Ch. 22 Psycho-therapeutic Agents PrepUs

A patient who suffers from asthma is given theophylline. What effect will theophylline have on the patient? 1.It will cause bronchoconstriction. 2.It will cause bradycardia. 3.It will cause insomnia. 4.It will relax smooth muscle.

3.It will cause insomnia.

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? 1. 1 2. 3 3. 4 4. 2

4. 2

The nurse expects to monitor a client's white blood count weekly when the client is prescribed: 1.Quetiapine 2.Aripiprazole 3.Olanzapine 4.Clozapine

4.Clozapine

The nurse understands that the main goal of therapy with CNS stimulants is to relieve symptoms of the disorders for which they are given. What is a secondary goal for their use? 1.To have clients use the drugs appropriately 2.To prevent side effects 3.To serve as a study aid 4.To prevent adverse reactions

1.To have clients use the drugs appropriately

When describing the action of conventional antipsychotic medications to a group of nursing students, which would the instructor address? 1.Inhibiting the release of serotonin in the brain 2.Stimulating GABA receptors in the brain 3.Inhibiting the release of dopamine in the brain 4.Stimulating the release of dopamine in the brain

3.Inhibiting the release of dopamine in the brain

A nurse educating a client starting lithium (Eskalith) should educate the client about which side effects? (Select all that apply.) 1.Dystonia 2.Extrapyramidal symptoms 3.Tremors 4.Polyuria 5.Tardive dyskinesia

3.Tremors 4.Polyuria

What should the nurse assess regarding a client's reports of insomnia? 1.the family history of insomnia and sleep 2.the amount of exercise in which the client engages 3.daily intake of caffeine-containing products 4.possible use of amphetamines

3.daily intake of caffeine-containing products

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? 1."I fell asleep on the bus last week and missed my stop." 2."I just don't feel hungry very much these days." 3."I banged my shin last week and the bruise it still there." 4."Sometimes I just feel so mad at my teacher or my coach."

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

A female client asks why it is not legal to have a year's worth of prescription refills for Ritalin, since she has been on it for more than a year. She would also like to have the largest dose possible, so she can use the prescription for 2 months, instead of one. She explains that it is very hard to get off work and come in for appointments. The nurse's best response would be: 1."You will speak with her health care provider about getting her a new prescription." 2."The prescription dose is always started as low as possible and the refills are monitored to prevent abuse." 3."You have to come in at least every month to have blood work done." 4."It is important that you take the largest dose possible to keep the condition under control."

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

What client is being treated with a typical antipsychotic? 1.A client whose thought disorder requires clozapine 25 mg PO b.i.d. 2.An agitated client who was given haloperidol during acute psychosis 3.A client with schizophrenia who received paliperidone 6 mg PO daily 4.A client who recently began taking ziprasidone

2.An agitated client who was given haloperidol during acute psychosis

A 28-year-old woman has been diagnosed with schizophrenia. The health care provider has prescribed a typical antipsychotic, haloperidol. Which will the nurse include in the teaching related to the most common adverse effects? 1.Neuroleptic malignant syndrome 2.Extrapyramidal symptoms 3.Agranulocytosis 4.Gastrointestinal problems

2.Extrapyramidal symptoms

A parenteral form of an antipsychotic is prescribed for a client who has become aggressive. When administering the drug, which site would be most appropriate for the nurse to use? 1.Ventrogluteal 2.Gluteus 3.Deltoid 4.Vastuslateralis

2.Gluteus

A female client relates that she is taking Valium for a muscle relaxant and Provigil for treatment of narcolepsy. Additionally, she informs you that she takes a contraceptive. As part of client education, the nurse would include: 1.Provigil may decrease the effects of Valium. 2.Provigil may decrease the effects of her contraceptive, and she may need to use other protection. 3.Provigil will not interfere with any of the medications she is taking. 4.Provigil should not be taken if the client is on a contraceptive.

