Week 5 sherpath Flashcards
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.”
“Second-generation antipsychotics (SGAs) have fewer side effects than first-generation antipsychotics (FGAs).”
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
Haloperidol decanoate
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
21 year old who is homeless and moves from city to city
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.”
“If you miss a dose, contact your health care provider to determine whether you should take it.”
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
Aripiprazole
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.”
“Tardive dyskinesia is possibly irreversible.”
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
Nausea
Extrapyramidal disorder
Insomnia
Akathisia
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
Exerts a moderate block of dopamine receptors
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
Fluphenazine
Haloperidol
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
Bipolar mania
Major depressive disorder
Irritability associated with autism spectrum disorder
In which substances is aripiprazole excreted?
Select all that apply.
Tears
Feces
Urine
Sweat
Saliva
Feces
Urine
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
Orthostatic hypotension
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
Patient who drinks alcohol
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
Serum glucose, cholesterol, and triglycerides
The nurse would assess for which finding in a patient taking fluphenazine who reports tremors and neck spasms?
Anticholinergic effects
Agranulocytosis
Tachycardia
Extrapyramidal symptoms
Extrapyramidal symptoms
The nurse would explain to a patient that fluphenazine is incompatible with which beverage?
Grapefruit juice
Milk
Apple juice
Kefir
Apple juice
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?”
“Tell me more about the symptoms you experienced.”
Match the drug with its appropriate classification.
Benzodiazepine
Benzodiazepine-like
Barbiturate
Melatonin receptor agonist
Answer choices
Diazepam
Zolpidem
Secobarbital
Ramelteon
Benzodiazepine
Diazepam
Benzodiazepine-like
Zolpidem
Barbiturate
Secobarbital
Melatonin receptor agonist
Ramelteon
Benzodiazepine-like drugs are used primarily for the treatment of which condition?
Insomnia
Anxiety
Seizures
Acute alcohol withdrawal
Insomnia
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.
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.
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
Zolpidem
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
Zolpidem
For which concerning symptom does the nurse closely monitor in a patient taking a benzodiazepine?
Respiratory depression
Sedation
Cardiac arrythmias
Development of renal impairment
Respiratory depression
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.
Use bed alarms.
Provide call light.
Keep side rails elevated.
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.”
“Grapefruit products may increase the drug’s concentration and effects.”
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
Depresses all levels of the central nervous system (CNS) by enhancing action of gamma-aminobutyric acid (GABA)
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
I am worried that this drug will stay in my system for a long time.”
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.”
“This medication can be sedating so I will not plan to drive until I know how it affects me.”
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
Blood pressure
Respiratory rate
Heart rate
Mental status
Oxygen saturation
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
Reports a history of sleep apnea
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.
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.
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
Vomiting
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
Lack of reduction in anxiety symptoms
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
A postpartum patient who is breastfeeding
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.
Buspirone is used for treatment of anxiety.
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.
Buspirone can be used for treatment of anxiety that lasts up to a year.
Which drug class is the first choice for the management of anxiety?
Opiates
Barbiturates
Selective serotonin reuptake inhibitors (SSRIs)
Benzodiazepines
Selective serotonin reuptake inhibitors (SSRIs)
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
2 to 3 weeks
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
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
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
Grapefruit juice
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.
Call the health care provider to verify the route.
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.
It is not a central nervous system (CNS) depressant.
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
Alanine transaminase (ALT) and aspartate transaminase (AST)
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.
Hold the medication and verify the prescription with the health care provider.
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
Patient with long-term anxiety who drinks alcohol
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?”
“Did you drink grapefruit juice with breakfast?”
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.
Hold the ketoconazole and notify the health care provider.
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.
Perform a focused assessment on the patient.
Contact the health care provider.
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.”
“This medication may make me dizzy; I will call for assistance when walking to the bathroom.”
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
Patients with a known drug allergy
