Behavioral Health Flashcards
The nurse is administering a prescribed antidepressant medication to a client in an inpatient mental health facility. Which action would the nurse perform to ensure the client is not stashing doses of medication?
A. Provide a 1:1 sitter for the client.
B. Observe the client swallowing the medication.
C. Ask a client’s family member to ensure the dose is taken.
D. Set the correct medication dose on the client’s meal tray.
B. Observe the client swallowing the medication.
A client has been in an acute care psychiatric unit for 3 days and is receiving haloperidol tablets orally to reduce agitation and preoccupation with auditory hallucinations. There has been no decrease in the client’s agitation or preoccupation with auditory hallucinations since the medication was started. Which intervention will the nurse take?
A. Ask the health care provider to change the medication.
B. Make certain that the client is swallowing the medication.
C. Conclude that therapeutic failure has occurred.
D. Secure a prescription for as-needed sedation until the client calms down
B. Make certain that the client is swallowing the medication.
Which reply by the nurse is appropriate when a client asks how psychotropic medications work?
A. “These medications decrease the metabolic needs of your brain.”
B. “These medications increase the production of healthy nervous tissue.”
C. “These medications affect the chemicals used in communication between nerve cells.”
D. “These medications regulate sensory input received from the external environment.”
C. “These medications affect the chemicals used in communication between nerve cells.”
A client begins escitalopram for treatment of a depressive episode. On the fifth day, the client refuses the medication, stating, ‘It doesn’t help, so what’s the use of taking it?’ Which is the best response by the nurse?
A. ‘It can take 1 to 4 weeks to see an improvement.’
B. ‘It takes 6 to 8 weeks for this medication to have an effect.’
C. ‘I’ll talk to your primary health care provider about increasing the dosage. That may help.’
D. ‘You should have felt a difference by now. I’ll notify the primary health care provider.’
A. ‘It can take 1 to 4 weeks to see an improvement.’
The nurse is educating a client on a new antidepressant prescription. Which statement by the client indicates the need for further teaching?
A. ‘This medication will cure my depression.’
B. ‘I should never double the dose to feel better.’
C. ‘I will see my health care provider every month.’
D. ‘It may take several weeks for the medication to take effect.’
A. ‘This medication will cure my depression.’
Which statement by the client indicates to the nurse that the teaching about taking an antidepressant medication has been understood?
A. ‘I need to take every dose of my medication as prescribed.’
B. ‘I need to discontinue the medication if I have side effects.’
C. ‘I don’t have to be concerned about taking my medications.’
D. ‘I can double the dose of the medication if I still feel depressed.’
A. ‘I need to take every dose of my medication as prescribed.’
The nurse is caring for a group of clients on the psychiatric unit. Which clinical findings will alert the nurse that serotonin syndrome has developed in one of the clients?
A. Continuous involuntary movement of the tongue and jaw
B. Extremely high blood pressure with headache and flushing
C. Blurred vision, urine retention, dry mouth, and constipation
D. Restlessness, tachycardia, fever, diarrhea, and altered mental status
D. Restlessness, tachycardia, fever, diarrhea, and altered mental status
Which medication class is preferred for managing anxiety disorders?
A. Anticholinergics
B. Lithium carbonate
C. Antipsychotic medications
D. Selective serotonin reuptake inhibitors
D. Selective serotonin reuptake inhibitors
A nurse is assessing a client who has been taking sertraline for 2 weeks. The nurse should identify which of the following findings as an indication that the medication is effective?
A. The client’s blood pressure is within the expected reference range.
B. The client reports a recent weight loss.
C. The client reports increase in a stable mood.
D. The client’s legs are not swollen.
C. The client reports increase in a stable mood.
The nurse is caring for a client taking a selective serotonin reuptake inhibitor (SSRI) for depression. Which statement by the client requires additional teaching?
A. ‘I should take the medication at the same time daily.’
B. ‘I can stop taking this medication when I feel better.’
C. ‘I will exercise to control any weight gain the medication may cause.’
D. ‘I need to report any agitation I experience to the health care provider.’
B. ‘I can stop taking this medication when I feel better.’
The client has been prescribed sertraline for depression. Which action should the nurse include in the plan of care?
A. Advise that the medication will be tapered prior to discontinuation
B. Monitor for signs of physical addiction
C. Emphasize that relief of symptoms occurs in one week
D. Assess for symptoms of a thrombus formation
A. Advise that the medication will be tapered prior to discontinuation
An older client hospitalized for depression is receiving citalopram. During discharge teaching, the client asks the nurse if there is anything that should be known about taking this medication. Which response is the nurse’s reply?
A. ‘You’re concerned about taking this medication.’
B. ‘You should take each dose of medication as prescribed.’
C. ‘You must discontinue the medication if side effects occur.’
D. ‘You may find it necessary to adjust the dosage if side effects occur.’
B. ‘You should take each dose of medication as prescribed.’
Which statement by the client indicates clarification is needed about the medication paroxetine?
A. “I’ll be a little drowsy in the mornings.”
B. “I’m expecting to feel somewhat better, but I may need other therapy.”
C. “I’ve been on the medication for 8 days now, and I don’t feel any better.”
D. “I know that I’ll probably have to take this medication for several months.”
C. “I’ve been on the medication for 8 days now, and I don’t feel any better.”
A nurse is assessing a client who was prescribed fluoxetine for panic disorder 5 days ago. The client tells the nurse their symptoms are not improving. Which statement will the nurse make to the client?
A. “It might be a few more weeks before your symptoms improve.”
B. “I will contact the healthcare provider to increase your dose.”
C. “Have you been taking the medication as directed?”
D. “Why do you feel your symptoms are not improving?”
A. “It might be a few more weeks before your symptoms improve.”
Which precaution will the nurse consider when initiating treatment with fluoxetine?
A. It must be given with milk and crackers to prevent hyperacidity and discomfort.
B. Eating cheese or pickled herring or drinking wine may cause a hypertensive crisis.
C. The blood level may not be sufficient to cause noticeable improvement for 2 to 4 weeks.
D. The blood level should be checked weekly for 3 months to make sure it is appropriate.
C. The blood level may not be sufficient to cause noticeable improvement for 2 to 4 weeks.
Sertraline is prescribed for a depressed client. Which information would the nurse include when teaching the client about this medication?
A. The medication can cause a hypertensive crisis.
B. The medication interferes with the reuptake of norepinephrine.
C. Specific foods should be avoided when one is taking the medication.
D. Several weeks may pass before the effects of the medication become evident.
D. Several weeks may pass before the effects of the medication become evident.
An antidepressant, sertraline, is prescribed for a depressed older client. After 1 week, the client’s son expresses concern that there does not seem to be much improvement. Which is the best response by the nurse?
A. “Antidepressant therapy requires several weeks before it becomes effective.”
B. “Antidepressant therapy will be more effective as physical condition improves.”
C. “Additional medications may be required before behavioral changes will be observed.”
D. “Additional time is needed for the medication to become effective because of the prolonged depression.”
An antidepressant, sertraline, is prescribed for a depressed older client. After 1 week, the client’s son expresses concern that there does not seem to be much improvement. Which is the best response by the nurse?
A. “Antidepressant therapy requires several weeks before it becomes effective.”
B. “Antidepressant therapy will be more effective as physical condition improves.”
C. “Additional medications may be required before behavioral changes will be observed.”
D. “Additional time is needed for the medication to become effective because of the prolonged depression.”
D. “Additional time is needed for the medication to become effective because of the prolonged depression.”
A client on antidepressant therapy develops hyponatremia. Which medication may be responsible for the client’s electrolyte imbalance?
A. Phenelzine
B. Paroxetine
C. Imipramine
D. Amitriptyline
B. Paroxetine
A nurse is teaching male client who has a depressive disorder about sertraline. Which of the following information should the nurse include in the teaching?
A. “This medication may cause an inability to orgasm.”
B. “You will notice an improvement in mood within 2 to 3 days.”
C. “A fever is an expected adverse effect of this medication.”
D. “Sertraline can cause temporary muscle rigidity.”
A. “This medication may cause an inability to orgasm.”
The nurse is teaching a client about some of the side effects of fluoxetine. What information should the nurse be certain to include?
A. Tachycardia, blurred vision, hypotension, anorexia
B. Orthostatic hypotension, vertigo, hunger, reactions to tyramine-rich foods
C. Drowsiness, dry mouth, changes in weight or appetite, reduced libido
D. Photosensitivity, seizures, edema, hyperglycemia
C. Drowsiness, dry mouth, changes in weight or appetite, reduced libido
A client who was prescribed sertraline to treat depression informs the nurse that they stopped taking the sertraline and began taking their partner’s tranylcypromine. The client reports experiencing “muscle twitches” and a “racing heart rate”. Which adverse reaction should the nurse immediately assess for?
A. Pulmonary edema
B. Mental status changes
C. Muscle weakness
D. Atrial fibrillation
B. Mental status changes
A depressed client is given 50 mg of sertraline at bedtime. Which medication-related side effect will the nurse NOT monitor for when assessing this client? Select all that apply.
A. Dry mouth
B. Paralytic Ileus (paralyzed intestines)
C. Constipation
D. Decrease libido (desire for sex)
B. Paralytic Ileus (paralyzed intestines)
C. Constipation
A nurse is teaching a client who has a depressive disorder about fluoxetine. Which of the following information should the nurse include in the teaching?
A. “You may experience a decreased sex drive while taking this medication.”
B. “You will notice an improvement in your depressive symptoms in 2 to 3 days.”
C. “You may notice that you have less appetite while taking this medication.”
D. “You may experience drooling while taking this medication.”
A. “You may experience a decreased sex drive while taking this medication.”
A client with depression was prescribed fluoxetine and reports restlessness, confusion, an elevated body temperature, and poor concentration. Which intervention would the nurse anticipate preparing for in the treatment of these signs and symptoms?
