Question 1

Which statement about depression is true?&#10;A) Depression does not affect the way a person interacts with others.&#10;B) Men are twice as likely to experience depression as women.&#10;C) Many older adults with depression are undiagnosed and untreated.&#10;D) Women are less likely than men to seek treatment for depression.

Accepted Answer

Because depression is often mistaken for a normal part of aging,many older adults with depression may be undiagnosed and untreated.Depression affects the way people feel about themselves and how they interact with others.Women are twice as likely as men to experience depression and women are also more likely than men to seek treatment.

Question 2

Which precaution is most important for the nurse to teach a patient who is prescribed any antidepressant drug?&#10;A) &#34;Avoid drinking grapefruit juice while taking this drug.&#34;&#10;B) &#34;Avoid drinking alcoholic beverages while taking this drug.&#34;&#10;C) &#34;Be sure to wear sunscreen and a hat when going outdoors.&#34;&#10;D) &#34;Drink at least 3 liters of fluid every day while taking this drug.&#34;

Accepted Answer

Most antidepressants cause some degree of drowsiness.Alcohol intensifies this action and can impair the patient's physical strength and mental alertness.

Question 3

Which statement about a common anxiety disorder is accurate?&#10;A) Panic disorders develop over a period of hours to days.&#10;B) Generalized anxiety disorder occurs when a person experiences excessive anxiety daily for 2 months.&#10;C) Phobic disorders are recurrent persistent fears of certain objects or situations that can cause panic attacks.&#10;D) Posttraumatic stress disorder is the result of frightening thoughts and dreams.

Accepted Answer

Panic disorders develop over a short period of time such as 10 minutes.Generalized anxiety disorder is when a person experiences excessive anxiety almost daily for more than 6 months.Posttraumatic stress disorder is caused by exposure to death or near-death experiences.

Question 4

A patient with depression has all of the following symptoms.For which symptom is he or she likely to receive treatment at an inpatient facility rather than as an outpatient?&#10;A) Expressing anger at a situation or person&#10;B) Suggesting a plan to hurt oneself&#10;C) Crying off and on for several hours or days&#10;D) Sleeping for 12 hours or longer daily

Accepted Answer

Most patients with depression are treated as outpatients; however,when a person has suicidal thoughts (also called suicidal ideation)and particularly if the person has a suicide plan,hospitalization may be required.

Question 5

What type of medication could be prescribed for a patient who experiences anxiety when speaking before a group?&#10;A) A benzodiazepine drug&#10;B) An SSRI drug&#10;C) A beta blocker&#10;D) A TCA drug

Accepted Answer

When a patient is facing an anxiety-producing event such as performing on stage or making a speech,beta blockers can be prescribed to control the symptoms of anxiety.Benzodiazepine drugs may cause dependence.SSRI drugs can take 3 to 5 weeks to control symptoms of anxiety.Tricyclic antidepressant (TCA)drugs are used to treat depression,not anxiety.

Question 6

Which statement about psychiatric disorders is true?&#10;A) The underlying cause of most mental illness is genetic.&#10;B) The incidence of anxiety and depression decreases with age.&#10;C) Children's psychiatric issues are usually short term and mild.&#10;D) Mental illnesses are a common reason for seeking health care.

Accepted Answer

Major mental illnesses are the most common cause of disability in the United States.About 23% of North American adults experience a clinically diagnosable mental illness each year.Between 9% and 13% of children younger than age 18 experience serious emotional disturbance with functional impairment,whereas 5% to 9% have serious emotional disturbance with extreme functional impairment caused by a mental illness.Only a small percentage of mental illnesses have a genetic origin.Anxiety and depressive disorders tend to increase with age.

Question 7

On admission to the acute care unit a patient tells the nurse that she stopped taking her prescribed clonazepam (Klonopin)2 days ago.What is the nurse's best first action?&#10;A) Ask the patient why she stopped taking the clonazepam.&#10;B) Administer a dose of clonazepam immediately.&#10;C) Document this information as the only action.&#10;D) Notify the prescriber and watch for seizures.

Accepted Answer

Clonazepam is a benzodiazepine drug.Suddenly stopping a drug from this class can cause potentially life-threatening withdrawal symptoms including nervousness,restlessness,tremulousness,weakness,and seizures.

