Pharm Ch 22

A nurse is caring for a patient who is taking haloperidol. The patient has orders for a new drug, and the nurse notes that it is highly protein bound. The nurse will plan care based on a(n): a. decreased risk for muscular contractions and spasms. b. decreased risk for toxic effects of haloperidol therapy. c. increased risk for toxic effects of haloperidol therapy. d. high drug efficacy of haloperidol.

c. increased risk for toxic effects of haloperidol therapy.

A female client is diagnosed with renal insufficiency. The nurse develops a teaching plan based on the diagnosis and antipsychotic drug usage. The client asks the nurse why it is so important to have renal function tests routinely. The nurse replies that if renal function test results become abnormal, what may be a consequence? a. The drug may need to be lowered in dosage or discontinued. b. The drug dosages will be increased to increase absorption. c. The drug will be discontinued immediately. d. The drug will be continued with caution.

a. The drug may need to be lowered in dosage or discontinued.

Moderate CNS depression is characterized by: a. Increasing hyperactivity, excessive talking, nervousness, and insomnia. b. A lack of interest in surroundings and inability to focus on a topic. c. Drowsiness or sleep; decreased muscle tone; decreased ability to move; and decreased perception of sensations such as pain, heat, and cold. d. Wakefulness, mental alertness, and decreased fatigue.

c. Drowsiness or sleep; decreased muscle tone; decreased ability to move; and decreased perception of sensations such as pain, heat, and cold.

A client is being treated with clozapine. What should the nurse monitor most closely? a. Cardiac enzymes b. AST, ALT and bilirubin c. White blood cell count d. Urine quantity and quality Exit quiz

c. White blood cell count

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: a. Modafinil should not be taken if the client is on a contraceptive. b. Modafinil will not interfere with any of the medications she is taking. c. Modafinil may decrease the effects of diazepam. d. Modafinil may decrease the effects of her contraceptive, and she may need to use other protection.

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

The community health nurse is conducting a class for parents of preschoolers. One of the parents asks if a child with ADHD will always have problems with hyperactivity. What is the nurse's best response? a. "ADHD usually starts in childhood and resolves before adolescence." b. "ADHD usually starts in childhood and resolves by adolescence." c. "ADHD usually starts in childhood and may persist through adulthood." d. "ADHD usually starts in childhood and resolves by adulthood."

c. "ADHD usually starts in childhood and may persist through adulthood."

For clients taking clozapine, it is necessary to regularly monitor what lab test during the initial months of therapy and periodically thereafter? a. blood urea nitrogen (BUN) b. partial thromboplastin time (PTT) c. red blood cell (RBC) count d. white blood cell (WBC) count

d. white blood cell (WBC) count

The nurse is teaching parents of a pediatric client diagnosed with ADHD. Teaching has been about the disorder and its treatment. The nurse determines that teaching has been effective when the parents state which? a "We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention." b. "We should stop the medication after 2 months to see how effective it is in really controlling his symptoms." c. "We need to be careful so he doesn't develop a substance abuse problem as he grows older." d. "We should set up regular routines for him but not worry if he violates the limits once in a while."

a "We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention."

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? a. "Continue the prescribed dose. It may take several days to work." b. "I'll report this to the nurse practitioner and see if he will add another drug to enhance the effects of the haloperidol." c. "I'll ask the nurse practitioner if the dosage can be increased." d. "I'll ask the nurse practitioner if the haloperidol can be discontinued and another drug started."

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

The nurse is aware that CNS stimulants are prescribed for clients with ADHD because these medications have what effect on behavior and attention? a. Improving b. Restoring c. Deteriorating d Contravening

a. Improving

What assessment finding should lead the nurse to suspect that a client receiving antipsychotic therapy is developing tardive dyskinesia? a. Lip smacking b. Abnormal eye movements c. Urinary incontinence d. Disorientation

a. Lip smacking

A 24-year-old client is being seen in the emergency department because of a high fever and cannot move the right arm. During the history-taking process, The nurse discovers the client is being treated with an antipsychotic medication for schizophrenia. The nurse knows that what may be happening with this client? a. The client may be having a neuroleptic malignant syndrome reaction to his antipsychotic medication and needs treatment immediately. b. The client may have broken his arm and not remember what happened because of his schizophrenia. c. The client may have influenza A and will need to be put into isolation. d. The client may have neuroleptic malignant syndrome, which will self-resolve in a few hours after rest and Tylenol.

a. The client may be having a neuroleptic malignant syndrome reaction to his antipsychotic medication and needs treatment immediately.

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? a. reduced adverse effects b. the possibility of oral administration c.absence of black box warnings d. lower cost

a. reduced adverse effects

The peditric client has been prescribed mehtylphenidate. Which statement should be included in the teaching plan for a client receiving methylphenidate? a. "The drug may cause weight gain." b. "Adverse effects include hypertension and nervousness." c. "There is no risk of dependence." d."The medication is usually taken just before bedtime."

b. "Adverse effects include hypertension and nervousness."

A client is taking antipsychotic medication and asks the nurse what dopamine is. What is a correct response by the nurse? a. "Dopamine is an enzyme that regulates your temperature." b. "Dopamine is a neurotransmitter that deals with pleasure and reward in the brain." c. "Dopamine is a part of the brain that controls your impulses and thoughts." d. "Dopamine is a medication that is given to fight infections and help with pain."

b. "Dopamine is a neurotransmitter that deals with pleasure and reward in the brain."

A nurse observes rhythmic, involuntary facial movements in a patient who has been administered antipsychotic drugs. The patient also makes chewing movements and, at times, his tongue protrudes. What is the most likely reason for the patient's behavior? a. Extrapyramidal syndrome b. Tardive dyskinesia c.Neuroleptic malignant syndrome d. Stevens-Johnson syndrome

b. Tardive dyskinesia

During health education with the nurse, what subject should be the primary focus for a client newly diagnosed with schizophrenia? a. maintenance of adequate nutrition b. the importance of adherence to prescribed treatment c. potential therapeutic effects of medication d. the need for weekly blood coagulation testing

b. the importance of adherence to prescribed treatment

The students are learning about medications to treat ADHD. The pharmacology instructor discusses the medication methylphenidate, used to treat attention deficit hyperactivity disorder. According to the instructor, methylphenidate is which? a. a respiratory stimulant. b. an anoretic agent. c. a central CNS stimulant. d. a selective serotonin reuptake inhibitor (SSRI).

c. a central CNS stimulant.

The main goal of therapy when using CNS stimulants is to: a. increase productivity and work longer hours. b. use the drugs as they are ordered. c. relieve the symptoms for which they were prescribed. d. increase the ability to study for long periods of time.

c. relieve the symptoms for which they were prescribed.

A client is receiving haloperidol. The nurse would be especially alert for the development of which adverse effect? a. Anticholinergic b. Sedation c. Hypotension d. Extrapyramidal

d. Extrapyramidal

Antipsychotic drugs are contraindicated in clients with: a. peptic ulcer disease, mild hypertension, chronic joint pain, and kidney failure. b. nausea, severe hypotension, or intractable hiccups. c. kidney damage, chronic obstructive lung disease, mild hypotension, and chronic bone pain. d. liver damage, coronary artery disease, severe hypertension, bone marrow depression, or cerebrovascular disease.

d. liver damage, coronary artery disease, severe hypertension, bone marrow depression, or cerebrovascular disease.