A. Withdrawing the medication
B. Administering isocarboxazid
C. Reducing the dose of the medication
D. Informing the client that these are expected side effects
A. Withdrawing the medication
A client on antidepressant therapy develops hyperthermia, seizures, and a heart rate of 200 beats per minute. Which medication would the nurse suspect is responsible for the condition?
A. Sertraline
B. Asenapine
C. Risperidone
D. Fluphenazine
A. Sertraline
The nurse is caring for a client with a new prescription for a selective serotonin reuptake inhibitor (SRRI) to treat depression. In reviewing the admission history and physical, which finding should the nurse clarify with the health care provider?
A. Diagnosis of peripheral vascular disease
B. Prescribed monoamine oxidase (MAO) inhibitor
C. History of morbid obesity
D. Reported frequent use of antacids
B. Prescribed monoamine oxidase (MAO) inhibitor
A client has a new prescription for sertraline, a selective serotonin reuptake inhibitor (SSRI) antidepressant. After reviewing the client’s medical record, which data is the nurse most concerned about?
A. Current prescription for phenelzine
B. History of an eating disorder
C. Current prescription for alprazolam
D. History of premenstrual dysphoric disorder
A. Current prescription for phenelzine
The nurse is preparing to administer prescribed sertraline to a client with a history of depression. Which statement by the client would require immediate follow-up?
A. “I noticed this medication gives me a dry mouth.”
B. “I would prefer to crush that medication.”
C. “I also take St. John’s wort with that medication.”
D. “I typically take the medication at night.”
C. “I also take St. John’s wort with that medication.”
Which medication is contraindicated in a pregnant client?
A. Sertraline
B. Paroxetine
C. Venlafaxine
D. Desipramine
B. Paroxetine
A pregnant client is treated with sertraline for depression. Which would the nurse infer about the medication’s action?
A. It will affect only the client.
B. It will affect only the fetus.
C. It will affect both the client and the fetus.
D. It will affect neither the client nor the fetus.
C. It will affect both the client and the fetus.
Which antidepressant is a second-generation medication?
A. Doxepin
B. Citalopram
C. Protriptyline
D. Trimipramine
B. Citalopram
Which medication worsens uncontrolled angle-closure glaucoma when used for the treatment of generalized anxiety disorder?
A. Lithium carbonate
B. Duloxetine
C. Buspirone
D. Chlorpromazine
B. Duloxetine
A client who is taking duloxetine asks the nurse if the medication treats depression or diabetes neuropathic pain. Which is the best response from the nurse?
A. “Duloxetine is used to treat depression but can also be used to lower blood sugar levels.”
B. “Duloxetine is not prescribed for either depression or diabetes.”
C. “Duloxetine is used to treat diabetes but can also be used to treat depression.”
D. “Duloxetine is used to treat depression but can be used to treat pain that can occur in people with diabetes.”
D. “Duloxetine is used to treat depression but can be used to treat pain that can occur in people with diabetes.”
Which second-generation antidepressant can worsen uncontrolled angle-closure glaucoma?
A. Trazodone
B. Bupropion
C. Duloxetine
D. Mirtazapine
C. Duloxetine
A client with major depression is prescribed the extended release form of venlafaxine. Which statement by the client indicates a need for additional teaching?
A. “I may feel nauseated and anorexic.”
B. “I will call my doctor if I experience impotence.”
C. “I can stop taking the drug when I start feeling better.”
D. “I should swallow the pill whole.”
C. “I can stop taking the drug when I start feeling better.”
Which disorder would the nurse identify as NOT being treated by venlafaxine?
A. Panic disorder
B. Major depression
C. Social anxiety disorder
D. Obsessive compulsive disorder
D. Obsessive compulsive disorder
A primary health care provider prescribes venlafaxine for a client with a diagnosis of major depressive disorder who has been taking herbal medications. Which herbal supplement is contraindicated when taking venlafaxine?
A. Ginseng
B. Valerian
C. Kava-kava
D. St. John’s wort
D. St. John’s wort
A client is lonely and extremely depressed, and the health care provider prescribes a tricyclic antidepressant. The client asks the nurse what the medication will do. Which response is the best would the nurse provide?
A. ‘This medication will help you forget why you’re lonely and depressed.’
B. ‘The medication will make you feel better.’
C. ‘You’ll start to feel much better after taking this medication for 2 or 3 days.’
D. ‘This will decrease your social anxiety so you will be more comfortable developing relationships with others.’
B. ‘The medication will make you feel better.’
2) Which instruction would the nurse give to clients prescribed psychotropic medications who are experiencing anticholinergic-like side effects?
A. ‘Restrict fluid intake.’
B. ‘Eat a diet high in carbohydrates.’
C. ‘Suck on sugar-free hard candies.’
D. ‘Avoid products that contain aspirin.’
C. ‘Suck on sugar-free hard candies.’
A primary health care provider diagnoses chronic, low-grade depression in a client. Which medication is indicated for this condition?
A. Alprazolam
B. Lithium salts
C. Amitriptyline
D. Clomipramine
C. Amitriptyline
A 65-year-old client is receiving amitriptyline. Which recommendation will the nurse make to the client concerning this medication?
A. ‘Obtain a complete cholesterol and lipid profile.’
B. ‘Have an eye examination to check for glaucoma.’
C. ‘Check your temperature daily for nighttime increases.’
D. ‘Watch for excessive sweating and possible weight loss.’
B. ‘Have an eye examination to check for glaucoma.’
To which nursing home resident could a nurse safely administer tricyclic antidepressants such as amitriptyline without questioning the health care provider’s order?
A. A client with mild hypertension
B. A client with narrow-angle glaucoma
C. A client with coronary artery disease (CAD)
D. A client with benign prostatic hypertrophy (BPH)
A. A client with mild hypertension
The nurse is teaching a client diagnosed with depression about a new prescription of nortriptyline. What information would be essential for the nurse to emphasize about this medication?
A. Episodes of diarrhea can be expected
B. The medication must be stored in the refrigerator
C. The use of alcohol should be avoided
D. Symptom relief occurs in a few days
C. The use of alcohol should be avoided
The nurse is teaching a client diagnosed with depression about a new prescription of nortriptyline. What information would be essential for the nurse to emphasize about this medication?
A. Episodes of diarrhea can be expected
B. The medication must be stored in the refrigerator
C. The use of alcohol should be avoided
D. Symptom relief occurs in a few days
C. The use of alcohol should be avoided
A nurse is caring for a client who is taking amitriptyline. The nurse should monitor for which of the following adverse effects?
A. Orthostatic hypotension
B. Drooling
C. Diarrhea
D. Metallic taste in mouth
A. Orthostatic hypotension
A nurse is reinforcing teaching with an older adult client who has major depressive disorder and a prescription for nortriptyline 25 mg daily. Which of the following client statements indicates understanding of the teaching?
A. “I should take my nortriptyline before breakfast.”
B. “I can no longer eat pepperoni pizza.”
C. “I will avoid drinking caffeinated beverages.”
D. “I should sit on the side of the bed before standing up in the morning.”
D. “I should sit on the side of the bed before standing up in the morning.”
A nurse is developing a plan of care for a client who has a depressive disorder and is taking amitriptyline. Which of the following actions should the nurse include in the plan of care?
A. Weigh the client weekly.
B. Administer the medication before breakfast.
C. Monitor for frequent urination.
D. Withhold medication if the client experiences blurred vision.
A. Weigh the client weekly.
Which statement does not accurately describes nortriptyline? Which of the following is incorrect?
A. Overdosage is often lethal.
B. Constipation and urinary retention may occur.
C. It is a selective serotonin reuptake inhibitor (SSRI).
D. Weight gain is a common side effect.
E. It increases effectiveness of monoamine oxidase inhibitors (MAOIs).
C. It is a selective serotonin reuptake inhibitor (SSRI).
E. It increases effectiveness of monoamine oxidase inhibitors (MAOIs).
Which instruction would the nurse give to clients prescribed psychotropic medications who are experiencing anticholinergic-like side effects?
A. ‘Restrict fluid intake.’
B. ‘Eat a diet high in carbohydrates.’
C. ‘Suck on sugar-free hard candies.’
D. ‘Avoid products that contain aspirin.’
C. ‘Suck on sugar-free hard candies.’
The nurse is teaching a client about tricyclic antidepressants. Which of the following is not a side effect?
A. Dry mouth
B. Drowsiness
C. Constipation
D. Severe hypertension
D. Severe hypertension
Nortriptyline is prescribed for a depressed client. Which time period identifies when the nurse would expect a therapeutic response?
A. 1 to 3 days
B. 12 to 24 hours
C. 30 minutes to 2 hours
D. 2 to 4 weeks
D. 2 to 4 weeks
A depressed client has been prescribed a tricyclic antidepressant. Which time period indicates how long it usually takes before the client notices a significant change in the depression?
A. 4 to 6 days
B. 2 to 4 weeks
C. 5 to 6 weeks
D. 12 to 16 hours
B. 2 to 4 weeks
Which medication class includes amitriptyline?
A. Tricyclics
B. Monoamine oxidase inhibitors (MAOIs)
C. Selective serotonin reuptake inhibitors (SSRIs)
D. Serotonin-norepinephrine reuptake inhibitors (SNRIs)
A. Tricyclics
A client is admitted for treatment of obsessive-compulsive disorder that is interfering with activities of daily living. Which medication is indicated for treatment of this condition?
A. Benztropine
B. Amantadine
C. Clomipramine
D. Diphenhydramine
C. Clomipramine
An 11-year-old client reports having bedwetting issues (enuresis). Which medication would the nurse anticipate when developing a teaching plan ?
A. Alprazolam
B. Imipramine
C. Lithium salts
d. Sertraline
B. Imipramine
Which adverse effect of imipramine requires further assessment and possible immediate medical intervention?
