Deck 23: Psychopharmacology

Question 1

The nurse is caring for a patient who is prescribed an antidepressant. The patient asks the nurse how the drug works. Which is the best response by the nurse?

A) "The medication will target neurotransmitters in the stomach."
B) "The medication will target specific cells in the central nervous system."
C) "The medication will enter your bloodstream and find the targeted area."
D) "The medication will target your central nervous system as a whole."

Answer 1

"The medication will target specific cells in the central nervous system."

Question 2

A patient in the emergency department (ED) is pacing the hallway, then sits briefly before getting up and walking again. What would be an appropriate description of this patient's psychomotor activity?

A) Energetic
B) Agitated
C) Retarded
D) Spontaneous

Answer 2

Agitated

Question 3

A patient is extremely agitated and presents a danger to others. The resident orders 5 mg haloperidol IM to be administered immediately in order to calm the patient. What kind of order is this?

A) PRN
B) STAT
C) Single order
D) Standing order

Answer 3

STAT

Question 4

A patient tells the nurse that he is experiencing gastrointestinal problems since he began taking a selective serotonin-reuptake inhibitor (SSRI) for depression. Which response by the nurse would be most appropriate?

A) "Try taking the medication will a full glass of water."
B) "Try taking the medication at bedtime."
C) "Try taking the medication with food."
D) "Try taking the medication at least an hour before eating."

Question 5

What does the novice nurse identify as a characteristic that assists psychotropic medications in penetrating the blood-brain barrier (BBB)?

A) They are acidic.
B) They are lipophilic.
C) They are water soluble.
D) They have large molecules.

Question 6

What are some of the drug types whose primary action is to target the transporters in the presynaptic portion on the neuronal cell? Select all that apply.

A) Opioid receptor agonists
B) Serotonin-reuptake inhibitors
C) Norepinephrine-reuptake inhibitors
D) Selective serotonin-reuptake inhibitors
E) Norepinephrine-dopamine-reuptake inhibitors.

Question 7

The nurse working on an inpatient psychiatric unit is caring for a patient with depression and substance use disorder. The nurse administers the patient's medication as ordered. Which patient response will the nurse report immediately to the health care provider?

A) Increased appetite
B) Dry mouth
C) Drowsiness
D) Decreased level of consciousness

Question 8

A patient who has been prescribed a selective serotonin-reuptake inhibitor (SSRI) asks the nurse how it works. What is the best response by the nurse?

A) "SSRIs maintain the drug in its bound form, allowing more of the drug to attach to the neurotransmitter."
B) "SSRIs increase enzymatic action in the blood-brain barrier."
C) "SSRIs improve acid-base balance, enhancing the penetration of the blood-brain barrier."
D) "SSRIs target blood-brain barrier transporters and prevent the reuptake of the neurotransmitter."

Question 9

A patient is complaining of being unable to get to sleep. There is a PRN order for temazepam. What should the nurse do? Select all that apply.

A) Check the PRN protocol.
B) Assess the patient's need.
C) Assess the patient's safety.
D) Review the patient's diagnosis.
E) Explore the patient's expectations.

Question 10

Which condition can contribute to a vulnerability of the blood-brain barrier (BBB)? Select all that apply.

A) Anxiety
B) Infection
C) Radiation
D) Dementia
E) High blood pressure

Question 11

What factors influence the metabolic liver enzymes contained in the cytochrome P450 system?

A) Genetics
B) Excretion
C) Drug half-life
D) Acid-base balance in the body

Question 12

A patient with bipolar disorder has been prescribed valproate. What precautions should the nurse explain to the patient as a result of possible drug interactions?

A) Taking valproate with clozapine decreases the effect of valproate.
B) Taking valproate with antacids can result in toxic levels of valproate.
C) Taking valproate with aspirin can result in toxic levels of valproate.
D) Taking valproate with lithium decreases the effectiveness of lithium.

Question 13

The nursing student is preparing a presentation for the class on the relationship of ligands to receptors. Which explanation should the student include in the presentation?

A) "The drug ligand works like a key that fits into a lock, which is the receptor protein in the neuron."
B) "The drug ligand is the door that opens into the house, which is the neuron."
C) "The receptor protein is like a flame that ignites the stove, which is the drug ligand."
D) "The drug ligand works like a comforter, providing a protective cover for the receptor protein."

Question 14

What is the role of blood-brain barrier (BBB) transporters in neurotransmission?

A) Facilitate medication absorption.
B) Increase neurotransmission activity.
C) Shuttle neurotransmitters away from the brain.
D) Maintain a steady state of available medication molecules.

Question 15

A nurse assessing a patient's cognition will include which elements as part of the assessment? Select all that apply.

A) Humor
B) Insight
C) Memory
D) Judgment
E) Fund of knowledge

Question 16

A nurse tells a patient a list of five objects to remember and, after five minutes, asks the patient to repeat the list. What is the nurse evaluating?

A) IQ
B) Thought content
C) Short-term memory
D) Long-term memory

Question 17

A nurse observes that a patient appears scared during a.m. assessment. Which of the ABCs of psychiatry is the nurse observing?

A) Affect
B) Attitude
C) Behavior
D) Cognition

Question 18

What aspects of medication administration can be influenced by the expected half-life of the drug? Select all that apply.

