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Essentials of Psychiatric Mental Health Nursing 7th Edition By Mary C – Test Bank
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Chapter 2: Biological Implications
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. A depressed client states, “I have a chemical imbalance in my brain. I have no control over my behavior. Medications are my only hope to feel normal again.” Which nursing response is appropriate?
| 1. | “Medications only address biological factors. Environmental and interpersonal factors must also be considered.” |
| 2. | “Because biological factors are the sole cause of depression, medications will improve your mood.” |
| 3. | “Environmental factors have been shown to exert the most influence in the development of depression.” |
| 4. | “Researchers have been unable to demonstrate a link between nature (biology and genetics) and nurture (environment).” |
____ 2. A client diagnosed with major depressive disorder asks, “What part of my brain controls my emotions?” Which nursing response is appropriate?
| 1. | “The occipital lobe governs perceptions, judging them as positive or negative.” |
| 2. | “The parietal lobe has been linked to depression.” |
| 3. | “The medulla regulates key biological and psychological activities.” |
| 4. | “The limbic system is largely responsible for one’s emotional state.” |
____ 3. Which part of the nervous system should a nurse identify as playing a major role during stressful situations?
| 1. | Peripheral nervous system |
| 2. | Somatic nervous system |
| 3. | Sympathetic nervous system |
| 4. | Parasympathetic nervous system |
____ 4. Which client statement reflects an understanding of circadian rhythms in psychopathology?
| 1. | “When I dream about my mother’s horrible train accident, I become hysterical.” |
| 2. | “I get really irritable during my menstrual cycle.” |
| 3. | “I’m a morning person. I get my best work done before noon.” |
| 4. | “Every February, I tend to experience periods of sadness.” |
____ 5. Which types of adoption studies should a nurse recognize as providing useful information for the psychiatric community?
| 1. | Studies in which children with mentally ill biological parents are raised by adoptive parents who were mentally healthy |
| 2. | Studies in which children with mentally healthy biological parents are raised by adoptive parents who were mentally ill |
| 3. | Studies in which monozygotic twins from mentally ill parents were raised separately by different adoptive parents |
| 4. | Studies in which monozygotic twins were raised together by mentally ill biological parents |
| 5. | All of the above |
____ 6. Six months after her husband and children were killed in a car accident, a client is diagnosed with ulcerative colitis. The nurse should recognize that this situation validates which study perspective?
| 1. | Neuroendocrinology |
| 2. | Psychoneuroimmunology |
| 3. | Diagnostic technology |
| 4. | Neurophysiology |
____ 7. A withdrawn client, diagnosed with schizophrenia, expresses little emotion and refuses to attend group therapy. What altered component of the nervous system should a nurse recognize as being responsible for this behavior?
| 1. | Dendrites |
| 2. | Axons |
| 3. | Neurotransmitters |
| 4. | Synapses |
____ 8. An instructor is teaching nursing students about neurotransmitters. Which best explains the process of how neurotransmitters released into the synaptic cleft may return to the presynaptic neuron?
| 1. | Regeneration |
| 2. | Reuptake |
| 3. | Recycling |
| 4. | Retransmission |
____ 9. A nurse concludes that a restless, agitated client is manifesting a fight-or-flight response. The nurse should associate this response with which neurotransmitter?
| 1. | Acetylcholine |
| 2. | Dopamine |
| 3. | Serotonin |
| 4. | Norepinephrine |
____ 10. A client is admitted to a psychiatric unit with the diagnosis of catatonic schizophrenia. Which of the client’s neurotransmitters should a nurse expect to be elevated?
| 1. | Serotonin |
| 2. | Dopamine |
| 3. | Gamma-aminobutyric acid (GABA) |
| 4. | Histamine |
____ 11. A client’s wife of 34 years dies unexpectedly. The client cries often and becomes socially isolated. The client’s therapist encourages open discussion of feelings, proper nutrition, and exercise. What is the best rationale for the therapist’s recommendations?
| 1. | The therapist is using an interpersonal approach. |
| 2. | The client has an alteration in neurotransmitters. |
| 3. | It is routine practice to remind clients about nutrition, exercise, and rest. |
| 4. | The client is susceptible to illness because of effects of stress on the immune system. |
____ 12. Which mental illness should a nurse identify as being associated with an increase in prolactin hormone level?
| 1. | Major depressive episode |
| 2. | Schizophrenia |
| 3. | Anorexia nervosa |
| 4. | Alzheimer’s disease |
____ 13. Which cerebral structure should a nursing instructor describe to students as the “emotional brain”?
| 1. | The cerebellum |
| 2. | The limbic system |
| 3. | The cortex |
| 4. | The left temporal lobe |
____ 14. A nurse understands that the abnormal secretion of growth hormone may play a role in which illness?
| 1. | Acute mania |
| 2. | Schizophrenia |
| 3. | Anorexia nervosa |
| 4. | Alzheimer’s disease |
____ 15. A client is admitted to an emergency department experiencing memory deficits and decreased motor function. What alteration in brain chemistry should a nurse correlate with the production of these symptoms?
| 1. | Abnormal levels of serotonin |
| 2. | Decreased levels of dopamine |
| 3. | Increased levels of norepinephrine |
| 4. | Decreased levels of acetylcholine |
____ 16. A nurse should recognize that a decrease in norepinephrine levels would play a significant role in which mental illness?
| 1. | Bipolar disorder: mania |
| 2. | Schizophrenia spectrum disorder |
| 3. | Generalized anxiety disorder |
| 4. | Major depressive episode |
____ 17. A nurse should expect that an increase in dopamine activity might play a significant role in the development of which mental illness?
| 1. | Schizophrenia spectrum disorder |
| 2. | Major depressive disorder |
| 3. | Body dysmorphic disorder |
| 4. | Parkinson’s disease |
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 18. Which of the following information should a nurse include when explaining causes of anorexia nervosa to a client? (Select all that apply.)
| 1. | There is a possible correlation between abnormal secretion of growth hormone and anorexia nervosa. |
| 2. | There is a possible correlation between antidiuretic hormone levels and anorexia nervosa. |
| 3. | There is a possible correlation between low levels of gonadotropin and anorexia nervosa. |
| 4. | There is a possible correlation between increased levels of prolactin and anorexia nervosa. |
| 5. | There is a possible correlation between altered levels of oxytocin and anorexia nervosa. |
____ 19. Which of the following symptoms should a nurse associate with the development of decreased levels of thyroid-stimulating hormone (TSH) in a newly admitted client? (Select all that apply.)
| 1. | Depression |
| 2. | Fatigue |
| 3. | Increased libido |
| 4. | Mania |
| 5. | Hyperexcitability |
Completion
Complete each statement.
