RN LS Pharmacology practice

nurse in an acute care mental health facility is preparing to administer morning medication for a client who has been taking lithium for 2 weeks and has a current lithium level of 1.0 mEq/L. Which of the following actions should the nurse take?

Administer the morning dose of lithium. Rationale: The nurse should administer the lithium dose since a lithium level of 1.0 mEq/L is within the expected initial therapeutic range of 0.8 to 1.3 mEq/L. At a therapeutic level the client might demonstrate adverse effects of lithium, such as a fine hand tremor, thirst, and mild nausea, and the nurse should note if any of these manifestations are present. The nurse should continue to monitor for adverse effects and signs of toxicity, which usually occur at levels of 1.5 mEq/L or higher.

nurse is providing teaching to a client who has seizures and a new prescription for phenytoin. Which of the following information should the nurse provide?

Alcohol increases the chance of phenytoin toxicity. Rationale: The nurse should include in the home instructions that alcohol alters the blood level of phenytoin.

A nurse is preparing to administer selegiline for a client who is admitted with major depression. Which of the following actions should the nurse take?

Apply to dry skin on the client's upper thigh. Rationale: Selegiline, a monoamine oxidase inhibitor (MAOI) is administered only by the transdermal route to treat depression. It can be administered orally to treat Parkinson's disease and other disorders.

Before administering a medication to a client, the nurse must identify the client. Which of the following methods of identification should the nurse use?

Ask the client's full name and date of birth. Rationale: The nurse must use two identifiers before administering medications. Acceptable identifiers include the client's name, date of birth, identification number within the facility or system, telephone number, and photo identification card or badge.

nurse is providing teaching for a client who has schizophrenia and a new prescription for fluphenazine. Which of the following information should the nurse provide?

"Sleepiness should subside within a week." Rationale: The nurse should inform the client that fluphenazine, like other first-generation antipsychotics, may cause sedation with early treatment, but should subside within a week or so.

nurse is teaching a client who has a depressive disorder about fluoxetine. Which of the following information should the nurse include in the teaching?

"You may experience difficulties with sexual functioning while taking this medication R: SSRI can cause sexual dysfunction

nurse is evaluating teaching for a client who has newly diagnosed depression and a new prescription for bupropion. Which of the following statements by the client indicates understanding of the teaching?

. "I may not notice a lifting of my mood for at least 2 weeks." Rationale: Bupropion is a norepinephrine-dopamine reuptake inhibitor (NDRI). As with other antidepressants, it can take 2 to 4 weeks for therapeutic effects to occur when taking bupropion.

nurse is preparing to administer phenytoin 75 mg PO every 6 hr. Available is phenytoin 25 mg/5mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

15 mL

A nurse is preparing to administer amantadine 150 mg PO every 12 hr. Available is amantadine 50 mg/5 mL syrup. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

15 mL Correct Rationale: Desired x Quantity = Amount to be given Have 150 mg x 5 mL = X mL 50 mg 750 = X mL 50 X = 15 mL

A nurse is preparing to administer chlordiazepoxide 50 mg PO every 8 hr to a client. The amount available is chlordiazepoxide 25 mg/capsule. How many capsules should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

2 capsule

A nurse is preparing to administer lithium 300 mg PO every 8 hr. Available is lithium carbonate 150 mg capsules. How many capsules should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

2 capsule(s) Correct Rationale: Desired x Quantity = Amount to be given Have 300 mg x 1 capsules = X capsules 150 mg 300 = X capsules 150 X = 2 capsules

9.A nurse is preparing to administer benztropine 2 mg IM every 12 hr to a client who is experiencing an extrapyramidal reaction. Available is benztropine 1 mg/mL for injection. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

2 mL

nurse is preparing to administer fluoxetine 30 mg PO daily to a client. The amount available is fluoxetine 10 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

3 tablet(s)

nurse is preparing to administer valproic acid 400 mg PO bid for migraine headaches. Available is valproic acid 250 mg/5mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

8 mL

nurse is reviewing abnormal laboratory values for four clients who have schizophrenia and take clozapine. For which of the following clients should the nurse withhold the medication and notify the provider immediately to have clozapine therapy discontinued?

