“I will take this medication in the morning to avoid insomnia.” Fluoxetine is a type of antidepressant that belongs to the class of selective serotonin reuptake inhibitors (SSRIs). It works by increasing the level of serotonin, a neurotransmitter that regulates mood, sleep, and appetite, in the brain.Fluoxetine can cause insomnia as a side effect, so it is recommended to take it in the morning.

Some of the other choices are wrong because:

• Choice B. “I will stop taking this medication if I have sexual dysfunction.” Fluoxetine can also cause sexual dysfunction as a side effect, such as reduced libido, difficulty with orgasm, or erectile dysfunction.

However, stopping the medication abruptly can cause withdrawal symptoms, such as nausea, headache, dizziness, and anxiety.Therefore, it is important to consult with the doctor before stopping or changing the dose of fluoxetine.

• Choice C. “I will increase my intake of cheese and red wine while taking this medication.” Fluoxetine can interact with foods that contain high levels of tyramine, a compound that can affect blood pressure and cause headaches.

Tyramine is found in aged cheeses, red wine, beer, cured meats, soy sauce, and other fermented or pickled foods.Consuming these foods while taking fluoxetine can increase the risk of a hypertensive crisis, which is a medical emergency that requires immediate attention.

• Choice D. “I will taper off this medication slowly when I feel better.” Fluoxetine should not be stopped or tapered off without the doctor’s guidance.

Although fluoxetine has a long half-life and is less likely to cause withdrawal symptoms than other SSRIs, some people may still experience them if they stop taking it too quickly.Withdrawal symptoms can include mood changes, irritability, agitation, confusion, insomnia, fatigue, flu-like symptoms, and electric shock sensations.

The doctor will advise on how to gradually reduce the dose of fluoxetine over several weeks or months to avoid these effects.

Thyroid function tests, serum electrolytes and serum creatinine levels should be monitored for a client who is taking lithium carbonate.This is because lithium can affect the thyroid gland, causing hypothyroidism or goiter.Lithium can also cause dehydration and electrolyte imbalance, which can increase the risk of toxicity.Lithium can also impair renal function, leading to increased serum creatinine levels.

Choice B is wrong because blood glucose levels are not affected by lithium.Choice D is wrong because liver function tests are not indicated for lithium therapy.

Normal ranges for thyroid function tests vary depending on the method and laboratory used, but generally include:

• Thyroid-stimulating hormone (TSH): 0.4 to 4.0 mIU/L

• Free thyroxine (FT4): 0.8 to 2.8 ng/dL

• Total triiodothyronine (T3): 80 to 200 ng/dL

Normal ranges for serum electrolytes include:

• Sodium: 135 to 145 mEq/L

• Potassium: 3.5 to 5.0 mEq/L

• Chloride: 98 to 106 mEq/L

• Bicarbonate: 22 to 26 mEq/L

Normal range for serum creatinine is 0.6 to 1.2 mg/dL for men and 0.5 to 1.1 mg/dL for women.

The client exhibits signs of akathisia, which is a common extrapyramidal side effect of haloperidol and other first-generation antipsychotics.Akathisia is characterized by restlessness, agitation, and difficulty staying still.

Choice A is wrong because it does not identify the specific type of movement disorder the client is experiencing.

Choice C is wrong because tardive dyskinesia is a different type of extrapyramidal side effect that involves involuntary movements of the tongue, lips, face, and limbs.

Choice D is wrong because neuroleptic malignant syndrome is a rare but life-threatening reaction to antipsychotics that causes high fever, muscle rigidity, altered mental status, and autonomic instability.

This pill will help you focus and pay attention better.This is because methylphenidate is a stimulant medication that increases the activity of certain brain chemicals, such as dopamine and norepinephrine, which are involved in attention and impulse control.

Choice B is wrong because this pill will not make you smarter or more popular.

These are unrealistic expectations that can lead to disappointment or misuse of the medication.

Choice C is wrong because this pill will not calm you down or make you less hyperactive.

Methylphenidate does not have a sedating effect, but rather helps you regulate your behavior and emotions.

Choice D is wrong because this pill will not cure your disorder or make you normal.

ADHD is a chronic condition that requires ongoing management and support.

There is no cure for ADHD, but medication can help reduce some of the symptoms and improve your functioning.

Seizures.

Alprazolam is a benzodiazepine that acts on the GABA receptors in the brain to reduce anxiety.

