Marshalltown Community College - NURSING PNN101

Chapter 10: Drug Therapy for Mental Health

Visovsky: Introduction to Clinical Pharmacology, 9th Edition

MULTIPLE CHOICE

1)Which drug category is useful in promoting sleep among patients with insomnia?

1. 1. Sedatives
   2. ACE inhibitors
   3. Atypical antipsychotics
   4. Selective serotonin reuptake inhibitors

2. You are preparing to give the benzodiazepine Valium to a patient as a premedication before surgery. The patient asks you how this drug works. What is your best response?
   1. “This drug works by binding to receptors acting with GABA to induce sleep.”
   2. “This drug is acts by preventing binding to the benzodiazepine receptors.”
   3. “This drug acts by inhibiting GABA responses to relax muscles.”
   4. “This drug acts by binding to opioid receptors.”

3. You are caring for a patient in the clinic setting who has been taking a benzodiazepine alprazolam (Xanax) for anxiety. What potential problem should you observe this patient for?
   1. Seizure activity
   2. Addiction
   3. Insomnia
   4. Anorexia

4. Which drug would you anticipate will be given to a patient who experienced an overdose of a benzodiazepine?
   1. Rifampin
   2. Naloxone

1. 3. Flumazenil
   4. Epinepherine

5. For which patient would benzodiazepines be contraindicated?
   1. A female with breast cancer.
   2. A woman who is 20 weeks pregnant.
   3. A male who has a history of smoking.
   4. A male who is about to undergo surgery.

6. What specific information should be part of the teaching plan for a patient taking a nonbenzodiazepine sedative?
   1. These drugs can interact with many foods and beverages.
   2. These drugs can cause you to be physically active at night.
   3. These drugs must be takes for at least 6 weeks to see any effects.
   4. Excess caffeine intake can work to increase the effectiveness of these drugs.

7. You are preparing to teach a patient with anxiety disorder about the actions of the nonbenzodiazepine drug buspirone. What would you inform the patient about how this drug works?
   1. “Buspirone acts by affecting the serotonin and dopamine neurotransmitters.”
   2. “Buspirone acts by inhibiting GABA pathways to decrease anxiety.”
   3. “Buspirone acts by affecting the monoamine oxidase pathway.”
   4. “Buspirone acts by inhibiting the action of dopamine receptors.”

8. Which drug is classified as a benzodiazepine?
   1. Lorazepam (Ativan)
   2. Buspirone (BuSpar)
   3. Benztropine (Cogentin)
   4. Chlorpromazine (Thorazine)

9. The family members of a patient admitted for hallucinations and delusions tells you that the patient is currently taking chlorpromazine (Thorazine) for the treatment of schizophrenia. Which statement about this drug is true?
   1. Throazine is associated with a higher risk of extrapyramidal symptoms.
   2. Thorazine relieves anxiety symptoms associated with schizophrenia.
   3. Thorazine is used for acute schizoaffective disorders.
   4. Thorazine is used for chronic mental illness.

10. The family of a patient who has been taking the antipsychotic fluphenazine (Prolixin) for the last 2 years. The patient’s family reports the patient has suddenly begun smacking her lips, and involuntarily sticking out her tongue. What would be your best first action?
    1. Call the healthcare provider to report these symptoms.
    2. Tell the family to hold the next dose of fluphenazine.
    3. Inform the family that these symptoms are expected, and of no concern.
    4. Tell the family that these symptoms will disappear over time as the drug dose stabilizes.

11. You are about to begin teaching a patient with a psychosis about taking typical antipsychotic drugs. Which of the following statements would you include in your teaching plan?
    1. “Do not abruptly stop taking this drug.”

1. 2. “Take these drugs with a glass of grapefruit juice.”
   3. “Take these drugs at night with your sleep drug.”
   4. “You will experience the effects of these drugs within 30 minutes of taking them.”

