Question 1

Which of the following medications carries the highest risk of QTc prolongation and therefore the need to monitor cardiac side effects most carefully?

Accepted Answer

Thioridazine (Mellaril) has been associated with a higher risk of QTc prolongation and potentially fatal cardiac arrhythmias, such as torsades de pointes, compared to other antipsychotics. Therefore, monitoring of cardiac side effects is especially important with this medication. Quetiapine and olanzapine have a lower risk of causing QTc prolongation, while risperidone falls somewhere in between.

Question 2

A client exhibiting which of the following antipsychotic side effects would require the nurse's immediate intervention?

Accepted Answer

Neuroleptic malignant syndrome is a potentially life-threatening side effect of antipsychotic medication and requires immediate medical attention. Impotence and drowsiness are common side effects and usually do not require immediate intervention. Parkinsonism can be managed with medication adjustments but does not require immediate intervention unless it is causing severe discomfort or distress for the client.

Question 3

Which of the following laboratory studies are routinely done on patients taking second generation antipsychotic medications?

Accepted Answer

Second generation antipsychotic medications can increase the risk of diabetes and glucose intolerance, making routine monitoring of serum glucose levels important for patients on these medications.

Question 4

Which of the following are extrapyramidal side effects that the nurse would assess as symptoms of dystonia?
Select all that apply.

Accepted Answer

Dystonia is a type of extrapyramidal side effect characterized by involuntary muscle contractions that cause twisting, repetitive movements, or abnormal postures. Symptoms of dystonia include pulling the neck down into the shoulders (A), forcing the back to arch and the neck to bend backward (B), and spasms of the neck and back (E). Inability to sit still (C) and decreased gastric motility and tachycardia (D) are not symptoms of dystonia.

Question 5

Because of the risk of postural hypotension, the client on clozapine (Clozaril) should be taught which of the following?

Accepted Answer

Postural hypotension is a potential side effect of clozapine, which is an antipsychotic medication. It is characterized by a sudden drop in blood pressure upon standing up from a lying or sitting position. Therefore, clients on clozapine should be advised to rise slowly from a lying position to prevent this from occurring.

Question 6

Which of the following questions would the nurse ask a woman to assess for hyperprolactinemia as a side effect of an antipsychotic medication?

Accepted Answer

Hyperprolactinemia, an increase in the hormone prolactin, can cause lactation and discharge from the breasts. This is a common side effect of antipsychotic medication. The other choices do not relate to hyperprolactinemia.

Question 7

The nurse instructs the clients to take the medications that are prescribed because the psychiatrist knows what is best for the client. How would the nurse's supervisor evaluate the effectiveness of the nurse's teaching?

Accepted Answer

The nurse's statement that the psychiatrist knows what is best for the client demonstrates a paternalistic attitude, which can contribute to client nonadherence. Clients are more likely to adhere to their medication regimen if they feel empowered to make decisions about their own care. The nurse should provide education about the benefits and risks of the medications and involve the client in the decision-making process.

Question 8

What is the primary rationale for the nurse asking a client on antidepressant medication about changes in sexual functioning?

Accepted Answer

Antidepressants can cause sexual dysfunction as a side effect, which can lead to nonadherence to medication. Therefore, it is important for the nurse to inquire about changes in sexual functioning to identify potential side effects and educate clients on how to manage them. Option A is not a primary rationale for asking about sexual functioning. Option B is true, but does not directly address the rationale for asking about sexual functioning. Option C is not true and is stigmatizing towards individuals with mental health issues.

Question 9

The nurse should monitor for which of the following in the client taking venlafaxine (Effexor)?

Accepted Answer

Venlafaxine can increase blood pressure, so the nurse should monitor the client’s blood pressure regularly. Tardive dyskinesia is a side effect commonly associated with long-term use of antipsychotic medication. Increased weight can be a side effect of other antidepressant medications, such as mirtazapine or paroxetine, but it is not a common side effect of venlafaxine. Prolonged QTc interval can be a potential side effect of certain medications, including some antidepressants, but it is not specifically associated with venlafaxine.

Question 10

The nurse tells a psychotic client with alcohol dependence not to drink while taking the antipsychotic medication. How would the nurse's supervisor evaluate this teaching statement?

