Psychiatric/Mental Health Drugs Level 1

A healthcare provider prescribes aripiprazole 15 mg by mouth once a day for a client with the diagnosis of schizophrenia. The hospital pharmacy sends aripiprazole 5 mg/tablet. How many tablets will the nurse administer? Record your answer as a whole number. ____ tablet(s)

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Which food should be avoided by a client who is prescribed monoamine oxidase inhibitors (MAOIs)? A. Bologna B. Potatoes C. Citrus fruit D. Grapefruit juice

A. Bologna Bologna has a high tyramine content; tyramine should not be consumed by clients taking monoamine oxidase inhibitors (MAOIs) because the drug interaction may cause severe hypertension. Potatoes and citrus fruits do not contain tyramine. Grapefruit juice may cause a negative drug interaction in clients taking buspirone.

A healthcare provider diagnoses attention deficit hyperactivity disorder (ADHD) in a 7-year-old child and prescribes methylphenidate. The nurse discusses the child's treatment with the parents. What does the nurse emphasize as important for the parents to do? A. Monitor the effect of the medication on their child's behavior. B. Increase or decrease the dosage, depending on the child's behavior. C. Avoid imposing too many rules, because this will frustrate the child. D. Point out to their child that behavior can be controlled.

A. Monitor the effect of the medication on their child's behavior. By monitoring and reporting changes in the child's behavior, the healthcare provider can determine the effectiveness of the medication. Dosage changes are the responsibility of the healthcare provider. Children need structure and rules; they provide a sense of security. Behavior is not deliberate or controllable; this statement may diminish the child's self-esteem if he or she cannot exert control.

Which statement about primary anxiolytic drugs requires correction? A. Benzodiazepines are indicated for ethanol withdrawal. B. Benzodiazepines increase the activity of gamma-aminobutyric acid. C.Benzodiazepines are the first-line drugs used in chronic anxiety disorders. D.Benzodiazepines act by depressing the activity in the region of the brainstem.

B. Benzodiazepines increase the activity of gamma-aminobutyric acid. Benzodiazepines act by decreasing the activity of gamma-aminobutyric acid, which is an inhibitory neurotransmitter. Apart from its indication in the treatment of depression, benzodiazepines are also prescribed for ethanol withdrawal, insomnia, and muscle spasms. Benzodiazepines are the first-line drug of choice in acute and chronic anxiety disorders. Benzodiazepines act by depressing activity in the areas of the brain called the brainstem and the limbic system.

A client with schizophrenia is started on a regimen of chlorpromazine. After 10 days a shuffling gait, tremors, and some rigidity are apparent. Benztropine mesylate 2 mg by mouth daily is prescribed. What does the nurse remember when administering these medications together? A. Both medications are cholinesterase inhibitors. B. Both medications have a cholinergic blocking action. C. The antipsychotic effects of chlorpromazine will be decreased. D.The synergistic effect of these medications will cause drooling.

B. Both medications have a cholinergic blocking action. Both medications block central acetylcholine receptors. Neither medication inhibits cholinesterase; neostigmine (Prostigmin) acts in this manner. Although benztropine mesylate can cause mental confusion when given in large doses, it does not reduce the antipsychotic effect of chlorpromazine. Both medications cause dry mouth.

Which second-generation antidepressant can worsen uncontrolled angle closure glaucoma? A. Trazodone B. Bupropion C. Duloxetine D. Mirtazapine

C. Duloxetine Duloxetine can worsen uncontrolled angle-closure glaucoma. Trazodone is contraindicated in clients with a known drug allergy. Bupropion is contraindicated for clients with seizures. Mirtazapine is contraindicated in cases of known drug allergy and concurrent use of monoamine oxidase inhibitors.

A client with an organic mental disorder becomes increasingly agitated and abusive. The primary healthcare provider prescribes haloperidol. For what untoward effects will the nurse assess the client? A.Jaundice and vomiting B. Tardive dyskinesia and nausea C. Parkinsonism and agranulocytosis D. Hiccups and postural hypotension

C. Parkinsonism and agranulocytosis The parkinsonian signs and symptoms are related to extrapyramidal tract effects, and agranulocytosis is related to bone marrow depression. Jaundice is an adverse reaction; vomiting is not. Tardive dyskinesia is an adverse reaction; nausea is not. The occurrence of orthostatic hypotension is low; hiccups usually do not occur.

A depressed client is prescribed citalopram hydrobromide. Six days later the client tearfully says to the nurse, "I'm taking an antidepressant, but it's not working. I'm hopeless." What is the best response by the nurse? A. "You feel hopeless." B. "It's easy to get discouraged." C."It takes 2 or 3 weeks before it begins to relieve depression." D. "Give it a little more time; it works more slowly in some people."

C."It takes 2 or 3 weeks before it begins to relieve depression." Informing the client about the expected response to the medication is factual information that may decrease the client's sense of hopelessness. Although empathic responses may be helpful, at this time the client needs information and reassurance based on fact. Citalopram hydrobromide does not work more slowly in some people.

Which drug most commonly causes extrapyramidal side effects (EPS)? a. Clozapine b. Haloperidol c. Risperidone d. Aripiprazole

b. Haloperidol Haloperidol is a typical antipsychotic that commonly causes extrapyramidal side effects. Clozapine is an atypical antipsychotic that has a low risk of causing extrapyramidal side effects. Risperidone and aripiprazole have a low risk of causing extrapyramidal side effects.

A client with a history of methamphetamine use is admitted to the medical unit. What clinical manifestation does the nurse expect when assessing the client? a. Constricted pupils b. Intractable diarrhea c. Increased heart rate d. Decreased respirations

c. Increased heart rate Methamphetamine is a stimulant that causes the release of adrenaline, which activates the sympathetic nervous system. The pupils will dilate, not constrict, because the sympathetic nervous system is activated. Clients withdrawing from opioids, not methamphetamine, experience diarrhea. The respirations will be increased, not decreased, because of the activation of the sympathetic nervous system.

A client asks the nurse how psychotropic medications work. How does the nurse reply? a."These medications decrease the metabolic needs of your brain." b. "These medications increase the production of healthy nervous tissue." c."These medications affect the chemicals used in communication between nerve cells." d."These medications regulate the sensory input received from the external environment."

c."These medications affect the chemicals used in communication between nerve cells." Most psychotropic medications affect neurotransmitters such as dopamine and norepinephrine, which enter the synapses between neurons, allowing them to signal each other. Psychotropic medications do not work by changing the metabolic needs of the brain. Psychotropic medications do not increase the production of nervous tissue. Although there may be some effect on sensory input, this is because of the change in neurotransmitters.

Which drug may lead to bruxism? a. Vilazodone b. Isocarboxazid c.Clomipramine d. Levomilnacipran

d. Levomilnacipran Serotonin reuptake inhibitors and serotonin/epinephrine reuptake inhibitors may lead to bruxism. Levomilnacipran is a serotonin/epinephrine reuptake inhibitor that may cause bruxism. Vilazodone is an atypical antidepressant that does not cause bruxism. Isocarboxazid is a monoamine oxidase inhibitor that does not cause bruxism. Clomipramine is a tricyclic antidepressant that does not cause bruxism. Bruxism is excessive teeth grinding or jaw clenching. It is an oral parafunctional activity; i.e., it is unrelated to normal function such as eating or talking.