Antidepressants
A nurse is reviewing the health history of a client newly prescribed bupropion. Which finding requires immediate follow-up?
History of seizure disorder.
Rationale:
Bupropion lowers the seizure threshold and is contraindicated in clients with seizure disorders.
A client taking risperidone gains 20 pounds over 3 months. Which adverse effect is the nurse identifying?
Metabolic Syndrome.
Rationale:
Atypical antipsychotics increase the risk for obesity, diabetes, and dyslipidemia.
A client prescribed buspirone asks how it differs from alprazolam. How should the nurse respond?
Buspirone has little risk for dependence.
Rationale:
Unlike benzodiazepines, buspirone does not typically cause physical dependence.
A client has a new prescription for latanoprost. What is the therapeutic purpose of this medication?
To reduce intraocular pressure in glaucoma.
Rationale:
Latanoprost is a prostaglandin analog used to lower intraocular pressure.
A client awakens immediately when the nurse calls their name and reports feeling drowsy. What stage of sleep is this considered?
Stage 1 NREM Sleep.
Rationale:
Stage 1 is very light sleep and awakening is easy.
A client taking fluoxetine reports agitation, diaphoresis, tremors, and diarrhea. The nurse should suspect what complication?
Serotonin Syndrome.
Rationale:
SSRIs increase serotonin levels. Excess serotonin can lead to serotonin syndrome, a potentially life-threatening condition.
A client receiving chlorpromazine develops neck spasms and difficulty swallowing.
Acute Dystonia.
Rationale:
This extrapyramidal symptom requires prompt treatment with benztropine or diphenhydramine
A client taking alprazolam drinks several glasses of wine and becomes difficult to arouse. What is the client experiencing?
Respiratory Depression.
Rationale:
Alcohol and benzodiazepines have additive CNS depressant effects.
A nurse is teaching a client about betaxolol ophthalmic drops. Which adverse effect should be reported immediately?
Bradycardia.
Rationale:
Although administered in the eye, systemic absorption may occur, causing beta-blocker effects.
A sleeping client is difficult to awaken and is undergoing psychological restoration. What cycle is this client experiencing?
Stage 3 NREM Sleep.
Rationale:
Deep restorative sleep occurs during Stage 3.
A client taking venlafaxine presents for a follow-up appointment. Which assessment finding requires additional evaluation?
Blood pressure of 180/100 mm Hg.
Rationale:
Venlafaxine can increase norepinephrine levels, causing hypertension.
A client taking chlorpromazine develops involuntary tongue movements and lip smacking. What is the client experiencing?
Tardive Dyskinesia.
Rationale:
Tardive dyskinesia may become irreversible if not identified early.
A client taking lithium develops nausea, diarrhea, and fine hand tremors. What is the client experiencing?
Daily Double
Early Lithium Toxicity.
Rationale:
These are early warning signs that lithium levels may be increasing.
A nurse is evaluating the effectiveness of glaucoma therapy. Which assessment finding indicates the medication is working?
Rationale:
The goal of glaucoma treatment is lowering intraocular pressure to prevent optic nerve damage.
These are much closer to the types of questions you would see on an ATI Pharmacology exam, a nursing school pharmacology test, or an NCLEX-style medication exam. They test therapeutic use, adverse effects, nursing interventions, client education, and contraindications rather than just disease knowledge.
A client reports waking up several times each night to urinate and feeling exhausted during the day. Which factor interfering with sleep should the nurse identify?
Nocturia
Rationale:
Nocturia disrupts normal sleep cycles and prevents the client from obtaining restorative sleep.
A client prescribed phenelzine states, "For lunch I had salami and aged cheddar cheese." What complication is the nurse most concerned about?
Hypertensive Crisis.
Rationale:
MAOIs combined with tyramine-rich foods can produce life-threatening hypertension.
A client taking risperidone develops a temperature of 103°F, severe muscle rigidity, and confusion. What is the client experiencing?
Neuroleptic Malignant Syndrome.
Rationale:
NMS is a life-threatening adverse reaction requiring immediate intervention.
A client taking alprazolam for anxiety says, "I feel much better, so I stopped taking my medication yesterday." What complication is the nurse most concerned about?
Withdrawal symptoms, including seizures.
Rationale:
Benzodiazepines should not be discontinued abruptly. Sudden withdrawal can cause rebound anxiety, tremors, insomnia, and seizures.
A client using pilocarpine ophthalmic drops reports difficulty seeing while driving at night. What is the most likely cause?
Daily Double
Miosis caused by the medication.
Rationale:
Pilocarpine constricts the pupil, reducing night vision.
A client reports sleeping 8 hours but awakens exhausted every morning. The spouse reports loud snoring and pauses in breathing throughout the night. What might this client be experiencing?
Daily Double
Obstructive Sleep Apnea.
Rationale:
Repeated airway obstruction prevents restorative sleep.
A client taking amitriptyline reports constipation, urinary retention, blurred vision, and dry mouth. These findings are associated with which medication effect?
Anticholinergic Effects.
Rationale:
TCAs produce significant anticholinergic adverse effects.
TCA stands for Tricyclic Antidepressant.
:
The nurse receives report on four clients. Which client should be assessed first?
Client with muscle rigidity and fever.
Rationale:
This client may be experiencing Neuroleptic Malignant Syndrome.
A client taking lithium develops confusion, slurred speech, severe tremors, and muscle weakness. What is the nurse's priority action?
Hold the medication and notify the provider immediately.
Rationale:
These findings indicate severe lithium toxicity.
The nurse is caring for a client prescribed betaxolol ophthalmic drops. Which client history should be reported to the provider before administering the medication?
Asthma.
Rationale:
Beta-blockers can cause bronchoconstriction and may worsen asthma.
A client with chronic sleep deprivation reports difficulty concentrating, irritability, and poor decision-making. The nurse recognizes that prolonged sleep deprivation also places the client at increased risk for which serious health conditions?
Correct Response:
Hypertension, diabetes mellitus, heart attack, stroke, obesity, and depression.
Rationale:
Chronic sleep loss has been linked to significant cardiovascular, metabolic, and mental health complications. This question requires students to connect sleep deprivation with long-term health outcomes rather than simply identify a sleep disorder.