Chapter 12: Psychopharmacology, Dietary Supplements, and Biologic Interventions

Format: Multiple Choice

Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies

Cognitive Level: Understand

Integrated Process: Nursing Process

Objective: 2

Page and Header: 169–171, Clinical Concepts

1. A nurse is performing an admission assessment. The client reports taking larger and larger doses of medication to get the desired effect. Based on this information, the nurse interprets this as suggesting what possible outcome?

A) Desensitization

B) Tolerance

C) Decreased therapeutic index

D) Toxicity

Page and Header: 178, Side Effects, Adverse Reactions, and Toxicity

2. An older adult reports anxiety and is prescribed diazepam by a primary care provider. The office nurse is asked to explain to the client the problematic side effects of this medication. Which instruction about this drug would be most important for the nurse to emphasize?

A) “You may experience minor urine incontinence from time to time.”

B) “You may find that you have temporary memory disturbances.”

C) “You need to use this medication cautiously because it can cause dependence.”

D) “You may feel dizzy and be prone to falls after taking this medication.”

Page and Header: 171, Absorption and Routes of Administration

3. A nurse is caring for a psychiatric client who is prescribed an antipsychotic agent. The client is also receiving an antacid that contains aluminum salts. Which action by the nurse would be most appropriate?

A) Give the antacid 1 hour before the antipsychotic medication.

B) Give the antacid at the same time as the antipsychotic medication.

C) Administer the antacid 1 hour after the antipsychotic medication.

D) Administer the antacid just before the client goes to sleep.

Page and Header: 166, Target Symptoms and Side Effects

4. A client is prescribed medication for a psychiatric disorder. After 3 days, the client reports being constipated. Which instruction would the nurse give the client?

A) “You need to eat more high-protein foods such as meat and peanut butter.”

B) “You need to eat more fruits and vegetables and drink more water.”

C) “Ask your psychiatrist to prescribe a stool softener for you.”

D) “This side effect should disappear within a week or so.”

Page and Header: 174, Age

5. A nurse is caring for a psychiatric client age 70 years who has been prescribed a number of medications. When educating the client on the medications, which explanation would be most appropriate?

A) “Your stomach empties more quickly as you age; therefore, you may feel the effect of your medications almost immediately.”

B) “Your entire GI system speeds up, so your medications are digested much more quickly. Therefore, it is important that you not drive after you take your medications.”

C) “Because of your age and related changes in liver functioning, you may have medication levels in your system with the potential to be toxic.”

D) “Because of age-related circulation changes, your body will be able to deliver therapeutic doses of your medication to select body sites more quickly.”

Page and Header: 179, Weight Gain

6. A client has been prescribed clozapine for treatment of schizophrenia. Which would the nurse include in the education plan for this client and family?

A) “You may experience hypertension while taking this medication.”

B) “One of the side effects of this medication is breast engorgement.”

C) “People taking this medication often experience dermatitis.”

D) “You may experience noticeable weight gain while taking this medication.”

Page and Header: 179–180, Blood Disorders

7. A client who has been taking clozapine for 6 weeks visits the clinic reporting fever, sore throat, and mouth sores. The nurse notifies the client’s physician because the nurse suspects what possible side effect of the medication?

A) Severe anemia

B) Neuroleptic malignant syndrome

C) Encephalitis

D) Agranulocytosis

Page and Header: 180–182, Acute Extrapyramidal Symptoms

8. A hospitalized client who has been taking an antipsychotic medication for 2 weeks begins pacing and walking throughout the unit. The client tells the nurse, “I cannot sit still.” The nurse documents this finding using what term?

A) Akinesia

B) Dystonia

C) Pseudoparkinsonism

D) Akathisia

Page and Header: 182, Chronic Syndromes: Tardive Dyskinesia

9. A nurse observes an older adult client who has been taking antipsychotic medications for 4 years. The nurse sees the client’s lips smacking and eyes blinking rapidly. The nurse also observes a protruding tongue. Which action by the nurse would be most appropriate?

A) Ask whether the client has been experiencing side effects.

B) Contact the client’s physician for a different medication order.

C) Document the client’s symptoms of possible tardive dyskinesia.

D) Instruct the client to begin tapering the medication.

Page and Header: 166, Drug Regulation and Use

10. A nurse is working as part of a team involved with the testing of a new psychiatric medication. The drug is currently being used in multiple clinical trials at various different sites. The nurse is engaged in which phase of testing?

A) Phase I

B) Phase II

C) Phase III

D) Phase IV

Page and Header: 200, Summary of Key Points

11. A psychiatric–mental health nurse practitioner is conducting a class on the pharmacodynamics of psychiatric medications for a group of psychiatric–mental health nurses. The nurse practitioner determines that additional education is needed when the group identifies which as a site of action?

A) Receptor

B) Ion channels

C) Neurotransmitters

D) Enzymes

Page and Header: 200, Summary of Key Points

12. A nurse is reviewing information about a psychiatric medication that describes the amount of the drug that actually reaches systemic circulation unchanged. The nurse identifies this using what term?

