A patient with a history of refractory depression but no history of cardiovascular disease is admitted to the emergency department with circulatory collapse. For which medication should the nurse should search the patient's medical record as a contributin
A) Tranylcypromine (Parnate)
The nurse searches the medical record for an antidepressant that can cause circulatory collapse, such as tranylcypromine, a monoamine oxidase inhibitor. Circulatory collapse generally occurs as a result of overdose or toxicity
A male surgical patient in the postanesthesia care unit who was given a benzodiazepine is not breathing. What is the nurse's priority after administering the antidote for this medication to the patient?
A) Monitoring for dysrhythmias
B) Taking seizure pre
D) Maintaining oxygen saturation
The nurse's priority is to support the patient's airway and breathing for adequate oxygenation, because reversing the effects of a benzodiazepine does not guarantee the return of breathing. The administration of flumazenil
The serum lithium level of a patient who takes lithium carbonate (Lithobid) is 1.8 mEq/L. The nurse assesses the patient for which clinical indicators consistent with this concentration of the drug? (Choose all that apply.)
A) Frequent diarrhea
B) Minor w
A, C, E, F
The therapeutic drug level for lithium is 1 to1.5 mEq/L. This patient's lithium level is above normal, so the nurse expects to observe clinical indicators of lithium toxicity, including diarrhea, muscle irritability, adherence to the therapeuti
The nurse prepares a patient who is taking sertraline (Zoloft) for discharge. Which instruction should the nurse include in patient teaching?
A) Take sertraline at same time each day.
B) Expect to feel better in 4 to 6 days.
C) Avoid overheating and direc
A) Take sertraline at same time each day.
Sertraline is a selective serotonin reuptake inhibitor, and the patient is most likely to experience therapeutic effectiveness if the medication is taken at the same time every day. The nurse instructs the patient
Just before initiating atypical antipsychotic pharmacotherapy in a male patient, the nurse finds that he has atrial fibrillation. For this reason, the nurse avoids administering antipsychotic agents that cause significant adverse effects involving certain
A, B, C, F
The patient has a cardiac dysrhythmia, so the nurse avoids administering an antipsychotic agent that might affect the cardiovascular system adversely. An antipsychotic agent that stimulates histaminic, muscarinic, serotonergic, or alpha-adrener
A patient with a history of abusing opioid analgesics needs an antianxiety agent. Which medication should the nurse expect to administer?
A) Diazepam (Valium)
B) Buspirone (BuSpar)
C) Venlafaxine (Effexor)
D) Escitalopram (Lexapro)
B) Buspirone (BuSpar)
Because the potential for abuse is low, buspirone is a suitable antianxiety agent for this patient. Diazepam is contraindicated because benzodiazepines are highly addictive. Venlafaxine is a serotonin-norepinephrine reuptake inhibito
A patient is detoxifying from alcohol abuse. Which type of medication is indicated to help the patient through withdrawal?
A) Dibenzapine
B) Benzisoxazole
C) Phenothiazine
D) Benzodiazepine
D) Benzodiazepine
A benzodiazepine is indicated in the management of the clinical manifestations of alcohol withdrawal because of their wide range of therapeutic effects. Dibenzapines, benzisoxazoles, and phenothiazines are antipsychotic agents and are no
A 75-year-old patient is experiencing insomnia. What is the most important reason that the nurse avoids administering a benzodiazepine as a hypnotic agent to this patient?
A) This will increase the risk of drug interactions.
B) Benzodiazepines can offer s
D) Older adults are sensitive to sedating effects.
Older adults tend to be more sensitive than younger people to the sedating effects of benzodiazepines, and, because older adults tend to take more medications than a younger adult, the likelihood that the
Which medication should the nurse avoid administering to a patient who takes phenelzine (Nardil) as a means of helping prevent a hypertensive crisis,?
