Chapter 04. Psychopharmacology
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.
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.
