Mental meds
A client who has been taking buspirone for two months returns to the clinic for a follow-up. The nurse determines that the medication is effective if there is an absent display of... A. Feelings of panic, fear, and uneasiness. B. Alcohol withdrawal symptoms. C. Thought broadcasting or delusions. D. Paranoid and suicidal thought process.
a
A patient has been prescribed a selective serotonin reuptake inhibitor (SSRI) for depression. The nurse should counsel the patient about which of the following possible side effects, among others? A. Fever, sweating, agitation, rapid heartbeat B. Blurred vision and ringing in the ears C. Stiff neck and vomiting D. Persistent dizziness
a
A patient has been prescribed disulfiram. The nurse would most appropriately counsel the patient about which of the following? A. A toxic reaction if alcohol is consumed. B. Likelihood of nausea and vomiting as common side effects. C. A sudden drop in blood pressure that may occur when standing up.
a
A patient started diazepam (Valium) 5 mg twice daily 6 months ago. Now, the patient requires 10 mg to achieve the same effect. This phenomenon results from: A. tolerance B. disinhibition C. dependence D. addiction
a
A patient was started on fluoxetine for depression 3 days ago. She now complains that it "doesn't help" and refuses to take it. Understanding the psychopharmacology, the nurse's best first action is to: A. discuss with the patient that these types of medications often take several weeks before seeing the results. B.document the patient's response and withhold the medication. C. place the patient in the seclusion room until she is compliant with her medications. D. encourage the prescriber to change SSRI agents.
a
Maintenance of a therapeutic serum level of lithium is dependent on adequate serum levels of: A. sodium B. chloride C. potassium D. magnesium
a
Methylphenidate is a CNS stimulant and is the drug of choice for individuals with attention-deficit/hyperactivity disorder (ADHD). The desired effects of methylphenidate may be noted as: A. increased attention span and concentration. B. sleepiness and lethargy C. increase in appetite D. bradycardia and diarrhea
a
Singer Michael Jackson allegedly abused alprazolam and propofol, an anesthetic. Which inference applies? A. Potentially lethal sedation and CNS depression would be expected with this drug combination. B. Tolerance to propofol probably developed very quickly in the presence of alprazolam. C. The singer had a substance dependence problem, but these medications had no interaction.
a
The waiting time between stopping a monoamine oxidase inhibitor (MAOI) and starting a selective serotonin reuptake inhibitor (SSRI) is which of the following? A. at least two weeks B. determined by taking an MAOI blood level C. determined by the half-life of the MAOI
a
When a patient is taking a traditional antipsychotic medication, the nurse should assess carefully for extrapyramidal side effects (EPSEs) particularly: A. akathisia B. hypotension C. constipation D. mydriasis
a
Which of the following is generally true of medications used to treat anxiety disorders? A. Just as with depression, the most common medications prescribed are serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs). B. Most patients see improvement of symptoms within 1 to 2 weeks of starting medication. C. A patient who has been prescribed an SSRI in the past for depression can expect to be prescribed a smaller dosage for a current anxiety disorder.
a
Signs and symptoms of lithium toxicity include: (select all that apply) A. drowsiness B. slurred speech C. increased appetitie D. agitation
a b
The FDA-approved indications for fluoxetine include: (select all that apply) A. major depressive disorder B. OCD C. bulimia nervosa D. seizures
a b c
Clozapine may cause: (select all that apply) A. syncope B. orthostatic hypotension C. tachycardia D. cardiac arrest
a b d
Escitalopram may cause serious, potentially fatal reactions when used with _______________. (select all that apply) A. amitriptyline B. duloxetine C. haloperidol D. valproate acid E. st john's wort F. setraline
a b e f
A client with depression is taking phenelzine. The nurse advises the client to avoid consuming which foods while taking the medication A. crackers B. yogurt C. vegetable salad D. oatmeal
b
A male patient who is taking the second-generation antipsychotic reports to the nurse that he has observed a clear fluid leaking from his right nipple for the past month. The nurse's best initial intervention is: A. inform the physician so that a prolactin level can be ordered. B. inform the patient that this could be a side effect of the medication. C. tell the patient that it is nothing to worry about. D. tell the patient that the medication must be discontinued.
b
A nurse notes that a client with schizophrenia and receiving an antipsychotic medication is having uncontrolled movement of the lips and tongue. The nurse determines that the client is experiencing? A.Parkinsonism B. Tardive dyskinesia. C. Neuroleptic malignant syndrome. D. Hypertensive crisis.
b
A patient diagnosed with mania begins lithium therapy on October 1. What is the earliest date a nurse can expect to see clinical improvement in the patient's condition? A. October 3 B. october 8 C. october 21 D. november 1
b
A tricyclic antidepressant (TCA) is prescribed for a patient newly diagnosed with depression. What information should be included in patient teaching? A. "Do not eat aged cheese while using this medication." B. "It might be 2 weeks or more before you notice the effects of this medicine." C. "You might experience sweating, tremors, and excessive urination."
