NUR 425 PHARM PSYCH FINAL STUDY GUIDE NOTES EXAM

NU 425 PHARM PSYCH FINAL STUDY GUIDE/NOTES Pharm Kee study guide 23 1. A patient’s wandering and hostility levels have increased per family reports. What should concern the nurse in this patient who is taking memantine (Namenda) 10 mg/d? - The patient is not taking enough of the medication 2. What statement by the patient indicates an understanding of how to relieve some side effects associated with the use of benzotropine mesylate (Cogentin)? “I can suck on hard candy or chew sugarless gum to prevent dry mouth” Pharm Kee 27 1. The nurse is caring for a patient who has begun taking chlorpromazine HCl (Thorazine) 75 mg BID to treat schizophrenia. A family member tells the nurse that the patient’s agitation, hallucinations, and delusional symptoms have improved, but the patient continues to withdraw from social interaction and won’t bathe unless reminded to do so. The nurse will tell the family member that a. all symptoms will eventually resolve over time with this medication. b. the patient may need an increased dose of the antipsychotic medication. c. these results may indicate that the patient does not have schizophrenia. d. they should consider discussing adding another medication. ANS: D 2. The nurse is assessing a young adult patient with schizophrenia who recently began taking fluphenazine (Prolixin). The patient is exhibiting spasms of facial muscles along with grimacing, and the nurse notes upward eye movements. The nurse suspects which side effect? a. Acute dystonia b. Akathisia c. Pseudoparkinsonism d. Tardive dyskinesia ANS: A 3. The nurse is preparing to administer loxapine (Loxitane) 50 mg to a patient who has schizophrenia. The patient has been taking this medication twice daily for 15 months. The nurse notes smacking lip movements and involuntary movements of all extremities. Which action by the nurse is correct? a. Administer the medication as ordered to treat these symptoms of psychosis. b. Hold the dose and notify the provider of these medication adverse effects. c. Request an order for an anticholinergic medication such as benztropine (Cogentin). d. Suggest that the provider increase the dose to 125 mg twice daily. ANS: B 4. A patient who takes loxapine (Loxitane) to treat schizophrenia is noted to be restless and fidgety and is pacing around the room. The nurse caring for this patient will perform which action? a. Contact the provider to discuss changing to benztropine (Cogentin). b. Notify the provider of these symptoms and request an order for lorazepam (Ativan). c. Question the patient about adherence to the drug regimen. d. Recognize these signs of a serious adverse drug reaction and notify the provider. ANS: B 5. A patient arrives in the emergency department with dehydration. The patient reports taking fluphenazine (Prolixin) to treat schizophrenia. The nurse notes rigid muscles and an altered mental status. The patient has a temperature of 103.6° F, a heart rate of 98 beats per minute, and a blood pressure of 90/58 mm Hg. The nurse will anticipate administering which medication? a. Dantrolene (Dantrium) b. Haloperidol (Haldol) c. Propranolol (Inderal) d. Tetrabenazine (Xenazine) ANS: A 6. The parent of a young adult who has schizophrenia is concerned that the patient spits out pills that are given. The nurse will suggest contacting the patient’s provider to discuss which intervention? a. Changing to a liquid form of the mediation b. Providing a home health nurse to supervise medication administration c. Teaching the patient the importance of taking the medication d. Weekly intramuscular injections of the medication ANS: A 7. The nurse is preparing to administer intramuscular haloperidol (Haldol) to a patient who has schizophrenia. What action will the nurse perform? a. Massage the site after injecting the medication to ensure complete absorption. b. Teach the patient to return every week to receive medication doses. c. Use a small bore needle when injecting the medication. d. Use the Z-track method and inject the medication into deep muscle tissue. ANS: D 8. The nurse is teaching a patient who will be discharged home on a typical antipsychotic medication to treat schizophrenia. Which statement by the patient indicates a need for further teaching? a. “I should not drink alcohol while taking this medication.” b. “I