- ____________________________ is the study of the biological foundations of cognitive, emotional, and behavioral processes.
Chapter 2: Biological Implications
Answer Section
MULTIPLE CHOICE
- ANS: 1
Chapter: Chapter 2, Biological Implications
Objective: Recognize various theorized influences in the development of psychiatric disorders including brain physiology, genetics, endocrine function, immune system, and psychosocial, and environmental factors.
Page: 15–19
Headings: The Parietal Lobes, The Occipital Lobes, Limbic System, Medulla
Integrated Processes: Teaching and Learning
Client Need: Psychosocial Integrity
Cognitive Level: Analysis [Analyzing]
Concept: Mood
Difficulty: Easy
| Feedback | |
| 1 | The nurse should advise the client that medications address biological factors, but there are other factors that affect mood. The nurse should educate the client on environmental and interpersonal factors that can lead to depression. |
| 2 | The statement is false because biological factors are not the sole cause of depression. |
| 3 | It is false that environmental factors have been shown to exert the most influence in the development of depression. |
| 4 | Researchers have demonstrated a link between nature and nurture. |
PTS: 1 CON: Mood
- ANS: 4
Chapter: Chapter 2, Biological Implications
Objective: Identify gross anatomical structures of the brain and describe their functions.
Page: 16
Headings: The Nervous System: An Anatomical Review > The Brain
Integrated Processes: Teaching and Learning
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Mood
Difficulty: Moderate
| Feedback | |
| 1 | The occipital lobes are the area of visual reception and interpretation. |
| 2 | Somatosensory input (touch, taste, temperature, etc.) occurs in the parietal lobes. |
| 3 | The medulla contains vital centers that regulate heart rate and reflexes. |
| 4 | The nurse should explain to the client that the limbic system is largely responsible for one’s emotional state. This system is often called the “emotional brain” and is associated with feelings, sexuality, and social behavior. |
PTS: 1 CON: Mood
- ANS: 3
Chapter: Chapter 2, Biological Implications
Objective: Discuss the physiology of neurotransmission in the central nervous system.
Page: 21
Heading: Autonomic Nervous System
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Comprehension [Understanding]
Concept: Mood
Difficulty: Moderate
| Feedback | |
| 1 | The peripheral nervous system does not play a major role during stressful situations. |
| 2 | The somatic nervous system is part of the peripheral nervous system. |
| 3 | The nurse should identify that the sympathetic nervous system plays a major role during stressful situations. The sympathetic nervous system prepares the body for the fight-or-flight response. |
| 4 | The parasympathetic nervous system is dominant when an individual is in a nonstressful state. |
PTS: 1 CON: Mood
- ANS: 3
Chapter: Chapter 2, Biological Implications
Objective: Discuss the physiology of neurotransmission in the central nervous system.
Page: 29–30
Heading: Circadian Rhythms
Integrated Processes: Teaching and Learning
Client Need: Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Analysis [Analyzing]
Concept: Sleep and Rest
Difficulty: Moderate
| Feedback | |
| 1 | This statement does not indicate understanding of circadian rhythms. |
| 2 | The menstrual cycle is not affected by the circadian rhythm. |
| 3 | By stating, “I am a morning person,” the client demonstrates an understanding that circadian rhythms may influence a variety of regulatory functions, including the sleep-wake cycle, regulation of body temperature, and patterns of activity. Most humans follow a 24-hour cycle that is largely affected by lightness and darkness. |
| 4 | Experiencing periods of sadness is not indicative of the circadian rhythm. |
PTS: 1 CON: Sleep and Rest
- ANS: 5
Chapter: Chapter 2, Biological Implications
Objective: Discuss the implications of psychobiological concepts to the practice of psychiatric/mental health nursing.
Page: 31
Heading: Genetics > Adoptions Studies
Client Need: Physiological Integrity: Physiological Adaptation
Concept: Evidence-based Practice
Cognitive Level: Analysis [Analyzing]
Integrated Processes: Teaching and Learning
Difficulty: Moderate
| Feedback | |
| 1 | This type of adoption study can provide information on children with mentally ill biological parents who are raised by adoptive parents who are mentally healthy parents. |
| 2 | This type of adoption study can provide information on children with mentally healthy biological parents who are raised by adoptive parents who are mentally ill. |
| 3 | This type of adoption study provides important information on monozygotic twins from mentally ill parents who were raised separately by different adoptive parents. |
| 4 | This type of adoption study provides important information on monozygotic twins who were raised together by mentally ill biological parents. |
| 5 | The nurse should determine that all of the studies could possibly benefit the psychiatric community. The studies may reveal research findings relating genetic links to mental illness. Adoption studies allow comparisons to be made of the influences of the environment versus genetics. |
PTS: 1 CON: Evidence-based Practice
- ANS: 2
Chapter: Chapter 2, Biological Implications
Objective: Discuss the influence of psychological factors on the immune system.
Page: 31
Heading: Psychoneuroimmunology > Implications of the Immune System in Psychiatric Illness
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Moderate
| Feedback | |
| 1 | Neuroendocrinology is the study of the interaction between the nervous system and the endocrine system. |
| 2 | Psychoneuroimmunology is the branch of medicine that studies the effects of social and psychological factors on the functioning of the immune system. Studies of the biological response to stress hypothesize that individuals become more susceptible to physical illness following exposure to stressful stimuli. |
| 3 | Diagnostic testing assists in diagnosing. |
| 4 | Neurophysiology is the physiology of the nervous system. |
PTS: 1 CON: Stress
- ANS: 3
Chapter: Chapter 2, Biological Implications
Objective: Describe the role of neurotransmitters in the central nervous system.
Page: 21
Heading: The Nervous System: An Anatomical Review > Neurotransmitters
Integrated Processes: Teaching and Learning
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Comprehension [Understanding]
Concept: Mood
Difficulty: Moderate
| Feedback | |
| 1 | Dendrites are processes that transmit impulses toward the cell body. |
| 2 | Axons transmit impulses away from the cell body. A junction between two neurons is a synapse. |
| 3 | The nurse should recognize that neurotransmitters play an essential function in the role of human emotion and behavior. Neurotransmitters are targeted and affected by many psychotropic medications. |
| 4 | A junction between two neurons is a synapse. |
PTS: 1 CON: Mood
- ANS: 2
Chapter: Chapter 2, Biological Implications
Objective: Describe the role of neurotransmitters in the central nervous system.
