Question 1

When used in combination with anxiolytic medication,alcohol leads to ____ effects and caffeine leads to ____ effects.&#10;A)Increased;increased&#10;B)Increased;decreased&#10;C)Decreased;decreased&#10;D)Decreased;increased

Accepted Answer

When used in combination with anxiolytic medication, alcohol can lead to increased sedation and drowsiness, which can be dangerous. On the other hand, caffeine can reduce the effectiveness of anxiolytic medication, leading to decreased sedation and potentially increased anxiety. Therefore, the best choice would be B, as alcohol leads to increased effects and caffeine leads to decreased effects when used in combination with anxiolytic medication.

Question 2

A client began taking lithium for the treatment of bipolar disorder approximately 1 month ago and asks why he has gained 12 pounds since then.Which is the most appropriate nursing response?&#10;A)&#34;I'm surprised you have gained;weight loss is the typical pattern when taking lithium.&#34;&#10;B)&#34;Your weight gain is more likely related to food intake than medication.&#34;&#10;C)&#34;Weight gain is a common,but troubling side effect.Let's talk about some strategies for safely improving your nutrition and exercise habits.&#34;&#10;D)&#34;There's not much you can do about the weight gain.It's better than being emotionally unstable though.&#34;

Accepted Answer

Weight gain is a known side effect of lithium, and the client's concern should be addressed in a supportive and informative manner. Option A is incorrect as weight gain is a known side effect of lithium. Option B is incorrect as it does not address the client's concern of weight gain associated with the medication. Option D is incorrect as it is dismissive of the client's concern and focuses solely on the benefits of the medication. Option C is the best choice as it acknowledges the client's concern, provides information about the medication side effects, and offers strategies to address the issue.

Question 3

A client with schizophrenia has recently begun a new medication,clozapine (Clozaril).About which potentially fatal side effect will the nurse teach the client?&#10;A)Agranulocytosis&#10;B)Akathisia&#10;C)Dystonia&#10;D)Akinesia

Accepted Answer

Clozapine has a black box warning for agranulocytosis, a potentially fatal side effect that can result in severe infection and death. The nurse should educate the client about the importance of regular blood monitoring and to report any signs of infection or illness immediately. Akathisia, dystonia, and akinesia are all side effects of antipsychotic medication but are not potentially fatal.

Question 4

An aging client with chronic schizophrenia takes an antipsychotic and propranolol,a beta-adrenergic blocking agent,for hypertension.Given the combined side effects of these drugs,which client teaching should the nurse provide?

A)"Make sure you concentrate on taking slow,deep,cleansing breaths."
B)"Watch your diet and try to engage in some regular physical activity."
C)"Rise slowly when you change position from lying to sitting or sitting to standing."
D)"Wear sunscreen and try to avoid midday sun exposure."

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Accepted Answer

Both antipsychotics and beta-adrenergic blocking agents can cause orthostatic hypotension, which is a sudden drop in blood pressure when changing position from lying to sitting or sitting to standing. Therefore, the nurse should instruct the client to rise slowly to avoid falls and dizziness. While options A, B, and D are important components of general health education, they are not specifically related to the combined side effects of these medications.

Question 5

A client with schizophrenia has recently begun a new medication,clozapine (Clozaril).Which blood cell counts should reveal a potentially fatal side effect of this medication? A)WBCs >3000/mm³;granulocytes >1500/mm³ B)WBCs <3000/mm³;granulocytes >1500/mm³ C)WBCs >3000/mm³;granulocytes <1500/mm³ D)WBCs <3000/mm³;granulocytes <1500/mm³

Accepted Answer

Clozapine can cause agranulocytosis, a potentially fatal side effect characterized by a significant decrease in white blood cell (WBC) count and granulocytes. Therefore, WBCs <3000/mm^3 and granulocytes <1500/mm^3 indicate this condition.

Question 6

A psychiatrist prescribes an MAOI for a client.When teaching the client about the effects of tyramine,which foods will the nurse caution the client to avoid?&#10;A)Pepperoni pizza and red wine&#10;B)Bagels with cream cheese and tea&#10;C)Apple pie and coffee&#10;D)Potato chips and diet cola

Accepted Answer

MAOIs interact with tyramine-rich foods and drinks, causing dangerous elevations in blood pressure. Foods to be avoided include aged cheese, smoked meats (such as pepperoni), red wine, and some fermented foods like sauerkraut. Bagels with cream cheese and tea, apple pie and coffee, and potato chips and diet cola are not particularly high in tyramine.

Question 7

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 includes all of the following symptoms except:

A)Change in mental status.
B)Myoclonus.
C)Blood pressure lability.
D)Priapism.