Abrupt discontinuation of alprazolam can cause withdrawal symptoms, such as seizures, tremors, insomnia, and anxiety.

To prevent this, alprazolam should be tapered off gradually under medical supervision.

Choice B is wrong because alprazolam does not cause hypotension when discontinued.

Hypotension is a possible side effect of alprazolam when taken, especially in high doses or with alcohol.

Choice C is wrong because alprazolam does not cause bradycardia when discontinued.

Bradycardia is a possible side effect of alprazolam when taken, especially in older adults or with other medications that slow down the heart rate.

Choice D is wrong because alprazolam does not cause constipation when discontinued.

Constipation is a possible side effect of alprazolam when taken, especially in older adults or with other medications that affect the gastrointestinal motility.

The correct answer is choice C. Diarrhea.Fluoxetine (Prozac) is a selective serotonin reuptake inhibitor (SSRI) that can cause gastrointestinal disturbances such as nausea, vomiting, and diarrhea.

The nurse should monitor the client for these adverse effects and advise them to take the medication with food and increase their fluid intake.

Choice A is wrong because hypertension is not a common adverse effect of fluoxetine.Fluoxetine can cause hypotension, especially when taken with other antihypertensive medications.

Choice B is wrong because bradycardia is not a common adverse effect of fluoxetine.Fluoxetine can cause tachycardia, palpitations, and arrhythmias in some cases.

Choice D is wrong because urinary retention is not a common adverse effect of fluoxetine.Fluoxetine can cause urinary frequency, urgency, and incontinence in some cases.

Normal ranges for blood pressure are 90/60 mmHg to 120/80 mmHg, for heart rate are 60 to 100 beats per minute, and for respiratory rate are 12 to 20 breaths per minute.

• Venlafaxine (Effexor) is a serotonin-norepinephrine reuptake inhibitor (SNRI) that can causeorthostatic hypotension, which is a drop in blood pressure when changing positions.Therefore, the client shouldchange positions slowlyto prevent dizziness or fainting.

• Venlafaxine (Effexor) can also increase the risk ofbleedingwhen combined with alcohol or other drugs that affect blood clotting.Therefore, the client shouldavoid alcoholwhile taking this medication.

• Venlafaxine (Effexor) can causenausea, especially when taken on an empty stomach.Therefore, the client shouldtake it with foodto reduce this adverse effect.

• Venlafaxine (Effexor) comes in both immediate-release and extended-release forms.

The extended-release tablets are designed to release the drug slowly over time and should not be altered.Therefore, the client shouldnot crush or chew extended-release tabletsas this can affect the drug’s absorption and effectiveness.

Choice E is wrong because taking venlafaxine (Effexor) at bedtime can causeinsomniadue to its stimulating effects on the central nervous system.Therefore, the client should take it in the morning or early afternoon.

Citalopram (Celexa) is a selective serotonin reuptake inhibitor (SSRI) that can cause insomnia as a side effect.Taking the medication in the morning can help reduce this effect and improve the client’s sleep quality.

Choice B is wrong because the client should not stop taking citalopram abruptly, as this can cause withdrawal symptoms such as dizziness, nausea, headache, and irritability.

The client should consult with the provider before discontinuing any medication.

Choice C is wrong because taking citalopram at night can worsen the insomnia and interfere with the client’s rest and recovery.

Choice D is wrong because taking citalopram with food does not affect its absorption or efficacy. The client can take citalopram with or without food according to their preference.

Normal ranges for citalopram are 20 to 40 mg per day for adults.The therapeutic plasma level is 40 to 120 ng/mL.

The client should have regular blood tests to monitor the drug level and avoid toxicity.

This is because antidepressants like fluoxetine (Prozac) work by increasing the levels of serotonin in the brain, which is a neurotransmitter that regulates mood, sleep, and appetite.However, serotonin levels do not change immediately after taking the medication, and it may take up to 4 to 6 weeks for the full benefits of the drug to occur.

Choice B.“You need to increase your dosage.” is wrong because increasing the dosage of fluoxetine without consulting a health care provider can cause serious side effects, such as serotonin syndrome, which is a potentially life-threatening condition that occurs when there is too much serotonin in the body.

Choice C. “You need to stop taking your medication immediately.” is wrong because stopping fluoxetine abruptly can cause withdrawal symptoms, such as nausea, headache, dizziness, and anxiety.Fluoxetine should be tapered off gradually under the guidance of a health care provider.

