Psych Pharm review questions
A nursing instructor is explaining the etiology of trauma-related disorders from a learning theory perspective. Which student statement indicates that teaching has been effective? a) "How clients perceive events and view the world affect their response to trauma" b) "The psychic numbing in PTSD is a result of a negative reinforcement" c) "The individual becomes addicted to the trauma owing to an endogenous opioid response" d) "Believing that the world is meaningful and controllable can protect an individual from PTSD"
a) "How clients perceive events and view the world affect their response to trauma"
A nurse is assessing a client 4 hours after receiving an initial dose o fluoxetine. Which of the following findings should the nurse report to the provider as indications of Serotonin Syndrome? Select all that apply. a.Hypothermia b.Hallucinations c.Muscular flaccidity d.Diaphoresis e.Agitation
b.Hallucinations d.Diaphoresis e.Agitation
Which of the following would be a priority component of the teaching plan for a patient prescribed phenelzine for the treatment of depression? a) Headaches may occur. OTC medications will usually be effective. b) Hyperglycemia may occur and any unusual thirst, hunger, or urination should be reported c) Read the labels of food and OTC drugs to avoid those with substances that should be avoided as directed d) Monitor BP for hypotension and report any blood pressure below 90/60
c) Read the labels of food and OTC drugs to avoid those with substances that should be avoided as directed
The nurse should immediately report the development of which of the following symptoms in a patient taking an antipsychotic medication? a) Fever, tackycardia, confusion, incontinence b) Pacing, squirming, or difficulty with gait such as bradykinsea c) Severe spasms of the muscles of the tongue, face, neck or back d) Sexual dysfunction or gynecomastia
c) Severe spasms of the muscles of the tongue, face, neck or back
A client diagnosed with Generalized Anxiety states "I know the best thing for me to do now is to just forget my worries" How should the nurse evaluate this statement? a) The client is developing b) The client's coping skills are improving c) The client has a distorted perception of problem resolution d) The client is meeting outcomes and moving toward discharge
c) The client has a distorted perception of problem resolution
The parents of a young patient receiving methylphenidate express concern that the health care provider has suggested the child have a "holiday" from the drug. What is the purpose of a drug-free period? a) To reduce or eliminate the risk of drug toxicity b) To allow the child's "normal" behaviors to return c) To decrease drug dependence and assess the patient's status d) To prevent the reoccurrence of a hypertensive crisis
c) To decrease drug dependence and assess the patient's status
A nurse is caring for a client who has schizophrenia and exhibits a lack of grooming and flat affect. The nurse should anticipate the prescription of which of the following medications? a. Chlorpromazine b. Thiothixene c. Risperdone d. Haloperidol
c. Risperdone
Besides antianxiety agents, which classification of drugs is also commonly given to treat anxiety and anxiety disorders? a.Antipsychotics b.Mood stabilizers c.Antidepressants d.Cholinesterase inhibitors
c.Antidepressants
What medication is given which treats nightmares from PTSD?
Prazosin (Minipress)
What symptoms should the nurse recognize that differentiate a client diagnosed with panic disorder from a client diagnosed with generalized anxiety disorder (GAD)? a) GAD is acute in nature, and panic disorder is chronic b) Chest pain is a common GAD symptoms, whereas this symptoms is absent in panic disorders c) Hyperventilation is a common symptom in GAD and rare in panic disorder d) Depersonalization is commonly seen in panic disorder and absent in GAD
d) Depersonalization is commonly seen in panic disorder and absent in GAD
While monitoring a patient who took a OD of barbituates, the nurse keeps in mind that the cause of death would be which of the following? a) Tackycardia b) Hypertension c) Dyspnea d) Respiratory Arrest
d) Respiratory Arrest
A 62-year-old woman has started taking donepezil for early-stage Alzheimer's disease. Her daughter expresses relief that "there is finally a pill to cure AD." What is the nurses best response? a."She should expect reversal of symptoms within a few days." b."The dosage should be increased if no improvement is noted." c."This drug may help to improve symptoms, but it is noted intended as a cure." d."Yes, it has been a great help for many patients."
c."This drug may help to improve symptoms, but it is noted intended as a cure."