Accepted Answer

Priapism (prolonged and painful erection) is not a symptom of serotonin syndrome. The other symptoms listed (change in mental status, myoclonus, and blood pressure lability) are all potential symptoms of serotonin syndrome.

Question 8

A client was recently admitted to the inpatient unit after a suicide attempt.He has been placed on a tricyclic antidepressant.Which action should the nurse implement to maintain the client's safety when he is discharged?

A)Provide a 6-month supply to ensure long-term compliance.
B)Provide a 1-week supply of medication with refills authorized only after he visits his provider.
C)Encourage him to increase fluid intake to counteract the common side effect of diarrhea.
D)Educate him not to eat foods that contain tyramine.

Accepted Answer

Providing a 6-month supply of medication can put the client at risk for overdose or misuse. Providing a 1-week supply with refills authorized only after the client visits his provider ensures that the client is monitored for medication effectiveness and any potential side effects. Encouraging increased fluid intake is not relevant to maintaining the client's safety when he is discharged on a tricyclic antidepressant. Educating the client not to eat foods containing tyramine is relevant for clients taking monoamine oxidase inhibitors, not tricyclic antidepressants.

Question 9

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

A)"Electroconvulsive therapy (ECT)is your best option at this point."
B)"Combined use can lead to a life-threatening condition called a hypertensive crisis."
C)"There is no reason why an MAOI couldn't be added to your therapy."
D)"They can't be used together because their mechanisms of action are very different."

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Accepted Answer

MAOIs have potentially dangerous interactions with many other medications and foods, and combining them with SSRIs and tricyclic antidepressants can lead to serotonin syndrome or hypertensive crisis, a potentially life-threatening condition. Therefore, the nurse should inform the client of the risks involved in combining MAOIs with their current medication regimen. A is incorrect because ECT is not necessarily the best or only option. C and D are incorrect because MAOIs should not be added to the medication therapy without careful consideration of the risks and benefits.

Question 10

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

A)"Continue taking Prozac as prescribed.You will continue to see improvement over the next few weeks."
B)"Make sure that you follow up with outpatient psychotherapy as you and the social worker have arranged."
C)"You may be able to discontinue the medication within 6 months to 1 year,but only under a doctor's supervision.However,there is a chance of recurring episodes."
D)"You should avoid foods with tyramine,including beer,beans,processed meats,and red wine."

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Accepted Answer

The discharge teaching should include information on potential drug interactions and dietary restrictions with medications like Prozac. Therefore, all options except for D are appropriate for discharge teaching. Choice D is incorrect because tyramine is not contraindicated with Prozac. Tyramine is a concern for individuals taking MAOIs (monoamine oxidase inhibitors), but not for individuals taking SSRIs (selective serotonin reuptake inhibitors) like Prozac.

Question 11

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

A)The medication may cause dry mouth.
B)The medication may cause nausea.
C)The medication should not be discontinued abruptly.
D)The medication may cause photosensitivity.

Accepted Answer

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

Question 12

Which statement about tricyclic antidepressant medications is accurate?&#10;A)Strong or aged cheese should not be eaten while taking them.&#10;B)Their full therapeutic potential may not be reached until 4 weeks.&#10;C)They may cause hypomania or recent memory impairment.&#10;D)They should not be given with antianxiety agents.

Accepted Answer

The answer of Which statement about tricyclic antidepressant medications is...

Question 13

As part of discharge teaching,which guideline regarding lithium therapy will the nurse plan to include?&#10;A)Avoid excessive use of beverages containing caffeine.&#10;B)Maintain a consistent sodium intake.&#10;C)Consume at least 2500 to 3000 mL of fluid per day.&#10;D)All of the above

Accepted Answer

The answer of As part of discharge teaching,which guideline regarding...

Question 14

A client with schizophrenia has recently begun a new medication,clozapine (Clozaril).About which signs and symptoms of a potentially fatal side effect will the nurse teach the client?&#10;A)Blurring vision and muscular weakness&#10;B)Sore throat,fever,and malaise&#10;C)Tremor,shuffling gait,and rigidity&#10;D)Fine tremor,tinnitus,and nausea

Accepted Answer

The answer of A client with schizophrenia has recently begun...

Question 15

Which medication does not require periodic blood-level monitoring?&#10;A)Eskalith (lithium carbonate)&#10;B)Depakote (valproic acid)&#10;C)Clozaril (clozapine)&#10;D)Paxil (paroxetine)

Accepted Answer

The answer of Which medication does not require periodic blood-level...

