Deck 4: Psychopharmacology

Question 1

A client with depression and substance abuse has an interrupted sleep pattern and demands a sedative. Which teaching would the nurse provide about sedative-hypnotics?

A) "Sedative-hypnotics are potentially addictive and gradually lose their effectiveness as one builds up tolerance to them."
B) "Sedative-hypnotics work best in combination with other techniques."
C) "Sedative-hypnotics are not permitted for use in clients with substance abuse disorders."
D) "Sedative-hypnotics are not as effective as the antidepressant medications for treating sleep disturbances."

Answer 1

"Sedative-hypnotics are potentially addictive and gradually lose their effectiveness as one builds up tolerance to them."

Question 2

In the treatment of anxiety disorders, benzodiazepines (such as Ativan and Xanax) are indicated for ______ use and have a ______ abuse potential.

A) short-term; high
B) long-term; high
C) short-term; low
D) long-term; low

Answer 2

short-term; high

Question 3

To which client would the nurse most likely administer a benzodiazepine?

A) One with alcohol withdrawals
B) One taking cough medicine
C) One with schizophrenia
D) One taking opioid pain agents

Answer 3

One with alcohol withdrawals

Question 4

Logan, age 8 years, takes methylphenidate (Ritalin) for attention deficit/hyperactivity disorder. His mother reports to the nurse that Logan has a very poor appetite, and she struggles to help him gain weight. Which teaching will the nurse provide?

A) Administer Logan's medication immediately after meals.
B) Give Logan's medication at bedtime.
C) Skip a dose of the medication when Logan does not eat anything.
D) Assure Logan's mother that Logan will eat when he is hungry.

Question 5

A client was recently admitted to the inpatient unit after a suicide attempt and has not responded to SSRIs or tricyclic antidepressants. The client asks the nurse, "Why can't monoamine oxidase inhibitors (MAOIs) be added to what I am on now?" Which response should the nurse make?

A) "Electroconvulsive therapy is your best option at this point."
B) "Combined use can lead to a life-threatening condition called hypertensive crisis."
C) "There is no reason why an MAOI couldn't be added to your therapy."
D) "They can't be used together because their mechanisms of action are very different."

Question 6

Which information should the nurse include in a staff education program about the history of psychopharmacology?

A) Some antipsychotic medications can cure mental illnesses.
B) Psychotropic medications are used as adjunctive therapy.
C) Antidepressants were the first type of mental health drugs.
D) Mood stabilizers help eliminate bipolar mental disorders.

Question 7

The client with schizophrenia has recently begun a new medication, clozapine (Clozaril). Which signs and symptoms of a potentially fatal side effect will the nurse teach the client about?

A) Blurring vision, dry mouth, and constipation
B) Sore throat, fever, and malaise
C) Tremor, shuffling gait, and rigidity
D) Fine tremor, tinnitus, and nausea

Question 8

A client with schizophrenia has recently begun a new medication, clozapine (Clozaril). Which potentially fatal side effect will the nurse teach the client about?

A) Agranulocytosis
B) Akathisia
C) Pseudoparkinsonism
D) Akinesia

Question 9

An aging client with chronic schizophrenia takes a beta-adrenergic blocking agent (propranolol) for hypertension and an antipsychotic. Given the combined side effects of these drugs, what teaching should the nurse provide?

A) "Make sure you concentrate on taking slow, deep, cleansing breaths."
B) "Watch your diet and try to engage in some regular physical activity."
C) "Rise slowly when you change position from lying to sitting or sitting to standing."
D) "Wear sunscreen and try to avoid midday sun exposure."

Question 10

Which medication would the nurse most likely administer to treat the extrapyramidal side effects of antipsychotic medications?

A) Diazepam (Valium)
B) Amitriptyline (Elavil)
C) Benztropine (Cogentin)
D) Methylphenidate (Ritalin)

Question 11

An elderly client has been diagnosed with major depression and is prescribed a selective serotonin reuptake inhibitor (SSRI). Which side effect would the nurse monitor for in this client?

A) Diarrhea
B) Pseudoparkinsonism
C) Hypertensive crisis
D) Hyponatremia

Question 12

As part of discharge teaching, which guideline regarding lithium therapy will the nurse plan to include?

A) Avoid foods high in tyramine.
B) Maintain a consistent sodium intake.
C) Consume at least 3,000 to 3,500 mL of fluid per day.
D) Watch for signs of tardive dyskinesia.

Question 13

The male client is experiencing a psychotic episode. He is in good physical health but has allergies to penicillin, prochlorperazine (Compazine), and bee stings. Which antipsychotic medication would be contraindicated for the client?

A) Haloperidol, because it is used only in elderly clients
B) Clozapine, because it is a typical, first generation antipsychotic
C) Risperidone, because it exacerbates symptoms of depression
D) Thioridazine, because of cross sensitivity among phenothiazines

Question 14

When used in combination with anxiolytic medication, alcohol leads to ______ effects, and caffeine leads to ______ effects.

A) increased; increased
B) increased; decreased
C) decreased; decreased
D) decreased; increased

Question 15

The client is taking selective serotonin reuptake inhibitor (SSRI). Which finding indicates the client is having a therapeutic effect from the SSRI?

A) Psychosis is reduced.
B) Neuropathy pain is relieved.
C) Panic attacks are prevented.
D) Obsessions are controlled.

Question 16

Which client would the nurse instruct to obtain routine blood-level monitoring?

A) A client taking lithium
B) A client taking buspirone
C) A client taking chlorpromazine
D) A client taking paroxetine

Question 17

Which information should the nurse share with the client about tricyclic antidepressant medications?

A) Strong or aged cheese should not be eaten while taking them.
B) Their full therapeutic potential may not be reached until 4 weeks.
C) They may cause hypomania or recent memory impairment.
D) They should not be given with antianxiety agents.

Question 18

The client with schizophrenia has recently begun a new medication, clozapine (Clozaril). Which laboratory result would reveal a potentially fatal side effect of this medication?

A) Elevated white blood cell count
B) Elevated bleeding times
C) Low platelet count
D) Low absolute neutrophil count

Question 19

A client was recently admitted to the inpatient unit after a suicide attempt and is prescribed a selective serotonin reuptake inhibitor (SSRI). Which sign or symptom would the nurse include in the teaching session about serotonin syndrome?

A) Constipation
B) Myoclonus
C) Hypothermia
D) Impotence

Question 20

A client is taking a monoamine oxidase inhibitor (MAOI). When teaching the client about diet, which foods will the nurse caution the client to avoid?

A) Pepperoni pizza and red wine
B) Bagels with cream cheese and tea
C) Apple pie and coffee
D) Potato chips and diet cola

Question 21

The physician prescribes an additional medication for a client taking an antipsychotic agent. The medication is to be administered "prn for EPS." When will the nurse plan to administer this medication?

A) When the client's white blood cell count falls below 3,000/mm³
B) When the client exhibits tremors and a shuffling gait
C) When the client reports having a dry mouth
D) When the client experiences a seizure

Question 22

The client is diagnosed with anxiety disorder. Which medication would the nurse administer for anxiety?

A) Chlorpromazine (Thorazine)
B) Clozapine (Clozaril)
C) Diazepam (Valium)
D) Methylphenidate (Ritalin)

Question 23

The nurse is preparing to assess a client before the physician prescribes a regimen of psychopharmacological therapy. Which components will the nurse assess? (Select all that apply.)

A) Medical history
B) Physical examination findings
C) Ethnocultural characteristics
D) Current medication
E) Marital status