Pharmacology test 1-Psychotherapeutic drugs
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.) Anxiety Insomnia Bradycardia Confusion Hypotension
Anxiety, Insomnia, Confusion
A client, prescribed dextroamphetamine for attention deficit hyperactivity disorder (ADHD) has developed a common adverse effect of the medication since beginning therapy. Which initial intervention should the client be encouraged to implement?
Increase fiber intake. Explanation: Constipation is a common adverse effect of dextroamphetamine. A client who is experiencing constipation should be instructed to increase fiber in the diet. The client should not take a laxative before attempting to manage the problem with dietary modifications. The client should not be instructed to take diphenoxylate hydrochloride because it is an antidiarrheal agent. The client should not be given metronidazole since it is an anti-infective agent.
A 9-year-old child receives antipsychotics to manage her disease. The child's mother asks why her daughter receives such a high dose of the medication compared with an adult. How will the nurse explain this to the mother?
"Children usually have a faster metabolic rate than adults and may therefore require relatively high doses for their size and weight."
The nurse is preparing to provide education to a client who has been prescribed clozapine for schizophrenia. What is the most important aspect of client teaching?
Maintaining medication regimen
Aripiprazole (atypical antipsychotic) is thought to exert its effect on which receptor in the brain? (Select all that apply.) Serotonin Dopamine Norepinephrine Muscarinic Nicotinic
Serotonin and Dopamine
The nurse is caring for a client who takes clozapine. The nurse would be most concerned if this client displays what symptom?
Temperature of 102°F Explanation: The nurse would be most concerned about a client's temperature of 102 because clozapine can cause agranulocytosis.
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 is being treated with clozapine (Atypical Psychotherapeutic). What should the nurse monitor most closely?
White blood cell count
Antipsychotic drugs are contraindicated in clients with:
liver damage, coronary artery disease, severe hypertension, bone marrow depression, or cerebrovascular disease.
The nurse is providing education to a client who has been prescribed an antipsychotic drug. Which statement suggests that the client understands the typical length of medication therapy?
"I may always have to take this medication."
A client's medication history includes a long-term prescription for modafinil. Which assessment question should the nurse ask the client to confirm why the medication was prescribed?
"Have you ever been diagnosed with narcolepsy?" Explanation: Modafinil is used to treat narcolepsy and to improve wakefulness in other sleep disorders. It is not used to treat insomnia, somnambulism, or depression.
The child is diagnosed with attention deficit hyperactivity disorder (ADHD). Which medication will most likely be administered in conjunction with treatment?
central nervous system (CNS) stimulants
Anticonvulsive medications are sometimes used in the treatment of bipolar disorder. What other drug is used to treat bipolar disorder? A.Lithium B.Valium C.Olanzapine D.Quetiapine
A.Lithium Explanation: The mainstay for treatment of mania has always been lithium. Many other drugs are used successfully in treating bipolar disorders including aripiprazole, olanzapine, quetiapine, and ziprasidone, which are atypical antipsychotics; and lamotrigine, an antiepileptic agent. Valium is a sedative and antianxiety agent. Flexeril is a muscle relaxant. Restoril is a hypnotic agent.
A nurse should be able to differentiate between the typical and atypical antipsychotic. Which are classified as atypical antipsychotics? (Select all that apply.) Lithium (Eskalith) Aripiprazole (Abilify) Chlorpromazine (Thorazine) Prochlorperazine (Compazine) Clozapine (Clozaril)
Aripiprazole and Clozapine
An adolescent client has been taking dextroamphetamine for the treatment of attention deficit hyperactivity disorder (ADHD) for 3 years, achieving significant improvements in behavior and mood. When assessing the child during a scheduled follow-up appointment, the nurse should prioritize what physical assessment to monitor for a potential adverse reaction to the therapy?
Measurement of height and body weight
The nurse is monitoring a client who is receiving antipsychotic drug therapy. What behaviors would cause the nurse to suspect the client is demonstrating an extrapyramidal effect? Select all that apply. sits with back to the wall to keep others from "hurting me" inability to stay seated for any length of time repeated, involuntary twisting of the arms near-constant lip smacking reporting hearing "voices"
inability to stay seated for any length of time repeated, involuntary twisting of the arms near-constant lip smacking
The nurse is planning care for a client who has been prescribed a CNS stimulant. What should the nurse establish as the primary goal of therapy?
relieve the symptoms for which they were prescribed. Explanation: The main goal of therapy with CNS stimulants is to relieve symptoms of the disorders for which they are given. A secondary goal is to have clients use the drugs appropriately. Stimulants are often misused and abused by people who want to combat fatigue and delay sleep, such as long-distance drivers, students, and athletes. College students reportedly use stimulants as study aids. Use of stimulants for these purposes is not justified.
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?
sleep patterns Explanation: Because methylphenidate is a central nervous system (CNS) stimulant, it carries the potential to disturb sleep patterns. The client's pupillary response, orientation, and sexual function are less likely to be affected.
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
EKG Explanation: In addition to baseline physical data including height, weight, and vital signs, the nurse should prepare the patient for an ECG. This would be important for ruling out any cardiovascular abnormalities that CNS stimulants might exacerbate, especially in this patient who is 7 years old. An EMG measures the electrical activity of muscle and is used to differentiate between neuropathy and myopathy. This test is not indicated in this patient. An EEG is a recording of the electrical activity of the brain and is used to help identify a focus of disturbance in the brain. An EEG may be performed to evaluate narcolepsy, sleeping patterns, and sleep apnea. However, it would not be indicated in this patient with ADHD. EPS is similar to a cardiac catheterization and can monitor the entire conduction system with mapping of normal and abnormal pathways of the heart. This test would not be needed unless the patient had a serious cardiac condition.
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:
tardive dyskinesia