NSG 552/ NSG552 Exam 1 V2 – Psychopharmacology Review | Wilkes (Latest 2026/ 2027 Update) 100% Verified Questions & Answers | Grade A

NSG 552/ NSG552 Exam 1 V2 – Psychopharmacology Review | Wilkes (Latest 2026/ 2027 Update) 100% Verified Questions & Answers | Grade A A patient with depression mentions to the nurse, My mother says depression is a chemical disorder. What does she mean? The nurses response is based on the theory that depression primarily involves which of the following neurotransmitters? a. Cortisol and GABA b. COMT and glutamate c. Monamine and glycine d. Serotonin and norepinephrine d. Serotonin and norepinephrine A patient has experienced a stroke (cerebral vascular accident) that has resulted in damage to the Broca area. Which evaluation does the nurse conduct to reinforce this diagnosis? a. Observing the patient pick up a spoon b. Asking the patient to recite the alphabet c. Monitoring the patients blood pressure d. Comparing the patients grip strength in both b. Asking the patient to recite the alphabet The patient diagnosed with schizophrenia asks why psychotropic medications are always prescribed by the doctor. The nurses answer will be based on information that the therapeutic action of psychotropic drugs is the result of their effect on: a. The temporal lobe; especially Wernickes area b. Dendrites and their ability to transmit electrical impulses c. The regulation of neurotransmitters especially dopamine d. The peripheral nervous system sensitivity to the psychotropic medications c. The regulation of neurotransmitters especially dopamine A student nurse mutters that it seems entirely unnecessary to have to struggle with understanding the anatomy and physiology of the neurologic system. The mentor would base a response on the understanding that it is: a. Necessary but generally for psychiatric nurses who focus primarily on behavioral interventions b. A complex undertaking that advance practice psychiatric nurses frequently use in their practice c. Important primarily for the nursing assessment of patients with brain trauma caused cognitive symptoms d. Necessary for planning psychiatric care for all patients especially those experiencing psychiatric disorders d. Necessary for planning psychiatric care for all patients especially those experiencing psychiatric disorders A patient asks the nurse, My wife has breast cancer. Could it be caused by her chronic depression? Which response is supported by research data? a. Too much stress has been proven to cause all kinds of cancer. b. There have been no research studies done on stress and disease yet. c. Stress does cause the release of factors that suppress the immune system. d. There appears to be little connection between stress and diseases of the body c. Stress does cause the release of factors that suppress the immune system. A patient who has a parietal lobe injury is being evaluated for psychiatric rehabilitation needs. Of the aspects of functioning listed, which will the nurse identify as a focus of nursing intervention? a. Expression of emotion b. Detecting auditory stimuli c. Receiving visual images d. Processing associations d. Processing associations At admission, the nurse learns that some time ago the patient had an infarct in the right cerebral cortex. During assessment, the nurse would expect to find that the patient: a. Demonstrates major deficiencies in speech b. Is unable to effectively hold a spoon in the left hand c. Has difficulty explaining how to go about using the telephone d. Cannot use his right hand to shave himself or comb his own b. Is unable to effectively hold a spoon in the left hand A patient with chronic schizophrenia had a stroke involving the hippocampus. The patient will be discharged on low doses of haloperidol. The nurse will need to individualize the patients medication teaching by: a. Including the patients caregiver in the education b. Being careful to stress the importance of taking the medication as prescribed c. Providing the education at a time when the patient is emotionally calm and relaxed d. Encouraging the patient to crush or dissolve the medication to help with swallowing a. Including the patients caregiver in the education The physician tells the nurse, The medication Im prescribing for the patient enhances the g aminobutyric acid (GABA) system. Which patient behavior will provide evidence that the medication therapy is successful? a. The patient is actively involved in playing cards with other patients. b. The patient reports that, I don't feel as anxious as I did a couple of days ago. c. The patient reports that both auditory and visual hallucinations have decreased. d. The patient says that, I am much happier than before I came to the hospital. b. The patient reports that, I don't feel as anxious as I did a couple of days ago. The patients family asks whether a diagnosis of Parkinsons disease creates an increased risk for any mental health issues. What question would the nurse ask to assess for such a comorbid condition? a. Has your father exhibited any signs of depression? b. Does your father seem to experience mood swings? c. Have you noticed your father talking about seeing things you cant see? d. Is your dad preoccupied with behaviors that he needs to repeat over and over? a. Has your father exhibited any signs of depression? Which explanation for the prescription of donepezil (Aricept) would the nurse provide for a patient in the early stage of Alzheimers disease? a. It will increase the metabolism of excess GABA. b. Excess dopamine will be prevented from attaching to receptor sites. c. Serotonin deficiency will be managed through a prolonged reuptake period. d. The acetylcholine deficiency will be managed by inhibiting cholinesterase. d. The acetylcholine deficiency will be managed by inhibiting cholinesterase. There remains a stigma attached to psychiatric illnesses. The psychiatric nurse makes the greatest impact on this sociological problem when: a. Providing educational programming for patients and the public b. Arranging for adequate and appropriate social support for the patient c. Assisting the