Question 8

A patient has been taking mirtazapine (Remeron)for the last 3 months.Which blood laboratory result from the patient does the nurse report to the prescriber? A) Lactate dehydrogenase 122 mg/dL B) International normalized ratio (INR) 1.3 C) White blood cell count (WBC) 2100/mm³ D) Platelet count 356,000/mm³

Accepted Answer

Mirtazapine can suppress bone marrow production of WBCs (neutropenia)which can greatly increase the patient's risk for infection.The normal WBC range is 5000 to 10,000/mm³.This patient's WBC count is low and drug dosage adjustment or drug changes are needed.

Question 9

A patient who has been prescribed diazepam (Valium)reports taking the as-needed (PRN)drug more often to keep anxiety symptoms under control and does not want the prescriber to stop prescribing it.What is the nurse's best interpretation of this information?

A) The patient may be developing signs of drug dependence.
B) The patient may be developing signs of drug tolerance.
C) The patient's anxiety is becoming more severe.
D) The patient should stop taking the drug immediately.

Accepted Answer

The signs of developing dependence on benzodiazepines include a strong desire or need to continue taking the drug,a need to increase the dose to feel the effects of the drug,and withdrawal effects after the drug is stopped such as irritability,nervousness,and trouble sleeping.Drug tolerance is a condition that occurs when the body gets used to a medicine so that either more medicine is needed or a different medicine is needed.

Question 10

What is the advantage of treating a patient with anxiety with a benzodiazepine drug rather than a selective serotonin reuptake inhibitor (SSRI)?&#10;A) Benzodiazepines are not likely to cause patient dependence when used for an extended period of time.&#10;B) Benzodiazepines have milder side effects and almost no adverse effect when compared with SSRIs.&#10;C) Benzodiazepines control anxiety and allow patients to live a relatively normal lifestyle.&#10;D) Benzodiazepines act to treat anxiety within 20 minutes and can be given on an as-needed basis.

Accepted Answer

Benzodiazepines have stronger side effects than SSRIs and are more likely to cause dependence in a patient who uses them for an extended period of time.Both benzodiazepines and SSRI drugs control anxiety and allow patients to live nearly normal lives.The major benefit of benzodiazepines is that they act within 30 minutes and can be taken as needed.

Question 11

A patient who has been prescribed clonazepam (Klonopin)for the last 3 months tells the nurse that he wants to stop this drug because he constantly feels like he is in a "fog." What is the nurse's best response?

A) "Quit taking the drug today and I will have the prescriber change your medication to another drug category."
B) "Continue to take this drug as prescribed because most patients eventually get used to the foggy sensation."
C) "We will give you a final dose of this drug today intravenously and then start you on a different drug."
D) "I will contact the prescriber but it will still be necessary to take this drug at a lower dosage for awhile."

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Accepted Answer

The answer of A patient who has been prescribed clonazepam...

Question 12

Which characteristic is typical of bipolar disorder?&#10;A) Severe highs and severe lows&#10;B) Increased risk for suicide&#10;C) Persistently low moods&#10;D) Lack of pleasure in life

Accepted Answer

The answer of Which characteristic is typical of bipolar disorder?&#10;A)...

Question 13

A patient who was prescribed citalopram (Celexa)1 week ago for depression reports feeling no different now from 1 week ago and wants to stop taking the drug.What is the nurse's best response?&#10;A) &#34;Treatment for depression is highly individual and this may not be the right drug for you.&#34;&#10;B) &#34;Most drugs for depression take at least 2 weeks to start making you feel better.&#34;&#10;C) &#34;Are you certain that you are taking the drug exactly the way it was prescribed?&#34;&#10;D) &#34;Be sure to stop smoking because cigarette smoking inactivates this drug.&#34;

Accepted Answer

The answer of A patient who was prescribed citalopram (Celexa)1...

Question 14

A patient is prescribed bupropion (Wellbutrin SR)100 mg twice daily.It is time for the second dose today and the drug sent up from the pharmacy is Wellbutrin 100 XL.What is the nurse's best action?&#10;A) Administer the Wellbutrin XL tablet in place of the Wellbutrin SR tablet.&#10;B) Cut the Wellbutrin XL tablet in half and then administer it.&#10;C) Call the pharmacy and obtain a Wellbutrin SR 100 mg tablet.&#10;D) Hold the dose and notify the prescriber.

Accepted Answer

The answer of A patient is prescribed bupropion (Wellbutrin SR)100...

Question 15

The parents of a 12-year-old who was prescribed fluoxetine (Prozac)inform the nurse that their child is having trouble sleeping.What is the nurse's best response?&#10;A) &#34;This is a normal expected side effect of fluoxetine.&#34;&#10;B) &#34;We may need to ask the prescriber to order something to help your child sleep.&#34;&#10;C) &#34;Children are more sensitive to the effects of this drug and may need a lower dose.&#34;&#10;D) &#34;Before bedtime be sure that your child does not eat or drink anything with caffeine.&#34;

Accepted Answer

The answer of The parents of a 12-year-old who was...