Page: 21
Heading: The Nervous System: An Anatomical Review > Neurotransmitters
Integrated Processes: Teaching and Learning
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Comprehension [Understanding]
Concept: Mood
Difficulty: Moderate
| Feedback | |
| 1 | Regeneration is incorrect wording to describe this process. |
| 2 | The nursing instructor should explain that the process by which neurotransmitters are released into the synaptic cleft and returned to the presynaptic neuron is termed reuptake. Reuptake is the process by which neurotransmitters are stored for reuse. |
| 3 | Recycling is incorrect wording to describe this process. |
| 4 | Retransmission is incorrect wording to describe this process. |
PTS: 1 CON: Mood
- ANS: 4
Chapter: Chapter 2, Biological Implications
Objective: Describe the role of neurotransmitters in the central nervous system.
Page: 21
Heading: Monoamines > Norepinephrine
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Comprehension [Understanding]
Concept: Mood
Difficulty: Moderate
| Feedback | |
| 1 | Acetylcholine functions include pain, arousal, and pain perception. |
| 2 | Dopamine functions include regulation of movement and coordination. |
| 3 | Serotonin plays a role in sleep, libido, and appetite. |
| 4 | The nurse should associate the neurotransmitter norepinephrine with the fight-or-flight response. Norepinephrine produces activity in the sympathetic postsynaptic nerve terminal and is associated with the regulation of mood, cognition, perception, locomotion, and sleep and arousal. |
PTS: 1 CON: Mood
- ANS: 2
Chapter: Chapter 2: Biological Implications
Objective: Describe the role of neurotransmitters in the central nervous system.
Page: 21
Heading: Monoamines > Norepinephrine
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Mood
Difficulty: Moderate
| Feedback | |
| 1 | Serotonin plays a role in sleep, libido, and appetite. |
| 2 | The nurse should expect that elevated dopamine levels might be an attributing factor to the client’s current level of functioning. Dopamine functions include regulation of movements and coordination, emotions, and voluntary decision-making ability. |
| 3 | GABA prevents postsynaptic excitation. |
| 4 | Histamine mediates allergic and inflammatory reactions. |
PTS: 1 CON: Mood
- ANS: 4
Chapter: Chapter 2: Biological Implications
Objective: Discuss the influence of psychological factors on the immune system.
Page: 31
Heading: Psychoneuroimmunology > Implications of the Immune System in Psychiatric Illness
Integrated Processes: Planning
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Moderate
| Feedback | |
| 1 | This approach is not proven by evidence-based research. |
| 2 | This rationale is not proven by evidence-based research. |
| 3 | Reminding clients about nutrition, exercise and rest is routine but is not proven by evidence-based research. |
| 4 | The therapist’s recommendations should be based on the knowledge that the client has been exposed to stressful stimuli and is at an increased risk to develop illness because of the effects of stress on the immune system. The study of this branch of medicine is called psychoneuroimmunology. |
PTS: 1 CON: Stress
- ANS: 2
Chapter: Chapter 2, Biological Implications
Objective: Recognize various theorized influences in the development of psychiatric disorders including brain physiology, genetics, endocrine function, immune system, and psychosocial, and environmental factors.
Page: 29
Heading: Psychoneuroimmunology > Prolactin
Integrated Processes: Teaching and Learning
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Stress
Difficulty: Moderate
| Feedback | |
| 1 | There is no known correlation between increased levels of prolactin and major depressive disorder. |
| 2 | Although the exact mechanism is unknown, there may be some correlation between increased levels of the hormone prolactin and schizophrenia. |
| 3 | There is no known correlation between increased levels of prolactin and anorexia nervosa. |
| 4 | There is no known correlation between increased levels of prolactin and Alzheimer’s disease. |
PTS: 1 CON: Stress
- ANS: 2
Chapter: Chapter 2, Biological Implications
Objective: Identify gross anatomical structures of the brain and describe their functions.
Page: 19
Heading: The Nervous System: An Anatomical Review > Limbic System
Integrated Processes: Teaching and Learning
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Mood
Difficulty: Easy
| Feedback | |
| 1 | The cerebellum is concerned with involuntary movement, posture, and equilibrium. |
| 2 | The limbic system is often referred to as the “emotional brain.” The limbic system is largely responsible for one’s emotional state and is associated with feelings, sexuality, and social behavior. |
| 3 | The cortex is identified by numerous folds called gyri and sulci. |
| 4 | The left temporal lobe is concerned with auditory functions. |
PTS: 1 CON: Mood
- ANS: 3
Chapter: Chapter 2, Biological Implications
Objective: Discuss the association of endocrine functioning to the development of psychiatric disorders.
Page: 31
Heading: Psychoneuroimmunology > Growth Hormone
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Comprehension [Understanding]
Concept: Mood
Difficulty: Moderate
| Feedback | |
| 1 | There is no correlation between abnormal levels of growth hormone and acute mania. |
| 2 | There is no correlation between abnormal levels of growth hormone and schizophrenia. |
| 3 | The nurse should understand that research has found a correlation between abnormal levels of growth hormone and anorexia nervosa. The growth hormone is responsible for growth in children, as well as continued protein synthesis throughout life. |
| 4 | There is no correlation between abnormal levels of growth hormone and Alzheimer’s Disease. |
PTS: 1 CON: Mood
- ANS: 4
Chapter: Chapter 2, Biological Implications
Objective: Describe the role of neurotransmitters in human behavior.
Page: 31
Heading: Psychoneuroimmunology > Acetylcholine
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Mood
Difficulty: Moderate
| Feedback | |
| 1 | Abnormal levels of serotonin do not cause memory deficits and decreased motor functions. |
| 2 | Abnormal levels of dopamine do not cause memory deficits and decreased motor functions. |
| 3 | Abnormal levels of norepinephrine do not cause memory deficits and decreased motor functions. |
| 4 | The nurse should correlate memory deficits and decreased motor function with decreased levels of acetylcholine. Acetylcholine is a major chemical effector of the autonomic nervous system. Functions of acetylcholine include sleep regulation, pain perception, the modulation and coordination of movement, and memory. |
PTS: 1 CON: Mood
- ANS: 4
Chapter: Chapter 2, Biological Implications
Objective: Discuss the physiology of neurotransmitters in human behavior.