patient to achieve the maximum level of independent functioning d. Regularly praising the patient for seeking and complying with appropriate treatment a. Providing educational programming for patients and the public The wife of a patient with paranoid schizophrenia tells the nurse, Ive learned that my husband has several close relatives with the same disorder. Does this problem run in families? The response based on recent discoveries in the field of genetics would be: a. Your children should be monitored closely for the disorder. b. Research tends to support a familiar tendency to schizophrenia. c. There is no concrete evidence; it is just as likely a coincidence. d. Only bipolar disorder has been identified to have a genetic b. Research tends to support a familiar tendency to schizophrenia. A patient whose symptoms of mild depression have been managed with antidepressants is concerned about the affect of accepting a promotion that will require working the night shift. What will be the basis of the response the nurse gives to address the patients concern? a. The connection between a new job and possible depression does exist. b. The medication can be adjusted to manage any increase in depression. c. The interruption in normal wake-sleep patterns can influence mood disorders. d. The change in sleep routine can be managed with a healthy sleep hygiene routine. c. The interruption in normal wake-sleep patterns can influence mood disorders. The nurse is discouraged because the patient exhibiting negative symptoms of schizophrenia has shown no improvement with the planned interventions to reduce the symptoms. The mentors remark that helps place the problem in perspective is: a. You aren't responsible for the behavior of any other person. b. Patients can be perverse and cling to symptoms despite our efforts. c. Negative symptoms have been associated with genetic pathology. d. It will take several trail and error attempts to get the right combination c. Negative symptoms have been associated with genetic pathology. The somatic nervous system provides sensory and motor innervation for: A) peripheral nerves. B) abdominal viscera. C) secretory glands. D) smooth muscle. A) peripheral nerves. The proteins and other materials used by the axon are synthesized and then flow down the axon through its cytoplasm. A) in the cell body B) by Nissl bodies C) through dendrites D) across synapses A) in the cell body Supporting cells of the nervous system, such as Schwann cells, satellite cells, and types of glial cells, function to provide neurons with: A) local protection. B) control functions. C) membrane permeability. D) integrative metabolism. A) local protection. Neurons are characterized by the ability to communicate with other neurons and body cells through: A) astrocytes. B) axon hillocks. C) nodes of Ranvier. D) action potentials. D) action potentials. Chemical synapses rely on in order to provide communication between neurons. A) diffusion B) gap junctions C) satellite cells D) transmitter molecules D) transmitter molecules The blood-brain and CSF-brain barriers control the chemical environment of the brain by allowing easy entrance to only a few chemicals that include: A) oxygen. B) protein. C) glutamate. D) potassium. A) oxygen. The perception of where a stimulus is in space and in relation to body parts is a function of the: A) occipital lobe. B) parietal lobe. C) hypothalamus. D) prefrontal cortex. B) parietal lobe. The pia mater is a connective tissue sheath that covers the spinal cord and also contains: A) spinal fluid. B) fibrocartilage. C) blood vessels. D) segmental nerves. B) fibrocartilage. Which of the following is the neurotransmitter for most postganglion sympathetic neurons? A) Enkephalin B) Glutamic acid C) Catecholamines D) Acetylcholine C) Catecholamines In contrast to the sympathetic nervous system, the functions of the parasympathetic nervous system include: A) sweating. B) anabolism. C) pupil dilation. D) vasoconstriction. B) anabolism. Which of the following substances provides the majority of the fuel needs of the neurologic system? A) Glycogen B) Glucose C) Amino acids D) Triglycerides B) Glucose A 60-year-old woman has been recently diagnosed with multiple sclerosis, a disease in which the oligodendrocytes of the patients central nervous system (CNS) are progressively destroyed. Which physiologic process within the neurologic system is most likely be affected by this disease process? A) Oxygen metabolism B) Neurotransmitter synthesis C) Nerve conduction D) Production of cerebrospinal fluid C) Nerve conduction A neuron has been hyperpolarized. How will this affect the excitability of the neuron? A) The neuron will have a membrane potential farther from the threshold. B) The neuron will be more difficult to repolarize after firing. C) The membrane potential of the neuron will be closer to the threshold. D) The neurons excitability will be significantly increased. A) The neuron will have a membrane potential farther from the threshold. A pregnant womans most recent ultrasound is suggestive of spina bifida, and her primary care provider has subsequently order further diagnostic testing. The pathophysiologic effects of this disease are due to: A) malformation of the mesoderm. B) abnormal closure of the neural tube. C) lesions in the dorsal root ganglia. D) hypertrophy of the primary vesicles. B) abnormal closure of the neural tube. Which of the following messages is most likely to be carried by general somatic afferent (GSA) neurons? A) The sensation of cold when touching ice B) The message to move a finger and thumb C) The message to move the larynx during speech D) Information about the position of a joint A) The sensation of cold when touching ice Which of the following processes is most likely to occur as a result of a spinal reflex? A) Peristalsis of the small and large bowel B) Control of oculomotor function in changing light levels C) Pain sensation from a potentially damaging knee movement D) Withdrawal of a hand from a hot stove element D) Withdrawal of a hand from a hot stove element A patient has required mechanical