A client is taking chlordiazepoxide (Librium) for generalized anxiety disorder symptoms. In which situation should a nurse recognize that this client is at greatest risk for drug overdose? A. When the client has a knowledge deficit related to the effects of the drug B. When the client combines the drug with alcohol C. When the client takes the drug on an empty stomach D. When the client fails to follow dietary restrictions
B. When the client combines the drug with alcohol
A nurse has been caring for a client diagnosed with generalized anxiety disorder (GAD). Which of the following nursing interventions would address this client's symptoms? (Select all that apply.) A. Encourage the client to recognize the signs of escalating anxiety. B. Encourage the client to avoid any situation that causes stress. C. Encourage the client to employ newly learned relaxation techniques. D. Encourage the client to cognitively reframe thoughts about situations that generate anxiety. E. Encourage the client to avoid caffeinated products.
A. Encourage the client to recognize the signs of escalating anxiety. C. Encourage the client to employ newly learned relaxation techniques. D. Encourage the client to cognitively reframe thoughts about situations that generate anxiety. E. Encourage the client to avoid caffeinated products.
Arthur, who is diagnosed with obsessive-compulsive disorder (OCD), reports to the nurse that he can't stop thinking about all the potentially life-threatening germs in the environment. What is the most accurate way for the nurse to document this symptom? A. Patient is expressing an obsession with germs. B. Patient is manifesting compulsive thinking. C. Patient is expressing delusional thinking about germs. D. Patient is manifesting arachnophobia of germs.
A. Patient is expressing an obsession with germs.
Joe, a patient being treated for PTSD, tells the nurse that his therapist is recommending cognitive therapy. He asks the nurse how that's supposed to help his nightmares. Which of these responses by the nurse provides accurate information about the benefits of this type of therapy? Select all that apply. A. The nightmares may be related to troubling thoughts and feelings; cognitive therapy will help you explore and modify those thoughts and feelings. B. It is designed to help you cope with anxiety, anger, and other feelings that may be related to your symptoms. C. It is designed to repeatedly expose you to the trauma you experienced so you can regain a sense of safety. D. Once you learn to repress these troubling feelings, the nightmares should cease.
A. The nightmares may be related to troubling thoughts and feelings; cognitive therapy will help you explore and modify those thoughts and feelings. B. It is designed to help you cope with anxiety, anger, and other feelings that may be related to your symptoms.
A patient who has been taking a benzo for 5 weeks has been instructed to stop the medication. Which instruction will the nurse provide to the patient on how to discontinue the medication? a) Stop taking the drug immediately b) Plan a gradual reduction in dosage c) Overlap this medication with another drug d) Take the medication every other day for a number of weeks
b) Plan a gradual reduction in dosage
Sandy, a rape survivor, is being treated for PTSD. Which of these statements are good indications that Sally is beginning to recover from PTSD? A. "I still have nightmares every night, but I don't always remember them anymore." B. "I'm not drinking as much alcohol as I had been over the last several months." C. "This traumatic event immobilized me for awhile, but I have found imagery helpful in reducing my anxiety." D. All of the above.
D. All of the above.
A cab driver, stuck in traffic, suddenly is lightheaded, tremulous, diaphoretic, and experiences tachycardia and dyspnea. A work-up in an emergency department reveals no pathology. Which medical diagnosis is suspected, and what nursing diagnosis should be the nurse's first priority? A. Generalized anxiety disorder and a nursing diagnosis of fear B. Mild anxiety disorder and a nursing diagnosis of anxiety C. Pain disorder and a nursing diagnosis of altered role performance D. Panic disorder and a nursing diagnosis of anxiety
D. Panic disorder and a nursing diagnosis of anxiety
Louisa recently experienced surviving a plane crash and is assessed by the nurse. Which statements made by Louisa indicate that she may be experiencing PTSD? (Select all that apply) a) "I keep having these thoughts about the crash that just pop into my mind at random times" b) "I am so afraid that I will never be able to fly again. I worry about it constantly" c) "I have nightmares every night about the crash where I picture myself dying" d) "I believe I was meant to survive the accident so that I can focus on the important things in life"
a) "I keep having these thoughts about the crash that just pop into my mind at random times" b) "I am so afraid that I will never be able to fly again. I worry about it constantly" c) "I have nightmares every night about the crash where I picture myself dying"
A military veteran is assessed for outpatient therapy after he reports having problems at home and at work. Which of the symptoms that he describes are commonly associated with PTSD? (Select all that apply) a) "I've been drinking and smoking pot daily" b) "I've been having trouble sleeping and I think I've been having nightmares but I can't remember them" c) "I slapped on my wide when she was trying to hug me" d) "I've been having intense pain in the leg where I sustained a combat wound"
a) "I've been drinking and smoking pot daily" b) "I've been having trouble sleeping and I think I've been having nightmares but I can't remember them" c) "I slapped on my wide when she was trying to hug me"
A client receiving EMDR therapy says "After only two sessions of my therapy, I am feeling great. Now I can stop and get on with my life" Which of the following nursing responses is most appropriate? a) "I am thrilled that you have responded so rapidly to EMDR" b) "To achieve lasting results, all eight phases of EMDR must be completed" c) "If I were you, I would complete EMDR and comply with doctor's orders" d) "How do you feel about continuing the therapy?"
