Week 5 sherpath

Question 1

The nurse is caring for a patient who takes aripiprazole who states, “My friend takes haloperidol; why can’t I take that?” Which nursing response is appropriate?

“We can talk with your health care provider to change to haloperidol.”

“Second-generation antipsychotics (SGAs) have fewer side effects than first-generation antipsychotics (FGAs).”

“Do you not wish to take your medication?”

“You must take aripiprazole for at least 6 months before switching.”

Answer 1

“Second-generation antipsychotics (SGAs) have fewer side effects than first-generation antipsychotics (FGAs).”

Question 2

Which drug would the nurse discuss with the health care provider as an option for a patient with psychosis who needs drug therapy with a long duration of action?

Aripiprazole

Fluphenazine

Haloperidol

Haloperidol decanoate

Answer 2

Haloperidol decanoate

Question 3

The nurse is caring for four patients with psychosis. Which patient may benefit most from haloperidol decanoate?

21 year old who is homeless and moves from city to city

30 year old who lives with parents and works at a restaurant

44 year old who engages in therapy in addition to drug therapy

52 year old who is married and who works from home

Answer 3

21 year old who is homeless and moves from city to city

Question 4

Which teaching would the nurse provide to a patient newly prescribed fluphenazine for schizophrenia?

“Be certain to take this medication with food.”

“This drug may change the color of your urine.”

“Take an antacid at the same time that you take this drug.”

“If you miss a dose, contact your health care provider to determine whether you should take it.”

Answer 4

“If you miss a dose, contact your health care provider to determine whether you should take it.”

Question 5

Which drug does the nurse anticipate will be prescribed for Mr. Crood because he states that fluphenazine made him feel bad?

Aripiprazole

Fluphenazine

Haloperidol

Haloperidol decanoate

Answer 5

Aripiprazole

Question 6

A patient taking fluphenazine reports symptoms including lip smacking and tongue protrusion. Which teaching would the nurse provide?

“This condition will always reverse when you stop the drug.”

“Tardive dyskinesia is possibly irreversible.”

“These are very unexpected symptoms.”

“These symptoms can lead to anaphylaxis.”

Answer 6

“Tardive dyskinesia is possibly irreversible.”

Question 7

The nurse would monitor an adult patient for which side effects commonly associated with aripiprazole?

Select all that apply.

Nausea

Diarrhea

Extrapyramidal disorder

Insomnia

Akathisia

Answer 7

Nausea

Extrapyramidal disorder

Insomnia

Akathisia

Question 8

Which information would the nurse teach a patient about how aripiprazole affects dopamine?

Increases release of dopamine

Inhibits reuptake of dopamine

Exerts a moderate block of dopamine receptors

Exerts a major block of dopamine receptors

Answer 8

Exerts a moderate block of dopamine receptors

Question 9

The health care provider indicates that a first-generation antipsychotic will be prescribed for a patient with psychosis. Which drugs would the nurse anticipate may be prescribed?

Select all that apply.

Aripiprazole

Fluphenazine

Clozapine

Haloperidol

Quetiapine

Answer 9

Fluphenazine

Haloperidol

Question 10

In addition to schizophrenia, aripiprazole is commonly used for which indications?

Select all that apply.

Dissociative disorder

Anorexia nervosa

Bipolar mania

Major depressive disorder

Irritability associated with autism spectrum disorder

Answer 10

Bipolar mania

Major depressive disorder

Irritability associated with autism spectrum disorder

Question 11

In which substances is aripiprazole excreted?

Select all that apply.

Tears

Feces

Urine

Sweat

Saliva

Answer 11

Feces

Urine

Question 12

Which side effect would the nurse assess for in a patient taking aripiprazole who nearly falls after standing up?

Tardive dyskinesia

Bradykinesia

Orthostatic hypotension

Akathisia

Answer 12

Orthostatic hypotension

Question 13

For which patient would the nurse question a prescription for aripiprazole?

Patient who drinks alcohol

Patient who has a history of bipolar disorder

Patient with a history of frequent constipation

Patient who did not respond well to fluphenazine

Answer 13

Patient who drinks alcohol

Question 14

Which laboratory result(s) would a nurse monitor for a patient taking an atypical antipsychotic drug?

