Question 1

A patient was recently admitted to the inpatient unit after a suicide attempt. During the hospitalization, the patient was placed on a tricyclic antidepressant. Which action should the nurse implement to maintain the patient's safety when the patient is discharged?

A) Provide the patient with a 6-month supply of medication.
B) Provide a 1-week supply of medication to be refilled after visiting the provider.
C) Instruct increased fluid intake to counteract the medication's side effects.
D) Provide education on fluid restrictions to prevent side effects.

Provide a 1-week supply of medication to be refilled after visiting the provider.

Accepted Answer

1.This is incorrect. Suicide risk often increases as antidepressant medication takes effect and the patient's level of depression and mood improve, and the patient should be monitored more frequently than every 6 months.
2.This is correct. Suicide risk often increases as antidepressant medication takes effect and the patient's level of depression and mood improve. The patient may then have increased energy with which to implement a suicide plan. Providing a 1-week supply to be refilled after visiting the provider may facilitate monitoring of the patient's overall level of depression.
3.This is incorrect. This would not be an intervention for safety, as the patient may experience dry mouth from the medication.
4.This is incorrect. This would not be a valid intervention, as the medication may cause dry mouth and there is no indication for a fluid restriction.

Question 2

Which statement best describes how the perspective on psychopharmacological use of phenothiazines has historically changed?&#10;A) Phenothiazines were originally used as a preoperative medication and found to improve the client's anxiety.&#10;B) Phenothiazines were originally used for infection control and found to improve a client's treatment compliance.&#10;C) Phenothiazines were originally used for postoperative care and found to improve the client's ability to recover from anesthesia.&#10;D) Phenothiazines were originally used for diabetics to control their appetite and blood sugars.&#10;

Accepted Answer

1.This is correct. Dr. Henri Laborit (1914 to 1995) found that the clients benefited from the administration of phenothiazines prior to surgery, and this foretold of a psychotropic use.
2.This is incorrect. There is no indication that this medication would have improved the likelihood of a client's adherence to a medical treatment plan.
3.This is incorrect. There is no stated historical indication that the medication was given postoperatively nor of the client's ability to recover quickly from anesthesia.
4.This is incorrect. There is no historical indication that this classification of medications was used to treat diabetes.

Question 3

A patient with depression and substance abuse has an interrupted sleep pattern. The patient demands 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, such as guided imagery."
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."

"Sedative-hypnotics are potentially addictive and gradually lose their effectiveness as one builds up tolerance to them."

Accepted Answer

1.This is correct. Sedative-hypnotics are potentially addictive and should be used with caution by patients with a history of substance use disorders, as tolerance can easily develop.
2.This is incorrect. This does not address the overall issue of the addictive properties of sedative-hypnotics and substance abuse disorders.
3.This is incorrect. This is not therapeutic communication and does not explain the rationale of the addictive properties of these medications.
4.This is incorrect. There is no correlation between sedative-hypnotics and antidepressant medications for sleep disturbances.

Question 4

A patient was admitted with a chronic level of major depression. The patient was started on an MAOI orally daily during this hospitalization. The nurse's discharge teaching should include which of the following?

A) "Continue taking medication as prescribed. You will continue to see improvement over the next few days."
B) "You will not need to follow up with outpatient psychotherapy, as you and the social worker have completed your therapy."
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

1.This is incorrect. This is nontherapeutic communication, as there is no indication that this medication is fast acting in days.
2.This is incorrect. A patient with chronic moderate depression should maintain follow-up appointments on a regular basis.
3.This is incorrect. There is no indication that the patient may stop the medication without first discussing it with the prescriber.
4.This is correct. Clients taking MAOIs should avoid foods with tyramine, including beer, beans, processed meats, and red wine, to prevent a hypertensive crisis.

Question 5

Which medication requires periodic blood-level monitoring?&#10;A) Eskalith (lithium carbonate)&#10;B) Haldol (haloperidol)&#10;C) Xanax (benzodiazepine)&#10;D) Paxil (paroxetine)&#10;

Accepted Answer

1.This is incorrect. Serum lithium levels are monitored regularly to ensure a therapeutic range is maintained.
2.This is incorrect. Haldol is not generally monitored for therapeutic blood ranges.
3.This is incorrect. Xanax generally is not monitored for a therapeutic blood range.
4.This is correct. Blood-level monitoring is usually performed for patients taking paroxetine.

Question 6

A patient with schizophrenia has recently begun a new medication, clozapine (Clozaril). Which is a fatal side effect that should be included in the teaching plan?&#10;A) Agranulocytosis&#10;B) Akathisia&#10;C) Dystonia&#10;D) Akinesia&#10;

Accepted Answer

1.This is correct. Agranulocytosis is a potentially fatal disorder in which the patient's WBC count drops to extremely low levels, placing the patient at great risk for infections.
2.This is incorrect. Akathisia is characterized by a feeling of inner restlessness and a compelling need to be in constant motion.
3.This is incorrect. Dystonia is characterized by persistent or intermittent muscle contractions causing abnormal, often repetitive, movements, postures, or both.
4.This is incorrect. Akinesia refers to a loss of standard motor functions or slowness that causes impaired movement of muscles.