ventilation following a traumatic head injury sustained in a motorcycle crash, during which he sustained damage to his respiratory center. Which of the patient's brain structures has been injured? A) Brain stem B) Midbrain C) Diencephalon D) Frontal lobe A) Brain stem A patient with a diagnosis of epilepsy has required surgical removal of part of her prefrontal cortex. Which of the following effects should her family and care team anticipate? A) Lapses in balance and coordination B) Deficits in regulation of the endocrine system C) Sensory losses D) Changes in behavior and judgment D) Changes in behavior and judgment A patient's primary care provider has prescribed a b-adrenergic receptor blocker. Which of the following therapeutic effects do the patient and care provider likely seek? A) Reduction in heart rate and blood pressure B) Slowing of gastrointestinal motility C) Increase in mental acuity D) Decreased production of gastric acid A) Reduction in heart rate and blood pressure Neurotrophic factors contribute to the maintenance of homeostasis in which 20. of the following ways? A) By catalyzing the effects of neurotransmitters B) By increasing the sensitivity of receptors on postsynaptic cells C) By promoting the growth and survival of neurons D) By selectively increasing or decreasing the release of neurotransmitters C) By promoting the growth and survival of neurons A nurse is teaching a medication class to a group of psychiatric patients. One of them asks the nurse why he has so much more trouble learning now when he's in his 60s than he did when he was younger. Which of the following concepts would the nurse integrate into the response? A) The extrapyramidal motor system B) The amygdala C) Neuroplasticity D) Psychoneuroimmunology C) Neuroplasticity Which of the following would a nursing instructor identify when describing the area of the brain involved with verbal language function, including areas for both receptive and expressive speech? A) Right hemisphere B) Parietal lobe C) Occipital lobe D) Left hemisphere D) Left hemisphere A nurse is developing a plan of care for a patient experiencing expressive aphasia. The nurse incorporates knowledge that the patient most likely has sustained damage to which of the following? A) The postcentral gyrus B) Brocas area C) Basal ganglia D) The hippocampus B) Brocas area The nurse is caring for an older adult who has experienced damage to the frontal lobe after an automobile accident. The nurse anticipates that the patient will have difficulty with which of the following? A) Smell B) Concept formation C) Receptive speech D) Hearing B) Concept formation The nurse is caring for a patient who has experienced damage to the parietal lobes of the brain. The nurse anticipates that the patient with have difficulty with which of the following? A) Perceiving sensory input B) Calculating a math problem C) Seeing objects in front of him D) Speaking fluently B) Calculating a math problem A patient has been diagnosed with memory dysfunction associated with Alzheimers disease. The nurse determines that damage to the patients brain includes deterioration of temporal lobe structures and the nerves of which of the following? A) Basal ganglia B) Limbic system C) Frontal lobe D) Hippocampus D) Hippocampus The nurse is caring for a hospitalized patient who has a disorder of the hypothalamus. When developing the patients plan of care, in which of the following areas would the nurse anticipate a problem? A) Sleep B) Constipation C) Speech D) Motor activity A) Sleep A patient who is scheduled to undergo a sleep deprivation electroencephalogram (EEG) in the morning is experiencing moderate anxiety about the procedure. Based on an understanding of this test, which of the following would the nurse avoid? A) Explaining in depth what to expect during the upcoming procedure B) Administering a benzodiazepine medication prescribed for anxiety C) Taking a thorough history of her use of prescribed and illicit drugs D) Giving her a noncaffeinated beverage of her choice B) Administering a benzodiazepine medication prescribed for anxiety A nursing instructor asks a student to explain the influence of chronobiology on depression. Which of the following would the student include when responding? A) The exact location of genes leads to identifying the gene responsible for causing depression. B) A break in the corpus coliseum blocks information exchange between the right and left hemispheres. C) Damage to the posterior areas of the parietal lobe leads to altered discriminative sensory function. D) Internal and external triggers can elicit biologic rhythm changes indicative of clinical depression. D) Internal and external triggers can elicit biologic rhythm changes indicative of clinical depression. When describing the various neurotransmitters, which of the following would the nurse identify as the primary cholinergic neurotransmitter? A) Dopamine B) Acetylcholine C) Norepinephrine D) Serotonin B) Acetylcholine A group of nursing students are reviewing the various neurotransmitters. The students demonstrate understanding when they identify which of the following as a neuropeptide? A) Melatonin B) Serotonin C) Glutamate D) Gamma-aminobutyric acid A) Melatonin The nurse is assessing a patient experiencing anxiety and observes increased sweating and gooseflesh. The nurse understands that these are the result of which substance? A) Acetylcholine B) Norepinephrine C) Serotonin D) Histamine B) Norepinephrine A nurse is developing a plan of care for a patient diagnosed with schizophrenia. The nurse integrates knowledge of this disorder, identifying which neurotransmitter as being primarily involved? A) Acetylcholine B) Dopamine C) Norepinephrine D) Serotonin B) Dopamine A group of students are reviewing information about neurotransmitter subtypes. The group demonstrates understanding of the information when they identify which neurotransmitter as having muscarinic and nicotinic receptors? A) Serotonin B) Gamma-aminobutyric acid (GABA) C) Dopamine D) Acetylcholine D) Acetylcholine A nurse is involved in gathering information about the