NURS 327 FINAL EXAM 1
NURS 327 FINAL EXAM 1 / NURS 327
EXAM 1 PREP /NURS 327 PREDICTOR
EXAM VERIFIED QUESTIONS AND
CORRECT DETAILED ANSWERS
(RATIONALES) |ALREADY GRADED A+
A patient prescribed alprazolam (Xanax) for symptoms of anxiety shares with the nurse that,
Im concerned about getting off this medication. Upon which fact will the nurse base the
response
to the patients concern?
a. Long elimination half-life will result in a manageable withdrawal treatment plan.
b. Rapid absorption and distribution to brain cells make withdrawal more difficult to
manage.
c. Sensitivity of the mesencephalic reticular activating system makes addiction
unlikely.
A+ TEST BANK 1
, NURS 327 FINAL EXAM 1
d. The combination of medication with an antidepressant often positively impacts
withdrawal.
ANS: B
In general, shorter-acting benzodiazepines are more difficult to taper and potentially cause more
problems with withdrawal. The remaining options are neither true nor relevant.
Which patient outcomes would be most applicable for the patient who has been taking
benzodiazepines? Patient will state:
a. That there are specific foods to avoid while on this medication
b. An understanding of how to increase medication dosage
c. That alcohol is a substance to avoid while on the medication
d. An understanding that he or she can return to work while on this medication
ANS: C
Combining a benzodiazepine with alcohol or other CNS depressant is potentially fatal. No food
restrictions exist. Dosage should not be changed without consultation with the physician.
Patients
may return to work unless experiencing sedation. In this case, they would be cautioned not to
operate machinery.
Which person with mania is the least likely candidate to receive lithium? The patient who is:
a. Six weeks pregnant
b. Recovering from a hysterectomy
c. Taking hormone replacement therapy
d. Displaying symptoms of postpartum depression
ANS: A
A+ TEST BANK 2
, NURS 327 FINAL EXAM 1
Lithium is contraindicated during pregnancy because of teratogenic effects. The remaining
options would not be contraindicative to lithium therapy.
An individual with poststroke depression is receiving an SSRI. What is the rationale for
giving the medication at breakfast and again at midday?
a. Prevent insomnia
b. Prevent toxic reactions
c. Decrease afternoon sleepiness
d. Give an opportunity to monitor behavior closely
ANS: A
CNS stimulants may cause insomnia if given late in the day. Toxicity is a result of excessive
medication in the system, not when it is administered. The drowsiness resulting from SSRI use
would not be minimized if taken as described. There is no expectation that resulting behaviors
will need to be so closely monitored.
A patient who has received lithium for 3 weeks to control acute mania has the following
symptoms: coarse hand tremor, diarrhea, vomiting, lethargy, and mild confusion. The priority
nursing action should be to:
a. Administer prn Cogentin to relieve the symptoms.
b. Provide reassurance that the symptoms are transient.
c. Obtain a stat lithium level; hold lithium pending results.
d. Assist the patient to decrease the sodium in their daily diet.
ANS: C
The symptoms the patient is experiencing are consistent with moderate lithium toxicity. The
nurse should hold lithium, obtain a stat lithium level, and notify the physician. Cogentin is
inappropriate; the symptoms are not EPS. The nurse may reassure the patient but cannot
suggest
that the symptoms will resolve over time. Minimizing salt would worsen lithium toxicity.
A patient with rapid cycling bipolar disorder is not responding well to lithium. The patient
tells the nurse, It feels as though Ill never get well. I get better, and then I get worse. The reply
A+ TEST BANK 3
, NURS 327 FINAL EXAM 1
that is based on knowledge of current therapy would be:
a. Youre feeling very discouraged arent you?
b. Its not all bad, is it? Sometimes you like being high.
c. Another drug, valproic acid, is proving effective for rapid cycling.
d. If your kidneys hold out, the lithium will eventually control the symptoms
ANS: C
Valproic acid is a first-line agent for the treatment of bipolar disorder. It is particularly effective
with rapid cycling. The other options are not responsive to the question stem, which asks for
knowledge of current therapy.
Which statement by a patient with generalized anxiety disorder for whom lorazepam (Ativan)
is prescribed as needed (prn) suggests the patient understands the purpose of the medication?
a. I can talk with my therapist more easily after my medication takes effect.
b. I wonder if I will have to take this medication for the rest of my entire life.
c. Im embarrassed and dont want anyone to know Im on this kind of medication.
d. Im going to ask for my prn dose so I can sleep instead of worrying about my kids.
ANS: A
The patient recognizes the therapeutic effects of the medication in assisting her to work
effectively with the therapist. The remaining options show questions and inappropriate use of
the
medication.