A) Dosage
B) Acid-base balance
C) Frequency of administration
D) Expected duration of drug in the body
E) Anticipated duration of targeted effects

Question 19

A nurse asks her mentor to identify the term describing a drug's ability to bind to a particular receptor site. The mentor knows that which is the most appropriate response?

A) Affinity
B) Selectivity
C) Intrinsic activity
D) Hyperosmolarity

Question 20

A nurse looks at the patient's wrist tag when she enters the room to administer medication. Which of the five "rights" is she verifying?

A) Right time
B) Right patient
C) Right medication
D) Right documentation

Question 21

A patient who has been prescribed sertraline (Zoloft) reports to the nurse that she uses St. John's Wort. What danger does the nurse recognize?

A) Tardive dyskinesia
B) Serotonin syndrome
C) Stevens-Johnson rash
D) Anaphylactic reaction

Question 22

A patient reports that she is going to stop taking Zyprexa because she always feels tired. What is an appropriate response for the nurse to make?

A) "If you just keep taking the medication, after a while you will not feel so tired."
B) "If you are so tired, this drug is probably not working the way it is supposed to work."
C) "You will have to learn to live with it because you cannot stop taking your medication."
D) "We can check with your doctor and see if a lower dose might be OK, but it is important not to stop taking your medications until this can be resolved."

Question 23

A patient is taking sertraline (Zoloft). Because of the danger of toxicity, the nurse advises the patient to avoid which food?

A) Milk
B) Peanuts
C) Grapefruit
D) Orange juice

Question 24

A patient has been administered a benzodiazepine one hour ago and is now agitated and angry. What does the nurse suspect the patient is demonstrating?

A) A target effect
B) A paradoxical response
C) An anaphylactic reaction
D) An idiosyncratic response

Question 25

In order to minimize neuromuscular side effects, which medication is likely to be prescribed for psychotic symptoms?

A) Lithium
B) Olanzapine
C) Galantamine
D) Haldoperidol

Question 26

A patient who is taking olanzepine (Zyprexa) also smokes. Which will the nurse include when discussing use of Zyprexa with this patient?

A) Smoking can diminish the effect of Zypreza.
B) Zyprexa will increase the negative effects of smoking.
C) Smoking can increase the possible toxicity of Zyprexa.
D) Smoking is bad for the patient's health but will not interact with Zyprexa.

Question 27

A nurse is working with a patient who is taking lithium for bipolar disorder. In addition to performing regular monitoring of lithium levels, what should the nurse tell the patient to educate them about using lithium.

A) "Avoid grapefruit juice."
B) "Never take the medication with food or milk."
C) "Lithium may interfere with your birth control medications."
D) "It is important to drink plenty of water and avoid overheating."

Question 28

What drug acts as an inhibitor to activity by the protein receptor?

A) Agonist
B) Antagonist
C) Therapeutic
D) Partial agonist

Question 29

A patient has been taking sertraline (Zoloft) for one month. What can the nurse anticipate as the patient's target reaction?

A) Weight gain
B) Decreased sexual interest
C) A remission of depression
D) A remission of hallucinations

Question 30

The nurse is providing medication education to a patient who has been prescribed ramelteon (Rozerem). The patient asks how it will improve his sleep. Which is the best response by the nurse?

A) "By inhibiting the work of melatonin in the body."
B) "It acts as an off switch to deactivate melatonin that your body produces."
C) "It produces the same response in the body as melatonin."
D) "It will prevent you from building up a tolerance to melatonin."

Question 31

What drug interactions in the liver are of primary importance? Select all that apply.

A) Excretion
B) Dependence
C) Induction
D) Inhibition
E) Tolerance

Question 32

A patient taking a selective serotonin-reuptake inhibitor (SSRI) is experiencing a decrease in sexual functioning. What medication might be considered to help restore the patient's sexual functioning?

A) Ativan
B) Wellbutrin
C) Trazadone
D) Propranolol

Question 33

A nurse is monitoring a patient who is taking lithium to make certain that the lithium levels are between 0.8 and 1.1 mmol/L. The nurse documents that the patient's levels comply with what criteria?

A) Potency
B) Target effect
C) Drug dependence
D) Therapeutic range

Question 34

The nurse is caring for a patient with Alzheimer disease. The patient has been taking donezepil (Aricept), and reports that has been helping but that it does not seem to be working as well as it used to. The health care provider writes an order for memantine (Namenda). Which statement will the nurse include in the education for the patient and caregiver?

A) "Memantine works by increasing activation of glutamine transmission."
B) "Memantine works by reducing activation of glutamine transmission."
C) "Memantine will enhance breakdown of acetylcholine."
D) "Memantine will inhibit breakdown of acetylcholine."

Question 35

A patient has been brought to the emergency department (ED) with a Stevens-Johnson rash. What might the nurse consider as a possible cause?

A) Target reaction to a drug
B) Allergic reaction to a drug
C) Paradoxical reaction to a drug
D) Idiosyncratic reaction to a drug

Question 36

What reactions to medications are influenced by chemical biotransformations in the liver's enzymatic pathways? Select all that apply.

A) Tolerance
B) Toxicity
C) Potency
D) Resistance
E) Therapeutic range