Holland/Adams/Brice, Core Concepts in Pharmacology 5th Edition Test Bank
Chapter 12

Question 1

Type: MCSA

The nurse is caring for a client with delusions, hallucinations, paranoia, disorganized behavior, and difficulty relating to others. The nurse identifies these symptoms as indicative of which disorder?

1. ADHD
2. Psychosis
3. Bipolar disorder
4. Depression

Cognitive Level: Understanding

Client Need: Psychosocial Integrity

Page Number: 162

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 12-1 Identify the signs characteristic of psychosis, and describe how psychotic episodes are controlled.

Question 2

Type: MCSA

The nurse is caring for a client with psychosis-like symptoms. Which explanation of these symptoms to the family is the most appropriate?

1. The only causes for psychosis are delusions, illusions, and disorganized behaviors.
2. Psychotic symptoms are only seen in clients with schizoaffective disorder.
3. Psychosis-like symptoms can be caused by trauma, overdoses of certain medications, and brain damage.
4. Psychotic symptoms are only seen in clients who become hospitalized.

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Page Number: 162

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-1 Identify the signs characteristic of psychosis, and describe how psychotic episodes are controlled.

Question 3

Type: MCMA

A schizophrenic client is being assessed by the nurse. The client is demonstrating positive symptoms. Which symptoms would be considered positive? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Hallucinations
2. Lack of interest
3. Disorganized thoughts
4. Unresponsiveness
5. Confused speech

Cognitive Level: Understand

Client Need: Psychosocial Integrity

Page Number: 163

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 12-2 Compare and contrast the positive and negative symptoms of schizophrenia, and explain the cause of schizophrenia and related behaviors.

Question 4

Type: MCMA

A schizophrenic client is being assessed by the nurse. The client is demonstrating negative symptoms. Which symptoms would be considered negative? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Delusions
2. Irrational actions
3. Lack of interest
4. Neglect of personal hygiene
5. Hyperactivity

Cognitive Level: Understanding

Client Need: Psychosocial Integrity

Page Number: 163

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 12-2 Compare and contrast the positive and negative symptoms of schizophrenia, and explain the cause of schizophrenia and related behaviors.

Question 5

Type: MCMA

Positive symptoms of schizophrenia are most effectively controlled by which medications? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Chlorpromazine (Thorazine)
2. Perphenazine (Phenazine)
3. Clonidine (Catapres)
4. Citalopram (Celexa)
5. Amitriptyline (Elavil)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 165

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-3 Discuss factors important to the successful management of psychosis, including the major generations of antipsychotics.

Question 6

Type: MCSA

A client with schizophrenia exhibits positive and negative symptoms. The nurse anticipates which drug to be prescribed for this client?

1. Chlorpromazine (Thorazine)
2. Clozapine (Clozaril)
3. Thioridazine (Mellaril)
4. Clonidine (Catapres)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 170

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-3 Discuss factors important to the successful management of psychosis, including the major generations of antipsychotics.

Question 7

Type: MCSA

Which statement is true regarding schizophrenia?

1. There appears to be a genetic component to schizophrenia.
2. There is not a genetic component to schizophrenia.
3. Schizophrenia is caused by a brain tumor.
4. It is caused by underactive dopaminergic pathways found in the basal nuclei.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 162

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-2 Compare and contrast the positive and negative symptoms of schizophrenia, and explain the cause of schizophrenia and related behaviors.

Question 8

Type: MCMA

What are the primary goals of pharmacotherapy for patients diagnosed with schizophrenia? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Cure schizophrenia.
2. Reduce psychotic symptoms to a level that allows the patient to maintain normal social relationships.
3. Increase delusional symptoms.
4. Reduce psychotic symptoms to a level that allows the patient to perform self-care.
5. Decrease psychotic symptoms so the patient can maintain employment.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Page Number: 165

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-3 Discuss factors important to the successful management of psychosis, including the major generations of antipsychotics.

