Deck 11: Psychotropic Drugs

Question 1

A patient diagnosed with bipolar disorder has an unstable mood, aggressiveness, agitation, talkativeness, and irritability. The nurse expects the health care provider to prescribe a medication from which group?

A) Psychostimulants
B) Mood stabilizers
C) Anticholinergics
D) Antidepressants

Answer 1

Mood stabilizers

Question 2

A patient asks, "What are neurotransmitters? The doctor said mine are imbalanced." Select the nurse's best response.

A) "How do you feel about having imbalanced neurotransmitters?"
B) "Neurotransmitters protect us from harmful effects of free radicals."
C) "Neurotransmitters are substances we consume that influence memory and mood."
D) "Neurotransmitters are natural chemicals that pass messages between brain cells."

Answer 2

"Neurotransmitters are natural chemicals that pass messages between brain cells."

Question 3

Which instruction has priority when teaching a patient about clozapine (Clozaril)?

A) "Avoid unprotected sex."
B) "Report sore throat and fever immediately."
C) "Reduce foods high in polyunsaturated fats."
D) "Use over-the-counter preparations for rashes."

Answer 3

"Report sore throat and fever immediately."

Question 4

A patient begins therapy with a phenothiazine medication. What teaching should the 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 changes in muscle movement.

Question 5

The parent of an adolescent diagnosed with schizophrenia asks the nurse, "My child's doctor ordered a PET. What kind of test is that?" Select the nurse's best reply.

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

Question 6

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

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

Question 7

A patient is hospitalized for severe depression. Of the medications listed below, the nurse can expect to provide the patient with teaching about which of the following?

A) Chlordiazepoxide (Librium)
B) Clozapine (Clozaril)
C) Sertraline (Zoloft)
D) Tacrine (Cognex)

Question 8

The therapeutic action of neurotransmitter inhibitors that block reuptake cause which of the following effects?

A) Decreased concentration of the blocked neurotransmitter in the central nervous system
B) Increased concentration of the blocked neurotransmitter in the synaptic gap
C) Destruction of receptor sites specific to the blocked neurotransmitter
D) Limbic system stimulation

Question 9

A patient shows signs of fear as well as increased heart rate and blood pressure. The nurse suspects increased activity of which neurotransmitter?

A) Gamma-aminobutyric acid (GABA)
B) Norepinephrine
C) Acetylcholine
D) Histamine

Question 10

A nurse can anticipate anticholinergic adverse effects are likely when a patient takes which of the following:

A) Lithium carbonate (Carbolith)
B) Buspirone hydrochloride (Bustab)
C) Imipramine hydrochloride (Impril)
D) Risperidone (Risperdal)

Question 11

The nurse prepares to assess a patient diagnosed with major depression for disturbances in circadian rhythms. Which question should the nurse ask this patient?

A) "Have you ever seen or heard things that others do not?"
B) "What are your worst and best times of the day?"
C) "How would you describe your thinking?"
D) "Do you think your memory is failing?"

Question 12

A patient taking medication for mental illness develops restlessness and an uncontrollable need to be in motion. Which drug action causes these symptoms to develop?

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

Question 13

A drug causes muscarinic receptor blockade. The nurse will assess the patient for which of the following?

A) Dry mouth
B) Gynecomastia
C) Pseudoparkinsonism
D) Orthostatic hypotension

Question 14

A patient with a long history of hypertension and diabetes now develops confusion. The health care provider wants to make a differential diagnosis between Alzheimer's disease and multiple infarcts. Which diagnostic procedure should the nurse expect to prepare the patient for first?

A) Skull X-rays
B) Computed tomography (CT) scan
C) Positron emission tomography (PET)
D) Single-photon emission computed tomography (SPECT)

Question 15

A nurse would anticipate that treatment for a patient with memory difficulties might include medications designed to have which of the following effects?

A) Inhibit gamma-aminobutyric acid (GABA)
B) Prevent destruction of acetylcholine
C) Reduce serotonin metabolism
D) Increase dopamine activity

Question 16

The nurse should assess a patient taking a drug with anticholinergic properties for inhibited function of which of the following?

A) Parasympathetic nervous system
B) Sympathetic nervous system
C) Reticular activating system
D) Medulla oblongata

Question 17

A patient has acute anxiety related to an automobile accident 2 hours ago. The nurse should teach the patient about medication from which group?

A) Tricyclic antidepressants
B) Antipsychotic drugs
C) Antimanic drugs
D) Benzodiazepines

Question 18

A patient's history shows drinking 4 to 6 litres of fluid and eating more than 6,000 calories per day. Which part of the central nervous system is most likely dysfunctional for this patient?

A) Amygdala
B) Parietal lobe
C) Hippocampus
D) Hypothalamus

Question 19

A patient tells the nurse, "My doctor prescribed Paxil (paroxetine) for my depression. I assume I'll have side effects like I had when I was taking Tofranil (imipramine)." The nurse's reply should be based on what information about the drug?

A) Paroxetine is a selective norepinephrine reuptake inhibitor.
B) Paroxetine is a tricyclic antidepressant.
C) Paroxetine is an MAO inhibitor.
D) Paroxetine is an SSRI.

