Mental Health Pharmacology > Pharmacology
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Showing 15 questions, Sign in for moreA nurse is caring for a client who has schizophrenia and exhibits a lack of grooming and a flat affect. The nurse should anticipate a prescription of which of the following medications?
Explanation
Risperidone is an atypical antipsychotic medication that can help improve the negative symptoms of schizophrenia, such as lack of grooming and flat affect.It can also reduce positive symptoms, such as hallucinations and delusions.
Choice A is wrong because Chlorpromazine (Thorazine) is wrong because it is a conventional antipsychotic medication that mainly treats positive symptoms of schizophrenia, but has little effect on negative symptoms.
Choice B is wrong because Thiothixene (Navane) is wrong for the same reason as choice A.It is also a conventional antipsychotic medication that mainly treats positive symptoms of schizophrenia, but has little effect on negative symptoms.
Choice D is wrong because Haloperidol (Haldol) is wrong for the same reason as choice A and B.It is also a conventional antipsychotic medication that mainly treats positive symptoms of schizophrenia, but has little effect on negative symptoms.
A nurse is teaching a client who has a new prescription for buspirone to treat anxiety. Which of the following information should the nurse include in the teaching?
Explanation
Avoid drinking grapefruit juice while taking this medication.This is because grapefruit juice can increase the blood levels of buspirone and cause adverse effects such as drowsiness, dizziness, and nausea.
Choice A is wrong because taking this medication on an empty stomach can cause stomach upset and reduce its absorption.It is better to take buspirone with food or milk.
Choice B is wrong because optimal therapeutic effects of buspirone can take several weeks to develop.It is not a fast-acting medication like benzodiazepines.
Choice D is wrong because this medication has a low risk for dependence compared to other anti-anxiety drugs.Buspirone does not cause withdrawal symptoms or tolerance.
The normal dosage range for buspirone is 15 to 60 mg per day in divided doses.The normal blood level of buspirone is 1 to 6 ng/mL.
A nurse is providing discharge teaching to a client who has a new prescription for phenelzine for depression. Which of the following foods should the nurse instruct the client to avoid while taking this medication? (Select all that apply.).
Explanation
The client should avoid foods that are high in tyramine while taking phenelzine, which is a monoamine oxidase inhibitor (MAOI) for depression. Tyramine can cause a hypertensive crisis when combined with MAOIs.
Choice B is wrong because shrimp is not high in tyramine and can be safely consumed by the client.
Choice D is wrong because raisins are not high in tyramine and can be safely consumed by the client.
Some examples of foods that are high in tyramine are avocado, cheddar cheese, pepperoni, aged meats, smoked fish, soy sauce, sauerkraut, beer, and red wine.
The normal range for blood pressure is less than 120/80 mmHg.A hypertensive crisis is defined as a systolic blood pressure of 180 mmHg or higher or a diastolic blood pressure of 120 mmHg or higher.The client should monitor their blood pressure regularly and report any signs of a hypertensive crisis, such as severe headache, chest pain, blurred vision, nausea, or confusion.
A patient has been prescribed an SSRI for depression and reports feeling more anxious since starting the medication. The nurse should:
Explanation
This is because SSRIs can cause increased anxiety in some patients during the first few weeks of treatment, but this usually subsides as the medication takes effect.Discontinuing the medication abruptly can cause withdrawal symptoms and worsen the depression.Increasing the dose of the medication is not advisable without consulting the prescriber, as it may increase the risk of adverse effects and serotonin syndrome.Administering an anxiolytic medication may interact with the SSRI and cause excessive sedation or respiratory depression.
Choice A is wrong because discontinuing the medication immediately can cause withdrawal symptoms and worsen the depression.
Choice B is wrong because increasing the dose of the medication is not advisable without consulting the prescriber, as it may increase the risk of adverse effects and serotonin syndrome.
Choice D is wrong because administering an anxiolytic medication may interact with the SSRI and cause excessive sedation or respiratory depression.
