Question 1

What information should the nurse include in patient teaching about psychotropic medication? Select all that apply.

Accepted Answer

Teaching about how to manage common annoying side effects, such as dry mouth and orthostatic hypotension, can promote medication compliance by the patient. Knowing what side effects to report promotes patient safety. In addition, knowing about common drug-drug interactions, such as the potentiating effects of alcohol on sedating drugs, promotes patient safety. Providing written materials is helpful to patients who can then refer to these resources rather than having to rely on memory. Pharmacokinetics and an extensive list of side effects are major aspects of the nurse's role but are not expected from patients.

Question 2

A patient taking a psychotropic medication reports, "This medicine isn't working right for me. It's causing side effects." Select the nurse's best comment to further assess the scenario.

Accepted Answer

Open-ended communication techniques are important strategies for exploring the patient's concerns. It is also important for the nurse to use culturally familiar terms. Patients are unlikely to know the meaning of terms such as tachycardia, diaphoresis, and urinary retention.

Question 3

Bearing in mind the function of the blood-brain barrier, dangers associated with administering large doses of water-soluble drugs relate primarily to the:

Accepted Answer

Water-soluble drugs penetrate the blood-brain barrier slowly and in insignificant amounts. A dose high enough to affect the brain would invariably cause adverse systemic side effects. The other effects are not related.

Question 4

A novice nurse asks, "What is the role of psychopharmacology in the psychotherapeutic management model?" A mentor should respond that psychopharmacology makes it possible to:

Accepted Answer

By effectively treating psychotic symptoms, the incidence of violent behaviors has been reduced. This makes possible the use of the least restrictive treatment alternative, an important facet of psychotherapeutic management. Psychopharmacology does not make the other options possible.

Question 5

A patient takes a psychotropic medication that affects serotonin receptors. The patient complains of anxiety, insomnia, and loss of appetite. What effect is the drug having on the serotonin receptors?

Accepted Answer

The patient's complaints indicate activation of serotonin receptors. None of the other options correctly identifies this effect.

Question 6

Studies about psychiatric patients' understanding of psychopharmacology suggest that the nursing diagnosis most applicable is:

Accepted Answer

Research has shown that most patients do not know important facts about the medications prescribed for them. As a result, they are often noncompliant. As knowledge deficits are removed, better compliance can be expected. Data are not present to suggest applicability of the other options.

Question 7

A week after beginning fluoxetine ( Prozac ), a patient complains, "I still feel so depressed all the time." Based on pharmacodynamics, the nurse's best action is to:

Accepted Answer

One week is probably an insufficient time for antidepressants to become effective in reducing patient symptoms. The phenomenon of receptor down-regulation develops in 2 to 4 weeks. The other options are not supported by research studies.

Question 8

A patient takes a psychotropic medication that affects norepinephrine receptors. The patient reports, "It feels like my heart is pounding in my chest." What effect is the drug having on the norepinephrine receptors?

Accepted Answer

The patient's complaints indicate activation of norepinephrine receptors. The medication has stimulated the action of b?-receptors. None of the other options correctly identifies this outcome.

Question 9

A nurse assesses a newly hospitalized patient with a long history of serious and persistent mental illness. The priority assessment information to obtain regarding medication safety is:

Accepted Answer

Information related to safety is the nurse's priority. Adverse reactions to psychotropic medications can be dangerous, even life-threatening. If a patient has had an adverse reaction to a particular drug, it would be unwise to administer it again. The other options do not address a safety issue.

Question 10

When discussing treatment of an aggressive patient with psychosis, a health care provider says, "I plan to prescribe the original antipsychotic drug." Which medication is relevant to the statement?

Accepted Answer

Only chlorpromazine and clozapine are antipsychotics. Chlorpromazine is a traditional drug, introduced in the early 1950s, whereas clozapine is a newer drug, introduced in the 1990s. Paroxetine and imipramine are antidepressants.

Question 11

The primary mechanisms of action of certain antidepressants result from neurotransmitter inactivation by enzyme-based metabolism and:

Accepted Answer

Neurotransmitters are inactivated in two ways: (1) they are metabolized by enzymes, and (2) they are taken back into the presynaptic storage vesicles-a process called reuptake. The other options have no physiologic basis in fact.

Question 12

Bioavailability of orally administered drugs is initially associated with which physiologic phenomenon?

Accepted Answer

First-pass metabolism in the liver reduces the bioavailability of orally administered drugs. The other options do not occur first.

Question 13

A patient takes a psychotropic medication that affects acetylcholine receptors. The patient complains of dry mouth and constipation. What effect is the drug having on the acetylcholine receptors?

Accepted Answer

The patient's complaints indicate suppression of the parasympathetic nervous system, which is associated with antagonism of the action of acetylcholine.

Question 14

The parent of a teen diagnosed with schizophrenia asks, "Why does schizophrenia usually appear in adolescence?" The nurse's reply would be based on which premise?

Accepted Answer

Arborization, or branching of dendrites, is a process that continues into adolescence. Some authorities have suggested that this might account for the appearance of schizophrenia at this period in life. The other options are of no relevance.

Question 15

A realistic outcome of patient teaching about psychotropic medication is that the patient will:

Accepted Answer

The correct response identifies basic information that each patient should have. Because the information is basic, the outcome, as stated, is realistic. The other options are less basic and less attainable.

Question 16

Sequence the following historical events beginning with the evolution of psychotropic medications:

Accepted Answer

Evolutionary events in the development of psychotropic drugs changed the care environment for patients with mental illness and had significant effects on the nurse's role.

Question 17

An outpatient diagnosed with schizophrenia has been omitting doses of medication. Which questions should the clinic nurse ask to determine the reasons for the problem? Select all that apply.

Accepted Answer

Each question listed refers to a common reason for patients not taking medication as prescribed.

Question 18

A nurse administers a highly protein-bound medication. Which patient would have the most immediate and powerful effect from this drug?

Accepted Answer

The older malnourished patient would have fewer serum proteins to bind the drug; therefore, higher amounts of free drug would be available to act immediately. The patients described in the distracters would have normal protein levels, so the drug would be bound.

Question 19

A nurse administering a selective serotonin reuptake inhibitor (SSRI) antidepressant should carefully observe the patient for symptoms related to:

Accepted Answer

Depression is thought to be related to decreased amounts of the neurotransmitters norepinephrine and serotonin. SSRIs increase the reuptake of serotonin, increasing the availability of this neurotransmitter at the synapse. If the SSRI is effective, the increased serotonin will result in a decrease in symptoms of depression. The other options would not be related to SSRI administration.

Question 20

A patient taking clozapine (Clozaril) says, "I get plenty of vitamin C by drinking 8 ounces of grapefruit juice each morning." Select the nurse's best response.

Accepted Answer

Only the correct option provides vital information based on the cytochrome P-450 enzyme system's involvement in drug metabolism. Clozapine metabolism is inhibited by the ingestion of grapefruit juice, making the likelihood of a toxic reaction to the drug more likely, because the drug accumulates in the body.

Quiz 12: Introduction to Psychotropic Drugs