Pharm 3 Exam 4
The nurse should warn a client who is taking a benzodiazepine about using which of the following medications in combination with his current medication? A) Antacids B) Acetaminophen (Tylenol) C) Vitamins D) Aspirin
A) Antacids
What lab results would help to evaluate a healthy liver? SATA. A) ALT B) AST C) BUN D) Creatinine E) Bilirubin
A, B, E
Which of the following interventions for anxiety are non-pharmacologicial? SATA. A) Providing calm, quiet environment B) Benzodiazapines C) Estabilishing a trusting relationship D) Antidepressants E) Self-care
A, C, E
What is the therapeutic index for lithium? A) 0.3-0.8 B) 0.6-1.2 C) 0.8-1.5 D) 1-2
B) 0.6-1.2
The nurse knows the patient understands her teaching about phenytoin when the client makes this statement: A) "I can still take my Warfarin while taking this medication." B) "Taking antacids before taking this medication is okay." C) "I should get regular dental check-ups while on this medication." D) "This medication can make me hypoglycemic so I need to eat snacks with sugar."
C) "I should get regular dental check-ups while on this medication."
While a client is taking alprazolam (Xanax), which of the following should the nurse instruct the client to avoid? A) Chocolate B) Cheese C) Alcohol D) Shellfish
C) Alcohol
Which condition will alert the nurse to a potential caution or contraindication regarding the use of a dopaminergic drug for treatment of mild Parkinson's disease? A) Diarrhea B) Tremors C) Angle-closure glaucoma D) Unstable gate
C) Angle-closure glaucoma
An older adult has been given a benzodiazepine for sleep induction, but the night nurse noted that the patient was awake most of the night, watching television and reading in bed. The nurse documents that the patient has had which type of reaction to the medication? A) Allergic B) Teratogenic C) Paradoxical D) Idiopathic
C) Paradoxical
Identify the non-benzodiazepine drug: A) Phenobarbital B) Alprazolam C) Zolpidem D) Ramelteon
C) Zolpidem
What lab results would help to evaluate a healthy kidney? SATA. A) ALT B) AST C) BUN D) Creatinine E) Bilirubin
C, D
Identify negative symptoms of schizophrenia: SATA. A) Hallucinations B) Delusions C) Flat affect D) Bizarre thinking E) Withdrawal F) Agitation G) Difficulty thinking
C, E, G
A client taking fluoxetine 40 mg PO every morning tells the nurse that her mouth "feels like cotton." Which statement by the client necessitates further assessment by the nurse? A) "I'm sucking on ice chips." B) "I'm using sugarless gum." C) "I'm sucking on sugarless candy." D) "I'm drinking 12 glasses of water every day."
D) "I'm drinking 12 glasses of water every day."
The nurse cares for a client receiving sertaline (SSRI). Which statement is most important for the nurse to make? A) "It will not have any effect on your sleeping patterns." B) "You don't have to worry about interactions with other medications." C) "You can drink beer and wine, but not mixed drinks, while taking this medication." D) "It might take 2-4 weeks for you to reach full therapeutic effect."
D) "It might take 2-4 weeks for you to reach full therapeutic effect."
The HCP prescribes lithium for the client. The nurse understands which other medication is contraindicated for this client? A) Diuretic B) MAOI C) Tricyclic antidepressant D) Antibiotic
A) Diuretic Rationale: Lithium causes sodium depletion, diuretics are contraindicated for clients on lithium
Which of the following medications is more commonly used as an anti-seizure medication? A) Phenobarbital B) Alprazolam C) Zolpidem D) Ramelteon
A) Phenobarbital
Which client statement indicates the need for additional teaching about benzodiazepines? A) "I can't drink alcohol while taking diazepam." B) "I can stop taking the diazepam anytime I want." C) "Diazepam can make me drowsy, so I shouldn't drive for a while." D) "Diazepam will help my tight muscles feel better."
B) "I can stop taking the diazepam anytime I want."
