Test Bank - Psychiatric Mental Health Nursing by Mary Townsend 9th Edition [All 38 Chapters fully covered]

This document contains the complete test bank for Psychiatric Mental Health Nursing by Mary C. Townsend, 9th Edition. It includes exam-style questions and answers covering all 38 chapters of the textbook, making it ideal for students preparing for nursing exams in mental health care. The content reflects NCLEX-style multiple choice and alternate-format questions, ensuring alignment with professional standards.

Table of Contents for Townsend Test Bank

Chapter 03. Psychopharmacology Test Bank Free Sample Questions 

Multiple Choice

1. The nurse manager on the psychiatric unit was explaining to the new staff the differences between typical and atypical antipsychotics. The nurse correctly states that atypical antipsychotics:

A. Remain in the system longer

B. Act more quickly to reduce delusions

C. Produce fewer extrapyramidal effects

D. Are risk free for neuroleptic malignant syndrome (NMS)

ANS: C

Atypical antipsychotics produce less D2blockade; thus movement disorders are less of a problem. No evidence suggests that the medication remains in the system longer nor that it acts more quicklyto reduce delusions. The atypicals are not risk free for NMS.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need:

Physiological Integrity: Pharmacological and Parenteral Therapies

2. The nurse would assess for neuroleptic malignant syndrome (NMS) if a patient on haloperidol (Haldol)

develops a:

A. 30 mm Hg decrease in blood pressure reading B. Respiratory rate of 24 respirations per minute C. Temperature reading of 104° F

D. Pulse rate of 70 beats per minute

ANS: C

Increased temperature is the cardinal sign of NMS. This BP is not a significant feature of NMS. There are no significant findings to support the options related to respirations or pulse rate.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:

Physiological Integrity: Pharmacological and Parenteral Therapies

3. A patient taking fluphenazine (Prolixin) complains of dry mouth and blurred vision. What would the nurse assess as the likely cause of these symptoms?

A. Decreased dopamine at receptor sites

B. Blockade of histamine C. Cholinergic blockade D. Adrenergic blocking ANS: C

Fluphenazine administration produces blockade of cholinergic receptors giving rise to anticholinergic effects, such as dry mouth, blurred vision, and constipation.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:

Physiological Integrity: Pharmacological and Parenteral Therapies

4. Which behavior displayed by a patient receiving a typical antipsychotic medication would be assessed as displaying behaviors characteristic of tardive dyskinesia (TD)?

A. Grimacing and lip smacking

B. Falling asleep in the chair and refusing to eat lunch

C. Experiencing muscle rigidity and tremors D. Having excessive salivation and drooling ANS: A

TD manifests as abnormal movements of voluntary muscle groups after a prolonged period of dopamine blockade. Movements may affect any muscle group, but muscles of the face, mouth, tongue, and digits are commonly affected. Falling asleep is reflective of the sedative effect of these medications. Muscle rigidity and drooling reflect EPS caused from imbalance between dopamine and acetylcholine.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:

Physiological Integrity: Pharmacological and Parenteral Therapies

5. A nurse administers a medication that potentiates the action of GABA. Which finding would be expected? A. Reduced anxiety

B. Improved memory

C. More organized thinking

D. Fewer sensory perceptual alterations

ANS: A

Increased levels of GABA reduce anxiety, thus any potentiation of GABA action should result in anxiety reduction. Memory enhancement is associated with acetylcholine and substance P. Thought disorganization is associated with dopamine. GABA is not associated with sensory perceptual alterations.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:

Physiological Integrity: Pharmacological and Parenteral Therapies

6. On the basis of current knowledge of neurotransmitter effects, a nurse could anticipate that the treatment plan for a patient with memory difficulties might include medications designed to:

A. inhibit GABA.

B. increase dopamine at receptor sites. C. decrease dopamine at receptor sites. D. prevent destruction of acetylcholine. ANS: D

Increased acetylcholine plays a role in learning and memory. Preventing destruction of acetylcholine by acetylcholinesterase would result in higher levels of acetylcholine, with the potential for improved memory. GABA is known to affect anxiety level rather than memory. Increased dopamine would cause symptoms associated with schizophrenia or mania rather than improve memory. Decreasing dopamine at receptor sites is associated with Parkinson’s disease rather than improving memory.