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

A client who was diagnosed with schizophrenia in 1962 was prescribed chlorpromazine (Thorazine). The client has been taking the medication for more than 40 years. What adverse effect will the client most likely experience? 1.Central nervous system agitation 2.Tardive dyskinesia 3.Hypertension 4.Urinary frequency

2.Tardive dyskinesia

The nurse is caring for a patient who is receiving drug therapy for a psychotic disorder. Which goals should the nurse include in a care plan for the patient following discharge from the hospital? 1.The patient will exhibit decreased symptoms of acute psychosis. 2.The patient will take medications as prescribed. 3.The patient will return for follow-up appointments when the patient believes they are necessary. 4.The patient will normalize sleeping and eating patterns.

2.The patient will take medications as 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? 1."ADHD usually starts in childhood and resolves before adolescence." 2."ADHD usually starts in childhood and resolves by adulthood." 3."ADHD usually starts in childhood and may persist through adulthood." 4."ADHD usually starts in childhood and resolves by adolescence."

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

A female client 25 years of age has begun taking lithium for treatment of bipolar disorder. Which statement indicates that the client needs further instruction? 1."I will call the health care provider if I experience diarrhea." 2."I will need to come to the clinic regularly for blood tests." 3."I will need to stop taking my birth control pills while I take lithium." 4."My lithium dose may change depending on the results of my blood tests."

3."I will need to stop taking my birth control pills while I take lithium."

The nurse is caring for a client who is prescribed haloperidol long term. What assessment should the nurse prioritize? 1.Assessment of the client's skin integrity 2.Monitoring the client's CD4 T-cell count 3.Assessment for involuntary movements 4.Monitoring the client's white cell differential

3.Assessment for involuntary movements

A male client with obesity comes to the clinic and informs the primary care provider (PCP) that he wants to have bypass surgery to lose 50 pounds. The client does not have diabetes or high blood pressure, so the PCP informs the client that as a first step, he wants the client to try to diet to lose weight. Which medication would the PCP then most likely order? 1.Dopram 2.Nuvigil 3.Didrex 4.Provigil

3.Didrex

A client is started on aripiprazole and the nurse notices the client is experiencing dry mouth and nasal congestion. What intervention does the nurse teach the client to minimize the side effects of the medication? 1.Consuming the medication with food 2.Discussing feelings of nervousness or restlessness 3.Drinking frequent sips of water 4.Calling the prescriber for an anticholingergic medication

3.Drinking frequent sips of water

A diabetic patient being treated for obesity tells the nurse that the patient is having adverse effects from the drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which adverse effects would need the nurse's immediate attention? 1.Jittery feeling 2.Decreased libido 3.Increased blood glucose 4.Dry eyes

3.Increased blood glucose

The peditric client has been prescribed mehtylphenidate (Ritalin). Which statement should be included in the teaching plan for a client receiving methylphenidate (Ritalin)? 1."Adverse effects include hypertension and nervousness." 2."The drug may cause weight gain." 3."There is no risk of dependence." 4."The medication is usually taken just before bedtime."

1."Adverse effects include hypertension and nervousness."

An African American male client routinely takes haloperidol to manage his psychosis. Recently, he presented to the physician's office with signs of tardive dyskinesia, and his physician modified the drug regimen over time. The client will now take the drug olanzapine and discontinue the haloperidol. What will the nurse tell the client to help decrease his anxiety about the new drug regimen? 1."When compared with haloperidol, olanzapine has been associated with fewer extrapyramidal reactions in African Americans." 2."The signs of tardive dyskinesia will diminish over time." 3."African Americans always experience tardive dyskinesia with antipsychotics." 4."The olanzapine does not produce side effects in African American males."

1."When compared with haloperidol, olanzapine has been associated with fewer extrapyramidal reactions in African Americans."

