Question 1

Which medication does not require periodic blood-level monitoring?

Accepted Answer

Paxil (paroxetine) does not require periodic blood-level monitoring.

Question 2

A client began taking lithium for the treatment of bipolar disorder approximately 1 month ago and asks why he has gained 12 lbs. since then. Which is the appropriate nursing response?

Accepted Answer

Weight gain is a common side effect of lithium, and it is important for the nurse to address the client's concerns and provide education on nutrition and exercise to manage weight gain safely. A is not a correct response as weight gain is a common side effect of lithium. B is not entirely accurate as lithium can cause changes in appetite and metabolism. D is not an appropriate response as it dismisses the client's concerns and does not provide support or education.

Question 3

A client with depression and substance abuse has an interrupted sleep pattern. She demands that her psychiatrist prescribe her a sedative. What teaching would the nurse provide about the rationale for the use of nonpharmacological interventions instead?

Accepted Answer

The nurse should educate the client about potential long-term consequences of using sedative-hypnotics, such as tolerance buildup and the risk of addiction. Instead, nonpharmacological interventions such as sleep hygiene education, relaxation techniques, and cognitive-behavioral therapy should be utilized in managing sleep disturbances in clients with depression and substance abuse.

Question 4

A client with schizophrenia has recently begun a new medication, clozapine (Clozaril). Which blood cell counts would reveal a potentially fatal side effect of this medication?

Accepted Answer

Clozapine can cause agranulocytosis, a potentially fatal side effect characterized by dangerously low levels of white blood cells (WBCs) and granulocytes. A WBC count of less than 3,000/mm³ and granulocytes less than 2,000/mm³ indicate this risk.

Question 5

A client was recently admitted to the inpatient unit after a suicide attempt and is prescribed a selective serotonin reuptake inhibitor (SSRI). The nurse teaches the client about serotonin syndrome. Which of the following is a symptom of serotonin syndrome?

Accepted Answer

The answer of A client was recently admitted to the...

Question 6

The nurse is assessing a client who has a diagnosis of schizophrenia and takes an antipsychotic agent daily. Which finding requires further nursing assessment?

Accepted Answer

A temperature of 101 degrees Fahrenheit requires further assessment as it could be a sign of infection or a potential side effect of the antipsychotic medication. Respirations of 22 beats per minute are within normal limits. Weight gain can be a common side effect of antipsychotic medication, but still should be monitored. Excess salivation is also a common side effect of antipsychotic medication, but not as concerning as a high fever.

Question 7

Which medication is most likely to be prescribed for the extrapyramidal side effects of antipsychotic medications?

Accepted Answer

Benztropine is an anticholinergic medication commonly prescribed to relieve the extrapyramidal side effects of antipsychotic medications such as dystonia, akathisia, and Parkinsonism. Diazepam is a benzodiazepine used to treat anxiety, amitriptyline is a tricyclic antidepressant used to treat depression, and methylphenidate is a stimulant used to treat attention-deficit hyperactivity disorder (ADHD). None of these medications directly treat extrapyramidal side effects.

Question 8

Which information suggests that caution is necessary in prescribing a benzodiazepine to an anxious client?

Accepted Answer

Benzodiazepines can be addictive and have a risk of misuse or abuse. Clients with a history of substance abuse, such as alcohol dependence, are at higher risk for developing benzodiazepine dependence. Therefore, caution should be exercised in prescribing these medications to clients with a history of addiction.

Question 9

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

Accepted Answer

Agranulocytosis is a potentially fatal side effect of clozapine. It is a blood disorder that can lead to a decreased white blood cell count, leaving the client susceptible to infections. Therefore, the nurse must monitor the client's white blood cell count regularly while taking clozapine.

Question 10

A 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?

Accepted Answer

Clozapine can cause agranulocytosis, which is a potentially fatal side effect characterized by a sore throat, fever, and malaise. It is essential to inform the client of these symptoms and advise them to seek medical attention immediately if they occur.

Question 11

A psychiatrist prescribes a MAOI for a client. When teaching the client about the effects of tyramine, which foods will the nurse caution the client to avoid?

Accepted Answer

Foods containing high amounts of tyramine should be avoided when taking MAOIs. Pepperoni pizza and red wine are both high in tyramine.

Question 12

In the treatment of anxiety disorders, benzodiazepines (such as Ativan and Xanax) are indicated for_________ use and have__________ abuse potential.

Accepted Answer

Benzodiazepines are typically prescribed for short-term use due to their high potential for abuse and dependence.

Question 13

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, "I heard about monoamine oxidase inhibitors (MAOIs). Why can't they be added to what I am on now? Wouldn't adding one help?" Which is the appropriate nursing response?

Accepted Answer

MAOIs can lead to a life-threatening condition called hypertensive crisis if combined with many other medications, including SSRIs and tricyclic antidepressants. It is important for the nurse to educate the client about the potential risks and to work with the healthcare provider to find a different treatment option. ECT may be an option in some cases, but it is not necessarily the best option for every client. Answers A and C are incorrect because they do not address the potential risks of combining MAOIs with other medications. Answer D is partially correct, but it does not provide the necessary information about the risks of combining these medications.

