Saunders Psychiatric Medications

The nurse is monitoring a client taking an antipsychotic medication for signs/symptoms of neuroleptic malignant syndrome (NMS). The nurse should expect to note which sign/symptom if NMS occurred? 1. Dysphagia 2. Bradycardia 3. Hypotension 4. Hyperpyrexia

4

he nurse is reinforcing medication discharge instructions for a client who has just begun taking isocarboxazid for depression and knows that the client needs further teaching after stating that which foods are safe to eat? Select all that apply. 1. Avocado 2. Apple 3. Bologna 4. Tomato 5. Broccoli

1,3

The nurse is caring for a client who has been admitted for alcohol abuse and knows that which medications may be prescribed in the treatment of this disorder? Select all that apply. 1. Diazepam 2. Bupropion 3. Disulfiram 4. Chlordiazepoxide 5. Methadone hydrochloride

1,3,4

A client is receiving a daily dose of oral fluphenazine. The nurse should reinforce instructions to the client to practice which intervention to minimize common side effects of this medication? 1. Monitor pulse daily. 2. Eat snacks at midmorning and bedtime. 3. Use hard, sour candy or sugarless gum. 4. Have blood pressure checked once a week.

3

A client receiving an anxiolytic medication complains that he feels very "faint" when he tries to get out of bed in the morning. The nurse explains to the client that which side effect is associated with this type of medication? 1. Postural hypotension 2. Cardiac dysrhythmias 3. Psychosomatic symptoms 4. Respiratory insufficiency

1

A client taking lithium carbonate reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus, and tremors. The lithium level is checked as a part of the routine follow-up, and the level is 3.0 mEq/L (3.0 mmol/L). The nurse knows that this is which level? 1. Toxic 2. Normal 3. Slightly above normal 4. Excessively below normal

1

A hospitalized client is started on phenelzine sulfate for the treatment of depression. At lunchtime, a tray is delivered to the client. Which food item on the tray should the nurse remove? 1. Yogurt 2. Crackers 3. Tossed salad 4. Oatmeal cookies

1

The nurse is caring for a client who is receiving lithium carbonate for the treatment of bipolar disorder and monitors the client for signs/symptoms of lithium toxicity. Which sign/symptom should alert the nurse to the potential for toxicity? 1. Vomiting 2. Headaches 3. Constipation 4. Increased urination

1

The nurse is collecting data from a client, and the client's spouse reports that the client is taking donepezil hydrochloride. Which disorder should the nurse suspect that this client may have based on the use of this medication? 1. Dementia 2. Schizophrenia 3. Seizure disorder 4. Obsessive-compulsive disorder

1

A client with fibromyalgia has not achieved pain relief with opioid pain medication. The client has a history of diabetes mellitus and atherosclerosis. The nurse anticipates that which single medications may be selected by the primary health care provider to be given in conjunction with the opioid pain medication? Select all that apply. 1. Duloxetine 2. Pregabalin 3. Alprazolam 4. Imipramine 5. Amitriptyline

1,2,3

A client is receiving lithium carbonate. The client's lithium carbonate level is 1.5 mEq/L, which indicates an early sign of toxicity. Which are some early signs/symptoms of toxicity? Select all that apply. 1. Slurred speech 2. Muscle weakness 3. Lethargy 0.7 mEq/L 4. Diarrhea 1.0 mEq/L 5. Weight gain 1.1 mEq/L 6. Blurred vision 1.7 mEq/L

1,2,3,4

A hospitalized client is prescribed phenelzine sulfate for the treatment of depression. The nurse reinforces instructions to the client and tells the client to avoid consuming which foods while taking this medication? Select all that apply. 1. Figs 2. Yogurt 3. Crackers 4. Aged cheese 5. Tossed salad 6. Oatmeal cookies

1,2,4

A client receiving long-term therapy with lithium carbonate has a toxic serum lithium level of 1.5 and 2 mEq/L. Which organ functions are the major long-term risk factors? Select all that apply. 1. Renal function 2. Cardiac function 3. Thyroid function 4. Endocrine function 5. Respiratory function 6. Musculoskeletal function

1,3

A client has a history of seizures. The primary health care provider has prescribed amitriptyline three times daily. The nurse seeks clarification of the prescription, knowing that the client is at risk for injury because of which adverse effect of the amitriptyline? 1. Decreased mental acuity 2. Decreased seizure threshold 3. Decreased platelet aggregation 4. Depressed immunological system2

2

A client with schizophrenia has been started on medication therapy with loxapine. The nurse determines that the client is experiencing the intended effects of the medication if which client behavior is observed? 1. Presence of fixed stare 2. Absence of delusional statements 3. Decreased appetite and food intake 4. Taking sips of water for dry mouth

2

When teaching a client who is being started on imipramine hydrochloride, when should the nurse tell the client that the medication would have the desired effects? 1. Desired effects start during the first week of administration. 2. Desired effects do not occur for 2 to 3 weeks of administration. 3. Desired effects start immediately following initial administration. 4. Desired effects do not occur until after 2 months of administration.

