Deck 4: Biological Basis for Understanding Psychopharmacology

Question 1

Priority teaching for a patient taking clozapine (Clozaril) should include which instruction?

A) Report sore throat and fever immediately.
B) Avoid foods high in polyunsaturated fat.
C) Use water-based lotions for rashes.
D) Avoid unprotected sex.

Answer 1

Report sore throat and fever immediately.

Question 2

A nurse should assess a patient taking a medication with anticholinergic properties for inhibited function of the:

A) parasympathetic nervous system.
B) sympathetic nervous system.
C) reticular activating system.
D) medulla oblongata.

Answer 2

parasympathetic nervous system.

Question 3

A nurse administers a medication that potentiates the action of gamma-aminobutyric acid (GABA). Which finding would be expected?

A) Reduced anxiety
B) Improved memory
C) More organized thinking
D) Fewer sensory perceptual alterations

Answer 3

Reduced anxiety

Question 4

The nurse wants to assess for disturbances in circadian rhythms in a patient admitted for major depressive disorder. Which question best implements this assessment?

A) "Do you ever see or hear things that others do not?"
B) "Do you have problems with short-term memory?"
C) "What are your worst and best times of day?"
D) "How would you describe your thinking?"

Question 5

A patient asks a nurse, "What are neurotransmitters? My doctor says mine are out of balance." The best reply would be:

A) "You must feel relieved to know that your problem has a physical basis."
B) "Neurotransmitters are chemicals that pass messages between brain cells."
C) "It is a high-level concept to explain. You should ask the doctor to tell you more."
D) "Neurotransmitters are substances we eat daily that influence memory and mood."

Question 6

A patient has disorganized thinking associated with schizophrenia. Neuroimaging would most likely show dysfunction in which part of the brain?

A) Brainstem
B) Cerebellum
C) Temporal lobe
D) Prefrontal cortex

Question 7

The therapeutic action of monoamine oxidase inhibitors (MAOIs) blocks neurotransmitter reuptake, causing:

A) increased concentration of neurotransmitters in the synaptic gap.
B) decreased concentration of neurotransmitters in serum.
C) destruction of receptor sites.
D) limbic system stimulation.

Question 8

The parent of an adolescent diagnosed with schizophrenia asks a nurse, "My child's doctor ordered a positron-emission tomography (PET) scan. What is that?" Select the nurse's best reply.

A) "PET uses a magnetic field and gamma waves to identify problems areas in the brain. Does your teenager have any metal implants?"
B) "It's a special type of x-ray image that shows structures of the brain and whether a brain injury has ever occurred."
C) "PET is a scan that passes an electrical current through the brain and shows brain wave activity. PET can help diagnose seizures."
D) "PET is a special scan that shows blood flow and activity in the brain."

Question 9

A patient is hospitalized for major depressive disorder. Of the medications listed, a nurse can expect to provide the patient with teaching about:

A) chlordiazepoxide (Librium).
B) fluoxetine (Prozac).
C) clozapine (Clozaril).
D) tacrine (Cognex).

Question 10

A patient has anxiety, increased heart rate, and fear. The nurse would suspect the presence of a high concentration of which neurotransmitter?

A) GABA
B) Histamine
C) Acetylcholine
D) Norepinephrine

Question 11

A patient has symptoms of acute anxiety related to the death of a parent in an automobile accident 2 hours earlier. The nurse should anticipate administering a medication from which group?

A) Tricyclic antidepressants
B) Atypical antipsychotics
C) Anticonvulsants
D) Benzodiazepines

Question 12

A nurse can anticipate anticholinergic side effects are likely to occur when a patient is taking:

A) lithium (Lithobid).
B) buspirone (BuSpar).
C) risperidone (Risperdal).
D) fluphenazine (Prolixin).

Question 13

A nurse cares for patients taking various medications, including buspirone (BuSpar), haloperidol (Haldol), trazodone (Desyrel), and phenelzine (Nardil). The nurse will order a special diet for the patient taking:

A) buspirone.
B) haloperidol.
C) trazodone.
D) phenelzine.

Question 14

A drug causes muscarinic-receptor blockade. A nurse will assess the patient for:

A) dry mouth.
B) gynecomastia.
C) pseudoparkinsonism.
D) orthostatic hypotension.

Question 15

A patient taking medication for mental illness develops restlessness and an uncontrollable need to be in motion. A nurse can correctly analyze that these symptoms are related to which drug action?