Question 16

Which assessment is most important for the nurse to measure or perform before administering the first dose of amitriptyline (Elavil)to a patient?&#10;A) Heart rate and rhythm&#10;B) Core body temperature&#10;C) Level of consciousness&#10;D) Blood pressure in the sitting position

Accepted Answer

The answer of Which assessment is most important for the...

Question 17

Which theory about the cause of depression is supported by research?&#10;A) Heredity or genetics&#10;B) Altered neuroendocrine function&#10;C) Psychosocial factors&#10;D) Neurotransmitter level imbalance

Accepted Answer

The answer of Which theory about the cause of depression...

Question 18

Which statement by a patient with chronic depression who is prescribed fluoxetine (Prozac)indicates to the nurse the need for additional teaching?&#10;A) &#34;It may take from 2 to 8 weeks for my depression to improve.&#34;&#10;B) &#34;If I have suicidal thoughts, I will contact my prescriber immediately.&#34;&#10;C) &#34;I will check my pulse every day and report irregular rhythms to my prescriber.&#34;&#10;D) &#34;When I am feeling better and no longer depressed, I will stop taking the Prozac.&#34;

Accepted Answer

The answer of Which statement by a patient with chronic...

Question 19

A patient asks the nurse why the prescriber is changing his anxiety medication from lorazepam (Ativan)to sertaline (Zoloft).What is the nurse's best response?&#10;A) &#34;Sertraline is a stronger drug and will do a better job of controlling your anxiety.&#34;&#10;B) &#34;Sertraline has milder side effects and a decreased risk for drug dependence.&#34;&#10;C) &#34;Sertraline acts much faster to get the symptoms of your anxiety under control.&#34;&#10;D) &#34;Sertraline can be taken only when needed to control symptoms of anxiety.&#34;

Accepted Answer

The answer of A patient asks the nurse why the...

Question 20

Although serotonin reuptake inhibitors (SSRIs)are used more commonly now to treat anxiety disorders than are benzodiazepines,for which patient situation does the nurse expect a benzodiazepine to be prescribed instead of an SSRI?

A) The patient is 18 years old.
B) Anxiety has been present daily for 6 months.
C) The patient has compulsive repetitive actions.
D) The anxiety attack is severe with hallucinations.

Accepted Answer

The answer of Although serotonin reuptake inhibitors (SSRIs)are used more...

Question 21

A patient who has been prescribed prochlorperazine (Compazine)calls the clinic and reports pink-tinged urine.What is the nurse's best action?&#10;A) Ask the patient whether grapefruit or grapefruit juice has been ingested within the last 24 hours.&#10;B) Remind the patient to drink more water to prevent this drug from damaging the kidneys.&#10;C) Reassure the patient that this is an expected side effect of the drug and needs no action.&#10;D) Instruct the patient to hold the next drug dose and notify the prescriber immediately.

Accepted Answer

The answer of A patient who has been prescribed prochlorperazine...

Question 22

Four hours after receiving risperidone (Risperdal),the patient on the psychiatric unit has a temperature elevation of 2 $\circ$ F.What is the nurse's best action?&#10;A) Administer the next dose of the drug as prescribed.&#10;B) Assess the patient for other signs and symptoms of infection.&#10;C) Hold the next drug dose and notify the prescriber immediately.&#10;D) Attempt to arouse the patient from sleep by gently shaking his or her arm.

Accepted Answer

The answer of Four hours after receiving risperidone (Risperdal),the patient...

Question 23

A female patient who has been prescribed diazepam (Valium)for anxiety tells the nurse that she and her husband are planning to have a child.What is the nurse's best response?&#10;A) &#34;Before becoming pregnant your dosage of diazepam will need to be decreased.&#34;&#10;B) &#34;You should always discuss any changes in your medications and lifestyle with your prescriber.&#34;&#10;C) &#34;Consult with your prescriber because taking diazepam while pregnant has been associated with birth defects.&#34;&#10;D) &#34;Diazepam may cause withdrawal effects when taken during pregnancy.&#34;

Accepted Answer

The answer of A female patient who has been prescribed...

Question 24

Which are common treatment methods for depression?&#10;A) Counseling&#10;B) Surgery&#10;C) Group meetings&#10;D) Psychotherapy&#10;E) Shock therapy

Accepted Answer

The answer of Which are common treatment methods for depression?&#10;A)...