b) "To achieve lasting results, all eight phases of EMDR must be completed"
The nurse is administering the antipsychotic drug clozapine and should monitor the patient for what long-term problem associated with this drug? (Select all that apply) a) Mood swings b) Agranulocytosis c) Weight gain d) Anorexia e) Increased appetite
b) Agranulocytosis c) Weight gain e) Increased appetite
A 20-year-old man is admitted to the psychiatric unit for treatment of acute schizophrenia and is stated on risperdone. Which patient effects should the nurse assess for to determine whether the drug is having therapeutic effects? a) Restful sleep, elevated mood, and coping abilities b) Decreased delusional thinking, and lessened AH/VH c) Orthostatic hypotension, reflex tackycardia, and sedation d) Relief of anxiety and improved sleep and dietary habits
b) Decreased delusional thinking, and lessened AH/VH
Zolpidem has been ordered for a patient for the treatment of insomnia. What information will the nurse provide for this patient? (select all that apply) a) Be cautious when performing morning activities because it may cause a significant "hangover" effect with drowsiness and dizziness. b) Take the drug with food; this enhances the absorption for quicker effects c) Take the drug immediately before going to bed; it has a quick action d) If the insomnia is long lasting, this drug may safely be used for up to one year e) Alcohol and other drugs that cause CNS depression should be avoided while taking this drug
a) Be cautious when performing morning activities because it may cause a significant "hangover" effect with drowsiness and dizziness. c) Take the drug immediately before going to bed; it has a quick action e) Alcohol and other drugs that cause CNS depression should be avoided while taking this drug
A patient is tested for psychosis with fluphenazine. What drug will the nurse anticipate may be given to prevent the development of acute dystonia? a) Benzotropine b) Diazepam c) Haloperidol d) Lorazepam
a) Benzotropine
Which symptoms should the nurse recognize that differentiate a client diagnosed with obsessive-compulsive (OCD) from a client diagnosed with obsessive-compulsive personality disorder? a) Clients diagnosed with OCD experience both obsessive and compulsions, and clients diagnosed with obsessive-compulsive personality disorder do not b) Clients diagnosed with obsessive-compulsive personality disorder experience both obsessions and compulsions, and clients diagnosed with OCD do not c) Client diagnosed with obsessive-compulsive personality disorder experience only obsessions. and clients diagnosed with OCD experience compulsions d) Clients diagnosed with OCD experience only obsessions, and clients diagnosed with obsessive-compulsive personality disorder experience only compulsions
a) Clients diagnosed with OCD experience both obsessive and compulsions, and clients diagnosed with obsessive-compulsive personality disorder do not
A nurse who works on an inpatient psychiatric unit is working on developing a treatment plan for a patient admitted with PTSD. The patient, a military veteran, reports that sometimes he thinks he sees bombs, exploding and the enemy rushing toward him. He has had aggressive outburst and was hospitalized after assaulting a co-worker during one of these episodes. Which of these nursing interventions are evidence-based response? (Select all that apply) a) Collaborate with the patient about how he would like the staff to response when he has episodes of reexperiencing traumatic events b) tell the patient it is not appropriate to hit other patients or staff and if that occurs, he will have to be discharged from the hospital c) Contact the doctor and recommend that the patient be ordered an antipsychotic medication d) Refer the patient to a support group with other military veterans
a) Collaborate with the patient about how he would like the staff to response when he has episodes of reexperiencing traumatic events d) Refer the patient to a support group with other military veterans
The nurse is monitoring for early signs of lithium toxicity. Which symptoms, if present, may indicate that toxicity is developing? (Select all that apply) a) Persistent GI upset b) confusion c) increased urination d) convulsions e) ataxia
a) Persistent GI upset b) confusion c) increased urination
When reviewing actions of a drug the nurse recognizes that a hypnotic is a drug that performs which of the following actions? a) Produces sleep b) Stops seizures c) Prevent nausea and vomiting d) Relieves pain