A) Paroxetine (Paxil)
B) Citalopram (Celexa)
C) Clomipramine (Anafranil)
D) Methylphenidate (Ritalin)
D) Methylphenidate (Ritalin)
The nurse avoids administering methylphenidate to a patient taking a monoamine oxidase inhibitor such as phenelzine to avoid a hypertensive crisis. This is because a sympathomimetic medication such as methyphenidate increases
The nurse administers amitriptyline hydrochloride to a patient with chronic depression. For which potential effects of the medication should the nurse monitor the patient? (Choose all that apply.)
A) Constipation
B) Hypotension
C) Hyperpyrexia
D) Hypergly
A, B, E, F
Amitriptyline is a tricyclic antidepressant that can induce such anticholinergic effects as constipation and urine retention. It can also cause dopaminergic- and adrenergic-blocker effects such as hypotension. Histamine blockade generally cause
A patient takes sertraline (Zoloft) for depression related to chronic pain. The nurse avoids administering which analgesic agent to help prevent serotonin syndrome?
A) Tramadol (Ultram)
B) Ibuprofen (Motrin)
C) Fentanyl (Duragesic)
D) Oxycodone (OxyContin
A) Tramadol (Ultram)
The nurse avoids administering tramadol to a patient who takes a selective serotonin reuptake inhibitor, because it increases the risk for serotonin syndrome. This is because tramadol exerts its analgesia by blocking the reuptake of n
Which piece of subjective data is contraindication to the use of clozapine (Clozaril)?
A) Allergy to phenothiazines
B) Self-destructive behaviors
C) Failed antipsychotic therapy
D) Acute lymphocytic leukemia
D) Acute lymphocytic leukemia
Clozapine is contraindicated in patients with a history of myeloproliferative disorders such as leukemia because this medication can cause fatal agranulocytosis. For this reason, weekly monitoring of the white blood cell (WBC
A male patient tells the nurse that he wants to stop taking citalopram (Celexa) because of the sexual side effects. Which instruction should the nurse provide in patient teaching to help relieve the patient's sexual dysfunction? (Choose all that apply.)
A
B, D, E, F
Sexual dysfunction is managed in several ways, including reduction in the regular dosage, "drug holidays," addition of a medication for erectile dysfunction, change of antidepressant, and avoidance of alcohol. The nurse encourages the patient t
Which patient is a poor candidate for therapy with diazepam (Valium) to treat generalized anxiety disorder?
A) One who had convulsions as a child
B) One with a history of alcoholism
C) One who has had a myocardial infarction
D) One with type 2 diabetes me
B) One with a history of alcoholism
The patient with a history of alcoholism is a poor candidate for therapy with diazepam because of the potential for substance abuse and the adverse effects of therapy. The patient has an addictive personality, meaning t
A male patient taking a monoamine oxidase inhibitor (MAOI) calls the nurse and reports headaches, tachycardia, nausea, and vomiting. Which patient teaching should the nurse implement?
A) Tell the patient to start drinking water.
B) Instruct the patient to
D) Have the patient call for emergency help.
Because the patient may be experiencing a hypertensive crisis related to the administration of the MAOI, the nurse instructs the patient to call 911 for emergency medical assistance. The nurse also instructs th
A patient who takes benztropine (Cogentin) needs an antidepressant. Which medication should the nurse avoid administering to prevent anticholinergic syndrome?
A) Selegiline (Emsam)
B) Duloxetine (Cymbalta)
C) Protriptyline (Vivactil)
D) Buproprion (Wellbu
C) Protriptyline (Vivactil)
Benztropine is a anticholinergic agent used in the treatment of Parkinson's disease. Tricyclic antidepressants can cause anticholinergic syndrome when combined with benztropine because they block cholinergic receptors. Selegili
A patient taking risperidone (Risperdal) has a necrotic foot ulcer that started as a minor scratch. Which of the following patient data should the nurse check to help prevent complications of the pharmacotherapy?