Question 9

Type: MCSA

Which medication has less EPS and anticholinergic symptoms than haloperidol (Haldol)?

1. Thiothixene (Navane)
2. Loxapine (Loxitane)
3. Pimozide (Orap)
4. Aripiprazole (Abilify)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 172

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-3 Discuss factors important to the successful management of psychosis, including the major generations of antipsychotics.

Question 10

Type: MCMA

The nurse is preparing to assess a client exhibiting extrapyramidal adverse effects. The nurse expects to see which symptoms? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Dry mouth
2. Akathisia
3. Parkinsonism
4. Tardive dyskinesia
5. Incontinence

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 167

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 12-4 Explain the goals of conventional, atypical and third-generation antipsychotic drugs; identify representative drugs, and explain their mechanisms of drug action, primary actions, and important adverse effects including extrapyramidal symptoms.

Question 11

Type: MCMA

A female client has been prescribed risperidone (Risperdal). The physician monitors the client for increased prolactin levels. The nurse anticipates which symptoms to be present in a female client with increased prolactin levels? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Menstrual disorders
2. Decreased libido
3. Sense of euphoria
4. Osteoporosis
5. Facial hair

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 172

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-4 Explain the goals of conventional, atypical and third-generation antipsychotic drugs; identify representative drugs, and explain their mechanisms of drug action, primary actions, and important adverse effects including extrapyramidal symptoms.

Question 12

Type: MCSA

Haloperidol (Haldol) has been prescribed for an elderly client. What does the nurse expect in regards to the initial dose?

1. Two times the adult dose
2. One-half the adult dose
3. Withheld due to client age
4. The same as an adult dose

Cognitive Level: Remember

Client Need: Physiological Integrity

Page Number: 168

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-4 Explain the goals of conventional, atypical and third-generation antipsychotic drugs; identify representative drugs, and explain their mechanisms of drug action, primary actions, and important adverse effects including extrapyramidal symptoms.

Question 13

Type: MCSA

The client receives ziprasidone (Geodon). What is priority teaching at time of discharge?

1. To avoid drinking alcohol
2. To be on a low-fat diet
3. To stop smoking
4. To exercise at least 60 minutes per day

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 173

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-4 Explain the goals of conventional, atypical and third-generation antipsychotic drugs; identify representative drugs, and explain their mechanisms of drug action, primary actions, and important adverse effects including extrapyramidal symptoms.

Question 14

Type: MCSA

The client receives clozapine (Clozaril). Which clinical finding is most important for the nurse to report immediately?

1. Increased appetite
2. Sore throat
3. Drowsiness
4. Constipation

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 171

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-4 Explain the goals of conventional, atypical and third-generation antipsychotic drugs; identify representative drugs, and explain their mechanisms of drug action, primary actions, and important adverse effects including extrapyramidal symptoms.

Question 15

Type: MCSA

The client receives clozapine (Clozaril). Before this drug is administered, the nurse should check which lab data?

1. Serum protein
2. Renal function
3. Liver function
4. White blood count

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 171

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 12-4 Explain the goals of conventional, atypical and third-generation antipsychotic drugs; identify representative drugs, and explain their mechanisms of drug action, primary actions, and important adverse effects including extrapyramidal symptoms.

Question 16

Type: MCSA

A client receives risperidone (Risperdal). The nurse observes that the client is experiencing severe muscle spasms of the back and neck. Which nursing action is a priority for this client?

1. Administer an additional dose of risperidone (Risperdal).
2. Withhold risperidone (Risperdal) until the symptoms subside.
3. Encourage the client to take a warm shower to relax the muscles.
4. Administer benztropine (Cogentin) IM.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 167

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-4 Explain the goals of conventional, atypical and third-generation antipsychotic drugs; identify representative drugs, and explain their mechanisms of drug action, primary actions, and important adverse effects including extrapyramidal symptoms.

