Deck 16: Drugs for Emotional, Mood, and Behavioral Disorders

Question 1

The patient has bipolar disorder and is in a manic phase. The physician prescribes lithium (Eskalith). The patient's current lithium level is 0.
1) A return to baseline behavior, calm and rational
2) Hyperactivity and pressured speech
3) Signs and symptoms of depression
4) A decrease in manic behavior
4) What will the nurse expect to assess in this patient?

Answer 1

2

Question 2

The 8-year-old patient is receiving methylphenidate (Ritalin). The patient's mother tells the nurse that he won't eat while on his medication. What is the best response by the nurse?

A) "It sounds like he is becoming depressed. I will speak to the doctor about starting an antidepressant medication."
B) "Give the medication after meals and encourage him to have supplements between meals."
C) "You are right to be concerned. I will speak to the doctor about starting an appetite stimulant medication."
D) "This is a very serious concern; it would be best for him to see a nutritionist for counseling."

Answer 2

"Give the medication after meals and encourage him to have supplements between meals."

Question 3

Which food items should the nurse advise a patient taking a monoamine oxidase inhibitor (MAOI) to avoid?

A) Orange juice, cottage cheese, and turkey
B) Spring water, ice cream, and salmon
C) Chocolate, wine, and fava beans
D) Spinach, rice, and venison

Answer 3

Chocolate, wine, and fava beans

Question 4

Which drug type is often used as a first-line treatment for depression due to its side effect profile?

A) Monoamine oxidase inhibitors (MAOIs)
B) Beta-adrenergic blockers
C) Tricyclic antidepressants (TCAs)
D) Selective serotonin reuptake inhibitors (SSRIs)

Question 5

Which symptoms experienced over 1 month would be most helpful to diagnose bipolar disorder?

A) Difficulty sleeping, obsession with death, hallucinations
B) Delusions, unkempt appearance, fatigue
C) Abnormal eating patterns, feelings of despair, flight of ideas
D) Increased goal-directed behavior and talkativeness, distractibility

Question 6

The mother of a 7-year-old child says to the nurse, "My child is distractible in school, cannot complete assignments on time, and interrupts other children while they are speaking. What do you think?" What is the best response by the nurse?

A) "This sounds like your child is depressed; depression looks different in children and is very serious."
B) "This sounds like bipolar disorder; you might want to have your child tested by a child psychiatrist."
C) "This could be attention-deficit hyperactivity disorder (ADHD); you might want to have your child tested."
D) "This sounds like typical 7-year-old behaviors to me; if they do not resolve, have your child tested."

Question 7

The patient has been receiving amitriptyline (Elavil) for 2 weeks. He tells the nurse he doesn't think this medicine is working, as he is still depressed. What is the best response by the nurse?

A) "It is working, but it can take several weeks to have an effect."
B) "You might still feel depressed, but you are looking much better."
C) "This may not be the best medicine for you; I'll call your doctor."
D) "It is working, but it can take several months to have an effect."

Question 8

The patient asks the nurse why she needs to continue using table salt because her prescribed lithium (Eskalith) is a salt. What is the best response by the nurse?

A) "You must continue to use salt to avoid lithium (Eskalith) toxicity. If you use sea salt, you don't need as much."
B) "You must use table salt or your kidneys will retain lithium (Eskalith), and you will become toxic."
C) "The amount is not important; just increase your table salt if you notice signs of lithium (Eskalith) toxicity."
D) "Salt is very important to avoid lithium (Eskalith) toxicity, but not as important as drinking 1 to 1.5 L of water per day."

Question 9

The nurse has completed medication education for a patient prior to the patient receiving phenelzine (Nardil). The nurse evaluates the education as effective when the patient makes which statements?

A) "I am really going to miss my morning coffee and sweet roll."
B) "I'll have to give up my beer at the football games."
C) "I can't eat fried chicken and gravy."
D) "I am not supposed to have processed meats or cheese."
E) "I really shouldn't eat at a restaurant; too many foods are on my restricted list."