Choice D. “Antidepressants do not work for everyone.” is wrong because although antidepressants may not be effective for some people, it is too early to conclude that fluoxetine is not working for this client after only several weeks of treatment.The client should continue taking the medication as prescribed and report any concerns or side effects to the health care provider.

Seizures.According to web search results, bupropion (Wellbutrin) is an antidepressant that can lower the seizure threshold and increase the risk of seizures in clients who have a history of head injury, brain tumor, or eating disorders. Therefore, the nurse should monitor the client for any signs of seizure activity and report them to the provider.

Choice A is wrong because hypertension is not a common adverse effect of bupropion.However, bupropion can cause tachycardia, agitation, insomnia, and headache.

Choice B is wrong because bradycardia is not an adverse effect of bupropion.Bupropion can cause tachycardia as a result of its stimulating effect on the central nervous system.

Choice C is wrong because diarrhea is not an adverse effect of bupropion.Bupropion can cause dry mouth, constipation, nausea, and vomiting.

“I should take this medication only when I feel anxious.” This statement indicates a need for further teaching because alprazolam should be taken on a regular schedule as prescribed by the provider, not on an as-needed basis.Taking alprazolam only when feeling anxious can increase the risk of dependence and withdrawal symptoms.

Choice A is wrong because it is a correct statement.Alcohol should be avoided while taking alprazolam because it can increase the sedative effects and the risk of respiratory depression.

Choice C is wrong because it is a correct statement.Alprazolam should not be stopped abruptly because it can cause withdrawal symptoms such as anxiety, insomnia, tremors, and seizures.

Choice D is wrong because it is a correct statement.Confusion and memory loss are possible adverse effects of alprazolam and should be reported to the provider.

Alprazolam is a benzodiazepine that is used to treat anxiety disorders.It works by enhancing the effects of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits brain activity and produces a calming effect.The normal dosage range for alprazolam is 0.25 to 0.5 mg three times daily, with a maximum dose of 4 mg per day.Alprazolam has a high potential for abuse and dependence, so it should be used with caution and for short periods of time.

The nurse should monitor the client’s blood pressure, respiratory rate, liver function tests and mental status because chlordiazepoxide (Librium) is a benzodiazepine that can cause respiratory depression, hypotension, hepatic impairment and sedation.The nurse should also monitor for signs of withdrawal such as anxiety, tremors, seizures and delirium.

Choice D is wrong because blood glucose level is not affected by chlordiazepoxide or alcohol withdrawal.Blood glucose level is more relevant for clients who have diabetes or are taking medications that alter glucose metabolism.

Normal ranges for blood pressure are 90/60 mmHg to 120/80 mmHg, for respiratory rate are 12 to 20 breaths per minute, for liver function tests are AST 10 to 40 U/L, ALT 7 to 56 U/L, ALP 45 to 115 U/L, bilirubin 0.1 to 1.2 mg/dL and for mental status are alert and oriented to person, place, time and situation.

Buspirone (BuSpar) is an anxiolytic medication that works by binding to serotonin and dopamine receptors in the brain, which helps regulate mood and reduce anxiety.

Choice B is wrong because it describes the mechanism of action of benzodiazepines, such as lorazepam or diazepam, which enhance the activity of GABA, a neurotransmitter that inhibits anxiety and arousal.

Choice C is wrong because it describes the mechanism of action of selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine or sertraline, which block the reuptake of serotonin, a neurotransmitter that influences mood and anxiety.

Choice D is wrong because it describes the mechanism of action of monoamine oxidase inhibitors (MAOIs), such as phenelzine or tranylcypromine, which inhibit the breakdown of norepinephrine, a neurotransmitter that affects alertness and energy.

Ketoconazole (Nizoral) can interact with zolpidem (Ambien) and increase its sedative effects.Ketoconazole is an antifungal medication that inhibits the metabolism of zolpidem, leading to higher plasma levels and increased risk of adverse effects such as drowsiness, dizziness, and impaired coordination.

Choice A is wrong because omeprazole (Prilosec) is a proton pump inhibitor that does not affect the metabolism or clearance of zolpidem.

Choice B is wrong because warfarin (Coumadin) is an anticoagulant that does not interact with zolpidem.However, warfarin levels may be affected by other medications or dietary factors that influence clotting.

