Schizophrenia Meds - Practice Questions
Lithium carbonate (Lithium) is to mania as clozapine (Clozaril) is to: a. anxiety b. depression c. psychosis d. akathisia
C. Psychosis
The nurse is discussing the side effects experienced by a female client taking antipsychotic medications. The client states "I haven't had a period in 4 months." What teaching should the nurse include in the plan of care? a. antipsychotic medications can cause a decrease in libido b. antipsychotic medications can interfere with the effects of birth control c. antipsychotic medications can cause amenorrhea, but ovulation still occurs d. antipsychotic medications can decrease RBC, leading to amenorrhea.
C. antipsychotic medications can cause amenorrhea but ovulation still occurs. If the client does not understand this, there is potential for pregnancy.
A client diagnosed with schizophrenia takes clozapine (clozaril) 200 mg QD. Lab results reveal RBC 4.7 million/mcL, ANC 800/mcL, and TSH 1.3 mIU/L. Which of the following should the nurse expect the physician to order? a. Levothyroxine sodium (Synthroid) 150 mcg QD b. Ferrous sulfate (Feosol) 100 mg TID c. discontinue clozapine d. discontinue clozapine, order Synthroid 150 mcg QD
C. discontinue clozapine. A normal adult level of absolute neutrophil count (ANC) is >1500/mcL.
A client has a history of schizophrenia, controlled by haloperidol. During an assessment, the nurse notes continuous restlessness. Which medication would the nurse expect the physician to prescribe? a. Haloperidol (haldol) b. Fluphenazine decanoate (Prolixin decanoate) c. Clozapine (clozaril) d. Benztropine mesylate (cogentin)
D. Benztropine mesylate (Cogentin) is an anticholinergic medication used for the treatment of EPS.
Which atypical antipsychotic medication has the highest potential for a client to experience serious side effects? a. Haloperidol (Haldol) b. Chlorpromazine (Thorazine) c. Risperidone (Risperidol) d. Clozapine (Clorazil)
D. Clozapine (Clorazil) Atypical antipsychotic that has severe side effects and is typically used as a last resort after failed medication trials. Diagnostic lab tests need to be performed weekly for 6 months, every other week for another 6 months, then monthly as long as clozapine is prescribed.
For the past year, a client has receive haloperidol (Haldol). The nurse administering the client's next dose notes a twitch on the right side of the client's face and tongue movements. Which nursing intervention takes priority? a. give haloperidol and benztropine (Cogentin) 1 mg IM prn per order. b. assess for other signs of hyperglycemia resulting from the use of haloperidol c. check the client's temperature and assess mental status d. hold haloperidol and call physician
D. Hold the Haldol and call the physician. These symptoms reflect Tardive Dyskenisia, a potentially irreversible side effect of antipsychotics.
The nurse documents that a client diagnosed with schizophrenia is experiencing anticholinergic side effects from long-term use of thioridazine. Which symptoms should the nurse note? a. Akinesia, dystonia, and pseudoparkinsonism b. Muscle rigidity, hyperpyrexia, and tachycardia c. Hyperglycemia and diabetes d. dry mouth, constipation, urinary retention
D. dry mouth, constipation, and urinary retention are signs of anticholinergic side effects. Thorazine has a high incidence of anticholinergic side effects.
A client has been prescribed ziprasidone (Geodon) 40 mg BID. Which of the following interventions are important related to the medication? (Select all that apply) a. Obtain a baseline EKG initially and periodically throughout treatment. b. Teach the client to take the medication with meals. c. Monitor the client's pulse because of the possibility of palpitations. d. Initiate seizure precautions and monitor closely. e. Watch for sings and symptoms of manic episode.
a, b, c. In rare potential it can elongate the QT interval. Needs to be taken with meals to be absorbed effectively. Palpitations can be a side effect and would be monitored.
