Pharmacology-Psychiatric/Mental Health Drugs- ADN 2B

A nurse recalls that the blockage of dopamine by antipsychotic drugs can cause extrapyramidal side effects such as akathisia. Which client behaviors reflect the presence of akathisia?

Motor restlessness, foot tapping, and pacing

The nurse teaches the client about foods to avoid while on phenelzine therapy. Which response given by the client indicates the need for further education?

"I should avoid raisins in my diet."

When talking with a client who has been receiving paroxetine, the nurse determines that more clarification is needed when the client makes which statement?

3

A young adult being treated for substance abuse asks the nurse about methadone. The nurse responds that methadone is useful in the treatment of opioid addiction because it has what characteristic?

Has an effect of longer duration

The nurse cares for a client diagnosed with bipolar disorder who was prescribed drug therapy. Laboratory reports reveal that the client's thyroxine levels are low. Which drug might have led to this condition?

lithium

A 55-year-old client who has a long history of drug and alcohol abuse mentions taking ginkgo biloba. The nurse knows that ginkgo biloba is taken to treat what condition?

memory impairment

Which class of medications is used to reduce tremors caused by lithium therapy?

Beta blockers

A client who is on haloperidol therapy has developed akathisia and acute dystonia. Which drugs would be used to manage extrapyramidal effects? Select all that apply.

3,5

A client with a diagnosis of bipolar I disorder with rapid cycling is readmitted 4 months after discharge. On the first day on the unit, the client continually interrupts the nurse and is increasingly talkative and loud. What is the most therapeutic response by the nurse?

"Tell me about the medication you've been taking."

A client on a psychiatric unit who has been hearing voices is receiving a neuroleptic medication for the first time. The client takes the cup of water and the pill and stares at them. What is the most therapeutic statement the nurse can make?

"This will help you not to hear the voices. It will only work if you take it."

An older client who is hospitalized for depression is receiving citalopram. During discharge teaching, the client asks the nurse whether there is anything that should be known about taking this medication. What is the nurse's reply?

"You should take each dose of medication as prescribed."

A pediatric client with a history of chickenpox is undergoing treatment for mental illness with psychotherapeutic drugs. Which is the expected adverse effect of the psychotherapeutic drug in the pediatric client?

1

Which drugs are used as the first-line treatment for posttraumatic stress disorder (PTSD)? Select all that apply.

1,2

A client on bupropion therapy for depression experiences seizures. Which actions of the primary healthcare provider are used to reduce the risk for seizures? Select all that apply.

1,3,4

The nurse cares for a client with schizophrenia and who is receiving ziprasidone. Which conditions in the client may indicate discontinuation of the drug? Select all that apply.

1,3,5

The primary healthcare provider informs the registered nurse that the client must be monitored on a regular basis because he or she is prescribed haloperidol. Which client conditions would warrant these instructions? Select all that apply.

1,3,5

The nurse noticed increased blood pressure in a client on treatment for depression. Which antidepressant drug does the nurse ask the primary healthcare provider to reconsider?

2

The primary healthcare provider prescribes an atypical antipsychotic drug to a client and asks the nurse to set up an appointment for the client to see an ophthalmologist. Which drug was prescribed to the client?

2

A healthcare provider prescribes clozapine to a client with schizophrenia. Which parameters should be assessed before initiating the drug? Select all that apply.

2,3,5

Which statements regarding the use of selegiline to treat depression are true? Select all that apply.

2,4,5

A client with a diagnosis of bipolar I disorder, depressive episode, is receiving lamotrigine. The nurse concludes that the medication is effective when the client displays which behavior change?

3

The nurse is caring for a 60-year-old client who is diagnosed with dementia. Which antipsychotic drugs would be contraindicated for the client? Select all that apply.

3

A client who is receiving haloperidol, 5 mg three times a day, complains of twitching of the fingers. What is the best response by the nurse?

4

A nurse is counseling a client who is taking lithium carbonate. What is the priority nursing assessment when a client is taking this medication?

4

Sertraline is prescribed for a depressed client. What information does the nurse include when teaching the client about this drug?

4

How long after the last dose will the nurse schedule to have a client's blood drawn to evaluate the serum lithium level?