A nurse works at a weight management clinic. To which overweight client could the nurse safely administer dextroamphetamine? 1.A 48-year-old Caucasian man who has adult-onset diabetes 2.A 38-year-old Caucasian woman with glaucoma 3.A 60-year-old African-American man who experiences angina 4.A 28-year-old African-American woman with hyperthyroidism

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

The nurse has admitted a client with a probable diagnosis of narcolepsy. The nurse assesses the client for what symptoms that are characteristic of this disorder? (Select all that apply.) 1.Cataplexy 2. Daytime Drowsiness 3.Unpredictable sleep during daytime hours 4.Transient insomnia 5.Difficult to rouse in the morning

1.Cataplexy 2. Daytime Drowsiness 3.Unpredictable sleep during daytime hours

The nurse is aware that medication dosage for a child with ADHD is stopped occasionally for what reason? 1.Evaluation of treatment regimen 2.Musculoskeletal growth 3.Brain growth 4.Onset of puberty

1.Evaluation of treatment regimen

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? 1.Dexmethylphenidate will stabilize Scott's mood so that he can concentrate. 2.Dexmethylphenidate will improve Scott's attention span so that he will be able to complete a task. 3.Dexmethylphenidate will increase Scott's ability to understand information better. 4.Dexmethylphenidate will improve Scott's memory.

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

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? 1.Slowed reaction time and poor coordination 2.Disorganized and often bizarre thinking 3.Short- and long-term memory deficits 4.Short manic episodes followed by long depressive episodes

2.Disorganized and often bizarre thinking

Mr. Kim, a 35-year-old native of Korea, is treated with haloperidol for schizophrenia with a history of alcohol abuse. The nurse understands that based on Mr. Kim's history, the dose of haloperidol should be decreased to prevent adverse effects. Which biological factor contributes to Mr. Kim's risk for toxicity? 1.His dietary practices, which may interfere with drug excretion 2.His age 3.His history of alcohol abuse, because his liver may not function properly 4.His ethnic background, because of the effects on metabolism of the drug

4.His ethnic background, because of the effects on metabolism of the drug

A group of nursing students are reviewing information about CNS stimulants. The students demonstrate understanding of the information when they identify which drug as being used to treat obesity? 1.Dexmethylphenidate 2.Methylphenidate 3.Modafinil 4.Phentermine

4.Phentermine

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? 1.Risk for imbalanced body temperature related to hypothalamic suppression 2.Risk for impaired liver function related to hepatotoxicity 3.Bowel incontinence related to gastrointestinal adverse effects 4.Risk for injury related to central nervous system depression

4.Risk for injury related to central nervous system depression

A nurse is teaching the client about CNS medications and how they are addictive. What is primary reason CNS medications are addictive? 1.The medication decreases the amount of dopamine released into the body, causing feelings of euphoria. 2.The medication stimulates the brain's visual centers, so the client sees everything more clearly. 3.The medication stimulates the brain's sleep centers, so the client can sleep more soundly. 4.The medication stimulates the brain's pleasure centers with enhanced neurotransmission of dopamine.

4.The medication stimulates the brain's pleasure centers with enhanced neurotransmission of 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 1.electromyelogram (EMG). 2.electroencephalogram (EEG). 3.electrophysiologic study (EPS). 4.electrocardiogram (ECG).

4.electrocardiogram (ECG).

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): 1.decreased risk for muscular contractions and spasms. 2.high drug efficacy of haloperidol. 3.decreased risk for toxic effects of haloperidol therapy. 4.increased risk for toxic effects of haloperidol therapy.

4.increased risk for toxic effects of haloperidol therapy.

What is the central nervous system stimulant of choice to treat narcolepsy? 1.atomoxetine 2.guarana 3.caffeine 4.modafinil

4.modafinil

During periods of dehydration, the client is at risk for lower serum lithium levels. TRUE or FALSE

False During periods of sodium depletion or dehydration, the kidney reabsorbs more lithium into the serum, often leading to toxic levels.

