Psychiatric Medications Questions

Q: A patient admitted to the hospital is exhibiting psychotic behavior. Which sign(s) and/or symptom(s) would support the diagnosis of psychosis? (Select one that does not apply.)

Correct answer: A. Constant eye contact during the admission history does not support the diagnosis of psychosis. Psychosis is characterized by impaired social functioning, hallucinations, and delusions, not by maintaining consistent eye contact, which typically indicates normal social engagement rather than a psychotic symptom. B: Deterioration of social functioning strongly indicates psychosis because it reflects withdrawal and impaired interpersonal relationships common in psychotic disorders. C: Reporting that the FBI solicited secret information exemplifies a delusion, a false belief characteristic of psychosis, reinforcing this option as relevant to the diagnosis. D: Confirmation of hearing voices represents auditory hallucinations, a hallmark symptom of psychosis, thereby supporting the diagnosis rather than contradicting it.

Q: A female client is 3-days postoperative and has been receiving meperidine (Demerol) for pain control. The family mentions to the nurse that the client has been taking phenelzine (Nardil) for years for her depression. The client did not list this medi…

Correct answer: D. Sedation, disorientation, and hallucinations are signs of a serious reaction between meperidine and phenelzine. This combination can cause serotonin syndrome, characterized by altered mental status, neuromuscular abnormalities, and autonomic dysfunction. The nurse should monitor for these neurological symptoms to prevent complications and ensure prompt intervention, as this interaction can be life-threatening if unrecognized. A: Increased pulse and respirations reflect sympathetic stimulation, not the central nervous system depression seen in this drug interaction. B: Hyperactivity and difficulty concentrating suggest stimulant effects, inconsistent with the sedative and neurotoxic symptoms caused by this medication combination. C: Increased tearing and increased urinary output are unrelated autonomic responses and do not correspond to the expected neuropsychiatric manifestations in this case.

Q: A selective serotonin reuptake inhibitor is prescribed for a patient. The nurse knows that which drug is a selective serotonin reuptake inhibitor?

Correct answer: A. Paroxetine is a selective serotonin reuptake inhibitor. Paroxetine specifically inhibits the reuptake of serotonin at the synaptic cleft, increasing serotonin levels in the brain, which improves mood and anxiety symptoms. It is widely used for depression and anxiety disorders, fitting the SSRI class. Its pharmacological action distinctly separates it from other antidepressants with different mechanisms of action. B: Amitriptyline is a tricyclic antidepressant affecting multiple neurotransmitters, mainly norepinephrine and serotonin, but lacks the selective serotonin reuptake inhibition characteristic of SSRIs. C: Divalproex sodium is an anticonvulsant and mood stabilizer, primarily used for epilepsy and bipolar disorder, not targeting serotonin reuptake. D: Bupropion hydrochloride acts mainly on dopamine and norepinephrine reuptake inhibition, without significant serotonin reuptake inhibition, thus not classified as an SSRI.

Q: is a side effect that can occur while a client is taking an antipsychotic medication, causing muscle rigidity, high fever, unstable vital signs, confusion, and agitation.

Correct answer: B. Neuroleptic malignant syndrome (NMS) is a side effect that can occur while a client is taking an antipsychotic medication, causing muscle rigidity, high fever, unstable vital signs, confusion, and agitation. NMS is a rare but life-threatening reaction characterized by severe muscle stiffness, hyperthermia, autonomic dysfunction, and altered mental status, differentiating it from other extrapyramidal symptoms linked to antipsychotics. Prompt recognition is critical for effective treatment. A: Drug-induced parkinsonism involves tremors, bradykinesia, and rigidity but lacks the systemic signs like high fever and autonomic instability seen in NMS. It is a chronic, less acute condition. C: Tardive dyskinesia manifests as involuntary, repetitive movements, particularly of the face and tongue, without the life-threatening fever or confusion characteristic of NMS. D: Dystonia presents with sustained muscle contractions and abnormal postures, typically early in treatment, but does not include fever, autonomic instability, or altered mental status seen in NMS.