A. Dry mouth, can’t spit.
B. Weight gain since started med.
C. Mild Blurred vision
D. Urinary hesitancy, unable to urinate
D. Urinary hesitancy, unable to urinate
Which nursing action is appropriate when administering imipramine?
A. Telling the client steroids will not be prescribed
B. Warning the client not to eat cheese
C. Monitoring the client for increased tolerance
D. Having the client checked for increased intraocular pressure
D. Having the client checked for increased intraocular pressure
Which instruction would the nurse give the client receiving a monoamine oxidase inhibitor (MAOI)?
A. It is necessary to avoid the sun.
B. Drowsiness is an expected side effect of this medication.
C. The therapeutic and toxic levels of the medication are very close.
D. Many prescribed and over-the-counter medications cannot be taken with this medication.
D. Many prescribed and over-the-counter medications cannot be taken with this medication.
Which foods should NOT be avoided by a client taking monoamine oxidase inhibitors (MAOIs)? Select all that apply.
A. Fresh Figs
B. Chianti (red wine)
C. Sausage
D. Cheddar cheese
A. Fresh Figs
The nurse is teaching a group of nursing students about the use of monoamine oxidase inhibitors (MAOIs). Which statement made by a student indicates the need for further teaching?
A. ‘I should advise the client to report any problems in vision.’
B. ‘I should encourage the client to eat food high in tyramine.’
C. ‘I should advise the client to report any symptoms of seizures.’
D. ‘I should encourage the client to wear a medical alert necklace.’
B. ‘I should encourage the client to eat food high in tyramine.’
The nurse is developing a teaching plan for a client prescribed monoamine oxidase inhibitors (MAOIs). Which food would the nurse instruct the client to avoid while receiving treatment?
A. Bologna
B. Potatoes
C. Citrus fruit
D. Grapefruit juice
A. Bologna
The nurse is teaching clients about dietary restrictions during monoamine oxidase inhibitor (MAOI) therapy. Which early effect would the nurse tell them to anticipate if they do not follow these restrictions?
A. Occipital headaches
B. Generalized urticaria
C. Severe muscle spasms
D. Sudden drop in blood pressure
A. Occipital headaches
Which food should NOT be avoided by a client who is taking a monoamine oxidase inhibitor? Select all that apply.
A. Citrus fruits
B. Aged cheese
C. Ripe avocados
D. Delicatessen meats
A. Citrus fruits
A client is prescribed a monoamine oxidase inhibitor (MAOI) for depression. The nurse includes teaching on foods and medications known to cause serious adverse effects when used in combination with MAOIs. Which adverse effect would the nurse include in the teaching plan?
A. A serious drop in blood pressure
B. A serious increase in blood pressure
C. A significant increase in liver enzymes
D. A significant increase in cholesterol levels
B. A serious increase in blood pressure
Which complication can occur if a client receiving isocarboxazid, a MAOI, fails to adhere to necessary dietary restrictions?
A. Syncope
B. Bradycardia
C. Hypertensive crisis
D. Hyperglycemic episodes
C. Hypertensive crisis
Which toxic effect would the nurse find in a client who has overdosed on isocarboxazid, a MAOI?
A. Mydriasis
B. Bradycardia
C. Hypothermia
D. Hypertensive circulatory collapse
D. Hypertensive circulatory collapse
Which food, if consumed along with phenelzine, may NOT cause a hypertensive crisis?
A. Yogurt
B. Red wine
C. Aged meat
D. Aged cheese
A. Yogurt
Which foods should the client receiving a monoamine oxidase inhibitor, such as phenelzine, avoid?
A. Pork, spinach, and fresh oysters
B. Milk, grapes, and meat tenderizers
C. Cheese, beer, and products with chocolate
D. Leafy green vegetables, fresh apples, and ice cream
C. Cheese, beer, and products with chocolate
The nurse teaches the client about foods to avoid while on phenelzine therapy. Which response by the client indicates the need for further education?
A. ‘I should avoid grapes in my diet.’
B. ‘I should avoid corned beef in my diet.’
C. ‘I should avoid burgundy and sherry in my diet.’
D. ‘I should avoid the foods that are made of pepperoni.’
A. ‘I should avoid grapes in my diet.’
A nurse is educating a client who was prescribed a monoamine oxidase inhibitor such as phenelzine (MAOI) for depression to avoid foods high in tyramine. Which foods should the client avoid?
A. Apple juice, ham salad, fresh pineapple
B. Fresh juice, carrots, vanilla pudding
C. Hamburger, fries, strawberry shake
D. Red wine, ripe raspberries, aged cheese
D. Red wine, ripe raspberries, aged cheese
The nurse is teaching a client who is receiving a monoamine oxidase inhibitor (MAOI) for clinical depression about potential side effects. Which intervention should the client implement to prevent potential adverse effects of the medication?
A. Avoid walking without assistance
B. Take frequent naps
C. Avoid chocolate and cheese
D. Take the medication with milk
C. Avoid chocolate and cheese
The nurse is monitoring a client who is taking newly prescribed phenelzine for depression. Which finding reported by the client would indicate the client is experiencing an adverse effect of the mediation?
A. Constipation
B. Dry mouth
C. Headache
D. Muscle fatigue
C. Headache
The nurse is collecting the health history from a client with depression who is taking prescribed phenelzine. Which statement would be appropriate for the nurse to make?
A. “How often do you exercise in a week?”
B. “Do you drink a lot of water?”
C. “Can you describe the types of foods you eat?”
D. “When was the last time you had blood work done?”
C. “Can you describe the types of foods you eat?”
Which antidepressant medication is a selective monoamine oxidase-B inhibitor?
A. Selegiline
B. Phenelzine
C. Isocarboxazid
D. Tranylcypromine
A. Selegiline
The nurse teaches the client about foods to avoid while taking selegiline for depression. Which foods identified by the client indicate to the nurse that instructions have NOT been understood?
A. Beer
B. Aged Cheese
C. Over ripe fruit
D. Leafy vegetables
D. Leafy vegetables
Which monoamine oxidase inhibitor would the nurse identify as being used to treat Parkinson disease?
A. Selegiline
B. Phenelzine
C. Isocarboxazid
D. Tranylcypromine
A. Selegiline
The nurse noticed increased blood pressure in a client being treated for depression. Which antidepressant medication would the nurse ask the primary health care provider to reconsider?
A. Fluoxetine
B. Bupropion
C. Trazodone
D. Mirtazapine
B. Bupropion
After reviewing the data of a client with depression, the primary health care provider decided not to prescribe bupropion. Which statements made by the client would NOT support the decision?
A. ‘I have a history of epilepsy.’
B. ‘I have recently been diagnosed with hyperlipidemia.’
C. ‘I have a history of congestive heart failure.’
D. ‘I have recently been diagnosed with anorexia nervosa.’
A. ‘I have a history of epilepsy.’
A friend asks the student nurse whether there is a medication marketed for smoking cessation. Which antidepressant medication would the student nurse identify for this clinical application?
A. Diazepam
B. Bupropion
C. Fluvoxamine
D. Chlordiazepoxide
B. Bupropion
The nurse is reviewing a client’s medication list and notes the client takes bupropion SR 150 mg oral twice a day. Which question is appropriate for the nurse to ask concerning the purpose of this medication?
A. “Did your cravings for nicotine decrease after starting this medication?”
B. “After taking this medication, did your hallucinations lessen?”
C. “Have you had any abnormal dreams while taking this medication?”
D. “How much weight have you gained on this medication?”
A. “Did your cravings for nicotine decrease after starting this medication?”
The client is taking bupropion to treat depression and is worried about taking the medication. The client tells the nurse a friend said the medication was removed from the market because it caused seizures. What is an appropriate response by the nurse?
A. Omit the next dose until you talk with your health care provider.
B. Your health care provider knows the best drug for your condition.
C. Ask your friend about the source of this information.
D. The recommended dose of this medication was changed, which lowered the risk of seizures.
D. The recommended dose of this medication was changed, which lowered the risk of seizures.
Which class of medications is frequently prescribed for a client with bipolar disorder (BPD) to induce sedation?
A. Antipsychotics
B. Antidepressants
C. Benzodiazepines
D. Mood stabilizers
C. Benzodiazepines
A mood-stabilizing medication is prescribed for a client’s bipolar disorder. Which client comment indicates to the nurse that further teaching is needed?
A. “I know I won’t have to stay on this medication for too long.”
B. “I understand that I’ll need to keep in touch with my primary health care provider.”
C. “Taking medication without using other forms of therapy may not be as effective.”
D. “Taking the medication is better than experiencing the highs and lows I’ve been having.”
A. “I know I won’t have to stay on this medication for too long.”
A nurse is caring for a client who has a serum lithium level of 2.0 mEq/L. Which of the following is the priority action for the nurse to take?
A. Notify the primary provider the result indicates toxicity.
B. Continue to monitor this expected maintenance level.
C. Request the provider increase the client’s medication dose.
D. Check the client for manifestations of hypernatremia.
A. Notify the primary provider the result indicates toxicity.
Laboratory reports reveal that the client’s thyroxine levels are low. Which medication might have led to this condition?
A. Lithium
B. Fluoxetine
C. Risperidone
D. Carbamazepine
A. Lithium
A client’s serum lithium level is 0.2 mEq/L (0.2 mmol/L). Which interpretation is correct?
A. Toxic level
B. Borderline toxic level
C. Subtherapeutic level
D. Borderline therapeutic level
C. Subtherapeutic level
The nurse observed seizures in a client who is taking lithium for cycles of mania. Which laboratory parameters may lead to this condition?
A. 1 mEq/L (1 mmol/L) serum lithium levels
B. 3 mEq/L (3 mmol/L) serum lithium levels
C. 135 mEq/L (135 mmol/L) serum sodium levels
D. 140 mEq/L (140 mmol/L) serum sodium levels
B. 3 mEq/L (3 mmol/L) serum lithium levels
The laboratory calls to report that a hospitalized client’s lithium level is 1.9 mEq/L (1.9 mmol/L) after 10 days of lithium therapy. Which response by the nurse is appropriate?