A client who has a WBC of 2,900 cells/mm3 Rationale: A white blood cell count of 2,900 cells/mm3 is below the normal reference range of 5000 to 10000 cells/mm3 . The client who takes clozapine is at risk for agranulocytosis; therefore, a client who has a WBC of less than 3000 mm3 should have clozapine withheld and treatment stopped until the WBC returns to normal. Clozapine should be permanently stopped if a client's WBC falls below 2000 mm3.

A nurse is preparing to administer phenytoin IV to a client who has a seizure disorder. Which of the following actions should the nurse plan to take?

Administer a saline solution after injection. Rationale: The nurse should flush the injection site with a saline solution after the injection of phenytoin to reduce and prevent venous irritation.

nurse is providing discharge teaching to a client who is taking risperidone. Which of the following instructions should the nurse include in the teaching?

Avoid becoming overheated while taking this medication." Rationale: Risperidone increases the risk of heat stroke; therefore, the client should be instructed to avoid hot baths, hot tubs, hot showers, and prolonged time outside in hot weather.

nurse is teaching a client who has a new prescription for chlorpromazine. Which of the following client statements indicates an understanding of the teaching?

B. "I may have a dry mouth while taking this medication." Rationale: Chlorpromazine causes anticholinergic effects, such as dry mouth and constipation.

nurse arrives for her shift and is preparing to count the controlled substances in the secure cabinet. Which of the following actions should the nurse take?

B. Verify that the amounts of each medication she counts match the amounts on the inventory record. Rationale: If the amounts available do not match the amounts on the inventory record after subtracting what the nurses administered during the previous shift and adding any medications the nurses added to the cabinet, the nurse must address and reconcile the count.

nurse is providing dietary teaching for a client who has a new prescription for a monoamine oxidase inhibitor (MAOI). When the client develops a sample lunch menu, which of the following items requires intervention by the nurse?

Bologna sandwich Rationale: Clients who are receiving an MAOI should avoid foods containing a high tyramine content. Bologna has a high tyramine content and should be avoided.

nurse is teaching a client who has multiple sclerosis about a new prescription for baclofen. Which of the following instructions should the nurse include in the teaching?

Do not take antihistamines with this medication." Rationale: The nurse should instruct the client not to take antihistamines while taking baclofen. Antihistamines will intensity the depressant effects of baclofen.

A nurse is teaching the parents of a school-age child who has ADHD about atomoxetine. Which of the following instructions should the nurse include in the teaching?

Give the dose in the morning to help prevent insomnia." Rationale: Insomnia is a common adverse effect of atomoxetine. Administering the dose in the morning will help prevent this adverse effect.

A nurse is providing teaching for a client who has schizophrenia and a new prescription for risperidone. Which of the following statements should the nurse include in the teaching?

Increase your fluid and fiber intake to prevent constipation. Rationale: Constipation is a common adverse effect of risperidone and the client should be taught strategies to prevent constipation, such as increasing the amount of fiber in the diet.

nurse is assessing for the presence of extrapyramidal side effects (EPS) in a client who is taking chlorpromazine. Which of the following findings should the nurse recognize as EPS? (Select all that apply.)

Muscle spasms of the neck B. Fidgeting behavior D. Tremors of the hands Rationale: Muscle spasms of the neck is correct. Muscle spasms of the neck are an example of EPS associated with conventional antipsychotics.Fidgeting behavior is correct. Fidgeting behavior, or akathisia, consists of behaviors such as pacing or fidgeting, which are distressing and uncomfortable for the client.Blurred vision is incorrect. Blurred vision can occur when taking chlorpromazine and is an anticholinergic manifestation, rather than an example of EPS.Tremors of the hands is correct. Hand tremors are Parkinsonian manifestations which are part of EPS.Sexual dysfunction is incorrect. Sexual dysfunction is a potential adverse effect of chlorpromazine, but it is not an EPS.