A) Leukocyte count
B) Liver function studi
C) Fasting blood glucose
Atypical antipsychotics can cause diabetes mellitus because they tend to impair glucose metabolism. Therefore the nurse checks the blood glucose level in a patient who presents with a deteriorating wound, because diabetes impairs
A female patient who takes lorazepam (Ativan) for anxiety tells the nurse that she plans to become pregnant. What is the best instruction for the nurse to give the patient?
A) Visit a women's healthcare provider.
B) Taper off the drug before conception.
C
B) Taper off the drug before conception.
The best instruction for the nurse to provide includes health promotion for the mother and fetus, so the nurse instructs the patient to taper off therapy as a means of avoiding the adverse effects of withdrawal and
A patient receives a prescription for quetiapine (Seroquel). Which instruction should the nurse include in patient teaching about self-administration of this medication?
A) Report abnormal movements.
B) Take the medication as needed for agitation.
C) Avoi
A) Report abnormal movements.
The nurse instructs the patient to report abnormal movements, which may indicate serious adverse effects of antipsychotic medications, including neuroleptic malignant syndrome, extrapyramidal symptoms, and tardive dyskinesia.
A patient takes venlafaxine (Effexor XL). Which medication does the nurse avoid administering because it acts on the same receptors in the brain as venlafaxine?
A) Warfarin (Coumadin)
B) Sumatriptan (Imitrex)
C) Fosphenytoin (Cerebyx)
D) Hydromorphone (Di
B) Sumatriptan (Imitrex)
The nurse avoids administering a serotonin receptor agonist such as sumatriptan to a patient receiving a selective serotonin reuptake inhibitor (SSRI) such as venlafaxine in an effort to prevent serotonin syndrome, a potentially l
Which of the following phenomena does the nurse recognize as positive symptoms of schizophrenia? (Choose all that apply.)
A) Hallucinations
B) Muscle rigidity
C) Restless activity
D) Chaotic thinking
E) Defective insight
F) Social withdrawal
A, D, E
Positive symptoms of schizophrenia include psychotic behaviors such as hallucinations. They also include conceptual disorganization, such as chaotic thinking and poor insight. Negative symptoms include social withdrawal and catatonia characterized
A male patient asks the nurse how long it will take for escitalopram (Lexapro) to be completely effective for him. Which time frame should the nurse include in patient teaching?
A) 1 week
B) 2 or 3 days
C) 2 or 3 months
D) Several weeks
D) Several weeks
Feedback: CORRECT
The nurse instructs the patient to adhere to therapy for several weeks to determine whether escitalopram will be an effective antidepressant for him. Escitalopram is a selective serotonin reuptake inhibitor (SSRIs), and
After benzodiazepine treatment fails, the nurse administers buspirone (BuSpar) to a patient with an anxiety disorder. What patient teaching should the nurse provide to help the patient realize the full benefit of buspirone therapy?
A) Avoid taking seroton
D) Self-administer buspirone on a consistent basis.
The nurse instructs the patient to take buspirone daily and to adhere to the dosing schedule to realize the full benefit of therapy, because consistent dosing is important in achieving the full therapeut
Which of the following benefits are desired effects of instructing a patient with depression to take the daily dose of clomipramine (Anafranil) at bedtime? (Choose all that apply.)
A) Helps the patient adhere to therapy
B) Causes significant sedation
C) R
A, B
The advantages of taking a tricyclic antidepressant (TCA) at bedtime are twofold: (1) It is easier for the patient to remember to take the medication, facilitating adherence and (2) it promotes sleep by causing maximal sedation at night. Bedtime dosi
A patient who has been taking alprazolam (Xanax) and has been compliant with the therapeutic regimen for 6 weeks is now complaining of adverse effects of the medication. Which of the following substances does the nurse instruct the patient to avoid to hel
A, B, D, E
Because they are also central nervous system (CNS) depressants, the nurse instructs the patient to avoid alcohol, opioids, antihistamines, and muscle relaxants because, when taken together with alprazolam they can cause significant CNS depressi
A female patient who has been taking lithium carbonate (Lithobid) for 1 week tells the nurse that she is experiencing dizziness. What is the best nursing intervention to implement in this situation?