Page: 21
Heading: Monoamines > Norepinephrine
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Mood
Difficulty: Moderate
| Feedback | |
| 1 | A decrease in norepinephrine would not lead to mania. |
| 2 | A decrease in norepinephrine would not lead to schizophrenia. |
| 3 | A decrease in norepinephrine would not lead to generalized anxiety disorder. |
| 4 | The nurse should recognize that a decrease in norepinephrine level would play a significant role in the development of major depressive disorder. The functions of norepinephrine include the regulation of mood, cognition, perception, locomotion, cardiovascular functioning, and sleep and arousal. |
PTS: 1 CON: Mood
- ANS: 1
Chapter: Chapter 2, Biological Implications
Objective: Discuss the physiology of neurotransmitters in human behavior.
Page: 21, 24
Heading: Psychoneuroimmunology > Dopamine
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Mood
Difficulty: Moderate
| Feedback | |
| 1 | The nurse should expect that an increase in dopamine activity might play a significant role in the development of schizophrenia spectrum disorder. Functions of dopamine include regulation of emotions, coordination, and voluntary decision-making ability. Increased dopamine activity is also associated with mania. |
| 2 | Increased dopamine activity is not associated with major depressive disorder. |
| 3 | Increased dopamine activity is not associated with body dysmorphic disorder. |
| 4 | Increased dopamine activity is not associated with Parkinson’s disease. |
PTS: 1 CON: Mood
MULTIPLE RESPONSE
- ANS: 1, 3
Chapter: Chapter 2, Biological Implications
Objective: Discuss the association of endocrine functioning to the development of psychiatric disorders.
Page: 29
Headings: Growth Hormone > Gonadotropic Hormones
Integrated Processes: Teaching and Learning
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Mood
Difficulty: Moderate
| Feedback | |
| 1. | The nurse should explain to the client that there is a possible correlation between anorexia nervosa and decreased levels of growth hormones. |
| 2. | There is no correlation between anorexia nervosa and antidiuretic hormone levels. |
| 3. | Research shows that there is possible correlation between low levels of gonadotropin and anorexia nervosa. |
| 4. | There is no correlation between anorexia nervosa and increased prolactin levels. |
| 5. | There is no correlation between anorexia nervosa and altered levels of oxytocin. |
PTS: 1 CON: Mood
- ANS: 1, 2
Chapter: Chapter 2, Biological Implications
Objective: Discuss the association of endocrine functioning to the development of psychiatric disorders.
Page: 28
Heading: Neuroendocrinology > The Anterior Pituitary (Adenohypophysis)
Integrated Processes: Teaching and Learning
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Mood
Difficulty: Moderate
| Feedback | |
| 1. | The nurse should associate depression with decreased levels of TSH. |
| 2. | The nurse should associate fatigue with decreased levels of TSH. |
| 3. | Decreased libido is associated with decreased levels of TSH. |
| 4. | Mania is not associated with decreased levels of TSH. |
| 5. | Hyperexcitability is not associated with decreased levels of TSH. |
PTS: 1 CON: Mood
COMPLETION
- ANS:
Psychobiology
Chapter: Chapter 2 Biological Implications
Objective: Discuss the implications of psychobiological concepts to the practice of psychiatric/mental health nursing.
Page: 15
Heading: Introduction
Integrated Processes: Teaching and Learning
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Mood
Difficulty: Moderate
Feedback: Psychobiology is the study of the biological foundations of cognitive, emotional, and behavioral processes. In recent years, a greater emphasis has been placed on the study of the organic basis for psychiatric illness.
PTS: 1 CON: Mood
Chapter 4: Psychopharmacology
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. When used in combination with anxiolytic medication, alcohol leads to _____________ effects, and caffeine leads to _______________ effects.
| 1. | increased; increased |
| 2. | increased; decreased |
| 3. | decreased; decreased |
| 4. | decreased; increased |
____ 2. A client was recently admitted to the inpatient unit after a suicide attempt. He has been placed on a tricyclic antidepressant. In terms of medication, what steps should be taken to maintain the client’s safety when he is discharged?
| 1. | Provide a 6-month supply to ensure long-term compliance. |
| 2. | Provide a 1-week supply of medication, with refills authorized only after he visits his provider. |
| 3. | Encourage him to increase fluid intake to counteract the common side effect of diarrhea. |
| 4. | Educate him not to eat foods that contain tyramine. |
____ 3. A client was recently admitted to the inpatient unit after a suicide attempt and is prescribed a selective serotonin reuptake inhibitor (SSRI). The nurse teaches the client about serotonin syndrome. Which of the following is a symptom of serotonin syndrome?
| 1. | Change in mental status |
| 2. | Myoclonus |
| 3. | Blood pressure lability |
| 4. | Priapism |
____ 4. A client was recently admitted to the inpatient unit after a suicide attempt and has not responded to SSRIs or tricyclic antidepressants. The client asks the nurse, “I heard about monoamine oxidase inhibitors (MAOIs). Why can’t they be added to what I am on now? Wouldn’t adding one help?” Which is the appropriate nursing response?
| 1. | “Electroconvulsive therapy is your best option at this point.” |
| 2. | “Combined use can lead to a life-threatening condition called hypertensive crisis.” |
| 3. | “There is no reason why an MAOI couldn’t be added to your therapy.” |
| 4. | “They can’t be used together because their mechanisms of action are very different.” |
____ 5. A client began taking lithium for the treatment of bipolar disorder approximately 1 month ago and asks why he has gained 12 lbs. since then. Which is the appropriate nursing response?
| 1. | “I’m surprised you have gained; weight loss is the typical pattern when taking lithium.” |
| 2. | “Your weight gain is more likely related to food intake than medication.” |
| 3. | “Weight gain is a common, but troubling side effect. Let’s talk about some strategies for safely improving your nutrition and exercise habits.” |
| 4. | “There’s not much you can do about the weight gain. It’s better than being emotionally unstable, though.” |
____ 6. The nurse is assessing a client who has a diagnosis of schizophrenia and takes an antipsychotic agent daily. Which finding requires further nursing assessment?