Question 7

A client with schizophrenia recently began a new medication, clozapine (Clozaril). Which blood cell counts reveal a potentially fatal side effect of this medication? A) WBCs greater than 3,000/mm³; granulocytes greater than 1,500/mm³ B) WBCs less than 3,000/mm³; granulocytes greater than 1,500/mm³ C) WBCs greater than 3,000/mm³; granulocytes less than 1,500/mm³ D) WBCs less than 3,000/mm³; granulocytes less than 1,500/mm³

Accepted Answer

1.This is incorrect. This reflects a normal WBC count and does not indicate agranulocytosis. 2.This is incorrect. Although the WBC count is low, the granulocytes are not, so this does not indicate a state of agranulocytosis. 3.This is incorrect. Although the granulocytes are low, the WBC count is not, so this does not indicate a state of agranulocytosis. 4.This is correct. A WBC count of less than 3000/mm³ and granulocytes less than 1500/mm³ reflect a low WBC count and indicate that the body's ability to fight infection is significantly decreased. Agranulocytosis is a potentially fatal disorder in which the client's WBC count drops to extremely low levels, placing the client at great risk for infections.

Question 8

The nurse is assessing a patient in the community health clinic who complains of having "the flu for over a week." The patient reports the diagnosis of bipolar disorder and compliance with the maintenance dosage of lithium carbonate. Upon further assessment the nurse finds that the patient has been coughing, a runny nose, chest congestion, blurred vision, fever of 100.9°F, and "ringing in their ears." What situation does the nurse anticipate?

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

Accepted Answer

1. This is incorrect. These are not signs of neuroleptic malignant syndrome.
2. This is incorrect. These are not signs of noncompliance with lithium therapy.
3. This is incorrect. This is not indicative of a tolerance to lithium carbonate. 
4. This is correct. Vomiting, diarrhea, blurred vision, tinnitus, tremors, and sedation are some symptoms of lithium toxicity. Lithium toxicity occurs with a serum lithium level over 1.2 mEq/L.

Question 9

The nurse is preparing a teaching plan for the parent of a child diagnosed with attention deficit-hyperactivity disorder. The parent voices concern over the child's poor appetite and inability to gain weight. Which of the following interventions would be the most appropriate to address the parent's concerns?

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

Accepted Answer

1.This is correct. Anorexia and weight loss are side effects of stimulant medications. Stimulants should be administered immediately after meals, and weight should be monitored at least once a week.
2.This is incorrect. This would not address the issue of poor appetite.
3.This is incorrect. This is not an appropriate intervention, as this would encourage nonadherence to the medication regimen.
4.This is incorrect. This suggests a behavior, not a side effect of the medication.

Question 10

Which disorder is genetically inherited?&#10;A) Autism&#10;B) Parkinson's disease&#10;C) Anorexia nervosa&#10;D) Obsessive compulsive disorder&#10;

Accepted Answer

1.This is correct. Autism, attention deficit-hyperactivity disorder, bipolar disorder, major depression, and schizophrenia all show some common gene variations, including differences in two genes that regulate the flow of calcium into cells.
2.This is incorrect. Parkinson's disease is caused by a deficiency in dopamine levels and is rarely genetic.
3.This is incorrect. Anorexia nervosa is not genetic.
4.This is incorrect. Obsessive compulsive disorder is not an inherited condition.

Question 11

Which diagnostic imaging procedure would the nurse prepare the client for to determine neurotransmitter-receptor interaction?&#10;A) Electroencephalography (EEG)&#10;B) Computed tomographic (CT) scan&#10;C) Magnetic resonance imaging (MRI)&#10;D) Positron emission tomography (PET) scan&#10;

Accepted Answer

The answer of Which diagnostic imaging procedure would the nurse...

Question 12

Which mental illness would a nurse identify as being associated with a decrease in prolactin levels?&#10;A) Attention deficit disorder&#10;B) Schizophrenia&#10;C) Anorexia nervosa&#10;D) Alzheimer's disease&#10;

Accepted Answer

The answer of Which mental illness would a nurse identify...

Question 13

Which client diagnosis would the nurse associate with a decrease in gamma-aminobutyric acid (GABA) levels?&#10;A) Alzheimer's disease&#10;B) Anorexia nervosa&#10;C) Panic disorder&#10;D) Depression&#10;

Accepted Answer

The answer of Which client diagnosis would the nurse associate...

Question 14

Learning has occurred when the student identifies that the neurotransmitter serotonin is catabolized by which enzyme?&#10;A) Catechol-O-methyltransferase (COMT)&#10;B) GABA transaminase&#10;C) Acetylcholinesterase&#10;D) Monoamine oxidase&#10;

Accepted Answer

The answer of Learning has occurred when the student identifies...

Question 15

Which hormone is used experimentally to increase socialization?&#10;A) Prolactin&#10;B) Oxytocin&#10;C) Gonadotropic hormones&#10;D) Growth hormone&#10;

Accepted Answer

The answer of Which hormone is used experimentally to increase...

Question 16

Elevated levels of adrenocorticotropic hormone (ACTH) are associated with which symptom?&#10;A) Fatigue&#10;B) Anxiety&#10;C) Depression&#10;D) Psychosis&#10;

Accepted Answer

The answer of Elevated levels of adrenocorticotropic hormone (ACTH) are...

Question 17

Which adoption studies about the influence of genetics on the development of psychiatric disorders were described by Knowles? Select all that apply.&#10;A) Studies in which children whose biological parents had a psychiatric disorder were raised by adoptive parents who did not have a psychiatric disorder&#10;B) Studies in which children whose biological parents did not have a psychiatric disorder were raised by adoptive parents who had a psychiatric disorder&#10;C) Studies in which children were raised together by biological parents who had a psychiatric disorder&#10;D) Studies in which children whose biological parents had a psychiatric disorder were raised by adoptive parents who also had a psychiatric disorder&#10;E) Studies in which children whose biological parents had a psychiatric disorder were raised by biological relatives who had a psychiatric disorder&#10;

Accepted Answer

The answer of Which adoption studies about the influence of...

Deck 2: Psychopharmacology