Choice D is wrong because metformin (Glucophage) is an antidiabetic medication that does not interact with zolpidem.Metformin may cause gastrointestinal side effects such as nausea, diarrhea, and abdominal pain, but these are not related to zolpidem use.

Monitor oxygen saturation and end-tidal CO2 levels.This is because midazolam (Versed) is a benzodiazepine that can cause respiratory depression and sedation, especially when given intravenously. The nurse should monitor the client’s oxygenation and ventilation status during and after the procedure to prevent hypoxia and hypercapnia.

Choice A is wrong because naloxone (Narcan) is an opioid antagonist that reverses the effects of opioids, not benzodiazepines.Naloxone would not prevent respiratory depression caused by midazolam.

Choice C is wrong because giving midazolam with food or milk would not prevent respiratory depression.Food or milk may delay the absorption of oral midazolam, but it would not affect the intravenous administration.

Choice D is wrong because reducing the dose of midazolam by half may not be sufficient to prevent respiratory depression.The dose of midazolam should be individualized based on the client’s age, weight, health status, and response to the drug. Reducing the dose by half may also compromise the quality of sedation and analgesia during the colonoscopy.

Lithium carbonate can cause a range of side effects, including increased urination, mild thirst, and electrolyte imbalances. These effects can lead to hyponatremia, which is a low level of sodium in the blood.Hyponatremia can cause symptoms such as confusion, weakness, and muscle cramps.

Choice A is wrong because lithium carbonate does not cause hypertension (high blood pressure).In fact, it may lower blood pressure by reducing the activity of the renin-angiotensin system.

Choice B is wrong because lithium carbonate does not cause hypotension (low blood pressure) by itself.However, it may enhance the effects of other drugs that lower blood pressure, such as diuretics or antihypertensives.

Choice C is wrong because lithium carbonate does not cause hypernatremia (high level of sodium in the blood).On the contrary, it can cause sodium loss through increased urination and thirst.Hypernatremia can cause symptoms such as dehydration, irritability, and seizures.

Grapefruit juice can interact with carbamazepine and increase its blood levels, which can lead to toxicity and adverse effects such as drowsiness, dizziness, blurred vision, nausea, vomiting, and rash.Therefore, the client should avoid grapefruit juice while taking this medication.

Choice B is wrong because taking carbamazepine with food does not affect its absorption or metabolism.

Choice C is wrong because jaundice is not a common side effect of carbamazepine.However, carbamazepine can cause liver toxicity, so the client should report any signs of nausea, vomiting, abdominal pain, or dark urine.

Choice D is wrong because carbamazepine may take several weeks to reach its full therapeutic effect for bipolar disorder.The client should not expect to see immediate improvement in mood symptoms.

Choice E is wrong because carbamazepine does not affect the efficacy of hormonal contraceptives.However, some other anticonvulsants, such as phenytoin and phenobarbital, can reduce the effectiveness of birth control pills and increase the risk of pregnancy.

This is because lithium carbonate can cause fluid and electrolyte imbalance, especially when the client has vomiting and diarrhea.Drinking fluids can help maintain hydration and prevent lithium toxicity, which can cause tremors, confusion, nausea, and muscle weakness.

Choice A is wrong because stopping the medication abruptly can cause withdrawal symptoms and relapse of bipolar disorder.The client should continue taking the medication as prescribed and report any adverse effects to the provider.

Choice B is wrong because taking an extra dose of the medication can increase the risk of lithium toxicity, which can be life-threatening.The client should not adjust the dosage without consulting the provider.

Choice D is wrong because taking an antacid can alter the absorption of lithium carbonate and affect its blood levels.The client should avoid taking any other medications without consulting the provider.

Normal ranges for lithium carbonate are 0.6 to 1.2 mEq/L for maintenance therapy and 1.0 to 1.5 mEq/L for acute mania.The client should have regular blood tests to monitor the lithium levels and adjust the dosage accordingly.

Valproic acid is an anticonvulsant drug that can cause gastrointestinal symptoms such as nausea, vomiting, diarrhea, and abdominal pain as common adverse effects.Taking the medication with food or milk can help reduce these symptoms and improve the drug tolerance.

Choice A is wrong because bleeding or bruising is not a common adverse effect of valproic acid, but a rare and serious one that indicates hepatotoxicity or thrombocytopenia. The client should report any signs of bleeding or bruising immediately, but not as a way to manage common adverse effects.

