Deck 17: Psychotherapeutic Drugs

Question 1

Which is a reason that SSRIs are more widely prescribed today than are tricyclic antidepressants (TCAs)?

A)SSRIs have fewer sexual adverse effects.
B)Unlike TCAs, SSRIs do not have drug-food interactions.
C)TCAs can cause serious cardiac toxicities if an overdose occurs.
D)SSRIs therapeutically respond faster than tricyclic antidepressants.

Answer 1

TCAs can cause serious cardiac toxicities if an overdose occurs.

Question 2

The wife of a patient who has been diagnosed with depression calls the office and says,"It's been an entire week since he started that new medicine for his depression,and there's no change! What's wrong with him?" Which statement is the best response from the nurse?

A)"The medication may not be effective for him.He may need to try another type."
B)"It may take up to 4 weeks to notice any therapeutic effects.Let's wait a little longer to see how he does."
C)"It sounds like he is tolerant to the drug.I'll check about increasing the dosage."
D)"Some patients never recover from depression.He may not respond to this therapy."

Answer 2

"It may take up to 4 weeks to notice any therapeutic effects.Let's wait a little longer to see how he does."

Question 3

A patient taking clozapine has shown marked improvement.Which statement by this patient indicates the experiencing of a common adverse effect of clozapine?

A)"I have been losing weight."
B)"I don't feel like eating at all."
C)"Look at how red my hands are."
D)"My mouth has been so dry lately."

Answer 3

"My mouth has been so dry lately."

Question 4

A patient has been taking the MAOI phenelzine (Nardil)for 6 months.The patient says he's going out to the local bar to meet a few friends for a beer.What important information should the nurse tell this patient?

A)Drinking beer is permitted as long as there is a designated driver.
B)He has no further dietary restrictions because he has taken the last dosage.
C)If he begins to experience a throbbing headache, rapid pulse, or nausea, he should stop drinking.
D)He needs to avoid foods with tyramine while on this medication.

Question 5

St.John's wort is a natural health product that some people use for the treatment of mild to moderate symptoms of depression.Use of St.John's wort is contraindicated in patients with which conditions?

A)Schizophrenia, Alzheimer's disease
B)Benign prostatic hypertrophy, diabetes
C)Dementia, emphysema
D)Heart disease, schizophrenia

Question 6

When administering an intramuscular injection of risperidone (Risperdal Consta),the nurse tells the patient that this medication dosage will be effective for how long?

A)24 hours
B)48 hours
C)1 week
D)2 weeks

Question 7

A 22-year-old female has been taking lithium (Carbolith)for 6 months.She has blood work every month,and the nurse assesses her for signs of toxicity.What are the indications of toxicity?

A)Serum lithium level of 0.8 mmol/L and excitability
B)Serum lithium level of 1.0 mmol/L and palpitations
C)Serum lithium level of 1.3 mmol/L and hypertension
D)Serum lithium level of 2.3 mmol/L and cardiac dysrhythmias

Question 8

A patient with a history of anxiety attacks is given a medication for these episodes.Which medication is appropriate for this problem?

A)fluphenazine
B)phenobarbital
C)bupropion
D)buspirone hydrochloride

Question 9

Which ethnic group often requires lower doses of benzodiazepines and tricyclic antidepressants?

A)Indigenous peoples
B)Asians
C)Latin Americans
D)Somalis

Question 10

Before beginning therapy with fluoxetine (Prozac),the nurse should assess for concurrent use of which medication?

A)acetylsalicylic acid
B)warfarin sodium
C)Diuretics
D)Nonsteroidal anti-inflammatory drugs

Question 11

A 44-year-old patient has been taking sertraline (Zoloft),a selective serotonin reuptake inhibitor (SSRI),for 4 months.The patient tells the nurse about having an interest in natural health products and wants to start taking St.John's wort.Which statement to the patient is an appropriate response from the nurse?

A)"That should be no problem."
B)"Soon you'll be able to stop taking the Zoloft!"
C)"Be sure to stop taking the herb if you notice a change in adverse effects."
D)"Taking St.John's wort with Zoloft may cause severe interactions and is not recommended."

Question 12

Which breakfast choice by a patient taking an MAOI indicates the need for additional teaching?

A)Orange juice
B)Fried eggs
C)Cheddar cheese omelet
D)French toast

Question 13

A patient has been taking haloperidol for 3 months for a psychotic disorder.Because the nurse is concerned about the development of extrapyramidal symptoms,the patient will be monitored for which symptom?

A)Cogwheel rigidity and blurred vision
B)Drowsiness and dizziness
C)Motor restlessness and muscle spasms
D)Dry mouth and constipation

Question 14

When the nurse is teaching the patient about monoamine oxidase inhibitors (MAOIs),which is important to emphasize?

A)Serum blood levels should be drawn every 2 weeks.
B)If drowsiness occurs, stop the medication immediately.
C)Drowsiness should decrease after the first few weeks of therapy.
D)Foods high in tyramine-such as cheese, beer, and wine-must be avoided.

Question 15

A nurse is monitoring a depressed patient who has just started antidepressant therapy.During which time period does the patient have the highest potential for self-injury and suicide?

A)At the beginning, before drug therapy is started
B)The period between the start of therapy and symptomatic improvement
C)Between 1 and 4 weeks of drug therapy
D)After 6 months of drug therapy

Question 16

Which statements are true regarding SSRIs? (Select all that apply.)

A)Foods and beverages containing tyramine should be avoided.
B)The nurse should monitor for extrapyramidal symptoms.
C)A potentially hazardous effect called serotonin syndrome may occur.
D)Therapeutic effects may not be seen for about 8 weeks after the medication is started.
E)If the patient has been on an MAOI, a 2- to 5-week or longer span of time should elapse before beginning an SSRI medication.
F)These drugs have anticholinergic effects, including constipation, urinary retention, dry mouth, and blurred vision.
G)SSRIs are associated with fewer side effects than are the older first-generation antidepressants.
H)St.John's Wort is often recommended to reduce the side effects that may occur with SSRIs.