Question 1

A client is prescribed thiothixene (Navane) and is experiencing muscle spasms of the neck. The client is grimacing and having difficulty speaking. Which action should the nurse take?

Accepted Answer

The client is exhibiting symptoms of acute dystonia, which is a potential side effect of thiothixene. Benztropine is an anticholinergic medication that can effectively treat acute dystonia. Chlorpromazine could also be used, but it is not the best choice as it has a higher risk of causing hypotension. Distracting the client or giving anti-inflammatories and heat will not effectively treat acute dystonia.

Question 2

A client prescribed haloperidol (Haldol) is not demonstrating an improvement of psychotic behaviour after taking the medication for 5 days. What changes in his treatment regime would the nurse expect?

Accepted Answer

Haloperidol can take several weeks to show full therapeutic effects, so no changes are necessary after just 5 days.

Question 3

A school-age client who is taking methylphenidate (Ritalin) for treatment of ADHD is seen in the clinic for routine follow-up. The nurse will automatically perform which functions? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The nurse should measure the client's height and weight to monitor growth and medication effectiveness. Assessing vital signs, especially heart rate and BP, is important because methylphenidate can increase heart rate and BP, which can lead to cardiovascular complications in some individuals. Obtaining labs to assess cardiovascular status, obtaining a fasting blood glucose, and obtaining a 24-hour urine collection for proteinuria are not routine follow-up measures for a school-age client taking methylphenidate for ADHD.

Question 4

A mother tells the nurse, "My son has ADHD and so does my sister's daughter. They are the same age, but they are on two different drugs. Why is that?" Which information should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

C) The choice of drug for ADHD can indeed be influenced by different dosing schedules, as some medications may require multiple doses throughout the day, while others are long-acting and only need to be taken once. This can affect the choice based on convenience, the child's school schedule, and the ability to adhere to the medication regimen.D) Individual response to medication varies widely among people with ADHD. Some children may respond better to one type of medication over another due to differences in their body's chemistry, the specific symptoms they exhibit, or side effects they experience. This variability necessitates a personalized approach to finding the most effective medication for each child.

Question 5

An adult client who is seen by the primary care provider for complaints of inability to focus and concentrate on college studies is prescribed methylphenidate (Ritalin). Which client comment indicates that the nurse should provide additional information about the drug?

Accepted Answer

Methylphenidate is a central nervous system stimulant that is typically taken early in the day to avoid insomnia or sleep disturbances. Taking it in the evening before bedtime may interfere with sleep and the nurse should provide additional information about the best time to take the medication. Options A and B indicate appropriate understanding of potential side effects and appropriate actions to take. Option C is a common side effect of methylphenidate and does not require additional information from the nurse.

Question 6

What should the nurse teach a client about obtaining prescribed central nervous system stimulant medications? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of What should the nurse teach a client...

Question 7

A client was prescribed chlorpromazine four weeks ago to treat symptoms of schizophrenia. The client's family has noted only a small improvement in symptoms and asks about changing to another treatment. Which response by the nurse is the most appropriate?

Accepted Answer

Chlorpromazine, like other antipsychotics, can take 6-8 weeks to show significant improvement in symptoms of schizophrenia.

Question 8

A nurse is developing the initial care plan for a client who is prescribed a central nervous system stimulant for the treatment of ADHD. Which nursing diagnoses will most likely be a part of this care plan? Note: Credit will be awarded only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of A nurse is developing the initial care...

Question 9

A client with a history of benign prostatic hyperplasia is beginning treatment for schizophrenia. Which medication would be contraindicated for this client?

Accepted Answer

Chlorpromazine can cause urinary retention, which can exacerbate symptoms of benign prostatic hyperplasia (BPH), making it contraindicated for this client.

Question 10

The nurse is preparing discharge instructions for a client being treated with medication and psychotherapy for schizophrenia. What priority should the nurse address with the client prior to discharge?

Accepted Answer

The priority for the nurse to address with the client prior to discharge is substance use. Drinking 1-3 beers before bedtime per day is a concerning behavior as it may interfere with the effectiveness of medication and potentially exacerbate symptoms of schizophrenia. The other options (smoking 1-3 cigarettes per day, eating grapefruit for breakfast, and drinking 1-3 caffeinated sodas per day) are not as concerning or may not have as significant of an impact on the client's treatment.

Question 11

A school-age client comes to the clinic for routine follow-up after being placed on Methylphenidate (Ritalin) 2 weeks ago for a diagnosis of ADHD. The client weighed 15 pounds over normal for height prior to the start of the Ritalin. The mother states concern that the client is no longer snacking, barely finishes meals, and "will lose too much weight." What is the nurse's best response to this concern?