A) Anticholinergic effects
B) Dopamine-blocking effects
C) Endocrine-stimulating effects
D) Ability to stimulate spinal nerves

Question 16

A patient begins therapy with a first generation antipsychotic medication. What teaching should a nurse provide related to the drug's strong dopaminergic effect?

A) Chew sugarless gum.
B) Increase dietary fiber.
C) Arise slowly from bed.
D) Report muscle stiffness.

Question 17

A patient has dementia. The health care provider wants to make a differential diagnosis between Alzheimer disease and multiple infarctions. Which diagnostic procedure should a nurse expect to prepare the patient for first?

A) Computed tomography (CT) scan
B) Positron emission tomography (PET) scan
C) Functional magnetic resonance imaging (fMRI)
D) Single-photon emission computed tomography (SPECT) scan

Question 18

A patient hospitalized with a mood disorder has aggression, agitation, talkativeness, and irritability. A nurse begins the care plan based on the expectation that the health care provider is most likely to prescribe a medication classified as a(n):

A) anticholinergic.
B) mood stabilizer.
C) psychostimulant.
D) tricyclic antidepressant.

Question 19

On the basis of current knowledge of neurotransmitter effects, a nurse anticipates that the treatment plan for a patient with memory difficulties may include medications designed to:

A) inhibit GABA production.
B) increase dopamine sensitivity.
C) decrease dopamine at receptor sites.
D) prevent destruction of acetylcholine.

Question 20

A patient has delusions and hallucinations. Before beginning treatment with a psychotropic medication, the health care provider wants to rule out the presence of a brain tumor. For which test will a nurse need to prepare the patient?

A) Cerebral arteriogram
B) Functional magnetic resonance imaging (fMRI)
C) Computed tomography (CT) scan or magnetic resonance imaging (MRI)
D) Positron emission tomography (PET) or single-photon emission computed tomography (SPECT)

Question 21

A patient's spouse, who is a chemist, asks a nurse how serotonin reuptake inhibitors (SSRIs) lift depression. The nurse should explain that SSRIs:

A) destroy increased amounts of neurotransmitters.
B) make more serotonin available at the synaptic gap.
C) increase production of acetylcholine and dopamine.
D) block muscarinic and alpha1-norepinephrine receptors.

Question 22

A patient has taken many conventional antipsychotic drugs over the years. The health care provider, who is concerned about early signs of tardive dyskinesia, prescribes risperidone (Risperdal). A nurse planning care for this patient understands that second generation antipsychotics:

A) are less costly.
B) have higher potency.
C) are more readily available.
D) produce fewer motor side effects.

Question 23

The spouse of a patient diagnosed with schizophrenia asks, "Which neurotransmitters are more active when a person has schizophrenia?" The nurse should state, "The current thinking is that the thought disturbances are related to increased activity of: (Select all that apply.)

A) GABA."
B) substance P."
C) histamine."
D) dopamine."
E) norepinephrine."

Question 24

The laboratory report for a patient taking clozapine (Clozaril) shows a white blood cell count of 3000 mm³ and a granulocyte count of 1500 mm³. The nurse should:

A) report the laboratory results to the health care provider.
B) give the next dose of the medication as prescribed.
C) administer aspirin and force fluids.
D) repeat the laboratory tests.

Question 25

A nurse prepares to administer an antipsychotic medication to a patient diagnosed with schizophrenia. Additional monitoring of the medication's effects and side effects will be most important if the patient is also diagnosed with which health problem? (Select all that apply.)

A) Parkinson disease
B) Graves disease
C) Osteoarthritis
D) Epilepsy
E) Diabetes

Question 26

An individual is experiencing problems associated with memory. Which cerebral structures are most likely to be involved in this deficit? (Select all that apply.)

A) Prefrontal cortex
B) Occipital lobe
C) Temporal lobe
D) Parietal lobe
E) Basal ganglia

Question 27

A nurse caring for a patient taking a selective serotonin reuptake inhibitor (SSRI) will develop outcome criteria related to:

A) mood improvement.
B) logical thought processes.
C) reduced levels of motor activity.
D) decreased extrapyramidal symptoms.

Question 28

A nurse administering psychotropic medications should be prepared to intervene when giving a drug that blocks the attachment of norepinephrine to alpha₁ receptors because the patient may experience:

A) increased psychotic symptoms.
B) severe appetite disturbance.
C) orthostatic hypotension.
D) hypertensive crisis.