Chapter 22
B
The nurse is teaching the mother of a child diagnosed with attention-deficit hyperactivity disorder how to administer methylphenidate (Ritalin). When would the nurse instruct the mother to administer this drug? A) Administer at lunch every day. B) Administer at breakfast every day. C) Administer at dinner every day. D) Administer at bedtime.
B
A patient diagnosed with bipolar disorder is to be 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.
A
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 turn pink or reddish. B) The urine output will be decreased. C) Diarrhea can be an adverse effect. D) Hyperexcitability can occur. Ans: A
A
A patient on chlorpromazine is feeling better and decides they no longer need their medication. The nurse teaches the patient that abrupt withdrawal of a typical antipsychotic medication can result in what? A) Insomnia B) Tardive dyskinesia C) Somnolence D) Constipation
B
A patient, in the manic phase of bipolar disorder, is being discharged home on an antimanic drug. What antimanic drug is used for long-term maintenance of bipolar disorders? A) Aripiprazole (Abilify) B) Lamotrigine (Lamictal) C) Quetiapine (Seroquel) D) Ziprasidone (Geodon)
D
The nurse works on an inpatient mental health unit. When administering antipsychotic medications, what patient would the nurse expect to require a standard dosage? A) African American adolescent diagnosed with schizophrenia B) Malaysian middle adult diagnosed with bipolar disorder C) Iranian older adult diagnosed with schizophrenia D) Caucasian young adult diagnosed with bipolar disorder
B
The nurse, providing teaching about a typical antipsychotic newly prescribed for the patient, cautions against use of alcohol with the drug by explaining it will have what effect? A) Prolonged QT interval B) Increased central nervous system (CNS) depression C) Increased anticholinergic effects D) Increased gastrointestinal (GI) adverse effects
C
A psychotic patient is admitted through the emergency department. The physician has ordered chlorpromazine (Thorazine) 25 mg intramuscularly. After administration of the medication, what is the nurses priority to evaluate? A) The patients ability to ambulate B) Return of the patients appetite C) A decrease in psychotic symptoms D) Blood pressure and pulse
D
The nurse is teaching the soon-to-be-discharged patient, diagnosed with schizophrenia, about his medications. What is a priority teaching point for this patient? A) The patient must eat three nutritious meals daily. B) Over-the-counter medications may be taken with antipsychotic drugs. C) Cough medicines potentiate the actions of antipsychotic drugs. D) Alcohol consumption should be avoided.
B
Which drug does not have a recommended pediatric dose? A) Pimozide (Orap) B) Lithium salts (Lithotabs) C) Haloperidol (Haldol) D) Risperidone (Risperdal)
C
A 16-year-old youth has just been diagnosed with schizophrenia. The parents ask the nurse what causes schizophrenia. What would be the nurses best response? A) Schizophrenia is caused by pain that the brain perceives. B) Schizophrenia is thought to occur due to trauma experienced in childhood. C) Schizophrenia is thought to reflect a fundamental biochemical abnormality. 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. Aripiprazole has been ordered. Before administering the medication, what is the nurses first priority? A) Weigh the patient. B) Obtain baseline vital signs. C) Call the physician. D) Administer the medication between meals.
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 salesperson who alternates between overactivity and periods of depression B) A 32-year-old hyperactive nursing student who cannot focus long enough to take a test C) A 55-year-old physician who suddenly falls asleep during the day without warning D) A 16-year-old youth who say he can make the light turn on by pointing at it and hears voices
C
A nurse is caring for a patient who is taking lithium for mania. The nurses assessment includes a notation of a lithium serum level of 2.4 mEq/L. The nurse anticipates seeing what? A) Fine tremors of both hands B) Slurred speech C) Clonic movements D) Nausea and vomiting
C
Haloperidol is a typical antipsychotic drug. What adverse effect is associated with this drug? A) Bradycardia B) Bradypnea C) Extrapyramidal effects D) Hypoglycemia
A
Parents bring a 15-year-old boy 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 symptoms, if described by the family, would support their conclusion? A) He hears and interacts with voices no one else can hear. B) He is overactive and always so excitable. C) He falls asleep in the middle of a sentence. D) He cannot concentrate and his grades are suffering.
A
Psychosis is a severe mental illness characterized by what? A) Disordered thought B) Increased social interaction C) Hypoactivity with aggressiveness D) Paranoid hallucinations
A
The mother of a child diagnosed with attention-deficit syndrome receives a prescription for a central nervous system (CNS) stimulant to treat her child. The mother asks the nurse, I dont understand why were giving a stimulant to calm him down? What is the nurses best response to this mother? A) It helps the reticular activating system (RAS), a part of the brain, to be more selective in response to incoming stimuli. B) It helps energize the child so they use up all of their available energy and then they can focus on quieter stimuli. C) No one truly understands why it works but it has been demonstrated to be very effective in treating ADHD. D) The drugs work really well and you will see a tremendous change in your child within a few weeks without any other treatment.