Identify the hydantoin drug: A) Alprazolam B) Phenytoin (Dilantin) C) Phenobarbital D) Zolpidem
B) Phenytoin (Dilantin)
What is the therapeutic index for carbamazepine (Tegretol)? A) 1-5 B) 3-6 C) 4-12 D) 5-15
C) 4-12
What is the therapeutic index for valproic acid (Depakote)? A) 10-20 B) 25-50 C) 50-100 D) 50-125
D) 50-125
The client with rapid-cycling bipolar disorder who is about to receive his 1700 hours dose of carbamazepine tells the nurse he has a sore throat and chills. What should the nurse do next? A) Administer the prescribed dose of carbamazepine B) Give the client Tylenol as prescribed PRN C) Report the symptoms to the HCP in the morning D) Call the HCP immediately to report changes
D) Call the HCP immediately to report changes
A client diagnosed with paranoid schizophrenia is still withdrawn, unkempt, and unmotivated to get out of bed. A UAP asks the nurse why the client is behaving this way after being on fluphenazine 10 mg for 7 days. What should the nurse tell the UAP? A) "Fluphenazine is most effective with the positive symptoms of schizophrenia." B) "The client will be less withdrawn and unmotivated when the fluphenazine takes effect." C) "The client's fluphenazine dose probably needs to be increased again." D) "Lack of motivation is a common side effect of fluphenazine."
A) "Fluphenazine is most effective with the positive symptoms of schizophrenia."
The client states to the nurse, "I take citalopram 40 mg every day as my HCP prescribed. I have also been taking St. John's wort 750 mg daily for the past 2 weeks." Which findings would indicate that the client is developing serotonin syndrome? SATA. A) Confusion B) Restlessness C) Constipation D) Diaphoresis E) Ataxia
A, B, D, E
Which labs should be monitored while a patient is taking phenytoin? SATA. A) PT B) BUN C) ALT D) INR
A, D
What is the therapeutic index of phenytoin? A) 5-10 B) 10-15 C) 10-20 D) 15-25
C) 10-20
A client admitted with a diagnosis of schizoaffective disorder, manic phase, who is currently taking fluoxetine, valproic acid, and olanzapine as prescribed, has had an increase in manic symptoms in the past week. The HCP prescribes valproic acid blood levels to be drawn at once. What does the nurse understand is the rationale for this prescription? A) All clients taking valproic acid need periodic valproic acid levels drawn B) Fluoxetine can decrease the effectiveness of the valproic acid C) A decrease in the level of valproic acid could explain the increase in manic symptoms D) The valproic acid level is needed before a short course of lorazepam for agitation can be prescribed
C) A decrease in the level of valproic acid could explain the increase in manic symptoms
When doing an admission drug history, the nurse notes that the patient has a prescription for lithium. The nurse suspects that this patient has been diagnosed with which condition? A) Paranoid schizophrenia B) Absence seizures C) Bipolar disorder D) OCD
C) Bipolar disorder
After a patient has been treated for depression for 4 weeks, the nurse calls the patient to schedule a follow-up visit. What concern will the nurse assess for during the conversation with the patient? A) Weakness B) Hallucinations C) Suicidal ideation D) Difficulty with urination
C) Suicidal ideation
The nurse is providing education for a patient who will be taking an antiepileptic drug for the first time. Which statement by the patient indicates that further teaching is indicated? A) "I will take the medicine at the same time every day." B) "I will check with my doctor before taking any OTC drugs." C) "I will keep the appointments to check my bloodwork." D) "I can drive to work again once my drug levels are normal."
D) "I can drive to work again once my drug levels are normal."
The nurse instructs a client diagnosed with bipolar disorder receiving lithium 300 mg three times a day. The nurse determines that teaching is effective if the client makes which statement? A) "I can still have my coffee." B) "I should increase my level of exercise." C) "I can sit in a hot tub." D) "I will eat a moderate amount of sodium."
D) "I will eat a moderate amount of sodium." Rationale: Lithium can cause excessive sodium loss
Which statement by a client taking lithium most indicates a need for more teaching? A) "I don't have to worry about my levels because my last level was normal." B) "I've been getting a lot of good exercise playing on my local soccer team." C) "I'm trying hard to watch my diet and eat healthy." D) "I've learned to take my lithium even when I have the stomach flu."
D) "I've learned to take my lithium even when I have the stomach flu." Rationale: Due to fluid levels in the body fluctuating from the flu lithium levels could become too high and cause lithium toxicity.
