Ch 22 - Psychotherapeutic Agents
A 16-year-old male has just been diagnosed with schizophrenia. The parents ask the nurse what causes schizophrenia. What would be the nurse's best response? A) "Schizophrenia is caused by pain that the brain perceives." B) "Brain tumors cause schizophrenia." C) "Schizophrenia is caused by abnormal thought processes and responses in the brain." D) "Schizophrenia is caused by seizure activity in the brain."
C
A 7-year-old boy is admitted to the pediatric behavioral health unit with a diagnosis of an acute psychotic episode. Aripiprozole has been ordered. Before giving the medication to the child, what would be your first priority? A) Weigh the patient B) Obtain baseline vital signs C) Call the physician D) Administer the medication between meals
C
A nurse is caring for a patient who is taking lithium for mania. The nurse's assessment includes a notation of a lithium serum level of 2.5 mEq/L. The nurse anticipates seeing what? A) Fine tremors of both hands B) Slurred speech C) Clonic movements D) Nausea and vomiting
C
A patient's medication has been changed to clozapine (Clozaril). Patients taking atypical non-phenothiazines, such as clozapine (Clozaril), should be evaluated for which life-threatening adverse effect? A) Renal insufficiency B) Emphysema C) Neuroleptic malignant syndrome D) Cerebral vascular accident (CVA)
C
A psychotic patient is admitted through the Emergency Department. The physician has ordered chlorpromazine (Thorazine) 25 mg IM. The nurse's primary concern will be to monitor for what? A) The patient's ability to ambulate B) The patient's desire to eat C) A decrease in psychotic symptoms D) Blood pressure and pulse
C
Anticonvulsive medications are sometimes used in the treatment of bipolar disorder. What other drug is used to treat bipolar disorder? A) Valium B) Flexeril C) Lithium D) Restoril
C
Haloperidol is a "typical" anti-psychotic drug. Like the phenothiazines it can cause which of the following? A) Bradycardia B) Bradypnea C) Extrapyramidal effects D) Hypoglycemia
C
A nurse is doing patient teaching with the caregivers of a new patient who is schizophrenic. What would the nurse explain about schizophrenia? (Mark all that apply.) A) There are sensory perceptions of people or objects that are not present in the external environment. B) There are false beliefs that persist in the absence of reason. C) Hearing voices D) Feeling things E) These patients often go into a fugue state.
A, B, C, D
A patient, 77-years-old, with a physiologic dementia has been admitted to your unit. Haldol has been ordered for this patient. What do you know about Haldol? (Mark all that apply.) A) It is classed as an anti-psychotic B) Its dosage needs to be lowered in the older adult population C) It often has a hyperactive effect on patients D) It should not be used to control behavior with dementia E) It should only be given every other day
A, B, D
A patient has just been prescribed a phenothiazine. During patient teaching about this drug what would be important for the nurse to tell the patient? A) The urine can become pink or reddish. B) The urine output will be decreased. C) Diarrhea can be an adverse effect. D) Hyperexcitability can occur.
A
A patient on chlorpromazine is feeling better and decides they no longer need their medication. What is a possible outcome of abrupt withdrawal of a typical anti-psychotic medication? A) Insomnia B) Tardive dyskinesia C) Somnolence D) Constipation
A
Chlorpromazine IM has been ordered for a patient on your unit. The nurse caring for the patient knows that they should instruct the patient to what? A) Remain recumbent for at least 30 minutes after the injection B) Do not eat or drink for 1 hour after the drug is administered C) Take the medication prior to 6:00 PM D) Stay active for at least 30 minutes after taking the medication
A
Psychosis is a severe mental illness characterized by what? A) Bizarre behavior B) Increased social interaction C) Hypoactivity with aggressiveness D) Paranoid hallucinations
A
The nurse is interviewing a new patient and their family shortly after a hospital admission. The patient has been diagnosed with schizophrenia. What would be an appropriate question to ask the family members of this patient? A) What inappropriate response to stimuli has the patient had? B) Does the patient take illicit drugs? C) Does the patient have any close friends? D) Is the patient easy to manage?