Choice C is wrong because valproic acid does not usually cause drowsiness or impaired mental function as a common adverse effect. The client should avoid driving or operating heavy machinery only if they experience these effects, but not as a routine precaution.

Choice D is wrong because unusual muscle movements are not a common adverse effect of valproic acid, but a rare and serious one that indicates neurotoxicity or encephalopathy. The client should stop taking the medication and seek medical attention if they experience any unusual muscle movements, but not as a way to manage common adverse effects.

Olanzapine (Zyprexa) is an antipsychotic medication that can cause increased prolactin levels, which can interfere with ovulation and fertility in women.Therefore, the nurse should instruct the client to use a reliable form of birth control while taking this medication.

Choice A is wrong because olanzapine (Zyprexa) can take several weeks to show therapeutic effects.The nurse should inform the client that they might not notice any improvement in their symptoms for 2 to 4 weeks.

Choice B is wrong because olanzapine (Zyprexa) can be taken with or without food.The nurse should advise the client to take the medication as prescribed and not to skip doses.

Choice C is wrong because olanzapine (Zyprexa) does not cause jaundice. However, it can cause weight gain, diabetes, and dyslipidemia.The nurse should monitor the client’s blood glucose and lipid levels and encourage a healthy diet and exercise.

Antipsychotics improve psychotic symptoms by blocking dopamine and serotonin receptors in the brain.This reduces the overactivity of these neurotransmitters that are associated with psychosis.

Choice A is wrong because antipsychotics do not increase dopamine and serotonin receptors, but block them.

Choice C is wrong because antipsychotics do not increase dopamine receptors, but block them.

Increasing dopamine receptors would worsen psychotic symptoms.

Choice D is wrong because antipsychotics do not decrease dopamine receptors, but block them. Decreasing dopamine receptors would reduce the effectiveness of antipsychotics.

Normal ranges of dopamine and serotonin levels in the brain vary depending on the individual and the brain region, but generally they are between 0.1 and 0.8 nanograms per milliliter (ng/mL) for dopamine and between 101 and 283 ng/mL for serotonin.

Second-generation antipsychotics have a low affinity for dopamine D2 receptors and a high affinity for serotonin 5-HT2A receptors.This means that they block less dopamine and more serotonin in the brain, which reduces the risk of extrapyramidal side effects and improves negative symptoms of schizophrenia.

Choice A is wrong because first-generation antipsychotics have a high affinity for dopamine D2 receptors and a low affinity for serotonin 5-HT2A receptors.This means that they block more dopamine and less serotonin in the brain, which increases the risk of extrapyramidal side effects and does not improve negative symptoms of schizophrenia.

Choice C is wrong because it is the opposite of choice A.First-generation antipsychotics do not have a low affinity for dopamine D2 receptors and a high affinity for serotonin 5-HT2A receptors.

Choice D is wrong because it is the opposite of choice B.Second-generation antipsychotics do not have a high affinity for dopamine D2 receptors and a low affinity for serotonin 5-HT2A receptors.

Choice E is wrong because both first-generation and second-generation antipsychotics do not have a high affinity for both dopamine D2 and serotonin 5-HT2A receptors.They have different affinities for these receptors, which account for their different effects and side effects.

Antipsychotic medications can also be used to treat other mental health disorders such as bipolar disorder.This is because some antipsychotics, such as aripiprazole (Abilify), act on both serotonin and dopamine receptors in the brain, which are involved in mood regulation.

Choice A is wrong because antipsychotic medications are not only used to treat psychotic symptoms, but also negative symptoms of schizophrenia, such as social withdrawal, flattened affect, and anhedonia.

Choice C is wrong because antipsychotic medications are not only used to treat schizophrenia, but also other psychotic disorders, such as schizoaffective disorder, delusional disorder, and brief psychotic disorder.

Choice D is wrong because antipsychotic medications are effective in treating other mental health disorders, such as bipolar disorder, major depressive disorder, and obsessive-compulsive disorder.Some antipsychotics also have antiemetic effects, such as chlorpromazine (Thorazine) and prochlorperazine (Compazine).

Antipsychotic medications can cause various adverse effects depending on the type and dose of the medication. This statement indicates that the client understands that antipsychotic drugs are not free of side effects and that they may vary in severity and type.

Choice A is wrong because antipsychotic medications do have adverse effects, such as extrapyramidal effects, neuroleptic malignant syndrome, tardive dyskinesia, and agranulocytosis.