inheritance of mental disorders using population genetics. Which of the following would the nurse be least likely to be evaluating? A) Concordance rates B) Occurrence in first-degree relatives C) Risk factor analysis D) Adoptions studies C) Risk factor analysis A nurse is reading a journal article about psychoneuroimmunology. Which 16. information would the nurse most likely find? Select all that apply. A) Neurotoxins role in receptor site damage B) Hypothalamicpituitarythyroid axis disruption C) Static activity of natural killer cells in response to stress D) Hypothalamic damage leading to immune dysfunction E) Interruption in the typical circadian rhythm cycle A) Neurotoxins role in receptor site damage B) Hypothalamicpituitarythyroid axis disruption D) Hypothalamic damage leading to immune dysfunction A patient is scheduled for a challenge test. Which of the following would the nurse include when explaining this test to the patient? A) Intravenous administration of a substance to induce symptoms B) Application of electrodes to the scalp for monitoring C) Evaluation electrical impulses recorded on graph paper D) Exposure to a flashing strobe light to elicit abnormal activity A) Intravenous administration of a substance to induce symptoms A patient with depression tells the nurse that he is to have a test that involves the recording of an electroencephalogram (EEG) throughout the night. The 18. nurse most likely identifies this testing as which of the following? A) Sleep deprivation EEG B) Polysomnography C) Evoked potentials D) Functional magnetic resonance imaging B) Polysomnography A group of nursing students are reviewing the role of serotonin in psychiatric disorders. The students demonstrate a need for additional study when they identify which disorder as being associated with its dysfunction? A) Depression B) Obsessive-compulsive disorder C) Panic disorder D) Schizophrenia D) Schizophrenia When describing neuronal transmission, an instructor describes the area where the electrical intracellular signal becomes a chemical one. The instructor is describing which of the following? A) Soma B) Synaptic cleft C) Terminal D) Receptor B) Synaptic cleft A newly admitted patient has the diagnosis of catatonic schizophrenia. Which behavior observed in the patient supports that diagnosis? a. Uses a rhyming form of speech b. Refuses to eat any unwrapped foods c. Laughs when watching a sad movie d. Maintains an immobilized state for hours d. Maintains an immobilized state for hours What would be an appropriate short-term outcome for a patient diagnosed with residual schizophrenia who exhibits ambivalence? a. Decide their own daily schedule. b. Decide which unit groups they will attend. c. Choose which clinic staff member to work with. d. Choose between two outfits to wear each morning. d. Choose between two outfits to wear each morning. What is the priority nursing diagnosis for a catatonic patient? a. Ineffective coping b. Impaired physical mobility c. Impaired social interaction d. Risk for deficient fluid volume d. Risk for deficient fluid volume Which nursing diagnosis is appropriate for a patient who insists being called Your Highness and demonstrates loosely associated thoughts? a. Risk for violence b. Defensive coping c. Impaired memory d. Disturbed thought processes d. Disturbed thought processes Which initial short-term outcome would be appropriate for a patient who was admitted expressing delusional thoughts? a. Accept that delusion is illogical. b. Distinguish external boundaries. c. Explain the basis for the delusions. d. Engage in reality-oriented conversation. d. Engage in reality-oriented conversation. Which of the following interventions should the nurse plan to use to reduce patient focus on delusional thinking? a. Confronting the delusion b. Refuting the delusion with logic c. Exploring reasons the patient has the delusion d. Focusing on feelings suggested by the delusion d. Focusing on feelings suggested by the delusion Which assessment observation supports a patients diagnosis of disorganized schizophrenia? a. Reports suicidal ideations b. Last relapse was 6 years ago c. Consistent inappropriate laughing d. Believes that the government is out to get me c. Consistent inappropriate laughing A patient tried to gouge out his eye in response to auditory hallucinations commanding, If thine eye offends thee, pluck it out. The nurse would analyze this behavior as indicating: a. Derealization b. Inappropriate affect c. Impaired impulse control d. Inability to manage anger c. Impaired impulse control An appropriate intervention for a patient with an identified nursing diagnosis of situational low self-esteem would be: a. Providing large muscle activities to relieve stress b. Attempting to determine triggers to hallucinations c. Engaging patient in activities designed to permit success d. Encouraging verbalization of feelings in a safe environment c. Engaging patient in activities designed to permit success A 19-year-old patient is admitted for the second time in 9 months and is acutely psychotic with a diagnosis of undifferentiated schizophrenia. The patient sits alone rubbing her arms and smiling. She tells the nurse her thoughts cause earthquakes, and that the world is burning. The nurse assesses the primary deficit associated with the patient's condition as: a. Social isolation b. Disturbed thinking c. Altered mood states d. Poor impulse b. Disturbed thinking A patient has been admitted with disorganized type schizophrenia. The nurse observes blunted affect and social isolation. He occasionally curses or calls another patient a jerk without provocation. The nurse asks the patient how he is feeling, and he responds, Everybody picks on me. They frobitz me. The patients communication exhibits: a. A neologism b. Loose associations c. Delusional thinking d. Circumstantial speech a. A neologism A patient has been admitted with disorganized type schizophrenia. The nurse asks the patient how he is feeling, and he responds, Everybody picks on me. They frobitz me. The best response for the nurse to make would be: a. Thats really too bad that