Normal ranges for SSRIs vary depending on the specific drug, but generally they are between 20 and 200 ng/mL.The therapeutic effects of SSRIs usually take 3 to 6 weeks to appear.
A patient has been prescribed an SNRI for depression and reports feeling more fatigued since starting the medication. The nurse should:
Explanation
This is because fatigue is a common side effect of SNRIs (serotonin and norepinephrine reuptake inhibitors) that usually improves over time.SNRIs are a type of antidepressant that work by correcting chemical imbalances of neurotransmitters in the brain.
Choice A is wrong because Discontinue the medication immediately is wrong because abruptly stopping an SNRI can cause withdrawal symptoms such as nausea, headache, and dizziness.
The patient should consult with their provider before stopping or changing their medication.
Choice B is wrong because Increase the dose of the medication is wrong because increasing the dose of an SNRI can increase the risk of adverse effects such as high blood pressure, anxiety, and sexual dysfunction.
The patient should follow the prescribed dose and not adjust it without medical advice.
Choice D is wrong because Administer a stimulant medication is wrong because stimulant medications can interact with SNRIs and cause serious problems such as serotonin syndrome, which is a potentially life-threatening condition characterized by agitation, confusion, fever, and muscle rigidity. The patient should avoid taking any other medications without consulting their provider.
Select all that apply: A client has been prescribed an MAOI for depression and reports eating aged cheese and drinking red wine at dinner last night.
Explanation
The client may experience hypertensive crisis if aged cheese or red wine are consumed while taking this medication.This is because aged cheese and red wine contain tyramine, an amino acid that can cause a dangerous increase in blood pressure when mixed with MAOIs.MAOIs are drugs that inhibit the enzyme that breaks down excess tyramine in the body.A hypertensive crisis can be deadly and requires emergency treatment.
Choice A and B are partially correct, but not complete. The client should be advised to avoid aged cheese and red wine while taking this medication, but this does not explain why or what could happen if they do not.
Choice D is wrong because serotonin syndrome is caused by too much serotonin, not tyramine.Serotonin syndrome can occur when MAOIs are taken with other drugs that increase serotonin levels, such as SSRIs.
Choice E is wrong because hypotension is low blood pressure, not high blood pressure.
Tyramine can cause hypertension, not hypotension.Hypotension can be a side effect of some MAOIs, but it is not related to tyramine intake.
A nurse is caring for a client who has been taking lorazepam (Ativan) for anxiety and insomnia for several months. The client tells the nurse that he wants to stop taking the medication because he feels better now. Which of the following responses should the nurse give?
Explanation
You can stop taking the medication as long as you taper off gradually.
This is because lorazepam (Ativan) is a benzodiazepine that can cause physical dependence and withdrawal symptoms if stopped abruptly.Tapering off the dose reduces the risk of withdrawal and rebound anxiety or insomnia.
Choice B is wrong because continuing to take the medication indefinitely may increase the risk of tolerance, dependence, and adverse effects such as sedation, confusion, and memory impairment.
Choice C is wrong because stopping the medication immediately can cause severe withdrawal symptoms such as seizures, tremors, agitation, and hallucinations.
Choice D is wrong because switching to a non-benzodiazepine medication without tapering off lorazepam may not prevent withdrawal symptoms and may cause drug interactions or adverse effects from the new medication.
Normal ranges for lorazepam (Ativan) are 0.02 to 0.03 mg/kg/day divided into two or three doses for anxiety and 0.01 to 0.02 mg/kg at bedtime for insomnia.
A nurse is teaching a client who has been prescribed hydroxyzine (Vistaril) for anxiety and pruritus due to an allergic reaction. Which of the following instructions should the nurse include in the teaching?
Explanation
Hydroxyzine (Vistaril) is an antihistamine that can cause drowsiness and sedation as side effects.Therefore, the client should avoid activities that require alertness and coordination while taking this medication.
