M11: Psych Flashcards
ch 30, 31, 27, review of 12 (M3)
Common mistakes practitioners make in treating anxiety disorders include:
1.Switching medications after an 8- to 12-week trial
2.Maximizing dosing of antianxiety medications
3.Encouraging exercise and relaxation therapy before starting medication
4.Thinking a partial response to medication is acceptable
4.Thinking a partial response to medication is acceptable
An appropriate first-line drug to try for mild to moderate generalized anxiety disorder would be:
1.Alprazolam (Xanax)
2.Diazepam (Valium)
3.Buspirone (Buspar)
4.Amitriptyline (Elavil)
3.Buspirone (Buspar)
An appropriate drug to initially treat panic disorder is:
1.Alprazolam (Xanax)
2.Diazepam (Valium)
3.Buspirone (Buspar)
4.Amitriptyline (Elavil)
2.Diazepam (Valium)
Very fast onset-longer 1/2 life; buspar is contraindicated w/ panic d/o. TCA-3rd line med; Xanax higher abuse potnential
Prior to starting antidepressants, patients should have laboratory testing to rule out:
1.Hypothyroidism
2.Anemia
3.Diabetes mellitus
4.Low estrogen levels
1.Hypothyroidism
David is a 34-year-old patient who is starting on paroxetine (Paxil) for depression. David’s
education regarding his medication would include:
1.Paroxetine may cause intermittent diarrhea.
2.He may experience sexual dysfunction beginning a month after he starts therapy.
3.He may have constipation and he should increase fluids and fiber.
4.Paroxetine has a long half-life so he may occasionally skip a dose.
2.He may experience sexual dysfunction beginning a month after he starts therapy.
Jamison has been prescribed citalopram (Celexa) to treat his depression. Education regardinghow quickly selective serotonin reuptake inhibitor (SSRI) antidepressants work would be:
1.Appetite and concentration improve in the first 1 to 2 weeks.
2.Sleep should improve almost immediately upon starting citalopram.
3.Full response to the SSRI may take 2 to 4 months after he reaches the fulltherapeutic dose.
4.His dysphoric mood will improve in 1 to 2 weeks.
1.Appetite and concentration improve in the first 1 to 2 weeks.
An appropriate drug for the treatment of depression with anxiety would be:
1.Alprazolam (Xanax)
2.Escitalopram (Lexapro)
3.Buspirone (Buspar)
4.Amitriptyline (Elavil)
2.Escitalopram (Lexapro)
An appropriate first-line drug for the treatment of depression with fatigue and low energy would be:
1. Venlafaxine (Effexor)
2. Escitalopram (Lexapro)
3. Buspirone (Buspar)
4. Amitriptyline (Elavil)
- Venlafaxine (Effexor)
The laboratory monitoring required when a patient is on a selective serotonin reuptake inhibitor is:
1. Complete blood count every 3 to 4 months
2. Therapeutic blood levels every 6 months after a steady state is achieved
3. Blood glucose every 3 to 4 months
4. There is no laboratory monitoring required
- There is no laboratory monitoring required
Jaycee has been on escitalopram (Lexapro) for a year and is willing to try tapering off of the selective serotonin reuptake inhibitor. What is the initial dosage adjustment when starting a taper off antidepressants?
1. Change dose to every other day dosing for a week
2. Reduce dose by 50% for 3 to 4 days
3. Reduce dose by 50% every other day
4. Escitalopram (Lexapro) can be stopped abruptly due to its long half-life
- Reduce dose by 50% for 3 to 4 days
The longer-term Xanax patient comes in and states they need a higher dose of the medication. They deny any additional, new, or accelerating triggers of their anxiety. What is the probable reason?
1. They have become tolerant of the medication, which is characterized by the need for higher and higher doses.
2. They are a drug seeker.
3. They are suicidal.
4. They only need additional counseling on lifestyle modification.
- They have become tolerant of the medication, which is characterized by the need for higher and higher doses.
What “onset of action” symptoms should be reviewed with patients who have been newly prescribed
a selective serotonin reuptake inhibitor?
1. They will have insomnia for a week.
2. They can feel a bit of nausea, but this resolves in a week.
3. They will have an “onset seizure” but this is considered normal.
4. They will no longer dream.
- They can feel a bit of nausea, but this resolves in a week.
Which of the following should not be taken with a selective serotonin reuptake inhibitor?
1. Aged blue cheese
2. Grapefruit
3. Alcohol
4. Green leafy vegetables
- Alcohol
Why is the consistency of taking paroxetine (Paxil) and never running out of medication more important than with most other selective serotonin reuptake inhibitors (SSRIs)?
1. It has a shorter half-life and withdrawal syndrome has a faster onset without taper.
2. It has the longest half-life and the withdrawal syndrome has a faster onset.
3. It is quasi-addictive in the dopaminergic reward system.
4. It is the most activating of SSRI medications and will cause the person to have
sudden deep sadness.
- It has a shorter half-life and withdrawal syndrome has a faster onset without taper.
The patient shares with the provider that he is taking his Prozac at night before going to bed. What is the best response?
1. This is a good idea because this class of medications generally makes people sleepy.
2. Have you noticed that you are having more sleep issues since you started that?
3. This a good way to remember to take your daily medications because it is near your toothbrush.
4. This is a good plan because you can eat grapefruit if there is 8–12 hours difference in the time each are ingested.
- Have you noticed that you are having more sleep issues since you started that?
The nurse is caring for a 7-year-old child who has difficulty concentrating and completing tasks and who cannot seem to sit still. Which diagnostic test may be ordered to assist with a diagnosis of attention deficit/hyperactivity disorder (ADHD) in this child?
