WITH ANSWERS
A nurse instructs a client taking a MAOI to avoid certain foods and drugs because
of the risk of:
a. Cardiac dysrhythmia
b. Hypotensive shock
c. Hypertensive crisis
d. Hypoglycemia - ANSWER-Correct answer: C
Clients taking MAO-inhibiting drugs must be on a low tyramine diet to prevent
hypertensive crisis. In the presence of MAO inhibitors, tyramine is not destroyed
by the liver and in high levels produces intense vasoconstriction, resulting in
elevated blood pressure.
A nurse caring for a patient taking an SSRI will develop outcome criteria related
to:
a. Coherent thought processes
b. Improvement in depression
c. Reduced levels of motor activity
d. Decreased extrapyramidal symptoms - ANSWER-Correct answer: B
,SSRIs affect mood, relieving depression in many cases. SSRIs do not act to reduce
thought disorders. SSRIs reduce depressive symptoms but have little effect on
motor hyperactivity. SSRIs do not produce extrapyramidal symptoms.
A patient has acute anxiety related to an automobile accident 2 hours ago. The
nurse should teach the client about medication from which group?
a. Tricyclic antidepressants
b. Antipsychotic drugs
c. Mood stabilizers
d. Benzodiazepines - ANSWER-Correct answer: D
Benzodiazepines provide anxiety relief. Tricyclic antidepressants are used to treat
symptoms of depression. Mood stabilizers are used to treat bipolar disorder.
Antipsychotic drugs are used to treat psychosis
Which instruction has priority when teaching a client about clozapine (Clozaril)?
a. "Avoid unprotected sex."
b. "Report sore throat and fever immediately."
c. "Reduce foods in polyunsaturated fats."
d. "Use over-the-counter preparation for rashes." - ANSWER-Correct answer: B
Clozapine therapy may produce agranulocytosis; therefore, signs of infection
should be immediately reported to the health care provider. In addition, the patient
should have white blood cell levels measured weekly. The other options are not
relevant to clozapine.
,The laboratory report for a client taking clozapine (Clozaril) shows a white blood
cell count of 3000 mm3. Select the nurse's best action.
a. Report the results to the health care provider immediately.
b. Administer the next dose as prescribed.
c. Give aspirin and force fluids.
d. Repeat the laboratory test. - ANSWER-Correct answer: A
These laboratory values indicate the possibility of agranulocytosis, a serious side
effect of clozapine therapy. These results must be immediately reported to the
health care provider, and the drug should be withheld. The health care provider
may repeat the test, but in the meantime, the drug should be withheld. (Note: This
question requires the application of previous learning regarding normal and
abnormal values of white blood cell counts.)
A client tells the nurse, "My doctor prescribe paroxetine (Paxil) for my depression.
I assume I'll have side effects like I had when I was taking imipramine (Tofranil)."
The nurse's reply should be based on the knowledge that paroxetine is a(n):
a. Selective norepinephrine reuptake inhibitor
b. Tricyclic antidepressant
c. Monoamine oxidase (MAO) inhibitor
d. SSRI - ANSWER-Correct answer: D
Paroxetine is an SSRI 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.
, A client is hospitalized for severe major depressive disorder. Of the medications
listed below, the nurse can expect to provide the client with teaching about:
a. chlordiazepoxide (Librium)
b. clozapine (Clozaril)
c. sertraline (Zoloft)
d. Tacrine (Cognex) - ANSWER-Correct answer: C
Sertraline (Zoloft) is an selective serotonin reuptake inhibitor (SSRI). This
antidepressant blocks the reuptake of serotonin, with few anticholinergic and
sedating side effects. Clozapine is an antipsychotic. Chlordiazepoxide is an
anxiolytic. Tacrine treats Alzheimer's disease.
Consider these medications: carbamazepine (Tegretol), lamotrigine (Lamictal),
gabapentin (Neurontin). Which medication below also belongs to this group?
a. galantamine (Razadyne)
b. valproate (Depakote)
c. buspirone (Buspar)
d. tacrine (Cognex) - ANSWER-Correct answer: B
The medications listed in the stem are mood stabilizers, anticonvulsant types.
Valproate (Depakote) is also a member of this group. The distracters are drugs for
treatment of Alzheimer's disease and anxiety.
A client diagnosed with bipolar disorder displays aggressiveness, agitation,
talkativeness, and irritability. The nurse expects the health care provider to
prescribe a medication from which group?
a. Psychostimulants