2

The nurse is caring for a client who has been prescribed citalopram and checks the client for which signs/symptoms of serotonin syndrome? Select all that apply. 1. Lethargy 2. Diarrhea 3. Bradycardia 4. Abdominal pain 5. Increased blood pressure

2,4,5

A client is taking a monoamine oxidase (MAO) inhibitor. The nurse plans care, knowing which information? 1. This classification of medications increases the amount of MAO in the liver. 2. Hypotensive crisis may be precipitated by foods that contain tyramine and tryptophan. 3. Symptomatology of MAO toxicity includes headache, hypertension, and nausea and vomiting. 4. Increased salivation, bradycardia, constipation, and mild insomnia are expected side effects.

3

A client taking buspirone hydrochloride for 1 month is scheduled for a follow-up appointment. The nurse gathers data from the client and interprets that the medication is effective if the client reports an absence of which sign/symptom? 1. Delusions 2. Paranoid thoughts 3. Palpitations and anxiety 4. Alcohol withdrawal signs/symptoms

3

A client arrives at the health care clinic and tells the nurse that they have been doubling their daily dosage of bupropion hydrochloride to help them get better faster. The nurse understands that the client is now at risk for which problem? 1. Insomnia 2. Weight gain 3. Seizure activity 4. Orthostatic hypotension

3

A client has begun taking phenelzine. At the initiation of therapy, the nurse teaches the client that which items are allowed in the diet? 1. Avocados, figs, and raisins 2. Red wines such as Chianti or sherry 3. Carrots, sweet potatoes, and squash 4. Lunchmeats such as bologna or salami

3

A client who is on lithium carbonate will be discharged at the end of the week. In reinforcing a discharge teaching plan, the nurse should include which instructions? 1. Avoid soy sauce, wine, and aged cheese. 2. Have the lithium level checked every week. 3. Take medication only as prescribed because it can become addicting. 4. Check with the psychiatrist before using any over-the-counter (OTC) medications or prescription medications.

4

A client is being treated for depression with amitriptyline hydrochloride. During the initial phases of treatment, which is the most important nursing intervention? 1. Prescribing the client a tyramine-free diet 2. Checking the client for anticholinergic effects 3. Getting baseline postural blood pressures before administering the medication and each time the medication is administered 4. Monitoring blood levels frequently because there is a narrow range between therapeutic and toxic blood levels of this medication

3

A client who is taking lithium carbonate is scheduled for surgery. The nurse would reinforce what information in the preoperative teaching about this medication? 1. The medication will be discontinued a week before the surgery and resumed 1 week postoperatively. 2. The medication is to be taken until the day of surgery and resumed by injection immediately postoperatively. 3. The medication will be discontinued 1 to 2 days before the surgery and resumed as soon as full oral intake is allowed. 4. The medication will be discontinued several days before surgery and resumed by injection in the immediate postoperative period.

3

A hospitalized client is taking clozapine for the treatment of a schizophrenic disorder. Which laboratory study prescribed for the client should the nurse specifically review to monitor for an adverse effect associated with the use of this medication? 1. Platelet count 2. Cholesterol level 3. White blood cell count 4. Blood urea nitrogen level

3

A nursing student is assigned to care for a client with a diagnosis of schizophrenia. Haloperidol is prescribed for the client, and the nursing instructor asks the student to describe the action of the medication. Which statement by the nursing student indicates an understanding of the action of this medication? 1. It is a serotonin reuptake blocker. 2. It inhibits the breakdown of released acetylcholine. 3. It blocks the uptake of norepinephrine and serotonin. 4. It blocks the binding of dopamine to the postsynaptic dopamine receptors in the brain.

4

Disulfiram is prescribed for a client and the nurse is collecting data on the client and is reinforcing instructions regarding the use of this medication. Which is most important for the nurse to determine before administration of this medication? 1. A history of hyperthyroidism 2. A history of diabetes insipidus 3. When the last full meal was consumed 4. When the last alcoholic drink was consumed

4

A client admitted to the hospital gives the nurse a bottle of clomipramine. The nurse notes that the medication has not been taken by the client in 2 months. Which behavior observed in the client would validate noncompliance with this medication? 1. Complaints of hunger 2. Complaints of insomnia 3. A pulse rate less than 60 beats per minute 4. Frequent hand washing with hot, soapy water

4

A client has been started on medication therapy with alprazolam. When the nurse teaches the client that the medication should not be discontinued abruptly, the client asks why. The nurse should incorporate which information in formulating a reply? 1. The client is likely to suffer irreversible kidney damage. 2. The client is likely to become resistant to medication effects. 3. It will make the medication much less effective if it must be restarted. 4. Rebound central nervous system (CNS) excitation could occur, including seizure activity.

4

A client in the mental health unit is administered haloperidol. What should the nurse check to determine its effectiveness? 1. The client's vital signs 2. The client's nutritional intake 3. The physical safety of other unit clients 4. The client's orientation and delusional status

4

The nurse is caring for a client on the mental health unit who has been declared incompetent through a formal legal proceeding. A guardian has been appointed. The nurse knows that guardians are typically selected from among family members. From the list of family members, what is the order of selection of a guardian for this client? List in descending order of importance from the first to the last choice. All options must be used. -Spouse -Adult children -Parents -Adult siblings -Adult nieces and nephews

In correct order