Q: The nurse suspects that a patient who is experiencing facial grimacing, involuntary upward eye movement, and muscle spasms of the tongue and face may have which condition?

Correct answer: C. Tardive dyskinesia is characterized by involuntary movements such as facial grimacing, upward eye movements, and muscle spasms of the tongue and face. This condition typically occurs as a delayed side effect of long-term antipsychotic use, distinguishing it from other extrapyramidal symptoms through its chronic, repetitive, and often irreversible nature affecting primarily the orofacial muscles. A: Akathisia involves a subjective feeling of restlessness and an uncontrollable need to move, without the presence of muscle spasms or involuntary facial movements described here. B: Acute dystonia presents with sudden muscle contractions and abnormal postures but typically occurs shortly after antipsychotic initiation and lacks the repetitive, chronic movements evident in this case. D: Pseudoparkinsonism mimics Parkinson’s disease symptoms like tremor and rigidity but does not involve the characteristic facial grimacing and tongue spasms seen in the patient’s presentation.

Q: The constitute a class of drugs that are commonly prescribed for cardiac arrhythmias but also have been found to be effective treatment for social phobias.

Correct answer: D. Beta-blockers constitute a class of drugs that are commonly prescribed for cardiac arrhythmias but also have been found to be effective treatment for social phobias. Beta-blockers reduce physical symptoms of anxiety like rapid heartbeat and trembling, making them suitable for social phobia management, especially in performance situations. Their cardiovascular and anxiolytic effects align with this dual therapeutic use. A: Benzodiazepines primarily target anxiety through sedative and hypnotic effects, but they are not specifically used for cardiac arrhythmias nor are they the first-line treatment for social phobias. B: Tricyclics are antidepressants used for depression and some anxiety disorders but lack the direct cardiac arrhythmia indication and are not the primary option for social phobia. C: Azaspirones, such as buspirone, treat generalized anxiety disorder but do not address cardiac arrhythmias or social phobia with the same efficacy as beta-blockers.

Q: In preparing discharge planning for a client who has been prescribed lithium for the treatment of bipolar disorder, the nurse must be sure that the client demonstrates an understanding of the need to monitor his or her diet for intake of:

Correct answer: D. The nurse must ensure the client understands the need to monitor sodium intake while taking lithium. Lithium levels in the blood are closely affected by sodium balance; low sodium can lead to lithium toxicity, while high sodium can reduce lithium effectiveness. Maintaining consistent sodium consumption helps stabilize lithium levels and prevents adverse effects, crucial for safe bipolar disorder management. A: potassium. Potassium intake does not significantly affect lithium levels or toxicity risk, making it less critical for monitoring during lithium therapy compared to sodium. B: carbohydrates. Carbohydrates influence energy and blood sugar but have no direct impact on lithium serum concentrations or toxicity, thus not relevant for lithium dietary monitoring. C: protein. Protein consumption affects general health but does not alter lithium excretion or blood levels, so it is not a necessary focus in lithium-related diet planning.

Q: When educating a client being treated with lithium, which item(s) in his or her diet should be monitored or avoided?

Correct answer: C. Clients on lithium therapy should monitor or avoid hot dogs and ham. Lithium levels are influenced by sodium intake, and processed meats like hot dogs and ham are high in sodium, which can affect lithium excretion and levels in the body. Maintaining a consistent sodium intake helps prevent toxicity or subtherapeutic lithium effects, making dietary sodium control crucial during treatment. A: Fresh fruit Fresh fruits generally have low sodium content and do not significantly influence lithium levels. They provide necessary nutrients without posing a risk to lithium balance or causing fluctuations in serum lithium concentrations. B: Whole milk Whole milk contains minimal sodium and does not interfere with lithium pharmacokinetics. It supplies calcium and vitamins but does not impact lithium excretion or absorption, making it safe for clients undergoing lithium treatment. D: Fresh vegetables Fresh vegetables are low in sodium and unlikely to disrupt lithium levels. They contribute essential vitamins and minerals without altering lithium metabolism, thus not requiring dietary restrictions or special monitoring during therapy.