A. The nurse will notify the health care provider of the findings because the level is dangerously high.
B. The nurse will monitor the client closely because the level of lithium in the blood is slightly high.
C. The nurse will continue the administration of the medication as prescribed because the level is within the therapeutic range.
D. The nurse will report the finding to the health care provider so the dosage can be increased because the level is below the therapeutic range.
A. The nurse will notify the health care provider of the findings because the level is dangerously high.
A client has been taking lithium carbonate for 3 days. The nurse has the client’s lithium level checked before administering the medication and finds it to be 0.3 mEq/L (0.3 mmol/L). Which action will the nurse take?
A. Notify the primary health care provider of an emergency.
B. Administer the medication as it takes time to reach therapeutic levels.
C. Watch for adverse side effects.
D. Withhold the next dose of the medication.
B. Administer the medication as it takes time to reach therapeutic levels.
The nurse is reviewing the medical record of a client taking lithium for the management of bipolar disorder. Which finding indicates safe therapeutic levels of the medication?
A. 0.3 mEq/L
B. 0.7 mEq/L
C. 1.0 mEq/L
D. 1.7 mEq/L
B. 0.7 mEq/L
The laboratory report of a client undergoing long-term treatment with lithium carbonate indicates a level of 2.5 mEq/L (1.5 mmol/L). Which action will the nurse take?
A. Watch for signs of lithium toxicity.
B. Assess for an increase in manic behavior.
C. Administer the next dose of lithium as prescribed.
D. Ask the client whether he or she has been taking the medication.
A. Watch for signs of lithium toxicity.
A 30-year-old who began lithium carbonate therapy 3 weeks ago is having blood drawn for a lithium medication level. Which range will the nurse recognize as therapeutic?
A. 0.1 to 0.5 mEq/L (0.1–0.3 mmol/L)
B. 0.6 to 1.2 mEq/L (0.4–1.4 mmol/L)
C. 1.3 to 1.9 mEq/L (1.5–1.9 mmol/L)
D. 2.0 to 2.3 mEq/L (2.0–2.3 mmol/L)
B. 0.6 to 1.2 mEq/L (0.4–1.4 mmol/L)
A client in the hyperactive phase of bipolar disorder is receiving lithium. The nurse sees that the client’s lithium blood level is 1.8 mEq/L (1.8 mmol/L). Which action would the nurse take?
A. Continue the usual dose of lithium and note any adverse reactions
B. Discontinue the medication until the lithium serum level drops to 0.5 mEq/L (0.5 mmol/L)
C. Ask the health care provider to increase the dose of lithium, because the blood lithium level is too low
D. Hold the medication and notify the health care provider immediately, because the blood lithium level may be toxic
D. Hold the medication and notify the health care provider immediately, because the blood lithium level may be toxic
Which time period correctly identifies how long after the last dose the nurse will schedule to have a client’s blood drawn to evaluate serum lithium level?
A. 2 to 4 hours
B. 4 to 6 hours
C. 6 to 8 hours
D. 10 to 12 hours
D. 10 to 12 hours
A client has been receiving lithium for the past 2 weeks for the treatment of bipolar disorder, manic phase. Which information will the nurse include in the teaching plan for this client?
A. A diuretic is necessary for anyone taking lithium.
B. Lithium may only be necessary for a few months.
C. The blood level of lithium must be checked every month.
D. A low-sodium diet must be followed while lithium is being taken.
C. The blood level of lithium must be checked every month.
A nurse is teaching a client who has bipolar disorder about lithium. Which of the following statements should the nurse include in the teaching?
A. “This medication is addictive, so you will need to discontinue it in six months.”
B. “Weight gain should be reported to your provider as an indication of lithium toxicity.”
C. “Your provider may prescribe a diuretic if you have trouble urinating while taking lithium.”
D. “We will monitor your lithium levels closely while you are taking this medication.”
D. “We will monitor your lithium levels closely while you are taking this medication.”
A client has been prescribed lithium. Which intervention must be implemented while the client is on lithium therapy?
A. Restricting the client’s daily sodium intake
B. Testing the client’s urine specific gravity weekly
C. Regularly testing the serum medication level
D. Withholding the client’s other medications for several days
C. Regularly testing the serum medication level
Which of the following statements by a client taking lithium for bipolar disorder indicates the need for additional teaching (is incorrect)?
A. “I will call my health care provider (HCP) if I have blurred vision, difficulty walking, or ringing in my ears.”
B. “I will need to have my blood drawn once a year to check the lithium level.”
C. “I should let my health care provider (HCP) know if I have a lot of vomiting or diarrhea.”
D. “I will be sure to drink about 6 to 8 glasses of water every day.”
B. “I will need to have my blood drawn once a year to check the lithium level.”
The nurse is counseling a client who is taking lithium carbonate. Which assessment is the priority nursing assessment when a client is taking this medication?
A. Daily weights
B. Psychomotor activity
C. Signs and symptoms of hypothyroidism
D. Serum medication level
D. Serum medication level
A client is to begin lithium carbonate therapy. Which baseline laboratory work will the nurse ensure is completed before medication administration?
A. Renal studies
B. Cardiac enzyme studies
C. Adrenal function studies
D. Pulmonary function studies
A. Renal studies
Which class of medications would the nurse identify as used to reduce tremors caused by lithium therapy?
A. Diuretics
B. Beta blockers
C. Anticholinergics
D. Nonsteroidal anti-inflammatory drugs
B. Beta blockers
Which adverse effect would the nurse anticipate in a client receiving lithium therapy for treatment of depression?
A. Ataxia (difficulty walking/coordination)
B. Confusion
C. Blurred vision
D. Paradoxical anxiety
A. Ataxia (difficulty walking/coordination)
The client is admitted for evaluation of lithium toxicity. Which of the following observations by the nurse would indicate that the condition is worsening?
A. Dry mouth
B. Drowsiness
C. Increased thirst
D. Ataxia
D. Ataxia
The serum lithium blood level of a client with a mood disorder, manic episode, is 2.3 mEq/L (2.3 mmol/L). Which assessment findings would the nurse NOT expect?
A. Improved symptoms
B. Decreased coordination
C. Vomiting
D. Diarrhea
A. Improved symptoms
A client who is taking lithium has slurred speech, an ataxic gait, and nausea. Which statement about these signs and symptoms is correct?
A. They are related to a subtherapeutic lithium level.
B. The signs and symptoms are associated with cyclic mood disorders.
C. These problems are common transient side effects of lithium.
D. These effects may indicate a toxic level of lithium.
D. These effects may indicate a toxic level of lithium.
A nurse is teaching a client who has bipolar disorder about lithium. Which of the following statements should the nurse include in the teaching?
A. “Decrease your fluid intake to 1 liter per day.”
B. “You might produce extra saliva while taking this medication.”
C. “Notify your provider if you experience vomiting or diarrhea.”
D. “Take the medication on an empty stomach.”
C. “Notify your provider if you experience vomiting or diarrhea.”
An older adult living in a long-term care facility has been receiving 600 mg of lithium twice a day for 3 weeks to ease manic behavior. The client is experiencing nausea and vomiting, diarrhea, thirst, polyuria, slurred speech, and muscle weakness. Which intervention is appropriate?
A. Withholding the next dose of lithium and drawing blood for a lithium level
B. Obtaining a prescription for the antidote to lithium and administering it immediately
C. Suggesting that the health care provider replace the lithium for an antiepileptic that will control the mania
D. Assessing the client for coarse hand tremor and, if it is present, giving the daily dose of lithium with a bit of water
A. Withholding the next dose of lithium and drawing blood for a lithium level
Lithium carbonate, 600 mg by mouth three times a day, is prescribed for a client. Which condition should the client be instructed to immediately report to their health care provider?
A. Difficulty urinating
B. Sensitivity to bright light or sun
C. Fine hand tremor or slurred speech
D. Sexual dysfunction or breast enlargement
C. Fine hand tremor or slurred speech
A woman diagnosed with bipolar disorder is to take lithium as part of her treatment. What should the nurse discuss with the client as part of the teaching plan?
A. Weight reduction
B. Smoking cessation
C. Risk of concomitant use of oral contraceptives
D. Alcohol abstinence
D. Alcohol abstinence
The nurse teaches a nursing student about the care of clients receiving lithium. Which statement made by the student is CORRECT.
A. “I will advise a client to strictly adhere to the dosage regimen.”
B. “I will advise a pregnant client to use the medication with caution during the first trimester.”
C. “I will recommend the patient self-taper when bipolar symptoms subside”
D. “I will instruct the client to restrict sodium intake while coadministering lithium and diuretics.”
A. “I will advise a client to strictly adhere to the dosage regimen.”
The nurse teaches a client about precautions to be taken before initiating lithium therapy. Which statements made by the client is incorrect and needs re-education?
A. ‘I will take the medication with meals or milk.’
B. ‘I will maintain normal sodium intake levels in my diet.’
C. ‘I will discontinue therapy if I experience any signs of diarrhea.’
D. ‘I will swallow slow-release tablets intact without crushing or chewing them.’
C. ‘I will discontinue therapy if I experience any signs of diarrhea.’
Rationale
The client should take lithium with meals or milk to decrease gastric upset. A sodium deficiency can cause lithium to accumulate; therefore the client should maintain normal levels of sodium in their diet. Slow-release tablets should be swallowed intact. Diarrhea can cause significant sodium loss, which may cause an accumulation of lithium. A client experiencing diarrhea should make dietary changes to reduce the risk of toxicity instead of discontinuing or terminating the medication therapy. If any signs of toxicity develop, the client should immediately terminate therapy and notify the prescriber.