you are being treated that way. b. Who do you mean when you say everybody? c. What difference does frobitzing make? d. Why do they frobitz? b. Who do you mean when you say everybody? Which patient behavior would support the diagnosis of residual schizophrenia with negative symptoms? a. Communicating using only rhyming phases b. Claims that worms are crawling in my brain c. Maintaining both arms suspended awkwardly overhead d. Shows no emotion when telling the story of a sisters recent death d. Shows no emotion when telling the story of a sisters recent death By discharge, which outcome is appropriate for a patient who hears voices telling him he is evil? a. Respond verbally to the voices. b. Verbalize the reason the voices say he is evil. c. Identify events that increase anxiety and promote hallucinations. d. Integrate the voices into his personality structure in a positive manner. c. Identify events that increase anxiety and promote hallucinations. Which response by the nurse would best assist a patient in deescalating aggressive behavior? a. Tell me whats going on. b. Why are you getting so upset? c. If you throw something, you will be restrained. d. Its time for group therapy. You can talk there. a. Tell me whats going on. A 34-year-old male admitted with catatonic schizophrenia has been mute and motionless for several days while at home prior to admission. He still appears stuporous in the hospital. Which nursing intervention would be an initial priority? a. Orienting the patient to the unit b. Reinforcing reality with the patient c. Establishing a nonthreatening relationship d. Assessing the patient for physical problems d. Assessing the patient for physical problems Which response is appropriate when a patients mother expresses guilt over causing my child to be schizophrenic? a. I can see how you would be upset over this turn of events. b. New findings suggest this disorder is biological in nature. c. Dont be so hard on yourself; your daughter needs you to be strong. d. Its difficult to see what produces stress for the child at the time its occurring. b. New findings suggest this disorder is biological in nature. Which response demonstrates both empathy and understanding of the relationship genetics has to the development of schizophrenia in twins? a. In fraternal twins, the chance of the other twin developing the disorder is quite small. b. Studies show that 50% of twins develop schizophrenia when it is present in the other twin. c. No one can say what will happen, so we will hope for the best for you and both of your sons. d. You poor woman! I wish I could tell you that your other son he will be free of the disorder. a. In fraternal twins, the chance of the other twin developing the disorder is quite small. The wife of a patient diagnosed with paranoid schizophrenia asks, Ive been told that my husbands illness is probably related to imbalanced brain chemicals. Can you be more specific? The response based on the dopamine hypothesis is: a. Breakdown of dopamine produces LSD, which in large amounts produces a. psychosis. b. An increase in the brain chemical dopamine explains the presence of delusions and hallucinations. c. Decreased amounts of the brain chemical dopamine explain the presence of c. delusions and hallucinations. d. An increase in the brain chemical dopamine explains the presence of lack of motivation and disordered affect. b. An increase in the brain chemical dopamine explains the presence of delusions and hallucinations. What is the basis for the reduction in disturbed thought processes when a patient is administered haloperidol (Haldol)? a. Reduction in the number of brain cells that crave dopamine b. Dopamine receptors are blocked, making dopamine less available c. Dopamine receptors are enhanced, making more dopamine available d. Medication causes an increased cellular production of dopamine b. Dopamine receptors are blocked, making dopamine less available During a treatment team meeting, the point is made that a patient with schizophrenia has recovered from the acute psychosis but continues to demonstrate apathy, avolition, and blunted affect. The nurse who relates these symptoms to serotonin (5HT2) excess will suggest that the patient receive: a. Haloperidol (Haldol) b. Chlorpromazine (Thorazine) c. Olanzapine (Zyprexa) d. Phenelzine (Nardil) c. Olanzapine (Zyprexa) What response would be anticipated when a patient who received chlorpromazine (Thorazine) for 15 years to treat schizophrenia is switched to Seroquel (quetiapine)? a. Development of pseudoparkinsonism b. Development of dystonic reactions c. Improvement in tardive dyskinesia d. Worsening of anticholinergic symptoms c. Improvement in tardive dyskinesia A patient admitted with the diagnosis of schizophreniform disorder R/O organic pathology. Based on this information, the nurse can expect that the patient will: a. Be scheduled for a magnetic resonance imaging (MRI) test b. See a mental health specialist for extensive psychological testing c. Have an immunologic assay performed within 2 days of the admission d. Participate in a dexamethasone suppression test (DST) administered by the staff a. Be scheduled for a magnetic resonance imaging (MRI) test In planning aftercare for a patient with schizophrenia and whose insurance benefits have been exhausted, the nurse who is concerned about overcoming negative symptoms will make provisions for the patient to have stimulation, structure, socialization, and support. Which option would best incorporate these factors? a. Day hospitalization b. Attending a psychosocial club c. Living with his elderly mother d. Spending free time in the mall b. Attending a psychosocial club A patient with catatonic schizophrenia has been standing with his left arm upraised and his right foot off the floor for the majority of the last 20 hours, eating only when allowed to eat standing up. Which nursing intervention has priority for this patient? a. Providing high-calorie drinks hourly b. Assessing for lower extremity edema bid c. Taking the patient to activities therapy once daily d. Encouraging the patient to sit or lie down for 