Identify positive symptoms of schizophrenia: SATA. A) Hallucinations B) Delusions C) Flat affect D) Bizarre thinking E) Withdrawal F) Agitation G) Difficulty thinking
A, B, D, F
A client takes diazepam while establishing a therapeutic dose of antidepressants for generalized anxiety disorder. Which instruction should the nurse give to this client? SATA. A) To consult with his HCP before he stops taking the drug B) To avoid eating cheese and other tyramine-rich foods C) To take the medication on an empty stomach D) Not to use alcohol while taking this drug E) To stop taking the drug if he experiences swelling of the lips and face and difficulty breathing
A, D, E
A client who is experiencing alcohol withdrawal exhibits tremors, diaphoresis, and hyperactivity. Blood pressure is 190/87, and pulse is 92 bpm. Which medication should the nurse expect to administer? A) Haloperidol B) Lorazepam C) Benztropine D) Naloxone
B) Lorazepam
The nurse cares for clients on the rehab unit. The client reports having trouble focusing the eyes when trying to read. The nurse learns the client has not had a problem in the past. The nurse notes the client has been receiving phenobarbital for more than a year. It is most important for the nurse to take which action? A) Assess for drowsiness B) Obtain an order for a blood specimen C) Explain to the client a tolerance to the medication has developed. D) Recommend the client have a vision test
B) Obtain an order for a blood specimen Rationale: Nystagmus is an early sign of barbiturate toxicity
The HCP orders gabapentin for a client reporting neuralgia. The client tells the nurse they have difficulty swallowing pills. Which response by the nurse is best? A) "Taking gabapentin with an antacid will help you swallow the capsule." B) "Crush the capsule and mix it with applesauce or jelly." C) "Chew the capsule so it will take effect faster." D) "Open the capsule and sprinkle it in juice or on applesauce."
D) "Open the capsule and sprinkle it in juice or on applesauce."
A client diagnosed with schizophrenia is being switched to risperidone long-acting injection. The client is told that he will remain on his oral dose of risperidone daily for approximately 1 month. The client says, "I didn't have to take pills when I was on fluphenazine shots in the past." What should the nurse tell the client? A) "Taking fluphenazine orally and by injection would not be as effective as the injection alone." B) "Risperidone is less potent than fluphenazine." C) "Your HCP did not believe you would take both pills and fluphenazine injections." D) "Risperidone initially takes a little longer to reach the ideal blood level."
D) "Risperidone initially takes a little longer to reach the ideal blood level."
The nurse instructs the client about MAOIs. Which client statement indicates to the nurse that further teaching is necessary? A) "I can't wait to eat a hot dog with sauerkraut." B) "I'm going to have to get some polycarbophil when I get home." C) "I will be playing double tennis with my neighbors." D) "When I get home, I am going to take my car out for a road trip."
A) "I can't wait to eat a hot dog with sauerkraut."
You assess your patient's understanding of lithium drug treatment using the teach-back technique. Identify the statement by your patient revealing a need for further education: A) "I need to be careful because lithium is addictive." B) "I will keep my appointments to have my drug levels checked." C) "I will take the lithium tablets with meals." D) "I will call my doctor if I have severe vomiting or diarrhea."
A) "I need to be careful because lithium is addictive."
The parent of a young adult client diagnosed with schizophrenia is asking questions about his son's antipsychotic medication, risperidone. Which of the following statements by the father reflects a need for further teaching? A) "I should give him benztropine to help prevent constipation from the risperidone." B) "If he experiences restlessness or muscle stiffness, he should tell the doctor." C) "If he becomes dizzy, I'll make sure he doesn't drive." D) "The risperidone should help him be more motivated and less withdrawn."
A) "I should give him benztropine to help prevent constipation from the risperidone."
Which statement made by an adolescent who has just begun taking an antidepressant would indicate the need for further teaching? A) "Now that I've been taking my antidepressant for a week, I'm going to feel better about myself." B) "A week ago when I started my antidepressant, I didn't care about eating, but now I want to eat a bit more." C) "After a week of taking my antidepressant, I can sleep a little better- 6 hours or so each night." D) "Now that I've had a week of antidepressant, it's a little easier to get up in the morning."
A) "Now that I've been taking my antidepressant for a week, I'm going to feel better about myself."
