Chapter 6

Question 1

Which postoperative narcotic analgesic will most likely be prescribed to a patient whose current medications include a monoamine oxidase inhibitor (MAOI), a thyroid hormone, and a multivitamin?

Answer 1

Morphine

Question 2

What occurs with mania associated with bipolar disorder?

Answer 2

Distinct episodes of elation

Question 3

What is the major advantage of selective serotonin reuptake inhibitors (SSRIs) over other types of antidepressant therapy?

Answer 3

They do not cause the anticholinergic and cardiovascular adverse effects.

Question 4

Lithium (Eskalith) is the drug of choice for which of the following disorders?

Answer 4

Bipolar disorders

Question 5

Which psychological manifestation of depression will improve in response to antidepressant therapy?

Answer 5

Social withdrawal

Question 6

On what is the choice of tricyclic antidepressants based?

Answer 6

Patient age and gender

Question 7

The nurse is teaching a patient about medication treatment for depression. The patient asks how long it will take before sleep and appetite will begin to improve. Which response by the nurse is most accurate?

Answer 7

1 week

Question 8

What is the action of MAOIs on neurotransmitters?

Answer 8

Blocking their destruction

Question 9

A patient who is taking an MAOI to treat depression admits to eating pickled herring and cheese and drinking red wine. Which assessment finding alerts the nurse to a potential complication?

Answer 9

Neck stiffness

Question 10

Which assessment would the nurse expect to observe in a patient who has been prescribed trazodone for treatment anxiety?

Answer 10

Drowsiness

Question 11

The nurse is caring for a patient who is taking a newly prescribed drug, nefazodone, for treatment of depression. Which physical assessment finding is most important for the nurse to report to the health care provider immediately?

Answer 11

Bradycardia

Question 12

The nurse is providing education to a patient who has been prescribed bupropion (Wellbutrin) for smoking cessation. Which statement by the patient would indicate the need for further teaching?

Answer 12

If I have the urge to smoke, I will take more medication.

Question 13

Which nursing action is most important when providing care to a patient diagnosed with a mood disorder?

Answer 13

Assess the patient for thoughts of suicide.

Question 14

A patient is admitted to a long term psychiatric setting. The MAOI medication previously prescribed is discontinued by the physician. New orders are obtained to initiate imipramine therapy. The nurse will provide the first dose of imipramine to the patient ____ the MAOI drug.

Answer 14

in 14 days following the last dose of

Question 15

A patient taking vilazodone has been vomiting persistently for 12 hours. The priority nursing diagnosis for this patient is:

Answer 15

fluid volume deficit.

Question 16

Which area(s) should be addressed by the nurse when obtaining a history of a patient admitted with depression? (Select all that apply.)
a. Current medications and medical history
b. Recent stressors and support system
c. Family history of mood disorder
d. Dietary patterns
e. Insurance coverage

Answer 16

A, B, C, D

Question 17

Which instruction(s) is/are most pertinent to include in the discharge teaching of a patient on lithium (Eskalith) who is being discharged? (Select all that apply.)
a. Persistent vomiting and profuse diarrhea are signs of toxicity and must be reported to the health care provider immediately.
b. It is important to comply with schedules for blood tests to assess therapeutic levels.
c. You should avoid foods such as Chianti wine and aged cheeses.
d. The common adverse effects to expect, which are excessive nausea, anorexia, and abdominal cramps, tend to resolve.
e. You will be gradually weaned off this medication.
f. Take the medication with food or milk.

Answer 17

A, B, D, F

Question 18

What will the nurse include in a teaching plan for a patient with depression being treated with amitriptyline (Elavil)? (Select all that apply.)
a. Dryness of the mouth is normal; sucking on sugar free hard candy and ice chips or chewing gum may help alleviate this problem.
b. Rise slowly from a supine or sitting position to avoid dizziness and orthostatic
hypotension.
c. Avoid alcohol and barbiturates.
d. If adverse effects occur, discontinue the medication.
e. An immediate elevation in mood will be noted.

Answer 18

A, B, C

Question 19

Which food(s) containing significant amounts of tyramine will be contraindicated when a patient is on MAOI therapy? (Select all that apply.)
a. Beer
b. Red meat
c. Aged cheeses
d. Green vegetables
e. Bananas

Answer 19

A, C, E

Question 20

Which nursing assessment(s) is/are important before the initiation of antidepressant therapy?(Select all that apply.)
a. Compliance with medication therapy within the last 2 months
b. Nonverbal interactions among patient and significant others present
c. Evaluation of the coherency, relevancy, and organization of thoughts in responses
d. Appearance and posture
e. Elimination pattern

Answer 20

A, B, C, D

Question 21

Which statement(s) is/are true regarding the pharmacologic actions of certain antidepressant drugs? (Select all that apply.)
a. MAOIs block the effects of dopamine in the CNS.
b. SSRIs inhibit the destruction and reuptake of serotonin at the synaptic cleft.
c. Tricyclic antidepressants block the action of norepinephrine and epinephrine in the SNS.
d. Monocyclic antidepressants such as bupropion (Wellbutrin) have an unknown mechanism of action.
e. SNRIs prolong the action of neurotransmitters by decreasing the destruction of serotonin and norepinephrine.

Answer 21

B, D, E

Question 22

Which drug(s) interact(s) with SSRI agents? (Select all that apply.)
a. Tranylcypromine (Parnate)
b. Lithium (Eskalith)
c. Warfarin (Coumadin)
d. Furosemide (Lasix)
e. Propranolol (Inderal)

Answer 22

A, B, C, E

Question 23

The nurse must be sure to instruct the patient about which potential adverse effect(s) of tricyclic antidepressants? (Select all that apply.)
a. Diarrhea
b. Dryness of mouth, nose, and throat
c. Constipation
d. Nocturia
e. Urinary retention
f. Blurred vision

Answer 23

B, C, E, F

Question 24

The nurse is preparing 0800 medications for a patient with the medical diagnosis of end stage renal disease. When reviewing the medication administration record (MAR), the nurse notices the patient is scheduled to receive an MAOI drug. Which intervention(s) will the nurse perform before administering the drug? (Select all that apply.)
a. Assess temperature.
b. Provide an alternative drug.
c. Hold the MAOI drug.
d. Consult with the prescribing health care provider.
e. Assess urine output prior to administration.

Answer 24

C, D