Antianxiety
1. When used in combination with anxiolytic medication, alcohol leads to ______ effects, and caffeine leads to _____________ effects.
1.increased: increased
2. increased: decreased
3.decreased: decreased
4. decreased; increased
2. increased; decreased
8. 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?
1. Sedative hypnotics are potentially addictive and gradually lose their effectiveness as one builds up tolerance to them.
2. Sedative hypnotics work best in combination with other techniques.
3. Sedative hypnotics are not permitted for use in clients with substance abuse disorders
4. Sedative hypnotics are not as effective as the antidepressant medications for treating sleep disturbances
1. Sedative hypnotics are potentially addictive and gradually lose their effectiveness as one builds up tolerance to them.
18. A client reports to the nurse that after 2 weeks their SSRI medication is not helping. Which action demonstrates the best clinical judgement by the RN?
1. Educate that it may not be fully effective for 4 weeks
2. Hold the next dose and contact MD
3. Check VS and labs for therapeutic blood levels
4. Assess if client is aware of mood swings or has a history of bipolar disorder
1. Educate that it may not be fully effective for 4 weeks
5. A client began taking lithium for the treatment of bipolar disorder approx 1 month ago and asks why he has gained 12 lbs since then. Which response by the nurse is appropriate?
1. Im surprised you have gained weight. Weight loss is a typical pattern when taking lithium.
2. Your weight gain is more likely related to food intake than medication.
3. Weight gain is a common but troubling side effect. Lets talk about some strategies for safely improving your nutrition and exercise habits.
4. There's not much you can do about the weight gain. Its better than being emotionally unstable.
3. Weight gain is a common but troubling side effect. Lets talk about some strategies for safely improving your nutrition and exercise habits.
20. which medication would the nurse most likely administer to treat the xtrapyramidal side effects of antipsychotic medications?
1. Diazepam (Valium)
2. Amitriptyline (Elavil)
3. Benztropine (Cogentin)
4. Methylphenidate (Ritalin)
3. Benztropine (Cogentin)
11. In the treatment of anxiety disorders, benzodiazepines such as Ativan and Xanax are indicated for ______ use and have a _______ abuse potential.
1. short term; high
2. long term; high
3. short term; low
4. long term; low
1. short term; high
3. 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?
1. constipation
2. Myoclonus
3. Hypothermia
4. Impotence
Ans 2. Myoclonus
Myoclonus is a brief involuntary irregular twitching of a muscle or joint
4. 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 cant MAOIs be added to what I am on now"? Which response should the nurse make?
1. Electroconvulsive therapy is your best option at this point
2. Combined use can lead to a life threatening condition called hypertensive crisis
3. There is no reason why an MAOI couldn't be added to your therapy
4. They cant be used together because their mechanisms of action are very different
2. Combined use can lead to a life threatening condition called hypertensive crisis
12. Which client would the nurse instruct to obtain routine blood-level monitoring?
1. a client taking lithium
2. a client taking buspirone
3. a client taking chlorpromazine
4. a client taking paroxetine
1. a client taking lithium
14. A client with schizophrenia has recently begun a new medication, clozapine (Clozaril). Which potentially fatal side effect will the nurse teach the client about?
1. Agranulocytosis
2. Akathisia
3. Pseudoparkinsonism
4. Akinesia
1. Agranulocytosis (white count drops, risk for infection)
25. A client is diagnosed with anxiety disorder. Which medication should the nurse administer for anxiety?
1. Chlorpromazine (Thorazine)
2. Clozapine (Clozaril)
3. Diazepam (Valium)
4. Methylphenidate (Ritalin)
3. Diazepam (Valium)
2. Which information should the nurse include in a staff education program about the history of psychopharmacology?
1. some antipsychotic medications can cure mental illness
2. psychotropic medications are used as adjunctive therapy
3. antidepressants were the first type of mental health drugs
4. mood stabilizers help eliminate bipolar mental disorders
2. psychotropic medications are used as adjunctive therapy
9.Which information should the nurse share with the client about tricyclic antidepressant medications?