Choice B is wrong because hydroxyzine can be taken with or without food.Taking it on an empty stomach does not increase absorption.
Choice C is wrong because hydroxyzine can cause dry mouth as a side effect, but the client does not need to drink plenty of fluids or suck on hard candy to prevent it.These measures may help relieve the discomfort of dry mouth, but they are not necessary instructions for taking hydroxyzine.
Choice D is wrong because hydroxyzine does not cause urinary retention or difficulty urinating as side effects.These are signs of anticholinergic toxicity, which can occur with other medications such as tricyclic antidepressants or antipsychotics.
A client with bipolar disorder is prescribed lithium carbonate (Lithobid). Which of the following laboratory values should be monitored regularly while taking this medication?
Explanation
Serum lithium levels should be monitored regularly while taking this medication because lithium has a narrow therapeutic range and can cause toxicity if the levels are too high or ineffective if the levels are too low.The normal range for serum lithium levels is 0.6 to 1.2 mEq/L (0.6 to 1.2 mmol/L).
Choice A is wrong because blood glucose levels are not affected by lithium and do not need to be monitored regularly.
Choice B is wrong because serum potassium levels are not affected by lithium and do not need to be monitored regularly.
Choice D is wrong because serum calcium levels are not affected by lithium and do not need to be monitored regularly.
A client with bipolar disorder is prescribed carbamazepine (Tegretol). Which of the following adverse effects should be reported immediately?
Explanation
According to web search results, carbamazepine (Tegretol) can cause a serious skin reaction called Stevens-Johnson syndrome, which requires immediate medical attention.A rash is an early sign of this condition and should be reported to the health care provider as soon as possible.
Choice A is wrong because drowsiness is a common side effect of carbamazepine (Tegretol) and does not indicate a serious problem.However, the client should be advised to avoid driving or operating machinery until the drowsiness subsides.
Choice B is wrong because nausea and vomiting are also common side effects of carbamazepine (Tegretol) and can be minimized by taking the medication with food or milk.The client should be instructed to drink plenty of fluids and report any signs of dehydration or electrolyte imbalance.
Choice D is wrong because dry mouth is another common side effect of carbamazepine (Tegretol) and can be relieved by sucking on sugarless candy or ice chips, chewing sugarless gum, or using saliva substitutes.The client should also maintain good oral hygiene and have regular dental check-ups to prevent dental problems.
A nurse is caring for a client who has bipolar disorder and is prescribed lamotrigine (Lamictal). Which of the following instructions should be included in the teaching? (Select all that apply.)
Explanation
Lamotrigine can cause a serious and potentially life-threatening skin reaction called Stevens-Johnson syndrome, which causes flu-like symptoms, followed by a red or purple rash that spreads and forms blisters.This is more likely to happen in the first 8 weeks of starting lamotrigine, or when the dose is increased too quickly. Therefore, the nurse should instruct the client to report any signs of rash immediately and stop taking the medication until further evaluation.
Choice B is wrong because lamotrigine can be taken with or without food. Taking it with food does not affect its absorption or effectiveness.
Choice C is wrong because lamotrigine does not affect hormonal contraceptives, and vice versa.However, the nurse should advise the client to inform their doctor if they are pregnant or planning to become pregnant, as lamotrigine may have some risks for the fetus.
Choice D is wrong because lamotrigine may take several weeks or months to show therapeutic effects, depending on the condition being treated. The nurse should encourage the client to be patient and adhere to the prescribed regimen.
Choice E is wrong because lamotrigine does not interact with grapefruit juice.However, the nurse should advise the client to avoid alcohol, as it may increase the risk of side effects such as drowsiness, dizziness, and seizures.
A nurse is caring for a client who has bipolar disorder and is taking lithium carbonate (Lithobid). Which of the following laboratory tests should be monitored periodically while the client is taking this medication?
