Psych Pharm Q's 4
Which antipsychotic drugs have the higher risk of causing tardive dyskinesia? Loxapine Quetiapine Haloperidol Ziprasidone Olanzapine
Loxapine Haloperidol
Which statement by the client indicates to the nurse that the teaching about taking an antidepressant medication has been understood? "I need to take every dose of my medication as prescribed." "I need to discontinue the medication if I have side effects." "I don't have to be concerned about taking my medications." "I can double the dose of the medication if I still feel depressed."
"I need to take every dose of my medication as prescribed."
How long after the last dose will the nurse schedule to have a client's blood drawn to evaluate the serum lithium level? 2 to 4 hours 4 to 6 hours 6 to 8 hours 8 to 12 hours
8 to 12 hours
When used in combination with certain foods and drugs, monoamine oxidase inhibitors (MAOIs) can cause serious side effects. Which condition could occur in clients treated with MAOIs for depression? A serious drop in blood pressure A serious increase in blood pressure A significant increase in liver enzymes A significant increase in cholesterol levels
A serious increase in blood pressure
A client's serum lithium level is 0.2 mEq/L (0.2 mmol/L). What is the nurse's interpretation of this finding? Within toxic range Borderline toxic range Below therapeutic range Borderline therapeutic range
Below therapeutic range
A client who is on haloperidol therapy has developed akathisia and acute dystonia. Which drugs would be used to manage extrapyramidal effects? Bupropion Duloxetine Benztropine Amitriptyline Trihexyphenidyl
Benztropine Trihexyphenidyl
A client who takes insulin for type 1 diabetes has a psychosis and is to receive haloperidol. Which response does a nurse anticipate with this drug combination? Depressed respiration Intensified action of both drugs Decreased control of the diabetes Increased danger of extrapyramidal side effects
Decreased control of the diabetes
The primary healthcare provider is concerned that one of the clients receiving haloperidol may be developing neuroleptic malignant syndrome. When assessing the client for this syndrome, for which clinical manifestations does the nurse monitor the client? Jaundice and malaise Tremors and seizures Diaphoresis and hyperpyrexia Dry skin and hyperbilirubinemia
Diaphoresis and hyperpyrexia
What medication does the nurse expect to administer to actively reverse the overdose sedative effects of benzodiazepines? Lithium Flumazenil Methadone Chlorpromazine
Flumazenil
A nurse is caring for a client who uses ritualistic behavior. What common antiobsessional medication does the nurse anticipate will be prescribed? Benztropine Amantadine Fluvoxamine Diphenhydramine
Fluvoxamine
The nurse is caring for a 60-year-old client who is diagnosed with dementia. Which antipsychotic drugs would be contraindicated for the client? Quetiapine Haloperidol Aripiprazole Risperidone Chlorpromazine
Haloperidol Chlorpromazine
A nurse is caring for a client with the diagnosis of schizophrenia who is started on fluphenazine decanoate. What is the primary advantage of this medication? There are no side effects. It has a long-lasting effect. It is safe to use during pregnancy. There is less need for laboratory monitoring.
It has a long-lasting effect.
Which drug may lead to bruxism? Vilazodone Isocarboxazid Clomipramine Levomilnacipran
Levomilnacipran
A nurse is teaching the parents of a child with attention deficit hyperactivity disorder. What does the nurse include as the most frequently prescribed medication for this disorder? Lorazepam Haloperidol Methylphenidate Methocarbamol
Methylphenidate
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? Monitor the effect of the medication on their child's behavior. Increase or decrease the dosage, depending on the child's behavior. Avoid imposing too many rules, because this will frustrate the child. Point out to their child that behavior can be controlled.
Monitor the effect of the medication on their child's behavior.