Accepted Answer

The nurse's statement is correct in advising the client not to drink while taking the antipsychotic medication. However, the supervisor may evaluate the statement in terms of its effectiveness in motivating the client. The supervisor may point out that without addressing the alcohol dependence, the client may be less likely to comply with the medication regimen, regardless of the nurse's advice. Therefore, the nurse should consider addressing the alcohol dependence as part of the client's overall treatment plan.

Question 11

A family member says to the nurse, "I think that my sister needs more medication because she says she cannot sit still and is moving her legs back and forth." The client's risperidone (Risperdal) was recently increased to 10 mg daily. What is the correct nursing response?

Accepted Answer

The nurse should assess the client for the side effect of akathisia, which causes restlessness and an inability to sit still. This is a common side effect of antipsychotic medications, including risperidone. Checking with the client directly is the best way to determine if she is experiencing this side effect or if there is another reason for her restlessness.

Question 12

Which of the following would indicate that the client needs more teaching related to coping with constipation as a side effect of antipsychotic medications?

Accepted Answer

Regular use of enemas is not a recommended or sustainable method for coping with constipation. This indicates a need for further education on more appropriate, long-term strategies for managing constipation as a side effect of antipsychotic medications. Options A, B, and C demonstrate knowledge of appropriate strategies for preventing and managing constipation.

Question 13

The client received aripiprazole (Abilify) on admission to the inpatient unit with a diagnosis of schizophrenia, paranoid type. Which of the following would the nurse note as a sign that the aripiprazole is becoming effective?

Accepted Answer

Increased ability to establish and maintain eye contact and engage in conversation for longer periods of time are signs that the aripiprazole is becoming effective in addressing the positive symptoms of schizophrenia, such as paranoia and delusions. Options A, B, and D do not specifically relate to the symptoms of schizophrenia or the effectiveness of aripiprazole.

Question 14

The client tells the nurse that their spouse does not believe that medications are needed to improve depression. What nursing response would be most helpful in improving the client's medication adherence?

Accepted Answer

Including the spouse in medication teaching can help them understand the importance of medication adherence in treating depression and possibly improve their support for the client's medication regimen. The other choices may undermine the client's relationship with their spouse and do not address the issue of medication adherence.

Question 15

Which of the following would indicate to the nurse that fluoxetine (Prozac) is effective for the client with major depressive disorder?

Accepted Answer

The answer of Which of the following would indicate to...

Question 16

NCCAM has identified five major domains of complementary and alternative therapies. The fifth domain of energy therapies does not include:

Accepted Answer

The fifth domain of energy therapies includes Healing Touch, Bioelectromagnetic-based therapies, and Reiki. Ayurveda is not an energy therapy, but falls under the domain of whole medical systems.

Question 17

A client taking fluoxetine (Prozac) asks about adding herbal therapy to the treatment. The nurse advises that select serotonin reuptake inhibitors should not be taken with:
Select all that apply.

Accepted Answer

The answer of A client taking fluoxetine (Prozac) asks about...

Question 18

A client with high blood pressure is concerned about medication side effects and wants to try "natural" strategies to treat it. The nurse suggests:

Accepted Answer

Using a combination of visual imagery and music can help reduce blood pressure by promoting relaxation and reducing stress.

Question 19

Taking into consideration the client's level of motivation and ability to manage complex instructions, a nurse counsels a client seen for repeated episodes of anxiety to consider adding the use of complementary and/or alternative modalities to help manage the anxiety. The nurse may suggest which of the following CAM modalities?

Accepted Answer

Acupressure is a non-invasive, simple and easy-to-use CAM modality that involves applying pressure to specific points on the body to reduce anxiety symptoms. It can also be taught to the client for self-management. Kudzu and Gingko have not been proven effective for anxiety and running may not be appropriate for all clients depending on their physical ability and motivation.

Question 20

Knowing you are familiar with CAM modalities, a colleague has asked for your advice on dealing with the symptoms of the colleague's mother's recently diagnosed early-stage Alzheimer's disease. You discuss the potential for the use of certain dietary supplements and suggest that the mother's diet include:

Accepted Answer

Omega-3 fatty acids have been shown to have potential benefits for cognitive function, including reducing inflammation and oxidative stress in the brain. Ginkgo leaf extract may have some cognitive benefits, but research has been mixed and it may interact with certain medications. Kava has been linked to liver damage and is not recommended for use. Thiamine (vitamin B1) is important for overall health but has not been shown to specifically benefit cognitive function in Alzheimer's disease.

Quiz 4: Vulnerable Populations