Question 1

A client with depression and substance abuse has an interrupted sleep pattern and demands a sedative. Which teaching would the nurse provide about sedative-hypnotics?

Accepted Answer

Sedative-hypnotics are potentially addictive and can lose their effectiveness over time due to developing tolerance. Additionally, clients with substance abuse disorders should not be prescribed sedative-hypnotics due to the risk of addiction and further substance abuse. The nurse could explore alternative non-pharmacological interventions for improving sleep patterns such as sleep hygiene or behavioral changes before administering a sedative-hypnotic medication.

Question 2

In the treatment of anxiety disorders, benzodiazepines (such as Ativan and Xanax) are indicated for ______ use and have a ______ abuse potential.

Accepted Answer

Benzodiazepines are typically prescribed for short-term relief of severe, disabling, or distressing anxiety symptoms due to their high potential for dependence and abuse.

Question 3

To which client would the nurse most likely administer a benzodiazepine?

Accepted Answer

Benzodiazepines are commonly used in the management of alcohol withdrawal, as they can help with anxiety, agitation, and seizures that can occur with the withdrawal process. They would not be indicated for someone taking cough medicine or opioid pain agents, and may not be appropriate for someone with schizophrenia depending on their individual symptoms and treatment plan.

Question 4

Logan, age 8 years, takes methylphenidate (Ritalin) for attention deficit/hyperactivity disorder. His mother reports to the nurse that Logan has a very poor appetite, and she struggles to help him gain weight. Which teaching will the nurse provide?

Accepted Answer

Administering Logan's medication immediately after meals may help stimulate his appetite and increase his desire to eat. This may help him gain weight while still receiving the necessary medication for his ADHD. Skipping a dose of medication when Logan does not eat anything could negatively impact his treatment, and simply assuring his mother that Logan will eat when he is hungry may not address the underlying issue of poor appetite. Giving the medication at bedtime may interfere with Logan's sleep.

Question 5

A client was recently admitted to the inpatient unit after a suicide attempt and has not responded to SSRIs or tricyclic antidepressants. The client asks the nurse, "Why can't monoamine oxidase inhibitors (MAOIs) be added to what I am on now?" Which response should the nurse make?

Accepted Answer

Combining SSRIs or tricyclic antidepressants with monoamine oxidase inhibitors (MAOIs) can lead to a life-threatening condition called hypertensive crisis, which is a sudden and severe increase in blood pressure that can lead to organ damage or failure. Therefore, it is contraindicated to combine these medications. Electroconvulsive therapy (ECT) may be an option for some clients, but it is not the only option and should not be presented as the only option. It is important to give the client accurate information about their treatment options and potential risks.

Question 6

Which information should the nurse include in a staff education program about the history of psychopharmacology?

Accepted Answer

Psychotropic medications are not intended to cure mental illnesses but are used as adjunctive therapy to manage symptoms. Antidepressants were not the first type of mental health drugs, as antipsychotics were introduced earlier. Mood stabilizers help manage symptoms of bipolar disorder but do not eliminate the disorder entirely. Therefore, the nurse should include information about psychotropic medications being used as adjunctive therapy in the staff education program about the history of psychopharmacology.

Question 7

The client with schizophrenia has recently begun a new medication, clozapine (Clozaril). Which signs and symptoms of a potentially fatal side effect will the nurse teach the client about?

Accepted Answer

Clozapine can cause agranulocytosis, which is a potentially fatal side effect involving a severe reduction in white blood cells. This can cause symptoms such as sore throat, fever, and malaise. The client should be taught to report any of these symptoms immediately to their healthcare provider. Blurring vision, dry mouth, and constipation are common side effects of clozapine but are not life-threatening. Tremor, shuffling gait, and rigidity are potential side effects of other antipsychotic medications but are not specifically associated with clozapine. Fine tremor, tinnitus, and nausea are also side effects of other medications and are not associated with clozapine.