Lithium level

Serum glucose, cholesterol, and triglycerides

Blood urea nitrogen (BUN) and creatinine

Hemoglobin and hematocrit

Answer 14

Serum glucose, cholesterol, and triglycerides

Question 15

The nurse would assess for which finding in a patient taking fluphenazine who reports tremors and neck spasms?

Anticholinergic effects

Agranulocytosis

Tachycardia

Extrapyramidal symptoms

Answer 15

Extrapyramidal symptoms

Question 16

The nurse would explain to a patient that fluphenazine is incompatible with which beverage?

Grapefruit juice

Milk

Apple juice

Kefir

Answer 16

Apple juice

Question 17

A patient with schizophrenia says, “I quit taking an antipsychotic because it makes me feel bad.” Which nursing response is the priority?

“Tell me more about the symptoms you experienced.”

“All antipsychotic drugs have some type of side effect.”

“Medications must be taken as prescribed to work effectively.”

“Are certain side effects manageable, whereas others are not?”

Answer 17

“Tell me more about the symptoms you experienced.”

Question 18

Match the drug with its appropriate classification.

Benzodiazepine

Benzodiazepine-like

Barbiturate

Melatonin receptor agonist

Answer choices

Diazepam

Zolpidem

Secobarbital

Ramelteon

Answer 18

Benzodiazepine
Diazepam

Benzodiazepine-like
Zolpidem

Barbiturate
Secobarbital

Melatonin receptor agonist
Ramelteon

Question 19

Benzodiazepine-like drugs are used primarily for the treatment of which condition?

Insomnia

Anxiety

Seizures

Acute alcohol withdrawal

Answer 19

Insomnia

Question 20

Which statements are accurate regarding benzodiazepines?

Select all that apply.

Benzodiazepines are highly addictive.

Benzodiazepines are commonly used for treatment of insomnia.

Benzodiazepines depress neuronal function at multiple sites within the central nervous system (CNS).

The effect of benzodiazepines can be sedating, hypnotic, or stupor inducing.

Benzodiazepines provide longer relief of anxiety symptoms than other sedative-hypnotic agents.

Examples of benzodiazepines include zolpidem, eszopiclone, and zaleplon.

Answer 20

Benzodiazepines are highly addictive.

Benzodiazepines depress neuronal function at multiple sites within the central nervous system (CNS).

The effect of benzodiazepines can be sedating, hypnotic, or stupor inducing.

Question 21

A patient is prescribed a drug for sleep that has been approved for long-term use. Which medication would the nurse anticipate will be prescribed?

Lorazepam

Zolpidem

Secobarbital

Alprazolam

Answer 21

Zolpidem

Question 22

A patient is prescribed a drug for sleep that has been approved for long-term use. Which medication would the nurse anticipate will be prescribed?

Lorazepam

Zolpidem

Secobarbital

Alprazolam

Answer 22

Zolpidem

Question 23

For which concerning symptom does the nurse closely monitor in a patient taking a benzodiazepine?

Respiratory depression

Sedation

Cardiac arrythmias

Development of renal impairment

Answer 23

Respiratory depression

Question 24

An older adult patient is prescribed a sedative-hypnotic in the hospital for insomnia. Which nursing actions are appropriate?

Select all that apply.

Use bed alarms.

Provide call light.

Keep side rails elevated.

Darken the room.

Provide electronic devices or television to help the patient go to sleep.

Answer 24

Use bed alarms.

Provide call light.

Keep side rails elevated.

Question 25

A patient states, “I take diazepam with grapefruit juice every morning.” Which nursing response is appropriate?

“Grapefruit products may increase the drug’s concentration and effects.”

“Grapefruit products may decrease the drug’s concentration and effects.”

“Grapefruit products have no effect on the drug’s concentration and effects.”

“Grapefruit products can increase gastrointestinal (GI) upset.”

Answer 25

“Grapefruit products may increase the drug’s concentration and effects.”

Question 26

Which phrase describes the mechanism of action of benzodiazepines?

Depresses all levels of the central nervous system (CNS) by enhancing action of gamma-aminobutyric acid (GABA)

Acts as a strong dopamine D2 antagonist

Blocks reuptake of serotonin and norepinephrine

Blocks monoamine oxidase activity

Answer 26

Depresses all levels of the central nervous system (CNS) by enhancing action of gamma-aminobutyric acid (GABA)

Question 27

Which patient statement about the pharmacodynamics of zolpidem requires further teaching by the nurse?

