More Exam 1 Review Questions

Question 1

1. The nurse notes that a patient who is taking lithium (Lithobid)
   seems confused, has ataxia, and coarse hand tremors. Which
   of the following should the nurse suspect?
   a) this is an expected reaction to lithium
   b) pseudoparkinson syndrome
   c) a medical problem unrelated to lithium
   d) toxic effects of the lithium

Answer 1

d) toxic effects of the lithium

Question 2

2. The nurse should understand that the therapeutic effects of
   the “typical or conventional” antipsychotics are associated
   with changes in which neurotransmitter?
   a) dopamine
   b) acetylcholine
   c) serotonin
   d) GABA

Answer 2

a) dopamine

Question 3

3. After a week of taking an SSRI (selective serotonin reuptake inhibitor), a patient is refusing to take the medication because “it isn’t helping”. The nurse’s first action should be:
   a) chart the patient’s refusal
   b) inform physician about the issue
   c) explain how long the med takes to work
   d) refer for ECT (electroconvulsive therapy)

Answer 3

c) explain how long the med takes to work

Question 4

4. Which should be the nurse’s first concern regarding the patient’s knowledge related to taking the MAOI medication, phenelzine (Nardil)?
   a) avoidance of foods containing tyramine
   b) maintenance of follow up visits
   c) hypotensive effects
   d) neurotransmitters that are affected

Answer 4

a) avoidance of foods containing tyramine

Question 5

5. Which medication is the best choice for the nurse to administer if the patient is experiencing a severe dystonic reaction?
   a) Haloperidol (Haldol) p.o.
   b) Lorazepam (Ativan) p.o.
   c) Benztropine (Cogentin) i.m.
   d) Chlorpromazine (Thorazine) p.o.

Answer 5

c) Benztropine (Cogentin) i.m.

Question 6

6. The nurse should include which of these statements when instructing the patient about benzodiazepines?
   a) avoid drinking alcohol when taking these meds
   b) increase the dosage whenever needed
   c) do not consume foods that are high in tyramine
   d) maintain salt and fluid balance each day

Answer 6

a) avoid drinking alcohol when taking these meds

Question 7

7. When teaching a patient about clozapine (Clozaril), what potential side effect should the nurse emphasize as most serious?
   a) agranulocytosis
   b) sedation
   c) anticholinergic effects
   d) hypotension

Answer 7

a) agranulocytosis

Question 8

8. When teaching a group of older adults about medications, what should the nurse include? MARK ALL THAT APPLY.
   a) Older adults are more sensitive to antipsychotics
   b) Older adults tend to get toxic more rapidly
   c) Older adults need higher doses of medications
   d) Older adults need lower doses of medications
   e) Older adults have the same med responses as adults

Answer 8

a) Older adults are more sensitive to antipsychotics
b) Older adults tend to get toxic more rapidly
d) Older adults need lower doses of medications

Question 9

9. The nurse who is caring for a patient that is taking high doses of haloperidol (Haldol) should recognize what symptoms associated with neuroleptic malignant syndrome?
   a) confusion and coarse tremors
   b) rigidity and fever
   c) drooling and shuffling gait
   d) inability to sit or stand still

Answer 9

b) rigidity and fever

Question 10

10. The nurse is performing an AIMS test on a patient. What should the nurse know the AIMS is designed to detect early?
    a) dystonia
    b) akathisia
    c) pseudoparkinsonism
    d) tardive dyskinesia

Answer 10

d) tardive dyskinesia

Question 11

11. The nurse should instruct the patient that which medication classification is more likely to lead to weight gain?
    a) Atypical antipsychotics
    b) Conventional antipsychotics
    c) Anxiolytics
    d) Stimulants

Answer 11

a) Atypical antipsychotics

Question 12

12. Which of these meds would it be most important for the nurse to monitor the patient for sexual side effects?
    a) Fluoxetine (Prozac)
    b) Benztropine (Cogentin)
    c) Lorazepam (Ativan)
    d) Lithium carbonate (Lithobid)

Answer 12

a) Fluoxetine (Prozac)

Question 13

13. A patient is taking benztropine (Cogentin) for side effects of an antipsychotic medication. What should the nurse monitor in this patient as potential side effects associated with benztropine?
    a. Diarrhea, nausea, fine tremors, thirst
    b. Constipation, urinary retention, dry mouth, blurred vision
    c. Dystonia, akathisia, pseudoparkinsonism, tardive dyskinesia
    d. Fever, lead pipe rigidity, elevated vital signs

Answer 13

b. Constipation, urinary retention, dry mouth, blurred vision

Question 14

14. A patient has been started on an SSRI type of medication. What should the nurse teach the patient?
    a. SSRIs cause more cardiac side effects than tricyclic antidepressants
    b. SSRIs require a special low tyramine diet to prevent a hypertensive crisis
    c. SSRIs may cause sexual problems in some patients
    d. SSRIs can be used safely with all other types of antidepressants including herbal types

Answer 14

c. SSRIs may cause sexual problems in some patients

Question 15

15. What is the most important thing for the nurse to monitor in a patient starting on amitriptyline (Elavil)?
    a. Potential overdose.
    b. Potential dry mouth.
    c. Potential constipation.
    d. Potential orthostatic hypotension.

Answer 15

a. Potential overdose.

Question 16

16. The nurse who is caring for a patient on lithium carbonate (Lithobid) should teach the patient about what common side effects?
    a. Dry mouth, urinary retention, dry eyes
    b. Increased thirst, increased urination, fine hand tremors
    c. Stiff neck, headache, hypertension
    d. Serotonin syndrome, confusion, hyperthermia

Answer 16

b. Increased thirst, increased urination, fine hand tremors

Question 17

17. What should the nurse teach the patient who is taking lithium (Lithobid) to do?
    a. Restrict salt intake
    b. Limit fluids to 4 glasses of water a day
    c. Report vomiting to the healthcare provider
    d. Take extra diuretics as needed

Answer 17

c. Report vomiting to the healthcare provider

Question 18

18. The nurse notes that a patient who cannot take lithium (Lithobid) has been started on an anticonvulsant. In mental health, anticonvulsants are typically used to treat which of these disorders?
    a. Antisocial disorder
    b. Bipolar disorder
    c. Schizophrenia
    d. Obsessive compulsive disorder

Answer 18

b. Bipolar disorder

Question 19

19. A patient is taking a benzodiazepine medication. The nurse should know which of these statements is true about benzodiazepines?
    a. They are contraindicated for alcohol withdrawal patients
    b. They have no abuse potential
    c. They can be safely mixed with alcohol
    d. They should be used cautiously in older adults

Answer 19

d. They should be used cautiously in older adults

Question 20

20. A nurse notes that a patient has an elevated temperature, lead pipe rigidity, confusion, and muteness. The patient has only been on high doses of an antipsychotic medication. What condition should the nurse suspect?
    a. Serotonin syndrome
    b. Neuroleptic malignant syndrome
    c. Hypertensive crisis
    d. Photosensitivity reaction

Answer 20

b. Neuroleptic malignant syndrome