivitamin supplements

b. reassuring the client that this is a common adverse effect with this medication

The nurse is caring for a young female client who is 5 weeks pregnant. What statement made by the nurse about the use of antidepressants during pregnancy is most accurate? a. "Most antidepressants are safe during pregnancy but those that are contraindicated should be avoided." b. "Antidepressants are contraindicated and must be discontinued if pregnancy occurs." c. "Antidepressants are used very cautiously during pregnancy and only when benefit outweighs risk." d. "Antidepressants must be chosen carefully because only a few are safe during pregnancy."

c. "Antidepressants are used very cautiously during pregnancy and only when benefit outweighs risk."

The nurse should include which instruction about antianxiety medications and drug interactions in the teaching plan? a. "Consult your healthcare provider about increasing the dose of digoxin while taking antianxiety drugs." b. "One to three alcoholic beverages a day may help you feel more relaxed while taking antianxiety drugs." c. "Avoid driving or operating heavy machinery when taking tricyclic antidepressants and starting antianxiety drugs." d. "If taking pain medications, you may need to increase the doses for effective pain relief while taking antianxiety medications."

c. "Avoid driving or operating heavy machinery when taking tricyclic antidepressants and starting antianxiety drugs."

A client comes to the clinic with a possible mood disorder diagnosis of unipolar depression. What question by the nurse will best help in assessing this client's mental status? a. "Can you name six things you would like to change in your life?" b. "What have you eaten in the last two days?" c. "Have you felt hopeless anytime lately?" d. "Why are you feeling sad?"

c. "Have you felt hopeless anytime lately?"

A 28-year-old man has been taking sertraline for a few months. On a follow-up visit the client reports a change in sexual functioning, dizziness, and insomnia. The most appropriate response by the nurse would be which? a. "Do you eat a lot of fat in your diet?" b. "How much of the drug are you taking at one time?" c. "Have you stopped taking the drug" d. "How much alcohol do you consume?"

c. "Have you stopped taking the drug"

A client has been taking fluoxetine (Prozac) for the last ten days. Today the client is reporting not feeling any better. What is the nurse's best response to this client? a. "Please come to the clinic immediately so you can be reassessed for suicidal thoughts." b. "I will tell the healthcare provider and see if there is another medication that would be better." c. "It may take another two to three weeks before the medication is completely effective." d. "I realize this is frustrating but most medications for mood disorders aren't fully effective for two to three months."

c. "It may take another two to three weeks before the medication is completely effective."

A male client explains to a nurse that he had been taking amitriptyline (Elavil) for depression and that his physician changed his medication to paroxetine (Paxil). The client is confused and doesn't understand why the medication was changed. The nurse's best response to the client would be: a. "Did you take the amitriptyline like you should have?" b. "Maybe the old medicine wasn't working anymore." c. "Would you like to talk with your physician about this?" d. "Paroxetine is newer and will be much better for you."

c. "Would you like to talk with your physician about this?"

A community health nurse follows many clients, several of whom have depression and who are taking antidepressants. What assessment finding should the nurse prioritize for reporting to the care provider? a. A client taking isocarboxazid with whom the nurse needed to review dietary restrictions b. A client who takes sertraline 24 mg PO daily says he has noticed some sexual dysfunction since starting the drug c. A client who began taking escitalopram two weeks ago says her mood has worsened since starting the drug d. A client who takes amitriptyline reports a dry mouth and occasional urinary hesitation

c. A client who began taking escitalopram two weeks ago says her mood has worsened since starting the drug

After administering diazepam (Valium) intramuscularly, what is the nurse's best action? a. Ask the nursing assistant to assess the site for erythema or bruising. b. Ask the nursing assistant to inform you of the client's respiratory rate when taking the next scheduled set of vital signs. c. Advise the client to remain in bed for at least 30 minutes. d. Instruct the nursing assistant to check for signs of hypertension.

c. Advise the client to remain in bed for at least 30 minutes. d. Instruct the nursing

The nurse is caring for a client treated with flumazenil for benzodiazepine toxicity. After administering flumazenil what should the nurse carefully assess for? a. Cerebral hemorrhage and dystonia b. Hypotension, arrhythmias, and cardiac arrest c. Agitation, confusion, and seizures d. Hypertension and renal insufficiency

c. Agitation, confusion, and seizures

A client has been prescribed phenelzine sulfate. When providing teaching, which food should the nurse instruct the client to avoid eating? a. Ice cream b. Apples c. Salami d. Leafy greens

c. Salami

A client is taking rivastigmine for Alzheimer disease. The nurse will evaluate the client regularly for: a. weight gain. b. decreased blood pressure. c. weight loss. d. increased blood pressure.

c. weight loss.

