Deck 16: Drugs Used for Depressive and Bipolar Disorders

Question 1

The nurse is caring for a patient who is taking a newly prescribed drug,nefazodone,for treatment of depression.Which physical assessment finding is most important for the nurse to report to the health care provider immediately?

A) Bradycardia
B) Dizziness
C) Drowsiness
D) Urinary retention

Answer 1

Bradycardia

Question 2

What occurs with mania associated with bipolar disorder?

A) Varying degrees of sadness
B) Distinct episodes of elation
C) Suicide
D) Psychomotor retardation

Answer 2

Distinct episodes of elation

Question 3

The nurse is teaching a patient about medication treatment for depression.The patient asks how long it will take before sleep and appetite will begin to improve.Which response by the nurse is most accurate?

A) 3 days
B) 1 week
C) 4 weeks
D) 2 months

Answer 3

1 week

Question 4

Which area(s)should be addressed by the nurse when obtaining a history of a patient admitted with depression?

A) Current medications and medical history
B) Recent stressors and support system
C) Family history of mood disorder
D) Dietary patterns
E) Insurance coverage

Question 5

Which assessment would the nurse expect to observe in a patient who has been prescribed trazodone for treatment anxiety?

A) Excessive thirst
B) Hand tremor
C) Drowsiness
D) Diarrhea

Question 6

Which psychological manifestation of depression will improve in response to antidepressant therapy?

A) Loss of energy
B) Palpitations
C) Sleep disturbances
D) Social withdrawal

Question 7

A patient who is taking an MAOI to treat depression admits to eating pickled herring and cheese and drinking red wine.Which assessment finding alerts the nurse to a potential complication?

A) Constipation
B) Hypotension
C) Neck stiffness
D) Urinary retention

Question 8

A patient taking vilazodone has been vomiting persistently for 12 hours.The priority nursing diagnosis for this patient is

A) nausea.
B) imbalanced nutrition (less than body requirements).
C) fluid volume deficit.
D) altered peripheral tissue perfusion.

Question 9

Lithium (Eskalith)is the drug of choice for which of the following disorders?

A) Psychotic episodes
B) Obsessive compulsive disorders (OCDs)
C) Bipolar disorders
D) Depressive disorders

Question 10

Which postoperative narcotic analgesic will most likely be prescribed to a patient whose current medications include a monoamine oxidase inhibitor (MAOI),a thyroid hormone,and a multivitamin?

A) Meperidine (Demerol)
B) Morphine
C) Ibuprofen (Advil)
D) Acetaminophen (Tylenol)

Question 11

Which nursing action is most important when providing care to a patient diagnosed with a mood disorder?

A) Assess the patient for thoughts of suicide.
B) Provide supplemental feedings as needed.
C) Assist with activities of daily living.
D) Offer opportunities for interaction with other patients.

Question 12

Which food(s)containing significant amounts of tyramine will be contraindicated when a patient is on MAOI therapy?

A) Beer
B) Red meat
C) Aged cheeses
D) Green vegetables
E) Bananas

Question 13

On what is the choice of tricyclic antidepressants based?

A) The need to decrease the action of norepinephrine, dopamine, or serotonin
B) Patient age and gender
C) An absence of adverse effects, such as orthostatic hypotension
D) The need for stimulation and increased mental alertness

Question 14

What is the action of MAOIs on neurotransmitters?

A) Blocking their reuptake
B) Increasing their production
C) Blocking their destruction
D) Increasing their reuptake

Question 15

What will the nurse include in a teaching plan for a patient with depression being treated with amitriptyline (Elavil)?

A) Dryness of the mouth is normal; sucking on sugar free hard candy and ice chips or chewing gum may help alleviate this problem.
B) Rise slowly from a supine or sitting position to avoid dizziness and orthostatic hypotension.
C) Avoid alcohol and barbiturates.
D) If adverse effects occur, discontinue the medication.
E) An immediate elevation in mood will be noted.

Question 16

A patient is admitted to a long-term psychiatric setting.The MAOI medication previously prescribed is discontinued by the physician.New orders are obtained to initiate imipramine therapy.The nurse will provide the first dose of imipramine to the patient _____ the MAOI drug.

A) immediately following the last dose of
B) in 1 week following the last dose of
C) in 14 days following the last dose of
D) before discontinuing

Question 17

Which nursing assessment(s)is/are important before the initiation of antidepressant therapy?

A) Compliance with medication therapy within the last 2 months
B) Nonverbal interactions among patient and significant others present
C) Evaluation of the coherency, relevancy, and organization of thoughts in responses
D) Appearance and posture
E) Elimination pattern

Question 18

The nurse is providing education to a patient who has been prescribed bupropion (Wellbutrin)for smoking cessation.Which statement by the patient would indicate the need for further teaching?

A) "My dose will increase after 3 days."
B) "I should swallow this medication whole."
C) "If I have the urge to smoke, I will take more medication."
D) "I do not need to taper my dose when the drug is discontinued."

Question 19

Which instruction(s)is/are most pertinent to include in the discharge teaching of a patient on lithium (Eskalith)who is being discharged?

A) "Persistent vomiting and profuse diarrhea are signs of toxicity and must be reported to the health care provider immediately."
B) "It is important to comply with schedules for blood tests to assess therapeutic levels."
C) "You should avoid foods such as Chianti wine and aged cheeses."
D) "The common adverse effects to expect, which are excessive nausea, anorexia, and abdominal cramps, tend to resolve."
E) "You will be gradually weaned off this medication."
F) "Take the medication with food or milk."

Question 20

What is the major advantage of selective serotonin reuptake inhibitors (SSRIs)over other types of antidepressant therapy?

A) They are less expensive than the other classes of antidepressants.
B) They cure major depressive illnesses.
C) They do not cause the anticholinergic and cardiovascular adverse effects.
D) Therapeutic relief is immediate.

Question 21

Which drug(s)interact(s)with SSRI agents?

A) Tranylcypromine (Parnate)
B) Lithium (Eskalith)
C) Warfarin (Coumadin)
D) Furosemide (Lasix)
E) Propranolol (Inderal)

Question 22

The nurse must be sure to instruct the patient about which potential adverse effect(s)of tricyclic antidepressants?

A) Diarrhea
B) Dryness of mouth, nose, and throat
C) Constipation
D) Nocturia
E) Urinary retention
F) Blurred vision

Question 23

The nurse is preparing 0800 medications for a patient with the medical diagnosis of end stage renal disease.When reviewing the medication administration record (MAR),the nurse notices the patient is scheduled to receive an MAOI drug.Which intervention(s)will the nurse perform before administering the drug?

A) Assess temperature.
B) Provide an alternative drug.
C) Hold the MAOI drug.
D) Consult with the prescribing health care provider.
E) Assess urine output prior to administration.

Question 24

Which statement(s)is/are true regarding the pharmacologic actions of certain antidepressant drugs?

A) MAOIs block the effects of dopamine in the CNS.
B) SSRIs inhibit the destruction and reuptake of serotonin at the synaptic cleft.
C) Tricyclic antidepressants block the action of norepinephrine and epinephrine in the SNS.
D) Monocyclic antidepressants such as bupropion (Wellbutrin) have an unknown mechanism of action.
E) SNRIs prolong the action of neurotransmitters by decreasing the destruction of serotonin and norepinephrine.