a) Produces sleep
A client diagnosed with with AD has been assigned the nursing diagnosis of anxiety R/T divorce. Which currently written outcome addresses this client's problem? a) Rate anxiety as 4 out of 10 by discharge b) States anxiety level has decreased by day one c) Accomplishes activities of daily living independently d) Demonstrates ability for adequate social functioning by day three
a) Rate anxiety as 4 out of 10 by discharge
A 16-year-old patient has taken an OD of citalopram and is brought to the ED. What symptoms would the nurse expect to be present? a) Seizures, HTN, tackycardia, extreme anxiety b) Hypotension, bradycardia, hypothermia, sedation c) Miosis, respiratory depression, absent bowel sounds, hypoactive reflexes d) Manic behavior, paranoia, delusions, tremors
a) Seizures, HTN, tackycardia, extreme anxiety
A patient admitted tot he hospital with PTSD is ordered the following medications. Which of these medications has a direct use in treating symptoms that are common is PTSD? (Select all that apply) a) alprazolam (Xanax) b) Propanol (Inderal) c) Docusate (Colace) d) Docusate (Dulcolax)
a) alprazolam (Xanax) b) Propanol (Inderal)
A nurse is caring for a client who take paroxetine to treat PTSD. The client states that he grinds his teeth at night, which causes pain in his mouth. The nurse should identify which of the following interventions as possible measures to manage the clients bruxism? Select all that apply. a. Concurrent administration of buspirone b. Administration of a different SSRI c. Use of a mouth guard d. Changing to a different class of antianxiety medication e. Increasing the dose of paroxetine
a. Concurrent administration of buspirone c. Use of a mouth guard d. Changing to a different class of antianxiety medication
A client diagnosed with posttraumatic stress disorder (PTSD) states, "Why did my doctor prescribe an antidepressant rather than an antianxiety drug for me?" Which of the following are the most appropriate nursing responses? (Select all that apply) a) "I'm not sure, because antianxiety drugs have been approved by the FDA for PTSD" b) "Antidepressants are now considered first-line treatment choice for PTSD" c) "Many people have adverse reactions to antianxiety drugs" d) "Because of their addictive properties, antianxiety drugs are less desirable" e) "There have been no controlled studies on the effect of antianxiety drugs on PTSD"
b) "Antidepressants are now considered first-line treatment choice for PTSD" d) "Because of their addictive properties, antianxiety drugs are less desirable"
A nursing instructor is teaching about specific phobias. Which student statement indicates that learning has occurred? a) "These clients do not recognize that their fear is excessive, and they rarely seek treatment" b) "These clients have overwhelming symptoms of panic when exposed to the phobic stimulus" c) "These clients experience symptoms that mirror a cerebrovascular accident (CVA)" d) "These clients experience the symptoms of tackycardia, dysphagia, and diaphoresis"
b) "These clients have overwhelming symptoms of panic when exposed to the phobic stimulus"
A family asks the nurse why their son was diagnosed with PTSD and others in the accident were not. Which of the following information should the nurse offer? (Select all that apply) a) An individual's religious affiliation can affect response to trauma b) Responses are affected by how an individual handled previous trauma c) Protectiveness of family and friends can help an individual deal with trauma d) Control over the possibility of reoccurrence can affect the response to trauma e) The time in which the trauma occurred can affect the individual's response
b) Responses are affected by how an individual handled previous trauma c) Protectiveness of family and friends can help an individual deal with trauma d) Control over the possibility of reoccurrence can affect the response to trauma e) The time in which the trauma occurred can affect the individual's response
Sammy is diagnosed with a trauma disorder and is being treated at an inpatient psychiatric unit. Which nursing short-term goal is most appropriate for Sammy? a) Sammy resolves all feelings of survivors guilt within a week b) Sammy demonstrates three relaxation techniques upon discharge c) Sammy moves through all stages of grief within 1 month d) Sammy agrees to seek community resources upon admission
b) Sammy demonstrates three relaxation techniques upon discharge