The nurse obtains the following vital signs on a client: BP 160/85, P 90, RR 24. The client is recently divorced and reports taking alprazolam for the past seven weeks but stopped the medication yesterday. What is the nurse's first action? a. Advise the client that increased blood pressure is an expected finding after discontinuing Xanax. b. Document the client's vital signs in the electronic medical record and advise the charge nurse. c. Ask the client about experiencing increased anxiety, difficulty concentrating, or tremors. d. Notify the health care provider of the abnormal vital signs.

c. Ask the client about experiencing increased anxiety, difficulty concentrating, or tremors

A client with dementia of Alzheimer disease is prescribed memantine. Before administering the drug to the client, which would the nurse observe while obtaining the client's health history? a. Resistance power b. Sleeping patterns c. Behavior patterns d. Eating habits

c. Behavior patterns

A 75-year-old client is brought to the emergency department by the family. The family relates that the client has confusion, seizures, and abnormal perception of movement. When the nurse looks at the medication that the family has brought to the ED, the nurse discovers that twice the number of tablets are missing from the vial as there should be if the prescription orders were being followed. What should the nurse suspect is wrong with this client? a. Antihypertensive toxicity b. Sedative toxicity c. Benzodiazepine toxicity d. Analgesic toxicity

c. Benzodiazepine toxicity

A nurse is reviewing information about anxiolytics. Which anxiolytics would the nurse identify as the safest to use in older adult clients? a. Hydroxyzine b. Lorazepam c. Buspirone d. Doxepin

c. Buspirone

A cholinesterase inhibitor is prescribed for a client showing signs of dementia. The nurse knows that which statement regarding cholinesterase inhibitors is correct? a. Olanzapine (Zyprexa) is a cholinesterase inhibitor used to treat Alzheimer's disease. b. Cholinesterase inhibitors are most effective in late-stage Alzheimer's disease. c. Cholinesterase inhibitors cause adverse gastrointestinal effects, including nausea and diarrhea. d. Cholinesterase inhibitors will stop the progression of Alzheimer's disease.

c. Cholinesterase inhibitors cause adverse gastrointestinal effects, including nausea and diarrhea.

A nurse and a client with Alzheimer's disease are discussing drug interactions with the cholinesterase inhibitors. The nurse will advise that which of these is a potential interaction? a. Ginkgo taken with a cholinesterase inhibitor may cause manic episodes. b. Cholinesterase inhibitors decrease the effects of theophylline. c. Cholinesterase inhibitors increase risk for gastrointestinal bleeding from nonsteroidal anti-inflammatory drugs (NSAIDs). d. Anticholinergic drugs will increase the effects of cholinesterase inhibitors.

c. Cholinesterase inhibitors increase risk for gastrointestinal bleeding from nonsteroidal anti-inflammatory drugs (NSAIDs).

The nurse in a long-term care facility is providing care for an 83-year-old client who has depression and who has been prescribed clomipramine. The client has twice reported urinary hesitation since starting this treatment and required intermittent urinary catheterization overnight to relieve bladder distention. What is the nurse's best action? a. Provide the client with increased opportunities for fluid intake. b. Monitor the client's urinary function closely over the next 48 hours. c. Contact the care provider promptly to advocate for a change in the medication regimen. d. Contact the provider to obtain an order for an indwelling urinary catheter.

c. Contact the care provider promptly to advocate for a change in the medication regimen.

A client is diagnosed with early stage Alzheimer's disease. The nurse recognizes which manifestations is characteristic of early-stage Alzheimer's? a. Poor verbal ability b. Assistance with bathing is needed c. Decreased social interaction d. Impaired memory of current happenings

c. Decreased social interaction

A nurse is explaining the difference between delirium and dementia to a client's son. The client is 72-years-old who is being treated for a kidney infection with IV antibiotics in a hospital. Prior to the hospitalization the client was working three days per week as a mechanical engineer. Today, when the son arrived, the client was hearing, seeing, and talking about angels. Which statements is correct? a. Delirium progresses into dementia as a client gets older. b. Dementia and delirium are the same thing. c. Delirium is temporary and is brought on by an illness or chemical imbalance. d. Dementia is temporary and is brought on by an illness or chemical imbalance.

c. Delirium is temporary and is brought on by an illness or chemical imbalance.

The nurse can distinguish delirium from dementia by knowing which of the following? a. Delirium has a gradual onset and can be resolved. b. Delirium has an acute onset and in progressive in course. c. Dementia has a gradual onset and is progressive in course. d. Dementia has an acute onset and can be resolved.

c. Dementia has a gradual onset and is progressive in course.