A nurse in a mental health clinic is caring for a client who has bipolar disorder and a prescription for an antipsychotic medication. The provider and nursing staff suspect the client is not adhering to his medication therapy. Which of the following interventions should the staff use to encourage the client's adherence? (Select all that apply.)

Provide for once-daily dosing. C. Use sustained-release forms. D. Engage the client in conversation following medication administration Rationale: Perform mouth checks following the administration of medication is incorrect. Mouth checks may not find pills that the client has hidden in his mouth. Provide for once-daily dosing is correct. Once-daily dosing of medications simplifies the therapy, making it easier for the client to comply. Use sustained-release forms is correct. Sustained-release forms remain in the client's system longer, requiring less frequent dosing. Engage the client in conversation following medication administration is correct. If the client is speaking, he will be less likely able to hide the medication in his mouth. Rotate staff that administers the medications is incorrect. Rotating treatment providers is an obstacle that increases the risk of a client's nonadherence to therapy.

A nurse is caring for a 2-year-old child who has seizures and is receiving phenytoin in suspension form. Which of the following actions should the nurse take before administering each dose?

Shake the container vigorously. Rationale: A suspension form of medication refers to one in which the particles of medication are mixed with, but not dissolved in, a fluid. It is important for the nurse to shake the container that contains the suspension because the child can be under-medicated if the medication is not evenly distributed.

nurse is assessing a client who has been taking sertraline for 2 weeks. The nurse should identify which of the following findings as an indication that the medication is effective?

The client reports increase in mood. Rationale: Sertraline is a selective serotonin reuptake inhibitor used to treat major depressive disorders. Therapeutic effects include increase in mood, and an increased interest in activities.

nurse reviews the laboratory report for a client who is receiving lithium three times daily PO. The client's current blood lithium level is 1.8 mEq/L. The nurse identifies that this lab value indicates which of the following?

The lithium level is at the toxic level. Rationale: A blood lithium level greater than 1.5 mEq/L indicates toxicity. The nurse should monitor the client for GI manifestations, coarse hand tremor, confusion, drowsiness, and should withhold the lithium and notify the provider. A therapeutic initial blood level of lithium is 0.8 to 1.4 mEq/L. Blood levels for lithium maintenance should be between 0.4 and 1.3 mEq/L.

A nurse is providing teaching to the parents of an adolescent who has a depressive disorder and a new prescription for trazodone. Which of the following information should the nurse include in the teaching?

Trazodone can cause suicidal thoughts in adolescents." Rationale: Trazodone includes a black box warning that it may cause suicidal ideation in children and adolescents.

nurse is caring for a client who has bipolar disorder and is taking lithium. The client reports blurred vision and ataxia. Which of the following actions should the nurse take?

Withhold the medication. Rationale: The nurse should withhold the medication, because the client is displaying manifestations of toxicity, which includes ataxia, confusion, large output of dilute urine, blurred vision, clonic movements, seizures, stupor, severe hypotension, and coma. Pulmonary complications may lead to death.

A nurse is providing teaching to a client who has schizophrenia and is to begin taking haloperidol. Which of the following information should the nurse include in the teaching?

You may experience dizziness upon standing while taking this medication." Rationale: Haloperidol may cause orthostatic hypotension; therefore, the client should be instructed to change positions slowly.

nurse is providing discharge teaching to a female client who has neuropathy and a new prescription for gabapentin. Which of the following statements should the nurse include in the teaching?

You may experience drowsiness while taking this medication." Rationale: The nurse should instruct the client that drowsiness can occur while taking this medication and to exercise caution while performing activities that require alertness.

A nurse is teaching a client who plans to take St. John's wort to treat her depression. Which of the following information should the nurse include in the teaching?

You may experience vivid dreams while taking St. John's wort." Rationale: The nurse should include in the teaching that St. John's Wort can cause the client to have vivid dreams due to the CNS effects.

nurse is preparing to administer haloperidol 5 mg IM to a client. The amount available is haloperidol 20 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest hundredth. Use a leading zero if it applies. Do not use a trailing zero.)

