Lone Star College System, North Harris - PSYC 1301

Chapter 26: Psychopharmacology Test Bank

MULTIPLE CHOICE

1)A patient will be starting on fluoxetine hydrochloride (Prozac) therapy and taking 20 mg PO every morning. Which information should the nurse provide to the patient?

1. 1. “Make sure that you take your pulse before getting out of bed in the morning.”
   2. “Try taking your medication with breakfast if you begin experiencing nausea.”
   3. “You may need to reduce your fluids at night because of nocturnal urination.”
   4. “Remember to avoid red wine, nuts, and any cheese except cottage and cream.”

2. A patient being treated for depression reports experiencing nausea, palpitations, and “a terrible headache.” When the physical examination determines the patient is diaphoresic and hypertensive, the nurse should ask:
   1. “When did you last take your phenelzine (Nardil)?”
   2. “Did you take your amitriptyline (Elavil) on schedule?”
   3. “What natural foods have you had in the last 24 hours?”
   4. “Have you had any alcohol to drink within the last 24 hours?”

3. A patient taking medication for depression states, “I need to stop taking my medication because it blurs my vision, and I’m making mistakes when I paint jewelry by hand.” Which response by a nurse would be most therapeutic?
   1. “If you cannot take medication, would you consider a course of 6 to 10 electroconvulsive therapy (ECT) treatments offered on an outpatient basis? ECT treatments usually work immediately.”
   2. “Do you recall the two of us discussing that blurred vision may occur but that it will resolve shortly? In the meantime, let’s discuss how to best avoid getting injured until your vision clears up.”
   3. “I understand your concern considering that you need to work to receive health insurance. Would you like me to ask the psychiatrist to change your medication?”
   4. “You may need to apply for a sick leave for 6 months until your depression improves enough to lessen the medication dosage.”

4. A patient who has been taking an antidepressant for 2 months shares with the nurse, “Since my depression is over, I’ve stopped the Prozac and I won’t need to see you any longer.” Which response by a nurse would be most therapeutic?
   1. “Do you recall that we discussed the need for you to take the medication for up to 1 year before trying to taper off the drug? Let’s discuss why it’s not advisable to stop your medication abruptly.”
   2. “It is not recommended that you stop the antidepressants abruptly. I strongly suggest that you continue seeing me regularly to ensure that any change in your condition will be treated immediately.”
   3. “You should not discontinue your medication without consulting your psychiatrist. You will very likely experience withdrawal symptoms and become more depressed than you were before.”
   4. “Although it isn’t wise to stop the medication as you have, you seem to be handling things very well. Call me if you have any questions and follow-up with your psychiatrist in a year.”

5. Which medication would the nurse expect to administer when observing that a patient being treated for schizophrenia is fidgety, demonstrates motor restlessness, and jiggles both legs when asked to sit down?
   1. Olanzapine (Zyprexa)
   2. Molindone (Moban)
   3. Biperiden (Akineton)
   4. Thioridazine (Mellaril)

6. Which set of instructions is most appropriate when preparing the patient for collection of a 24- hour creatinine clearance for a prelithium workup?
   1. “Collect all urine when you wake up and for 12 hours thereafter, and then discard all collected urine, noting the time. Begin again to collect all urine, and refrigerate it for the next 12 hours after your blood is drawn.”
   2. “Discard your first morning urine on awakening, and then begin to time and collect your urine. Keep it refrigerated in a clean 3-L plastic container. Your blood may be drawn at any time during the collection.”
   3. “Sign this consent form; then collect your urine for the next 24 hours after discarding the first urine of the morning and then refrigerate the clean 3-L container between voidings.”
   4. “Sign this consent form, and then begin to collect your urine in a clean 3-L plastic container for 24 hours. You may refrigerate the urine collection if you wish.”

7. Which statement represents the most appropriate instructions for a patient with a past suicide attempt who is prescribed amitriptyline (Elavil), 150 mg PO at bedtime?
   1. “You will need to pick up your 7-day supply of medication at the pharmacy each week.”
   2. “Your prescription will provide you with a 6-month supply to save you money and time.”