Question 14

A client was admitted with major depression that was a single episode and moderate. During her stay, she was started on Prozac (fluoxetine) at 40 mg orally every day. The nurse's discharge teaching should include all of the following except:

Accepted Answer

While it is important to emphasize the importance of continuing Prozac as prescribed and following up with outpatient therapy, the information about tyramine-containing foods is not relevant to the client's treatment plan for depression. This information is more pertinent for someone taking monoamine oxidase inhibitors (MAOIs) for depression.

Question 15

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

Accepted Answer

When used in combination with anxiolytic medication, alcohol and anxiolytic meds both increase CNS depression effects. When used in combination with anxiolytic medication, caffeine decreases the sedative effects of anxiolytic medication, leading to increased anxiety symptoms. Therefore, the answer is B - increased effects with alcohol and decreased effects with caffeine.

Question 16

A client was recently admitted to the inpatient unit after a suicide attempt. He has been placed on a tricyclic antidepressant. In terms of medication, what steps should be taken to maintain the client's safety when he is discharged?

Accepted Answer

Providing only a 1-week supply of medication with refills authorized only after a visit with his provider can help ensure ongoing medication management and monitoring of potential side effects or adverse reactions. A 6-month supply could increase the risk of overdose or misuse. Encouraging increased fluid intake and avoiding foods with tyramine may be relevant for other medications, but not for tricyclic antidepressants.

Question 17

A client has been diagnosed with major depression and is prescribed imipramine (Tofranil). What information specifically related to this class of antidepressants will the nurse plan to include in client and family education?

Accepted Answer

The answer of A client has been diagnosed with major...

Question 18

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?

Accepted Answer

Both propranolol and antipsychotics have the potential to lower blood pressure and cause orthostatic hypotension, which can lead to falls and other injuries. The nurse should instruct the client to rise slowly when changing positions to decrease the likelihood of this side effect. While options A and B may be beneficial for overall health, they do not specifically address the potential side effects of these medications. Option D is not necessarily relevant in this case as it does not relate to the client's medications or diagnoses.

Question 19

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

Accepted Answer

All of the above guidelines are important in the management of lithium therapy. Excessive intake of caffeine can increase lithium levels and potentially lead to toxicity. Maintaining consistent sodium intake can help regulate lithium levels, as sodium depletion can increase lithium excretion. Adequate fluid intake, at least 2,500 to 3,000 mL per day, is important in preventing dehydration and maintaining kidney function, as lithium can affect the kidneys.

Question 20

Which statement about the tricyclic group of antidepressant medications is accurate?

Accepted Answer

Tricyclic antidepressants often take several weeks to reach their full therapeutic potential, and patients should be advised of this when starting the medication. Choices A, C, and D are not accurate statements about the tricyclic group of antidepressants.

Quiz 4: Psychopharmacology

Which medication does not require periodic blood-level monitoring?

A client began taking lithium for the treatment of bipolar disorder approximately 1 month ago and asks why he has gained 12 lbs. since then. Which is the appropriate nursing response?

A client with depression and substance abuse has an interrupted sleep pattern. She demands that her psychiatrist prescribe her a sedative. What teaching would the nurse provide about the rationale for the use of nonpharmacological interventions instead?

A client with schizophrenia has recently begun a new medication, clozapine (Clozaril) . Which blood cell counts would reveal a potentially fatal side effect of this medication?

A client was recently admitted to the inpatient unit after a suicide attempt and is prescribed a selective serotonin reuptake inhibitor (SSRI) . The nurse teaches the client about serotonin syndrome. Which of the following is a symptom of serotonin syndrome?

The nurse is assessing a client who has a diagnosis of schizophrenia and takes an antipsychotic agent daily. Which finding requires further nursing assessment?

Which medication is most likely to be prescribed for the extrapyramidal side effects of antipsychotic medications?

Which information suggests that caution is necessary in prescribing a benzodiazepine to an anxious client?

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 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 psychiatrist prescribes a MAOI for a client. When teaching the client about the effects of tyramine, which foods will the nurse caution the client to avoid?

In the treatment of anxiety disorders, benzodiazepines (such as Ativan and Xanax) are indicated for_ use and have__ abuse potential.

A client was admitted with major depression that was a single episode and moderate. During her stay, she was started on Prozac (fluoxetine) at 40 mg orally every day. The nurse's discharge teaching should include all of the following except:

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

A client was recently admitted to the inpatient unit after a suicide attempt. He has been placed on a tricyclic antidepressant. In terms of medication, what steps should be taken to maintain the client's safety when he is discharged?

A client has been diagnosed with major depression and is prescribed imipramine (Tofranil) . What information specifically related to this class of antidepressants will the nurse plan to include in client and family education?

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?

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

Which statement about the tricyclic group of antidepressant medications is accurate?