A patient has been taking chlorpromazine (Thorazine) for the past 2 weeks. He drools, has
hand tremors, and walks with a shuffling gait. The nurse would correctly attribute these
behaviors to:
a. Akinesia
A+ TEST BANK 4
NURS 327 FINAL EXAM 1 / NURS 327
EXAM 1 PREP /NURS 327 PREDICTOR
EXAM VERIFIED QUESTIONS AND
CORRECT DETAILED ANSWERS
(RATIONALES) |ALREADY GRADED A+
A patient prescribed alprazolam (Xanax) for symptoms of anxiety shares with the nurse that,
Im concerned about getting off this medication. Upon which fact will the nurse base the
response
to the patients concern?
a. Long elimination half-life will result in a manageable withdrawal treatment plan.
b. Rapid absorption and distribution to brain cells make withdrawal more difficult to
manage.
c. Sensitivity of the mesencephalic reticular activating system makes addiction
unlikely.
A+ TEST BANK 1
, NURS 327 FINAL EXAM 1
d. The combination of medication with an antidepressant often positively impacts
withdrawal.
ANS: B
In general, shorter-acting benzodiazepines are more difficult to taper and potentially cause more
problems with withdrawal. The remaining options are neither true nor relevant.
Which patient outcomes would be most applicable for the patient who has been taking
benzodiazepines? Patient will state:
a. That there are specific foods to avoid while on this medication
b. An understanding of how to increase medication dosage
c. That alcohol is a substance to avoid while on the medication
d. An understanding that he or she can return to work while on this medication
ANS: C
Combining a benzodiazepine with alcohol or other CNS depressant is potentially fatal. No food
restrictions exist. Dosage should not be changed without consultation with the physician.
Patients
may return to work unless experiencing sedation. In this case, they would be cautioned not to
operate machinery.
Which person with mania is the least likely candidate to receive lithium? The patient who is:
a. Six weeks pregnant
b. Recovering from a hysterectomy
c. Taking hormone replacement therapy
d. Displaying symptoms of postpartum depression
ANS: A
A+ TEST BANK 2
, NURS 327 FINAL EXAM 1
Lithium is contraindicated during pregnancy because of teratogenic effects. The remaining
options would not be contraindicative to lithium therapy.
An individual with poststroke depression is receiving an SSRI. What is the rationale for
giving the medication at breakfast and again at midday?
a. Prevent insomnia
b. Prevent toxic reactions
c. Decrease afternoon sleepiness
d. Give an opportunity to monitor behavior closely
ANS: A
CNS stimulants may cause insomnia if given late in the day. Toxicity is a result of excessive
medication in the system, not when it is administered. The drowsiness resulting from SSRI use
would not be minimized if taken as described. There is no expectation that resulting behaviors
will need to be so closely monitored.
A patient who has received lithium for 3 weeks to control acute mania has the following
symptoms: coarse hand tremor, diarrhea, vomiting, lethargy, and mild confusion. The priority
nursing action should be to:
a. Administer prn Cogentin to relieve the symptoms.
b. Provide reassurance that the symptoms are transient.
c. Obtain a stat lithium level; hold lithium pending results.
d. Assist the patient to decrease the sodium in their daily diet.
ANS: C
The symptoms the patient is experiencing are consistent with moderate lithium toxicity. The
nurse should hold lithium, obtain a stat lithium level, and notify the physician. Cogentin is
inappropriate; the symptoms are not EPS. The nurse may reassure the patient but cannot
suggest
that the symptoms will resolve over time. Minimizing salt would worsen lithium toxicity.
A patient with rapid cycling bipolar disorder is not responding well to lithium. The patient
tells the nurse, It feels as though Ill never get well. I get better, and then I get worse. The reply
A+ TEST BANK 3
, NURS 327 FINAL EXAM 1
that is based on knowledge of current therapy would be:
a. Youre feeling very discouraged arent you?
b. Its not all bad, is it? Sometimes you like being high.
c. Another drug, valproic acid, is proving effective for rapid cycling.
d. If your kidneys hold out, the lithium will eventually control the symptoms
ANS: C
Valproic acid is a first-line agent for the treatment of bipolar disorder. It is particularly effective
with rapid cycling. The other options are not responsive to the question stem, which asks for
knowledge of current therapy.
Which statement by a patient with generalized anxiety disorder for whom lorazepam (Ativan)
is prescribed as needed (prn) suggests the patient understands the purpose of the medication?
a. I can talk with my therapist more easily after my medication takes effect.
b. I wonder if I will have to take this medication for the rest of my entire life.
c. Im embarrassed and dont want anyone to know Im on this kind of medication.
d. Im going to ask for my prn dose so I can sleep instead of worrying about my kids.
ANS: A
The patient recognizes the therapeutic effects of the medication in assisting her to work
effectively with the therapist. The remaining options show questions and inappropriate use of
the
medication.
A patient has been taking chlorpromazine (Thorazine) for the past 2 weeks. He drools, has
hand tremors, and walks with a shuffling gait. The nurse would correctly attribute these
behaviors to:
a. Akinesia
A+ TEST BANK 4
