ATI Psych Med Exam - NRSG 220

Order: 75mg Available: 100mg/mL

0.75mL

Order: 150mg PO 12 hours Available: 50mg/5mL How much per dose?

15 mL

A nurse is reviewing the medical history of four clients. Which of the following clients may develop extrapyramidal symptoms from medication therapy?

A client who has schizophrenia and is taking antipsychotic medication. A client who has schizophrenia and is taking antipsychotic medication can develop extrapyramidal manifestations, such as acute dystonia, parkinsonism, Atticus, this year, and tardive dyskinesia.

A nurse is admitting a client who is in the manic phase of bipolar disorder. The nurse should plan to make which of the following room assignments for the client?

A private room in a quiet location on the unit. A private room in a quiet location is ideal for a client with mania. The client me easily become overstimulated by the number of people in activities and there's nursing care unit a private room can be used for a time out during the day and to settle down to sleep at night.

A nurse in the emergency department is planning care for a client who is admitted for an overdose of phencyclidine PCP. Which of the following action should the nurse plan to take?

Administer ammonium chloride. Ammonium chloride, acidifies the urine and promotes excretion of PCP. In addition, the nurse should monitor the client respiratory status and be prepared to assist with intubation and mechanical ventilation.

A nurse is preparing to administer selegiline for a client who is admitted with major depression. Which of the following actions should the nurse take?

Apply to dry skin on the client's upper thigh. This medication is a monamine oxidase inhibitor MAOI is administered only by the transdermal route to treat depression. It can be administered orally to treat Parkinson's disease and other disorders.

What is the needs to know for medications.

Catagory (not specific name, except lithium) Side effects Which could hav extrapyrimadal effects What foods should you avoid whih ones might need to switched in times, night or day. LITHIUM MAOI's (esp. restrictive dietary)

A nurse is teaching a client about the uses of chamomile, which of the following information should the nurse include in the teaching?

Chamomile may act as a calming agent. Chamomile may act as a calming agent for clients who have sleep issues.

A client becomes very dejected and states, "No one really cares what happens to me. Life isn't worth living anymore." Which of the following responses should the nurse make? A) "of course people care, your family comes to visit every day" B) "why do you feel that way?" C) "tell me who you think doesn't care about you" D) "I care about you, and I am concerned that you feel so sad"

D) "I care about you, and I am concerned that you feel so sad" This is an open, ended therapeutic statement that focuses on the clients feelings, shows empathy and allows for further explanation of the clients believe that this is not worth living in order to keep the client safe from suicidal thoughts

A nurse is caring for a client who has severe manifestations of schizophrenia, and is medicated PRN for agitation with haloperidol. The nurse should assess the client for which of the following adverse effects?

Dysrhythmias. Cardiac dysrhythmias are a risk for a client taking Haldol and other conventional antipsychotic medication's. The client should be monitored for changes in vital signs, tachycardia, and ECG changes, including prolonged QT interval, while taking held her. There's a risk for cardiac arrest due to torsades de pointes

A nurse is teaching a client who has a new prescription for chlorpromazine. Which of the following client statements indicates an understanding of the teaching?

I may have a dry mouth while taking this medication. This medication causes anticholinergic effects such as dry mouth and constipation.

A nurse is teaching a client who has a new prescription for paroxetine. Which of the following statements by the client indicates an understanding of the teaching?

I may not feel like eating as much. Anorexia, and they decreased appetite are adverse effects of paroxetine.

A nurse is providing teaching for a client who has binge eating disorder and is morbidly obese. The client has been prescribed orlistat. Which of the following statements indicates to the nurse that the client understands the teaching?

I will stop taking orlistat and call my doctor if my urine gets darker in color. Orlistat can cause severe liver damage there for the client should be taught manifestations of liver damage, including dark, colored, urine light colored stools, jaundice, anorexia, vomiting, and fatigue.

A nurse is planning care for a client who has a prescription for alprazolam. For which of the following adverse effects, should the nurse plan to monitor?

