Pharm Ch 22 Prepu

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? Increased blood glucose Decreased libido Dry eyes Jittery feeling

Increased blood glucose

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? Stevens-Johnson syndrome Extrapyramidal syndrome Tardive dyskinesia Neuroleptic malignant syndrome

Tardive dyskinesia

For clients taking clozapine, it is necessary to monitor what lab test for the first 6 months? Liver enzymes White blood cells PT/PTT Hemoglobin

White blood cells

Atomoxetine has been selected as the primary pharmacologic treatment for a young adult diagnosed with attention deficit hyperactivity disorder (ADHD). What characteristic makes this a good drug of choice for this population of clients? Select all that apply.

a lower potential for abuse a low risk for dependency is administered orally

During an intake assessment, the nurse notes that the client cannot sit still and continually stands up and walks around the room. The nurse knows that the term for this behavior is: dystonia. avolution. akathisia. anhedonia.

akathisia.

After administration of haloperidol to an acutely dehydrated client, the nurse should prioritizewhat nursing assessment? blood pressure deep tendon reflexes core body temperature visual acuity

blood pressure

A client, who has been diagnosed with schizophrenia and is taking an antipsychotic medication, reports constant thirst, frequent urination, and feeling nauseous. The nurse knows that the client may: have undiagnosed diabetes. have the flu. be making up the symptoms simply to get attention. have a urinary tract infection.

have undiagnosed diabetes.

A black, male client routinely takes haloperidol to manage his psychosis. Recently, he presented to the health care provider's (HCP's) office with signs of tardive dyskinesia, and his HCP 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? "The olanzapine does not produce side effects in black males." "Black clients always experience tardive dyskinesia with antipsychotics." "The signs of tardive dyskinesia will diminish over time." "When compared with haloperidol, olanzapine has been associated with fewer extrapyramidal reactions in black clients."

"When compared with haloperidol, olanzapine has been associated with fewer extrapyramidal reactions in black clients."

A nurse is providing care for a client diagnosed with attention deficit hyperactivity disorder (ADHD) who has been taking methylphenidate for several months. When monitoring for potential adverse effects, the nurse should include what assessments? pupillary response sleep patterns orientation to person, place, and time sexual function

sleep patterns

A nurse caring for an elderly client should monitor the client for what as older clients are more sensitive to the side effects of CNS depressants? (Select all that apply.) Confusion Insomnia Hypotension Anxiety Bradycardia

Anxiety Insomnia Confusion

A client with dementia has been very agitated lately. What type of medication might the provider prescribe to help with the agitation? Antipsychotic Narcotic Antibiotic Antidepressant

Antipsychotic

Which client statement reflects an understanding of typical length of antipsychotic medication therapy? "I may always have to take this medication." "I will need medication if my hallucinations get worse." "If I take good care of myself, I'll be off medications soon." "Medications are less effective once my symptoms subside."

"I may always have to take this medication."

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? "He is prone to developing severe adverse effects if he stays on it any longer." "We need to check and see if he still has symptoms that require drug therapy." "He probably doesn't need the medication anymore since he is getting older." "The drug should be used for a specified period of time and then switched to another."

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

The nurse is teaching parents of a pediatric client diagnosed with ADHD. Teaching has been about the disorder and its treatment. The nurse determines that teaching has been effective when the parents state which? "We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention." "We should stop the medication after 2 months to see how effective it is in really controlling his symptoms." "We should set up regular routines for him but not worry if he violates the limits once in a while." "We need to be careful so he doesn't develop a substance abuse problem as he grows older."

"We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention."

The nurse administers chlorpromazine intramuscularly to a client. The nurse would maintain the client in bed for at least how long after administering the drug?

1/2 hour

A nurse is assessing a client who is receiving an antipsychotic agent for possible anticholinergic effects. What would the nurse assess? Neuroleptic malignant syndrome Nasal congestion Laryngospasm Arrhythmia

Nasal congestion

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

Temperature of 102°F

A young client has been prescribed an antipsychotic agent to relieve psychotic symptoms. Which goal of care is the priority?

The client will remain safe.

A nurse is teaching the client about CNS medications and how they are addictive. What is primary reason CNS medications are addictive?

The medication stimulates the brain's pleasure centers with enhanced neurotransmission of dopamine.