8-12

When used in combination with certain foods and drugs, monoamine oxidase inhibitors (MAOIs) can cause serious side effects. Which condition could occur in clients treated with MAOIs for depression?

A serious increase in blood pressure

A client with schizophrenia who has been taking clozapine is to be started on 10 mg of olanzapine instead. The nurse explains to the client, in terms that can be understood, that olanzapine is being substituted for clozapine because it does not produce which side effect?

Agranulocytosis

A client who is taking haloperidol has developed tardive dyskinesia. Which therapy is beneficial for the client?

Administering benzodiazepines

A primary healthcare provider diagnoses chronic low-grade depression in a client. Which drug may be prescribed for this client?

Amitriptyline

What are the adverse effects of mirtazapine? Select all that apply.

Asthenia Drowsiness Abnormal dreams

A client's serum lithium level is 0.2 mEq/L (0.2 mmol/L). What is the nurse's interpretation of this finding?

Below therapeutic range

A client has recently started taking a new neuroleptic drug, and the nurse notes extrapyramidal effects. Which drug does the nurse anticipate will be prescribed to limit these side effects?

Benztropine mesylate

Donepezil is prescribed for a senior client who has mild dementia of the Alzheimer type. What information does the nurse include when discussing this medication with the client and family?

Blood tests that reflect liver function will be performed routinely.

The laboratory calls to report that a hospitalized client's lithium level is 1.9 mEq/L (1.9 mmol/L) after 10 days of lithium therapy. How will the nurse respond to this information?

By notifying the primary healthcare provider of the findings, because the level is dangerously high

Which antiseizure drugs are used to stabilize a client's mood by suppressing mania associated with bipolar disorder (BPD)? Select all that apply.

Carbamazepine Divalproex sodium

A nurse understands that after the administration of alprazolam it is important to assess the client for side effects. What will the nurse do initially?

Check the blood pressure.

A client is hospitalized with social anxiety disorder. The client has a history of exhibiting intense, irrational fear of being scrutinized by others. Which primary anxiolytic medications would be prescribed to the client? Select all that apply.

Clonazepam Alprazolam

Which sedative-hypnotics are used to treat insomnia effects associated with a panic disorder? Select all that apply.

Clonazepam Alprazolam

A client on the psychiatric unit who is receiving high-dosage risperidone is exhibiting tremors of the hands. What will be the nurse's first intervention?

Contacting the primary healthcare provider

The primary healthcare provider is concerned that one of the clients receiving haloperidol may be developing neuroleptic malignant syndrome. When assessing the client for this syndrome, for which clinical manifestations does the nurse monitor the client?

Diaphoresis and hyperpyrexia

A nurse is administering hydroxyzine to a client. The nurse will monitor the client for which common side effects of this drug?

Drowsiness and dry mouth

A monoamine oxidase inhibitor (MAOI) is prescribed, and the nurse is formulating a teaching plan. What will the nurse instruct the client to avoid while taking this drug?

Fermented foods

Lithium carbonate, 600 mg by mouth three times a day, is prescribed for a client. The nurse concludes that the teaching about its side effects is understood when the client says that the primary healthcare provider will be notified immediately if what condition occurs?

Fine hand tremor or slurred speech

The nurse is caring for a 60-year-old client who is diagnosed with dementia. Which antipsychotic drugs would be contraindicated for the client? Select all that apply.

Haloperidol Chlorpromazine

A client with a diagnosis of schizophrenia is discharged from the hospital. At home the client forgets to take the medication, is unable to function, and must be rehospitalized. What medication may be prescribed that can be administered on an outpatient basis every 2 to 3 weeks?

Fluphenazine

An 11-year-old client reports having the habit of bedwetting (enuresis). Which drug may be prescribed to this client?

Imipramine

The nurse is to administer a muscle relaxant just before a client undergoes electroconvulsive therapy. The major disadvantage of this drug is that it inhibits which muscles?

Intercostal and diaphragmatic muscles

A nurse is caring for several clients who have severe psychiatric disorders. What is the major reason that a primary healthcare provider prescribes an antipsychotic medication for these clients?

Manage symptoms of psychosis

A primary healthcare provider prescribes divalproex. What does the nurse consider an appropriate indication for the use of this drug?