A primary healthcare provider prescribes 10 mg of haloperidol by mouth twice a day for a client who is also receiving phenytoin for control of epilepsy. When planning the client's care, the nurse considers that, when anticonvulsants interact with haloperidol, what effect may occur? Masking of haloperidol's therapeutic effect Interference with haloperidol's absorption Enhancement of haloperidol's rate of metabolism Potentiation of haloperidol's central nervous system depressant effect
Potentiation of haloperidol's central nervous system depressant effect
When reviewing the medications for a group of clients on a psychiatric unit, the nurse concludes that the pharmacotherapy for anxiety disorders is moving away from benzodiazepines and moving toward which other drug class? Anticholinergics Lithium carbonate Antipsychotic medications Selective serotonin reuptake inhibitors
Selective serotonin reuptake inhibitors
Sertraline is prescribed for a depressed client. What information does the nurse include when teaching the client about this drug? The drug can cause a hypertensive crisis. The drug interferes with the reuptake of norepinephrine. Specific foods should be avoided when one is taking the drug. Several weeks may pass before the effects of the drug become evident.
Several weeks may pass before the effects of the drug become evident.
The primary healthcare provider prescribed imipramine to a client with depression. Which adverse effects would the nurse anticipate in the client? Asthenia Skin rash Hepatotoxicity Photosensitivity Blood dyscrasias
Skin rash Photosensitivity Blood dyscrasias
Considering the anticholinergic-like side effects of many of the psychotropic drugs, the nurse will encourage clients taking these drugs to take which action? Restrict their fluid intake. Eat a diet high in carbohydrates. Suck on sugar-free hard candies. Avoid products that contain aspirin.
Suck on sugar-free hard candies.
In addition to hydration during alcohol withdrawal delirium, parenteral administration of lorazepam is prescribed for a client. The nurse knows that this drug is given during detoxification primarily for what purpose? To prevent injury when seizures occur To enable the client to sleep better during periods of agitation To reduce the anxiety tremor state and prevent more serious withdrawal symptoms To quiet the client and encourage cooperation by promoting acceptance of the treatment plan
To reduce the anxiety tremor state and prevent more serious withdrawal symptoms
The laboratory report of a client undergoing long-term treatment with lithium carbonate indicates a level of 1.5 mEq/L (1.5 mmol/L). What will the nurse do? Watch for signs of lithium toxicity. Expect an increase in manic behavior. Administer the next dose of lithium as prescribed. Ask the client whether he or she has been taking the medication.
Watch for signs of lithium toxicity.
A nurse is interviewing a client in the mental health clinic. Which statement by the client indicates an irreversible adverse response to long-term therapy with an antipsychotic medication? "My mouth is always dry." "I can't seem to sleep at night." "I don't have much of an appetite." "I cannot control my tongue movements."
"I cannot control my tongue movements."
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? "I have less pain." "I have been sleeping better." "My blood glucose is under control." "My blood pressure is coming down."
"I have been sleeping better."
The nurse teaches the client about foods to avoid while on phenelzine therapy. Which response given by the client indicates the need for further education? "I should avoid raisins in my diet." "I should avoid corned beef in my diet." "I should avoid burgundy and sherry in my diet." "I should avoid the foods that are made of pepperoni."
"I should avoid raisins in my diet."
The registered nurse is teaching the nursing student about the interventions to be followed while caring for a client undergoing treatment with anxiolytic drugs. Which statement made by the nursing student indicates the need for further teaching? "I should monitor vital signs of the client." "I should check the client's oral cavities for cheeking of drugs." "I should encourage the client to use compression stockings." "I should encourage the client to change positions quickly."
"I should encourage the client to change positions quickly."