30 minutes hourly b. Assessing for lower extremity edema bid Which nursing action best addresses the needs of a paranoid patient who believes the food is poisoned? a. Explaining that others eat the food and are not harmed b. Allowing the patient to select food from vending machines c. Encouraging the patient to discuss why someone would poison the food d. Taking steps to prevent the patient from verbalizing the delusional thoughts b. Allowing the patient to select food from vending machines Prior to discharge, the nurse plans to teach the patient and family about relapse. Which items will the nurse include in the teaching? a. Recognizing warning signs of relapse b. Using street drugs judiciously and only in small amounts c. Lowering medication dosage to manage emerging side effects d. Notifying the nurse of warning signs present for more than one month a. Recognizing warning signs of relapse Because of the cognitive disturbances associated with schizophrenia, which technique will be useful as the nurse teaches a patient about self management? a. Use only verbal instruction. b. Teach material in small segments. c. Offer opportunities for making numerous choices. d. Plan the teaching for a time when the patient has been recently medicated b. Teach material in small segments. The wife of a patient newly diagnosed with paranoid schizophrenia is concerned that her husband will be this sick for the rest of his life. What information can the nurse provide to the wife? a. This disorder generally responds well with treatment and follow-up. b. All types of schizophrenia by their nature are chronic relapsing disorders. c. Outcomes are related to the patients pre-hospital symptoms of disorganization. d. The typical outcome for this diagnosis is that total remission is not achievable. a. This disorder generally responds well with treatment and follow-up. A patient is exhibiting auditory hallucinations in addition to being forgetful and easily confused. Which diagnosis does the nurse base this patients interventions on? a. Social isolation b. Deficient knowledge c. Situational low self-esteem d. Impaired cognitive functioning d. Impaired cognitive functioning A patient experiences intrusive, insulting auditory hallucinations. Which independent behavioral technique can the nurse teach the patient to employ when the voices are troublesome? a. Introduce a distraction like reading. b. Use positive talk to offset the insults. c. Sing or whistle to compete with the voices. d. Increase the daily dose of an antipsychotic medication. c. Sing or whistle to compete with the voices. A patient with schizophrenia tells the nurse as they sit in the day room, I hear voices telling me bad things. The most therapeutic response the nurse can make is: a. Tell me what the voices are saying. b. I believe you hear voices, but I dont hear them myself. c. The voices are not real. Theyre a product of your imagination. d. Do you think the voices would go away if we went into your room to talk? b. I believe you hear voices, but I dont hear them myself. A patient tells the nurse, When Im in the day room, I hear people whispering about me, and that makes me want to punch them. What direction will the nurse provide the staff regarding interacting with this patient? a. To minimize the need to whisper, utilize nonverbal techniques when possible. b. Stay physically close to this patient and use touch as a tool to interact with him. c. Treat this patient matter-of-factly. Be direct; dont talk about him or others in his presence. d. Interact with this patient only when necessary. The fewer interactions, the fewer misinterpretations there will be. c. Treat this patient matter-of-factly. Be direct; dont talk about him or others in his presence. A patient with schizophrenia is medication compliant and has well-controlled symptoms. He has, however, never been successful in holding a job because of poor social skills and lack of understanding of basic job skills. The nurse case manager should consider referring the patient: a. For cognitive therapy b. To assertiveness training c. To a day hospital program d. For psychosocial rehabilitation d. For psychosocial rehabilitation A patient prescribed an antipsychotic medication develops a high fever, unstable blood pressure, and muscle rigidity. Her next dose of medication is due. The nurse should: a. Administer the medication and monitor the vital signs every 4 hours. b. Give a lower dose of the medication for 24 hours and monitor the blood pressure. c. Prepare to administer a prn dose of the anticholinergic drug benztropine (Cogentin). d. Hold the medication and immediately describe the patients symptoms to the doctor. d. Hold the medication and immediately describe the patients symptoms to the doctor. The nurse is assessing a patient who is complaining of hearing voices. What is this patient experiencing? a. Delusions b. Flight of ideas c. Disorganized thinking d. Hallucinations d. Hallucinations A patient with schizophrenia has been nonadherent with his home medication regimen. He requires frequent admissions to the intensive psychiatric unit for treatment of acute psychotic episodes. Which medication regimen would be appropriate for this patient? a. Daily home nursing visits to administer the prescribed oral medication b. Continuous inpatient hospitalization for medication therapy c. Administration of depot antipsychotic medication d. Subcutaneous medication administration c. Administration of depot antipsychotic medication What is the most common cause of nonadherence to antipsychotic pharmacologic treatment? a. Expense b. Increased symptoms of chemical dependency c. Extrapyramidal effects d. Inability of the patient to understand the need to take medications c. Extrapyramidal effects Which type of adverse effects is present when a patient displays prolonged tonic contractions of the tongue, oculogyric crisis, and torticollis? a. Dystonic reactions b. Pseudoparkinsonism c. Akathisia d. Tardive dyskinesia a. Dystonic reactions The nurse is teaching a patient who is taking clozapine (Clozaril) to have weekly blood tests for the first 6 months