Question 8

A client with schizophrenia has recently begun a new medication, clozapine (Clozaril). Which potentially fatal side effect will the nurse teach the client about?

Accepted Answer

A potentially fatal side effect of clozapine is agranulocytosis, which is a severe decrease in white blood cells that can lead to infection and sepsis. Therefore, the nurse must teach the client to report any signs of infection, such as fever, sore throat, or chills, immediately. Close monitoring of the client's blood cell count is also necessary while taking clozapine.

Question 9

An aging client with chronic schizophrenia takes a beta-adrenergic blocking agent (propranolol) for hypertension and an antipsychotic. Given the combined side effects of these drugs, what teaching should the nurse provide?

Accepted Answer

Both propranolol and antipsychotics can cause orthostatic hypotension, which is a drop in blood pressure upon standing up quickly. Therefore, the nurse should advise the client to rise slowly when changing positions to avoid falls or injury. Choices A and B are important for overall health and wellbeing but do not directly relate to the combined side effects of the medications. Choice D is not relevant to the medications mentioned in the scenario.

Question 10

Which medication would the nurse most likely administer to treat the extrapyramidal side effects of antipsychotic medications?

Accepted Answer

Benztropine (Cogentin) is a medication commonly used to treat the extrapyramidal side effects of antipsychotic medications. Diazepam (Valium) is a benzodiazepine used for anxiety and muscle relaxation, amitriptyline (Elavil) is a tricyclic antidepressant used for depression and neuropathic pain, and methylphenidate (Ritalin) is a stimulant used for ADHD. None of these medications are indicated for the treatment of extrapyramidal side effects.

Question 11

An elderly client has been diagnosed with major depression and is prescribed a selective serotonin reuptake inhibitor (SSRI). Which side effect would the nurse monitor for in this client?

Accepted Answer

Hyponatremia is a possible side effect of SSRI use, as it can lead to decreased sodium levels in the blood. The other options are not commonly associated with SSRI use.

Question 12

As part of discharge teaching, which guideline regarding lithium therapy will the nurse plan to include?

Accepted Answer

Maintaining a consistent sodium intake is important while taking lithium, as both sodium and lithium are processed by the same receptors in the body. Fluctuations in sodium intake can lead to fluctuations in lithium levels, which can be dangerous. The other options are not specific to lithium therapy.

Question 13

The male client is experiencing a psychotic episode. He is in good physical health but has allergies to penicillin, prochlorperazine (Compazine), and bee stings. Which antipsychotic medication would be contraindicated for the client?

Accepted Answer

Thioridazine is contraindicated because of the client's allergy to prochlorperazine (Compazine), which is also a phenothiazine. There is a risk of cross-sensitivity among drugs in the phenothiazine class.

Question 14

When used in combination with anxiolytic medication, alcohol leads to ______ effects, and caffeine leads to ______ effects.

Accepted Answer

Alcohol can enhance the sedative effects of anxiolytic medications, leading to increased effects. Caffeine, a stimulant, can counteract the sedative effects, leading to decreased effects.

Question 15

The client is taking selective serotonin reuptake inhibitor (SSRI). Which finding indicates the client is having a therapeutic effect from the SSRI?

Accepted Answer

The answer of The client is taking selective serotonin reuptake...

Question 16

Which client would the nurse instruct to obtain routine blood-level monitoring?

Accepted Answer

Lithium is a mood stabilizer and requires routine blood level monitoring to ensure therapeutic levels and prevent toxicity.

Question 17

Which information should the nurse share with the client about tricyclic antidepressant medications?

Accepted Answer

Tricyclic antidepressant medications may take up to 4 weeks for their full therapeutic potential to be reached. Other options listed are not specific to tricyclic antidepressants.

Question 18

The client with schizophrenia has recently begun a new medication, clozapine (Clozaril). Which laboratory result would reveal a potentially fatal side effect of this medication?

Accepted Answer

Clozapine (Clozaril) can cause agranulocytosis, a potentially fatal side effect characterized by a dangerously low absolute neutrophil count (ANC), which increases the risk of severe infections. Regular monitoring of ANC is required for patients on clozapine.