Accepted Answer

The nurse should acknowledge the mother's concern and offer practical advice for addressing the issue. Option A is not the best response because it may cause unnecessary anxiety for the mother and child. Option B is incorrect because although weight loss is a common side effect of methylphenidate, it is not desirable for this client who was already overweight prior to starting the medication. Option D is incorrect because Ritalin is not a weight-loss medication and it is not appropriate to suggest that it will help the client to return to a normal weight.

Question 12

A student nurse is about to administer her client aripiprazole (Abilify) to treat both the positive and negative symptoms of schizophrenia. What will the student nurse inform her instructor is the medication's mechanism of action?

Accepted Answer

Aripiprazole (Abilify) is a partial agonist at dopamine type 2 (D2) and serotonin type 2 (5-HT2A) receptors. This means that it activates these receptors to a lesser degree than full agonists, which can lead to a reduction of both the positive and negative symptoms of schizophrenia. The medication does not increase norepinephrine activity or inhibit the re-uptake of serotonin at the synapse, nor does it bind to the GABA receptor.

Question 13

The nurse provides information regarding methylphenidate (Concerta) to the parents of a school-age client. Which statements indicate that the parents have good understanding of the information? Note: Credit will be awarded only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of The nurse provides information regarding methylphenidate (Concerta)...

Question 14

MCSA Nursing students have completed their module on pharmacology for Attention Deficit/Hyperactivity Disorder. What statement by a student indicates an understanding of the actions of a CNS stimulant?

Accepted Answer

CNS stimulants such as methylphenidate and amphetamines work by activating the reticular activating system in the brain, which in turn increases focus and awareness. Option B describes the mechanism of action for antidepressants and antipsychotics. Option C describes the mechanism of action for alpha2 agonists used for hypertension. Option D describes the mechanism of action for norepinephrine reuptake inhibitors used for depression and anxiety disorders.

Question 15

A client who was prescribed thioridazine 2 days ago presents with muscle spasms of the tongue. The health care provider orders diphenhydramine Benztropine. What is the rationale for this medication?

Accepted Answer

Diphenhydramine and Benztropine are both medications used to reverse acute dystonia, which is a side effect of thioridazine. Muscle spasms of the tongue fall under the category of acute dystonia, so these medications are appropriate to use in this case. Option A is incorrect because decreasing saliva and mucous secretions is not the primary purpose of these medications in this situation. Option C is incorrect because anaphylaxis is not a concern in this case. Option D is incorrect because sedation is not the desired outcome in this case.

Question 16

A client recently prescribed methylphenidate (Ritalin) for treatment of ADHD complains of an inability to go to sleep at night. Which nursing actions are indicated? Note: Credit will be awarded only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The nurse should assess for caffeine intake, as this can interfere with sleep, especially if consumed late in the afternoon or evening hours. The nurse should also assess the time of day that the client is taking Ritalin, as taking it too late in the day can interfere with sleep. Finally, the nurse should assess for nonpharmacologic measures that the client is taking to induce sleep, as these may need to be modified or intensified to improve sleep. Informing the health care provider or suggesting melatonin may be appropriate interventions, but they are not indicated as the best choices in this scenario.

Question 17

An infant in the neonatal intensive care unit is prescribed caffeine IV as treatment for apnea. Which medical orders should the nurse plan for, based on the addition of this medication? Note: Credit will be awarded only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of An infant in the neonatal intensive care...

Question 18

The mother of a paediatric client prescribed Clonidine (Catapres) for treatment of ADHD makes these remarks. Which statements indicate that the nurse should provide additional information about the drug? Note: Credit will be awarded only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

Clonidine can cause drowsiness as a side effect, so statement A is incorrect. Statement C is incorrect because there is no standard practice of taking a child off Clonidine every 6 months; such decisions are based on individual treatment plans.

Question 19

MCSA A young mother asks the nurse, why her son is being ordered atomoxetine instead of Ritalin to treat his ADHD. How does the nurse respond to this question?

Accepted Answer

Atomoxetine has been shown to be equally effective in treating ADHD compared to Ritalin, but with potentially fewer side effects such as decreased appetite and weight loss.

Question 20

A client with a history of suicidal behaviour and schizophrenia stopped taking perphenazine after four weeks of therapy. The client is currently experiencing a return of hallucinations. What might the nurse assess when determining the reason the client stopped taking the medication? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

Perphenazine can cause side effects such as sedation, weight gain, agitation, fatigue, and headache, which might lead the client to stop taking the medication. Lack of desire to consume alcohol is not a typical side effect of perphenazine.

Quiz 5: Pharmacology of Alterations in the Central Nervous System