The nurse and the client are discussing various drugs for management of anxiety. The client asks, "How do these drugs work?" The nurse knows that interaction with the central nervous system neurotransmitter gamma-aminobutyric acid (GABA) is the mechanism of which drug? a. Meprobamate (Equanil, Miltown) b. Hydroxyzine (Vistaril) c. Diazepam (Valium) d. Doxepin (Sinequan)

c. Diazepam (Valium)

A client with a severe depression has been hospitalized, and the health care provider has ordered amitriptyline. What common adverse effect might this client have? a. Fever b. Hypertension c. Dry mouth d. Decreased B/P

c. Dry mouth

Clients taking benzodiazepines, especially older adult clients, are at high risk for which effect? a. Constipation b. Hepatic failure c. Falls d. Heart failure

c. Falls

A client has been taking citalopram for 2 weeks and has expressed a desire to discontinue it, stating, "I don't feel any better than I did before I started these pills." What should the nurse teach the client? a. The drug requires six to eight weeks before it reaches peak levels b. Improvements are likely evident to others even if not to the client c. It may take up to two more weeks before the client feels better d. The client's pessimism is likely a symptom of the underlying depression

c. It may take up to two more weeks before the client feels better

A client is scheduled to undergo a bronchoscopy for the investigation of a bronchial mass. What benzodiazepine should the clinic nurse anticipate administering for conscious sedation? a. Oxazepam b. Chlordiazepoxide c. Midazolam d. Triazolam

c. Midazolam`

A client has been prescribed a benzodiazepine daily for treatment of an anxiety disorder. In order to minimize the chances of withdrawal symptoms, the nurse knows to include what precaution in client teaching? a. Exchanging the drug for an anticonvulsant b. Substituting the immediate-acting form of the drug with a long-acting form c. Tapering the dose of drug over a prolonged period of time d. Replacing the drug with a herbal supplement in anticipation of stopping the medication

c. Tapering the dose of drug over a prolonged period of time

The nurse would contact the health care provider prior to administering lithium if is discovered that the client is allergic to what? a. Eggs b. Milk c. Tartrazine (yellow dye) d. Penicillin

c. Tartrazine (yellow dye)

The nursing instructor is teaching a student about the drugs used for Alzheimer's disease. Even though cholinesterase inhibitors do not cure the disease, the instructor informs the student that they do help to slow the progression. The instructor then asks the student, "When a drug is stopped due to side effects, what happens to the client?" The student's best response would be: a. The client will show no changes. b. The side effects will worsen. c. The client loses any benefit they have received from the drug. d. The client will deteriorate at a faster rate.

c. The client loses any benefit they have received from the drug.

What would be important to include in the teaching of the client about the side effects of buspirone? a. The medication can cause nausea and vomiting. b. The medication has been shown to cause palpitations. c. The medication can cause light-headedness. d. The medication causes significant drowsiness.

c. The medication can cause light-headedness.

What is the major reason that monoamine oxidase inhibitors (MAOs) are rarely used in clinical practice today? a. They are ineffective in treating depression or anxiety disorders. b. They are under a scheduled drug classification. c. They may cause dangerous interactions with some foods and drugs. d. They can cause gastrointestinal (GI) bleeding and esophageal varices.

c. They may cause dangerous interactions with some foods and drugs.

A client with Alzheimer's disease asks the nurse for more information regarding cholinesterase inhibitors. The nurse knows that which statement regarding these drugs is correct? a. All cholinesterase inhibitors are administered on a twice-daily schedule. b. Cholinesterase inhibitors are administered only in the late stages of Alzheimer's disease. c. When cholinesterase inhibitors are discontinued, their beneficial effect ceases after 6 weeks. d. Cholinesterase inhibitors are contraindicated in dementias of vascular origin.

c. When cholinesterase inhibitors are discontinued, their beneficial effect ceases after 6 weeks.

An 83-year-old client has a diagnosis of moderate Alzheimer's disease. The client's physician recently prescribed oral rivastigmine, but the client was unable to tolerate the drug due to its gastrointestinal effects. As a result, he has been ordered the transdermal patch form of the medication. When administering this form of rivastigmine, the nurse should do which? a. apply the patch to a mucous membrane to facilitate complete absorption. b. teach the client's family to apply a second patch if they notice an acute exacerbation of his confusion. c. apply the patch to the client's back to reduce the chance that he will remove it. d. teach the client about the importance of rotating sites when he applies the patch.

c. apply the patch to the client's back to reduce the chance that he will remove it.