0.25 mL

A nurse is preparing to administer buspirone 7.5 mg PO every 12 hr to a client. The amount available is buspirone 15 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

0.5 tablet(s)

.A nurse is preparing to administer haloperidol 75 mg IM per week. Available is haloperidol decanoate 100mg/mL for injection. How many mL should the nurse administer per dose? (Round the answer to the nearest hundredth. Use a leading zero if it applies. Do not use a trailing zero.)

0.75 mL

nurse is caring for a client who has schizophrenia and is experiencing hallucinations. The provider prescribes chlorpromazine 50 mg IM every 4 hr as needed. Available is chlorpromazine injection 25 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

2 ml

nurse is preparing to administer olanzapine 20 mg PO daily. Available is olanzapine 10 mg orally-disintegrating tablets. How many tablets should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

2 tablet(s)

A nurse is providing medication teaching for a client who has a new prescription for phenelzine. Which of the following statements should the nurse include in the teaching?

A. "You should change positions slowly while taking this medication." Rationale: Clients should change positions slowly while taking an MAOI due to the risk of orthostatic hypotension. Lightheadedness and fainting are common when taking phenelzine

nurse is instructing the parents of a client who has a new prescription for methylphenidate. Which of the following instructions should the nurse include?

A. Avoid activities that require alertness such as driving. The client should avoid driving and other activities that require alertness until the effects of this medication are known.

A nurse is caring for a client who has been hospitalized for treatment of bipolar disorder and will be discharged with a prescription for lithium. The nurse's discharge teaching should include information cautioning against which of the following factors that may cause lithium toxicity?

A. Experiencing diarrhea Rationale: Lithium is used to treat the manic stage of bipolar disorder. Toxicity occurs when the level of lithium in the blood becomes too high. A low sodium level, or factors which result in a low sodium level, (such as dehydration, diarrhea, sweating, excess exercise in hot weather, diuretic use, a low sodium diet) increases the lithium level because the kidney processes sodium and lithium in the same way. If sodium levels fall, the body conserves lithium, causing lithium levels to rise.

A nurse is assessing a client who has schizophrenia and is taking aripiprazole. The nurse should notify the provider of which of the following findings?

A. Muscle stiffness Rationale:Muscle rigidity is a manifestation of neuroleptic malignant syndrome, which is a potentially serious adverse effect of aripiprazole, and should be reported to the provider immediately.

A nurse is caring for a client who is taking amitriptyline. The nurse should monitor for which of the following adverse effects?

A. Orthostatic hypotension Rationale: Orthostatic hypotension is a possible adverse effect of amitriptyline.

.A nurse is caring for a client who has a new prescription for risperidone. Which of the following rating scales should the nurse complete prior to administering the first dose of risperidone?

A. The Abnormal Involuntary Movement Scale Rationale: Risperidone, an antipsychotic, can cause tardive dyskinesia, involuntary movements that may include the tongue, lips, and face. The nurse should perform the AIMS assessment prior to initiating treatment with risperidone and then at regularly scheduled intervals thereafter.

nurse is reviewing medications for a newly admitted client who has bipolar disorder and is experiencing mania. Which of the following client prescriptions should the nurse realize is expected to reduce the client's mania?

Carbamazepine Rationale: Carbamazepine, an antiseizure medication and a mood stabilizer, is prescribed to treat and prevent mania in clients who have bipolar disorder.

nurse is teaching a client who has a new prescription for paroxetine. Which of the following statements by the client indicates an understanding of the teaching?

D. "I may not feel like eating as much." Rationale: Anorexia and a decreased appetite are adverse effects of paroxetine.

nurse is reinforcing teaching with an older adult client who has major depressive disorder and a prescription for nortriptyline 25 mg daily. Which of the following client statements indicates understanding of the teaching?

D. "I should sit on the side of the bed before standing up in the morning." Nortriptyline is a TCA. It blocks reuptake of norepinephrine and serotonin in the synaptic space, intensifying the effects of these neurotransmitters. Orthostatic hypotension is a potential complication of TCAs. Clients should be instructed to change positions slowly and to sit and lie down if symptoms occur. If a significant decrease in blood pressure is noted in the hospitalized client, the medication should be held, and the provider should be notified.

nurse is providing teaching for a client who has a new prescription for clozapine. Which of the following statements indicates the client understands the teaching?