Choice B is wrong because antipsychotic medications can have more than mild adverse effects, such as drowsiness.Some of the adverse effects can be serious and life-threatening, such as neuroleptic malignant syndrome.

Choice D is wrong because antipsychotic medications do not only cause serious adverse effects.Some of the adverse effects can be mild and manageable, such as dry mouth, blurred vision, and constipation.

Normal ranges for blood pressure, pulse, temperature, and white blood cell count are:

• Blood pressure: 120/80 mmHg

• Pulse: 60-100 beats per minute

• Temperature: 36.5-37.5°C (97.7-99.5°F)

• White blood cell count: 4.5-11 x 10^9/L

Weight loss is not a common adverse effect of antipsychotic medications.In fact, most antipsychotics are associated with weight gain and metabolic syndrome, which can increase the risk of diabetes and cardiovascular disease.Some antipsychotics, such as clozapine (Clozaril®) and olanzapine (Zyprexa®), are more likely to cause weight gain than others.

The other choices are common adverse effects of antipsychotic medications.Sedation, dry mouth, and blurred vision are examples of anticholinergic effects, which are more prominent with first-generation antipsychotics and clozapine.These effects can be managed by reducing the dose, switching to a different antipsychotic, or using adjunctive medications.

Antipsychotics primarily target serotonin and dopamine, two neurotransmitters that are involved in psychosis and other mental disorders.Antipsychotics reduce or increase the effect of these neurotransmitters in the brain to regulate their levels and reduce psychotic symptoms.

Choice B is wrong because acetylcholine and norepinephrine are not the main neurotransmitters affected by antipsychotics.Acetylcholine is involved in memory and learning, while norepinephrine is involved in arousal and stress. Antipsychotics may have some effects on these neurotransmitters, but they are not their primary targets.

Choice C is wrong because GABA and glutamate are not the main neurotransmitters affected by antipsychotics.GABA is an inhibitory neurotransmitter that reduces neuronal activity, while glutamate is an excitatory neurotransmitter that increases neuronal activity. Antipsychotics may have some effects on these neurotransmitters, but they are not their primary targets.

Choice D is wrong because dopamine and GABA are not the main neurotransmitters affected by antipsychotics. As mentioned above, dopamine is one of the primary targets of antipsychotics, but GABA is not. Antipsychotics may have some effects on GABA, but they are not their primary targets.

Antipsychotic medications are used to treat psychotic disorders such as schizophrenia, bipolar disorder, and delusional disorder. They work by blocking dopamine receptors in the brain, which reduces the positive symptoms of psychosis such as hallucinations, delusions, and agitation. However, antipsychotic medications also have many adverse effects, some of which are related to their dopamine-blocking action and some of which are related to their effects on other neurotransmitters such as serotonin, acetylcholine, histamine, and norepinephrine.

Some of the common adverse effects of antipsychotic medications are:

• Sedation: This is caused by the blockade of histamine receptors in the brain and can affect alertness, concentration, and coordination.

Sedation is more common with older antipsychotics such as chlorpromazine and haloperidol than with newer ones such as risperidone and quetiapine.

• Dry mouth: This is caused by the blockade of acetylcholine receptors in the salivary glands and can lead to dental problems, difficulty swallowing, and increased thirst.

Dry mouth is more common with older antipsychotics than with newer ones.

• Blurred vision: This is also caused by the blockade of acetylcholine receptors in the eye muscles and can affect visual acuity and accommodation.

Blurred vision is more common with older antipsychotics than with newer ones.

• Weight gain: This is caused by the blockade of serotonin receptors in the hypothalamus and can lead to increased appetite, metabolic changes, and obesity.

Weight gain is more common with newer antipsychotics such as olanzapine and clozapine than with older ones.

Therefore, weight loss is not a common adverse effect of antipsychotic medications and is the correct answer.

Chlorpromazine and haloperidol belong to the first-generation antipsychotics (FGAs), which are also known as conventional or typical antipsychotics.They primarily block dopamine receptors in the brain and are effective for treating positive symptoms of schizophrenia, such as hallucinations and delusions.

ChoiceBis wrong because quetiapine is a second-generation antipsychotic (SGA), which is also known as atypical antipsychotic.It blocks both dopamine and serotonin receptors in the brain and is effective for treating both positive and negative symptoms of schizophrenia, such as anhedonia and flattened affect.