Explanation
Renal function tests should be monitored periodically while the client is taking lithium carbonate (Lithobid).This is because lithium can cause renal impairment and electrolyte imbalances, which can affect the kidney function and increase the risk of lithium toxicity. Renal function tests can include blood urea nitrogen (BUN), creatinine, and urine specific gravity.
Choice A is wrong because thyroid function tests are not routinely required for clients taking lithium carbonate.However, lithium can cause hypothyroidism in some cases, so thyroid function tests may be done if the client has symptoms of low thyroid hormone levels, such as fatigue, weight gain, or cold intolerance.
Choice B is wrong because liver function tests are not necessary for clients taking lithium carbonate.Lithium does not affect the liver enzymes or cause liver damage.
Choice D is wrong because coagulation studies are not relevant for clients taking lithium carbonate.Lithium does not affect the blood clotting factors or increase the risk of bleeding.
A nurse is providing discharge teaching to a client who has a new prescription for imipramine (Tofranil). Which of the following instructions should the nurse include in the teaching?
Explanation
Avoid exposure to sunlight.Imipramine (Tofranil) is a tricyclic antidepressant that can cause photosensitivity and increase the risk of sunburn.The nurse should instruct the client to wear sunscreen, protective clothing, and sunglasses when outdoors.
Choice B is wrong because taking imipramine on an empty stomach can cause nausea and vomiting.The nurse should advise the client to take the medication with food or milk.
Choice C is wrong because discontinuing imipramine abruptly can cause withdrawal symptoms such as headache, nausea, and malaise.The nurse should instruct the client to taper off the medication gradually under the supervision of the provider.
Choice D is wrong because increasing intake of foods rich in vitamin K is not related to imipramine therapy.Vitamin K is a clotting factor that can interact with anticoagulants such as warfarin.Imipramine does not affect vitamin K levels or coagulation.
A nurse is caring for a client who has schizophrenia and is taking risperidone (Risperdal). Which of the following findings should alert the nurse to a potential adverse effect of this medication? (Select all that apply.)
Explanation
These are all possible signs ofneuroleptic malignant syndrome (NMS), a rare but serious adverse effect of risperidone and other antipsychotic medications.
NMS is a life-threatening condition that requires immediate medical attention.It is characterized by fever, muscle rigidity, altered mental status, autonomic instability and elevated creatine kinase levels.
Choice B is wrong because polyuria is not a common side effect of risperidone.Polyuria can be caused by other conditions such as diabetes mellitus, diabetes insipidus or diuretic use.
Normal ranges for vital signs and laboratory values are as follows:
• Temperature: 36.5°C to 37.5°C (97.7°F to 99.5°F)
• Heart rate: 60 to 100 beats per minute
• Blood pressure: 120/80 mm Hg or lower
• Respiratory rate: 12 to 20 breaths per minute
• Oxygen saturation: 95% or higher
• Creatine kinase: 22 to 198 U/L for males and 10 to 171 U/L for females
A client is prescribed clozapine (Clozaril). The nurse should closely monitor the client for which potential adverse effect?
Explanation
Stevens-Johnson syndrome.Clozapine (Clozaril) is an atypical antipsychotic drug that can cause a rare but serious skin reaction called Stevens-Johnson syndrome, which is characterized by blisters, rash, and peeling skin. The nurse should monitor the client for any signs of skin irritation or infection and instruct the client to report them immediately.
Choice A is wrong because extrapyramidal symptoms are more common with typical antipsychotics than with atypical antipsychotics. Extrapyramidal symptoms include involuntary movements, muscle stiffness, and tremors.
Choice B is wrong because neuroleptic malignant syndrome is a life-threatening adverse reaction of antipsychotics that involves high fever, muscle rigidity, altered mental status, and autonomic instability. It is not specific to clozapine and can occur with any antipsychotic drug.
Choice D is wrong because tardive dyskinesia is a long-term adverse effect of antipsychotics that involves repetitive and involuntary movements of the tongue, jaw, face, and limbs. It is also more common with typical antipsychotics than with atypical antipsychotics.
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