A nursing student questions an instructor regarding the order for fluvoxamine (Luvox) 300 mg daily for a client diagnosed with obsessive-compulsive disorder. Which instructor response is most accurate? a) High doses of tricyclic medications will be required for effective treatment for OCD b) Selective serotonin reuptake inhibitor (SSRI) doses, in excess of what is effective for treatment depression, may be required for OCD c) The dose of Luvox is low because of the side effects of daytime drowsiness d) The dose of this SSRI is outside the therapeutic range and needs to be questioned
b) Selective serotonin reuptake inhibitor (SSRI) doses, in excess of what is effective for treatment depression, may be required for OCD
Prior to discharge, the nurse plans for patient teaching related to side effects of first generation antipsychotics to the patient and family. Which of the following should be included? a) The patient may experience withdrawal and slowed activity b) Severe muscle spasms may occur early in therapy c) TD is likely early in therapy. d) Medications should be taken as prescribed to prevent adverse effects
b) Severe muscle spasms may occur early in therapy
A 17-year-old patient has been prescribed escitalopram for increasing anxiety uncontrolled by other measures. Because of this patient's age, the nurse will ensure that the patients are taught what important information? a) cigarette smoking will counteract the effects of the drug. b) signs of increasing depression or suicide should be reported immediately. c) The drug causes dizziness and alternative schooling arrangements may be needed for the first two months of use. d) anxiety and excitability may increase during the first 2 weeks of use but then will have significant improvement.
b) signs of increasing depression or suicide should be reported immediately.
A nurse is caring for a client who is prescribed lithium therapy. The client states that he wants to take ibuprofen for OA pain relief. Which of the following statement should the nurse make? a."That is a good choice. IBU does not interact with lithium." b."Regular ASA would be a better choice than IBU." c."Lithium decreases the effectiveness of IBU." d."The IBU will make your lithium level fall too low."
b."Regular ASA would be a better choice than IBU."
The nurse determines that the teaching plan for a patient prescribed sertraline has been effect when the patient makes which statement? a) "I should not decrease my sodium or water intake" b) "The drug can be taken concurrently with the phenelzine that I'm taking" c) "It may take up to a month for the drug to reach full therapeutic effects and I'm feeling better" d) "There are no other drugs I need to worry about; Zoloft doesn't reach with them"
c) "It may take up to a month for the drug to reach full therapeutic effects and I'm feeling better"
How would the nurse best describe the major maladaptive client response to panic disorder? a) Client overuse medical care because of physical symptoms b) Clients use illegal drugs to ease symptoms c) Clients perceive having no control over life situations d) Clients develop compulsions to deal with anxiety
c) Clients perceive having no control over life situations
A client is experiencing a severe panic attack. Which nursing intervention would meet this client's physiological need? a) Teach deep breathing relaxation exercises b) Place a client in a Trendelenburg position c) Have the client breath into a paper bag d) Administer the order prn buspirone (BuSpar)
c) Have the client breath into a paper bag
The patient states that he has not taken his antipsychotic drug for the past 2 weeks because it was causing sexual dysfunction. What is the nurses primary concern at this time? a) A hypertensive crisis may occur with such abrupt withdrawal of the drug b) Significant muscle twitching may occur, increasing fall risk c) EPS such as secondary parkinsonism are likely to occur d) Symptoms of psychosis are likely to return
d) Symptoms of psychosis are likely to return
A patient is receiving temazepam. Which if these responses should a nurse expect the patient to have if the medication is achieving the desired effect? a) The patient sleeps in 3- hour intervals, awakens for a short time, and then falls back to sleep. b) The patient reports feeling less anxiety during activities of daily living. c) The patient reports having fewer episodes of panic attacks when stressed. d) The patient reports sleeping 7 hours without awakening.
d) The patient reports sleeping 7 hours without awakening.
