Nur 307_EAQ_Neuro
A patient is diagnosed with post-traumatic stress disorder (PTSD). What can the patient expect in relation to first-line therapy? Select all that apply. 1. Psychotherapy 2. a tricyclic antidepressant 3. A monoamine oxidase inhibitor (MAOI) 4. A selective serotonin reuptake inhibitor (SSRI) medication 5. A serotonin/norepinephrine reuptake inhibitor (SNRI) medication
- psychotherapy - A selective serotonin reuptake inhibitor (SSRI) medication - A serotonin/norepinephrine reuptake inhibitor (SNRI) medication Psychotherapy either alone or with drug therapy is recommended for PTSD. Regarding drugs, evidence of efficacy is strongest for three SSRIs (fluoxetine, paroxetine, and sertraline) and one SNRI (venlafaxine). Of these four drugs, only two—paroxetine and sertraline—are U.S. Food and Drug Administration-approved to treat PTSD. If none of the first-line drugs is effective, the guidelines suggest several alternatives: mirtazapine, a tricyclic antidepressant such as amitriptyline or imipramine, or an MAOI (phenelzine).
A patient who has been taking alprazolam and has been compliant with the therapeutic regimen for 6 weeks is now complaining of adverse effects of the medication. Which substances will the nurse instruct the patient to avoid to help prevent intensification of this medication's adverse effects? Select all that apply. Alcohol Opioids Tobacco Antihistamines Muscle relaxants Caffeinated drinks
-Alcohol. -Opioids. -Antihistamines. -Muscle relaxants. Because they are also central nervous system (CNS) depressants, the nurse instructs the patient to avoid alcohol, opioids, antihistamines, and muscle relaxants; when taken together with alprazolam, they can cause significant CNS depression, including respiratory depression. Tobacco use is likely to be harmful, but it is unlikely to intensify the adverse effects of a benzodiazepine. Caffeine, a xanthine stimulant, is likely to ameliorate CNS depression associated with benzodiazepines.
The nurse identifies which antidepressants as effective in the treatment of generalized anxiety disorder (GAD)? Select all that apply. Paroxetine Fluoxetine Duloxetine Escitalopram Venlafaxine
-Paroxetine (PAXIL). -Duloxetine (CYMBALTA). -Escitalopram (LEXAPRO). -Venlafaxine (EFFEXOR). Paroxetine, duloxetine, escitalopram, and venlafaxine are approved for the treatment of GAD. Fluoxetine is not approved for the treatment of GAD.
Which statements about zaleplon does the nurse identify as true? Select all that apply. -Zaleplon is a benzodiazepine. -Zaleplon is used to maintain sleep throughout the night. -Zaleplon is indicated for long-term management of insomnia. -Zaleplon should be administered with a reduced dose of cimetidine. -Zaleplon interacts with the neurotransmitter gamma-aminobutyric acid (GABA).
-Zaleplon should be administered with a reduced dose of cimetidine. -Zaleplon interacts with the neurotransmitter gamma-aminobutyric acid (GABA). Zaleplon belongs to a new class of drugs called the pyrazolopyrimidines. It is indicated for short-term management of insomnia. Zaleplon has a rapid onset and short duration of action and therefore is beneficial for initiating sleep but not for maintaining it throughout the night. A reduced dose of cimetidine should be administered with Zaleplon, and caution should be employed. Zaleplon interacts with the neurotransmitter GABA.
The nurse is caring for a patient who has obsessive-compulsive disorder. The patient is prescribed citalopram. What dosing schedule is appropriate? 100 mg daily in the morning 20 mg in the morning, increased to 80 mg/day 20 mg once daily, increased to a maximum of 40 mg/day 10 mg once daily, increased to a maximum of 20 mg/day
20 mg once daily, increased to a maximum of 40 mg/day Citalopram is a selective serotonin reuptake inhibitor used in the treatment of obsessive compulsive disorder. The dose is 20 mg once daily increased to a maximum of 40 mg/day.
What medication would the nurse anticipate a provider prescribing for treatment of generalized anxiety disorder? - Phenelzine - Alprazolam - Trazodone - Amoxapine
Alprazolam *note - only know b/c of suffix -lam is a benzo The approved first-line choices are benzodiazepines, and alprazolam is a benzodiazepine. Trazodone and phenelzine are monoamine oxidase inhibitors. Amoxapine is a tricyclic antidepressant.
The patient has an order to be treated with alprazolam. The nurse recognizes that this drug may be indicated for which condition? Seizures Insomnia Alcohol withdrawal General anxiety disorder
Alprazolam Alprazolam is known to be effective in treating fear limited to anxiety. It is not considered a first-line treatment for alcohol withdrawal, seizures, or insomnia.