ChoiceCis wrong because olanzapine is also a second-generation antipsychotic (SGA) that has similar effects and indications as quetiapine.

ChoiceEis wrong because risperidone is also a second-generation antipsychotic (SGA) that has similar effects and indications as quetiapine and olanzapine.

Normal ranges for antipsychotic medications vary depending on the type, dose, and duration of treatment.

However, some general guidelines are:

• For chlorpromazine, the therapeutic range is 100 to 300 ng/mL and the toxic level is above 1000 ng/mL.

• For haloperidol, the therapeutic range is 5 to 20 ng/mL and the toxic level is above 50 ng/mL.

• For quetiapine, the therapeutic range is 100 to 800 ng/mL and the toxic level is above 1500 ng/mL.

• For olanzapine, the therapeutic range is 20 to 80 ng/mL and the toxic level is above 200 ng/mL.

• For risperidone, the therapeutic range is 4 to 24 ng/mL and the toxic level is above 50 ng/mL.

Drowsiness is a common adverse effect of antipsychotics, especially in the first few weeks of treatment.Antipsychotics block dopamine receptors in the brain, which can cause sedation and fatigue.

Choice B is wrong because antipsychotics usually increase appetite, not decrease it.This can lead to weight gain and metabolic problems.

Choice C is wrong because antipsychotics do not cause increased energy and restlessness.These symptoms may indicate a manic episode or akathisia, which is a movement disorder that can be caused by antipsychotics.

Choice D is wrong because antipsychotics do not directly improve mood. They are used to treat psychotic symptoms such as hallucinations and delusions.Mood stabilizers or antidepressants may be needed to treat mood disorders.

This statement indicates a serious adverse effect that should be reported to the healthcare provider because it may suggestneuroleptic malignant syndrome (NMS), a potentially fatal condition that can occur with antipsychotic medications.NMS is characterized by muscle rigidity, altered mental status, tachycardia, sweating, fever, and autonomic instability.It requires immediate medical attention and discontinuation of the antipsychotic medication.

Choice A is wrong because “I have been feeling a bit dizzy when I stand up.” This statement indicates a common adverse effect of antipsychotic medications calledorthostatic hypotension, which is a drop in blood pressure when changing positions.It is usually mild and transient, and can be managed by rising slowly and avoiding dehydration.

Choice B is wrong because “I have been experiencing dry mouth and constipation.” This statement indicates another common adverse effect of antipsychotic medications calledanticholinergic effects, which are caused by the blockade of acetylcholine receptors in the peripheral nervous system.They include dry mouth, blurred vision, urinary retention, constipation, and tachycardia.They are usually mild and can be managed by drinking fluids, chewing sugarless gum, using artificial tears, and increasing dietary fiber.

Choice C is wrong because “I have noticed a slight increase in my blood sugar levels.” This statement indicates a possible adverse effect of antipsychotic medications calledhyperglycemia, which is an elevation of blood glucose levels.It is more common with atypical antipsychotics than with typical antipsychotics, and it may increase the risk of diabetes mellitus.It is usually monitored by regular blood tests and controlled by diet, exercise, and medication if needed.

Sedation and weight gain are common side effects of atypical antipsychotic medications.These medications act on both dopamine and serotonin receptors in the brain and may also have some antidepressant effects.

Choice A is wrong because weight loss and hypotension are not typical side effects of atypical antipsychotics.In fact, weight gain is more likely to occur.

Choice B is wrong because hyperactivity and insomnia are not typical side effects of atypical antipsychotics.These medications may cause difficulty sleeping and extreme tiredness.

Choice C is wrong because blurred vision and urinary retention are not typical side effects of atypical antipsychotics.These medications may cause dry mouth and constipation.

Other possible side effects of atypical antipsychotics include dizziness, seizures, allergic reactions, heart problems, and high prolactin levels.Some atypical antipsychotics may also cause extrapyramidal symptoms, such as muscle spasms, restlessness, tremors, or abnormal movements.

These are more common with typical antipsychotics.

Atypical antipsychotics are used to treat various mental health conditions, such as schizophrenia, bipolar disorder, OCD, and treatment-resistant mania.They may also be prescribed off-label for other conditions, such as Tourette’s syndrome.

This is because fluoxetine (Prozac) is a selective serotonin reuptake inhibitor (SSRI) that can increase the level of serotonin in the brain. Serotonin syndrome is a potentially life-threatening condition that occurs when there is too much serotonin in the body. It can cause symptoms such as agitation, confusion, tremors, muscle rigidity, fever, and seizures.