Question 10

The patient has been depressed, and the physician plans to begin treatment with an antidepressant medication. In performing the initial assessment, what is the most important question for the nurse to ask?

A) "How much alcohol do you consume during the week?"
B) "Are you allergic to any medications?"
C) "How long have you been depressed?"
D) "Have you had any thoughts about killing yourself?"

Question 11

The nurse has completed medication education with the patient who is receiving lithium (Eskalith). What is the priority patient outcome?

A) The patient will be able to work a normal work schedule and will receive adequate sleep.
B) The patient will identify signs of lithium (Eskalith) toxicity and verbalize measures to avoid it.
C) The patient will engage in activities of daily living and report enjoyment with them.
D) The patient will report stabilization of mood, including absence of mania or depression.

Question 12

The physician has prescribed sertraline (Zoloft) for the patient who is anxious and depressed. The patient calls the nurse to report that he has experienced delayed ejaculation since being on this medication. What is the best response by the nurse?

A) "I will let your doctor know, and he will most likely change your medication."
B) "This does happen, but treating your depression is a bigger priority."
C) "I am concerned that you will become suicidal if you stop the medication."
D) "Keep taking the medicine, as this usually goes away after a few months."

Question 13

The nurse is conducting a group education session for patients who have been diagnosed with depression. The nurse evaluates the education as effective when a patient makes which comments about the cause of depression?

A) "Depression has many causes; they could include environmental as well as brain-based disorders."
B) "Depression includes impaired relationships and is also an inherited illness."
C) "We really don't know what causes depression; it has not been studied very much."
D) "Depression results from unresolved conflicts in your childhood."
E) "Depression results from parents who are cold and distant and don't really care about their children."

Question 14

Which statement is accurate regarding attention-deficit hyperactivity disorder (ADHD)?

A) ADHD is characterized by periods of mania and periods of depression.
B) Anxiety and social withdrawal are more frequently seen in girls than in boys.
C) Diagnosis is higher in girls than in boys.
D) ADHD is generally diagnosed later in life.

Question 15

What is the priority outcome for a 6-year-old patient who had been started on methylphenidate (Ritalin)?

A) The patient will avoid altercations with peers.
B) The patient will be able to complete age-appropriate chores at home.
C) The patient will use age-appropriate play with peers.
D) The patient will maintain weight within norms for this age group.

Question 16

Which drug type used to treat depression works by preventing enzymatic destruction of the neurotransmitter norepinephrine?

A) Serotonin-norepinephrine reuptake inhibitors (SNRIs)
B) Selective serotonin reuptake inhibitors (SSRIs)
C) Tricyclic antidepressants (TCAs)
D) Monoamine oxidase inhibitors (MAOIs)

Question 17

The patient receives imipramine (Tofranil) as treatment for depression. He is admitted to the emergency department following an intentional overdose of this medication. What will the priority assessment by the nurse include?

A) The patient's cardiac status
B) The patient's liver function
C) The patient's renal status
D) The patient's neurological function

Question 18

A patient was prescribed sertraline (Zoloft) for the treatment of depression and anxiety. The patient's spouse calls the clinic and reports the patient is increasingly moody and seems "disconnected with life." What is the best response by the nurse?

A) "Try giving him some diphenhydramine (Benadryl) to see if that helps him relax."
B) "Bring him to the clinic for assessment today.."
C) "Hold his medication today and see if his mood improves."
D) " "Double the daily dose of sertraline (Zoloft) and call us back in three days."

Question 19

Depression that occurs during cold winter months would be classified as

A) baby blues.
B) bipolar disorder.
C) seasonal affective disorder.
D) obsessive-compulsive disorder.

Question 20

The patient tells the nurse, "I thought I was just depressed, but my doctor says I have bipolar disorder. What is that?" What is the best response by the nurse?

