Deck 3: Biological Basis for Understanding Psychotropic Drugs

Question 1

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) "You must feel relieved to know that your problem has a physical basis."
C) "Neurotransmitters are substances we eat daily that influence memory and mood."
D) "Neurotransmitters are natural chemicals that pass messages between brain cells."

Answer 1

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

Question 2

A drug causes muscarinic receptor blockade.The nurse will assess the patient for

A) dry mouth.
B) gynecomastia.
C) pseudoparkinsonism.
D) orthostatic hypotension.

Answer 2

dry mouth.

Question 3

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 muscle stiffness

Answer 3

Report muscle stiffness

Question 4

Which instruction has priority when teaching a patient taking 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."

Question 5

A patient has delusions and hallucinations.The health care provider wishes to rule out the presence of a brain tumor.For which test will the nurse need to prepare the patient?

A) PET
B) MRI
C) SPECT
D) Cerebral arteriogram

Question 6

A patient has acute anxiety related to an automobile accident 2 hours ago.The patient needs teaching about drugs from which group?

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

Question 7

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 or multiple infarcts.Which diagnostic procedure should the nurse expect to prepare the patient for first?

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

Question 8

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

A) parasympathetic nervous system.
B) sympathetic nervous system.
C) reticular activating system.
D) medulla oblongata.

Question 9

A nurse can anticipate anticholinergic side effects are likely when a patient takes:

A) lithium (Lithobid).
B) buspirone (BuSpar).
C) risperidone (Risperdal).
D) fluphenazine (Prolixin).

Question 10

A nurse assesses that a patient has fear as well as increased heart rate and blood pressure.The nurse suspects increased activity of which neurotransmitter?

A) GABA
B) Histamine
C) Acetylcholine.
D) Norepinephrine

Question 11

A nurse could anticipate that treatment for a patient with memory difficulties might include medications designed to:

A) inhibit GABA.
B) increase dopamine activity.
C) reduce neurotensin metabolism.
D) prevent destruction of acetylcholine.

Question 12

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 the knowledge that paroxetine is a:

A) selective norepinephrine reuptake inhibitor.
B) tricyclic antidepressant.
C) MAO inhibitor.
D) SSRI.

Question 13

A patient with bipolar disorder has an unstable mood,aggressiveness,agitation,talkativeness,and irritability.The nurse begins care planning based on the expectation that the health care provider is most likely to prescribe a medication classified as a(n):

A) anticholinergic.
B) mood stabilizer.
C) psychostimulant.
D) antidepressant.

Question 14

The nurse wants to assess a patient with major depression for disturbances in circadian rhythms.Select the best question for this aspect of the assessment.

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

Question 15

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

A) chlordiazepoxide (Librium).
B) clozapine (Clozaril).
C) sertraline (Zoloft).
D) tacrine (Cognex).

Question 16

The therapeutic action of neurotransmitter inhibitors that block reuptake cause:

A) decreased concentration of the neurotransmitter in the central nervous system.
B) increased concentration of neurotransmitter in the synaptic gap.
C) destruction of receptor sites.
D) limbic system stimulation.

Question 17

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

A) Hippocampus
B) Frontal lobe
C) Cerebellum
D) Brainstem

Question 18

The nurse administers a medication that potentiates the action of GABA.Which effect would be expected?

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

Question 19

The parent of an adolescent 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.An injection is given and images are taken.It 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 type of x-ray that shows structures of the brain and whether there has ever been a brain injury."

Question 20

A patient taking medication for mental illness develops restlessness and an uncontrollable need to be in motion.The nurse analyzes that these symptoms relate to which drug action?

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

Question 21

A category 5 hurricane is approaching.Which change in an individual's vital signs is most likely?

A) Pulse rate changes from 90 to 72
B) Pupil size changes from 6 mm to 4 mm
C) Complaints of intestinal cramping begin
D) Blood pressure changes from 114/62 to 136/78

Question 22

A patient has difficulty with mathematical calculations.Which area of the brain is most likely involved with this problem?

A) frontal lobe
B) parietal lobe
C) temporal lobe
D) occipital lobe
E) brainstem

Question 23

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

A) H₁
B) 5 HT₂
C) GABA
D) Acetylcholine

Question 24

A nurse prepares to administer antipsychotic medication to a patient with schizophrenia.Additional monitoring for adverse effects will be most important if the patient is also has which health problem? Select all that apply.

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

Question 25

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

A) Amygdala
B) Hippocampus
C) Occipital lobe
D) Temporal lobe
E) Basal ganglia

Question 26

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

A) cardiac dysrhythmia.
B) hypotensive shock.
C) hypertensive crisis.
D) cardiogenic shock.

Question 27

A drug blocks the attachment of norepinephrine to a? receptors.The patient may experience:

A) hypertensive crisis.
B) orthostatic hypotension.
C) severe appetite disturbance.
D) an increase in psychotic symptoms.

Question 28

Correctly sequence these structures of the brainstem,beginning with the most superior.

A) Pons
B) Midbrain
C) Medulla oblongata

Question 29

The laboratory report for a patient taking clozapine (Clozaril)shows a white blood cell count of 3000 mm³.Select the nurse's best action.

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

Question 30

A nurse caring for a patient taking an SSRI will develop outcome criteria related to:

A) mood improvement.
B) coherent thought processes.
C) reduced levels of motor activity.
D) decreased extrapyramidal symptoms.

Question 31

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

A) Galantamine (Reminyl)
B) Valproate (Depakote)
C) Buspirone (BuSpar)
D) Tacrine (Cognex)

Question 32

A nurse cares for patients taking various medications,including buspirone (BuSpar),haloperidol (Haldol),carbamazepine (Tegretol),trazodone (Desyrel),and phenelzine (Nardil).The nurse will order a special diet for the patient who takes:

A) buspirone.
B) haloperidol.
C) carbamazepine.
D) trazodone.
E) phenelzine.

Question 33

Questions that would be nonjudgmental when obtaining information about patient use of herbal remedies include: Select all that apply.

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) "Have you experienced toxic effects from mixing herbals and prescription drugs?"
E) "What differences in your symptoms do you notice when you take herbal supplements?"

Question 34

SSRIs improve depression by which action? SSRIs:

A) destroy increased amounts of serotonin.
B) block muscarinic and a1 norepinephrine receptors.
C) make more serotonin available at the synaptic gap.
D) increase production of acetylcholine and dopamine.

Question 35

A nurse cares for four patients who are receiving clozapine,lithium,fluoxetine,and venlafaxine,respectively.With which patient should the nurse be most alert for alterations in cardiac or cerebral electrical conductivity and fluid and electrolyte imbalance? The patient receiving:

A) lithium (Lithobid).
B) clozapine (Clozaril).
C) fluoxetine (Prozac).
D) venlafaxine (Effexor).