NU 473 week 2 practice questions

The wife of a client who is taking haloperidol calls the clinic and reports that her husband has taken the first dose of the drug and it is not having a therapeutic effect. An appropriate response by the nurse would be which?

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

The nurse is teaching a client with schizoaffective disorders (SAD) about the client's prescribed medication therapy. The nurse determines that additional education is needed when the client states what?

"One day, I won't have to worry about taking any medication."

What instructions should a nurse include when teaching a client who has depression about the use of amitriptyline?

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

Which test should be scheduled every week for a patient taking clozapine?

WBC Rationale: Use of the drug clozapine has been associated with severe agranulocytosis, (i.e., decreased white blood cells), so weekly WBC count tests are scheduled

A nursing instructor is describing the effects of CNS stimulants and their potential for addiction due to their euphoric sensations. The instructor determines that the discussion was successful when the students identify which substance as being involved with this pleasurable feeling?

dopamine

A nurse is providing care for a client diagnosed with attention deficit hyperactivity disorder (ADHD) who has been taking methylphenidate for several months. When monitoring for potential adverse effects, the nurse should include what assessments?

sleep patterns Rationale: Because methylphenidate is a central nervous system (CNS) stimulant, it carries the potential to disturb sleep patterns

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

2 Rationale: The nervous system has two main divisions: the central nervous system and the peripheral nervous system.

The nurse is providing education to a client who has been prescribed an antipsychotic drug. Which statement suggests that the client understands the typical length of medication therapy?

"I may always have to take this medication." Rationale: People with schizophrenia usually need to take antipsychotics for years because there is a high rate of relapse (acute psychotic episodes) when drug therapy is discontinued

A female client asks why it is not legal to have a year's worth of prescription refills for Ritalin, since she has been on it for more than a year. She would also like to have the largest dose possible, so she can use the prescription for 2 months, instead of one. She explains that it is very hard to get off work and come in for appointments. The nurse's best response would be:

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

A black, male client routinely takes haloperidol to manage his psychosis. Recently, he presented to the health care provider's (HCP's) office with signs of tardive dyskinesia, and his HCP modified the drug regimen over time. The client will now take the drug olanzapine and discontinue the haloperidol. What will the nurse tell the client to help decrease his anxiety about the new drug regimen?

"When compared with haloperidol, olanzapine has been associated with fewer extrapyramidal reactions in black clients." Rationale: People who develop tar dive dyskinesia can't control their facial movements. They develop facial tics like lip-smacking, tongue thrusting and rapid blinking

A nurse is caring for a 30-year-old man whose wife has recently died. The client has been diagnosed with clinical depression and is demonstrating insufficient coping skills. Which action by the nurse would be most important?

Ask the client whether he is thinking about killing himself.

A client on the psychiatry unit with a longstanding history of schizophrenia has been prescribed risperidone. What assessment should the nurse prioritize to best evaluate therapeutic effect of the treatment in the care of this client?

Assessment of the client's behaviors and thought processes

What should the nurse's ongoing assessment of a client receiving a CNS stimulant for respiratory depression include? (Select all that apply.)

Blood pressure Pulse Respiratory rate Respiratory pattern Level of consciousness

The nurse is providing education to a client who has been prescribed clozapine. During teaching, the nurse should inform the client of the need for regular monitoring of what laboratory test during the initial months of therapy and periodically thereafter?

Complete blood count (CBC)

Dexmethylphenidate has been prescribed to Scott, a 7-year-old boy who was diagnosed with ADHD. The mother asks how this medication will help her son. Which would be the most accurate description of the purpose of this medication?

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

A 28-year-old woman has been diagnosed with schizophrenia. The health care provider has prescribed a typical antipsychotic, haloperidol. Which will the nurse include in the teaching related to the most common adverse effects?

Extrapyramidal symptoms

Which agent would a nurse identify as a selective serotonin reuptake inhibitor?

Fluvoxamine

A client with schizophrenia has been taking haloperidol for several years. The care team and the client have collaborated and chosen to transition the client to an atypical antipsychotic in an effort to reduce adverse effects and maximize therapeutic effects. In order to reduce the client's risk of extrapyramidal effects during the transition from haloperidol to an atypical antipsychotic, the care team should implement which intervention?

Gradually taper the dose of haloperidol.

A client, prescribed dextroamphetamine for attention deficit hyperactivity disorder (ADHD) has developed a common adverse effect of the medication since beginning therapy. Which initial intervention should the client be encouraged to implement?

Increase fiber intake. Rationale: Constipation is a common adverse effect of dextroamphetamine. A client who is experiencing constipation should be instructed to increase fiber in the diet.

