Psych EAQ's
A depressed client is prescribed citalopram hydrobromide. Six days later the client tearfully says to the nurse, "I'm taking an antidepressant, but it's not working. I'm hopeless." What is the bestresponse by the nurse?
"it takes 2 or 3 weeks before it begins to relieve depression" - used to treat depression. Citalopram is in a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). It is thought to work by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance.
A client asks the nurse how psychotropic medications work. How does the nurse reply?
"these medications affect the chemicals used in communication between nerve cells" - Most psychotropic medications affect neurotransmitters such as dopamine and norepinephrine, which enter the synapses between neurons, allowing them to signal each other.
Nortriptyline three times a day is prescribed for a depressed client. When does the nurse expect a therapeutic response?
2-3 weeks - Antidepressant and Nerve pain medication - as with other tricyclics, optimal therapeutic effects take 2-3 weeks
Benztropine
Anti-Tremor Anticholinergic It can treat Parkinson's disease and side effects of other drugs
A client with schizophrenia is started on a regimen of chlorpromazine. After 10 days a shuffling gait, tremors, and some rigidity are apparent. Benztropine mesylate 2 mg by mouth daily is prescribed. What does the nurse remember when administering these medications together?
Both medications have a cholinergic-blocking action
A nurse is caring for several clients with major thought disorders such as schizophrenia. They are all being treated with neuroleptic drugs. How do these drugs act in the body to promote mental health?
By blocking access to dopamine receptors at the postsynaptic receptor site
Which toxic effect would the nurse find in a client who has overdosed on isocarboxazid?
Circulatory collapse - an antidepressant (monoamine oxidase inhibitor). This medication treats depression by restoring the balance of certain natural substances (neurotransmitters) in the brain.
What is the best drug of choice for treating obsessive-compulsive disorder?
Clomipramine - Antidepressant and Nerve pain medication It can treat obsessive-compulsive disorder
During an interview and assessment, a 60-year-old client reports to the nurse, "I've been using St. John's wort to try to feel more like myself again. I'm not sure whether it's going to work." The nurse will pursue an assessment related to the client's report of which symptom?
Depression - for mild to moderate depression and sometimes seasonal affective disorder, mild anxiety and sleep problems
Which drug worsens uncontrolled angle-closure glaucoma when used for the treatment of generalized anxiety disorder?
Duloxetine - an antidepressant medicine. It's used to treat depression and anxiety. It's also used to treat nerve pain, such as fibromyalgia, and can be used to treat stress urinary incontinence in women
Which medications are used over the long-term to treat generalized anxiety disorder (GAD)? Select all that apply.
Duloxetine Venlafaxine Escitalopram
Which drug is used to treat both generalized anxiety disorder and depression?
Duloxetine - an antidepressant medicine. It's used to treat depression and anxiety. It's also used to treat nerve pain, such as fibromyalgia, and can be used to treat stress urinary incontinence in women
An antianxiety medication is prescribed for an extremely anxious client. The client says, "I'm afraid to take this medication because I heard they're addictive." The nurse teaches the client that antianxiety medications have what properties?
Have the potential for physiologic and psychological dependence
Imipramine, 75 mg three times per day, is prescribed for a client. What nursing action is appropriate when this medication is being administered?
Having the client checked for increased intraocular pressure and teaching about glaucoma symptoms
A client with a history of methamphetamine use is admitted to the medical unit. What clinical manifestation does the nurse expect when assessing the client?
Increased HR - Stimulant It can treat ADHD. It can also help obese patients lose weight.
Which drugs may cause an increase in the serum clozapine level? Select all that apply.
Ketoconazole (anti fungal) Erythomycin
Which drug may lead to bruxism?
Levomilnacipran
Which statement about psychotherapeutic drugs in elderly clients requires correction?
Low serum levels of the drug are reported in elderly clients on psychotherapeutic drugs
Which antipsychotic drugs have the higher risk of causing tardive dyskinesia? Select all that apply.
Loxapine Haloperidol - tardive dyskinesia results in involuntary, repetitive body movements
Which medication is the first choice drug for the treatment of attention deficit hyperactivity disorder (ADHD)?
Methylphenidate - a central nervous system stimulant. It affects chemicals in the brain and nerves that contribute to hyperactivity and impulse control. Methylphenidate is used to treat attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), and narcolepsy.
After assessing a client, the nurse suspects that the client has shift-work sleep disorder (SWSD). Which medication would be prescribed to the client?
Modafinil - a unique nonamphetamine stimulant used to treat shift-work sleep disorder (SWSD). This drug promotes wakefulness in clients suffering from excessive sleepiness associated with SWSD.
What drug does a nurse anticipate that the primary healthcare provider will prescribe for a client demonstrating clinical manifestations associated with an opioid overdose?
