Deck 16: Psychotherapeutic Drugs

Question 1

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 of the following statements is the best response by 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 1

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

Question 2

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 of the following conditions?

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

Answer 2

Schizophrenia and Alzheimer's disease

Question 3

A patient with the diagnosis of schizophrenia is hospitalized and is taking chlorpromazine (Thorazine).He has shown marked improvement.Which of the following statements by this patient indicates that he is experiencing a common adverse effect of chlorpromazine?

A)"I can't sleep at night."
B)"I feel hungry all the time."
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 haloperidol for 3 months for a psychotic disorder.Because the nurse is concerned about the development of extrapyramidal symptoms (EPS),the patient will be monitored for which of the following?

A)Cogwheel rigidity and blurred vision
B)Drowsiness and dizziness
C)Tremors and muscle twitching
D)Dry mouth and constipation

Question 5

Which of the following breakfast choices by a patient taking a monoamine oxidase inhibitor (MAOI)indicates the need for additional teaching?

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

Question 6

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 time 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 7

A 44-year-old patient has been taking sertraline (Zoloft),a selective serotonin reuptake inhibitor (SSRI)for 4 months.She tells the nurse she has been interested in natural health products and wants to start taking St.John's wort.Which statement below is an appropriate response for 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 8

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

A)midazolam (Versed)
B)phenobarbital
C)bupropion (Wellbutrin)
D)buspirone (BuSpar)

Question 9

A patient has been taking the monoamine oxidase inhibitor (MAOI)phenelzine (Nardil)for 6 months.His physician has discontinued the medication,and the patient says he's going out to the local bar to celebrate.What important information should the nurse tell this patient?

A)Drinking beer is permitted as long as he has 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)Because the drug remains in the body for up to 2 weeks after it has been discontinued,he needs to avoid foods high in tyramine for 2 weeks.

Question 10

Which of the following statements are true regarding selective serotonin reuptake inhibitors (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 a monoamine oxidase inhibitor,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 the older first-generation antidepressants.
H)Cogentin is often also prescribed to reduce the side effects that may occur.

Question 11

When the nurse is teaching the patient about tricyclic antidepressants,which of the following 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 12

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 indications of toxicity?

A)Serum lithium level 0.8 mEq/L and excitability
B)Serum lithium level 1.0 mEq/L and palpitations
C)Serum lithium level 1.5 mEq/L and hypertension
D)Serum lithium level 2.5 mEq/L and cardiac dysrhythmias

Question 13

Before beginning therapy with amitriptyline (Elavil),the nurse should assess for concurrent use of which of the following types of medications?

A)acetylsalicylic acid (Aspirin)
B)warfarin (Coumadin)
C)Diuretics
D)Nonsteroidal anti-inflammatory drugs

Question 14

Which of the following is a reason that selective serotonin reuptake inhibitors (SSRIs)are more widely prescribed today than are tricyclic antidepressants (TCAs)?

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

Question 15

Which of the following ethnic groups often require lower doses of benzodiazepines and tricyclic antidepressants?

A)Aboriginal peoples
B)Asians
C)Hispanics
D)Somalis

Question 16

When administering an intramuscular injection of hydroxyzine (Atarax),which of the following does the nurse need to remember?

A)Administer it with lidocaine (Xylocaine)to reduce local irritation.
B)Inject the medication over 2 minutes to reduce irritation.
C)Apply ice to the site after the injection to enhance absorption.
D)Use the Z-track method to prevent tissue injury at the site of injection.