D. "I will rise slowly from a lying position to prevent fainting while taking this medication." Rationale: Clozapine can cause orthostatic hypotension, especially during the first few weeks of therapy. The client should be taught to rise slowly from a lying or sitting position.

nurse is preparing to administer phenytoin 50 mg by intermittent IV bolus to a client who has a seizure disorder. Which of the following actions should the nurse take?

D. Administer the medication over 1 min. Rationale: The nurse should administer phenytoin slowly, no faster than 50 mg/min.

nurse is caring for a client who has a prescription for olanzapine. The nurse should monitor the client for which of the following manifestations as an expected response to this medication?

Decreased auditory hallucinations Rationale: Olanzapine is prescribed for the treatment of the manifestations of schizophrenia, one of which is auditory hallucinations.

nurse is caring for a client who has Parkinson's disease and is taking diphenhydramine 25 mg PO TID. Which of the following therapeutic outcomes should the nurse expect to see?

Decreased tremors Rationale: Clients who have Parkinson's disease often experience trembling, muscle rigidity, difficulty walking, and problems with balance and coordination. Antihistamines, like diphenhydramine, have a mild anticholinergic effect and may be helpful in controlling tremors in the early stage of the disease.

nurse is assessing a client who is taking bupropion. The nurse should recognize which of the following findings as an indication that the medication is effective?

Decreased urge to smoke Rationale: Bupropion is an antidepressant, also used for smoking cessation.

4.A nurse is caring for a client who reports an upset stomach after taking chlorpromazine. Which of the following responses should the nurse make?

Drink a glass of milk with each dose of your medication." Rationale: Drinking a glass of milk, or other fluid or food, can help decrease gastric distress associated with chlorpromazine.

A nurse is planning to administer haloperidol to a client who has acute psychosis. The nurse should monitor the client for which of the following findings as an adverse effect of the medication?

Dystonia Rationale: The nurse should monitor the client for dystonia after administering Haloperidol. Dystonia is a repetitive muscular contraction that may cause twisting of the body.

nurse is caring for a client who has major depressive disorder and was prescribed citalopram 2 weeks ago with a planned dosage increase 1 week ago. The client reports having an improved appetite, but still feels very depressed and is still having trouble sleeping. Which of the following actions should the nurse take?

Explain that antidepressants often take several weeks to be fully effective. Rationale: SSRIs are used along with certain anticonvulsant medications in the treatment of bipolar disorder. It can take 4 to 6 weeks before therapeutic effects occur after beginning an antidepressant medication.

A nurse is caring for a client who has schizophrenia and is taking haloperidol. The nurse should monitor for which of the following adverse effects of haloperidol?

Extrapyramidal symptoms Rationale: Extrapyramidal symptoms include movement disorders and are associated with typical antipsychotic medications, such as haloperidol.

.A nurse is preparing to administer ophthalmic solution to a client. Which of the following actions should the nurse take?

Hold the ophthalmic solution 2 cm (3/4 in) above the lower conjunctival sac. Rationale: The nurse should hold the bottle of ophthalmic solution 1 to 2 cm (1/2 to 3/4 in) above the lower conjunctival sac.

A nurse is teaching a client who has depression about a new prescription for fluoxetine 20 mg daily. Which of the following statements by the client indicates understanding of the teaching?

I should notify my provider if I develop a skin rash." Rationale: Serious skin rashes, such as Stevens-Johnson syndrome, can occur while taking fluoxetine. The client should notify the provider if a rash occurs.

A nurse is providing teaching to a client who has schizophrenia and is receiving chlorpromazine. Which of the following client statements indicates an understanding of the teaching?

I will contact my provider if I have difficulty urinating." Rationale: Chlorpromazine is a first-generation, or typical, antipsychotic medication. The client should be instructed to monitor for increased anticholinergic adverse effects, such as dry mouth and urinary retention. Difficulty urinating could be a sign of urinary retention and should be reported to the provider for further evaluation.

nurse is performing discharge teaching for a client who has seizures and a new prescription for phenytoin. Which of the following statements by the client indicates a need for further teaching?