Question 1

A patient admitted to the hospital is exhibiting psychotic behavior. Which sign(s) and/or symptom(s) would support the diagnosis of psychosis? (Select one that does not apply.)

Rationale:

Constant eye contact during the admission history does not support the diagnosis of psychosis. Psychosis is characterized by impaired social functioning, hallucinations, and delusions, not by maintaining consistent eye contact, which typically indicates normal social engagement rather than a psychotic symptom. B: Deterioration of social functioning strongly indicates psychosis because it reflects withdrawal and impaired interpersonal relationships common in psychotic disorders. C: Reporting that the FBI solicited secret information exemplifies a delusion, a false belief characteristic of psychosis, reinforcing this option as relevant to the diagnosis. D: Confirmation of hearing voices represents auditory hallucinations, a hallmark symptom of psychosis, thereby supporting the diagnosis rather than contradicting it.

Question 2

A female client is 3-days postoperative and has been receiving meperidine (Demerol) for pain control. The family mentions to the nurse that the client has been taking phenelzine (Nardil) for years for her depression. The client did not list this medication on admission. What signs and symptoms should the nurse look for in case of reaction between these two medications?

Rationale:

Sedation, disorientation, and hallucinations are signs of a serious reaction between meperidine and phenelzine. This combination can cause serotonin syndrome, characterized by altered mental status, neuromuscular abnormalities, and autonomic dysfunction. The nurse should monitor for these neurological symptoms to prevent complications and ensure prompt intervention, as this interaction can be life-threatening if unrecognized. A: Increased pulse and respirations reflect sympathetic stimulation, not the central nervous system depression seen in this drug interaction. B: Hyperactivity and difficulty concentrating suggest stimulant effects, inconsistent with the sedative and neurotoxic symptoms caused by this medication combination. C: Increased tearing and increased urinary output are unrelated autonomic responses and do not correspond to the expected neuropsychiatric manifestations in this case.

Question 3

A selective serotonin reuptake inhibitor is prescribed for a patient. The nurse knows that which drug is a selective serotonin reuptake inhibitor?

Rationale:

Paroxetine is a selective serotonin reuptake inhibitor. Paroxetine specifically inhibits the reuptake of serotonin at the synaptic cleft, increasing serotonin levels in the brain, which improves mood and anxiety symptoms. It is widely used for depression and anxiety disorders, fitting the SSRI class. Its pharmacological action distinctly separates it from other antidepressants with different mechanisms of action. B: Amitriptyline is a tricyclic antidepressant affecting multiple neurotransmitters, mainly norepinephrine and serotonin, but lacks the selective serotonin reuptake inhibition characteristic of SSRIs. C: Divalproex sodium is an anticonvulsant and mood stabilizer, primarily used for epilepsy and bipolar disorder, not targeting serotonin reuptake. D: Bupropion hydrochloride acts mainly on dopamine and norepinephrine reuptake inhibition, without significant serotonin reuptake inhibition, thus not classified as an SSRI.

Question 4

is a side effect that can occur while a client is taking an antipsychotic medication, causing muscle rigidity, high fever, unstable vital signs, confusion, and agitation.

Rationale:

Neuroleptic malignant syndrome (NMS) is a side effect that can occur while a client is taking an antipsychotic medication, causing muscle rigidity, high fever, unstable vital signs, confusion, and agitation. NMS is a rare but life-threatening reaction characterized by severe muscle stiffness, hyperthermia, autonomic dysfunction, and altered mental status, differentiating it from other extrapyramidal symptoms linked to antipsychotics. Prompt recognition is critical for effective treatment. A: Drug-induced parkinsonism involves tremors, bradykinesia, and rigidity but lacks the systemic signs like high fever and autonomic instability seen in NMS. It is a chronic, less acute condition. C: Tardive dyskinesia manifests as involuntary, repetitive movements, particularly of the face and tongue, without the life-threatening fever or confusion characteristic of NMS. D: Dystonia presents with sustained muscle contractions and abnormal postures, typically early in treatment, but does not include fever, autonomic instability, or altered mental status seen in NMS.