A client is prescribed olanzapine (Zyprexa). Which of the following client statement indicates that teaching regarding the medication has been effective? (SATA) a. "I must in the facility and be monitored for 3 hours after receiving the injection" b. "I cannot drive for the remainder of the day" c. "I must register paperwork with the drug company" d. "I need to notify staff if I get over tired or confused" e. "After my first 3 injections, the risk of adverse effects decreases"
a. "I must in the facility and be monitored for 3 hours after receiving the injection" b. "I cannot drive for the remainder of the day" c. "I must register paperwork with the drug company" d. "I need to notify staff if I get over tired or confused" Because of the risk of post-injection delirium/sedation syndrome
Which of the following medications would be given to a client in the outpatient setting, diagnosed with schizophrenia experiencing non-adherence? (SATA) a. Olanzapine (Zyprexa) b. Ziprasidone (Geodon) c. Haloperidol (Haldol) d. Aripiprazole (Abilify) e. Paliperidone (Invega)
a. Olanzapine (Zyprexa) ~long-acting injections that can be given every 4 weeks to assist with medication adherence d. Aripiprazole (Abilify) ~long-acting injections that can be given every 4 weeks to assist with medication adherence e. Paliperidone (Invega) ~long-acting injection given every 3 months to assist with medication adherence
An instructor is teaching students about psychiatric medications. Which of the following antipsychotic medications needs to be given with food? (Select all that apply" a. Ziprasidone (Geodon) b. Vilazodone (Viibryd) c. Lurasidone (Latuda) d. Aripiprazole (Abilify) e. Asenapine (Saphris)
a. Ziprasidone (Geodon) c. Lurasidone (Latuda) both need at least 350 calories to facilitate absorption
A client recently prescribed fluphenazine (Prolixin) complaint to the nurse of severe muscle spasms. Vitals - BP:160/92, P: 110, T: 101.5. Which nursing intervention takes priority? a. Check the chart for a PRN order of benztropine mesylate (Cogentin) because of increased EPS. b. Hold the next dose of fluphenazine and call the physician immediately to report findings c. Schedule an examination with the client's physician to evaluate cardiovascular function d. Ask the client about any recreational drug use, and ask the physician to order a drug screen
b. Hold the next dose of fluphenazine and call the physician immediately to report findings Hold the does because NMS is a life-threatening situation
Which of the following antipsychotic medications could be administered on an inpatient psychiatric unit to prevent a client from cheeking, or hiding medication in the mouth? (SATA) a. Mirtazipine (Remeron SolTab) b. Olanzapine (Zyprexa) c. Paliperidone (Invega) d. Aripiprazole (Abilify) e. Asenapine (Saphris)
b. Olanzapine (Zyprexa) ~dissolve rapidly in saliva d. Aripiprazole (Abilify) ~dissolve rapidly in saliva e. Asenapine (Saphris) ~sublingual tab
A client is newly prescribe hydroxyzine (Atarax) 50 mg ohs and clozapine (Cozaril) 25 mg BID. Which is an appropriate nursing diagnosis? a. Risk for injury R/T serotonin syndrome b. Risk for injury R/T possible seizures c. Risk for injury R/T clozapine toxicity d. Risk for injury R/T depressed mood
b. Risk for injury R/T possible seizures a side effect of clozapine is that it lowers seizure threshold. The nurse should initiate seizure precautions.
A client prescribed quetiapine (Seroquel) 50 mg BID has nursing diagnosis of "Risk for injury R/T sedation." Which nursing intervention appropriately addresses this client's problem? a. Assess for homicidal and suicidal ideations b. Remove clutter from the environment to prevent injury c. Monitor orthostatic changes in BP or pulse d. Evaluate for auditory or visual hallucinations
b. remove clutter form environment to prevent injury
A woman is prescribed risperidone (Resperdal) 1 mg BID. At her 3-month follow-up, the client states. "I knew it was a possible side effect, but I can't believe I'm not getting my period anymore." Which is a priority teaching need? a. "Sometimes amenorrhea is a temporary side effect of medications and should resolve itself" b. "I am sure this was very scary for you. How long has it been since your last menstrual cycle?" c. "Although your menstrual cycle has stopped, there is still potential for you to become pregnant" d. "Maybe amenorrhea is not due to your medication. Have your menstrual cycles been regular in the past?"
c. "Although your menstrual cycle has stopped, there is still potential for you to become pregnant"
A client is exhibiting sedation, auditory hallucinations, dystonia, and grandiosity. The client was prescribed haloperidol (Haldol) 5 mg TID and trihexyphenidyl (Artane) 4 mg BID. Which statement about these medications is accurate? a. Artane will assist the client with sedation. b. Artane will assist the client with auditory hallucinations. c. Haldol will assist the client in decreasing grandiosity d. Haldol will assist the client with dystonia
c. Haldol will assist the client in decreasing grandiosity will assist the client in decreasing grandiosity
A client prescribed aripiprazole (Abilify) 10 mg Qam. The client complains to the nurse of sedation and dizziness. Vitals - BP: 100/60, P: 60, RR: 20, T: 97.4. Which nursing diagnosis takes priority? a. Risk for non-adherance R/T irritating side effects b. Knowledge deficit R/T new medication prescribed c. Risk for injury R/T orthostatic hypotension d. Activity intolerance R/T dizziness and drowsiness
c. Risk for injury R/T orthostatic hypotension Orthostatic hypotension is a side effect of aripiprazole. It is important for nurses to recognize that the client is at increased risk for injury
A client has an order for "ziprasidone (Geodon) 20 mg IM Q4h PRN for agitation with a maximum daily dose of 40 mg/day." Administration times are documented in the medication record. Which times indicate safe medication administration? a. 0800 and 1100 b. 1200, 1700, 2100 c. 0900, 1200, 2100 4. 1300 and 1700.
d. 1300 and 1700 4 hours apart and equal max daily dose