A client diagnosed with bipolar disorder is prescribed lithium. Which intervention would be essential for the nurse to emphasize when teaching the client about this medication?
A. Maintain adequate daily salt intake
B. Reduce fluid intake to minimize diuresis
C. Take the medication before meals
D. Use antacids to prevent heartburn
A. Maintain adequate daily salt intake
Which mineral is important for a client to maintain an adequate daily intake of when lithium therapy is instituted?
A. Iron
B. Sodium
C. Potassium
D. Magnesium
B. Sodium
The nurse discusses the implications of diet and fluid intake with a client who is receiving lithium therapy. Which instruction will the nurse give the client and family about nutrition?
A. A regular diet should be maintained.
B. A weight-reducing diet should be implemented.
C. Daily fluid intake should be limited to 1 L.
D. Daily salt intake should be limited to 2000 g.
A. A regular diet should be maintained.
A health care provider prescribes lithium carbonate for a client with bipolar disorder, depressive episode. Which instructions will the nurse NOT include when teaching the client about lithium?
A. Take the medication with food.
B. Adjust the dosage if your mood improves.
C. Have a snack with milk before going to bed.
D. It may take several weeks for beneficial results to occur.
B. Adjust the dosage if your mood improves.
A client is diagnosed with acute mania, and the health care provider plans to prescribe lithium therapy. Which client condition would cause the provider to NOT change the course of therapy?
A. Hyperlipidemia
B. Pregnancy
C. Renal insufficiency
D. Severe dehydration
A. Hyperlipidemia
Which finding in the health history of a client being treated for bipolar disorder indicates the need to discontinue lithium?
A. Hypothyroidism
B. Fine-hand tremors
C. Decrease in appetite
D. Positive pregnancy test
D. Positive pregnancy test
A primary health care provider plans to have a client with a diagnosis of bipolar disorder continue taking lithium after discharge. Which statement by the client confirms that teaching about the medication plan has been understood?
A. “I know that I should stop the medication if I think I’m getting sick.”
B. “I know that I may need to take the medication for the rest of my life.”
C. “I know that this medication causes no serious side effects when it’s taken correctly.”
D. “I know that I’ll have to increase the dosage at the beginning of a manic episode.”
B. “I know that I may need to take the medication for the rest of my life.”
Which medication would the nurse recognize as an effective mood-stabilizing medication used in clients with bipolar disorder for the acute treatment of mania and prevention of recurrent mania and depressive episodes?
A. Doxepin
B. Amitriptyline
C. Clozapine
D. Lithium carbonate
C. Clozapine
A client with a diagnosis of bipolar I disorder, manic episode, is started on a regimen of an antipsychotic agent and lithium carbonate. Which purpose does the antipsychotic serve?
A. Potentiates the action of lithium for more effective results
B. Interacts with lithium to prevent progression to the depressive phase
C. Helps decrease the risk of lithium toxicity in the first week of therapy
D. Acts to calm the client while allowing time for the lithium to reach a therapeutic level
D. Acts to calm the client while allowing time for the lithium to reach a therapeutic level
A client with bipolar disorder is taking lithium. The nurse should notify the health care provider when the client is prescribed which additional medication?
A. Furosemide
B. Finasteride
C. Insulin
D. Amlodipine
A. Furosemide
A health care provider prescribes divalproex for a client with the diagnosis of bipolar I disorder, manic episode. Which side effects of this medication might the client report during a follow-up visit?
A. Dizziness, nausea, and vomiting
B. Photosensitivity, agitation, and restlessness
C. Abdominal cramps, tremor, and muscle weakness
D. Weight gain, drowsiness, and diminished concentration
A. Dizziness, nausea, and vomiting
Which use correctly identifies why a primary health care provider would prescribe divalproex for a patient diagnosed with bipolar disorder?
A. Control of acute agitation due to schizophrenia
B. Treatment of the agitated phase of a paranoid state
C. Management of manic episodes in bipolar disorder
D. Modification of the depressive phase of major depression
C. Management of manic episodes in bipolar disorder
Which adverse effect would the nurse continually assess for in a client receiving valproic acid?
A. Yellow sclerae
B. Motor restlessness
C. Ringing in the ears
D. Torsion of the neck
A. Yellow sclerae
A nurse is caring for a client who has bipolar disorder and a new prescription for valproate. Which of the following instructions should the nurse give the client about the use of this medication?
A. Thyroid function tests should be performed every 6 months.
B. A pretreatment electroencephalogram (EEG) will be done.
C. Liver function tests must be monitored.
D. High serum sodium levels can cause toxic levels of valproate.
C. Liver function tests must be monitored.
The nurse understands which antiepileptic medication would be used as the first-line treatment for absence seizures?
A. Phenytoin
B. Diazepam
C. Valproic acid
D. Acetazolamide
C. Valproic acid
A school-age child with a seizure disorder has been on long-term carbamazepine therapy. Which intervention would the nurse incorporate into the plan of care?
A. Assessing the mouth for gingivitis
B. Checking the pupillary reaction to light
C. Keeping an accurate intake and output record
D. Monitoring the child’s complete blood cell counts
D. Monitoring the child’s complete blood cell counts
A nurse is caring for an adolescent client who is receiving carbamazepine for partial seizure disorder. Which of the following statements by the client’s parent is the nurse’s priority?
A. “He takes a 2-hour nap every day after school.”
B. “He says he feels sick to his stomach after taking this medication.”
C. “He has so many new bruises on his body.”
D. “He says his mouth is always dry.”
C. “He has so many new bruises on his body.”
A client is receiving carbamazepine for the treatment of a manic episode of bipolar disorder. Which information about carbamazepine is incorrect?
A. ‘You’ll have to take a diuretic with this medication.’
B. You may have blood disorders while taking this medication
C. You may want to suck on sugar-free hard candy when you get a dry mouth.’
D. ‘We’ll need to test your blood often during the first few weeks of therapy.’
A. ‘You’ll have to take a diuretic with this medication.’
The nurse teaches the client about effects of carbamazepine that would be reported to the primary health care provider. Which should the patient report?
A. Slight nausea
B. Dizziness
C. Unusual bleeding or bruising
D. Sensitivity to bright light or sun
C. Unusual bleeding or bruising
Which effect would the nurse monitor to evaluate the effectiveness of carbamazepine in the management of a client’s trigeminal neuralgia?
A. Pain intensity
B. Gait
C. Range of motion
D. Seizure activity
A. Pain intensity
A client with schizophrenia, paranoid type, demonstrates a shuffling gait and tilts the head toward one shoulder. Which detail would the nurse conclude about these clinical manifestations?
A. They are expected characteristics of this illness.
B. They are consistent with an acute exacerbation of the illness.
C. They are possible adverse effects of the antipsychotic medication.
D. They are life threatening and require immediate intervention.
C. They are possible adverse effects of the antipsychotic medication.
Which common, manageable side effect will the nurse assess for in a client receiving antipsychotic medication?
A. Jaundice
B. Melanocytosis (large spots on skin
C. Drooping eyelids
D. Unintentional tremor
D. Unintentional tremor
The nurse assesses a client who has been taking haloperidol for several months. Which of the following statements made by the client should be reported to the health care provider immediately?
A. “My bowel movements have become harder and less frequent.”
B. “I occasionally have a dry, harsh cough.”
C. “I’m having jerky movements with my arms, & face that I can’t control.”
D. “I’m having difficulties with falling asleep at night.”
C. “I’m having jerky movements with my arms, & face that I can’t control.”
A client is prescribed a new antipsychotic medication, haloperidol. The nurse is teaching the client about possible side effects, including tardive dyskinesia (TD). Which statement is accurate about tardive dyskinesia?
A. The high fever, sweating and muscle stiffness will last about one week
B. TD occurs within minutes of the first dose of any antipsychotic drug
C. The longer someone is treated with an antipsychotic medication, the higher the risk for developing TD
D. Almost every client treated with antipsychotic medications will eventually develop TD
C. The longer someone is treated with an antipsychotic medication, the higher the risk for developing TD
A client with schizophrenia is given antipsychotic medication. Which permanent adverse effect would lead to this medication being discontinued?
A. Akathisia (inability to sit down = restlessness)
B. Tardive dyskinesia
C. Parkinsonian syndrome
D. Acute dystonic reaction
B. Tardive dyskinesia
Which side effect of antipsychotic medications may be irreversible?
A. Akathisia (can’t stay still)
B. Tardive dyskinesia (involuntary facial movements)
C. Parkinsonian syndrome (shuffling and hand tremors)
D. Acute dystonic reaction (sudden involuntary muscle spasms)
B. Tardive dyskinesia (involuntary facial movements)
Which potentially irreversible extrapyramidal side effect (this is a broad muscular dysfunction term) would the nurse monitor for when a client with the diagnosis of chronic, undifferentiated schizophrenia is receiving an antipsychotic medication?
A. Torticollis (twisted muscle neck)
B. Oculogyric crisis (eye rolling)
C. Tardive dyskinesia (involuntary facial movements)
D. Pseudoparkinsonism (shuffling, hand shakes)
C. Tardive dyskinesia (involuntary facial movements)
The nurse is caring for a client who reports the onset of symptoms associated with tardive dyskinesia after taking haloperidol. Which finding would the nurse expect to observe?
A. Behavior changes related to judgment
B. Fine motor tremors of the hands while eating
C. Involuntary yelling of random words
D. Rapid, repetitive tongue movements
D. Rapid, repetitive tongue movements
A client receiving high doses of haloperidol tells the nurse, ‘I just can’t sit still, and I feel jittery.’ Which side effect would the nurse suspect the client is experiencing?
A. Akathisia (restlessness/agitation)
B. Torticollis (involuntary neck muscle contracting)
C. Tardive dyskinesia (involuntary facial movement)
D. Parkinsonian syndrome (shuffling, hand shaking)
A. Akathisia (restlessness/agitation)
The nurse suspects acute akathisia in a client receiving antipsychotic therapy for treatment of schizophrenia. Which is NOT characteristic of akathisia?