Question 5

The nurse suspects that a patient who is experiencing facial grimacing, involuntary upward eye movement, and muscle spasms of the tongue and face may have which condition?

Rationale:

Tardive dyskinesia is characterized by involuntary movements such as facial grimacing, upward eye movements, and muscle spasms of the tongue and face. This condition typically occurs as a delayed side effect of long-term antipsychotic use, distinguishing it from other extrapyramidal symptoms through its chronic, repetitive, and often irreversible nature affecting primarily the orofacial muscles. A: Akathisia involves a subjective feeling of restlessness and an uncontrollable need to move, without the presence of muscle spasms or involuntary facial movements described here. B: Acute dystonia presents with sudden muscle contractions and abnormal postures but typically occurs shortly after antipsychotic initiation and lacks the repetitive, chronic movements evident in this case. D: Pseudoparkinsonism mimics Parkinson’s disease symptoms like tremor and rigidity but does not involve the characteristic facial grimacing and tongue spasms seen in the patient’s presentation.

Question 6

The constitute a class of drugs that are commonly prescribed for cardiac arrhythmias but also have been found to be effective treatment for social phobias.

Rationale:

Beta-blockers constitute a class of drugs that are commonly prescribed for cardiac arrhythmias but also have been found to be effective treatment for social phobias. Beta-blockers reduce physical symptoms of anxiety like rapid heartbeat and trembling, making them suitable for social phobia management, especially in performance situations. Their cardiovascular and anxiolytic effects align with this dual therapeutic use. A: Benzodiazepines primarily target anxiety through sedative and hypnotic effects, but they are not specifically used for cardiac arrhythmias nor are they the first-line treatment for social phobias. B: Tricyclics are antidepressants used for depression and some anxiety disorders but lack the direct cardiac arrhythmia indication and are not the primary option for social phobia. C: Azaspirones, such as buspirone, treat generalized anxiety disorder but do not address cardiac arrhythmias or social phobia with the same efficacy as beta-blockers.

Question 7

In preparing discharge planning for a client who has been prescribed lithium for the treatment of bipolar disorder, the nurse must be sure that the client demonstrates an understanding of the need to monitor his or her diet for intake of:

Rationale:

The nurse must ensure the client understands the need to monitor sodium intake while taking lithium. Lithium levels in the blood are closely affected by sodium balance; low sodium can lead to lithium toxicity, while high sodium can reduce lithium effectiveness. Maintaining consistent sodium consumption helps stabilize lithium levels and prevents adverse effects, crucial for safe bipolar disorder management. A: potassium. Potassium intake does not significantly affect lithium levels or toxicity risk, making it less critical for monitoring during lithium therapy compared to sodium. B: carbohydrates. Carbohydrates influence energy and blood sugar but have no direct impact on lithium serum concentrations or toxicity, thus not relevant for lithium dietary monitoring. C: protein. Protein consumption affects general health but does not alter lithium excretion or blood levels, so it is not a necessary focus in lithium-related diet planning.

Question 8

When educating a client being treated with lithium, which item(s) in his or her diet should be monitored or avoided?

Rationale:

Clients on lithium therapy should monitor or avoid hot dogs and ham. Lithium levels are influenced by sodium intake, and processed meats like hot dogs and ham are high in sodium, which can affect lithium excretion and levels in the body. Maintaining a consistent sodium intake helps prevent toxicity or subtherapeutic lithium effects, making dietary sodium control crucial during treatment. A: Fresh fruit Fresh fruits generally have low sodium content and do not significantly influence lithium levels. They provide necessary nutrients without posing a risk to lithium balance or causing fluctuations in serum lithium concentrations. B: Whole milk Whole milk contains minimal sodium and does not interfere with lithium pharmacokinetics. It supplies calcium and vitamins but does not impact lithium excretion or absorption, making it safe for clients undergoing lithium treatment. D: Fresh vegetables Fresh vegetables are low in sodium and unlikely to disrupt lithium levels. They contribute essential vitamins and minerals without altering lithium metabolism, thus not requiring dietary restrictions or special monitoring during therapy.