A) "Bipolar disorder is just another type of depression, except your depression occurs in cycles."
B) "Bipolar disorder is a type of depression that includes attention deficit disorder symptoms."
C) "Bipolar disorder just means that your mood alternates with the seasons, and it becomes worse in the winter."
D) "Bipolar disorder means you have cycles of depression as well as hyperactivity, or mania."

Question 21

Which statement best explains drugs like methylphenidate help a patient with attention-deficit hyperactivity disorder (ADHD)?

A) Neurotransmitters are blocked, limiting the effects they can produce within the PNS.
B) Activation of certain areas of the brain causes increased attention and ability to focus.
C) Neurotransmitter levels are reduced, which produces a calming effect within the CNS.
D) Certain areas of the brain are deactivated, resulting in a calming effect.

Question 22

The parent of a child being treated for ADHD says a neighbor child with the same diagnosis is on a "drug holiday." How should the nurse explain this treatment option?

A) "Drug holidays may be used to reduce dependence on medications or to assess symptoms."
B) "If you feel like the medication is sedating your child too much, you can hold doses for 3 or 4 days which is known as a drug holiday."
C) "Drug holidays are times when dosage is increased to assess the patient's tolerance to medications."
D) "You should not consider using a drug holiday until you have discussed that option with your provider."
E) "Drug holidays require careful scheduling."

Question 23

A 40-year-old patient experiencing periods of mania and periods of depression would most likely benefit from which of the following?

A) Atomoxetine (Strattera)
B) Amitriptyline (Elavil)
C) Methylphenidate (Ritalin)
D) Carbamazepine (Tegretol)

Question 24

The traditionally prescribed drug types used to treat attention-deficit hyperactivity disorder (ADHD) include

A) CNS depressants.
B) parasympathomimetics.
C) CNS stimulants.
D) sympathomimetics.

Question 25

A patient who has been taking antidepressant medication for several months and is demonstrating an improvement in symptoms tells the nurse that counseling sessions might be helpful. Which types of therapies will the nurse review with the patient?

A) Behavioral therapy
B) Interpersonal therapy
C) Cognitive-behavioral therapy
D) Psychodynamic therapy
E) Crisis therapy

Question 26

The nurse is instructing a patient on the cause of bipolar disorder. What neurotransmitters will the nurse describe as contributing to the manic phase of this disorder?

A) Excessive glutamate
B) Excessive norepinephrine
C) Deficiency of gamma-aminobutyric acid
D) Deficiency of dopamine
E) Excessive serotonin

Question 27

During a health history, the nurse wants to include an assessment of depression with an older patient. What statements will the nurse use to make this assessment?

A) "How often do you go out to socialize with friends?"
B) "Explain your self-care activities."
C) "How much alcohol do you consume every day?"
D) "How is living with your oldest daughter and her family working out for you?"
E) "Are you feeling depressed?"

Question 28

During a health history, the nurse is concerned that a patient with depression is at risk for suicide when the patient

A) states that "suicide is always an option."
B) describes a previous unsuccessful attempt at suicide by aspirin overdose.
C) states that the prescribed medication is not working and that feelings of depression are worse.
D) requests prescriptions for pain medication and a sleeping aid.
E) expresses interest in meeting with friends more often.

Question 29

A patient with depression does not want to take prescribed medication because of the side effects. What can the nurse suggest to help with medication adherence?

A) Use ice chips to help alleviate dry mouth.
B) Chew gum or use hard candy to help alleviate dry mouth.
C) Avoid alcohol-based mouthwash to help alleviate dry mouth.
D) Use "dry eye" drops to help with eye dryness.
E) Ask the pharmacist to fill the prescription with the same drug from a different manufacturer.

Question 30

The nurse is concerned that a patient is moving into the manic phase of bipolar disorder when what is assessed?

A) Not sleeping
B) Losing weight
C) Sluggish activity
D) Complaints of muscle pain
E) Constant talking