Which statement by a client who has been taking buspirone as prescribed for 2 days indicates the need for further teaching? A) "This medication will help my tight, aching muscles." B) "I may not feel better for 7-10 days." C) "The drug does not cause physical dependence." D) "I can take this medication with food."
A) "This medication will help my tight, aching muscles."
The client with acute mania is prescribed 600 mg of lithium PO three times per day. The HCP also prescribes 5 mg of haloperidol PO at bedtime. Which action should the nurse take? A) Administer the medication as prescribed B) Question the HCP about the prescription C) Administer the haloperidol but not the lithium D) Consult with the nursing supervisor before administering the medications
A) Administer the medication as prescribed
A client on haloperidol has stiff muscles, restlessness, and internal jumpiness. The client has all of the following medications prescribed as needed. Which one would be most appropriate for the nurse to administer to decrease the client's symptoms? A) Benztropine B) Lorazepam C) Olanzapine D) Trazodone
A) Benzotropine Rationale: The reported signs are extrapyramidal side effects. The drug of choice is Benzotropine due to its anti-Parkinson effects on the body.
The client diagnosed with schizophrenia is placed on haloperidol 5 mg bid. The nurse observes the client for which symptoms? A) Constipation and dry mouth B) Vomiting and diarrhea C) Diuresis and sodium loss D) Hypertension and insomnia
A) Constipation and dry mouth
A patient who has been taking lithium for 6 months has had severe vomiting and diarrhea from a gastrointestinal flu. The nurse will assess for which potential problem at this time? A) Dehydration B) Chest pain C) Anxiety D) Agitation
A) Dehydration
An HCP has prescribed valproic acid for a client with bipolar disorder who has achieved limited success with lithium. Which information should the nurse teach the client about taking valproic acid? A) Follow-up blood tests are necessary while on this medication B) The extended-release tablet can be crushed if necessary for ease of swallowing C) Tachycardia and upset stomach are common side effects D) Consumption of a moderate amount of alcohol is safe if the medication is taken in the morning
A) Follow-up blood tests are necessary while on this medication
A patient is taking gabapentin but does not have a history of seizures. The nurse recognizes that this drug is also indicated for which of these? A) Neuralgia B) Viral infections C) Parkinson's disease D) Depression
A) Neuralgia
An outpatient client who has been receiving haloperidol for 2 days develops muscular rigidity, altered consciousness, a temperature of 103°F, and trouble breathing on day 3. The nurse interprets these findings as indicating which complication? A) Neuroleptic malignant syndrome (NMS) B) Tardive dyskinesia C) Extrapyramidal adverse effects D) Drug-induced parkinsonism
A) Neuroleptic malignant syndrome (NMS)
A patient is taking levodopa-carbidopa as part of the therapy for Parkinson's disease. Which intervention by the nurse is appropriate at this time? A) Notify the patient that this drug causes discoloration of the urine B) Limit the patient's intake of tyramine-containing foods C) Monitor the results of renal studies because this drug can seriously affect renal function D) Force fluids to prevent dehydration
A) Notify the patient that this drug causes discoloration of the urine
The nurse is giving medications to a patient. Which drug or drug class, when administered with lithium, increases the risk for lithium toxicity? A) Thiazides B) Levofloxacin C) Calcium citrate D) Beta blockers
A) Thiazides
Before hospitalization, a client needed increasingly larger doses of barbiturates to achieve the same euphoria as when he began using. The nurse develops a plan of care that takes into account that the client is likely suffering from which of the following? A) Tolerance B) Addiction C) Abuse D) Dependence
A) Tolerance
A client diagnosed with schizophrenia is being discharged on aripiprazole 5 mg every night. When developing the teaching plan about the most common adverse effects, which information should the nurse include? SATA. A) Headaches B) Transient mild anxiety C) Insomnia D) Torticollis E) Pill rolling movements
A, B, C
A client is diagnosed with generalized anxiety disorder (GAD) and given a prescription for venlafaxine. Which information should the nurse include in a teaching plan for this client? SATA. A) Various strategies for reducing anxiety B) The benefits and mechanisms of actions of venlafaxine in treating GAD C) How venlafaxine will eliminate his anxiety at home and work D) The management of common side effects of venlafaxine E) Substituting adaptive coping strategies for maladaptive ones F) The positive effects of venlafaxine being evident in 4-5 days