A nurse is working with a client who is taking an MAOI. What would be the most important instruction to the client? a. adhere to combination drug therapy. b. avoid taking the drug on an empty stomach. c. avoid use of soy sauce in the diet. d. discuss the cultural significance of taking an MAOI.

c. avoid use of soy sauce in the diet.

The client in the final stage of Alzheimer's disease tends to suffer from weight loss and eating problems. This is primarily due to: a. fatigue. b. inability to make food choices. c. inability to swallow. d. loss of appetite.

c. inability to swallow.

Cholinesterase inhibitors act to increase the levels of acetylcholine in the central nervous system by which of the following mechanisms? a. inhibiting cholinesterase production b. inhibiting acetylcholine production c. inhibiting acetylcholine's breakdown d. inhibiting cholinesterase breakdown

c. inhibiting acetylcholine's breakdown

An older adult was diagnosed with depression several decades ago and has been taking tricyclic antidepressants (TCAs) ever since, with good effect. The nurse should recognize what therapeutic action of this client's medication? a. inhibiting generalized neuron activity, preventing overexcitability or stimulation b. blocking the reuptake of serotonin, which increases the levels of norepinephrine c. inhibiting reuptake of norepinephrine and serotonin d. inhibiting monoamine oxidase inhibitors that break down norepinephrine

c. inhibiting reuptake of norepinephrine and serotonin

A client has been taking lorazepam on a regular basis for several months since a personal tragedy. The client states they just stopped taking the medication abruptly. The nurse should assess for what effects? Select all that apply. a. urinary retention and change in sexual functioning b. bradycardia and constipation c. nausea and headache, vertigo, malaise, and nightmares d. dry mouth and constipation e. vertigo and nightmares

c. nausea and headache, vertigo, malaise, and nightmares e. vertigo and nightmares

A client prescribed fluoxetine 1 week ago presents for a scheduled follow-up appointment. What should be the focus of the client's nursing assessment to best assure client safety? a. cardiac rate and rhythm b. improvement in the ability to concentrate c. presence of suicidal ideation d. indications of a type IV hypersensitivity reaction

c. presence of suicidal ideation

The nurse is creating a care plan for a client taking a selective serotonin reuptake inhibitor (SSRI). What would be an appropriate nursing diagnosis for this client? a. risk for infection related to immunosuppressant effects of medication b. disturbed thought processes related to CNS effects of medication c. risk for autonomic dysreflexia related to CNS effects of medication c. risk for impaired skin integrity related to vasodilation and delayed wound healing

c. risk for autonomic dysreflexia related to CNS effects of medication

A client taking rivastigmine reports to the clinic nurse that she has been having gastrointestinal problems since she started the medication. The nurse will advise the client to do which? a. stop taking the medication. b. continue taking the medication as prescribed. c. take the medication with food. d. take the medication 1 hour before eating.

c. take the medication with food.

A new mother asks her nurse about the safety of taking St. John's wort for postpartum depression. What would be the nurse's best response? a. "St. John's wort is a natural and safe alternative to prescription antidepressants." b. "Most experts agree that St. John's wort is effective in treating depression but that it can contribute to hypertension." c. "It's not clear that St. John's wort is effective in treating depression, but it won't cause any harm." d. "There is insufficient evidence to support the use of St. John's wort, and drug interactions may be extensive."

d. "There is insufficient evidence to support the use of St. John's wort, and drug interactions may be extensive."

A hospitalized client asks the nurse why the health care provider prescribed an anxiolytic medication. What is the nurse's best response? a. "Anxiolytic drugs are different from antianxiety drugs, because they work without a tranquilizing effect." b. "Anxiolytics are prescribed to treat anxiety and can be purchased without a prescription after discharge." c. "An anxiolytic, such as alprazolam, is usually prescribed for long-term anxiety disorders." d. "This type of medication is typically prescribed to treat excess anxiety that interferes with daily activities."

d. "This type of medication is typically prescribed to treat excess anxiety that interferes with daily activities."