KEY: Cognitive Level: Comprehension | Integrated Processes: Nursing Process: Planning | Client Need:

Physiological Integrity: Pharmacological and Parenteral Therapies

7. A patient has disorganized thinking associated with schizophrenia. A PET scan would most likely show dysfunction in which part of the brain?

A. Temporal lobe

B. Cerebellum

C. Brainstem

D. Frontal lobe

ANS: D

The frontal lobe is responsible for intellectual functioning. The temporal lobe is responsible for the sensation of hearing. The cerebellum regulates skeletal muscle coordination and equilibrium. The brainstem regulates internal organs.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:

Physiological Integrity: Pharmacological and Parenteral Therapies

8. A nurse should assess a patient taking a drug with anticholinergic properties for inhibited function of the: A. parasympathetic nervous system.

B. sympathetic nervous system. C. reticular activating system. D. medulla oblongata.

ANS: A

Acetylcholine is the neurotransmitter found in high concentration in the parasympathetic nervous system. When acetylcholine action is inhibited by anticholinergic drugs, parasympathetic symptoms such as blurred vision, dry mouth, constipation, and urinary retention appear. The functions of the sympathetic nervous system the reticular activating system, and the medulla oblongata are not affected by anticholinergics.

KEY: Cognitive Level: Comprehension | Integrated Processes: Nursing Process: Assessment | Client Need:

Physiological Integrity: Pharmacological and Parenteral Therapies

9. The therapeutic action of monoamine oxidase inhibitors (MAOIs) blocks neurotransmitter reuptake, causing:

A. increased concentration of neurotransmitter in the synaptic gap. B. decreased concentration of neurotransmitter in the synaptic gap. C. destruction of receptor sites.

D. limbic system stimulation.

ANS: A

If the reuptake of a substance is inhibited, it accumulates in the synaptic gap and its concentration increases, permitting ease of transmission of impulses across the synaptic gap. Normal transmission of impulses across synaptic gaps is consistent with normal rather than depressed mood. The other options are not associated with blocking neurotransmitter reuptake.

KEY: Cognitive Level: Comprehension | Integrated Processes: Nursing Process: Implementation | Client

Need: Physiological Integrity: Pharmacological and Parenteral Therapies

10. A patient taking medication for mental illness develops restlessness and an uncontrollable need to be in motion. A nurse can correctly analyze that these symptoms are related to which drug action?

A. Dopamine-blocking effects

B. Anticholinergic effects

C. Endocrine-stimulating effects

D. Ability to stimulate spinal nerves

ANS: A

Medication that blocks dopamine often produces disturbances of movement such as akathisia because dopamine affects neurons involved in both thought processes and movement regulation. Anticholinergic effects include dry mouth, blurred vision, urinary retention, and constipation. Akathisia is not caused by endocrine stimulation or spinal nerve stimulation.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:

Physiological Integrity: Pharmacological and Parenteral Therapies

11. A nurse assesses that a patient demonstrates anxiety, increased heart rate, and fear. The nurse would suspect the presence of a high concentration of which neurotransmitter?

A. GABA

B. Histamine

C. Acetylcholine D. Norepinephrine ANS: D

Norepinephrine is the neurotransmitter associated with sympathetic nervous system stimulation, preparing the individual for “fight or flight.” GABA is a mediator of anxiety level. A high concentration of histamine is associated with an inflammatory response. A high concentration of acetylcholine is associated with parasympathetic nervous system stimulation.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:

Physiological Integrity: Pharmacological and Parenteral Therapies

12. A patient has symptoms of acute anxiety related to the death of a parent in an automobile accident 2 hours ago. The patient will need teaching about a drug from which group?