A) First-pass effect

B) Bioavailability

C) Solubility

D) Biotransformation

Page and Header: 180–182, Acute Extrapyramidal Symptoms

13. A client receiving an antipsychotic agent develops acute extrapyramidal symptoms. Which response by the nurse would be most appropriate?

A) “These symptoms are not real; the medication makes your brain think they are real.”

B) “You have developed an allergy to the medication, so we need to change it.”

C) “These are the results of the drug and can be treated; your illness is not getting worse.”

D) “The sunlight together with the medication has caused these symptoms; just stay indoors.”

Page and Header: 183–184, Pharmacokinetics

14. A nurse administers a prescribed dose of lithium at 8 p.m. The nurse would schedule a specimen to be obtained for a blood concentration at which time?

A) 10 p.m.

B) 12 p.m.

C) 4 p.m.

D) 8 a.m.

Page and Header: 185, Antidepressant Medications

15. A client is brought to the emergency department by a sibling, who reports that the client became very agitated and “started hallucinating.” Further assessment reveals tachycardia, incoordination, vomiting, and diarrhea. The sibling states that the client is taking paroxetine for depression. Which would the nurse most likely suspect?

A) Neuroleptic malignant syndrome

B) Acute dystonic reaction

C) Serotonin syndrome

D) Hypothyroidism

Page and Header: 170, Table 12.2. Drug Actions on Neurotransmitters

16. After teaching a client who is prescribed imipramine about the drug, the nurse determines that the education was effective when the client makes which statement?

A) “I need to be careful because the drug can make me sleepy.”

B) “I don’t have to worry about getting dizzy when I get up from lying down.”

C) “I might notice some excess saliva in my mouth at different times.”

D) “I need to avoid foods with fiber because diarrhea can occur.”

Page and Header: 196, Herbal Therapies

17. A client diagnosed with depression asks a nurse about possible herbal supplements. Which supplement would the nurse identify as being commonly used?

A) Valerian

B) St. John’s wort

C) Kava

D) Melatonin

Page and Header: 182, Box 12.4 Risk Factors for Tardive Dyskinesia

18. A nurse is reviewing the medical records of several clients receiving antipsychotic agents. Which factors, if noted, would the nurse identify as placing a client at greater risk for tardive dyskinesia?

A) Male gender

B) Age 30 to 45 years

C) History of depression

D) Short duration of treatment

Page and Header: 190, Table 12.10. Example of a Tyramine-Restricted Diet

19. After educating a client who is receiving phenelzine, the nurse determines that the education was successful when the client states the need to avoid consuming which food or beverage?

A) Fresh cottage cheese

B) Cooked sliced ham

C) Tap beers

D) Soy milk

Page and Header: 175–176, Stabilization Phase

20. During the stabilization phase of drug therapy for a client who is hospitalized with a psychiatric disorder, which action would be most appropriate?

A) Discussing the timing of tapering the medication

B) Instructing the client about relapse prevention

C) Determining whether the medication is losing its effect

D) Assessing the client for target symptoms and side effects

Page and Header: 183, Lithium

21. A group of nursing students are reviewing information related to drug therapy for mood disorders. The students demonstrate understanding of the information when they identify which agent as the gold standard for treating bipolar disorder?

A) Carbamazepine

B) Lithium

C) Valproate

D) Lamotrigine

Page and Header: 176, Antipsychotic Medications

22. A client is experiencing hallucinations and delusions. The nurse would expect the prescribing health care provider to order which class of drug?

A) Mood stabilizer

B) Antipsychotic

C) Antianxiety agent

D) Stimulant

Page and Header: 186, Table 12.8. Antidepressant Medications

23. A nurse is preparing a continuing education presentation about various psychopharmacologic agents for a group of psychiatric–mental health nurses. The nurse is planning to discuss selective serotonin reuptake inhibitors. Which agents would the nurse include in this group? Select all that apply.

A) Fluoxetine

B) Duloxetine

C) Sertraline

D) Venlafaxine

E) Bupropion

F) Amoxapine

Page and Header: 198, Box 12.5 Interventions for the Patient Receiving Electroconvulsive Therapy

24. A nurse is preparing a client for electroconvulsive therapy. Which would the nurse include in the client’s plan of care? Select all that apply.

A) Ensuring that there is a signed informed consent on the client’s chart

B) Telling the client only fluids, not food, are allowed before the procedure

C) Alerting the client to the possibility of confusion after the treatment

D) Informing the client that dentures can remain in place for the treatment

E) Ensuring that the client is closely supervised for at least the first 12 hours afterward

Page and Header: 191, Table 12.11. Antianxiety and Sedative–Hypnotic Medications

25. A group of nurses is reviewing the various drug classes used to treat psychiatric disorders. The nurses demonstrate understanding when they identify which as examples of antianxiety medications? Select all that apply.

A) Selegiline

B) Lorazepam

C) Buspirone

D) Zolpidem

E) Methylphenidate