I'll be glad when I can stop taking this medicine." Rationale: Phenytoin is an anticonvulsant used to treat various types of seizures. Clients on anticonvulsant medications commonly require them for lifetime administration, and phenytoin should not be stopped without the advice of the client's provider.

A nurse is teaching a client who has a new prescription for fluoxetine to treat depression. Which of the following statements by the client indicates an understanding of the teaching?

I'll take this medicine first thing in the morning." Rationale: The client should take fluoxetine in the morning to reduce the risk for insomnia.

58.A nurse is providing teaching to a client who has a new diagnosis of Parkinson's disease. On which of the following medications should the nurse prepare to instruct the client?

Levodopa/carbidopa Rationale: Levodopa/carbidopa is the cornerstone of Parkinson's treatment. The nurse should prepare to instruct the client on the use of this medication.

A nurse is caring for a client who has bipolar disorder and a new prescription for valproate. Which of the following instructions should the nurse give the client about the use of this medication?

Liver function tests must be monitored. Rationale: Pancreatitis, hepatic dysfunction, and thrombocytopenia are serious adverse effects occasionally associated with valproate. Liver function tests should be monitored periodically to check for hepatic failure.

nurse is planning to administer olanzapine 10 mg IM to a client who has schizophrenia. Which of the following actions should the nurse take?

Monitor the client for at least 3 hr after the injection. Rationale: Olanzapine injection can lead to post injection delirium/sedation syndrome. The nurse should monitor the client for a minimum of 3 hr following the injection.

A nurse is developing a care plan for a client who has schizophrenia and is taking chlorpromazine. Which of the following actions should the nurse include in the plan?

Monitor the client's respirations every 4 hr. Rationale: Chlorpromazine can cause respiratory depression, dyspnea, and laryngospasm.

.A nurse is reviewing discharge instructions with a client who has bipolar disorder and is taking lithium. Which of the following manifestations should the nurse include as an indication of mild toxicity?

Muscle weakness Rationale: The nurse should instruct the client that muscle weakness is a manifestation of mild toxicity.

nurse is assessing a client who is receiving treatment with multiple antipsychotic medications and who suddenly became ill. Findings include blood pressure changes, hyperpyrexia, and diaphoresis. The nurse should recognize that which of the following adverse effects may be occurring?

Neuroleptic malignant syndrome Rationale: The client's findings indicate possible neuroleptic malignant syndrome which is a potentially life-threatening adverse effect of antipsychotic medications. The nurse should promptly recognize and report findings of neuroleptic malignant syndrome since prompt treatment is necessary.

nurse is teaching a female client who is experiencing alcohol withdrawal about chlordiazepoxide. Which of the following information should the nurse include in the teaching?

Notify the provider if pregnancy is desired or suspected." Rationale: Pregnancy is a contraindication to chlordiazepoxide. This medication is a pregnancy class D, indicating definite risks to a fetus.

A nurse is providing discharge teaching to a client who has a new prescription for lithium. Which of the following information should the nurse include in the teaching?

Obtain a daily weight. Rationale: Clients who are taking lithium should monitor their daily weight due to the risk of fluid imbalance.

nurse is reviewing medication records for several clients who have bipolar disorder. The nurse should recognize that which of the following medications are used to treat clients who have bipolar disorder? (Select all that apply.)

Paroxetine B. Lithium C. Donepezil D. Valproate F. Carbamazepine Rationale: Paroxetine is correct. Paxil is an antidepressant in a class of medications called selective serotonin reuptake inhibitors (SSRIs). SSRIs are used to treat depressive episodes associated with bipolar disorder.Lithium is correct. Lithium is a salt that acts on the central nervous system and is used to treat the manic stage of bipolar disorder. It may also reduce the frequency and severity of depression in bipolar disorder.Donepezil is incorrect. Donepezil is a cholinesterase inhibitor used to improve cognition in clients who have Alzheimer's disease.Valproate is correct. Valproate is an anticonvulsant medication which is also effective as a mood stabilizer for clients who have bipolar disorder.Carbamazepine is correct. Carbamazepine is an anticonvulsant medication which is also effective as a mood stabilizer for clients who have bipolar disorder.