A, B, D, E
The client with bipolar disorder, manic phase, has a sub-therapeutic valproic acid level. Which client behaviors should the nurse judge to be due to this level of valproic acid? SATA. A) Irritability B) Grandiosity C) Anhedonia D) Hypersomnia E) Flight of ideas
A, B, E
The nurse in the mental health clinic understands which foods must be avoided by clients taking MAOIs? SATA. A) Aged cheeses B) Lunch meats C) Nuts D) Leafy green vegetables E) Tofu F) Chocolate
A, B, E, F
What are the side effects of amitriptyline? SATA. A) Orthostatic hypotension B) Hypertension C) Sedation D) Insomnia
A, C
Which of the following drugs are known to interact with phenytoin? SATA. A) Warfarin B) Tylenol C) Antacids D) NSAIDs
A, C
Identify the uses for Alprazolam: SATA. A) Anxiety B) Depression C) Seizures D) Migraine E) Pre-op sedation F) Insomnia G) Substance abuse withdrawal
A, C, E, G
A pregnant client in her third trimester is started on chlorpromazine 25 mg 4 times daily. Which instructions are most important for the nurse to include in the client's teaching plan? A) "Don't drive because there's a possibility of seizures occurring." B) "Avoid going out in the sun without a sunscreen with a sun protection factor of at least 30." C) "Stop the medication immediately if constipation occurs." D) "Tell your HCP if you experience an increase in blood pressure."
B) "Avoid going out in the sun without a sunscreen with a sun protection factor of at least 30." Rationale: Chlorpromazine is a typical antipsychotic that can cause sun-sensitive skin.
A client diagnosed with OCD has been taking sertraline but would like to have more energy every day. At his monthly checkup, he reports that his massage therapist recommended St. John's wort to help his depression. What should the nurse tell this client? A) "St. John's wort is a harmless herb that might be helpful in this instance." B) "Combining St. John's wort with sertraline can cause a serious reaction called serotonin syndrome." C) "If you take St. John's wort, we will have to decrease the dose of your sertraline." D) "St. John's wort is not very effective for depression, but we can increase your sertraline dose."
B) "Combining St. John's wort with sertraline can cause a serious reaction called serotonin syndrome."
The nurse cares for the client receiving an SNRI for two months. The client tells the nurse of being unable to maintain an erection and wants to stop taking the medication to see if this is causing the problem. Which response by the nurse is most appropriate? A) "SNRIs do not cause sexual side effects." B) "I'll contact the HCP so the dosage of medication can be reduced gradually." C) "The sexual side effects will decrease with time." D) "Your inability to maintain an erection is due to anxiety."
B) "I'll contact the HCP so the dosage of medication can be reduced gradually."
The nurse instructs a client receiving phenytoin sodium. The nurse determines further teaching is necessary if the client makes which statement? A) "I should not drink alcohol while taking this medication." B) "If my urine changes color, I should immediately go to the emergency department." C) "I should avoid activities requiring alertness for the first 3 days that I take this medication." D) "I should not abruptly discontinue this medication."
B) "If my urine changes color, I should immediately go to the emergency department."
After the nurse teaches a client with bipolar disorder about lithium therapy, which client statement indicates the need for additional teaching? A) "It's important to keep using a regular amount of salt in my diet." B) "It's okay to double my next dose of lithium if I forget a dose." C) "I should drink about 8-10 8oz glasses of water each day." D) "I need to take my medicine at the same time each day."
B) "It's okay to double my next dose of lithium if I forget a dose."
The nurse is reviewing the drugs currently taken by a patient who will be starting drug therapy with carbamazepine (Tegretol). Which drug may raise a concern for interactions? A) Digoxin (Lanoxin) B) Acetaminophen (Tylenol) C) Diazepam (Valium) D) Warfarin (Coumadin)
B) Acetaminophen (Tylenol) Rationale: Using acetaminophen together with carbamazepine may alter the effects of acetaminophen and cause serious side effects that may affect the patient's liver.