Inability to recall events. Alprazolam is a benzodiazepine medication used to manage anxiety and panic disorders. Antero grade amnesia, impaired recall of events that take place after dosing, is an adverse effect. Other adverse effects of benzodiazepines include central, nervous system, depression, CNS, depression, Antero grade amnesia, sleep related behaviors, such as eating, meals, while sleeping, paradoxical affects of excitation, euphoria, and heightened anxiety.

A nurse is caring for a young adult client who says he is experiencing increased anxiety and an ability to concentrate which of the following responses should the nurse make?

It sounds like you're having a difficult time. This therapeutic response is an open ended empathetic statement that encourage the client to talk.

A nurse is caring for a client who has bipolar disorder and a new prescription for valproate. Which of the following instruction should the nurse give the client about the use of this medication?

Liver function test must be monitored. Pancreatitis, hepatic dysfunction, and thrombocytopenia are serious adverse effects occasionally associated with valproate. Liver function test should be monitored. Periodically to check for hepatic failure.

A nurse is assessing for the presence of extra pie, remote at all side effects EPS and a client who is taking chlorpromazine. Which of the following findings should the nurse recognize as EPS? Select all that apply. Muscle spasms of the neck. Fidgeting behavior. Blurred vision. Tremors of the hands. Sexual dysfunction.

Muscle spasms of the neck fidgeting behavior tremors of the hands.

The nurse is caring for a client who has a serum lithium of 2.0. Which of the following is a priority action for the nurse to take?

Notify the primary care provider. The result indicates toxicity. The therapeutic rain range for lithium should be 0.8 to 1.4. The nurse should recognize the client could require hospitalization and report the finding to the provider. The nurse should check the client for findings associated with advanced, severe lithium toxicity such as vision changes neurological impairment in hypotension.

A nurse is teaching a client who has bipolar disorder about lithium. Which of the following statements should the nurse include in the teaching?

Notify your provider if you experience, vomiting or diarrhea. Vomiting and diarrhea are both manifestations of lithium toxicity, and should be reported to the provider, vomiting and diarrhea, can also cause dehydration, which can result in lithium toxicity.

A nurse is caring for a client who is exhibiting signs of serotonin syndrome. Which of the following is the priority nursing intervention?

Preparing for artificial ventilation Delirium, severe, vital, sign changes, and apnea may be present in the client who has serotonin syndrome. Preparing for artificial ventilation is the priority intervention, when, taking the airway, breathing, circulation approach to client care.

A nurse is teaching a group of clients about Saint johns wort. Which of the following information should the nurse include in the teaching?

Saint johns wort can be used to treat mild depression. The nurse should teach that Saint johns wort increases their serotonin level of serotonin enhancing, and a depressants, which may place the client at risk for serotonin syndrome.

A nurse is providing discharge, teaching to a client with a new prescription of phenelzine. The nurse should instruct the client to avoid which of the following foods when taking this medication.?

Salami. Aged foods, such as hard cheeses and meats, salami, and air dried sausage should be avoided when taking an oral MAOI, such as this medication.

A nurse reviews the laboratory result for a client who is receiving lithium three times daily PO. The clients current blood lithium is 1.8. The nurse identifies that this lab value indicates which of the following?

The lithium level is at a toxic level. A blood lithium level greater than 1.5 indicates toxicity the nurse should monitor the client for G.I. manifestations, course hand, tremor, confusion, drowsiness, and shit with hopefully lithium and notify the provider. The therapeutic initial blood level of lithium is 0.8 to 1.4. Blood levels should for lithium maintain should be 0.4 to 1.3.

A nurse is assessing a client who is taking Bupropion. The nurse should recognize which of the following findings is an indication that the medication is effective?

Decreased urge to smoke. This medication is an antidepressant, which is also used for smoking sensation.

A nurse is caring for a client who is experiencing acute manifestations of withdrawal from alcohol, which of the following medication should the nurse expect to administer to the client?

