ch 2

Question 1

the nurse is teaching a client taking an MAOI about foods with tyramine that they should avoid. Which statement indicates a need for further teaching?

Answer 1

I’m so glad i can have pizza as long as i don’t order pepperoni

Question 2

a client who has been depressed and suicidal started taking a tricyclic antidepressant 2 weeks ago and is now ready to leave the hospital to go home. which is a concern for the nurse as discharge plans are finalized?

Answer 2

the nurse will evaluate the risk for suicide by overdose of the antidepressant

Question 3

the signs of lithium toxicity include which?

Answer 3

-severe vomiting, diarrhea, and weakness

Question 4

which is a concern for children taking stimulants for ADHD for several years?

Answer 4

-growth suppression

Question 5

the nurse is caring for client with schizophrenia who is taking haloperidol (Haldol). The client complains of restlessness, cannot sit still, and has muscle stiffness. Of the following prn medications, which would the nurse administer?

Answer 5

-Benztropine (Cogentin), 2 mg PO

Question 6

client teaching for lamotigrine (Lamictal) should include which instructions?

Answer 6

-report any rashes to your doctor immediately

Question 7

which physician order would the nurse question for a client who has stated that they are allergic to phenothiazines?

Answer 7

-Prolixin, 5 mg PO tid

Question 8

clients taking which type of psychotropic medications need close monitoring of their cardiac status?

Answer 8

antipsychotics

Question 9

the nurse is assessing a patient suffering a head injury as a result of an altercation with two other individuals. The patient has difficulty accurately reporting the events of the altercation and appears very emotional during the assessement. The nurse suspects which part of the brain received the greatest amount of injury?

Answer 9

cerebrum

Question 10

an abnormality of which of the following structures of the cerebrum would be associated with schizophrenia?

Answer 10

frontal lobe

Question 11

a patient with bipolar disorder asks the nurse, “why did i get this illness?” I don’t want to be sick.” the nurse would best respond with,

Answer 11

we dont fully understand the cause, but mental illnesses do seem to run in families

Question 12

which of the following statements about the neurobiological causes of mental illness is most accurate?

Answer 12

several mental disorders may be linked to genetic and nongenetic factors

Question 13

which of the following is an inhibitory neurotransmitter?

Answer 13

GABA

Question 14

which of the following is a neuromodulator?

Answer 14

neuropeptides

Question 15

the nurse is leading a medication education group for patient with depression. A patient states he has read that herbal treatment are just as effective as prescription medications. the best response is

Answer 15

we need to look at the research very closely to see how reliable the studies are

Question 16

the nurse is preparing a patient for an MRI scan of the head. the nurse should ask the patient

Answer 16

are you anxious about being in tight spaces?

Question 17

how should the nurse respond to a family member who asks how alzheimer’s disease is diagnosed?

Answer 17

positron emission tomography (PET) scans can identify the amyloid plaques and tangles of alzheimer’s disease in living clients

Question 18

a patient is being seen in the crisis unit reporting that poison letters are coming in the mail. the patient has no history of psychiatric illness. which of the following medication would the patient most likely be started on?

Answer 18

aripiprazole

Question 19

which of the following types of antipsychotic medications is most likely to produce extrapyramidal effects?

Answer 19

first generation antipsychotic drugs

Question 20

a patient with schizophrenia is being treated with olanzapine (zyprexa) 10 mg daily. the patient asks how the medication works. the nurse explains that the mechanism of action is believed to be

Answer 20

blocking dopamine receptors in the brain

Question 21

a patient with depression has been taking paroxetine (paxil) for the last 3 months and has noticed improvement of symptoms. which of the following side effects would the nurse expect the patient to report?

Answer 21

a decrease in sexual pleasure during intimacy

Question 22

which one of the following drugs should the nurse expect the patient to require serum level monitoring?

Answer 22

lithium

Question 23

which of the following disorders are exrapyramidal symptoms that may be caused by antipsychotic drugs? select all that apply.

Answer 23

-akathasia

-pseudoparkisonism

-dystonia

Question 24

which of the following antidepressant drugs is a preferred drug for clients at high risk for suicide?

Answer 24

sertraline (zoloft)

Question 25

the nurse knows that the client understands the rationale for dietary restrictions when taking MAOI when the client makes which of the following statements?

Answer 25

I should avoid foods that are high in the amino acid tyramine such as aged cheese, cured meats, wine, and chocolate

Question 26

a client who is taking paroxetine (paxil) reports to the nurse that he has been nauseated since beginning the medication. which of the following actions is indicated initially?