“I will take this drug after I am in bed for the night.”

“I am glad I will be able to get enough REM sleep.”

“I am worried that this drug will stay in my system for a long time.”

“I will make sure I can get at least 6 to 8 hours of sleep before taking this drug

Answer 27

I am worried that this drug will stay in my system for a long time.”

Question 28

Which patient statement about the pharmacodynamics of diazepam indicates that medication teaching has been effective?

“I know it will take a while for this medication to begin to work.”

“This medication could hurt my kidneys if I take it for a long time.”

“I will be taking this medication permanently to treat my anxiety.”

“This medication can be sedating so I will not plan to drive until I know how it affects me.”

Answer 28

“This medication can be sedating so I will not plan to drive until I know how it affects me.”

Question 29

Which assessment data would the nurse obtain before the administration of diazepam?

Select all that apply.

Blood pressure

Respiratory rate

Heart rate

Temperature

Mental status

Oxygen saturation

Answer 29

Blood pressure

Respiratory rate

Heart rate

Mental status

Oxygen saturation

Question 30

Which assessment finding would cause the nurse to hold the dose of zolpidem and notify the health care provider?

Has used a benzodiazepine in the past to induce sleep

Reports a history of sleep apnea

Blood pressure 130/80, pulse 90, respiratory rate 20

Weight loss of 2 lb over the course of 5 days

Answer 30

Reports a history of sleep apnea

Question 31

Which instructions would the nurse provide to a patient who has been prescribed diazepam?

Select all that apply.

Mix with grapefruit juice.

Crush the tablet and mix it with applesauce.

Chew the tablet.

This drug can be taken with or without food.

The oral concentrate form of diazepam can be diluted with water.

Answer 31

Crush the tablet and mix it with applesauce.

This drug can be taken with or without food.

The oral concentrate form of diazepam can be diluted with water.

Question 32

The nurse educates the patient who has been taking zolpidem for more than a year to avoid sudden discontinuation of the drug to minimize which effect?

Pruritis

Anorexia

Vomiting

Restlessness

Answer 32

Vomiting

Question 33

A patient using St. John’s wort for depressive symptoms has been prescribed a benzodiazepine for management of mild panic attacks. Which drug interaction will the nurse discuss with the patient?

Constipation

Excessive sleepiness

Slowed rate of breathing

Lack of reduction in anxiety symptoms

Answer 33

Lack of reduction in anxiety symptoms

Question 34

Which patient, if prescribed a benzodiazepine, would the nurse contact the provider about?

A 60-year-old patient with renal insufficiency

A 5-year-old patient who is otherwise healthy

A 45-year-old patient with multiple sclerosis

A postpartum patient who is breastfeeding

Answer 34

A postpartum patient who is breastfeeding

Question 35

Which statement about buspirone is true?

Buspirone depresses the central nervous system (CNS).

Buspirone is an example of a benzodiazepine.

Buspirone is used for treatment of anxiety.

Buspirone cannot be used if a patient has taken a benzodiazepine.

Answer 35

Buspirone is used for treatment of anxiety.

Question 36

Which information would the nurse provide when a patient asks if buspirone can be taken for long-term management of anxiety?

Buspirone can only be used for short-term treatment of anxiety.

Buspirone can be used long term, but efficacy decreases over time.

Buspirone can be used for treatment of anxiety that lasts up to a year.

Buspirone must be taken with another drug to manage long-term anxiety.

Answer 36

Buspirone can be used for treatment of anxiety that lasts up to a year.

Question 37

Which drug class is the first choice for the management of anxiety?

Opiates

Barbiturates

Selective serotonin reuptake inhibitors (SSRIs)

Benzodiazepines

Answer 37

Selective serotonin reuptake inhibitors (SSRIs)

Question 38

A patient is being started on buspirone. Which time frame describes how long it will take for an initial response to appear?

Immediately

48 hours

2 to 3 weeks

1 month

Answer 38

2 to 3 weeks

Question 39

When Ms. Gamez returns for a follow-up visit, which assessment finding indicates that buspirone and psychotherapy have been effective?

Select all that apply.