A patient has been admitted to the ED because of an overdose of an oral benzodiazepine. He is very drowsy but still responsive. The nurse will prepare for which immediate intervention? A) Hemodialysis to remove the medication B) Administration of flumazenil C) Administration of naloxone D) Intubation and mechanical ventilation
B) Administration of flumazenil
In caring for a patient experiencing alcohol withdrawal, the nurse expects to administer which medication or medication class as a treatment for this condition? A) Lithium B) Benzodiazepines C) Busiprone D) Antidepressants
B) Benzodiazepines
A patient who has been taking levodopa-carbidopa for Parkinson's disease for over 1 year wants to start a low-carb high-protein weight-loss diet. The nurse tells the patient this type of diet may have what effect on his drug therapy? A) There will be no problems with this diet while on this medication B) The high-protein diet can slow or prevent absorption of this medication C) The high-protein diet may cause increased blood levels of this medication D) The high-protein diet will cause no problems as long as the patient also takes pyridoxine (Vitamin B12)
B) The high-protein diet can slow or prevent absorption of this medication Rationale: Patients taking levodopa-carbidopa should be on a low-protein diet because protein binds to the medication which causes prevention or slowing of the absorption of this drug
A client diagnosed with bipolar disorder asks the nurse why it is necessary to have a serum lithium level drawn every 3-4 months. The nurse's response should be based on which factor? A) To monitor compliance with the medication B) To prevent toxicity related to the drug's therapeutic range C) To monitor the client's white blood cell count D) To comply with governmental safety requirements
B) To prevent toxicity related to the drug's therapeutic range
An outpatient client who has a history of paranoid schizophrenia and chronic alcohol dependency has been taking aripiprazole for several months. She reports that she stopped drinking 4 days ago. The client is very frightened by tactile hallucinations of bugs crawling under the skin. Which factor should the nurse incorporate into the plan of care when explaining the tactile hallucinations? A) Alcohol intoxication B) Ineffectiveness of aripiprazole C) Alcohol withdrawal D) Interaction of alcohol and aripiprazole
C) Alcohol withdrawal
The nurse is reviewing the prescriptions for a patient who will be discharged to home after being hospitalized for a hysterectomy. The patient asked for a sleeping pill, and the surgeon wrote a prescription for zolpidem (Ambien), 10 mg at bedtime as needed for sleep. What is the nurse's priority action at this time? A) Review the potential adverse effects with the patient B) Suggest that the patient try drinking a class of wine at bedtime C) Contact the prescriber to question the dose of Ambien D) Assist the patient to find a pharmacy to fill the prescription on her way home
C) Contact the prescriber to question the dose of Ambien Rationale: Max dose of Ambien for women is 5 mg, max dose of Ambien for men is 5-10 mg due to risk for next-morning impairment after its use.
The wife of a client admitted for treatment with newly diagnosed paranoid schizophrenia visits 2 days after her husband's admission and states to the nurse, "Why is he not eating? He is still talking about his food being poisoned." Which appraisal by the nurse is most accurate? A) Her expectations of her husband are realistic B) The wife's inquiry is reasonable C) Education about her husband's medications is needed D) An increase in the client's medication is indicated
C) Education about her husband's medications is needed
An older adult client was prescribed lorazepam 1 mg three times a day to help calm her anxiety after her husband's death. The next day, the client calls her daughter asking when she is picking her up to go to the graveside. The client says she has been up walking up and down the driveway for the past hour waiting for her daughter. Noting the client's agitation, hyperactivity, and insistence, the daughter calls the nurse to report her mother's behavior. Which finding would the nurse suspect as the cause of the mother's behavior, and what action would she suggest? A) The client is manic and may need a sleeping pill B) The client is experiencing a medication interaction and should go to the ED C) The client is experiencing a paradoxical reaction to the lorazepam and should the stop the new medication immediately D) The client is overcome by grief and probably needs an antidepressant
C) The client is experiencing a paradoxical reaction to the lorazepam and should the stop the new medication immediately
Which considerations are important for the nurse to remember when administering a benzodiazepine as a sedative-hypnotic drug? SATA. A) These drugs are intended for long-term management of insomnia B) These drugs can be administered safely with other CNS depressants for insomnia C) The dose needs to be given about 1 hour before the patient's bedtime D) The drug is used as a first choice for treatment of sleeplessness E) The patient needs to be evaluated for the drowsiness that may occur the morning after a benzodiazepine is taken
C, E
A client reports having blurred vision after 4 days of taking haloperidol 1 mg twice a day and benztropine 2 mg twice a day. The nurse contacts the HCP to explain the situation, background, and assessment and to make a recommendation. Which information reported to the HCP is the correct assessment of the situation? A) "Mr. Robert is taking 1 mg of haloperidol twice a day and benztropine 2 mg twice a day." B) "I think Mr. Roberts might need a lower dose of benztropine." C) "Mr. Roberts reports having blurred vision since this morning." D) "The higher dose of benztropine could be causing Mr. Roberts' blurred vision."