Choice A is wrong because extrapyramidal symptoms are more commonly associated with antipsychotic medications, not SSRIs. Extrapyramidal symptoms include involuntary movements, muscle spasms, and restlessness.

Choice C is wrong because neuroleptic malignant syndrome is a rare but serious reaction to antipsychotic medications, not SSRIs. Neuroleptic malignant syndrome causes high fever, muscle rigidity, altered mental status, and autonomic instability.

Choice D is wrong because anticholinergic crisis is a result of excessive blockade of acetylcholine receptors by medications such as antihistamines, tricyclic antidepressants, and antiparkinsonian drugs. Anticholinergic crisis can cause dry mouth, blurred vision, urinary retention, constipation, tachycardia, and delirium.

The normal range of serotonin in the blood is 101 to 283 ng/mL.

According to the web search results, prazosin (Minipress) is an alpha-1 adrenergic blocker that can help reduce nightmares and insomnia in clients with PTSD by blocking the effects of norepinephrine. It can also lower blood pressure by causing vasodilation, so clients should change positions slowly to prevent orthostatic hypotension.

Choice C is wrong because prazosin does not increase appetite or cause weight gain.

Choice D is wrong because prazosin does not cause dry mouth, but rather nasal congestion.

Choice E is wrong because prazosin does not cause drowsiness, but rather insomnia in some clients.

According to the web search results, akathisia is an adverse effect of haloperidol, which is a medication used to treat Tourette syndrome. Akathisia is a condition that causes restlessness and an inability to sit still.

Choice B is wrong because Dystonia is wrong because it is a condition that causes involuntary muscle contractions and abnormal postures, not restlessness.

Choice C is wrong because Tardive dyskinesia is wrong because it is a condition that causes involuntary movements of the face, tongue, and limbs, not restlessness.

Choice D is wrong because Parkinsonism is wrong because it is a condition that causes tremors, rigidity, and bradykinesia, not restlessness.

Normal ranges for haloperidol are 0.5 to 20 ng/mL.

Higher levels can cause toxicity and adverse effects.

Bupropion (Wellbutrin) is an antidepressant that works by increasing the levels of dopamine and norepinephrine in your brain. These are neurotransmitters that regulate mood, motivation, and reward.By increasing their levels, bupropion can help improve your symptoms of depression.

Choice A is wrong because it describes the mechanism of action of selective serotonin and norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor) or duloxetine (Cymbalta).These drugs block the reuptake of serotonin and norepinephrine, making more of them available in the synaptic cleft.

Choice C is wrong because it describes the mechanism of action of monoamine oxidase inhibitors (MAOIs), such as phenelzine (Nardil) or tranylcypromine (Parnate). These drugs inhibit the breakdown of serotonin and norepinephrine, as well as dopamine and tyramine, by the enzyme monoamine oxidase.This increases their levels in the brain, but also poses a risk of hypertensive crisis if the client consumes foods high in tyramine.

Choice D is wrong because it describes the mechanism of action of benzodiazepines, such as diazepam (Valium) or alprazolam (Xanax). These drugs enhance the activity of gamma-aminobutyric acid (GABA), which is an inhibitory neurotransmitter that reduces anxiety and induces relaxation.However, these drugs are not used to treat depression, and can cause dependence and withdrawal symptoms.

Amitriptyline (Elavil) is a tricyclic antidepressant that can increase the levels of serotonin in the brain. Buspirone (BuSpar) is an anti-anxiety medication that also affects serotonin receptors.Taking these two medications together can cause serotonin syndrome, which is a potentially life-threatening condition characterized by agitation, confusion, fever, tremors, and muscle rigidity.

Choice B is wrong because lithium carbonate (Lithobid) is a mood stabilizer that does not interact with buspirone or affect serotonin levels.

Choice C is wrong because diazepam (Valium) is a benzodiazepine that enhances the effects of GABA, an inhibitory neurotransmitter.It does not interact with buspirone or affect serotonin levels.

Choice D is wrong because zolpidem (Ambien) is a sedative-hypnotic that acts on GABA receptors.It does not interact with buspirone or affect serotonin levels.

The normal range of serotonin in the blood is 101 to 283 ng/mL.Serotonin syndrome can occur when serotonin levels exceed 500 ng/mL.)

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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.