1. 3. “I’m going to strongly suggest that your spouse dispense this medication to you each evening.”
   4. “Stop by the clinic each evening for your medication so your emotional state of mind can be assessed.”

8. A nurse observes a patient diagnosed with schizophrenia tapping both feet, smacking both lips, and making contorted faces while speaking to another patient. These behaviors prompt the nurse to suspect the patient is experiencing:
   1. neuroleptic malignant syndrome.
   2. Parkinson syndrome.
   3. tardive dyskinesia.
   4. torticollis.

9. A patient who has been treated with clozapine (Clozaril) for 9 months calls to cancel a clinic appointment because of flulike symptoms, including a sore throat, fever, and tiredness. The nurse demonstrates the best understanding on the management of these symptoms when responding:
   1. “I think you need to drink lots of juices and water and go to bed. Call me at the end of the week to reschedule your appointment.”
   2. “I want you to please keep the appointment, and I will arrange for some blood work to be done while you are here.”
   3. “It’s flu season all right. Get better soon, and call me to reschedule when you’re feeling better.”
   4. “This may be something much more serious than the flu. Go to the hospital at once.”

10. When assessing a patient who has been prescribed an antipsychotic medication, which statement would indicate a need for further patient education?
    1. “I’m already too thin; I’m concerned that I’m going to get even thinner on this new type of medication.”
    2. “I’m a warm weather person, I follow the sun—I live in Florida in the winter and Maine in the summer.”
    3. “I just got married, and my wife and I are so excited about starting a family as soon as we can.”
    4. “My parents said that as soon as I am off the medication, they’ll give me the money for a car.”

11. During a home visit with a patient diagnosed with schizophrenia the patient tells the nurse, “I’m going to stop going to the clinic for my fluphenazine decanoate (Prolixin) shots because I think I’m okay now.” Which statement represents the best understanding of the effect of the patient’s decision on the prognosis?
    1. “So you think you’re better now. Let’s discuss why you’ve decided to stop taking your medication.”
    2. “Your doctor knows what’s best for you. Just look at how well you’re feeling now so don’t stop taking the medication.”
    3. “Our philosophy is to use the least amount of medicine that is needed to treat a problem. Tell me why you think that you are okay now.”
    4. “I’m afraid that you’ll be sick again very soon if you aren’t taking your medication, but you are an adult and entitled to make your own decisions.”

12. A nurse is assessing a patient who was recently prescribed an antipsychotic medication. Which side effects could the nurse expect to observe?
    1. Constipation, decreased sweating, and increased sensitivity to heat
    2. Increased moisture around the eyes, vomiting, and frontal headache
    3. Slurred speech, hand tremors, and severe occipital headache
    4. Sleeplessness, irritability, and muscle weakness

13. A patient who is taking psychotropic medication is experiencing constipation. Which intervention would the nurse plan for the patient?
    1. Drinking six to eight glasses of water daily and eating green vegetables and bran
    2. Drinking 10 to 12 glasses of water daily and eating a serving of beef liver weekly
    3. Taking a laxative and stool softener daily in addition to eating prunes and dates
    4. Using a retention enema weekly and adding bran and vegetables in the daily diet

14. A patient who is taking lithium shares with the nurse, “I’m planning to breast-feed my baby who is due to be born in 2 months.” Which statement shows the best understanding of the effect of lithium on breast-feeding?
    1. “Your medication would be excreted in your breast milk, so let’s discuss a safer option for your baby.”
    2. “Your medication will cause the breast milk to have an unpleasant taste and will

likely cause your infant to be gassy.”

1. 3. “This medication will likely affect your ability to lactate, resulting in a marked decrease in breast milk production.”
   4. “This medication can cause extreme mood fluctuations, which can have a negative effect on your ability to produce breast milk.”