| 1. | Respirations of 22 beats/minute |
| 2. | Weight gain of 8 lbs. in 2 months |
| 3. | Temperature of 101oF |
| 4. | Excess salivation |
____ 7. An aging client with chronic schizophrenia takes a beta-adrenergic blocking agent (propranolol) for hypertension and an antipsychotic. Given the combined side effects of these drugs, what teaching should the nurse provide?
| 1. | “Make sure you concentrate on taking slow, deep, cleansing breaths.” |
| 2. | “Watch your diet and try to engage in some regular physical activity.” |
| 3. | “Rise slowly when you change position from lying to sitting or sitting to standing.” |
| 4. | “Wear sunscreen and try to avoid midday sun exposure.” |
____ 8. A client with depression and substance abuse has an interrupted sleep pattern. She demands that her psychiatrist prescribe her a sedative. What teaching would the nurse provide about the rationale for the use of nonpharmacological interventions instead?
| 1. | “Sedative-hypnotics are potentially addictive and gradually lose their effectiveness as one builds up tolerance to them.” |
| 2. | “Sedative-hypnotics work best in combination with other techniques.” |
| 3. | “Sedative-hypnotics are not permitted for use in patients with substance abuse disorders.” |
| 4. | “Sedative-hypnotics are not as effective as the antidepressant medications for treating sleep disturbances.” |
____ 9. Which statement about the tricyclic group of antidepressant medications is accurate?
| 1. | Strong or aged cheese should not be eaten while taking them. |
| 2. | Their full therapeutic potential may not be reached until 4 weeks. |
| 3. | They may cause hypomania or recent memory impairment. |
| 4. | They should not be given with antianxiety agents. |
____ 10. A client was admitted with major depression that was a single episode and moderate. During her stay, she was started on Prozac (fluoxetine) at 40 mg orally every day. The nurse’s discharge teaching should include all of the following except:
| 1. | Continue taking Prozac as prescribed. You will continue to see improvement over the next few weeks. |
| 2. | Make sure that you follow up with outpatient psychotherapy as you and the social worker have arranged. |
| 3. | You may be able to discontinue the medication within 6 months to 1 year, but only under a doctor’s supervision. However, there is a chance of recurring episodes. |
| 4. | You should avoid foods with tyramine, including beer, beans, processed meats, and red wine. |
____ 11. In the treatment of anxiety disorders, benzodiazepines (such as Ativan and Xanax) are indicated for_________ use and have__________ abuse potential.
| 1. | short-term; high |
| 2. | long-term; high |
| 3. | short-term; low |
| 4. | long-term; low |
____ 12. Which medication does not require periodic blood-level monitoring?
| 1. | Eskalith (lithium carbonate) |
| 2. | Depakote (valproic acid) |
| 3. | Clozaril (clozapine) |
| 4. | Paxil (paroxetine) |
____ 13. As part of discharge teaching, which guideline regarding lithium therapy will the nurse plan to include?
| 1. | Avoid excessive use of beverages containing caffeine. |
| 2. | Maintain a consistent sodium intake. |
| 3. | Consume at least 2,500 to 3,000 mL of fluid per day. |
| 4. | All of the above |
____ 14. A client with schizophrenia has recently begun a new medication, clozapine (Clozaril). Which potentially fatal side effect will the nurse teach the client about?
| 1. | Agranulocytosis |
| 2. | Akathisia |
| 3. | Dystonia |
| 4. | Akinesia |
____ 15. A client with schizophrenia has recently begun a new medication, clozapine (Clozaril). Which signs and symptoms of a potentially fatal side effect will the nurse teach the client about?
| 1. | Blurring vision and muscular weakness |
| 2. | Sore throat, fever, and malaise |
| 3. | Tremor, shuffling gait, and rigidity |
| 4. | Fine tremor, tinnitus, and nausea |
____ 16. A client with schizophrenia has recently begun a new medication, clozapine (Clozaril). Which blood cell counts would reveal a potentially fatal side effect of this medication?
| 1. | WBCs, >3,000/mm3; granulocytes, >2,000/mm3 |
| 2. | WBCs, <3,000/mm3; granulocytes, >2,000/mm3 |
| 3. | WBCs, >3,000/mm3; granulocytes, <2,000/mm3 |
| 4. | WBCs, <3,000/mm3; granulocytes, <2,000/mm3 |
____ 17. A psychiatrist prescribes a MAOI for a client. When teaching the client about the effects of tyramine, which foods will the nurse caution the client to avoid?
| 1. | Pepperoni pizza and red wine |
| 2. | Bagels with cream cheese and tea |
| 3. | Apple pie and coffee |
| 4. | Potato chips and Diet Coke |
____ 18. A client has been diagnosed with major depression and is prescribed imipramine (Tofranil). What information specifically related to this class of antidepressants will the nurse plan to include in client and family education?
| 1. | The medication may cause dry mouth. |
| 2. | The medication may cause nausea. |
| 3. | The medication should not be discontinued abruptly. |
| 4. | The medication may cause photosensitivity. |
____ 19. Which information suggests that caution is necessary in prescribing a benzodiazepine to an anxious client?
| 1. | The client has a history of alcohol dependence. |
| 2. | The client has a history of diabetes mellitus. |
| 3. | The client has a history of schizophrenia. |
| 4. | The client has a history of hypertension. |
____ 20. Which medication is most likely to be prescribed for the extrapyramidal side effects of antipsychotic medications?
| 1. | Diazepam (Valium) |
| 2. | Amitriptyline (Elavil) |
| 3. | Benztropine (Cogentin) |
| 4. | Methylphenidate (Ritalin) |
____ 21. A client takes a maintenance dosage of lithium carbonate for a bipolar disorder. She has come to the community health clinic, stating that she “has had the flu for over a week.” She describes her symptoms as coughing, runny nose, chest congestion, fever, and gastrointestinal upset. Her temperature is 100.9°F. What situation does the nurse anticipate?
| 1. | She has consumed some foods high in tyramine. |
| 2. | She has stopped taking her lithium carbonate. |
| 3. | She has probably developed a tolerance to the lithium carbonate. |
| 4. | The lithium carbonate may be producing symptoms of toxicity. |
____ 22. Joey, age 8 years, takes methylphenidate (Ritalin) for attention deficit/hyperactivity disorder. His mother complains to the nurse that Joey has a very poor appetite, and she struggles to help him gain weight. What teaching will the nurse provide?