1. Strong or aged cheese should not be eaten while taking them
2. Their full therapeutic potential may not be reached until 4 weeks
3. They may cause hypomania or recent memory impairment
4. They should not be given with antianxiety agents
2. Their full therapeutic potential may not be reached until 4 weeks
13. As part of the discharge teaching, which guideline regarding lithium therapy will the nurse plan to include?
1. Avoid foods high in tyramine
2. Maintain a consistent sodium intake
3. Consume at least 4,000 to 5,000 mL of fluid per day
4. Watch for signs of tardive dyskinesia
2. Maintain a consistent sodium intake
6. The nurse is assessing a client who has a diagnosis of schizophrenia and takes an antipsychotic agent daily. Which finding requires further nursing assessment immediately?
1. Respirations of 20 breaths/min
2. Weight gain of 8 lbs in 2 months
3. Temp of 101 F
4. Excess salivation
3. Temp of 101 F
22. Logan age 8, takes methylphenidate (Ritalin) for ADHD. His mother reports that he has a very poor appetite and she struggles to help him gain weight. Which teaching will the nurse provide?
1. Administer Logan's medication immediately after meals
2. Give Logan's medication at bedtime.
3. Skip a dose of the medication when Logan does not eat anything
4. Assure Logan's mother that Logan will eat when he is hungry
1. Administer Logan's medication immediately after meals
15. 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?
1. Blurring vision, dry mouth and constipation
2. sore throat, fever, and malaise
3. Tremor, shuffling gait and rigidity
4. Fine tremor, tinnitus and nausea
2. sore throat, fever, and malaise
10.What are some safety concerns for patients taking SSRIs. ? Select all that apply.
1. Suicidal Ideation
2. Hypertensive Crisis.
3. Serotonin Syndrome
4. Discontinuation Syndrome.
1. Suicidal Ideation
3. Serotonin Syndrome
4. Discontinuation Syndrome
21. a female client takes a maintenance dosage of lithium for bipolar disorder. She has come to the community health clinic stating that she has ahd the flu for several days. She describes her symptoms as muscle weakness, coughing, headache, fever and gastrointestinal upset. her temperature is 100.9 F. which situation does the nurse anticipate?
1. She has consumed some foods high in tyramine while taking lithium
2. She has stopped taking her lithium
3. She has probably developed a tolerance to the lithium
4. She has signs and symptoms of toxicity from the lithium
4. She has signs and symptoms of toxicity from the lithium
7. 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?
1. Make sure you concentrate of taking slow, deep, cleansing breaths
2. watch your diet and try to engage in some regular physical activity
3. Rise slowly when your change position from lying to sitting or sitting to standing
4. Wear sunscreen and try to avoid midday sun exposure
3. Rise slowly when your change position from lying to sitting or sitting to standing
19. To which client would the nurse most likely administer a benzodiazepine?
1. One with alcohol withdrawals
2. One taking cough medicine
3. One with schizophrenia
4. One taking opioid pain agents
1. One with alcohol withdrawals
26. The nurse is preparing to assess a client before the physician prescribes a regimen of psychopharmacological therapy. which components will the nurse assess? Select all that apply.
1. Medical history
2. Physical examination findings
3. Ethnocultural characteristics
4. Current medication
5. Marital status
1. Medical history
2. Physical examination findings
3. Ethnocultural characteristics
4. Current medication
17. a client is taking an MAOI. When teaching the client about diet, which foods will the nurse caution the client to avoid?
1. Pepperoni pizza and red wine
2. Bagels with cream cheese and tea
3. Apple pie and coffee
4. Potato chips and diet cola
1. Pepperoni pizza and red wine
What is the therapeutic range for lithium?
1. 0.6 to 1.2 mEq/L
2. 0.5 to 1.6 mEq/L
3. 0.6 to 1.5 mEq/L
4. 0.5 to 2.0 mEq/L
1. 0.6 to 1.2 mEq/L
23. A client who is prescribed haloperidol is observed to be staring at the ceiling and says they cannot move their eyes. The nurse notices that the client also appears to have muscle spams in their legs and hands. What is the most appropriate action for the nurse to take at this point?
1. Conduct an AIMS test
2. Administer prn benztropine (Cogentin)
3. Withhold the next dose of antipsychotic medication
4. Contact the physician
2. Administer prn benztropine (Cogentin)