A. Anxiety
B. Agitation
C. Stooped posture
D. Restless movement
C. Stooped posture
The nurse recalls that the blockage of dopamine by antipsychotic medications can cause extrapyramidal side effects such as akathisia. Which client behaviors reflect the presence of akathisia (restlessness/agitation)?
A. Acute muscle spasms and torticollis
B. Bizarre facial and tongue movements
C. Motor restlessness, foot tapping, and pacing
D. Tremor, shuffling gait, drooling, and rigidity
C. Motor restlessness, foot tapping, and pacing
The nurse is caring for a client who received the first dose of fluphenazine two hours ago. The client suddenly experiences torticollis (uncontrolled twisting neck muscles) and an involuntary spastic muscle movement. After administering the ordered anticholinergic drug, which of the following actions should the nurse implement?
A. Immediately place the client in a seclusion room
B. Have respiratory support equipment available
C. Administer a prn dose of an anti-psychotic medication
D. Assess the client for anxiety and agitation
B. Have respiratory support equipment available
A client is receiving haloperidol for agitation, and the nurse is monitoring the client for side effects. Which response identified by the nurse is unrelated to an extrapyramidal tract effect?
A. Akathisia (restlessness, can’t stop moving)
B. Opisthotonos (SEVERE muscle contraction, arched back)
C. Oculogyric crisis (uncontrolled eye rolling)
D. Hypertensive crisis
D. Hypertensive crisis
The primary health care provider is concerned that a client receiving haloperidol may be developing neuroleptic malignant syndrome. Which clinical manifestations would the nurse monitor for in this client when assessing for this syndrome?
A. Jaundice and malaise
B. Tremors and seizures
C. Diaphoresis and hyperpyrexia (elevated temperature)
D. Dry skin and hyperbilirubinemia
C. Diaphoresis and hyperpyrexia (elevated temperature)
The nurse is assessing a client who takes a prescribed antipsychotic medication, haloperidol. Which findings require immediate discontinuation of this medication?
A. Cheek puffing and involuntary movements of extremities and trunk
B. Agitation and constant state of motion
C. Hyperthermia and severe muscle rigidity
D. Involuntary rhythmic stereotypic movements and tongue protrusion
C. Hyperthermia and severe muscle rigidity
The nurse assesses a client receiving antipsychotic medications for treatment of schizophrenia. The nurse notes the client has a temperature of 102°F (38.9°C) and an abnormal blood pressure. Which adverse effect of the antipsychotic medication would the nurse suspect causes this condition?
A. Akathisia (restlessness)
B. Tardive dyskinesia (involuntary movements of face)
C. Extrapyramidal symptoms (a mixture of uncontrolled movements, restlessness, and Parkinson like symptoms “shuffling, stooped posture, shaky hands”)
D. Neuroleptic malignant syndrome (sky rocketing B/P and temperature)
D. Neuroleptic malignant syndrome (sky rocketing B/P and temperature)
A client is prescribed chlorpromazine. Which action will prevent life-threatening complications during administration when the client is anxious and restless?
A. Provide adequate restraint.
B. Monitor the client’s vital signs.
C. Protect against exposure to direct sunlight.
D. Watch the client for extrapyramidal side effects.
A client is prescribed chlorpromazine. Which action will prevent life-threatening complications during administration when the client is anxious and restless?
A. Provide adequate restraint.
B. Monitor the client’s vital signs.
C. Protect against exposure to direct sunlight.
D. Watch the client for extrapyramidal side effects.
B. Monitor the client’s vital signs.
The nurse is providing care for a client who is diagnosed with schizophrenia and treated with clozapine. The client reports that his leg has developed an involuntary movement and he can feel his heart beating. Which other assessment findings should the nurse gather before calling the health care provider (HCP)?
A. Bowel sounds in all four abdominal quadrants
B. Vital signs including oral temperature
C. Glasgow Coma Scale (GCS) to measure level of consciousness
D. Total urinary output for the last 24 hours
B. Vital signs including oral temperature
Neuroleptic malignant syndrome develops in a client taking a conventional antipsychotic medication. What is NOT a signs and symptoms would the nurse expect in neuroleptic malignant syndrome?
A. Hyperpyrexia
B. Increased muscle tone
C. Respiratory depression due to chest rigidity
D. Lip-smacking
D. Lip-smacking
A nurse is developing a care plan for a client who has schizophrenia and is taking chlorpromazine. Which of the following actions should the nurse include in the plan?
A. Monitor the client’s respirations every 4 hr.
B. Administer an antacid with the medication to decrease nausea.
C. Weigh the client daily.
D. Monitor the client for signs of bleeding.
A. Monitor the client’s respirations every 4 hr.
Which assessment finding DOES NOT supports the diagnosis of neuroleptic malignant syndrome (NMS) in a client with schizophrenia being treated with haloperidol? Select all that apply. One, some, or all responses may be correct.
A. Rigidity
B. Sweating
C. Tongue rolling & arching of trunk
D. Temperature 105.8°F (41°C)
C. Tongue rolling & arching of trunk
The nurse is educating a client about newly prescribed chlorpromazine. Which of the following should the nurse include in the teaching as an adverse effect of the medication?
A. Photosensitivity
B. Muscle rigidity
C. Weight gain
D. Dry mouth
B. Muscle rigidity
During a follow-up visit, a client who has been taking 3 mg of risperidone twice a day for the past 8 days reports tremors, shortness of breath, a fever, and sweating. Which action will the nurse take next?
A. Call 911 and have the client transported to the nearest psychiatric unit.
B. Take the client’s vital signs and arrange for immediate transfer to a hospital.
C. Check the number of risperidone tablets left in the prescription bottle to see whether there was an overdose.
D. Request a prescription for 2 mg of intramuscular benztropine stat and assess the client in 10 to 15 minutes for symptom relief.
B. Take the client’s vital signs and arrange for immediate transfer to a hospital.
A nurse is teaching a client who has a new prescription for chlorpromazine. Which of the following client statements indicates an understanding of the teaching?
A. “This medication will help me stop smoking.”
B. “I may have a dry mouth while taking this medication.”
C. “I should expect flu-like symptoms while taking this medication.”
D. “This medication may cause me to urinate frequently.”
B. “I may have a dry mouth while taking this medication.”
A nurse is providing teaching to a client who has schizophrenia and is receiving chlorpromazine. Which of the following client statements indicates an understanding of the teaching?
A. “I will contact my provider if I have difficulty urinating.”
B. “I am less likely to get an infection while taking this medication.”
C. “Weight loss is a sign that my medication dose is too high.”
D. “I may need to take this medication with an antacid due to stomach upset.”
A. “I will contact my provider if I have difficulty urinating.”
The nurse teaches a client about the possible side effects of a newly prescribed antipsychotic medication. The nurse concludes that the client needs further instruction when the client reports plans to call the clinic if which problem occurs? Which of the following is NOT a side/adverse effect of anti-psychotics
A. Tremors
B. Constipation
C. Blurred vision
D. Ringing in the ears
D. Ringing in the ears
Which extrapyramidal effects should be assessed for in a client with schizophrenia, undifferentiated type, who is receiving a typical antipsychotic/neuroleptic medication?
A. Shuffling gait, tremors, and restlessness
B. Nausea, vomiting, and muscle cramps
C. Drowsiness, disorientation, and slurred speech
D. Tachycardia, urine retention, and constipation
A. Shuffling gait, tremors, and restlessness
Which major reason explains why clients with severe psychiatric disorders are prescribed antipsychotic medications?
A. Improvement of judgment
B. Promotion of social skills
C. Elimination of neurotic tendencies
D. Symptom management of psychosis
D. Symptom management of psychosis
A client diagnosed with schizophrenia is started on an antipsychotic/neuroleptic medication. Which purpose explains what this medication is used to achieve?
A. To keep the client quiet and relaxed
B. To control the client’s behavior and reduce stress
C. To reduce the client’s need for physical restraints
D. To make the client more receptive to psychotherapy
D. To make the client more receptive to psychotherapy
An antipsychotic medication has been prescribed for a client with delusions who physically and verbally abuses others. Which client behavior demonstrates a therapeutic response to the medication?
A. The client begins to get involved with the activities of others on the unit.
B. The client becomes aware of the behavior and its consequences.
C. The client remains preoccupied with the delusions but is less verbally abusive.
D. The client continues to be abusive but delusions decrease.
B. The client becomes aware of the behavior and its consequences.
Which action is accurate in explaining how neuroleptic medications, such as first-generation anti-psychotic such as haloperidol or second generation anti-psychotic such as risperidone act in the body to promote mental health for clients diagnosed with schizophrenia?
A. They inhibit enzymes at the postsynaptic receptor site.
B. They decrease serotonin at the postsynaptic receptor site.
C. They increase dopamine uptake at the postsynaptic receptor site.
D. They block access to dopamine receptors at the postsynaptic receptor site.
D. They block access to dopamine receptors at the postsynaptic receptor site.
The nurse develops a teaching plan for fluphenazine. Which would the nurse caution the client to avoid while taking it?
A. Eating cheeses
B. Nighttime driving
C. Staying in the sun
D. Taking medications containing aspirin
C. Staying in the sun
A client with a diagnosis of schizophrenia, paranoid type, has been receiving a phenothiazine medication. Which action is important for the nurse to take to assist this client when the psychiatric daycare center plans a fishing trip?
A. Provide the client with sunscreen.
B. Caution the client to limit exertion during the trip.
C. Give the client an extra dose of medication to take after lunch.
D. Take the client’s blood pressure before allowing participation in the outing.
A. Provide the client with sunscreen
The nurse is teaching a client with intractable hiccups about chlorpromazine. Which information should the nurse include?