A) Tell the patient to continue therapy.
B) Direct the p
B) Direct the patient to change positions slowly.
As a means of maintaining the patient's safety, the most important nursing intervention is instructing the patient to change positions slowly to prevent dizziness. Once action has been taken to maintain pa
A patient who is taking an atypical antipsychotic agent for schizophrenia presents with a poorly healing leg ulcer and hyperglycemia. Which atypical antipsychotic agent is the best medication for the nurse to administer?
A) Olanzapine (Zyprexa)
B) Quetiap
A) Olanzapine (Zyprexa)
The best atypical antipsychotic agent for the nurse to administer in this case is ziprasidone, which has the least significant impact on patient weight and therefore on glucose metabolism. Olanzapine carries one of the highest risk
A male patient taking lorazepam (Ativan) reports lethargy and confusion. Which action should the nurse implement next?
A) Tell the patient that the symptoms will dissipate gradually.
B) Plan nursing care to manage a benzodiazepine overdose.
C) Ask the pat
C) Ask the patient how many doses he has taken in the past 8 hours.
The nurse's next intervention is to investigate the patient's complaint completely before planning or implementing nursing care, because nursing care is based on patient assessment data.
A patient who is has taken fluoxetine (Prozac) for 2 weeks to treat an anxiety disorder complains that he is not satisfied with the therapy. What is the best information for the nurse to include in patient teaching to promote adherence to the therapeutic
D) A therapeutic effect is expected 2 to 4 weeks after the start of therapy.
The full therapeutic effects of selective serotonin reuptake inhibitor (SSRI) therapy may take 4 to 6 weeks to appear, so this patient can anticipate experiencing a therapeutic e
What is the most important benefit of taking a parenteral formulation of an antipsychotic medication?
A) Fewer doses needed for therapy
B) More likely to adhere to therapy
C) Better chance of effectiveness
D) Injected as a long-acting agent
B) More likely to adhere to therapy
The primary benefit of administering an injectable form of an antipsychotic agent is that patient adherence to therapy improves because fewer doses are required to achieve therapeutic effectiveness. Parenteral antipsych
A female patient with psychosis is experiencing adverse effects of conventional antipsychotic pharmacotherapy, including dystonia, akathisia, and abnormal limb movements. The nurse collaborates with psychiatrist to enact a change in therapy. Which medicat
C) Risperidone (Risperdal)
Risperidone is the best medication for this patient; she is experiencing dopamine receptor-related adverse effects of a conventional antipsychotic agent, and risperidone has strong antidopaminergic properties, as well as antiadr
A patient with schizophrenia is does not adhere to the pharmacotherapy regimen. Which potential cause of nonadherence is the nurse's priority because it is the most difficult to improve?
A) High incidence of adverse side effects
B) Inability to realize th
B) Inability to realize the need for therapy
The nurse's priority is the promotion of continued pharmacotherapy. Because a cure does not exist, a patient with schizophrenia is likely to have altered thought processes that impair his or her ability to reco
Which medication is used as first-line therapy?
A) Sertraline (Zoloft)
B) Haloperidol (Haldol)
C) Meprobamate (Miltown)
D) Chlorpromazine (Thorazine)
A) Sertraline (Zoloft)
Sertraline, a selective serotonin reuptake inhibitor, is a first-line therapy for depression. Haloperidol and chlorpromazine are conventional antipsychotic agents but not first-line therapies for psychosis. Meprobamate is an anxioly
What is the main receptor in the central nervous sytem (CNS) to be blocked by conventional antipsychotic drugs?
A) Serotonin
B) Dopamine
C) Acetylcholine
D) Norepinephrine
B) Dopamine
Conventional antipsychotic agents block dopamine receptors, primarily in the CNS. The blockade of dopamine receptors is responsible for the therapeutic and toxic effects of these medications. Atypical antipsychotic agents block dopamine-2 rece