A client has been taking the prescribed dose of clozapine. The nurse will assess the client for which life-threatening side effect of this drug? Polycythemia Agranulocytosis Hypertensive crisis Pseudoparkinsonism
Agranulocytosis
Clozapine, an atypical antipsychotic, is prescribed for a client with psychosis. It is important for client to have frequent blood tests for which possible complication? Anemia Hemophilia Agranulocytosis Thrombocytopenia
Agranulocytosis
A nurse is counseling a client who is taking lithium carbonate. What is the priority nursing assessment when a client is taking this medication? Daily weights Psychomotor activity Red blood cell counts Blood level of the drug
Blood level of the drug
Which toxic effect would the nurse find in a client who has overdosed on isocarboxazid? Mydriasis Bradycardia Hypothermia Circulatory collapse
Circulatory collapse
Which is a second-generation antidepressant drug? Doxepin Citalopram Protriptyline Trimipramine
Citalopram
Which client may benefit from the administration of the herbal preparation of Hypericum perforatum? Client with dementia Client with schizophrenia Client with sleep disorder Client with Alzheimer disease
Client with sleep disorder
An 80-year-old client with depression requires the prescription of antidepressant drugs. Which tricyclic antidepressant drug is appropriate? Doxepin Amoxapine Nortriptyline Trimipramine
Nortriptyline
The healthcare provider prescribes donepezil 5 mg by mouth once a day for a client exhibiting initial signs of dementia of the Alzheimer type. The client is already taking digoxin 0.125 mg in the morning and alprazolam 0.5 mg twice a day. What will the nurse teach the client's spouse to do? Hang a list of medications with the times at which the spouse should take them. Prefill a weekly drug box with the medications for the spouse to self-administer. Remind the spouse in the morning which medications must be taken during the day. Provide the spouse with the medications at the appropriate times they should be taken.
Prefill a weekly drug box with the medications for the spouse to self-administer.
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? Provide the client with sunscreen. Caution the client to limit exertion during the trip. Give the client an extra dose of medication to take after lunch. Take the client's blood pressure before allowing participation in the outing.
Provide the client with sunscreen.
A client with depression is to be given fluoxetine. What precaution will the nurse consider when initiating treatment with this drug? It must be given with milk and crackers to prevent hyperacidity and discomfort. Eating cheese or pickled herring or drinking wine may cause a hypertensive crisis. The blood level may not be sufficient to cause noticeable improvement for 2 to 4 weeks. The blood level should be checked weekly for 3 months to monitor for an appropriate level.
The blood level may not be sufficient to cause noticeable improvement for 2 to 4 weeks.
A recently married 22-year-old woman is brought to the trauma center by the police. She has been robbed, beaten, and sexually assaulted. The client, although anxious and tearful, appears to be in control. The primary healthcare provider prescribes 0.25 mg of alprazolam for agitation. The nurse will administer this medication when what event occurs? The client's crying increases. The client requests something to calm her. The nurse determines a need to reduce her anxiety. The primary healthcare provider is getting ready to perform a vaginal examination.
The client requests something to calm her.
The registered nurse is teaching about monoamine oxidase (MAO) inhibitors to a nursing student. Which statement made by the nursing student indicates the need for further teaching? "Isocarboxazid is a selective MAO-B inhibitor." "MAO inhibitors are prescribed as adjunct to diphenhydramine." "Hypertensive crisis is a reported adverse effect of MAO inhibitors." "MAO inhibitors are prescribed to clients with Parkinson disease." "Interaction of sympathomimetic drugs with MAO inhibitors may cause hypertensive crisis."
"Isocarboxazid is a selective MAO-B inhibitor." "MAO inhibitors are prescribed as adjunct to diphenhydramine."
A client has been taking escitalopram for treatment of a major depressive episode. On the fifth day of therapy the client refuses the medication, stating, "It doesn't help, so what's the use of taking it?" What is the best response by the nurse? "It can take 1 to 4 weeks to see an improvement." "It takes 6 to 8 weeks for this medication to have an effect." "I'll talk to your primary healthcare provider about increasing the dosage. That may help." "You should have felt a response by now. I'll notify the primary healthcare provider right now."
"It can take 1 to 4 weeks to see an improvement."
After reviewing the data of a client who has been taking clozapine for two months, the primary healthcare provider instructs the client to discontinue the drug for a few weeks. Which laboratory parameter assessed by the primary healthcare provider would support the intervention? Hemoglobin of 12g/dL White blood cell count of 2,500/mm 3 Red blood cell count of 4.2 million/mm 3 Platelet count of 30,000/mm 3
White blood cell count of 2,500/mm 3, Because clozapine may cause agranulocytosis