A
The nurse administers chlorpromazine intramuscularly to the preoperative patient who is extremely anxious about surgery in the morning. What priority teaching point will the nurse provide this patient? A) Remain recumbent for at least 30 minutes after the injection. B) Do not eat for 1 hour after the drug is administered. C) Encourage fluids with the goal of 3,000 mL/d. D) Avoid eating avocados and oranges when taking this medication.
A
The nurse admits a patient newly diagnosed with schizophrenia to the inpatient mental health unit. What is the priority reason for why the nurse includes the family when collecting the nursing history? A) The patient may not be able to provide a coherent history. B) The patient may not be able to speak due to reduced level of consciousness. C) The family will feel better if they are included in the process. D) The patient will be less anxious if the family listens while he answers questions.
A
The nurse is caring for a child receiving a central nervous system (CNS) stimulant who was admitted to the pediatric intensive care unit following repeated seizures after a closed head injury. The physician orders phenytoin to control seizures and lorazepam to be administered every time the child has a seizure. What is the nurses priority action? A) Call the doctor and question the administration of phenytoin. B) Call the doctor and question the administration of lorazepam. C) Wait 24 hours before beginning to administer phenytoin. D)
A, B, C, D
The nurse is caring for a patient newly diagnosed with schizophrenia. His parents say they have heard the term before but do not really understand exactly what schizophrenia means. How would the nurse describe the disorder? (Select all that apply.) A) Thought disorder B) Difficulty functioning in society C) Hallucinations can be auditory, visual, or sensory D) Can be cured with the correct medications E) Enter into fugue state in most cases
D
The nurse is caring for a patient taking an oral neuroleptic medication. What is the nurses priority assessment to monitor for? A) Urge incontinence B) Orthostatic hypotension C) Bradycardia D) Tardive dyskinesia
A
The nurse is caring for an adolescent patient who began taking an antipsychotic drug last month to treat newly diagnosed schizophrenia. The drug has not been effective and the mother asks the nurse if this means the adolescents symptoms cannot be controlled by drugs. What is the nurses best response? A) Patients commonly have to try different drugs until the most effective drug is identified. B) Some patients do not respond to drugs and have to rely solely on behavior therapy. C) Most likely your child was not taking the medication properly as prescribed. D) He may need to take multiple drugs before effects will be seen that control his symptoms.
D
The nurse is caring for four patients. Which patient would the nurse know that clozapine (Clozaril) is contraindicated for? 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
The nurse is preparing to administer methylphenidate to the child admitted to the pediatric unit after breaking a leg when jumping off the garage roof at home. Where will the nurse find the medication? A) In the patients drawer B) In the refrigerator C) At the patients bedside D) In the controlled substance cabinet
C
The nurse is presenting an in-service at a childrens 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 the importance of monitoring what? A) Long bone growth B) Visual acuity C) Weight and complete blood count D) Urea and nitrogen levels
D
The patient taking an antipsychotic drug asks the nurse how long he will continue to feel the effects of the drug after stopping the medication. What is the nurses best response? A) 2 to 4 hours B) 2 to 4 weeks C) 2 to 4 months D) 6 months
B
The pharmacology instructor is explaining to their class the difference between the typical and the atypical groups of antipsychotic drugs. What medication would the instructor explain to the students has fewer extrapyramidal effects and greater effectiveness than older antipsychotic drugs in relieving negative symptoms of schizophrenia? A) Chlorpromazine (Thorazine) B) Clozapine (Clozaril) C) Thiothixene (Navane) D) Haloperidol (Haldol)
A
The physician has ordered olanzapine (Zyprexa) for a new patient. What laboratory test should be done before administration of olanzapine? A) Blood glucose B) Urine specific gravity C) Cholesterol D) Hemoglobin and hematocrit
C
What antiepileptic medication might the nurse administer to treat bipolar disorder? A) Apriprazole (Abilify) B) Cyclobenzaprine (Flexeril) C) Lamotrigine (Lamictal) D) Temazepam (Restoril)
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.
A
A child was diagnosed with attention-deficit hyperactivity disorder and methylphenidate was prescribed for treatment to be taken once a day in a sustained release form. On future visits what is a priority nursing assessment for this child? A) Weight and height B) Breath sounds and respiratory rate C) Urine output and kidney function D) Electrocardiogram (ECG) and echocardiogram
B, D
A patient, who is 77 years old, is admitted with a diagnosis of dementia. Haloperidol (Haldol) has been ordered for this patient. What nursing considerations would govern the nurses actions? (Select all that apply.) A) It is classed as an atypical antipsychotic. B) A lowered dosage is indicated for older adult. 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.
C
A patients medication has been changed to clozapine (Clozaril). The nurse evaluates this patient for which life-threatening adverse effect? A) Renal insufficiency B) Emphysema C) Neuroleptic malignant syndrome D) Cerebrovascular accident (CVA)