Deck 16: Psychotherapeutic Drugs

Question 1

A patient has been taking the selective serotonin reuptake inhibitor (SSRI) sertraline (Zoloft) for about 6 months. At a recent visit, she tells the nurse that she has been interested in herbal therapies and wants to start taking St. John's wort. Which response by the nurse is appropriate?

A) "That should be no problem."
B) "Good idea! Hopefully you'll be able to stop taking the Zoloft."
C) "Be sure to stop taking the herb if you notice a change in side effects."
D) "Taking St. John's wort with Zoloft may cause severe interactions and is not recommended."

Answer 1

"Taking St. John's wort with Zoloft may cause severe interactions and is not recommended."

Question 2

The nurse reads in the patient's medication history that the patient is taking buspirone (BuSpar). The nurse interprets that the patient may have which disorder?

A) Anxiety disorder
B) Depression
C) Schizophrenia
D) Bipolar disorder

Answer 2

Anxiety disorder

Question 3

A patient has been admitted to the emergency department with a suspected overdose of a tricyclic antidepressant. The nurse will prepare for what immediate concern?

A) Hypertension
B) Renal failure
C) Cardiac dysrhythmias
D) Gastrointestinal bleeding

Answer 3

Cardiac dysrhythmias

Question 4

When a patient is receiving a second-generation antipsychotic drug, such as risperidone (Risperdal), the nurse will monitor for which therapeutic effect?

A) Fewer panic attacks
B) Decreased paranoia and delusions
C) Decreased feeling of hopelessness
D) Improved tardive dyskinesia

Question 5

A patient wants to take a ginseng dietary supplement. The nurse instructs the patient to look for which potential adverse effect?

A) Drowsiness
B) Palpitations and anxiety
C) Dry mouth
D) Constipation

Question 6

A patient has been taking lithium for 1 year, and the most recent lithium level is 0.9 mEq/L. Which statement about the laboratory result is correct?

A) The lithium level is therapeutic.
B) The lithium level is too low.
C) The lithium level is too high.
D) Lithium is not usually monitored with blood levels.

Question 7

The nurse is reviewing the food choices of a patient who is taking a monoamine oxidase inhibitor (MAOI). Which food choice would indicate the need for additional teaching?

A) Grapefruit juice
B) Fried eggs over-easy
C) Pepperoni pizza
D) Pancakes and maple syrup

Question 8

A patient with the diagnosis of schizophrenia is hospitalized and is taking a phenothiazine drug. Which statement by this patient indicates that he is experiencing a common adverse effect of phenothiazines?

A) "I can't sleep at night."
B) "I feel hungry all the time."
C) "Look at how red my hands are."
D) "My mouth has been so dry lately."

Question 9

While monitoring a depressed patient who has just started SSRI antidepressant therapy, the nurse will observe for which problem during the early time frame of this therapy?

A) Hypertensive crisis
B) Self-injury or suicidal tendencies
C) Extrapyramidal symptoms
D) Loss of appetite

Question 10

Clozapine (Clozaril), an atypical antipsychotic, is prescribed for a patient. The nurse will monitor for which adverse effect during this drug therapy?

A) Edema
B) Photosensitivity
C) Hypotension
D) Severe neutropenia

Question 11

Which statements are true regarding the selective serotonin reuptake inhibitors (SSRIs)?

A) Avoid foods and beverages that contain tyramine.
B) Monitor the patient for extrapyramidal symptoms.
C) Therapeutic effects may not be seen for about 4 to 6 weeks after the medication is started.
D) If the patient has been on an MAOI, a 2- to 5-week or longer time span is required before beginning an SSRI medication.
E) These drugs have anticholinergic effects, including constipation, urinary retention, dry mouth, and blurred vision.
F) Cogentin is often also prescribed to reduce the adverse effects that may occur.

Question 12

A patient has been taking haloperidol (Haldol) for 3 months for a psychotic disorder, and the nurse is concerned about the development of extrapyramidal symptoms. The nurse will monitor the patient closely for which effects?

A) Increased paranoia
B) Drowsiness and dizziness
C) Abnormal muscle movements
D) Dry mouth and constipation

Question 13

A patient who has been taking a selective serotonin reuptake inhibitor (SSRI) states that he "felt awful" when he started taking an over-the-counter St. John's wort herbal product at home. The nurse suspects that he is experiencing serotonin syndrome. Which of these are symptoms of serotonin syndrome?

A) Agitation
B) Drowsiness
C) Tremors
D) Bradycardia
E) Sweating

Question 14

The wife of a patient who has been diagnosed with depression calls the office and says, "It's been an entire week since he started that new medicine for his depression, and there's no change! The medicine is not working!" What is the nurse's best response?

A) "The medication may not be effective for him. He may need to try another type."
B) "It may take up to 6 weeks to notice any therapeutic effects. Let's wait a little longer to see how he does."
C) "It sounds like the dose is not high enough. I'll check about increasing the dosage."
D) "Some patients never recover from depression. He may not respond to this therapy."

Question 15

Before beginning a patient's therapy with selective serotonin reuptake inhibitor (SSRI) antidepressants, the nurse will assess for concurrent use of which medications or medication class?

A) Aspirin
B) Anticoagulants
C) Diuretics
D) Nonsteroidal anti-inflammatory drugs

Question 16

A patient is to receive an intravenous dose of lorazepam (Ativan). The order reads, "Give lorazepam, 1 mg, IV push, now." Identify how many milliliters the nurse will administer for this dose. The medication vial contains 2 mg/mL. _______

Question 17

A patient has been taking the monoamine oxidase inhibitor (MAOI) phenelzine (Nardil) for 6 months. The patient wants to go to a party and asks the nurse, "Will just one beer be a problem?" Which advice from the nurse is correct?

A) "You can drink beer as long as you have a designated driver."
B) "Now that you've been on the drug for 6 months, there will be no further dietary restrictions."
C) "If you begin to experience a throbbing headache, rapid pulse, or nausea, you'll need to stop drinking."
D) "You need to avoid all foods that contain tyramine, including beer, while taking this medication."

Question 18

The nurse is reviewing medications used for depression. Which of these statements is a reason that selective serotonin reuptake inhibitors (SSRIs) are more widely prescribed today than tricyclic antidepressants?

A) SSRIs have fewer sexual side effects.
B) Unlike tricyclic antidepressants, SSRIs do not have drug-food interactions.
C) Tricyclic antidepressants cause serious cardiac dysrhythmias if an overdose occurs.
D) SSRIs cause a therapeutic response faster than tricyclic antidepressants.