A
The nursing instructor is discussing psychosis with the nursing students. What behavior would the instructor explain people with psychosis exhibit? A) Disorganized and often bizarre thinking B) Slowed reaction time and poor coordination C) Short manic episodes followed by long depressive episodes D) Short- and long-term-memory deficits
A
The physician has ordered olanzapine (Zyprexa) for a new patient. What laboratory test should be done prior to the administration of olanzapine (Zyprexa)? A) Blood glucose B) Urine specific gravity C) Cholesterol D) Hemoglobin and hematocrit
A
17. The pharmacology instructor points out that the use of anti-psychotic drugs perioperatively has very real risks. What is a risk of using anti-psychotic medications during a surgical procedure? A) Hypertension B) Increased CNS activity C) Tachypnea D) Adverse drug interactions
B
A bipolar patient is being discharged home in 48 hours. The nurse has completed patient teaching regarding the use of lithium. What statement by the patient indicates an understanding of their responsibility? A) "I will increase my salt intake." B) "I will increase my fluid intake." C) "I will decrease my salt intake." D) "I will decrease my fluid intake."
B
A group of patients are being screened to see which patients would be the best candidate for a psychotherapeutic drug trial that helps people concentrate longer on activities. Which patient would be best suited for this trial? A) A 28-year-old sales person who made over $100,000 last year, but has recently been in bed for 10 days and unable to function B) A 32-year-old nursing student who is hyperactive, unable to take a test in the room with her classmates, and requires accommodations C) A 55-year-old physician who suddenly falls asleep during the day without warning D) A 16-year-old male who listens behind closed doors and states he can make the light turn on by pointing at it with his right forefinger
B
A patient who is in the manic phase of bipolar disorder is being sent home on an anti-manic drug. Which of the following antimanic drugs is used for long-term maintenance of bipolar disorders? A) Aripiprazole (Abilify) B) Lamotrigine (Lamictal) C) Questiapine (Seroquel) D) Ziprasidone (Geodon)
B
The pharmacology instructor is explaining to their class the difference between the "typical" and the "atypical" groups of anti-psychotic drugs. What medication would the instructor explain to the students has fewer extrapyramidal effects and greater effectiveness than older anti-psychotic drugs in relieving negative symptoms of schizophrenia? A) Chlorprothixene (Taractan) B) Clozapine (Clozaril) C) Thiothixene (Navane) D) Haloperidol (Haldol)
B
Which drug does not have a recommended pediatric dose? A) Orap B) Lithium C) Haldol D) Risperdal
B
The nurse is presenting an in-service at a children's unit on hyperactivity. The nurse is told that a 6-year-old on the unit is being treated with methylphenidate (Ritalin). The presenting nurse talks about discharge teaching for this patient and what should be monitored during follow-up visits. What will the presenting nurse say will be monitored by the clinic nurse on follow-up visits to the clinic? A) Long bone growth measurements B) Visual acuity C) Weight and complete blood count D) Urea and nitrogen levels
C
What nursing intervention is appropriate for a 70-year-old female patient receiving lithium? A) Instruct the patient to use barrier contraceptives B) Monitor blood glucose levels C) Monitor fluid and sodium intake D) Encourage the patient to check daily for weight loss
C
Many bipolar patients quit taking their medications. Research has now indicated what may be effective in the long-term prevention of recurrent psychosis? A) Gene therapy B) Depot injections of anti-psychotic drugs C) Intense, one-on-one psychotherapy D) Lamictal 25 mg po q day
D
Parents bring a 15-year-old male into the clinic. The parents tell the nurse that there is a family history of schizophrenia and they fear their son has developed the disease. What is an appropriate question to ask the parents? A) Which of your family members did not have schizophrenia? B) What symptoms should he have? C) What physicians have you taken your son to? D) How long has your son been exhibiting symptoms?
D
The clinic nurse provides all the phone numbers of the health care providers to the family of a schizophrenic patient. What is one intervention the healthcare provider can initiate to show support of the patient? A) Begin a support group for the patients B) Check medication records on a weekly basis C) Find weekly respite care for the providers D) Provide safety measures such as side rails to the patient
D
The nurse is caring for 4 patients. Which patient would the nurse know that clozapine (Clozaril) is contraindicated in? A) 17-year-old adolescent B) 23-year-old with diabetes insipidus C) 32-year-old with osteoarthritis D) 45-year-old with bone marrow depression
D
When engaging in patient teaching with patients taking anti-psychotic medications and their families, what would be important to include to decrease adverse effects of the medication? A) The patient must eat three nutritious meals daily B) Take only OTC medications with anti-psychotic drugs C) Cough medicines potentiate the actions of anti-psychotic drugs D) Alcohol should be avoided
D
You are caring for a patient who is taking an oral neuroleptic medication. What would be important to include in the patient teaching? A) Urge incontinence B) Orthostatic hypotension C) Bradycardia D) Tardive dyskinesias
D