Diazepam. Diazepam is a benzo diazepam and is used to treat acute alcohol withdrawal. Diazepam helps to decrease the intensity of withdrawal, prevent seizures and help stabilize, vital signs.

A nurse in the emergency department is assessing a client for suspected cocaine intoxication. Which of the following findings should the nurse expect?

Dilated pupils. Dilated pupils are a finding of cocaine intoxication due to the stimulation of the sympathetic nervous system.

A nurse is planning to administer haloperidol to a client who has acute psychosis. The nurse should monitor the client for which of the following findings as an adverse effect of this medication.?

Dystonia. The nurse should monitor the client for dystonia after administering this medication, dystonia is a repetitive muscular contractions that can cause twisting of the body.

A nurse is caring for a client who has been hospitalized for treatment of bipolar disorder, and will be discharged with a prescription for lithium. The nurse's discharge instruction should include information cautioning against which of the following factors that may cause lithium toxicity?

Experiencing diarrhea. Lithium is used to treat manic stage of bipolar disorder. Toxicity occurs when level of lithium in the blood becomes too high to low sodium level or factors which result in low sodium level, such as dehydration, diarrhea, sweating access, exercise in hot weather diarrhetic use low sodium diet increases lithium level, because the kidney process is sodium and lithium in the same way if sodium levels fall, the body conserves lithium, causing levels to rise rise

A nurse is caring for a client who has major depressive disorder and has prescribed citalopram two weeks ago with a plan dosage increase one week ago. The client reports having an improved appetite, but still feels very depressed and is still having trouble sleeping. Which of the following action should the nurse take?

Explain the anti-depressants often takes several weeks to be fully effective. SSRIs are used along with certain anticonvulsant medication's in the treatment of bipolar disorder. It can take 4 to 6 weeks before therapeutic effect occurs after beginning an antidepressant medication..

A nurse is evaluating teaching for a client who has a newly diagnosed depression and a new prescription for bupropion. Which of the following statements by the client indicates understanding of the teaching?

I may not notice a lifting of mood for at least two weeks. Bupropion on is a norepinephrine dopamine roof. Take inhibitor NDRI. As with other anti-depressants it can take 2 to 4 weeks for therapeutic effects to occur when taking bupropion

A nurse is teaching a client who has depression about a new prescription for fluoxetine 20 mg daily. Which of the following statements by the client indicates an understanding of the teaching?

I should notify my provider if I develop a skin rash. Serious skin rashes, such as Steven Johnson syndrome can occur while taking fluoxetine. The client should notify the provider if a rash occurs.

A nurse is reinforcing teaching with an older adult client who has major depressive disorder and a prescription for nortriptyline, 25 mg daily. Which of the following client statements indicates understanding of the teaching?

I should sit on the side of the bed before standing up in the morning. This medication is a TCA. It blocks root take of norepinephrine and serotonin in the synaptic space, intensifying the affects of these neurotransmitters. Orthostatic hypotension is a potential complication of TCAs. Client should be instructed to change position slowly into sitIn a lie down if symptoms occur. If a significant decrease in blood pressure is noted in the hospitalized client the medication should be held in the provider should be notified.

A nurse is admitting a client who has experienced a weight loss of 11 kg 25 pounds in the past three months. The client weighs 40 kg 88 pounds and believes she is fat which of the following aspects of care should the nurse consider the first priority for this client?

Identify the clients nutritional status. According to the nurses process, the nurse should perform an assessment first to gather enough data regarding nutritional status and other findings in order to plan implement and evaluate care. Assessment identifies client nutrition needs, as well as complications to client might be experiencing related to the eating disorder.

A nurse is providing discharge, teaching to a client who has bipolar disorder and will be discharged with a prescription for lithium. The nurse should teach the client that which of the following factors puts her at risk for lithium toxicity?

The client runs 4 miles outdoors every afternoon. Strenuous exercise in outdoor heat which can lead to dehydration puts the client at risk for lithium tusk. Cecily, mild to moderate exercise, will not lead to lithium toxicity, but if the client engages in strenuous activity during hot weather, she should take care to her place any water and sodium that have been lost through profuse sweating. This applies to other factors that can cause the client to become dehydrated, such as having diarrhea Or taking diuretics.