Question 17

Type: MCSA

The client has a medical diagnosis of schizophrenia, and receives aripiprazole (Abilify). What is the primary expected client outcome related to dopamine reduction?

1. Client will have reduced psychotic behavior.
2. Client will have improved sleep patterns.
3. Client will decrease anxiety.
4. Client will improve social relationships.

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 172

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 12-4 Explain the goals of conventional, atypical and third-generation antipsychotic drugs; identify representative drugs, and explain their mechanisms of drug action, primary actions, and important adverse effects including extrapyramidal symptoms.

Question 18

Type: MCSA

A client has been prescribed chlorpromazine (Thorazine). The client asks the nurse when the medication will become effective. Based on the knowledge of the medication, which response by the nurse is most appropriate?

1. In 7–8 weeks
2. Immediately
3. Within a few days
4. In 6 months

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 166

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-4 Explain the goals of conventional, atypical and third-generation antipsychotic drugs; identify representative drugs, and explain their mechanisms of drug action, primary actions, and important adverse effects including extrapyramidal symptoms.

Question 19

Type: MCSA

A client is being discharged home with a prescription for chlorpromazine (Thorazine). What should the nurse instruct this client to avoid?

1. Increased fiber intake
2. Chewing gum
3. Caffeine
4. Increased fluids

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 169

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-4 Explain the goals of conventional, atypical and third-generation antipsychotic drugs; identify representative drugs, and explain their mechanisms of drug action, primary actions, and important adverse effects including extrapyramidal symptoms.

Question 20

Type: MCSA

The nurse administers an IM dose of risperidone (Risperdal) to a client. How long until the nurse will need to administer another dose?

1. 1 day
2. 3 weeks
3. 4–6 weeks
4. 1–2 weeks

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 171

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-4 Explain the goals of conventional, atypical and third-generation antipsychotic drugs; identify representative drugs, and explain their mechanisms of drug action, primary actions, and important adverse effects including extrapyramidal symptoms.

Question 21

Type: MCMA

Which statements are true regarding chlorpromazine (Thorazine)? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Many clients overdose on this medication.
2. Delay in achieving an orgasm.
3. Anticholinergic effects such as dry mouth, postural hypotension, and urinary retention are common.
4. Chlorpromazine (Thorazine) has a wide safety margin between a therapeutic and a lethal dose.
5. This drug will cause psychological dependence.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 166

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-4 Explain the goals of conventional, atypical and third-generation antipsychotic drugs; identify representative drugs, and explain their mechanisms of drug action, primary actions, and important adverse effects including extrapyramidal symptoms.

Question 22

Type: MCMA

According to the nurse, which side effects are possible for a client receiving a dopamine system stabilizer? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Drowsiness
2. Diarrhea
3. Constipation
4. Nausea
5. Vomiting

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 172

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-4 Explain the goals of conventional, atypical and third-generation antipsychotic drugs; identify representative drugs, and explain their mechanisms of drug action, primary actions, and important adverse effects including extrapyramidal symptoms.

Question 23

Type: MCSA

Which drug class can cause bone marrow suppression?

1. Nonphenothiazine drugs
2. Atypical antipsychotic drugs
3. Phenothiazine drugs
4. Beta blockers

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 173

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-4 Explain the goals of conventional, atypical and third-generation antipsychotic drugs; identify representative drugs, and explain their mechanisms of drug action, primary actions, and important adverse effects including extrapyramidal symptoms.

Question 24

Type: MCSA

Which drug class can cause diabetes mellitus type II?

1. Atypical antipsychotic drugs
2. Phenothiazine drugs
3. Beta blockers
4. Nonphenothiazine drugs

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 172

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-4 Explain the goals of conventional, atypical and third-generation antipsychotic drugs; identify representative drugs, and explain their mechanisms of drug action, primary actions, and important adverse effects including extrapyramidal symptoms.