For clients taking clozapine (Clozaril), it is necessary to monitor what lab test for the first 6 months?

White Blood Cells

A client is prescribed olanzapine for the treatment of schizophrenia. The client is voiding three times each night and is always thirsty. Based on the adverse effects of olanzapine, what should the nurse suspect is triggering the client's reported polyuria and polydipsia? 1.renal calculi 2.urinary tract infection 3.hyperthyroidism 4.diabetes mellitus

diabetes mellitus

The school nurse is conducting a screening of kindergarten students. The nurse will assess the children for what characteristics of ADHD? (Select all that apply.) 1.Hyperactivity 2.Improved retention 3.Playing well with others 4.Short attention span 5.Impulsivity

1.Hyperactivity 4.Short attention span 5.Impulsivity

The nurse is caring for a client who takes clozapine. The nurse would be most concerned if this client displays what symptom? 1.Temperature of 102°F 2.Weight gain of 1 lb in the last week 3.Blood sugar of 108 4.Blood pressure of 98/64

1.Temperature of 102°F

Moderate CNS depression is characterized by: 1.Drowsiness or sleep; decreased muscle tone; decreased ability to move; and decreased perception of sensations such as pain, heat, and cold. 2.Increasing hyperactivity, excessive talking, nervousness, and insomnia. 3.A lack of interest in surroundings and inability to focus on a topic. 4.Wakefulness, mental alertness, and decreased fatigue.

1.Drowsiness or sleep; decreased muscle tone; decreased ability to move; and decreased perception of sensations such as pain, heat, and cold.

A male client tells the nurse he is going to stop taking his medication because he is always having fine tremors and slurred speech. These reactions are preventing him from teaching art classes like he used to do. The nurse knows that what action could help him? 1.He could talk with his health care provider and ask to have his medication dosage decreased, or change his medication to a second-generation antipsychotic. 2.He could learn to teach other classes via online education so that he wouldn't have to talk out loud. 3.He could tell his health care provider that the antipsychotics are not working and he needs a larger dose, or another medication added. 4.He could stop taking his medication and see if he still has schizophrenia.

1.He could talk with his health care provider and ask to have his medication dosage decreased, or change his medication to a second-generation antipsychotic.

A nurse is administering a CNS stimulant to a client with narcolepsy. The nurse understands that this drug does not cause cardiac and other systemic stimulatory effects like other CNS stimulants. Which drug is the nurse most likely administering? 1.Modafinil 2.Dopram 3.Caffeine 4.Dexmethylphenidate

1.Modafinil

A patient has been administered an antipsychotic. Which reaction should be reported immediately? 1.Dry mouth 2.Rigidity 3.Orthostatic hypotension 4.Drowsiness

2.Rigidity

A client is being treated with clozapine. What should the nurse monitor most closely? 1.Urine quantity and quality 2.Cardiac enzymes 3.White blood cell count 4.AST, ALT and bilirubin

3.White blood cell count

A male client is diagnosed with narcolepsy by his physician. He asks the physician to prescribe modafinil, because it works so well for his friend. The physician will not prescribe the medication because of what aspect of the client's history? 1.Ischemic changes on his electrocardiograms 2.Gout and a history of tophi 3.Pancreatitis 4.Cirrhosis of the liver

1.Ischemic changes on his electrocardiograms

A client calls the clinic reporting only being able to get a 1-month supply of pills for the client's son, who takes a CNS stimulant for ADHD. The nurse understands that these medications are given in limited numbers for what reason? 1.It reduces the likelihood of drug dependence or diversion. 2.The cost is prohibitive when prescribed in a large number. 3.HMOs will not reimburse the cost for larger numbers. 4.Changes in dosages are common.

1.It reduces the likelihood of drug dependence or diversion.