A. Avoid dairy products that contain lactose.
B. Avoid tyramine-containing foods.
C. Avoid direct sunlight.
D. Take on an empty stomach.
C. Avoid direct sunlight.
Which medication will cause a heightened skin reaction to sunlight?
A. Lithium
B. Sertraline
C. Methylphenidate
D. Chlorpromazine
D. Chlorpromazine
The nurse is providing discharge instructions to a client with a prescription for chlorpromazine. Which finding should the nurse teach the client to report immediately?
A. Fever
B. Alopecia
C. Insomnia
D. Breast enlargement
A. Fever
A client has been prescribed chlorpromazine for the management of positive symptoms of schizophrenia. Which response would the nurse provide?
A. “This is the medication that your health care provider prescribed.”
B. “This will help you not to hear the voices. It will only work if you take it.”
C. “There must be a reason that you don’t want to take your medicine.”
D. “That is a side effect of this medication.”
B. “This will help you not to hear the voices. It will only work if you take it.”
Which statement would the nurse emphasize when teaching a client about taking fluphenazine decanoate?
A. Driving is forbidden.
B. There will be a feeling of increased energy.
C. Sunscreen should be used for outdoor activities.
D. Blood pressure may become elevated.
C. Sunscreen should be used for outdoor activities.
Which action should be avoided by the client taking fluphenazine?
A. Eating cheeses
B. Nighttime driving
C. Staying in the sun
D. Taking medications containing aspirin
C. Staying in the sun
The nurse understands which as the primary advantage of using fluphenazine for treatment of schizophrenia?
A. There are no side effects.
B. It has a long-lasting effect.
C. It is safe to use during pregnancy.
D. There is less need for laboratory monitoring.
B. It has a long-lasting effect.
A client with a diagnosis of schizophrenia is discharged from the hospital. At home, the client forgets to take medication, becomes unable to function, and must be rehospitalized. Which medication can prevent this problem when administered on an outpatient basis every 2 to 3 weeks?
A. Lithium
B. Diazepam
C. Fluvoxamine
D. Fluphenazine
D. Fluphenazine
Which primary advantage applies to the use of fluphenazine for treatment of schizophrenia?
A. There are no side effects.
B. It has a long-lasting effect.
C. There is less need for laboratory monitoring.
D. It is safe to use during pregnancy.
B. It has a long-lasting effect.
A nurse is planning to administer olanzapine 10 mg IM to a client who has schizophrenia. Which of the following actions should the nurse take?
A. Monitor the client for at least 3 hr after the injection.
B. Administer the medication into the deltoid muscle.
C. Instruct the client to expect difficulty sleeping.
D. Withhold the medication if the client reports hallucinations.
A. Monitor the client for at least 3 hr after the injection.
A nurse is caring for a client who reports an upset stomach after taking chlorpromazine. Which of the following responses should the nurse make?
A. “Taking the medication on an empty stomach will decrease your stomach upset.”
B. “Talk to your provider about decreasing your dose of medication.”
C. “Drink a glass of milk with each dose of your medication.”
D. “Lie down for 30 minutes after each dose to help prevent stomach upset.”
C. “Drink a glass of milk with each dose of your medication.”
The nurse understands that haloperidol is most effective for clients who exhibit which type of behavior?
A. Depressed
B. Overactive
C. Withdrawn
D. Manipulative
B. Overactive
Which type of behavior exhibited by a patient would haloperidol most effectively treat?
A. Depressed
B. Overactive
C. Withdrawn
D. Manipulative
B. Overactive
A young adult client with schizophrenia is prescribed haloperidol. When the nurse administers the medication, the client asks, ‘What’s this for?’ Which response by the nurse is correct?
A. ‘This medication raises your seizure threshold.’
B. ‘It will help you relax and think more clearly.’
C. ‘This medication helps keep thoughts together.’
D. ‘It will help you maintain an even mood and controls your temper.’
B. ‘It will help you relax and think more clearly.’
Which medication is the most common cause of extrapyramidal side effects (dystonia -involuntary muscle movements, akathisia – restlessness, pseudoparkinsonism – shuffling hand shakes) “?
A. Clozapine
B. Haloperidol
C. Risperidone
D. Aripiprazole
B. Haloperidol
A client with an organic mental disorder becomes increasingly agitated and abusive and is prescribed haloperidol. Which potential adverse effects would the nurse monitor for in this client related to this drug?
A. Tremors
B. Pseudoparkinsonism related to extrapyramidal syndrome
C. Syndrome of inappropriate antidiuretic hormone (SIADH)
D. Type 2 diabetes mellitus
B. Pseudoparkinsonism related to extrapyramidal syndrome
Which adverse effect would the nurse assess for in a client receiving haloperidol?
A. Ataxia (unsteady walking/gait)
B. Asthenia (weakness)
C. Insomnia
D. Gynecomastia (enlarged breasts in men)
D. Gynecomastia (enlarged breasts in men)
A client who is receiving haloperidol 5 mg three times a day complains of twitching of the fingers. Which response will the nurse provide?
A. ‘This is a temporary situation until your body adjusts to the medication.’
B. ‘You need the medication that we’re giving you. You’ll get used to the side effects soon.’
C. ‘Let’s wait a few days and see whether the side effects of the medication you’re taking go away.’
D. ‘I’ll ask the primary health care provider to prescribe a medication that will help overcome the side effects of haloperidol.’
D. ‘I’ll ask the primary health care provider to prescribe a medication that will help overcome the side effects of haloperidol.’
Which activity would the nurse teach the client to avoid while taking haloperidol?
A. Driving at night
B. Staying in the sun
C. Eating aged cheeses
D. Taking medications containing aspirin
B. Staying in the sun
The nurse teaches a client about the side effects and precautions associated with the antipsychotic medication haloperidol. Which statement indicates the client has understood the teaching?
A. “I’ll call my health care provider right away if I have any diarrhea or vomiting.”
B. “I won’t eat anything containing tyramine while I’m taking this medication.”
C. “I’ll avoid direct sunlight and make sure to use sunscreen when I go outside.”
D. “I’ll be sure to drink enough fluids.”
C. “I’ll avoid direct sunlight and make sure to use sunscreen when I go outside.”
Which information would the nurse provide a client beginning treatment with haloperidol to prevent injury?
A. Monitor temperature.
B. Wear a mask when out.
C. Change positions slowly.
D. Report pacing and squirming
C. Change positions slowly
The nurse is caring for a client who is prescribed an antipsychotic medication, haloperidol. Which statement correctly identifies why it is important for the nurse to monitor the client’s blood pressure?
A. Rising trends in blood pressure will indicate when an antiparkinsonian medication is needed
B. Most antipsychotic medications cause wide fluctuations in blood pressure throughout the day
C. Blood pressure will determine if dietary restrictions should be implemented
D. Orthostatic hypotension is a common side effect
D. Orthostatic hypotension is a common side effect
A client with schizophrenia is receiving haloperidol 2 mg orally three times a day. The client approaches the nurse’s station presenting with eyes rolled upward towards the head. The nurse recognizes this finding as what type of side effect?
A. Dysphagia
B. Nystagmus
C. Tardive dyskinesia
D. Oculogyric (eye rolling) crisis
D. Oculogyric (eye rolling) crisis
A client begins fighting and biting other clients. The primary health care provider prescribes a stat injection of haloperidol. Which approach accurately describes how will the nurse should implement this prescription?
A. Quickly, with an attitude of concern
B. After the client agrees to receive the injection
C. Before the client realizes what is happening
D. Quietly, without any explanation of the reason for it
A. Quickly, with an attitude of concern
Thirty minutes after administering fluphenazine to a client, the nurse notes that the client’s jaw is rigid, the client is drooling, and the client’s speech is slurred. Which as-needed prescribed medication will the nurse administer?
A. Diazepam, 10 mg by mouth
B. Trihexyphenidyl, 1 mg by mouth
C. Haloperidol, 2 mg intramuscularly (IM)
D. Benztropine, 2 mg IM
D. Benztropine, 2 mg IM
A client receiving fluphenazine develops dystonia/extrapyramidal (uncontrolled shakes) side effect early in therapy. Which medication would the nurse anticipate administering to reverse this side effect?
A. Nafarelin
B. Fluoxetine
C. Trandolapril
D. Benztropine
D. Benztropine
A client receiving fluphenazine decanoate develops dystonia early in therapy. Which medication would the nurse anticipate administering to reverse this side effect?
A. Nafarelin
B. Fluoxetine
C. Trandolapril
D. Benztropine
D. Benztropine
Which reason explains why so many psychiatric clients are given benztropine or trihexyphenidyl in conjunction with phenothiazine-derivative neuroleptic medications?
A. They reduce postural hypotension.
B. They potentiate the effects of the neuroleptic medication.
C. They combat the extrapyramidal side effects of the neuroleptic medication.
D. They ameliorate the depression that may accompany schizophrenia.
C. They combat the extrapyramidal side effects of the neuroleptic medication.
A client develops extrapyramidal effects after taking a neuroleptic medication, haloperidol and the nurse notes extrapyramidal effects. Which medication can limit these side effects?
A. Zolpidem
B. Hydroxyzine
C. Dantrolene
D. Benztropine mesylate
D. Benztropine mesylate
A client receiving fluphenazine decanoate develops dystonia early in therapy. Which medication would the nurse anticipate administering to reverse this side effect?
A. Nafarelin
B. Fluoxetine
C. Trandolapril
D. Benztropine
D. Benztropine
Which nursing intervention is priority when caring for a client with schizophrenia who begins to have difficulty breathing and whose eyes begin to roll up after receiving the first dose of chlorpromazine?
A. Administer intravenous (IV) benztropine.
B. Reduce chlorpromazine dosage.
C. Administer oral benzodiazepine.
D. Obtain serum liver function tests.
A. Administer intravenous (IV) benztropine.
A client with schizophrenia is taking benztropine in conjunction with an antipsychotic. The client tells the nurse, ‘Sometimes I forget to take the benztropine.’ Which action will the nurse teach the client to take if this happens again?