Answer 26

suggest that the client take the medication with food

Question 27

in planning for a client’s discharge, the nurse must know that the most serious risk for the client taking a tricyclic antidepressant is which of the following?

Answer 27

suicide by overdose

Question 28

a client with severe and persistent mental illness has been taking antipsychotic medication for 20 years. the nurse observes that the clients behavior includes repetitive movement of the mouth and tongue, facial grimacing, and rocking back and forth. the nurse recognizes these behaviors as indicative of

Answer 28

tardive dyskinesia

Question 29

a client is seen in the clinic with clinical manifestations for an inability to sit still and a rigid posture. the side effects would be correctly identified as which of the following?

Answer 29

akathisia

Question 30

which of the following is a term used to describe the occurrence of the eye rolling back in a locked position, which occurs with acute dystonia?

Answer 30

oculogryic crisis

Question 31

which of the following medications rarely causes extrapyramidal side effects (EPS)?

Answer 31

ziprasidone (geodon)

Question 32

which of the following increases the risk for neuroleptic malignant syndrome (NMS)?

Answer 32

dehydration

Question 33

which of the following was the first non stimulant medication specifically designed and tested for ADHD?

Answer 33

atomoxetine (stattera)

Question 34

which of the following is the primary consideration with clients taking antidepressants?

Answer 34

suicide

Question 35

which of the following would not be included as a symptom of drug-induced parkinsonism

Answer 35

tachycardia

Question 36

which drug classification is the primary medication treatment for schizophrenia?

Answer 36

antipsychotics

Question 37

a client on the unit suddenly cries out in fear. The nurse notices that the client’s head is twisted to one side, his back is arched, and his eyes have rolled back in their sockets. The client has recently begun drug therapy with haloperidol (Haldol). based on this assessment, the first action of the nurse would be to

Answer 37

give a prn dose of benztropine (Congentin) IM

Question 38

one week after beginning therapy with thiothixine (navane) the client demonstrates muscle rigidity, a temp of 103, and elevated serum creatinine phosphokinase level, stupor, and incontinence. the nurse should notify the physician because these symptoms are indicative of

Answer 38

neuroleptic malignant syndrome

Question 39

a client with bipolar disorder has been taking lithium and today his serum blood level is 2.0 mEq/L. what effects would the nurse expect to see?

Answer 39

nausea, diarrhea, and confusion

Question 40

for a client taking clozapine (clozaril) which of the following symptoms should the nurse report to the physician immediately as it may be indicative of a potentially fatal side effect?

Answer 40

sore throat and malaise

Question 41

a patient with bipolar disorder takes lithium 300 mg three times daily. the nurse evaluates that the dose is appropriate when the patient reports

Answer 41

minimal mood swings

Question 42

when the client experiences facial flushing, a throbbing headache, nausea and vomiting after consuming alcohol while taking disulfiram (antabuse) the nurse is aware that this is due to which of the following?

Answer 42

the intended therapeutic result

Question 43

when the client asks the nurse how long it will take before the SSRI antidepressant medication will be effective, which of the following replies is most accurate and therapeutic

Answer 43

you will have gradual improvement of symptoms over the next few weeks, but the changes may be so subtle you may not notice them for a while. it is important for you to keep taking the medication

Question 44

a client has a lithium level of 1.2 mEq/L. which of the following interventions by the nurse is indicated?

Answer 44

no intervention is necessary at this time

Question 45

a patient is seen for frequent exacerbation of schizophrenia due to non adherence to medication regimen. the nurse should assess for which of the following common contributors to non adherence?

Answer 45

the patient dislikes the weight gain associated with antipsychotic therapy

Question 46

which of the following side effects of lithium are frequent causes of non compliance? select all that apply.

Answer 46

-weight gain -lethargy

Question 47

the nurse is educating a patient and family about strategies to minimize the side effects of antipsychotic drugs. which of the following should be included in the plan. select all that apply.,

Answer 47

-developing an exercise program is important -increase foods high in fiber -use sunscreen when outdoors

Question 48

the nurse has completed health teaching about dietary restrictions for a client taking an MAOI. the nurse will know that the teaching has been effective by which of the following client statements?

Answer 48

it will be difficult for me to avoid pepperoni

Question 49

when teaching a client about restriction for tranylcypromine (parnate) the nurse will tell the client to avoid which of the following foods

Answer 49

broad beans