b
An acutely manic patient is started on divalproex. The experienced nurse understands valproate acid can be measured: A. by basal body temperature and heart rate. B. through a serum blood level. C. brain activity via an electroencephalogram. D. via urine testing.
b
Anticonvulsants frequently used as mood stabilizers for the treatment of mania and bipolar spectrum disorders because they: A.stabilize dopamine pathways B. reduce synaptic kindling C.increase serotonin D.decrease norepinephrine and GABA levels
b
Methylphenidate is prescribed to an 8-year-old child for the treatment of attention-deficit/hyperactivity disorder (ADHD). The nurse plans to monitor which of the following during the medication therapy? A. deep tendon reflex B. height and weight C. fluid intake and output D. basal temperature and breath sound
b
Psychopharmaceutical agents are prescribed for individuals with substance use disorders for all of the following reasons except: A. To help manage the obsessive-compulsive aspect of substance misuse B. To elevate the patient's mood in a manner comparable to the action of the misused substance C. To assist the patient in maintaining sobriety
b
The physician discusses the appropriateness of prescribing a serotonin/norepinephrine reuptake inhibitor (SNRI) for a patient. Which of the following medications are in this category? A. Tranylcypromine and phenelzine sulfate B. Venlafaxine and duloxetine C. Sertraline and escitalopram D. Bupropion and mirtazapine
b
The therapeutic effects of imipramine (TCA) develop over _____________. A. several days B. several weeks C. two months D. one week
b
Which of the following symptoms is a sign of mild lithium toxicity: A. Muscle fasciculations and oliguria. B. Coarse hand tremor and lethargy. C. Tinnitus and blurred vision. D. Confusion and ataxia.
b
Which patient has the greatest risk for overdose with a benzodiazepine? A patient who: A. takes the drug before meals. B. combines the drug with alcohol. C. takes the drug with antacids. D. experiences depression as well as anxiety.
b
A nurse counsels a patient who has been prescribed a monoamine oxidase inhibitor (MAOI) to treat depression to avoid foods containing tyramine. Which of the following foods should the patient avoid? (select all that apply) A. Milk and cream B.Tofu C.Yogurt D.Pepperoni E. unripie bananas
b c d
Which of the following is a common side effect of both first- and second-generation antipsychotic drugs? (select all that apply) A. Impaired kidney and liver functioning B. Extrapyramidal side effects such as pseudo-parkinsonism or acute dystonia C. Excessive sedation D. Metabolic effects such as weight loss and hypolipidemia E. Neuroleptic malignant syndrome
b c e
A patient with depression has taken a selective serotonin reuptake inhibitors (SSRIs) for 1 month. The nurse should use direct questions to evaluate which potential side effect? A. wt gain B. aggressive impulses C. sexual dysfunction D. paranoid delusions
c
A patient with rapid-cycling bipolar disorder is not responding to lithium therapy. At the next multidisciplinary team meeting, the nurse should point out that many rapid-cycling bipolar patients have been effectively treated using: A. phenytoin B. setraline C. divalproex
c
For which one of the following types of drugs is the consumption of grapefruit juice contraindicated? A. Mood stabilizers B. Serotonin/norepinephrine reuptake inhibitors (SNRIs) C. Second-generation antipsychotics D. Anticonvulsants
c
Monoamine oxidase inhibitors (MAOIs) can cause numbness, prickling, or tingling feelings, which are called: A. edema B. melancholia C. paresthesias D. orthostatic hypotension
c
Most drugs used to treat Alzheimer's disease affect: A. monoamine oxidase reuptake systems. B. serotonin and norepinephrine production. C. cholinergic pathways, enzymes, and receptors. D. the Krebs cycle and GABA neuronal inhibition
c
Mr. Robbins is placed on quetiapine, which has the potential side effects of elevating cholesterol. Which laboratory test should you monitor related to this side effect? A. liver function tests B. CBC C. lipid profile D. serum digoxin
c
Nurse Trini knows that the following drugs have been known to be effective in treating obsessive-compulsive disorder (OCD): A. chlordiazepoxide and diazepam. B. divalproex and lithium C. fluvoxamine and clomipramine. D. benztropine and diphenhydramine.
c
Patients taking tricyclic antidepressants (TCAs) exhibit more side effects than patients taking selective serotonin reuptake inhibitors (SSRIs), because TCAs: A. selectively inhibit dopamine reuptake. B. block enzymatic breakdown of norepinephrine and serotonin. C. inhibit reuptake of norepinephrine and serotonin.