The health care provider would not prescribe duloxetine (Cymbalta) for a client with a mood disorder if the client took which other medication? a. A medication for diabetes b. A medication for tonsillitis c. A medication for diarrhea. d. A medication for hypertension

d. A medication for hypertension

The psychiatric-mental health nurse is overseeing care of several clients who are being treated with selective serotonin reuptake inhibitors. Which client should the nurse monitor most closely for adverse effects? a. A 60-year-old female client who is also taking hormone replacement therapy b. A client whose treatment regimen also includes electroconvulsive therapy (ECT) c. A 79-year-old client who has a comorbidity of early stage dementia d. A severely depressed 14-year-old client who is receiving inpatient care

d. A severely depressed 14-year-old client who is receiving inpatient care

A nursing instructor is preparing a presentation on the etiology of Alzheimer's disease. When discussing the role of neurotransmitters in the course of the disease, which would the instructor emphasize? a. Norepinephrine b. Dopamine c. Serotonin d. Acetylcholine

d. Acetylcholine

The nurse is caring for a client who has had a benzodiazepine toxicity. What can Flumazenil , an antidote for benzodiazepine toxicity, cause? a. Hypertension and renal insufficiency b. Cerebral hemorrhage and dystonia c. Hypotension, arrhythmias, and cardiac arrest d. Agitation, confusion, and seizures

d. Agitation, confusion, and seizures

A nursing instructor is conducting a class about drugs that affect the central nervous system (CNS). The instructor determines that the teaching was successful when the students identify which as a component of the CNS? Select all that apply. a. Autonomic nerves b. Efferent nerves c. Afferent nerves d. Brain e. Spinal cord

d. Brain e. Spinal cord

A client prescribed a selective serotonin reuptake inhibitor has begun taking St. John's wort daily. The nurse should teach the client that this combination may result in what adverse reaction? a. Worsened symptoms of depression b. Development of blood dyscrasias c. Hemostatic instability d. Dangerous drug interactions

d. Dangerous drug interactions

In addition to relieving agitation and anxiety, what is a rationale for using benzodiazepines in the treatment of a critically ill client? a. Decreased blood pH b. Increased diffusion and perfusion c. Increased level of consciousness d. Decreased cardiac workload

d. Decreased cardiac workload

A nurse and client are discussing management of anxiety. Which statements regarding management of anxiety is correct? a. Anti-anxiety drugs are recommended for long-term management of anxiety symptoms. b. Benzodiazepine overdose often is fatal. c. All anti-anxiety drugs are controlled substances. d. Excess anxiety can be immobilizing.

d. Excess anxiety can be immobilizing.

Some medications can cause extra-pyramidal effects. Which anti-anxiety drugs may cause involuntary movement? a. Chlordiazepoxide (Librium) b. Buspirone (BuSpar) c. Diazepam (Valium) d. Hydroxyzine (Vistaril)

d. Hydroxyzine (Vistaril)

A client is prescribed hydroxyzine. The nurse would be alert for the development of which effect early on? a. Abdominal cramping b. Inflammation of the mouth c. Inflamed mucous membranes d. Mild drowsiness

d. Mild drowsiness

While reviewing the medical record of a client with moderate dementia of the Alzheimer type, the nurse notes that the client has been receiving memantine. The nurse identifies memantine as which type? a. Benzodiazepine b. Cholinesterase inhibitor c. Atypical antipsychotic d. NMDA receptor antagonist

d. NMDA receptor antagonist

A nurse is working with a 9-year-old child who exhibits signs and symptoms of obsessive-compulsive disorder (OCD). What nursing action is most likely to be appropriate? a. Educate the family about the safe and effective use of phenelzine. b. Ensure that the provider assesses the client's cortisol levels. c. Assist the family with accessing cognitive behavioral therapy. d. Provide health education about fluvoxamine.

d. Provide health education about fluvoxamine.

A nursing student is preparing a care plan and is choosing a nursing diagnosis for her client with Alzheimer's disease. The client is taking Exelon. Which would be an appropriate nursing diagnosis for this client? a. Risk for Injury related to being confined to the Alzheimer's unit b. Imbalanced Nutrition: More Than Body Requirements c. Learning Impairment related to decreased hearing d. Risk for Injury related to dizziness and fatigue

d. Risk for Injury related to dizziness and fatigue

At the insistence of her roommate, a college student has presented to the campus medical clinic and reports a history of anhedonia, insomnia, anorexia and fatigue. The client is diagnosed with depression and the nurse is providing health education about the client's prescribed SSRI. What teaching should the nurse prioritize? a. The signs and symptoms of hepatotoxicity b. The importance of follow-up blood work c. The need to avoid high-tyramine foods d. The need to use barrier contraceptives

d. The need to use barrier contraceptives

The client is prescribed dextroamphetamine. The nurse is counseling the client prior to beginning this medication. Which information should the nurse include in the teaching? a. You may see an improvement in symptoms within 5 to 7 days. b. You may see an improvement within 24 to 48 hours. c. Take this medication with food at night. d. Take this medication first thing in the morning on an empty stomach. e. Take this medication in the morning with breakfast.

e. Take this medication in the morning with breakfast