Management of manic episodes of bipolar disorder

A client who is going to be discharged has been receiving 3 mg of risperidone three times a day. What will the nurse teach the client about the medication?

May cause sedation if taken concurrently with alcohol

A client who is diagnosed with schizophrenia was prescribed antipsychotic drugs. During a follow-up visit, the client had developed extrapyramidal symptoms. Which drugs might be responsible for these symptoms? Select all that apply.

Perphenazine Fluphenazine Trifluoperazine

What will the nurse do when determining whether a client is experiencing adverse effects of risperidone?

Question if dizziness is experienced.

A client begins fighting and biting other clients. The primary healthcare provider prescribes a stat injection of haloperidol. How will the nurse implement this prescription?

Quickly, with an attitude of concern

A client is on antipsychotic therapy for schizophrenia. During a follow-up visit, the nurse suspects acute akathisia. Which symptoms in the client support the nurse's suspicion? Select all that apply.

Restless movement Anxiety Agitation

The nurse suspects serotonin syndrome in a client prescribed second-generation antidepressants for depression. Which assessment findings observed by the nurse would be beneficial in diagnosing the severity of the syndrome? Select all that apply.

Rhabdomyolysis Hyperthermia

A nurse is caring for a client who has abruptly stopped taking a barbiturate. What withdrawal complication does the nurse anticipate that the client may experience?

Seizures

A primary healthcare provider prescribes venlafaxine for a client with the diagnosis of major depressive disorder who has been taking herbal medications. When discussing this medication with the client, the nurse will determine whether the client is taking which herbal supplement?

St. John's wort

A nurse is caring for a client who is addicted to opioids and who has undergone major surgery. The client is receiving methadone. What is the purpose of this medication?

Switches the user from illicit opioid use to use of a legal drug

A client is responding within 5 minutes of receiving naloxone to combat respiratory depression from an overdose of heroin. Why will a nurse continue to closely monitor this client's status?

Symptoms of the heroin overdose may return after the naloxone is metabolized.

A client who is taking lithium arrives at the mental health center for a routine visit. The client has slurred speech, has an ataxic gait, and complains of nausea. What does the nurse know about these signs and symptoms?

These effects may indicate a toxic level of lithium.

A client is to take an antipsychotic drug twice a day. Two-thirds of the daily dose is given in the evening and one-third in the morning. What will the nurse tell the client is the rationale for this schedule?

To reduce sedation during the daytime

A client with a known history of opioid addiction is treated for multiple stab wounds to the abdomen. After surgical repair the nurse notes that the client's pain is not relieved by the prescribed morphine injections. The nurse realizes that the failure to achieve pain relief indicates that the client is probably experiencing what phenomenon?

Tolerance

A client is receiving imipramine, a tricyclic antidepressant, for depression. The nurse assesses the client for side effects and adverse effects. Which adverse effect requires further assessment and possible medical intervention?

Urinary hesitancy

A client has been taking lithium carbonate for 3 days. The nurse has the client's lithium level checked before administering the medication and finds it to be 0.3 mEq/L (0.3 mmol/L). What action will the nurse take?

administer the med

A client is prescribed sertraline, an antidepressant. What does the nurse include when preparing a teaching plan about the side effects of this drug?

agitation

On the first day of the month a primary healthcare provider prescribes an antipsychotic medication for a client with schizophrenia. The initial dosage is 25 mg once a day, to be titrated in increments of 25 mg every other day to a desired dosage of 175 mg daily. On what day of the month will the client reach the desired daily dose of 175 mg?

day 13

The nurse cares for a client with bipolar disorder who is receiving drug therapy. The laboratory report reveals that the client's serum sodium level is 132 mEq/L (132 mmol/L). Which drug might have led to this condition?

fluxotine

A client is to begin lithium carbonate therapy. The nurse will ensure that the client has completed what baseline lab work before the drug's administration?

renal studies

A client diagnosed with depression is prescribed phenelzine. Which foods consumed along with this drug would cause a hypertensive crisis? Select all that apply.

soy sauce soybean oil over ripe bannana

For which adverse effect does the nurse continually assess a client who is receiving valproic acid?

yellow sclera