Question 20

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

A) Hippocampus
B) Frontal lobe
C) Cerebellum
D) Brain stem

Question 21

Consider these medications: carbamazepine (Tegretol), lamotrigine (Lamictal), gabapentin (Neurontin). Which medication below also belongs with this group?

A) Galantamine hydrobromide (Reminyl)
B) Valproate (Depakene)
C) Buspirone hydrochloride (Bustab)
D) Rivastigmine hydrogen tartrate (Exelon)

Question 22

A nurse cares for a group of patients receiving various medications, including haloperidol (Haldol), carbamazepine (Tegretol), trazodone (Oleptro), and phenelzine (Nardil). The nurse will order a special diet for the patient who takes which of the following?

A) Carbamazepine
B) Haloperidol
C) Phenelzine
D) Trazodone

Question 23

An individual hiking in the forest encounters a large poisonous snake on the path. Which change in this individual's vital signs is most likely?

A) Pulse rate changes from 90 to 72.
B) Respiratory rate changes from 22 to 18.
C) Complaints of intestinal cramping begin.
D) Blood pressure changes from 114/62 to 136/78.

Question 24

By which mechanism do selective serotonin reuptake inhibitors (SSRI) improve depression?

A) Destroying increased amounts of serotonin
B) Making more serotonin available at the synaptic gap
C) Increasing production of acetylcholine and dopamine
D) Blocking muscarinic and $\alpha$ 1 norepinephrine receptors

Question 25

A nurse prepares to administer a second-generation antipsychotic medication to a patient diagnosed with schizophrenia. Additional monitoring for adverse effects will be most important if the patient has which co-morbid health problems?

A) Parkinson's disease
B) Grave's disease
C) Hyperlipidemia
D) Osteoarthritis
E) Diabetes

Question 26

Questions the nurse could ask that would be nonjudgemental when obtaining information about patient use of herbal remedies include which of the following?

A) "You don't regularly take herbal remedies, do you?"
B) "What herbal medicines have you used to relieve your symptoms?"
C) "What over-the-counter medicines and nutritional supplements do you use?"
D) "What differences in your symptoms do you notice when you take herbal supplements?"
E) "Have you experienced problems from using herbal and prescription drugs at the same time?"

Question 27

A professional football player is seen in the emergency department after losing consciousness from an illegal block. Prior to discharge, the nurse assists the patient to schedule an outpatient computed tomography (CT) scan for the next day. Which strategy should the nurse use to ensure the patient remembers the appointment?

A) Write the appointment day, time, and location on a piece of paper and give it to the player.
B) Log the appointment day, time, and location into the player's cell phone calendar feature.
C) Ask the health care provider to admit the patient to the hospital overnight.
D) Verbally inform the patient of the appointment day, time, and location.

Question 28

An obese patient has a diagnosis of schizophrenia. Medications that block which receptors would contribute to further weight gain?

A) H?
B) 5 HT?
C) Acetylcholine
D) Gamma-aminobutyric acid (GABA)

Question 29

A nurse caring for a patient taking a selective serotonin reuptake inhibitor (SSRI) will develop outcome criteria related to which of the following?

A) Coherent thought processes
B) Improvement in depression
C) Reduced levels of motor activity
D) Decreased extrapyramidal symptoms

Question 30

A drug blocks the attachment of norepinephrine to $\alpha$ 1 receptors. The patient may experience which of the following?

A) Hypertensive crisis
B) Orthostatic hypotension
C) Severe appetite disturbance
D) An increase in psychotic symptoms

Question 31

The laboratory report for a patient taking clozapine (Clozaril) shows a white blood cell count of 3 000 mm³. Select the nurse's best action.

A) Report the results to the health care provider immediately.
B) Administer the next dose as prescribed.
C) Give aspirin and force fluids.
D) Repeat the laboratory test.

Question 32

A nurse instructs a patient taking a drug that inhibits monoamine oxidase (MAO) to avoid certain foods and drugs because of the risk of which of the following?

A) Cardiac dysrhythmia
B) Hypotensive shock
C) Hypertensive crisis
D) Hypoglycemia

Question 33

An individual is experiencing problems with memory. Which of these structures are most likely to be involved in this deficit?

A) Amygdala
B) Hippocampus
C) Occipital lobe
D) Reticular activating system (RAS)
E) Basal ganglia

Question 34

A nurse cares for four patients who are receiving clozapine, lithium, fluoxetine, and venlafaxine, respectively. The nurse should be most alert for problems associated with fluid and electrolyte imbalance with the patient receiving which drug?

A) Lithium
B) Clozapine (Clozaril)
C) Fluoxetine (Prozac)
D) Venlafaxine (Effexor)

Question 35

A patient's sibling says, "My brother has a mental illness, but the doctor ordered a functional magnetic resonance image (fMRI) test. That seems unnecessary and wasteful." Select the nurse's best responses.

A) "Sometimes there are physical causes for psychiatric symptoms. This test will help us understand whether that is the situation."
B) "Some mental illnesses are evident on fMRIs. This test will give information to help us plan the best care for your brother."
C) "Tell me more about what is concerning you about the testing."
D) "It sounds like you do not truly believe your brother had a mental illness."
E) "It would be better for you to discuss your concerns with the doctor."