Question 16

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

A)"Sedative-hypnotics are potentially addictive and gradually lose their effectiveness as one builds up tolerance to them."
B)"Sedative-hypnotics work best in combination with other techniques."
C)"Sedative-hypnotics are not permitted for use in patients with substance abuse disorders."
D)"Sedative-hypnotics are not as effective as the antidepressant medications for treating sleep disturbances."

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Accepted Answer

The answer of A client with depression and substance abuse...

Question 17

Which information suggests caution is necessary in prescribing a benzodiazepine to an anxious client?&#10;A)The client has a history of alcohol dependence.&#10;B)The client has a history of diabetes mellitus.&#10;C)The client has a history of schizophrenia.&#10;D)The client has a history of hypertension.

Accepted Answer

The answer of Which information suggests caution is necessary in...

Question 18

The nurse is assessing a client who has a diagnosis of Schizophrenia and takes an antipsychotic agent daily.Which finding requires further nursing assessment?&#10;A)Respirations of 22 beats/minute&#10;B)Weight gain of 8 pounds in 2 months&#10;C)Temperature of 101&#176;F&#10;D)Excess salivation

Accepted Answer

The answer of The nurse is assessing a client who...

Question 19

In the treatment of anxiety disorders,benzodiazepines (e.g. ,Ativan,Xanax)are indicated for____ use and have____ abuse potential.&#10;A)Short-term;high&#10;B)Long-term;high&#10;C)Short-term;low&#10;D)Long-term;low

Accepted Answer

The answer of In the treatment of anxiety disorders,benzodiazepines (e.g....

Question 20

Which medication is most likely to be prescribed for the extrapyramidal side effects of antipsychotic medications?&#10;A)Diazepam (Valium)&#10;B)Amitriptyline (Elavil)&#10;C)Benztropine (Cogentin)&#10;D)Methylphenidate (Ritalin)

Accepted Answer

The answer of Which medication is most likely to be...

Question 21

A client is diagnosed with Anxiety Disorder.Which medication is prescribed for anxiety?&#10;A)Chlorpromazine (Thorazine)&#10;B)Clozapine (Clozaril)&#10;C)Diazepam (Valium)&#10;D)Methylphenidate (Ritalin)

Accepted Answer

The answer of A client is diagnosed with Anxiety Disorder.Which...

Question 22

A client is experiencing a psychotic episode.The client has allergies to penicillin,prochlorperazine (Compazine),and bee stings.Which antipsychotic medication is contraindicated for this client?&#10;A)Haloperidol (Haldol)&#10;B)Clozapine (Clozaril)&#10;C)Risperidone (Risperdal)&#10;D)Thioridazine (Mellaril)

Accepted Answer

The answer of A client is experiencing a psychotic episode.The...

Question 23

A physician prescribes an additional medication for a client taking an antipsychotic agent.The medication is to be administered "prn for EPS." Which is the most appropriate nursing assessment to determine when to give this medication?

A)WBCs <3000/mm³
B)Tremors and a shuffling gait
C)Dry mouth
D)Generalized seizures

Accepted Answer

The answer of A physician prescribes an additional medication for...

Question 24

A client takes a maintenance dosage of lithium carbonate for a bipolar disorder.She has come to the community health clinic,stating that she "has had the flu for over a week." She describes her symptoms as coughing,runny nose,chest congestion,fever,and gastrointestinal upset.Her temperature is 100.9°F.She is complaining of blurred vision and "ringing in the ears." Which situation does the nurse anticipate?

A)Ingestion of foods containing tyramine
B)Noncompliance with lithium therapy
C)Tolerance to the lithium carbonate
D)Lithium toxicity

Accepted Answer

The answer of A client takes a maintenance dosage of...

Question 25

The nurse is preparing to assess a client before the physician prescribes a regimen of psychopharmacological therapy.Which components will the nurse assess? Select all that apply.&#10;A)Medical history&#10;B)Physical examination findings&#10;C)Ethnocultural characteristics&#10;D)Current medication&#10;E)None of above

Accepted Answer

The answer of The nurse is preparing to assess a...

Question 26

Joey,age 8 years,takes methylphenidate (Ritalin)for attention-deficit/hyperactivity disorder (ADHD).His mother complains to the nurse that Joey has a very poor appetite,and she struggles to help him gain weight.Which teaching will the nurse provide?

A)Administer Joey's medication immediately after meals.
B)Administer Joey's medication at bedtime.
C)Skip a dose of the medication when Joey does not eat anything.
D)Assure Joey's mother that Joey will eat when he is hungry.

Accepted Answer

The answer of Joey,age 8 years,takes methylphenidate (Ritalin)for attention-deficit/hyperactivity disorder...

Deck 4: Psychopharmacology