1.Computerized tomography (CT) of the head
2.Electrocardiogram (ECG)
3.Electroencephalogram (EEG)
4.Magnetic resonance imaging (MRI) ofthe brain
3.Electroencephalogram (EEG)
The nurse is teaching a child and a parent about taking methylphenidate (Ritalin) to treat attention deficit/hyperactivity disorder (ADHD). Which statement by the parent indicates an understanding of the teaching?
1.I should give this drug to my child at bedtime.
2.My child should avoid products containing caffeine.
3.The drug should be stopped immediately if my child develops aggression.
4.We should monitor my child’s weight since weight gain is common.
2.My child should avoid products containing caffeine.
The parent of a child who is taking amphetamine (Adderall) to treat attention deficit/hyperactivity disorder (ADHD) asks the provider to recommend an over-the-counter medication to treat a cold. What will the nurse tell the parent?
1.Avoid any products containing pseudoephedrine or caffeine.
2.Never give over-the-counter medications with Adderall.
3.Sudafed is a safe and effective decongestant.
4.Use any over-the-counter medication from the local pharmacy.
1.Avoid any products containing pseudoephedrine or caffeine.
The nurse is checking an 8-year-old child who has attention-deficit/hyperactivity disorder (ADHD) into a clinic for an annual well-child visit. The child takes methylphenidate HCl (Ritalin). Which assessments are especially important for this child?
1.Heart rate, respiratory rate, and oxygen saturation
2.Height, weight, and blood pressure
3.Measures of fine- and gross-motor development
4.Nausea, vomiting, and gastrointestinal upset
2.Height, weight, and blood pressure
The parent of an adolescent who has taken methylphenidate 20 mg/day for 6 months for attention deficit/hyperactivity disorder (ADHD) brings the child to clinic for evaluation of a recent onset of nausea, vomiting, and headaches. The parent expresses concern that the child seems less focused and more hyperactive than before. What will the nurse do next?
1. Ask the child whether the drug is being taken as prescribed.
2. Contact the provider to discuss increasing the dose to 30 mg/day.
3. Recommend taking the drug with meals to reduce gastrointestinal side effects.
4. Report signs of drug toxicity to the patient’s provider.
- Ask the child whether the drug is being taken as prescribed.
The nurse is teaching a parent about methylphenidate (Ritalin) to treat attention deficit/hyperactivity disorder (ADHD). Which statement by the parent indicates understanding of the teaching?
1. I should consult a pharmacist when giving my child OTC medications.
2. I will only give my child diet soft drinks while administering this medication.
3. Medication therapy means that behavioral therapy will not be necessary.
4. Weight gain is a common side effect of this medication.
- I should consult a pharmacist when giving my child OTC medications.
The parents of a 6-year-old child diagnosed with ADHD will most typically describe their child’s behavior as:
1. a learning disorder and muscle paralysis.
2. nervousness and sleeplessness.
3. hyperactivity and decreased attention span
4. hyperactivity and nervousness.
- hyperactivity and decreased attention span
A pediatric nurse admits a child who has a history of ADHD. The nurse is aware that ADHD may display as:
1. poor coordination and abnormal electroencephalogram (EEG).
2. abnormal EEG and decrease in intelligence.
3. minimal brain dysfunction and a marked decrease in intelligence.
4. developmental delay and poor coordination.
- poor coordination and abnormal electroencephalogram (EEG).
A nurse is teaching the family of a child with ADHD about her diet and medications. The child is prescribed methylphenidate (Ritalin) every day. In teaching about the client’s diet, it is most important that the nurse encourage the child to avoid which foods and/or drinks?
1. High-sodium foods
2. High-sugar foods and drinks
3. High-fat foods
4. Caffeinated foods and drinks
- Caffeinated foods and drinks
A client with ADHD is prescribed methylphenidate (Ritalin). Based on the half-life of the drug, how often should the nurse administer the drug?
1. Daily
2. Twice a day
3. Every 8 hours
4. Every 12 hours
- Twice a day
The nurse is teaching a group in the community about drug abuse. Which statement by the nurse is correct?
1.Cue-induced cravings eventually disappear after long periods of abstinence by the person addicted todrugs.
2.Drug abuse and drug addiction are synonymous terms, describing dependence on drugs.
3.Drug addiction is characterized by emotional, mental, and sometimes physical dependence.
4.Drug addiction occurs when physical dependence is present.
3.Drug addiction is characterized by emotional, mental, and sometimes physical dependence.
The nurse is caring for a patient who is being treated for chronic alcohol intoxication. The nurse notes that the patients serum alcohol level is 0.40 mg%. The patient is awake and talkative even though this is a potentially lethal dose. The nurse recognizes this as alcohol
1.addiction.
2.dependence.
3.misuse.
4.tolerance.
4.tolerance.
What does the nurse understand must occur in order to produce withdrawal syndrome?
1.Addiction
2.Craving
3.Drug tolerance
4.Physical dependence
4.Physical dependence
The nurse is counseling a patient who wants to stop smoking. Which statement by the nurse is correct?
1. Bupropion (Zyban) is effective and does not have serious adverse effects.
2. Nicotine replacement therapies are effective and eliminate the need for behavioral therapy.
3. Varenicline (Chantix) may be used short-term for 1 to 2 months.
4. You may experience headaches and increased appetite for several months after stopping smoking.
- You may experience headaches and increased appetite for several months after stopping smoking.
A patient with asthma has been using a nicotine transdermal 24-hour patch for 3 weeks to quit smoking. The patient reports having difficulty sleeping. What action will the nurse take?
1. Ask the provider for a prescription for Nicotrol NS.
2. Recommend removing the patch at bedtime.
3. Suggest using an 18-hour patch instead.
4. Tell the patient to stop the patch and join a support group.
- Suggest using an 18-hour patch instead.