A. Tricyclic antidepressants

B. Antimanic drugs

C. Benzodiazepines

D. Antipsychotic drugs

ANS: C

Benzodiazepines provide anxiety relief. Tricyclic antidepressants are used to treat symptoms of depression. Antimanic drugs are used to treat bipolar disorder. Antipsychotic drugs are used to treat psychosis.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Planning | Client Need:

Physiological Integrity: Pharmacological and Parenteral Therapies

13. A patient is hospitalized for severe depression. Of the medications listed below, a nurse can expect to provide the patient with teaching about:

A. clozapine (Clozaril)

B. chlordiazepoxide (Librium) C. tacrine (Cognex)

D. fluoxetine (Prozac)

ANS: D

Fluoxetine is an SSRI. It is an antidepressant that blocks the reuptake of serotonin with few anticholinergic and sedating side effects. Clozapine is an antipsychotic. Chlordiazepoxide is an anxiolytic. Tacrine is used to treat Alzheimer’s disease.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Planning | Client Need:

Physiological Integrity: Pharmacological and Parenteral Therapies

14. A patient hospitalized with a mood disorder has an elevated unstable mood, aggressiveness, agitation, talkativeness, and irritability. A nurse begins care planning based on the expectation that the health care provider is most likely to prescribe a medication classified as a(n):

A. anticholinergic. B. mood stabilizer C. psychostimulant D. antidepressant ANS: B

The symptoms describe a manic attack. Mania is effectively treated by the antimanic drug lithium and selected anticonvulsants such as carbamazepine, valproic acid, and lamotrigine. No drugs from the other classifications listed are effective in the treatment of mania.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Planning | Client Need:

Physiological Integrity: Pharmacological and Parenteral Therapies

15. A drug causes muscarinic receptor blockade. A nurse will assess the patient for: A. gynecomastia

B. pseudoparkinsonism

C. orthostatic hypotension

D. dry mouth

ANS: D

Muscarinic receptor blockade includes atropine-like side effects such as dry mouth, blurred vision, and constipation. Gynecomastia is associated with decreased prolactin levels. Movement defects are associated with dopamine blockade. Orthostatic hypotension is associated with alpha-1 antagonism.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:

Physiological Integrity: Pharmacological and Parenteral Therapies

16. A patient tells a nurse, "My doctor prescribed Paxil [paroxetine] for my depression. I suppose I’ll have side effects like I had when I was taking Tofranil [imipramine]." The nurse’s reply should be based on the knowledge that paroxetine is a(n):

A. tricyclic antidepressant

B. MAOI

C. selective serotonin reuptake inhibitor

D. selective norepinephrine reuptake inhibitor

ANS: C

Paroxetine is a selective serotonin reuptake inhibitor and will not produce the same side effects as imipramine, a tricyclic antidepressant. The patient will probably not experience dry mouth, constipation, or orthostatic hypotension.

KEY: Cognitive Level: Comprehension | Integrated Processes: Nursing Process: Implementation | Client

Need: Physiological Integrity: Pharmacological and Parenteral Therapies

17. A nurse can anticipate anticholinergic side effects are likely when a patient is taking: A. lithium (Lithobid).

B. isperidone (Risperdal). C. buspirone (BuSpar).

D. fluphenazine (Prolixin).

ANS: D

Fluphenazine, a first-generation antipsychotic, exerts muscarinic blockade, resulting in dry mouth, blurred vision, constipation, and urinary retention. Lithium therapy is more often associated with fluid balance problems, including polydipsia, polyuria, and edema. Risperidone therapy is more often associated with movement disorders, orthostatic hypotension, and sedation. Buspirone is associated with anxiety reduction without major side effects.

KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Planning | Client Need:

Physiological Integrity: Pharmacological and Parenteral Therapies

18. A nurse instructs a patient taking a drug that inhibits monoamine oxidase (MAO) to avoid certain foods and drugs because of the risk of:

A. hypotensive shock. B. hypertensive crisis. C. cardiac dysrhythmia. D. cardiogenic shock ANS: B

Patients taking MAO-inhibiting drugs must be on a tyramine-free diet to prevent hypertensive crisis. In the presence of MAOIs, tyramine is not destroyed by the liver and in high levels produces intense vasoconstriction, resulting in elevated blood pressure.

KEY: Cognitive Level: Comprehension | Integrated Processes: Nursing Process: Planning | Client Need:

Physiological Integrity: Pharmacological and Parenteral Therapies