of treatment to monitor for which potential complication? a. Agranulocytosis b. Vitamin deficiencies c. Clotting abnormalities d. Polycythemia a. Agranulocytosis A male patient becomes verbally aggressive and insists the nurse is poisoning him as she attempts to administer haloperidol (Haldol). Which action will the nurse take? a. Support the patients decision to refuse the medication. b. Discreetly ask an assistant to put the medication in the patients food. c. Firmly redirect the patient to take the medication. d. Speak privately with the patient and reinforce medication action. c. Firmly redirect the patient to take the medication. Which statement is true regarding the adverse effects associated with antipsychotic medications? a. Tardive dyskinesia is a common, reversible condition. b. Painful dystonic reactions can occur in the first 72 hours of initiation of therapy. c. Neuroleptic malignant syndrome (NMS) is a common adverse effect. d. Pseudoparkinsonian symptoms can cause Parkinsons disease. b. Painful dystonic reactions can occur in the first 72 hours of initiation of therapy. To what does potency of an antipsychotic medication refer? a. Severity of adverse effects associated with the drug b. Length of time that it takes to reach a therapeutic blood level of the drug c. Milligram doses used for the medication d. Effectiveness of the drug in alleviating psychotic behavior c. Milligram doses used for the medication Dystonic reactions, pseudoparkinsonism, akathisia, and tardive dyskinesia are types of which effect? a. Extrapyramidal symptoms b. Allergic reactions c. Idiosyncratic reactions d. Therapeutic responses a. Extrapyramidal symptoms Which is an appropriate nursing intervention for a patient who has recently been prescribed clozapine (Clozaril)? a. Assess for signs and symptoms of hypoglycemia. b. Encourage a low fiber diet. c. Measure the patients waist circumference. d. Monitor for insomnia. c. Measure the patients waist circumference. A young male patient taking an antipsychotic is experiencing an oculogyric crisis. The nurse prepares to administer: a. diphenhydramine. b. haloperidol. c. aripiprazole. d. risperidone. a. diphenhydramine. What occurs with mania associated with bipolar disorder? a. Varying degrees of sadness b. Distinct episodes of elation c. Suicide d. Psychomotor retardation b. Distinct episodes of elation Which postoperative narcotic analgesic will most likely be prescribed to a patient whose current medications include a monoamine oxidase inhibitor (MAOI), a thyroid hormone, and a multivitamin? a. Meperidine (Demerol) b. Morphine c. Ibuprofen (Advil) d. Acetaminophen (Tylenol) b. Morphine What is the major advantage of selective serotonin reuptake inhibitors (SSRIs) over other types of antidepressant therapy? a. They are less expensive than the other classes of antidepressants. b. They cure major depressive illnesses. c. They do not cause the anticholinergic and cardiovascular adverse effects. d. Therapeutic relief is immediate. c. They do not cause the anticholinergic and cardiovascular adverse effects. Lithium (Eskalith) is the drug of choice for which of the following disorders? a. Psychotic episodes b. Obsessive compulsive disorders (OCDs) c. Bipolar disorders d. Depressive disorders c. Bipolar disorders Which psychological manifestation of depression will improve in response to antidepressant therapy? a. Loss of energy b. Palpitations c. Sleep disturbances d. Social d. Social On what is the choice of tricyclic antidepressants based? a. The need to decrease the action of norepinephrine, dopamine, or serotonin b. Patient age and gender c. An absence of adverse effects, such as orthostatic hypotension d. The need for stimulation and increased mental alertness b. Patient age and gender The nurse is teaching a patient about medication treatment for depression. The patient asks how long it will take before sleep and appetite will begin to improve. Which response by the nurse is most accurate? a. 3 days b. 1 week c. 4 weeks d. 2 months b. 1 week What is the action of MAOIs on neurotransmitters? a. Blocking their reuptake b. Increasing their production c. Blocking their destruction d. Increasing their reuptake c. Blocking their destruction A patient who is taking an MAOI to treat depression admits to eating pickled herring and cheese and drinking red wine. Which assessment finding alerts the nurse to a potential complication? a. Constipation b. Hypotension c. Neck stiffness d. Urinary retention c. Neck stiffness Which assessment would the nurse expect to observe in a patient who has been prescribed trazodone for treatment anxiety? a. Excessive thirst b. Hand tremor c. Drowsiness d. Diarrhea c. Drowsiness The nurse is caring for a patient who is taking a newly prescribed drug, nefazodone, for treatment of depression. Which physical assessment finding is most important for the nurse to report to the health care provider immediately? a. Bradycardia b. Dizziness c. Drowsiness d. Urinary a. Bradycardia The nurse is providing education to a patient who has been prescribed bupropion (Wellbutrin) for smoking cessation. Which statement by the patient would indicate the need for further teaching? a. My dose will increase after 3 days. b. I should swallow this medication whole. c. If I have the urge to smoke, I will take more medication. d. I do not need to taper my dose when the drug is discontinued. c. If I have the urge to smoke, I will take more medication. Which nursing action is most important when providing care to a patient diagnosed with a mood disorder? a. Assess the patient for thoughts of suicide. b. Provide supplemental feedings as needed. c. Assist with activities of daily living. d. Offer opportunities for interaction with other patients. a. Assess the patient for thoughts of suicide. A patient is admitted to a long term psychiatric setting. The MAOI medication previously prescribed is discontinued by the physician. New orders are obtained to initiate imipramine therapy. The nurse will provide the first dose of imipramine to the patient the MAOI drug. a. immediately following the last dose of b. in 