Naloxone - a narcotic antagonist that displaces opioids from receptors in the brain, thereby reversing respiratory depression
Which atypical antipsychotics are approved for long-term use to prevent the recurrence of mood episodes in clients with bipolar disease? Select all that apply.
Olanzapine Ziprasidone Aripiprazole
A nurse notes that haloperidol is most effective for clients who exhibit which type of behavior?
Overactive - reduces emotional tension, excessive psychomotor activity, panic, and fear
Which drug is contraindicated in a pregnant client dx with bipolar disorder?
Paroxetine - an antidepressant of the selective serotonin reuptake inhibitor(SSRI) class. It is used to treat major depressive disorder, obsessive-compulsive disorder, panic disorder, social anxiety disorder, posttraumatic stress disorder, generalized anxiety disorder and premenstrual dysphoric disorder.
Which condition contraindicates the use of ginseng herbal therapy?
Pregnancy
A primary healthcare provider prescribes oxazepam for a client who is beginning to experience withdrawal symptoms while undergoing detoxification. What are the primary reasons that oxazepam is given during detoxification?
Reduces the anxiety-tremor state and prevents more serious withdrawal symptoms - Sedative It can treat anxiety, anxiety with depression, and symptoms of alcohol withdrawal.
Which drug would the nurse administer transdermally to treat a client with major depression?
Selegiline - used to help control the symptoms of Parkinson's disease and for depression
The primary healthcare provider prescribes a neuroleptic drug to a client diagnosed with schizophrenia. On what basis would the primary healthcare provider choose the drug?
Side effects - first generation antipsychotic drugs are also known as neuroleptics; the selection of these drugs are primarily based on side effects rather than therapeutic effects
A client has been taking 3 mg of risperidone twice a day for the past 8 days. At the follow-up appointment, the client reports tremors, shortness of breath, a fever, and sweating. What will the nurse do?
Take the clients VS and arrange for immediate transfer to a hospital - These clinical manifestations signal the presence of neuroleptic malignant syndrome; the cardinal sign of this condition is a high body temperature. Therefore the nurse first should document the hyperthermia and then arrange for immediate hospitalization.
client has been receiving lithium for the past 2 weeks for the treatment of bipolar disorder, manic phase. What will the nurse include in the teaching plan for this client?
The blood level of lithium must be checked every month - Lithium compounds, also known as lithium salts, are primarily used as a psychiatric medication. They are primarily used to treat bipolar disorder and treat major depressive disorder that does not improve following the use of antidepressants
A nurse is administering medications to clients on a psychiatric unit. What does the nurse identify as the reason that so many psychiatric clients are given the drug benztropine or trihexyphenidyl in conjunction with the phenothiazine-derivative neuroleptic medications?
They combat the extrapyramidal side effects of the neuroleptic drug.
Which client condition is contraindicated for prescribing clozapine?
bone marrow depression - Antipsychotic It can treat schizophrenia. It can also lower the risk of suicidal behavior in patients with schizophrenia or schizoaffective disorder. - can cause neutropenia, increasing susceptibility to infection
Which drug is contraindicated in clients with eating and seizure disorders?
bupropion - an antidepressant medication that works in the brain. It is approved for the treatment of major depressive disorder (MDD), seasonal affective disorder (SAD), and to help people quit smoking (smoking cessation).
Which condition is contraindicated for St. John's wort herbal therapy?
dementia
A client is receiving haloperidol for agitation, and the nurse is monitoring the client for side effects. Which response identified by the nurse is unrelated to an extrapyramidal tract effect?
hypertensive crisis
A client with the diagnosis of schizophrenia, paranoid type, has been receiving a phenothiazine drug. When the psychiatric daycare center plans a fishing trip, it will be important for the nurse to take which action
provide sunscreen - phenothiazines commonly cause photosensitivity - a group of nitrogen and sulfur-containing heterocyclic compounds, labeled as the first-generation typical antipsychotic medications used for the treatment of schizophrenia, bipolar disorders, control nausea and vomiting, and other psychotic disorders with delusional manifestations.
A client with an organic mental disorder becomes increasingly agitated and abusive. The primary healthcare provider prescribes haloperidol. For which potential adverse effects will the nurse monitor this client?
pseudoparkinsonism and urinary retention - haloperidol is an antipsychotic; SSRI's can cause tremors, ataxia, paresthesias, SIADH, DM, palpitations
Chlorpromazine (Thorazine)
psychiatric medication that belongs to the class of drugs called phenothiazine antipsychotics. It works by helping to restore the balance of certain natural substances in the brain.
A client has been receiving fluphenazine for several months. The nurse will assess the client for which side effects?
tremors and uncoordinated movements - an antipsychotic medication used to treat schizophrenia and psychotic symptoms such as hallucinations, delusions, and hostility.