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? 1.Metabolism may be slowed and drug elimination half-lives prolonged, with resultant accumulation and increased risk of adverse effects. 2.Metabolism may be slowed and drug elimination half-lives shortened, with resultant accumulation and increased risk of adverse effects. 3.Metabolism may be accelerated and drug elimination half-lives shortened, causing an increased risk of adverse effects. 4.Metabolism may be accelerated and drug elimination half-lives prolonged, with resultant accumulation and increased risk of adverse effects.

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

The parents of a child receiving a central nervous system stimulant for treatment of attention deficit disorder asks the nurse why they are stopping the drug for a time. Which statement by the nurse would be most appropriate? 1."The drug should be used for a specified period of time and then switched to another." 2."He probably doesn't need the medication anymore since he is getting older." 3."He is prone to developing severe adverse effects if he stays on it any longer." 4."We need to check and see if he still has symptoms that require drug therapy."

4."We need to check and see if he still has symptoms that require drug therapy."

Antipsychotic drugs are contraindicated in clients with: 1.kidney damage, chronic obstructive lung disease, mild hypotension, and chronic bone pain. 2.peptic ulcer disease, mild hypertension, chronic joint pain, and kidney failure. 3.nausea, severe hypotension, or intractable hiccups. 4.liver damage, coronary artery disease, severe hypertension, bone marrow depression, or cerebrovascular disease.

4.liver damage, coronary artery disease, severe hypertension, bone marrow depression, or cerebrovascular disease.

A female client 70 years of age is receiving lithium. Which nursing intervention is appropriate for this client? 1.Monitor fluid and sodium intake every 12 hours. 2.Encourage the client to check daily for weight loss. 3.Instruct the client to use barrier contraceptives. 4.Check blood glucose levels every six hours.

1.Monitor fluid and sodium intake every 12 hours.

A nurse observes rhythmic, involuntary facial movements in a patient who has been administered antipsychotic drugs. The patient also makes chewing movements and, at times, his tongue protrudes. What is the most likely reason for the patient's behavior? 1.Tardive dyskinesia 2.Stevens-Johnson syndrome 3.Neuroleptic malignant syndrome 4.Extrapyramidal syndrome

1.Tardive dyskinesia

A female client is diagnosed with renal insufficiency. The nurse develops a teaching plan based on the diagnosis and antipsychotic drug usage. The client asks the nurse why it is so important to have renal function tests routinely. The nurse replies that if renal function test results become abnormal, what may be a consequence? 1.The drug may need to be lowered in dosage or discontinued. 2.The drug will be continued with caution. 3.The drug dosages will be increased to increase absorption. 4.The drug will be discontinued immediately.

1.The drug may need to be lowered in dosage or discontinued.

Monitoring of patients taking lithium (Eskalith) includes periodically obtaining a serum lithium level; at what level may toxic reactions occur? 1.Greater than 0.5 mEq/mL 2.Greater than 1.5 mEq/mL 3.Greater than 1 mEq/mL 4.Greater than 1.25 mEq/mL

2.Greater than 1.5 mEq/mL

The nurse is aware that CNS stimulants are prescribed for clients with ADHD because these medications have what effect on behavior and attention? 1.Contravening 2.Improving 3.Restoring 4.Deteriorating

2.Improving

While caring for a client who is receiving antipsychotic therapy, the nurse observes lip smacking, a darting tongue, and slow and aimless arm movements. The nurse interprets this as: 1.tardive dyskinesia. 2.dystonia. 3.pseudoparkinsonism. ' 4.akathisia.

1.tardive dyskinesia.

Which reaction should a nurse monitor for in a patient who has been administered doxapram? 1.Urinary pattern 2.Tinnitus 3.Increased heart rate 4.Impaired vision

1.Urinary pattern

A 10-year-old child is being administered CNS stimulants for ADHD. What should the nurse instruct the parents to record periodically? 1.Weight and growth 2.Voiding pattern 3.Social interaction 4.Sleeping pattern

1.Weight and growth