D) "The higher dose of benztropine could be causing Mr. Roberts' blurred vision."
A hospitalized client is complaining of having difficulty sleeping. Which action will the nurse take first to address the problem? A) Administer a sedative-hypnotic drug if ordered B) Offer tea with the herbal preparation valerian root C) Encourage the patient to exercise by walking up and down the halls a few times if tolerated D) Provide an environment that is restful, and reduce loud noises
D) Provide an environment that is restful, and reduce loud noises
When assessing a client who is receiving tricyclic antidepressant therapy, the nurse should be alert for which finding that could suggest the client is experiencing anticholinergic effects? A) Tremors and cardiac arrhythmias B) Sedation and delirium C) Respiratory depression and convulsions D) Urine retention and blurred vision
D) Urine retention and blurred vision
The nurse is assessing a newly admitted patient who has a history of seizures. During the assessment, the patient has a generalized seizure that does not stop for several minutes. The nurse expects that which drug will be ordered for this condition? A) Depakote (valproic acid) B) Gabapentin (Neurontin) C) Tegretol (carbamazepine) D) Valium (diazepam)
D) Valium (diazepam)
The client is placed on citalopram (SSRI) 10 mg daily. For which adverse effect does the nurse instruct the family to observe? A) Photophobia B) Dizziness C) Epistaxis D) Hypertensive crisis
B) Dizziness
Which food should the nurse tell the client to avoid while taking phenelzine (MAOI)? A) Roasted chicken B) Salami C) Fresh fish D) Hamburger
B) Salami
Which of the following medications is not safe for children under 2 years old or for clients with liver disorders? A) Gabapentin B) Valproic acid (Depakote) C) Carbamazepine D) Phenytoin (Dilantin)
B) Valproic acid (Depakote)
A patient who has been taking lithium for 6 months has had severe vomiting and diarrhea from a gastrointestinal flu. The nurse will assess for which potential problem at this time? A) Anxiety B) Chest pain C) Agitation D) Dehydration
D) Dehydration
Which response would the nurse expect to find in a patient with a phenytoin (Dilantin) level of 25 mcg/mL? A) Ataxia B) Hypertension C) Seizures D) No unusual response; this level is therapeutic
A) Ataxia Rationale: Therapeutic index for phenytoin is between 10-20 mcg/mL.
A client receiving lithium therapy for the treatment of his bipolar disorder has a lithium level of 0.85 mEq/L. The appropriate nursing action is: A) Record the lab results in the client's chart and continue with medication administration as prescribed B) Hold the next dose of lithium C) Observe for signs of lithium toxicity D) Notify the HCP immediately
A) Record the lab results in the client's chart and continue with medication administration as prescribed
Identify the typical (conventional) antipsychotic medications. SATA. A) Fluphenazine B) Phenobarbital C) Haloperidol D) Aripiprazole
A, C
The nurse is administering an antiepileptic drug and will follow which guidelines? SATA. A) Monitor the patient for drowsiness B) Medications may be stopped if seizure activity disappears C) Give the medication at the same time every day D) Give the medication on an empty stomach E) Notify the prescriber if the patient is unable to take the medication
A, C, E
Which comment indicates that the client understands the nurse's teaching about sertraline? A) "Sertraline will probably cause me to gain weight." B) "This medicine can cause delayed ejaculation." C) "Dry mouth is a permanent side effect of sertraline." D) "I can take my medicine with St. John's wort."
B) "This medicine can cause delayed ejaculation."