Question 25

An older patient taking lithium carbonate (Eskalith)for 2 months has all of the following conditions.Which symptom does the nurse report to the prescriber as a possible side effect that may require a change of drug or drug dosage?

A) Dry mouth
B) Increased belching after meals
C) Weight loss of 6 lb in 1 week
D) International normalized ratio (INR) of 1.1

Accepted Answer

The answer of An older patient taking lithium carbonate (Eskalith)for...

Question 26

A patient is prescribed 30 mg of chlorpromazine (Thorazine)intramuscularly.The drug available is 25 mg per 1 mL.How many milliliters does the nurse draw into the syringe?&#10;_____ mL

Accepted Answer

The answer of A patient is prescribed 30 mg of...

Question 27

How do the major antipsychotic drugs exert their effects to reduce psychotic episodes?&#10;A) They block dopamine receptors and reduce neuronal impulse transmission.&#10;B) They redirect nerve impulses away from excitatory areas of the brain and into brain inhibitory areas.&#10;C) They enhance the breakdown of excitatory neurotransmitter chemicals so that impulse transmission is slower.&#10;D) They block the reuptake of neurotransmitters so that the concentration of these chemicals is increased in the brain.

Accepted Answer

The answer of How do the major antipsychotic drugs exert...

Question 28

A patient has been prescribed amitriptyline (Elavil).What does the nurse plan to include in the teaching plan for this patient?&#10;A) &#34;Smoking cigarettes can decrease the effectiveness of amitriptyline in treating your depression.&#34;&#10;B) &#34;Check your pulse every day and report any irregular rhythms to your prescriber right away.&#34;&#10;C) &#34;Amitriptyline should help to improve your depression symptoms within 7 to 14 days.&#34;&#10;D) &#34;Avoid driving or operating dangerous equipment until you know how the drug will affect you.&#34;&#10;E) &#34;Be sure to include foods with lots of fiber in your diet to prevent the side effect of constipation.&#34;

Accepted Answer

The answer of A patient has been prescribed amitriptyline (Elavil).What...

Question 29

Which food or beverage does the nurse teach a patient who is prescribed quietiapine (Seroquel)to avoid?&#10;A) Coffee and caffeine&#10;B) Fresh berries and vegetables&#10;C) Aged cheese and smoked meat&#10;D) Grapefruit and grapefruit juice

Accepted Answer

The answer of Which food or beverage does the nurse...

Question 30

Which safety precaution is most important for the nurse to teach an older adult who is prescribed chlorpromazine (Thorazine)?&#10;A) &#34;Avoid going barefoot, even in the house.&#34;&#10;B) &#34;Change positions slowly when rising to stand.&#34;&#10;C) &#34;Drink plenty of water to avoid having to strain during a bowel movement.&#34;&#10;D) &#34;Use a thermometer to check the temperature of your bath or shower water to avoid a scald injury.&#34;

Accepted Answer

The answer of Which safety precaution is most important for...

Question 31

The family of a patient who was prescribed chlorpromazine (Thorazine)report that the patient continually rolls his tongue and smacks his lips.What is the nurse's best action?&#10;A) Reassure the patient and family that this response is an expected side effect of the drug.&#10;B) Instruct the family to ensure that the patient drinks plenty of fluids and performs oral hygiene at least three times daily.&#10;C) Instruct the family to hold the next dose of the drug and have the patient seen by the prescriber as soon as possible.&#10;D) Emphasize to the family that this drug cannot be stopped quickly and to gradually reduce the dose over a 2- to 3-week period.

Accepted Answer

The answer of The family of a patient who was...

Question 32

Which are common anxiety disorders?&#10;A) Dysthymia&#10;B) Panic disorder&#10;C) Bipolar disorder&#10;D) Phobic disorder&#10;E) Obsessive-compulsive disorder

Accepted Answer

The answer of Which are common anxiety disorders?&#10;A) Dysthymia&#10;B) Panic...

Question 33

A patient with anxiety is prescribed oxazepam (Serax).What safety measures must the nurse be sure to include in this patient's plan of care?&#10;A) Call for help when getting out of bed.&#10;B) Use a walker for ambulation.&#10;C) Assess gait for steadiness.&#10;D) Change positions slowly.&#10;E) Take two tablets whenever a dose is missed.

Accepted Answer

The answer of A patient with anxiety is prescribed oxazepam...

Deck 22: Drugs for Depression,anxiety,and Psychosis