| 1. | Administer Joey’s medication immediately after meals. |
| 2. | Administer Joey’s medication at bedtime. |
| 3. | Skip a dose of the medication when Joey does not eat anything. |
| 4. | Assure Joey’s mother that Joey will eat when he is hungry. |
____ 23. A client is experiencing a psychotic episode. He is in good physical health but has allergies to penicillin, prochlorperazine (Compazine), and bee stings. Which antipsychotic medication would be contraindicated for the client?
| 1. | Haloperidol, because it is used only in elderly patients |
| 2. | Clozapine, because it is incompatible with desipramine |
| 3. | Risperidone, because it exacerbates symptoms of depression |
| 4. | Thioridazine, because of cross-sensitivity among phenothiazines |
____ 24. A physician prescribes an additional medication for a client taking an antipsychotic agent. The medication is to be administered “prn for EPS.” When will the nurse plan to give this medication?
| 1. | When the client’s white blood cell count falls below 3,000/mm3 |
| 2. | When the client exhibits tremors and a shuffling gait |
| 3. | When the client complains of dry mouth |
| 4. | When the client experiences a seizure |
____ 25. A client is diagnosed with anxiety disorder. Which medication is prescribed for anxiety?
| 1. | Chlorpromazine (Thorazine) |
| 2. | Clozapine (Clozaril) |
| 3. | Diazepam (Valium) |
| 4. | Methylphenidate (Ritalin) |
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 26. The nurse is preparing to assess a client before the physician prescribes a regimen of psychopharmacological therapy. Which components will the nurse assess? (Select all that apply.)
| 1. | Medical history |
| 2. | Physical examination findings |
| 3. | Ethnocultural characteristics |
| 4. | Current medication |
Chapter 4: Psychopharmacology
Answer Section
MULTIPLE CHOICE
- ANS: 2
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antianxiety agents.
Page: 67
Heading: Interactions
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analysis [Analyzing]
Concept: Addiction and Behaviors
Difficulty: Easy
| Feedback | |
| 1 | Alcohol leads to increased effects and caffeine leads to decreased effects. |
| 2 | Anxiolytic medications work through depression of certain central nervous system (CNS) functions. Alcohol, which is a CNS depressant, would increase/potentiate their effects. Caffeine, which is a CNS stimulant, would decrease/inhibit their effects. |
| 3 | Alcohol leads to increased effects and caffeine leads to decreased effects |
| 4 | Alcohol leads to increased effects and caffeine leads to decreased effects. |
PTS: 1 CON: Addiction and Behaviors
- ANS: 2
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antidepressants.
Page: 69
Heading: Clinical Pearl
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analysis [Analyzing]
Concept: Stress
Difficulty: Easy
| Feedback | |
| 1 | A limited supply should be given to reduce the risk for suicide. |
| 2 | To prevent suicide through overdose on antidepressant medication, a limited supply should be given at discharge. Clients with a history of depression who have a lifting of mood may have an increased risk for suicide. Giving the client a larger supply of antidepressant medication increases the chances of overdose. |
| 3 | Although increasing fluid intake is generally a way to promote health, it will not decrease the client’s risk for suicide. |
| 4 | Avoiding foods with tyramine will not decrease the chances of suicide. |
PTS: 1 CON: Stress
- ANS: 4
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antidepressants.
Page: 69
Heading: Clinical Pearl
Integrated Processes: Nursing Process: Teaching and Learning
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Application [Applying]
Concept: Violence
Difficulty: Easy
| Feedback | |
| 1 | Change in mental status is not a symptom of serotonin syndrome. |
| 2 | Myoclonus is not a symptom of serotonin syndrome. |
| 3 | Blood pressure lability is not a symptom of serotonin syndrome. |
| 4 | Impotence may be a side effect of an SSRI antidepressant. |
PTS: 1 CON: Violence
- ANS: 2
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antidepressants.
Page: 70
Heading: Table 4-4 Drug Interactions with SSRIs
Integrated Processes: Nursing Processes: Teaching/Learning
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Application [Applying]
Concept: Violence
Difficulty: Easy
| Feedback | |
| 1 | This statement does not provide accurate information to the client. |
| 2 | If MAOIs are taken with other antidepressants, a hypertensive crisis could result. |
| 3 | The statement is false; use of an MAOI with an SSRI could cause harm to the client. |
| 4 | This statement is not therapeutic or accurate. |
PTS: 1 CON: Violence
- ANS: 3
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: mood-stabilizing agents.
Page: 74
Heading: Lithium Maintenance
Integrated Processes: Nursing Processes: Teaching and Learning
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Application [Applying]
Concept: Mood
Difficulty: Easy
| Feedback | |
| 1 | Weight gain is typical with lithium treatment. |
| 2 | While a healthy diet is helpful at reducing weight gain, this side effect is common with lithium treatment. |
| 3 | Weight gain is a common side effect of lithium therapy. To ensure compliance the nurse should help the client develop strategies to prevent excessive weight gain. |
| 4 | This statement is not therapeutic to the client. |
PTS: 1 CON: Mood
- ANS: 3
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antipsychotics.
Page: 80–81
Heading: Table 4-12 Safety Issues in Planning and Implementing Care for Clients Taking, Antipsychotic Medication
Integrated Processes: Nursing Processes: Caring
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Application [Applying]
Concept: Mood
Difficulty: Moderate
| Feedback | |
| 1 | This finding is considered normal. |
| 2 | Slow weight gain is not concerning. |
| 3 | A fever could be one of the first signs of an infection caused by reduced immunity from agranulocytosis secondary to antipsychotic medication. |
| 4 | This symptom is not life-threatening. |
PTS: 1 CON: Mood
- ANS: 3
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antipsychotics.
Page: 80–81
Heading: Table 4-12 Safety Issues in Planning and Implementing Care for Clients Taking, Antipsychotic Medication
Integrated Processes: Nursing Processes: Teaching and Learning
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Easy
| Feedback | |
| 1 | This will not prevent the client from having a syncopal episode. |
| 2 | While watching diet is important, it will not prevent the client from suffering from propranolol side effects. |
| 3 | The antipsychotic medication can cause orthostatic hypotension that could be magnified by the propranolol. |
| 4 | Wearing sunscreen will not prevent syncopal episodes. |
PTS: 1 CON: Health Promotion
- ANS: 1
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: sedative-hypnotics.