A client comes to the community mental health center with symptoms of overwhelming anxiety related to a job loss, an impending move, and a sibling being diagnosed with cancer. The client states, "I used to use alcohol to cope, but ever since I've been going to those AA meetings -2 years now- I have been able to remain sober." The nurse anticipates the health care provider will order which medication for this client? A) Chlordiazepoxide B) Buspirone C) Alprazolam D) Diazepam
B) Buspirone
The nurse is teaching a patient about treatment with an SSRI antidepressant. Which teaching considerations are appropriate? SATA. A) The patient should be told which foods contain tyramine and instructed to avoid these foods B) The patient should be instructed to use caution when standing up from a sitting position C) The patient should not take any products that contain the herbal product St. John's wort D) This medication should not be stopped abruptly E) Drug levels may become toxic if dehydration occurs F) The patient should be told to check with the prescriber before taking any OTC medications
B, C, D, F
When the nurse is developing a teaching plan for a client about medications prescribed for depression, which component is most important for the nurse to include? A) Pharmacokinetics of the medication B) Current research related to the medication C) Management of common adverse effects D) Dosage regulation and adjustment
C) Management of common adverse effects
A newly admitted client diagnosed with paranoid schizophrenia is pacing rapidly and wringing his hands. He states that another client is out to get him. Then he says, "Protect me, select me, reject me." What should the nurse do next? A) Administer his oral PRN lorazepam and haloperidol B) Place the client in temporary seclusion C) Call the HCP for prescription restraints D) Ask the other clients to leave the immediate area
A) Administer is oral PRN lorazepam and haloperidol
A client with panic disorder is taking alprazolam 1 mg PO three times daily. The nurse understands that this medication is effective in blocking the symptoms of panic because of its specific action on which neurotransmitters? A) Gamma-aminobutyrate B) Serotonin C) Dopamine D) Norepinephrine
A) Gamma-aminobutyrate
A client will be discharged on lithium 600 mg three times daily. When teaching the client and his family about lithium therapy, the nurse determines that the teaching has been effective if the client and family state that they will notify the HCP immediately with which symptoms? SATA. A) Nausea B) Muscle weakness C) Vertigo D) Fine hand tremors E) Vomiting F) Anorexia
B, C, E
The nurse is preparing to give medications. Which is an appropriate nursing action for intravenous (IV) phenytoin (Dilantin)? SATA. A) Give IV doses via rapid IV push B) Administer in normal saline solutions C) Administer in dextrose solutions D) Use a filter for IV infusion E) Ensure continuous infusion of the drug
B, D
Patient teaching for a patient receiving an MAOI would include instructions to avoid which food products? SATA. A) Orange juice B) Swiss cheese C) Shrimp D) Milk E) Pepperoni pizza
B, E
A client has been taking 30 mg of duloxetine twice daily for 2 months because of depression and vague aches and pains. While interacting with nurse, the client discloses a pattern of drinking a six-pack of beer daily for the past 10 years to help with sleep. What will the nurse do first? A) Refer the client to the concurrent disorders program at the clinic B) Share the information at the next interdisciplinary treatment conference C) Report the client's beer consumption to the HCP D) Teach the client relaxation exercises to perform before bedtime
C) Report the client's beer consumption to the HCP
The nurse is caring for a patient who has been taking clozapine (atypical antipsychotic) for 2 months. Which lab test(s) should be performed regularly while the patient is taking this medication? A) Platelet count B) WBC count C) Liver function studies D) Renal function studies
B) WBC count
The client diagnosed with severe major depression has been taking citalopram for the past 2 weeks. Which parameter should the nurse monitor most closely at this time? A) Suicidal ideation B) Sleep C) Appetite D) Energy level
A) Suicidal ideation
The nurse is reviewing lab values of a client receiving clozapine. Which of the following lab values does the nurse immediately report to the HCP? A) WBC of 3500 B) Hemoglobin of 11.9 g/dL C) Sodium level of 136 mEq/L D) Hyaline casts in the urine analysis
A) WBC of 3500
A patient is suffering from status epilepticus, the nurse expects the HCP to prescribe which drug(s) for treatment? SATA. A) Alprazolam B) Phenobarbital C) Dilantin D) Zolpidem
A, B
The nurse provides care for a client who has been taking a tricyclic antidepressant for the last 12 days. Which behavior does the nurse assess for? A) Angry behavior B) Suicidal behavior C) Withdrawal from reality D) Early-morning waking
B) Suicidal behavior