12. A patient who has been taking the atypical antipsychotic risperidone (Risperdal) reports weight gain after taking the drug for 3 months. What would you tell this patient?
    1. “Stop this drug immediately.”
    2. “Weight gain can be an adverse effect of this drug.”
    3. “Weight gain is an expected side-effect of this drug.”
    4. “I will notify your healthcare provider, so the drug can be changed.”
13. You are teaching a patient about the adverse effects associated with selective serotonin reuptake inhibitors (SSRIs). Which adverse effect would you inform your patient about?
    1. Metallic taste.
    2. Sexual dysfunction.
    3. Cardiovascular disease.
    4. Extrapyramidal symptoms.

14. A patient who has been prescribed a serotonin norepinephrine reuptake inhibitor (SNRI) one week ago reports that she has not noticed any difference in her depression level since beginning this drug. What is your best response?
    1. “Begin taking two tablets daily to increase blood serum levels.”
    2. “Add a tablet of St, John’s Wort to increase the drug’s effects.”
    3. “You should call your healthcare provider immediately.”
    4. “It may take several weeks for this drug to take effect.”

15. A young adult patient taking an SSRI for the past 2 weeks comes in for an evaluation and follow-up appointment. Which potential side effect should you check for in this patient?
    1. Suicidal thoughts.
    2. Psychotic episodes.
    3. Delusional thinking.
    4. Schizo-affective disorders.

16. Which of the following drugs classifications for the treatment of mental health problems is contraindicated for patients with vision problems?
    1. Antipsychotics.
    2. Tricyclic antidepressants.
    3. Selective serotonin reuptake inhibitors.
    4. Serotonin norepinephrine reuptake inhibitors.

17. A patient who has been taking imipramine comes to the clinic for a routine follow-up appointment. Which of the following assessments would be appropriate to perform?
    1. Skin assessment.
    2. Hearing assessment.
    3. Elimination assessment.
    4. Vital signs and weight assessment.
18. You are caring for a patient who will begin treatment for anxiety and depression that has been unresponsive to other drugs with isocarboxazid. Which of the following statements made by the patient would indicate understanding of the teaching related to this drug?
    1. “I will take both my isocarboxazid and my SSRI drugs at the same time each day.”
    2. “I will avoid situations that cause me to lose fluids and become dehydrated.”
    3. “I will avoid eating foods containing tyramine that can increase blood pressure.”
    4. “I will take my isocarboxazid weekly, as this drug is long-acting”

19. Which of the following drugs would be appropriate for the treatment of bipolar illness?
    1. Lithium
    2. Sertoline
    3. Alprazolam
    4. Chlorpromazine

20. You have just completed teaching with a patient who is beginning lithium. Which of the following statements made by the patient demonstrates understanding of this drug?
    1. “I will need to increase my salt intake while taking this drug.”
    2. “I will need regular blood testing while taking this drug.”
    3. “I may develop mild memory loss while taking this drug.”
    4. “Lithium cannot be taken with tyrosine-containing foods.”

21. You are taking the history of a patient who is suspected of having lithium toxicity. What symptoms would you expect the patient to report?
    1. Increased drowsiness, weakness and nausea.
    2. Heart palpitations, seizures, and muscle spasm.
    3. Decreased urine output, vision loss and irritability.
    4. Increased mania, excessive salivation and tachycardia.

MULTIPLE RESPONSE

1. Which symptoms would you expect a patient who is experiencing mania? (Select all that apply.)
   1. Catatonia
   2. CNS depression
   3. Increased energy
   4. Grandiose notions
   5. Poor judgement
   6. Excessive sleepiness

2. What disorders would a selective serotonin uptake inhibitor (SSRI) be prescribed for? (Select all that apply.)
   1. Psychosis.
   2. Depression.
   3. General anxiety disorder.
   4. Traumatic stress disorder.
   5. Manic depressive disorder.
   6. Obsessive-compulsive disorder.

3. Too much serotonin can lead to the adverse effect known as serotonin syndrome. Which of the following symptoms are associated with serotonin syndrome? (Select all that apply.)
   1. Confusion.
   2. Restlessness
   3. Dilated pupils.
   4. Increased sweating.
   5. Severe constipation.
   6. Extremely high blood pressure.