.A nurse is teaching a client who is to start taking warfarin about herbal supplements. The nurse should inform the client that which of the following herbal supplements can interact adversely with warfarin?

St. John's wort Rationale: The nurse should instruct the client that St. John's wort can decrease anticoagulation when taking warfarin.

A nurse is providing teaching to a client who has schizophrenia about thioridazine. Which of the following instructions should the nurse include in the teaching?

Report any sign of infection to the provider immediately." Rationale: Thioridazine can cause agranulocytosis, a life-threatening adverse effect that includes manifestations, such as fever, sore throat, mouth sores, and fatigue.

nurse is teaching the parents of a child who has ADHD about methylphenidate. Which of the following statements should the nurse include in the teaching?

Restrict your child's intake of caffeine while she is taking this medication." Rationale: The nurse should instruct the parents that the child should avoid caffeine while taking methylphenidate as it increases the stimulating effects of the medication. Caffeine can also lead to irritability in the child.

nurse is providing discharge teaching to a client with a new prescription for phenelzine. The nurse should instruct the client to avoid which of the following foods when taking this medication?

Salami Rationale:Aged foods, such as hard cheeses and meats, salami, and air-dried sausage should be avoided when taking an oral MAOI such as phenelzine.

nurse is teaching a client who has a new prescription for phenytoin. The nurse should instruct the client to monitor for and report which of the following adverse effects of this medication?

Skin rash Rationale: Phenytoin is an antiepileptic medication used to treat partial seizures and generalized tonic-clonic seizures. Phenytoin can cause a rash that can progress to Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). If a rash develops, the client should notify the provider immediately and stop the use of phenytoin.

A nurse is teaching a client who has a new prescription for lithium to treat bipolar disorder. The nurse should instruct the client to ensure an adequate intake of which of the following dietary elements?

Sodium Rationale: Lithium is a salt. If sodium level falls, the client will retain lithium and have an increased risk for lithium toxicity.

A nurse is teaching a group of clients about St. John's wort. Which of the following information should the nurse include in the teaching?

St. John's wort can be used to treat mild depression." Rationale: The nurse should teach that St. John's wort increases the serotonin level of serotonin-enhancing antidepressants, which may place the client at risk for serotonin syndrome.

nurse is caring for a client who has generalized anxiety disorder and is taking buspirone. Which of the following adverse effects should the nurse report to the provider?

Sweating Rationale: Sweating is a manifestation of serotonin syndrome and should be reported to the provider.

91.A nurse is teaching the family of a client who has Alzheimer's disease about donepezil. Which of the following information should the nurse include in the teaching?

Syncope episodes may occur when taking this medication." Rationale: The nurse should inform the family to monitor for syncope, which places the client at risk for falling.

nurse is assessing a client who has schizophrenia and has been on long-term treatment with chlorpromazine. He notes the client is experiencing some involuntary movements of the tongue and face. The nurse should suspect the client has developed which of the following adverse effects?

Tardive dyskinesia Rationale: These findings indicate tardive dyskinesia, which can develop in clients during long-term therapy with chlorpromazine. For many clients, the manifestations are irreversible.

A nurse is providing discharge teaching to a client who has bipolar disorder and will be discharged with a prescription for lithium. The nurse should teach the client that which of the following factors puts her at risk for lithium toxicity?

The client runs 4 miles outdoors every afternoon. Rationale: Strenuous exercise in outdoor heat, which can lead to dehydration, puts the client at risk for lithium toxicity. Mild to moderate exercise will not lead to lithium toxicity, but if the client engages in strenuous exercise during hot weather, she should take care to replace any water and sodium that have been lost through profuse sweating. This also applies to other factors that can cause the client to become dehydrated, such as having diarrhea or taking diuretics.

A nurse is teaching male client who has a depressive disorder about sertraline. Which of the following information should the nurse include in the teaching?