Page: 85
Heading: Contraindications/Precautions
Integrated Processes: Nursing Processes: Teaching and Learning
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Easy
| Feedback | |
| 1 | Sedative-hypnotics are potentially addictive and should be used with caution by clients with a history of substance abuse. Tolerance can easily develop. |
| 2 | This statement is not accurate regarding sedative-hypnotics. |
| 3 | Sedative-hypnotics can become habit forming. |
| 4 | This statement is misleading to the client. |
PTS: 1 CON: Health Promotion
- ANS: 2
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antidepressants.
Page: 67
Heading: Applying the Nursing Process in Psychopharmacological Therapy > Antianxiety Agents
Integrated Processes: Nursing Processes: Communication and Documentation
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analysis [Analyzing]
Concept: Health Promotion
Difficulty: Easy
| Feedback | |
| 1 | This statement is misleading to the client. |
| 2 | It may take several weeks for tricyclic medications to reach their full therapeutic effect. |
| 3 | These medications do not cause hypomania or recent memory impairment. |
| 4 | These medications can be administered with antianxiety agents. |
PTS: 1 CON: Health Promotion
- ANS: 4
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antidepressants.
Page: 71
Heading: Table 4-7. Diet Restrictions for Clients on MAOI Therapy.
Integrated Processes: Nursing Processes: Teaching and Learning
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Easy
| Feedback | |
| 1 | The client should see improvement over the next few weeks. |
| 2 | The client should follow up as scheduled. |
| 3 | The client should only discontinue the medication under a doctor’s supervision. |
| 4 | This is true regarding MAOIs, not an SSRI antidepressant, such as fluoxetine. |
PTS: 1 CON: Health Promotion
- ANS: 1
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antidepressants.
Page: 71
Heading: Table 4-7.
Integrated Processes: Nursing Processes: Teaching and Learning
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Easy
| Feedback | |
| 1 | Because tolerance to these medications occurs, there is high risk for abuse. Therefore, they should be used as a short-term intervention for anxiety. |
| 2 | Benzodiazepines should not be used for long-term treatment of anxiety. |
| 3 | Benzodiazepines have high abuse potential. |
| 4 | Benzodiazepines should not be used for long-term treatment of anxiety, as they have high abuse potential. |
PTS: 1 CON: Health Promotion
- ANS: 4
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antidepressants.
Page: 77
Heading: Lithium Maintenance, Clozaril and the risk for agranulocytosis, Table 4-10 Safety Issues and Nursing Interventions for Clients Taking Mood Stabilizers.
Integrated Processes: Nursing Processes: Communication and Documentation
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Comprehension
Concept: Health Promotion
Difficulty: Easy
| Feedback | |
| 1 | Blood level monitoring is required for Eskalith (lithium carbonate) |
| 2 | Blood level monitoring is required for Depakote (valproic acid) |
| 3 | Blood level monitoring is required for Clozaril (clozapine). |
| 4 | Blood level monitoring is usually not done for Paxil (paroxetine). |
PTS: 1 CON: Health Promotion
- ANS: 4
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: mood stabilizers.
Page: 77
Headings: Interactions, Table 4-10 Safety Issues and Nursing Interventions for Clients Taking Mood Stabilizers.
Integrated Processes: Nursing Processes: Communication and Documentation
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analysis [Analyzing]
Concept: Health Promotion
Difficulty: Easy
| Feedback | |
| 1 | The client should avoid excessive use of beverages containing caffeine. |
| 2 | The client should maintain a consistent sodium intake. |
| 3 | The client should consume at least 2,500 to 3,000 mL of fluid per day. |
| 4 | Caffeine, a stimulant, should be limited in clients with mania. Adequate sodium and fluid intake is necessary to prevent lithium toxicity. |
PTS: 1 CON: Health Promotion
- ANS: 1
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antipsychotics.
Page: 81
Heading: Clozaril and risk for agranulocytosis
Integrated Processes: Nursing Processes: Teaching/Learning
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Easy
| Feedback | |
| 1 | Agranulocytosis is a potentially fatal disorder in which the client’s white blood cell count drops to extremely low levels, placing the client at great risk for infections. |
| 2 | The client is not at risk for akathisia. |
| 3 | The client is not at risk for dystonia. |
| 4 | The client is not at risk for akinesia. |
PTS: 1 CON: Health Promotion
- ANS: 2
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antipsychotics.
Page: 81
Heading: Table 4-12 Safety Issues in Planning and Implementing Care for Clients Taking Antipsychotic Medications.
Integrated Processes: Nursing Process: Teaching and Learning
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Easy
| Feedback | |
| 1 | Blurred vision and muscular weakness are not side effects of clozapine (Clozaril). |
| 2 | These are symptoms of agranulocytosis, which is a potentially fatal disorder in which the client’s white blood cell count drops to extremely low levels. This places the client at great risk for infections. |
| 3 | Tremor, shuffling gait, and rigidity are not side effects of clozapine (Clozaril). |
| 4 | Fine tremor, tinnitus, and nausea are not side effects of clozapine (Clozaril). |
PTS: 1 CON: Health Promotion
- ANS: 4
Chapter: Chapter 4 Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antidepressants.
Page: 81
Heading: Clozaril and risk for agranulocytosis.
Integrated Processes: Nursing Processes: Communication and Documentation
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Easy
| Feedback | |
| 1 | The following results do not indicate agranulocytosis: WBCs, >3,000/mm3; granulocytes, >2,000/mm3. |
| 2 | The following results do not indicate agranulocytosis: WBCs, <3,000/mm3; granulocytes, >2,000/mm3. |
| 3 | The following results do not indicate agranulocytosis: WBCs, >3,000/mm3; granulocytes, <2,000/mm3. |
| 4 | These blood test results are indicative of agranulocytosis, a potentially fatal disorder in which the client’s white blood cell count drops to extremely low levels. |
PTS: 1 CON: Health Promotion
- ANS: 1
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antipsychotics.
Page: 71
Heading: Table 4-7. Diet Restrictions for Clients on MAOI Therapy.
Integrated Processes: Nursing Processes: Teaching and Learning
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Easy
| Feedback | |
| 1 | Both these foods are high in tyramine. |
| 2 | Bagels with cream cheese and tea are not high in tyramine. |
| 3 | Apple pie and coffee are not high in tyramine. |
| 4 | Potato chips and Diet Coke are not high in tyramine. |
PTS: 1 CON: Health Promotion
- ANS: 4
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antidepressants.
Page: 71
Heading: Others (Heterocyclics and SNRIs.)