One panic attack experienced in the past 4 weeks

Has been to court twice for divorce without anxiety

Continues to see psychotherapist once weekly

Can feel anxiety rising, which prompts her to start focused breathing exercises

Reports she is reluctant to talk with her work supervisor about work concerns

Answer 39

One panic attack experienced in the past 4 weeks

Has been to court twice for divorce without anxiety

Continues to see psychotherapist once weekly

Can feel anxiety rising, which prompts her to start focused breathing exercises

Question 40

The nurse is caring for an inpatient who is prescribed buspirone. Which item would the nurse remove from the patient’s dietary tray?

Potato chips

Grapefruit juice

Grilled chicken

Salad with green, leafy vegetables

Answer 40

Grapefruit juice

Question 41

The health care provider prescribes buspirone intramuscularly. Which nursing action is appropriate?

Call the health care provider to verify the route.

Administer the medication in the patient’s peripherally inserted central catheter (PICC) line.

Administer the medication in the deltoid muscle of the left arm.

Call the health care provider to prescribe lidocaine for the injection site.

Answer 41

Call the health care provider to verify the route.

Question 42

In which way does buspirone differ from other anxiolytics?

It is fast acting.

It is highly addictive.

It is not a central nervous system (CNS) depressant.

It can be taken with grapefruit juice.

Answer 42

It is not a central nervous system (CNS) depressant.

Question 43

Which laboratory value(s) would the nurse follow for a patient who has been taking buspirone regularly?

Alanine transaminase (ALT) and aspartate transaminase (AST)

Blood urea nitrogen (BUN) and creatinine

White blood cell count

Fasting blood glucose

Answer 43

Alanine transaminase (ALT) and aspartate transaminase (AST)

Question 44

A patient is having an acute anxiety attack because of the anticipation of surgery the following day. The health care provider prescribes buspirone. Which nursing action is appropriate?

Administer the medication.

Give the medication intravenously.

Confirm the prescription with the charge nurse.

Hold the medication and verify the prescription with the health care provider.

Answer 44

Hold the medication and verify the prescription with the health care provider.

Question 45

Which patient who would benefit from buspirone does the nurse discuss with the health care provider?

Patient with long-term anxiety who drinks alcohol

Patient having an acute anxiety attack

Patient having pain from a broken hip

Patient who has chronic insomnia

Answer 45

Patient with long-term anxiety who drinks alcohol

Question 46

A patient taking buspirone uses the call light after breakfast to report feeling “really spacey.” Which nursing response is appropriate?

“Does the room feel cold to you?”

“Have you seen the health care provider yet?”

“Do you need me to escort you to the bathroom?”

“Did you drink grapefruit juice with breakfast?”

Answer 46

“Did you drink grapefruit juice with breakfast?”

Question 47

The health care provider prescribes ketoconazole for a patient. Before administration of the new medication, the patient’s family brings in an updated medication list that includes buspirone. Which action should the nurse take?

Administer ketoconazole as prescribed.

Hold the ketoconazole and notify the health care provider.

Administer buspirone at least 2 hours after buspirone dose.

Teach the patient and family that ketoconazole can be started 24 hours after the most recent buspirone dose.

Answer 47

Hold the ketoconazole and notify the health care provider.

Question 48

The nurse notes in the medical administration record (MAR) that a nurse from the previous shift administered buspirone to a patient who is also taking a monoamine oxidase inhibitor (MAOI). Which actions would the nurse take?

Select all that apply.

Prepare to administer the next doses of medication.

Perform a focused assessment on the patient.

Contact the health care provider.

Contact the rapid response team.

Provide teaching about the benefit of taking buspirone and an MAOI together.

Answer 48

Perform a focused assessment on the patient.

Contact the health care provider.

Question 49

Before administering buspirone to a patient, the nurse provides teaching. Which patient statement demonstrates that teaching has been effective?

“I will have immediate relief once I take this.”

“This will help with my insomnia tonight.”

“I’m going to order a grapefruit with my sandwich at lunch.”

“This medication may make me dizzy; I will call for assistance when walking to the bathroom.”

Answer 49

“This medication may make me dizzy; I will call for assistance when walking to the bathroom.”

Question 50

Buspirone is contraindicated for which patients?

Patients with a history of chronic obstructive pulmonary disease (COPD)

Patients with a cardiac condition

Patients with a known drug allergy

Patients with a history of drug misuse

Answer 50

Patients with a known drug allergy