Pharmacology Chapter 22 Psychotherapeutic Agents
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?
"ADHD usually starts in childhood and may persist through adulthood."
A 21-year-old client refuses to take his oral antipsychotic medication. What would be the appropriate action for the nurse do?
Attempt to reason with the client. If he still refuses, contact the provider for further instructions.
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.
A client is being treated with clozapine. What should the nurse monitor most closely?
White blood cell count
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 central CNS stimulant.
For which client would the nurse question the use of antipsychotic medication therapy?
an 81-year-old whose delusions and psychosis are attributable to dementia
When assessing an adolescent client diagnosed with attention deficit hyperactivity disorder (ADHD) for therapeutic effects of methylphenidate, the nurse should focus on improvement associated with what client function? Select all that apply.
behavior motor task performance cognitive task performance
After administration of haloperidol to an acutely dehydrated client, the nurse should prioritize what nursing assessment?
blood pressure
What medication is an example of a phenothiazine antipsychotic?
chlorpromazine
A client is prescribed olanzapine for the treatment of schizophrenia. The client is voiding three times each night and is always thirsty. Based on the adverse effects of olanzapine, what should the nurse suspect is triggering the client's reported polyuria and polydipsia?
diabetes mellitus
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
electrocardiogram (ECG).
The peditric client has been prescribed mehtylphenidate. Which statement should be included in the teaching plan for a client receiving methylphenidate?
"Adverse effects include hypertension and nervousness."
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
A client with dementia has been very agitated lately. What type of medication might the provider prescribe to help with the agitation?
Antipsychotic
A patient expresses that being diagnosed with narcolepsy has been devastating for him. Which statement by the patient should the nurse focus on initially during the assessment?
"I sometimes wonder if it is worth living a life that has so many restrictions."
A family member asks if a relative, who is taking prochlorperazine for schizophrenia, can go on a beach vacation. What is one point of education that the nurse would make sure the client and family understand?
"Prochlorperazine can make you very sensitive to light. Make sure you wear sunscreen and cover up as much as possible to prevent sunburn."
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."
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.
The nurse should suspect lithium toxicity in a client that experiences which symptoms? (Select all that apply.)
Diarrhea Lack of coordination Muscle weakness
For which adverse reactions should the nurse monitor the patient who has been administered antipsychotic drugs?
Dry mouth
What assessment finding should lead the nurse to suspect that a client receiving antipsychotic therapy is developing tardive dyskinesia?
Lip smacking
Which drug shares the abuse potential of amphetamines and is a Drug Enforcement Administration (DEA) schedule II controlled substance?
Methylphenidate, a centrally acting CNS stimulant
The nurse on the unit has several clients taking clozapine. For which client is clozapine, an antipsychotic, contraindicated?
The 45-year-old with bone marrow depression
A 10-year-old boy is taking dextroamphetamine (Dexedrine) daily for ADHD. At each clinic visit, the nurse must assess the child. The priority assessment since he is on this medication would be which?
height and weight.
What is the central nervous system stimulant of choice to treat narcolepsy?
modafinil
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
A client has been treated with chlorpromazine for many years. The nurse observes that a client with a long history of chlorpromazine therapy demonstrates lip smacking and appears to be chewing continually. The nurse should recognize that this client is likely experiencing what adverse effect of the medication?
tardive dyskinesia
While caring for a client who is receiving antipsychotic therapy, the nurse observes lip smacking, a darting tongue, and slow and aimless arm movements. The nurse interprets this as:
tardive dyskinesia.
During health education with the nurse, what subject should be the primary focus for a client newly diagnosed with schizophrenia?
the importance of adherence to prescribed treatment
For clients taking clozapine, it is necessary to regularly monitor what lab test during the initial months of therapy and periodically thereafter?
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?
"We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention."
A male client with obesity comes to the clinic and informs the primary care provider (PCP) that he wants to have bypass surgery to lose 50 pounds. The client does not have diabetes or high blood pressure, so the PCP informs the client that as a first step, he wants the client to try to diet to lose weight. Which medication would the PCP then most likely order?
Didrex
During periods of dehydration, the client is at risk for lower serum lithium levels.
False
A parenteral form of an antipsychotic is prescribed for a client who has become aggressive. When administering the drug, which site would be most appropriate for the nurse to use?
Gluteus
The school nurse is conducting a screening of kindergarten students. The nurse will assess the children for what characteristics of ADHD? (Select all that apply.)
Hyperactivity Impulsivity Short attention span
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 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?
The client may be having a neuroleptic malignant syndrome reaction to his antipsychotic medication and needs treatment immediately.
A high school age client, brought to the emergency department (ED) by friends after taking a "whole handful of dextroamphetamine," is now lapsing in and out of consciousness. The ED nurse should prioritize what assessment related to dextroamphetamine overdose?
cardiac monitoring
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.
A client visits the occupational health office of the factory in which he works. He has fallen asleep on the line and has a history of muscle weakness. This instance is not the first time he has fallen asleep on the line. These behaviors support which medical diagnosis?
narcolepsy
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?
Tardive dyskinesia
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."
A client is started on aripiprazole and the nurse notices the client is experiencing dry mouth and nasal congestion. What intervention does the nurse teach the client to minimize the side effects of the medication?
Drinking frequent sips of water
A nurse is reviewing a bipolar client's serum lithium level, which is 1.8 mEq/L. What is the nurse's best action?
Inform the prescriber and monitor for GI and CNS effects
A female client 25 years of age has begun taking lithium for treatment of bipolar disorder. Which statement indicates that the client needs further instruction?
"I will need to stop taking my birth control pills while I take lithium."
Serotonin abnormalities are thought to be involved in the following disorders:
Mental depression and sleep disorders.
A client who was diagnosed with schizophrenia in 1962 was prescribed chlorpromazine. The client has been taking the medication for more than 40 years. What adverse effect will the client most likely experience?
Tardive dyskinesia
A 13-year-old has been prescribed dextroamphetamine for the treatment of attention deficit hyperactivity disorder (ADHD) since age 10, achieving significant improvements in behavior and mood. When assessing the child during a scheduled follow-up appointment, the nurse should prioritize what physical assessment to monitor for a potential adverse reaction to the therapy?
measurement of height and body weight