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

Increased blood glucose

A female client relates that she is taking diazepam for a muscle relaxant and modafinil for treatment of narcolepsy. Additionally, she informs you that she takes a contraceptive. As part of client education, the nurse would include:

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

A client with schizophrenia is receiving antipsychotic therapy. The nurse understands that which is a medical emergency should it develop in the client?

Neuroleptic malignant syndrome

Which is a true statement regarding depressive disorders?

Norepinephrine, dopamine, and serotonin have been implicated.

A newly admitted client's history includes multiple suicide attempts. How can the nurse on the psychiatric-mental health unit best protect the client's safety?

Performing vigilant assessment and close observation

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?

Phenelzine Rationale: MAOIs are drugs used in the treatment of mood disorders. They require that the client follow a strict diet that restricts tyramine to prevent a hypertensive crisis.

A client with a diagnosis of schizophrenia has a history of auditory and visual hallucinations. Which intervention is most likely to minimize the client's hallucinations?

Provide frequent contact and communication with the client Rationale: To prevent or minimize hallucinations, the nurse should help present and maintain reality by frequent contact and communication with the client

A psychiatric nurse is discussing the advantages of atypical antipsychotics with the parents of a teenager who has been diagnosed with schizophrenia. When comparing these drugs with the older, typical antipsychotics, what advantage should the nurse cite?

Reduced adverse effects

The nurse is providing education to a client who has been prescribed clozapine. The nurse should emphasize the importance of what monitoring routine during teaching?

Regular complete blood counts

SPICES facilitates assessment and information gathering about the following:

S—Sleep disorders P—Problems with eating or feeding I—Incontinence C—Confusion E—Evidence of falls S—Skin breakdown

A young client has been prescribed an antipsychotic agent to relieve psychotic symptoms. Which goal of care is the priority?

The client will remain safe.

The nurse is evaluating the plan of care for a client with schizophrenia. Which observation bestsuggests that the plan has been effective?

The client has resumed employment and attends social functions.

The nurse is caring for a patient who is receiving drug therapy for a psychotic disorder. Which goals should the nurse include in a care plan for the patient following discharge from the hospital?

The patient will take medications as prescribed.

When completing a baseline assessment of a client with depression, which diagnostic tests would the nurse anticipate?

Thyroid function tests

Atomoxetine has been selected as the primary pharmacologic treatment for a young adult client diagnosed with attention deficit hyperactivity disorder (ADHD). What characteristics make this a good drug of choice for this population of clients? Select all that apply.

a lower potential for abuse a low risk for dependency is administered orally

For which client would the nurse question the use of antipsychotic medication therapy?

an older adult client whose delusions and psychosis are attributable to dementia Rationale: Many antipsychotics are associated with increased risk of death in older adults who have dementia

The child is diagnosed with attention deficit hyperactivity disorder (ADHD). Which medication will most likely be administered in conjunction with treatment?

central nervous system (CNS) stimulants

When assessing a client immediately following electroconvulsive therapy (ECT), the nurse expects what in a client?

confusion Rationale: After ECT treatment, the client may be mildly confused or briefly disoriented. He or she is very tired and often has a headache. The client will have some short-term memory impairment.

sundowning syndrome

describes a phenomenon when a person habitually becomes confused, disoriented or agitated after dark

A client, who has been diagnosed with schizophrenia and is taking an antipsychotic medication, reports constant thirst, frequent urination, and feeling nauseous. The nurse knows that the client may:

have undiagnosed diabetes.

depression/suicidal ideation in older adults is more likely recognized by:

hopelessness rather than sadness is more often associated with suicidal intent.

Phenothiazines such as chlorpromazine are occasionally used for clinical indications not associated with psychiatric illness. What indications would be included? Select all that apply.

preoperative restlessness nausea and vomiting Rationale: Chlorpromazine is administered rectally or IM for the control of nausea and vomiting.

A nurse is obtaining baseline physical data from a 7-year-old patient who is to be started on dextroamphetamine for ADHD. After obtaining vital signs, height, and weight, the nurse will prepare the patient for an

ECG

A client diagnosed with schizophrenia is exhibiting disorganized behavior and imitating what the nurse is saying. What term is used to identify this behavior?

Echolalia

A client is admitted to the psychiatric hospital with a diagnosis of schizophrenia. During the physical examination, the client's arm remains outstretched after the nurse obtains the pulse and blood pressure, and the nurse must reposition the arm. The nurse interprets this as what?

Waxy flexibility Rationale: Waxy flexibility, the ability to assume and maintain awkward or uncomfortable positions for long periods, is characteristic of catatonic schizophrenia.