This medication may cause an inability to orgasm." Rationale: Sertraline may cause sexual dysfunction, including anorgasmia, impotence, or decreased libido.

A nurse is caring for a client who has bipolar disorder and has been taking lithium for 1 year. Before administering the medication, the nurse should check to see that which of the following tests have been completed?

Thyroid hormone assay Rationale: Thyroid testing is important because long-term use of lithium may lead to thyroid dysfunction.

A nurse is caring for a client who was admitted with acute psychosis and is being treated with haloperidol. The nurse should suspect that the client may be experiencing tardive dyskinesia when the client exhibits which of the following? (Select all that apply.)

Tongue thrusting and lip smacking Facial grimacing and eye blinking F. Involuntary pelvic rocking and hip thrusting movements Rationale: Urinary retention and constipation is incorrect. Haloperidol can cause anticholinergic effects, such as dry mucous membranes, urinary retention, and constipation. However, these are not manifestations of tardive dyskinesia.Tongue thrusting and lip smacking is correct. Individuals who have tardive dyskinesia make repetitive and uncontrollable movements such as tongue thrusting and lip smacking.Fine hand tremors and pill rolling is incorrect. The side effects of haloperidol can include extrapyramidal (parkinsonian) symptoms, such as fine hand tremors and pill rolling. However, these are not manifestations of tardive dyskinesia.Facial grimacing and eye blinking is correct. Individuals who have tardive dyskinesia make repetitive and uncontrollable movements such as facial grimacing and eye blinking.Involuntary pelvic rocking and hip thrusting movements is correct. Repetitive, irregular, and involuntary movements of the head, neck, trunk, and extremities can occur in tardive dyskinesia.

nurse is assessing a client who has schizophrenia which has been treated with fluphenazine for several years. Which of the following findings should the nurse document as manifestations of tardive dyskinesia (TD)?

Twisting tongue movements Rationale: Twisting tongue movement, tics, sudden involuntary jerking movements of the extremities, and other findings occur in TD. The nurse should notify the provider of these findings since treatment includes reducing dosage of antipsychotic medications or perhaps changing to a second-general antipsychotic medication.

. A nurse is teaching a client who has bipolar disorder and a prescription for lithium to recognize the manifestations of toxicity. Which of the following statements by the client indicates an understanding of the teaching?

Vomiting is an indication of toxicity." Rationale: Since vomiting and diarrhea are early signs of lithium toxicity, the client should omit the next dose of lithium and call the provider.

A nurse is teaching a client who has bipolar disorder about lithium. Which of the following statements should the nurse include in the teaching?

We will monitor your lithium levels closely while you are taking this medication." Rationale: Lithium has a very narrow therapeutic range. The dose must be increased slowly to avoid toxicity. Serum levels are monitored twice weekly until they reach therapeutic levels, after which, levels are monitored at least every 2 months.

A nurse is developing a plan of care for a client who has a depressive disorder and is taking amitriptyline. Which of the following actions should the nurse include in the plan of care?

Weigh the client weekly. Rationale: Weight gain is a common adverse effect of amitriptyline.

.A nurse is assessing a client who has schizophrenia and is taking risperidone. Which of the following findings should the nurse expect?

Weight gain Rationale: Weight gain is an expected adverse effect of risperidone.

nurse is reviewing the medical record of a client who has schizophrenia and is receiving olanzapine. Which of the following findings should the nurse identify as an adverse effect of olanzapine?

Weight gain of 3 lb in 2 weeks Rationale: Weight gain is a common adverse effect of olanzapine.

A nurse is preparing to teach a client about his prescription of lithium for the treatment of bipolar disorder. Which of the following statements should the nurse include in the teaching?

You will need to stop this medication if you experience diarrhea." Rationale: Diarrhea can lead to dehydration and potentially elevated lithium levels and toxicity. Diarrhea, vomiting, and lethargy can also indicate lithium toxicity. The nurse should inform the client to stop taking the medication if the any indications of lithium toxicity occur. 9. A nurse is teaching a client who has a new prescription for fluoxetine to treat depression. Whic