Chapter 4: Psychopharmacology

Chapter 4: Psychopharmacology

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     1.   When used in combination with anxiolytic medication, alcohol leads to _____________ effects, and caffeine leads to _______________ effects.

1.	increased; increased
2.	increased; decreased
3.	decreased; decreased
4.	decreased; increased

 

 

____     2.   A client was recently admitted to the inpatient unit after a suicide attempt. He has been placed on a tricyclic antidepressant. In terms of medication, what steps should be taken to maintain the client’s safety when he is discharged?

1.	Provide a 6-month supply to ensure long-term compliance.
2.	Provide a 1-week supply of medication, with refills authorized only after he visits his provider.
3.	Encourage him to increase fluid intake to counteract the common side effect of diarrhea.
4.	Educate him not to eat foods that contain tyramine.

 

 

____     3.   A client was recently admitted to the inpatient unit after a suicide attempt and is prescribed a selective serotonin reuptake inhibitor (SSRI). The nurse teaches the client about serotonin syndrome. Which of the following is a symptom of serotonin syndrome?

1.	Change in mental status
2.	Myoclonus
3.	Blood pressure lability
4.	Priapism

 

 

____     4.   A client was recently admitted to the inpatient unit after a suicide attempt and has not responded to SSRIs or tricyclic antidepressants. The client asks the nurse, “I heard about monoamine oxidase inhibitors (MAOIs). Why can’t they be added to what I am on now? Wouldn’t adding one help?” Which is the appropriate nursing response?

1.	“Electroconvulsive therapy is your best option at this point.”
2.	“Combined use can lead to a life-threatening condition called hypertensive crisis.”
3.	“There is no reason why an MAOI couldn’t be added to your therapy.”
4.	“They can’t be used together because their mechanisms of action are very different.”

 

 

____     5.   A client began taking lithium for the treatment of bipolar disorder approximately 1 month ago and asks why he has gained 12 lbs. since then. Which is the appropriate nursing response?

1.	“I’m surprised you have gained; weight loss is the typical pattern when taking lithium.”
2.	“Your weight gain is more likely related to food intake than medication.”
3.	“Weight gain is a common, but troubling side effect. Let’s talk about some strategies for safely improving your nutrition and exercise habits.”
4.	“There’s not much you can do about the weight gain. It’s better than being emotionally unstable, though.”

 

Chapter 4: Psychopharmacology

Answer Section

 

MULTIPLE CHOICE

 

1. ANS:  2

Chapter: Chapter 4, Psychopharmacology Core Concepts

Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antianxiety agents.

Page: 67

Heading: Interactions

Integrated Processes: Nursing Process

Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies

Cognitive Level: Analysis [Analyzing]

Concept: Addiction and Behaviors

Difficulty: Easy

 

	Feedback
1	Alcohol leads to increased effects and caffeine leads to decreased effects.
2	Anxiolytic medications work through depression of certain central nervous system (CNS) functions. Alcohol, which is a CNS depressant, would increase/potentiate their effects. Caffeine, which is a CNS stimulant, would decrease/inhibit their effects.
3	Alcohol leads to increased effects and caffeine leads to decreased effects
4	Alcohol leads to increased effects and caffeine leads to decreased effects.

 

 

PTS:   1                    CON:  Addiction and Behaviors

 

2. ANS:  2

Chapter: Chapter 4, Psychopharmacology Core Concepts

Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antidepressants.

Page: 69

Heading: Clinical Pearl

Integrated Processes: Nursing Process

Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies

Cognitive Level: Analysis [Analyzing]

Concept: Stress

Difficulty: Easy

 

	Feedback
1	A limited supply should be given to reduce the risk for suicide.
2	To prevent suicide through overdose on antidepressant medication, a limited supply should be given at discharge. Clients with a history of depression who have a lifting of mood may have an increased risk for suicide. Giving the client a larger supply of antidepressant medication increases the chances of overdose.
3	Although increasing fluid intake is generally a way to promote health, it will not decrease the client’s risk for suicide.
4	Avoiding foods with tyramine will not decrease the chances of suicide.

 

 

PTS:   1                    CON:  Stress

 

3. ANS:  4

Chapter: Chapter 4, Psychopharmacology Core Concepts

Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antidepressants.

Page: 69

Heading: Clinical Pearl

Integrated Processes: Nursing Process: Teaching and Learning

Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies

Cognitive Level: Application [Applying]

Concept: Violence

Difficulty: Easy

 

	Feedback
1	Change in mental status is not a symptom of serotonin syndrome.
2	Myoclonus is not a symptom of serotonin syndrome.
3	Blood pressure lability is not a symptom of serotonin syndrome.
4	Impotence may be a side effect of an SSRI antidepressant.

 

 

PTS:   1                    CON:  Violence

 

4. ANS:  2

Chapter: Chapter 4, Psychopharmacology Core Concepts

Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: antidepressants.

Page: 70

Heading: Table 4-4 Drug Interactions with SSRIs

Integrated Processes: Nursing Processes: Teaching/Learning

Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies

Cognitive Level: Application [Applying]

Concept: Violence

Difficulty: Easy

 

	Feedback
1	This statement does not provide accurate information to the client.
2	If MAOIs are taken with other antidepressants, a hypertensive crisis could result.
3	The statement is false; use of an MAOI with an SSRI could cause harm to the client.
4	This statement is not therapeutic or accurate.

 

 

PTS:   1                    CON:  Violence

 

5. ANS:  3

Chapter: Chapter 4, Psychopharmacology Core Concepts

Objective: Describe indications, actions, contraindications, precautions, side effects, and nursing implications for the following classes of drugs: mood-stabilizing agents.

Page: 74

Heading: Lithium Maintenance

Integrated Processes: Nursing Processes: Teaching and Learning

Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies

Cognitive Level: Application [Applying]

Concept: Mood

Difficulty: Easy

 

	Feedback
1	Weight gain is typical with lithium treatment.
2	While a healthy diet is helpful at reducing weight gain, this side effect is common with lithium treatment.
3	Weight gain is a common side effect of lithium therapy. To ensure compliance the nurse should help the client develop strategies to prevent excessive weight gain.
4	This statement is not therapeutic to the client.

 

 

PTS:   1                    CON:  Mood