should use a heating pad to treat muscle spasms while taking this medication.” c. “I should use sunscreen while taking this medication.” d. “I will need frequent blood tests while taking this medication.” ANS: B 9. A patient who is about to begin taking the atypical antipsychotic medication clozapine (Clozaril) is concerned about side effects. What information will the nurse include when teaching the patient about this medication? a. “You are more likely to experience dry mouth, constipation, and urinary retention.” b. “You may experience weight gain, drowsiness, and headaches.” c. “You will not experience extrapyramidal side effects with this medication.” d. “You will not need frequent lab work while taking this medication.” ANS: B 10. A family member of a patient who has been taking fluphenazine (Prolixin) for 3 months calls to report that the patient is exhibiting agitation and restlessness. The nurse learns that the patient’s delusional thinking and hallucinations have stopped since taking the medication. The nurse will perform which action? a. Reassure the family member that tolerance to these side effects will subside over time. b. Remind the family member that complete drug effects may not occur for several more weeks. c. Suggest that the family member contact the provider to discuss an order for a benzodiazepine. d. Tell the family member to withhold the medication and notify the patient’s provider. ANS: C 11. A patient has been taking risperidone (Risperdal) for 2 weeks. The patient reports drowsiness and headache. What will the nurse do? a. Counsel the patient to request changing to aripiprazole (Abilify). b. Reassure the patient that these are common side effects of the medication. c. Suggest that the patient have serum glucose testing. d. Suggest that these may be signs of agranulocytosis. ANS: B 12. The nurse is performing a medication history on a patient who reports taking lorazepam (Ativan) for the past 6 months to treat an anxiety disorder. The patient states that the medication is not working as well as previously. The nurse will a. contact the provider to discuss changing to another benzodiazepine. b. notify the provider and discuss increasing the dose of lorazepam. c. suspect worsening of the anxiety disorder. d. understand that the patient has developed tolerance to this drug. ANS: D 13. A patient who is taking chlorpromazine calls the clinic to report having reddish-brown urine. What action will the nurse take? a. Notify the provider and request orders for creatinine clearance and BUN levels. b. Reassure the patient that this is a harmless side effect of this medication. c. Tell the patient to come to the clinic for a urinalysis. d. Tell the patient to discard any drug on hand and request a new prescription. ANS: B 14. A patient has begun taking buspirone hydrochloride (BuSpar) 7.5 mg twice daily to treat acute anxiety and calls 1 week later to report little change in symptoms. What will the nurse tell the patient? a. “Therapeutic effects may not be evident for another week.” b. “The provider may need to increase the dose to 15 mg twice daily.” c. “Notify the provider and request an order for another anxiolytic.” d. “Stop taking the drug and notify the provider that it doesn’t work.” ANS: A 15. A patient who is taking fluphenazine (Prolixin) to treat psychosis is experiencing symptoms of acute dystonia. While performing a medication history, the nurse learns that the patient takes herbal medications. Which herbal supplement would be of concern? a. Ginkgo b. Ginseng c. Kava kava d. St. John’s wort ANS: C 16. A patient is brought to the emergency department with decreased respirations and somnolence. The nurse notes a heart rate of 60 beats per minute and a blood pressure of 80/58 mm Hg. The patient is known to take alprazolam (Xanax) to treat anxiety. Which medication will the nurse anticipate the provider to order? a. Benztropine (Cogentin) b. Flumazenil (Romazicon) c. Lorazepam (Ativan) d. Propranolol (Inderal) ANS: B 17. A patient arrives in the emergency department complaining of difficulty breathing, dizziness, sweating, and heart palpitations. The patient reports having had similar episodes previously. The nurse will expect the provider to order which medication? a. Flumazenil (Romazicon) b. Haloperidol (Haldol) c. Lorazepam (Ativan) d. Propranolol (Inderal) ANS: C