Q's
The nurse realizes more medication teaching is necessary when the 30-year-old patient taking lorazepam (Ativan) states:
A. "I must stop drinking coffee and colas."
B. "I can stop this drug after 3 weeks if I feel better."
C. "I must stop drinking alcoholic beverages."
D. "I should not become pregnant while taking this drug."
B. "I can stop this drug after 3 weeks if I feel better."
- Lorazepam should not be discontinued abruptly, but gradually, over a period of several days. Caffeine and alcohol should be avoided when taking lorazepam, a benzodiazepine. This drug should not be taken during pregnancy because of possible teratogenic effects.
A patient has been diagnosed with neuroleptic malignant syndrome. The nurse anticipates administration of which medication to treat this patient?
A. Dantrolene (Dantrium)
B. Tetrabenazine (Xenazine)
C. Propranolol (Inderal)
D. Lorazepam (Ativan)
A. Dantrolene (Dantrium)
- Treatment of NMS involves immediate withdrawal of antipsychotics, adequate hydration, hypothermic blankets, and administration of antipyretics, benzodiazepines, and muscle relaxants such as dantrolene (Dantrium).
What foods contain tyramine?
- Yogurt
- Avacados
- Soy sauce
- Fava beans
- Pepperoni
- Pickles
- Raisins
Which statement by a patient indicates that more teaching on phenothiazine therapy for the treatment of psychosis is needed?
A. "It might take 6 weeks or more for the drug to take effect."
B. "I will get up slowly from a seated position."
C. "When I start to feel better, I will cut the dose of my medication in half."
D. "I will avoid exposure to direct sunlight."
C. "When I start to feel better, I will cut the dose of my medication in half."
- The drug should be taken exactly as ordered. Antipsychotics do not cure the mental illness but do alleviate symptoms. Compliance with drug regimen is extremely important.
A patient with reactive depression is ordered to receive fluoxetine (Prozac). Which information will the nurse include when teaching this patient?
A. The medication takes effect in 1 week
B. The medication increases libido
C. The medication should be taken with grapefruit juice
D. The medication may cause headaches and insomnia
D. The medication may cause headaches and insomnia
- Side effects include headache, nervousness, restlessness, insomnia, blurred vision, tremors, GI distress, and sexual dysfunction. The drug takes about 2 to 4 weeks for onset, decreases libido, and has no interaction with grapefruit juice.
Which advice will the nurse include when teaching the patient about lithium therapy?
A: Take the drug on an empty stomach
B: Eliminate all sodium from your diet
C: Stop taking the lithium when you feel better
D: It may take 1 to 2 weeks before you have any benefits from taking the medication
D: It may take 1 to 2 weeks before you have any benefits from taking the medication
- The effectiveness of lithium may not be evident until 1 to 2 weeks after the start of therapy. The patient should be taught to maintain adequate sodium intake and to avoid crash diets that affect physical and mental health. The patient should be taught to take lithium with meals to decrease gastric irritation.
A patient on risperidone (Risperdal) may be at increased risk for injury due to
A. increased potential for aspiration due to sedation
B. increased risk for falls due to orthostatic hypotension
C. increased risk for infection due to neutropenia
D. increased risk for suicide due to changes in thought processes
B. increased risk for falls due to orthostatic hypotension
- Orthostatic hypotension is the most common adverse reaction seen in patients treated with risperidone (Risperdal)
Before administering an MAO inhibitor, it is most important for the nurse to assess the patient's
A: sexual history
B: socioeconomic status
C: dietary intake
D: hydration status
C: dietary intake
- Certain drug and food interactions with MAO inhibitors can be fatal. Foods that contain tyramine have sympathomimetic-like effects and can cause a hypertensive crisis. These types of food must be avoided by MAOI users.
Which statement about amitriptyline (Elavil) does the nurse identify as being true?
A. The drug is administered first thing in the morning
B. The drug should be discontinued slowly
C. The onset of antidepressant effect is 48 hours
D. Hypertension is a frequent side effect of this drug
B. The drug should be discontinued slowly
- When discontinuing TCAs such as amitriptyline (Elavil), the drug should be gradually decreased to avoid withdrawal symptoms such as nausea, vomiting, anxiety, and akathisia. TCAs are given at night to minimize problems caused by their sedative action. The onset of the antidepressant effect of amitriptyline is 1 to 4 weeks. Orthostatic hypotension is a common side effect of amitriptyline (Elavil).
Assessment findings for a patient with neuroleptic malignant syndrome (NMS) include:
A. bradycardia
B. hypothermia
C. muscle weakness
D. rhabdomyolysis
D. rhabdomyolysis
- NMS symptoms include muscle rigidity, sudden high fever, altered mental status, blood pressure fluctuations, tachycardia, dysrhythmias, seizures, rhabdomyolysis, acute renal failure, respiratory failure, and coma.
Which laboratory test is most important for the nurse to monitor when a patient is receiving lithium (Lithobid)?
A. Urinalysis
B. Serum glucose
C. Serum electrolytes
D. Complete blood count
C. Serum electrolytes
- Serum sodium levels need to be monitored in patients taking lithium. Lithium tends to deplete sodium. Lithium must be used with caution, if at all, by patients taking diuretics.
A patient with major depression has been prescribed fluoxetine (Prozac). What nursing diagnosis would be most appropriate?
A. Social isolation
B. Impaired physical mobility
C. Impaired urinary elimination
D. Disturbed sensory perception
A. Social isolation
A nurse caring for a patient in an outpatient setting notes that the patient is currently taking lorazepam for anxiety and her breath smells of alcohol. The nurse reports this to the health care provider because:
A: Taking alcohol with lorazepam can be fatal
B: Taking alcohol with lorazepam may increase sedative effects
C: All patients using alcohol should be referred for assistance
D: Lorazepam and alcohol antagonize one another
B. taking alcohol with Lorazpam may increase sedative effects
- Alcohol and other CNS depressants should not be taken with benzodiazepines because respiratory depression could result
When providing dietary teaching for a patient taking monamine oxidase inhibitors (MAOIs), the nurse should teach the patient to avoid which food?
A: Yogurt
B: Avocado
C: Grapefruit
D: Potato chip
A: Yogurt
- When taking monamine oxidase inhibitors (MAOIs), patients should avoid cheese, red wine, beer, liver, bananas, yogurt, and sausage
A patient with major depression has been prescribed fluoxetine (Prozac). What appropriate dosing regimen would the nurse expect?
A: 20 mg every morning
B: 40 mg 3 times per day
C: 50 mg at bedtime
D: 100 mg 4 times per day
A: 20 mg every morning
- Fluoxetine (Prozac) is usually initially ordered at 20 mg every morning and may be increased every 2 weeks with a maximum dose of 80 mg/day.