The nurse is assessing a patient who has been prescribed buspirone to treat generalized anxiety disorder. For which adverse effects will the nurse monitor in the patient? Select all that apply. Nausea Anxiety Sedation Dizziness Lightheadedness
Nausea Dizziness Lightheadedness Nausea, dizziness, and lightheadedness are adverse effects of buspirone caused by the mechanism of action of the drug. Buspirone relieves anxiety and is nonsedating.
The nurse is caring for a patient who is prescribed a sedative-hypnotic. What is a primary effect of this class of medications? Cardiac stimulation Respiratory depression Prevention of psychosis Central nervous system depression
Central nervous system depression The sedative-hypnotics drugs depress central nervous system function. They are used primarily for two common disorders: anxiety and insomnia. Sedative-hypnotics are not cardiac stimulants. Respiratory depression is an adverse effect. Some individuals may experience psychosis as a paradoxical effect after taking a sedative-hypnotic medication.
The nurse notes that the healthcare provider is considering starting the patient on a benzodiazepine for anxiety. Which medication does the nurse anticipate administering to the patient? Amitriptyline Diazepam Doxepin Imipramine
Diazepam Diazepam is a benzodiazepine commonly administered for generalized anxiety disorder. Amitriptyline, doxepin, and imipramine are tricyclic antidepressants.
The nurse is caring for a patient receiving buspirone for the treatment of anxiety. Which symptom is most likely explained as an adverse effect of this drug? Dizziness Drowsiness Weight gain Risk for abuse
Dizziness Buspirone is an antianxiety medication with few side effects. The most common side effects are dizziness, nausea, headache, nervousness, lightheadedness, and excitement. Buspirone does not cause drowsiness or weight gain, and does not carry a risk for abuse.
The nurse notes in the patient's chart that the healthcare provider is considering adding a tricyclic antidepressant to the patient's treatment regimen. The nurse recognizes that the healthcare provider may select which drug? Doxepin Trazodone Maprotiline Amoxapine
Doxepin Doxepin is a tricyclic antidepressant. Trazodone is a serotonin antagonist and reuptake inhibitor. Maprotiline and amoxapine are tetracyclic antidepressants.
The patient is suspected of having overdosed on a benzodiazepine medication. The nurse expects that the healthcare provider will prescribe which medication? - Oxazepam - Lorazepam - Flumazenil - Buspirone HCl
Flumazenil Flumazenil is a benzodiazepine antagonist used to reverse benzodiazepine overdoses. Oxazapam and lorazepam are benzodiazepines; therefore, they would worsen the patient's condition. Buspirone HCl is another anti-anxiety medication.
Alprazolam is prescribed for an adult with panic attacks. The nurse recognizes that this drug exerts its therapeutic effect by interacting with which neurotransmitter? Acetylcholine Norepinephrine Serotonin (5-HT) Gamma-aminobutyric acid (GABA)
GABA Alprazolam is a benzodiazepine; this class of drugs reduces anxiety by potentiating the action of GABA. Acetylcholine, norepinephrine, and serotonin are not the primary neurotransmitters with which alprazolam interacts.
What are the side effects of venlafaxine? Select all that apply. Nausea Anorexia Dry mouth Hypertension Slurred speech
Nausea Anorexia Hypertension Venlafaxine is a serotonin-norepinephrine reuptake inhibitor that is used to treat major depression in the patient. Anorexia, hypertension, and nausea develop in many patients. Nausea usually subsides with treatment. Hypertension is an infrequent occurrence at doses used to treat anxiety disorders. Dry mouth is not associated with venlafaxine.
A patient is prescribed a sedative-hypnotic agent. The nurse realizes the patient is most likely diagnosed with which disorder? Anxiety Seizures Schizophrenia Bipolar disorder
anxiety The sedative-hypnotics are used primarily for two common disorders: anxiety and insomnia. Antipsychotics are one of the drugs used to treat schizophrenia and bipolar disorder. Seizures are treated with antiepileptics and benzodiazepines.
Upon admission, the nurse notes zolpidem on a patient's drug history. The nurse recognizes that this drug is commonly prescribed to treat which condition? Insomnia Absence seizures Paranoid schizophrenia Obsessive-compulsive disorder (OCD)
insomnia Zolpidem is a hypnotic approved for short-term treatment of insomnia. Zolpidem is not used to treat absence seizures, paranoid schizophrenia, or OCD.