15. What will a health care provider include in medication teaching for a patient who will be starting a monoamine oxidase inhibitor (MAOI) medication after ending treatment with sertraline hydrochloride (Zoloft)?
    1. “Here is some information concerning the foods you must avoid when you are taking your new medication. In 2 weeks, after your last dose of Zoloft, we will meet and I will give you a prescription for your MAOI and answer any questions you may have.”
    2. “After you have been off Zoloft for 1 week, come see me. I will order the new medication for you. This list includes all the foods you will not be able to eat while taking your new medicine. We’ll review your diet and medication when we meet, and we will get a blood sample as well.”
    3. “After 4 weeks off Zoloft, come see me. The prescription for your new medication will be ready along with a list of foods you will need to avoid once you start taking the medication. I’ll order some blood work at that time as well.”
    4. “After 2 days off Zoloft, come in to see me before going to work. I’ll give you a prescription for the new medication, and we can review the foods you will need to avoid while taking the new medication.”

16. A patient who is prescribed an antidepressant medication says, “I’ve been getting dizzy in the morning when I wake up ever since I started this drug. Do you think I should stop taking it?” Which communication would reflect the most therapeutic nursing intervention on the basis of the patient’s problem?
    1. “It’s important to change positions slowly and dangle your feet at the side of the bed before getting up.”
    2. “You’ll have to stop driving your car while you’re taking your medicine, and napping during the day should help.”

1. 3. “This medication does not usually cause dizziness unless it’s being taken along with alcohol, wine, or beer.”
   4. “This should not be happening. Stop taking this medicine, and I’ll notify your doctor to prescribe something else.”

17. Which assessment data would indicate to the nurse that the patient who is prescribed a benzodiazepine is experiencing a medication side effect?
    1. Dizziness
    2. Reduced irritability
    3. Reduced nervousness
    4. Physiological dependency

18. A patient taking a benzodiazepine says to the nurse, “I really like this pill because if I just take an extra one when I get very anxious, I always feel a lot better.” What is the nurse’s best response?
    1. “That isn’t the way the medication is to be taken. I think you need to talk to your doctor so something more effective can be prescribed for you.”
    2. “Let’s review the way you use this medication. Remember to try the coping measures that we discussed to help manage your nervousness.”
    3. “You are not taking the medication as the doctor ordered. I think the doctor will be very concerned that you are abusing your medication.”
    4. “You really shouldn’t be adjusting your medication dosage like that. You need to take the medication only as it was originally prescribed by your physician.”

19. In order to accurately predict how the body absorbs, distributes, metabolizes, and eliminates psychotropic medications the nurse must be familiar with a medication’s:
    1. half-life.
    2. side effects.
    3. pharmacokinetics.
    4. therapeutic dosage range.

20. When a patient requires an ever-increasing dose of a medication to achieve the same therapeutic effect, the nurse must assess the patient for:
    1. withdrawal.
    2. patency.
    3. side effects.
    4. tolerance.

21. A nurse is caring for a female diagnosed with a mental disorder who has been prescribed medication. Which fact will most impact the nurse’s assessment for possible side effects?
    1. Women are at higher risk for tardive dyskinesia while taking conventional antipsychotic medications.
    2. Women experience more severe side effects than men while taking atypical antidepressants.
    3. Women are more susceptible to developing a dependence on most psychiatric medications than are men.
    4. Women are less susceptible to developing the common side effects of antipsychotic medications than are men.

22. A nurse who administers an antipsychotic medication explains to the client patient how the medication helps manage the symptoms by affecting:
    1. dopamine and GABA.
    2. serotonin and dopamine.
    3. synaptic neurovesicles and neurodendrites.
    4. monoamine oxidase inhibitors and serotonin.

23. In order to effectively provide appropriate patient teaching regarding the effects of psychotropic medications, the nurse is required to have a thorough understanding of which drug-related topic?
    1. Clinical indicators
    2. Pharmacology algorithms
    3. Monotherapeutic symptoms
    4. Doses of all atypical psychotropic drugs

MULTIPLE RESPONSE

1. Which instructions will the nurse include in the teaching plan of a patient who is prescribed fluphenazine (Prolixin) and has developed a thickly white-coated tongue? (Select all that apply.)
   1. Avoid foods high in sugar.
   2. Brush teeth and tongue frequently.
   3. Continue taking your medication; the coating will subside in about 3 weeks.
   4. Nasal inhalants should be avoided since they can interact with your medication and