Integrated Processes: Nursing Processes: Communication and Documentation
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analysis [Analyzing]
Concept: Health Promotion
Difficulty: Easy
| Feedback | |
| 1 | This medication does not cause dry mouth. |
| 2 | This medication does not cause nausea. |
| 3 | This medication can be discontinued under a doctor’s supervision. |
| 4 | Tricyclic antidepressants cause photosensitivity. |
PTS: 1 CON: Health Promotion
- ANS: 1
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antipsychotics.
Page: 81
Heading: Issues in Antipsychotic Maintenance Therapy.
Integrated Processes: Nursing Processes: Caring
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analysis [Analyzing]
Concept: Addiction and Behaviors
Difficulty: Easy
| Feedback | |
| 1 | Tolerance and psychological dependence are common problems with the long-term use of benzodiazepines. They should be used cautiously with clients who have a history of substance abuse. |
| 2 | Clients with a history of diabetes mellitus can still take benzodiazepines. |
| 3 | Clients with a history of schizophrenia can still take benzodiazepines. |
| 4 | Clients with a history of hypertension can still take benzodiazepines. |
PTS: 1 CON: Addiction and Behaviors
- ANS: 3
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: Antipsychotics.
Page: 83
Heading: Applying the Nursing Process in Psychopharmacological Therapy > Antianxiety Agents
Integrated Processes: Nursing Processes: Communication and Documentation
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analysis [Analyzing]
Concept: Health Promotion
Difficulty: Easy
| Feedback | |
| 1 | Diazepam (Valium) would not be prescribed for the extrapyramidal side effects of antipsychotic medications. |
| 2 | Amitriptyline (Elavil) would not be prescribed for the extrapyramidal side effects of antipsychotic medications. |
| 3 | Benztropine (Cogentin) is one of the most commonly used medications for extrapyramidal side effects. |
| 4 | Methylphenidate (Ritalin) would not be prescribed for the extrapyramidal side effects of antipsychotic medications. |
PTS: 1 CON: Health Promotion
- ANS: 4
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antipsychotics.
Page: 77
Headings: Lithium Maintenance, Clozaril and the risk for agranulocytosis, Table 4-10 Safety Issues and Nursing Interventions for Clients Taking Antipsychotics
Integrated Processes: Nursing Processes: Teaching and Learning
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analysis [Analyzing]
Concept: Health Promotion
Difficulty: Easy
| Feedback | |
| 1 | The nurse would not anticipate the cause to be foods high in tyramine. |
| 2 | Discontinuation of lithium carbonate is not likely. |
| 3 | The development of tolerance to lithium carbonate is not likely. |
| 4 | Blurred vision, gastrointestinal upset, and tinnitus are symptoms of lithium toxicity. |
PTS: 1 CON: Health Promotion
- ANS: 1
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antipsychotics.
Page: 89
Heading: Applying the Nursing Process in Psychopharmacological Therapy > Agents for Attention Deficit/Hyperactivity Disorder (ADHD)
Integrated Processes: Nursing Process: Teaching and Learning
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Application[Applying]
Concept: Health Promotion
Difficulty: Easy
| Feedback | |
| 1 | To reduce the anorexia associated with methylphenidate (Ritalin), the medication should be given after meals. |
| 2 | Administering Joey’s medication at bedtime could keep him awake at night. |
| 3 | Joey will likely have a decrease in appetite. The medication should be given after breakfast. |
| 4 | Assuring Joey’s mother that he will eat when hungry does not help improve Joey’s appetite. |
PTS: 1 CON: Health Promotion
- ANS: 4
There may be cross-sensitivity among phenothiazines. Both prochlorperazine (Compazine) and thioridazine (Mellaril) are phenothiazines. Since the client has a known allergy to one phenothiazine, he should not be given another phenothiazine. The other options would not be contraindicated because of cross sensitivities.
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antipsychotics.
Page: 78
Heading: Applying the Nursing Process in Psychopharmacological Therapy > Antipsychotic Agents
Integrated Processes: Nursing Process: Communication and Documentation
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Easy
| Feedback | |
| 1 | Haloperidol would not be contraindicated because of cross sensitivities. |
| 2 | Clozapine would not be contraindicated because of cross sensitivities. |
| 3 | Risperidone would not be contraindicated because of cross sensitivities. |
| 4 | There may be cross-sensitivity among phenothiazines. Both prochlorperazine (Compazine) and thioridazine (Mellaril) are phenothiazines. Since the client has a known allergy to one phenothiazine, he should not be given another phenothiazine. |
PTS: 1 CON: Health Promotion
- ANS: 2
Tremors and a shuffling gait are examples of extrapyramidal side effects (EPS). The other options are not examples of extrapyramidal side effects.
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antipsychotics.
Page: 81
Heading: Issues in Antipsychotic Maintenance Therapy
Integrated Processes: Nursing Process: Communication and Documentation
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Easy
| Feedback | |
| 1 | White blood cell count is not an example of an EPS. |
| 2 | Tremors and a shuffling gait are examples of EPS. |
| 3 | Dry mouth is not an extrapyramidal side effect. |
| 4 | Seizure is not an extrapyramidal side effect. |
PTS: 1 CON: Health Promotion
- ANS: 3
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antianxiety agents.
Page: 85
Heading: Action
Integrated Processes: Nursing Process: Communication and Documentation
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Analysis [Analyzing]
Concept: Health Promotion
Difficulty: Easy
| Feedback | |
| 1 | Chlorpromazine (Thorazine) is not an antianxiety agent. |
| 2 | Clozapine (Clozaril) is not an antianxiety agent. |
| 3 | Diazepam (Valium) is an antianxiety agent. |
| 4 | Methylphenidate (Ritalin) is not an antianxiety agent. |
PTS: 1 CON: Health Promotion
MULTIPLE RESPONSE
- ANS: 1, 2, 3, 4
Chapter: Chapter 4, Psychopharmacology Core Concepts
Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antipsychotics.
Page: 64–67
Heading: Apply the steps of the nursing process to the administration of psychotropic medications.
Integrated Processes: Nursing Process: Caring
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Easy
| Feedback | |
| 1. | The nurse should assess medical history. |
| 2. | The nurse should assess physical examination findings. |
| 3. | The nurse should assess ethnocultural characteristics. |
| 4. | The nurse should assess current medications. |
PTS: 1 CON: Health Promotion
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