c
Select the accurate information about the pharmacokinetics of lithium. A. Wide therapeutic index B. Poorly absorbed in the gastrointestinal (GI) tract C. Excreted by the kidneys
c
The ___________ form of ziprasidone is frequently used for control of acutely agitated patients. A. rectal B. PO C. IM D. IV
c
The risk of experiencing serotonin syndrome when selective serotonin reuptake inhibitors (SSRIs) are given with monoamine oxidase inhibitors (MAOIs) such as phenelzine. Serotonin syndrome is best characterized in which of the following? A. Hypotension and urinary retention. B. Tea-colored urine and constipation. C. Muscle rigidity and high fever. D. A productive cough and vomiting.
c
When a patient is prescribed risperidone for schizoaffective disorder, the nurse must alert the patient to the potential for neuroleptic malignant syndrome. Which of the following would be accurate information to give the patient? A. Neuroleptic malignant syndrome occurs within 72 hours of beginning to take an antipsychotic drug or increasing the dose. The patient should be alert to tremors and rigidity of the muscles and slurred speech. B. Neuroleptic malignant syndrome is a failure of the bone marrow to make enough white blood cells after taking an antipsychotic drug over an extended period. It is characterized by a tendency to get infections accompanied by high fever. C. Neuroleptic malignant syndrome is potentially fatal. It usually occurs during the first 2 weeks after starting an antipsychotic drug or increasing the dose and is characterized by high fever, muscle stiffness, paranoia, sweating, and large changes in blood pressure.
c
Valproate acid has FDA-approved indications for: (select all that apply) A. Mitochondrial disorders B. Hepatic impairment C. acute mania D. Prevention of migraine headaches E. Simple and complex absence seizures
c d e
A 19-year-old female client with depression who has been taking amitriptyline for three weeks returns to the clinic for a follow-up. The nurse anticipates the possibility of observing which of the following symptoms? A. Loss of interest in personal appearance. B. Neglect of responsibilities. C. Lack of energy. D. Suicidal thoughts.
d
A client taking lithium carbonate started complaining of nausea, vomiting, diarrhea, drowsiness, muscle weakness, tremor, blurred vision and ringing in the ears. The lithium serum level is 2 mEq/L. The nurse interprets this value as: A. therapeutic level B. below therapeutic level C. non-toxic level D. toxic level
d
A client with schizophrenia has been started on medication therapy with clozapine. A nurse assesses the results of which laboratory study to monitor for adverse effect related to this medication? A. random blood sugar B. liver function studies C. platelet count D. white blood cell
d
A newly admitted client has started taking bupropion. The nurse understands which of the following side effects that would indicate an overdose of the medication? A. headache B. urinary retention C. constipation D. seizure
d
A patient diagnosed with schizophrenia has taken thiothixene 5 mg/day for 4 years with good symptom control. Today, the patient is admitted with paranoia and auditory hallucinations. The nurse should determine if the patient's symptoms are related to: A. development of tolerance to the drug. B. activation of serotonin receptors. C. an expected illness-exacerbation cycle. D. not taking the drug as prescribed.
d
A patient has taken clonazepam for years to manage panic attacks but impulsively stopped the drug. Thirty hours later, the patient comes to the emergency room in distress. What is the nurse's priority action? A. Prepare to administer flumazenil. B. Institute a behavior modification program. C. Refer the patient for addiction counseling. D. Begin seizure precautions.
d
A patient with severe kidney disease is started on lithium by a new resident. As the nurse on duty your best initial response would be to: A. contact the residents attending and report him for malpractice. B. refuse to give the medication and tell the patient why. C. arrange to have the client's dialysis increased. D. contact the resident to remind him that the client has kidney disease and lithium is contraindicated.
d
Atomoxetine selectively ____________ the presynaptic reuptake of norepinephrine resulting in a(n) ________________ attention span. A. impedes, reduced B. increases, extended C. obstructs, decreased D. inhibits, improved
d
Nortriptyline was prescribed for a 68-year-old patient diagnosed with depression and insomnia. Benefits specific to use of nortriptyline would include: A. weight loss B. anhedonia C. regular BMs D. improved sleep pattern
d
Venlafaxine is extensively metabolized on first pass through the ___________. A. kidney B. pancreas C. lungs D. liver
d
Your patient is taking the antipsychotic medications clozapine and divalproex sodium (Depakote), both of which can contribute to weight gain. For what should this patient be carefully monitored? A. decreased BP B. decreased serum calcium C. urine nitrates D. increased BG
d
Methylphenidate is not effective for narcoleptic patients. T/F
false
Phenelzine does not need to be discontinued several days before elective surgery that requires anesthesia. T/F
false
Taking food with buspirone alters absorption. T/F
false
Administering risperidone with levodopa is contraindicated. T/F
true
Bupropion can be used for smoking cessation. T/F
true