A. Take two pills at the next regularly scheduled dose.
B. Notify the primary health care provider about the missed dose immediately.
C. Take a dose as soon as possible, up to 2 hours before the next dose.
D. Skip the dose, then take the next regularly scheduled dose 2 hours early.
C. Take a dose as soon as possible, up to 2 hours before the next dose.
A client with schizophrenia is started on a regimen of chlorpromazine. After a shuffling gait, tremors, and some rigidity develop, benztropine mesylate is prescribed. Which characteristics do these medications share?
A. Cholinesterase inhibition
B. Anticholinergic properties
C. Antipsychotic effects
D. Antimanic properties
B. Anticholinergic properties
A client with schizophrenia who is receiving an antipsychotic medication begins to exhibit a shuffling gait and tremors. The primary health care provider prescribes the anticholinergic medication benztropine, 2 mg daily. Which symptom should the nurse should inquire about when assessing the client?
A. Constipation
B. Hypertension
C. Increased salivation
D. Excessive perspiration
A. Constipation
The nurse is reviewing the medical record of a client who received a new prescription for benztropine. For which condition in the client’s record should the nurse clarify the prescription with the health care provider?
A. Cataracts
B. Schizophrenia
C. Glaucoma
D. Parkinson’s disease
C. Glaucoma
A client with Parkinson’s disease is prescribed benztropine (Cogentin). For which of the following should the nurse call the health care provider immediately?
A. The client is complaining of dizziness when standing up.
B. The client is exhibiting bradykinesia and slurred speech.
C. The client’s heart rate increased from 80 to 95 beats per minute.
D. The client has a history of primary angle-closure glaucoma.
D. The client has a history of primary angle-closure glaucoma.
Which clinical finding would support the rationale for the addition of valproate and olanzapine to a client’s medication regimen?
A. Euphoric mania
B. Dysphoric mania
C. Rapid cycling mania
D. Mania with psychosis
D. Mania with psychosis
Which information would the nurse include when teaching the family about the administration of olanzapine?
A. It must be given by Z-track administration.
B. A special tyramine-free diet is required.
C. It dissolves instantly after oral administration.
D. An empty stomach increases its effectiveness.
C. It dissolves instantly after oral administration.
Which advantage does olanzapine have over other antipsychotic medications for clients in a behavioral health unit?
A. Extrapyramidal symptoms do not occur.
B. Medication effects last for weeks after administration.
C. Dopamine is increased at receptor sites, decreasing psychotic behavior.
D. Tablets disintegrate immediately in the mouth, preventing tablet “cheeking.”
D. Tablets disintegrate immediately in the mouth, preventing tablet “cheeking.”
Which statement is true regarding antipsychotic medications?
A. All first- and second-generation antipsychotics are equally effective.
B. Second-generation antipsychotics pose a risk of extrapyramidal symptoms.
C. First-generation antipsychotics pose a significant risk of metabolic side effects.
D. Clozapine is more effective than other second-generation antipsychotics.
D. Clozapine is more effective than other second-generation antipsychotics.
The nurse is educating a client who is taking clozapine to treat schizophrenia. Which adverse effect of clozapine would the nurse emphasize as being important to report to the health care provider?
A. Inability to sit still
B. Tardive dyskinesia
C. Temperature rise
D. A high risk for falls
C. Temperature rise
Which patient condition would contraindicate the use of the medication clozapine?
A. Seizures
B. Glaucoma
C. Dysrhythmias
D. Bone marrow depression
D. Bone marrow depression
Which adverse effect is least likely to occur in a client who is prescribed clozapine?
A. Seizures
B. Sedation
C. Akathisia
D. Myocarditis
D. Myocarditis
A health care provider prescribes clozapine to a client with schizophrenia. Which parameter would the nurse NOT assess before administering the medication?
A. Prolactin levels (milk production/lactation in women)
B. White blood cell count
C. Body mass index
D. Absolute neutrophil count (type of WBC)
A. Prolactin levels (milk production/lactation in women)
The health care provider instructs a client who has been taking clozapine for 2 months to discontinue the medication for a few weeks. Which laboratory parameter would the nurse recognize as supporting the intervention?
A. Platelet count of 30,000/mm 3
B. Hemoglobin of 12 g/dL
C. White blood cell count of 2,500/mm 3
D. Red blood cell count of 4.2 million/mm 3
C. White blood cell count of 2,500/mm 3
A client who is taking clozapine calls the nurse in the psychiatric clinic to report the sudden development of a sore throat and high fever. Which instruction will the nurse give the client?
A. Stay in bed, drink fluids, take a dose of aspirin, and ask the primary health care provider to reduce the dosage of clozapine.
B. Discontinue the medication immediately and see the primary health care provider as soon as an appointment becomes available.
C. Continue the medication, drink fluids, take aspirin, and see the primary health care provider in a few days if the symptoms do not improve.
D. Discontinue the medication and, if the primary health care provider is unavailable today, go to the emergency department for evaluation.
D. Discontinue the medication and, if the primary health care provider is unavailable today, go to the emergency department for evaluation.
Which cautionary advice would the nurse give the client who has been prescribed olanzapine for a diagnosis of bipolar disorder, manic episode?
A. “Sit up slowly.”
B. “Report double vision.”
C. “Expect increased salivation.”
D. “Take the medication on an empty stomach.”
A. “Sit up slowly.”
A client with schizophrenia who has been taking clozapine is to start on 10 mg of olanzapine instead. Which adverse effect will be avoided by substituting olanzapine for clozapine?
A. Hypotension
B. Gastric upset
C. Agranulocytosis (low WBC-neutrophils)
D. Metabolic syndrome (elevated fats, sugar/glucose)
C. Agranulocytosis (low WBC-neutrophils)
Which adverse effect will the nurse assess for in a client who has been taking the prescribed dose of clozapine ?
A. Polycythemia (too many blood cells)
B. Agranulocytosis (too few WBC-neutrophils)
C. Hypertensive crisis
D. Depressed atrioventricular conduction
B. Agranulocytosis (too few WBC-neutrophils)
Which possible complication requires frequent blood tests when a client diagnosed with psychosis is taking clozapine?
A. Anemia (low RBC)
B. Hemophilia (blood does not clot)
C. Agranulocytosis (low WBC – neutrophils)
D. Thrombocytopenia (low platelets)
C. Agranulocytosis (low WBC – neutrophils)
A client who is going to be discharged has been receiving 3 mg of risperidone 3 times a day. Which information will the nurse give the client about the medication?
A. May be reduced if the client feels better at home
B. May be discontinued after the client is discharged
C. May cause sedation if taken concurrently with alcohol
D. Should be taken early in the day to be sure that it is not forgotten
C. May cause sedation if taken concurrently with alcohol
A client receiving high-dosage risperidone exhibits hand tremors. Which would be the nurse’s first intervention?
A. Withholding the medication
B. Telling the client it is transitory
C. Giving the client finger exercises
D. Contacting the primary health care provider
D. Contacting the primary health care provider
Which psychotropic medication may cause metabolic syndrome (high fat and glucose in body)?
A. Lithium
B. Diazepam
C. Alprazolam
D. Risperidone
D. Risperidone
Which assessment will assist the nurse in determining whether a client is experiencing adverse effects of risperidone?
A. Monitor for episodes of diarrhea.
B. Test sensation of lower extremities.
C. Question if dizziness is experienced.
D. Auscultate breath sounds to detect wheezing.
C. Question if dizziness is experienced
A nurse is assessing a client who has schizophrenia and is taking risperidone. Which of the following findings should the nurse expect?
A. Weight gain
B. Dependent edema
C. Nightmares
D. Bradycardia
A. Weight gain
A nurse is providing discharge teaching to a client who is taking risperidone. Which of the following instructions should the nurse include in the teaching?
A. “Avoid becoming overheated while taking this medication.”
B. “This medication may increase your blood pressure.”
C. “Flu-like symptoms are an expected adverse effect of this medication.”
D. “Muscle twitches can occur the first few weeks while taking this medication.”
A. “Avoid becoming overheated while taking this medication.”
A nurse is assessing a client who has schizophrenia and is taking aripiprazole. The nurse should notify the provider of which of the following findings?
A. Muscle stiffness
B. Insomnia
C. Constipation
D. Weight gain of 5 lb in 1 month
A. Muscle stiffness
*The nurse is reviewing the medical record of a client with bipolar disorder. The client is prescribed aripiprazole (Abilify) 10 mg once a day but reports that they have not taken the medication in several weeks. Which action should the nurse take?
A. Educate the client on the importance of taking their medications as prescribed.
B. Request for the medication to be changed to a once monthly injection.
C. Instruct the client’s partner to make sure the medication is taken every day.
D. Inform the client that they will have to be admitted to an inpatient psychiatric facility.
A. Educate the client on the importance of taking their medications as prescribed.
The nurse is caring for a client who uses ritualistic behavior. Which medication is indicated for treatment of this condition?
A. Benztropine
B. Amantadine
C. Fluvoxamine
D. Diphenhydramine
C. Fluvoxamine
A client with obsessive-compulsive disorder has an anxiety level that is approaching a panic level, and the client’s ritual is interfering with work and daily living. Which selective serotonin reuptake inhibitor (SSRI) would be considered when preparing a teaching plan?
A. Haloperidol
B. Fluvoxamine
C. Imipramine
D. Benztropine
B. Fluvoxamine
A client with obsessive-compulsive disorder has an anxiety level that is approaching a panic level, and the client’s ritual is interfering with work and daily living. For which selective serotonin reuptake inhibitor (SSRI) would the nurse anticipate preparing a teaching plan?
A. Haloperidol
B. Fluvoxamine
C. Imipramine
D. Benztropine
B. Fluvoxamine