A client with schizophrenia has been taking haloperidol for several years. The care team and the client have collaborated and chosen to transition the client to an atypical antipsychotic in an effort to reduce adverse effects and maximize therapeutic effects. In order to reduce the client's risk of extrapyramidal effects during the transition from haloperidol to an atypical antipsycotic, the care team should implement which intervention? have a 2- to 3-week "drug holiday" between stopping the haloperidol and starting the atypical antipsychotic arrange for weekly electroconvulsive therapy (ECT) during the time of transition gradually taper the dose of haloperidol administer haloperidol and the atypical antipsychotic drug concurrently for 6 to 8 weeks

gradually taper the dose of haloperidol

A psychiatric nurse is discussing the advantages of atypical antipsychotics with the parents of a teenager who has been diagnosed with schizophrenia. When comparing these drugs with the older, typical antipsychotics, what advantage should the nurse cite? reduced adverse effects the possibility of oral administration lower cost absence of black box warnings

reduced adverse effects

A client has been treated with chlorpromazine for many years. The nurse observes that a client with a long history of chlorpromazine therapy demonstrates lip smacking and appears to be chewing continually. The nurse should recognize that this client is likely experiencing what adverse effect of the medication? neuroleptic malignant syndrome akathisia dystonias tardive dyskinesia

tardive dyskinesia

A client is taking antipsychotic medication and asks the nurse what dopamine is. What is a correct response by the nurse? "Dopamine is a neurotransmitter that deals with pleasure and reward in the brain." "Dopamine is an enzyme that regulates your temperature." "Dopamine is a part of the brain that controls your impulses and thoughts." "Dopamine is a medication that is given to fight infections and help with pain."

"Dopamine is a neurotransmitter that deals with pleasure and reward in the brain."

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

Disorganized and often bizarre thinking

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? He could tell his health care provider that the antipsychotics are not working and he needs a larger dose, or another medication added. He could stop taking his medication and see if he still has schizophrenia. 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. He could learn to teach other classes via online education so that he wouldn't have to talk out loud.

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.

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

Improving

Serotonin abnormalities are thought to be involved in the following disorders: Mental depression and sleep disorders. Epilepsy and strokes. Attention deficit disorder. Severe anxiety and hyperactivity.

Mental depression and sleep disorders.

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? hyperthyroidism renal calculi urinary tract infection diabetes mellitus

diabetes mellitus

Monitoring what laboratory test is most important in the first months of clozapine therapy? monthly creatinine levels weekly liver enzymes daily international normalized ratio (INR) regular complete blood counts

regular complete blood counts

A male client taking an antipsychotic medication calls the psychiatric clinic and tells the nurse he is stopping his medication. He states that he has taken it for a week and it doesn't work. What is the nurse's best response? "Antipsychotic medications take two to three weeks to demonstrate an effect on the disorder." "Antipsychotic medications take 6 to 10 weeks to demonstrate an effect on the disorder." "That's strange, most clients see a change after a dose or two." "Go ahead and stop the medication and I'll tell the health care provider about your decision."

"Antipsychotic medications take 6 to 10 weeks to demonstrate an effect on the disorder."

Monitoring of patients taking lithium includes periodically obtaining a serum lithium level; at what level may toxic reactions occur?

Greater than 1.5 mEq/mL

A nurse is charting on a client who has repetitive tongue and jaw movements, and a facial tick. What term could the nurse use to document these findings? Mandibular occlusion Tardive dyskinesia Extrapyramidal syndrome Hyperactivity of the face

Tardive dyskinesia

The nurse on the unit has several clients taking clozapine. For which client is clozapine, an antipsychotic, contraindicated? The 23-year-old with diabetes insipidus The 45-year-old with bone marrow depression The 32-year-old with osteoarthritis The 16-year-old with an upper respiratory infection

The 45-year-old with bone marrow depression

Which test should be scheduled every week for a patient taking clozapine? Serum lithium Blood glucose WBC count pH level

WBC count

What is the central nervous system stimulant of choice to treat narcolepsy? caffeine atomoxetine guarana modafinil

modafinil

A 24-year-old client is being seen in the emergency department because of a high fever and cannot move the right arm. During the history-taking process, The nurse discovers the client is being treated with an antipsychotic medication for schizophrenia. The nurse knows that what may be happening with this client? The client may have influenza A and will need to be put into isolation. The client may have broken his arm and not remember what happened because of his schizophrenia. The client may be having a neuroleptic malignant syndrome reaction to his antipsychotic medication and needs treatment immediately. The client may have neuroleptic malignant syndrome, which will self-resolve in a few hours after rest and Tylenol.

The client may be having a neuroleptic malignant syndrome reaction to his antipsychotic medication and needs treatment immediately.

When writing a plan of care for a client beginning drug therapy for treatment of schizophrenia, which might be an appropriate nursing diagnosis? Self-Care Deficit related to hyperactivity Impaired Physical Mobility related to sedation Risk for Injury related to hyperactivity Altered Tissue Perfusion related to hypertension

Impaired Physical Mobility related to sedation

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? Drinking frequent sips of water Calling the prescriber for an anticholingergic medication Discussing feelings of nervousness or restlessness Consuming the medication with food

Drinking frequent sips of water

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? The patient will take medications as prescribed. The patient will return for follow-up appointments when the patient believes they are necessary. The patient will exhibit decreased symptoms of acute psychosis. The patient will normalize sleeping and eating patterns.

The patient will take medications as prescribed.