Question 19

A client was recently admitted to the inpatient unit after a suicide attempt and is prescribed a selective serotonin reuptake inhibitor (SSRI). Which sign or symptom would the nurse include in the teaching session about serotonin syndrome?

Accepted Answer

Serotonin syndrome is a potentially life-threatening condition that can occur when there is an excess of serotonin in the body. Myoclonus, or muscle twitching, is one of the common signs of serotonin syndrome. Constipation, hypothermia, and impotence are not typical signs of serotonin syndrome.

Question 20

A client is taking a monoamine oxidase inhibitor (MAOI). When teaching the client about diet, which foods will the nurse caution the client to avoid?

Accepted Answer

Monoamine oxidase inhibitors (MAOIs) interact with tyramine, which is found in some foods and drinks. Foods high in tyramine can cause a sudden, dangerous increase in blood pressure. Pepperoni pizza and red wine are high in tyramine, so the nurse should caution the client to avoid them. Bagels with cream cheese and tea, apple pie and coffee, and potato chips and diet cola are not high in tyramine and do not need to be avoided.

Quiz 4: Psychopharmacology

A client with depression and substance abuse has an interrupted sleep pattern and demands a sedative. Which teaching would the nurse provide about sedative-hypnotics?

In the treatment of anxiety disorders, benzodiazepines (such as Ativan and Xanax) are indicated for use and have a abuse potential.

To which client would the nurse most likely administer a benzodiazepine?

Logan, age 8 years, takes methylphenidate (Ritalin) for attention deficit/hyperactivity disorder. His mother reports to the nurse that Logan has a very poor appetite, and she struggles to help him gain weight. Which teaching will the nurse provide?

A client was recently admitted to the inpatient unit after a suicide attempt and has not responded to SSRIs or tricyclic antidepressants. The client asks the nurse, "Why can't monoamine oxidase inhibitors (MAOIs) be added to what I am on now?" Which response should the nurse make?

Which information should the nurse include in a staff education program about the history of psychopharmacology?

The client with schizophrenia has recently begun a new medication, clozapine (Clozaril) . Which signs and symptoms of a potentially fatal side effect will the nurse teach the client about?

A client with schizophrenia has recently begun a new medication, clozapine (Clozaril) . Which potentially fatal side effect will the nurse teach the client about?

An aging client with chronic schizophrenia takes a beta-adrenergic blocking agent (propranolol) for hypertension and an antipsychotic. Given the combined side effects of these drugs, what teaching should the nurse provide?

Which medication would the nurse most likely administer to treat the extrapyramidal side effects of antipsychotic medications?

An elderly client has been diagnosed with major depression and is prescribed a selective serotonin reuptake inhibitor (SSRI) . Which side effect would the nurse monitor for in this client?

As part of discharge teaching, which guideline regarding lithium therapy will the nurse plan to include?

The male client is experiencing a psychotic episode. He is in good physical health but has allergies to penicillin, prochlorperazine (Compazine) , and bee stings. Which antipsychotic medication would be contraindicated for the client?

When used in combination with anxiolytic medication, alcohol leads to effects, and caffeine leads to effects.

The client is taking selective serotonin reuptake inhibitor (SSRI) . Which finding indicates the client is having a therapeutic effect from the SSRI?

Which client would the nurse instruct to obtain routine blood-level monitoring?

Which information should the nurse share with the client about tricyclic antidepressant medications?

The client with schizophrenia has recently begun a new medication, clozapine (Clozaril) . Which laboratory result would reveal a potentially fatal side effect of this medication?

A client was recently admitted to the inpatient unit after a suicide attempt and is prescribed a selective serotonin reuptake inhibitor (SSRI) . Which sign or symptom would the nurse include in the teaching session about serotonin syndrome?

A client is taking a monoamine oxidase inhibitor (MAOI) . When teaching the client about diet, which foods will the nurse caution the client to avoid?