A nurse is caring for a client who has schizophrenia and generalized anxiety disorder. The client has a prescription for alprazolam 0.25 mg PO every eight hours PRN anxiety. For which of the following client statements should the nurse consider administering alprazolam?

The client states my heart is pounding out of my chest. Alprazolam is a benzodiazepine and is used to treat anxiety. The medication works in the CNS to decrease the severity of panic attacks, decreasing Zaidi and insomnia, and promote relaxation of muscles. Physiological symptoms of anxiety as it reaches the panic level often include tension, impatience, apprehension, increased, heart rate and respiratory rates confusion feelings of impending doom, an extreme fight and tear. Expected adverse effects of alprazolam are dizziness, lightheadedness, and drowsiness. The nurse should closely monitor the client and assist the client with ambulation self-care needs.

A nurse is caring for a client who was admitted with acute psychosis and has been treated with haloperidol. The nurse should suspect that the client may be experiencing tardive dyskinesia when the client exhibits which of the following? Select all that apply. Urinary retention and constipation. Tongue thrusting and lipsmacking. Find hand, tremors and pill rolling. Facial grimacing an eye, blinking. Involuntary pelvic, rocking and hip thrusting movements.

Tongue thrusting in lip smacking. Facial grimacing an eye, blinking. Involuntary pelvic, rocking and hip Thrusting movements.

A nurse is assessing a client who has schizophrenia, which it has been treated with fluphenazine for several years. Which of the following findings should the nurse document as manifestations of tardive dyskinesia (TD)?

Twisting tongue movements. Twisting tongue, movements, text, sudden, involuntary, jerking movements of the extremities, and other findings in TD. The nurse to notify the provider of these, finding since treatment includes reducing dosage of antipsychotic medication, or perhaps changing to a second General antipsychotic medication.

A nurse on a mental health unit is caring for a client who has generalized anxiety disorder. The client received a telephone call that was upsetting and now the clients pacing up and down the corners of the unit. Which of the following action should the nurse take?

Walk with a client at a gradually slower pace. When the client is experiencing increased anxiety, is it it? It is importantFor the nurse to remain with the client and promote a calm atmosphere by walking with a client at a gradually Slowey pace. The nurse provides gross motor activity as an anxiety out late that helps the calm the client and demonstrates therapeutic offering of self.

A nurse is caring for a client who has bipolar disorder and is taking lithium. The client reports blurred vision and ataxia. Which of the following action should the nurse take?

Withhold the medication. The nurse should withhold the medication because the client is displaying manifestations of toxicity, which includes ataxia, confusion, large output of dilute urine, blurred vision, clonic, movements, seizures, stupor, severe hypotension, and coma. Pulmonary complications may lead to death.

A nurse is providing teaching to a client who has schizophrenia, and is to begin taking haloperidol. Which of the following information should the nurse include in the teaching?

You may experience dizziness upon standing while taking this medication. Haloperidol may cause orthostatic hypotension there for the client should be instructed to change positions slowly.

A nurse is providing medication, teaching for a client who has new prescription of phenelzine. Which of the following statement should the nurse include in the teaching?

You should change position slowly while taking this medication. Clients should change position slowly while taking an MAOI, due to the risk of orthostatic hypotension, lightheadedness, and fainting, are common when taking this medication.

A nurse is an emergency department is caring for a client who has been taking haloperidol (Haldol) for the past 3 months. The client has a temperature of 38.9 C (102 F), a blood pressure of 150/110 mm Hg, and tachycardia. The nurse should know that these manifestations indicate a diagnosis of:

neuroleptic malignant syndrome (NMS). Neuroleptic malignant syndrome is rare and potential Lee, fatal adverse effect of antipsychotic medication's that require emergency medical attention. Manifestations of NMS are sudden and include changes in level of consciousness, seizures, and stupor.