CH 22

A nurse works at a weight management clinic. To which overweight client could the nurse safely administer dextroamphetamine? A 48-year-old Caucasian man who has adult-onset diabetes A 60-year-old African-American man who experiences angina A 28-year-old African-American woman with hyperthyroidism A 38-year-old Caucasian woman with glaucoma

A 48-year-old Caucasian man who has adult-onset diabetes

Serotonin abnormalities are thought to be involved in the following disorders: Severe anxiety and hyperactivity. Mental depression and sleep disorders. Attention deficit disorder. Epilepsy and strokes.

Mental depression and sleep disorders.

A pediatric client has been admitted to the floor and started on Ritalin therapy for ADHD. The nurse knows that an important daily intervention for this client would be which? Weigh the client daily. Perform ROM exercises daily. Record a daily summary of client's behavior. Suction the client daily.

Record a daily summary of client's behavior.

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 Dystonia Akathisia Neuroleptic malignant syndrome

Tardive dyskinesia

A nursing instructor is describing the effects of CNS stimulants and their potential for addiction due to their euphoric sensations. The instructor determines that the discussion was successful when the students identify which substance as being involved with this pleasurable feeling? epinephrine serotonin norepinephrine dopamine

dopamine

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 electromyelogram (EMG). electroencephalogram (EEG). electrocardiogram (ECG). electrophysiologic study (EPS).

electrocardiogram (ECG).

A client asks to have a year's worth of prescription refills for methylphenidate, explaining that it is very hard to leave work for clinic appointments. How should the nurse respond to that request to best assure client safety? "I understand the inconvenience, but you have to come in at least every month to have blood work done." "The prescription dose is always started as low as possible, and the refills are monitored to prevent abuse." "I will speak with your health care provider about increasing the size of each refill." "It would be very costly to purchase a years' worth of medication at one time."

"The prescription dose is always started as low as possible, and the refills are monitored to prevent abuse."

A nurse is reviewing a client's serum lithium level and determines that the level is therapeutic by which result? 2.0 mEq/L 0.2 mEq/L 1.4 mEq/L 0.8 mEq/L

0.8 mEq/L

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? 3 2 1 4

2

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 increase Scott's ability to understand information better. Dexmethylphenidate will stabilize Scott's mood so that he can concentrate. Dexmethylphenidate will improve Scott's attention span so that he will be able to complete a task. Dexmethylphenidate will improve Scott's memory.

Dexmethylphenidate will improve Scott's attention span so that he will be able to complete a task.

A client is prescribed risperidone for the treatment of schizophrenia. The client is voiding three times each night and is always thirsty. Based on the adverse effects of risperidone, what should the nurse suspect is triggering the client's reported polyuria and polydipsia? Hyperthyroidism Renal calculi Urinary tract infection Diabetes mellitus

Diabetes mellitus

A teenage client, treated with dextroamphetamine for attention deficit hyperactivity disorder (ADHD) for the last 10 years, is now diagnosed with hyperthyroidism. What intervention should be implemented with this client to provide safe management of all conditions? Discontinue the dextroamphetamine. Assess the client for pulmonary edema. Discontinue the high-calorie diet. Administer a proton pump inhibitor.

Discontinue the dextroamphetamine.

When teaching about the action of conventional antipsychotic medications to a group of nursing students, which would the instructor include? Inhibiting the release of dopamine in the brain Stimulating the release of dopamine in the brain Inhibiting the release of serotonin in the brain Stimulating GABA receptors in the brain

Inhibiting the release of dopamine in the brain

The nurse is preparing to provide education to a client who has been prescribed clozapine for schizophrenia. What is the most important aspect of client teaching? Reporting signs of neuralgia Stopping medications if weight gain occurs Maintaining medication regimen Limiting alcohol to two drinks per day

Maintaining medication regimen

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

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

A nurse is planning the care of a client who has been diagnosed with schizophrenia and who will begin treatment with a typical antipsychotic. The nurse should identify what nursing diagnosis? Risk for injury related to central nervous system depression Risk for impaired liver function related to hepatotoxicity Bowel incontinence related to gastrointestinal adverse effects Risk for imbalanced body temperature related to hypothalamic suppression

Risk for injury related to central nervous system depression

A young client has been prescribed an antipsychotic agent to relieve psychotic symptoms. Which goal of care is the priority? The client will interact therapeutically with peers. The client will remain safe. The client will demonstrate independent health maintenance. The client will participate in activities of daily living (ADL).

The client will remain safe.

A nurse is teaching the client about CNS medications and how they are addictive. What is primary reason CNS medications are addictive? The medication decreases the amount of dopamine released into the body, causing feelings of euphoria. The medication stimulates the brain's pleasure centers with enhanced neurotransmission of dopamine. The medication stimulates the brain's visual centers, so the client sees everything more clearly. The medication stimulates the brain's sleep centers, so the client can sleep more soundly.

The medication stimulates the brain's pleasure centers with enhanced neurotransmission of dopamine.

