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!!conc
erned!!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!!addictio
n!!unlikely.
A+ TEST BANK 1
, NURS 327 FINAL EXAM 1
d. The!!combination!!of!!medication!!with!!an!!antidepressant!!often!!positively!!impac
ts!!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!!benzo
diazepines?!!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!!opti
ons!!would!!not!!be!!contraindicative!!to!!lithium!!therapy.
An!!individual!!with!!poststroke!!depression!!is!!receiving!!an!!SSRI.!!What!!is!!the!!rationale!!for!!gi
ving!!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!!m
edication!!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!!behavior
s!!will!!need!!to!!be!!so!!closely!!monitored.
A!!patient!!who!!has!!received!!lithium!!for!!3!!weeks!!to!!control!!acute!!mania!!has!!the!!following!!s
ymptoms:!!coarse!!hand!!tremor,!!diarrhea,!!vomiting,!!lethargy,!!and!!mild!!confusion.!!The!!priorit
y!!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!!di
et.!!ANS:!!C
The!!symptoms!!the!!patient!!is!!experiencing!!are!!consistent!!with!!moderate!!lithium!!toxicity.!!The!!n
urse!!should!!hold!!lithium,!!obtain!!a!!stat!!lithium!!level,!!and!!notify!!the!!physician.!!Cogentin!!is!!ina
ppropriate;!!the!!symptoms!!are!!not!!EPS.!!The!!nurse!!may!!reassure!!the!!patient!!but!!cannot!!sugge
st
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!!rep
A+ TEST BANK 3
, NURS 327 FINAL EXAM 1
ly
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.!!T
he!!other!!options!!are!!not!!responsive!!to!!the!!question!!stem,!!which!!asks!!for!!knowledge!!of!!curre
nt!!therapy.
Which!!statement!!by!!a!!patient!!with!!generalized!!anxiety!!disorder!!for!!whom!!lorazepam!!(Ativa
n)! ! is!!prescribed!!as!!needed!!(prn)!!suggests!!the!!patient!!understands!!the!!purpose!!of!!the!!medic
ation?
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!!medicatio
n.
A!!patient!!has!!been!!taking!!chlorpromazine!!(Thorazine)!!for!!the!!past!!2!!weeks.!!He!!drools,!!h
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!!conc
erned!!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!!addictio
n!!unlikely.
A+ TEST BANK 1
, NURS 327 FINAL EXAM 1
d. The!!combination!!of!!medication!!with!!an!!antidepressant!!often!!positively!!impac
ts!!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!!benzo
diazepines?!!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!!opti
ons!!would!!not!!be!!contraindicative!!to!!lithium!!therapy.
An!!individual!!with!!poststroke!!depression!!is!!receiving!!an!!SSRI.!!What!!is!!the!!rationale!!for!!gi
ving!!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!!m
edication!!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!!behavior
s!!will!!need!!to!!be!!so!!closely!!monitored.
A!!patient!!who!!has!!received!!lithium!!for!!3!!weeks!!to!!control!!acute!!mania!!has!!the!!following!!s
ymptoms:!!coarse!!hand!!tremor,!!diarrhea,!!vomiting,!!lethargy,!!and!!mild!!confusion.!!The!!priorit
y!!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!!di
et.!!ANS:!!C
The!!symptoms!!the!!patient!!is!!experiencing!!are!!consistent!!with!!moderate!!lithium!!toxicity.!!The!!n
urse!!should!!hold!!lithium,!!obtain!!a!!stat!!lithium!!level,!!and!!notify!!the!!physician.!!Cogentin!!is!!ina
ppropriate;!!the!!symptoms!!are!!not!!EPS.!!The!!nurse!!may!!reassure!!the!!patient!!but!!cannot!!sugge
st
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!!rep
A+ TEST BANK 3
, NURS 327 FINAL EXAM 1
ly
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.!!T
he!!other!!options!!are!!not!!responsive!!to!!the!!question!!stem,!!which!!asks!!for!!knowledge!!of!!curre
nt!!therapy.
Which!!statement!!by!!a!!patient!!with!!generalized!!anxiety!!disorder!!for!!whom!!lorazepam!!(Ativa
n)! ! is!!prescribed!!as!!needed!!(prn)!!suggests!!the!!patient!!understands!!the!!purpose!!of!!the!!medic
ation?
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!!medicatio
n.
A!!patient!!has!!been!!taking!!chlorpromazine!!(Thorazine)!!for!!the!!past!!2!!weeks.!!He!!drools,!!h
A+ TEST BANK 4