What disease process is haloperidol used to treat? Tourette's syndrome muscular dystrophy early-onset dementia myasthenia gravis

Tourette's syndrome

What are common skin reactions that a nurse should warn a client about when they are initiated on antipsychotic therapy? (Select all that apply.) Hyperpigmentation Stevens-Johnson syndrome Urticaria Photosensitivity Toxic epidermal necrolysis

Urticaria Photosensitivity

The nurse is planning care for a client who has been prescribed a CNS stimulant. What should the nurse establish as the primary goal of therapy? relieve the symptoms for which they were prescribed. use the drugs as they are ordered. increase productivity and work longer hours. increase the ability to study for long periods of time.

relieve the symptoms for which they were prescribed.

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 resolves by adolescence." "ADHD usually starts in childhood and resolves before adolescence." "ADHD usually starts in childhood and may persist through adulthood." "ADHD usually starts in childhood and resolves by adulthood."

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

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

"Adverse effects include hypertension and nervousness."

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

"Adverse effects include hypertension and nervousness."

The instructor is discussing psychosis with the nursing students. The instructor knows that teaching was effective when the students identify what behaviors are exhibited by people with psychosis? Short- and long-term memory deficits Disorganized and often bizarre thinking Slowed reaction time and poor coordination Short manic episodes followed by long depressive episodes

Disorganized and often bizarre thinking

Monitoring of patients taking lithium includes periodically obtaining a serum lithium level; at what level may toxic reactions occur? Greater than 1.25 mEq/mL Greater than 0.5 mEq/mL Greater than 1 mEq/mL Greater than 1.5 mEq/mL

Greater than 1.5 mEq/mL

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? Take diphenoxylate hydrochloride. Take an over-the-counter (OTC) laxative daily. Increase fiber intake. Take metronidazole.

Increase fiber intake.

A nurse is teaching the client about CNS medications and how they are addictive. What is primary reason CNS medications are addictive? The medication stimulates the brain's sleep centers, so the client can sleep more soundly. The medication stimulates the brain's visual centers, so the client sees everything more clearly. The medication decreases the amount of dopamine released into the body, causing feelings of euphoria. The medication stimulates the brain's pleasure centers with enhanced neurotransmission of dopamine.

The medication stimulates the brain's pleasure centers with enhanced neurotransmission of dopamine.

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): decreased risk for muscular contractions and spasms. increased risk for toxic effects of haloperidol therapy. decreased risk for toxic effects of haloperidol therapy. high drug efficacy of haloperidol.

increased risk for toxic effects of haloperidol therapy.

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

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

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 have influenza A and will need to be put into isolation. The client may be having a neuroleptic malignant syndrome reaction to his antipsychotic medication and needs treatment immediately. The client may have broken his arm and not remember what happened because of his schizophrenia. The client may have neuroleptic malignant syndrome, which will self-resolve in a few hours after rest and Tylenol.

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

Which test should be scheduled every week for a patient taking clozapine? pH level Serum lithium WBC count Blood glucose

WBC count

The nurse is working with a 12 year-old client who has been diagnosed with attention-deficit hyperactivity disorder and prescribed methylphenidate (Ritalin). What statement by the client would suggest the presence of adverse drug effects? "I just don't feel hungry very much these days." "I fell asleep on the bus last week and missed my stop." "I banged my shin last week and the bruise is still there." "Sometimes I just feel so mad at my teacher or my coach."

"I just don't feel hungry very much these days."

The nurse is working with a 12 year-old client who has been diagnosed with attention-deficit hyperactivity disorder and prescribed methylphenidate (Ritalin). What statement by the client would suggest the presence of adverse drug effects? "Sometimes I just feel so mad at my teacher or my coach." "I just don't feel hungry very much these days." "I fell asleep on the bus last week and missed my stop." "I banged my shin last week and the bruise is still there."

"I just don't feel hungry very much these days."

What client is being treated with a typical antipsychotic? A client whose thought disorder requires clozapine 25 mg PO b.i.d. An agitated client who was given haloperidol during acute psychosis A client with schizophrenia who received paliperidone 6 mg PO daily A client who recently began taking ziprasidone

An agitated client who was given haloperidol during acute psychosis

A male client's health care provider orders antipsychotic medications for him. He experiences little or no side effects from the medications and is able to function successfully in both his home and work environments. Six weeks later, he is diagnosed with hepatitis B. He begins to experience adverse reactions to his medications. A possible reason for the adverse reactions might be that, in the presence of liver disease, what may happen? Metabolism may be slowed and drug elimination half-lives shortened, with resultant accumulation and increased risk of adverse effects. Metabolism may be accelerated and drug elimination half-lives prolonged, with resultant accumulation and increased risk of adverse effects. Metabolism may be accelerated and drug elimination half-lives shortened, causing an increased risk of adverse effects. Metabolism may be slowed and drug elimination half-lives prolonged, with resultant accumulation and increased risk of adverse effects.

Metabolism may be slowed and drug elimination half-lives prolonged, with resultant accumulation and increased risk of adverse effects.

The nurse is caring for a client who takes clozapine. The nurse would be most concerned if this client displays what symptom? Blood sugar of 108 Temperature of 102°F Weight gain of 1 lb in the last week Blood pressure of 98/64

Temperature of 102°F