1 week following the last dose of c. in 14 days following the last dose of d. before discontinuing c. in 14 days following the last dose of A patient taking vilazodone has been vomiting persistently for 12 hours. The priority nursing diagnosis for this patient is: a. nausea. b. imbalanced nutrition (less than body requirements). c. fluid volume deficit. d. altered peripheral tissue perfusion. c. fluid volume deficit. You are admitting a new patient who is depressed. Your initial contact should do what? A. Address why he is depressed B. Keep communication open C. Lift his spirits D. Establish trust D. Establish trust In caring for a patient with major depression, the nurse knows that the patient needs: A. Frequent changes in activities. B. Introduction to multiple new staff members. C. Behavior modification that restructures feelings. D. Well-defined, structured interactions at the beginning of treatment. D. Well-defined, structured interactions at the beginning of treatment. Patients with major depression commonly display signs of: A. Energy. B. Repetitive, compulsive behaviors. C. Worthlessness. D. Visual hallucinations. C. Worthlessness. When your patient says I am depressed, what is the best response? A. We all feel that way now and then. B. Why do you feel that way? C. Everything will be OK once you snap out of it. D. Tell me more about what is going on with you. D. Tell me more about what is going on with you. Your patient takes tranylcypromine for depression. Which of the following is most likely to indicate dietary restrictions have not been followed? A. Hypertensive crisis B. Syncope C. Muscle spasms D. Increased depression A. Hypertensive crisis Your depressed patient who is taking a tricyclic antidepressant is advised of possible anticholinergic side effects. Which of the following is NOT an anticholinergic side effect? A. Blurred vision B. Difficulty starting urine stream C. Dry mouth D. Muscle rigidity D. Muscle rigidity Helen, a 47-year-old client with a long history of severe depression, has not responded to antidepressant medications or psychotherapy. The nurse caring for the patient knows that the treatment of choice for depression unresponsive to conventional treatment would be: A. Lithium. B. Electroconvulsive therapy (ECT). C. Light therapy. D. Neurolinguistic programming. B. Electroconvulsive therapy (ECT). Your depressed patient is just started on duloxetine (Cymbalta). Which statement by the spouse tells you that family teaching has been effective? A. I cant wait for him to be back to his old self in the next day or so. B. I realize we cant expect big changes right away. C. I have to take him for weekly blood tests to monitor the drug dosage. I will make sure he doesnt eat any aged cheese for the next 2 months until the D. dose is stabilized. B. I realize we cant expect big changes right away. Biological theories of depressive disorders include all of the following except: A. Chemical imbalances are responsible. B. The patient experiences maladaptive thought processes. C. There are genetic tendencies that run in families. D. Hormonal factors make women more susceptible than men. B. The patient experiences maladaptive thought processes. Light therapy has been shown to be effective in treating patients with: A. Bipolar disorder. B. Dysthymia. C. Major depression with seasonal pattern. D. Schizophrenia. C. Major depression with seasonal pattern. You are doing patient teaching for Margaret, who has been prescribed amitriptyline (Elavil) for treatment of depression. Which of the following statements suggests that Margaret needs further instruction? A. I know I might not start feeling better for a few weeks, but Ill keep taking the medication just as the doctor prescribed. B. Ill keep some hard candies in my purse in case my mouth gets dry from the medicine. C. Once I start feeling better, Im looking forward to cutting down on this medication. D. Im worried I may gain some weight, but thats a small price to pay for feeling better. C. Once I start feeling better, Im looking forward to cutting down on this medication. What is the main difference between major depression and dysthymic depression? A. Dysthymia is a short-term depression and major depression lasts for years. B. Dysthymia is a chronic, low-level depression that lasts for years, while major depression is more severe. C. Dysthymia is more likely to be caused by psychological factors and major depression is caused by neurological dysfunction. D. Dysthymia is normally treated with psychotherapy only, while major depression is treated with antidepressants and psychotherapy. B. Dysthymia is a chronic, low-level depression that lasts for years, while major depression is more severe. Your depressed patient is starting a new medication called phenelzine (Nardil). Which teaching would be most important to emphasize? A. Educate the patient to take this medication ongoing, even as symptoms improve. B. Instruct the patient and family about the many food-drug interactions. C. Instruct the patient about interventions to relieve dry mouth. D. Inform the patient that this medication takes 4 to 6 weeks to take full effect. B. Instruct the patient and family about the many food-drug interactions. Which of the following antidepressants is a tricyclic? A. Bupropion (Wellbutrin) B. Sertraline (Zoloft) C. Nortripyline (Pamelor) D. Venlafaxine (Effexor) C. Nortripyline (Pamelor) Which statement is most true about depression? A. It is more common in women than men. B. It is rare to have more than one episode of major depression in ones lifetime. C. Young children do not suffer from depression. D. As one ages, there is reduced risk of depression. A. It is more common in women than men. A newly admitted client has been diagnosed with major depressive disorder. Which nursing diagnosis takes priority? A. Impaired social interaction B. Self-esteem deficit C. Hopelessness D. Self-care deficit C. Hopelessness The nurse knows that the two factors that often differentiate major depression from dysthymia depression are: A. Amounts of mania and sadness. B. Presence or absence of anger and guilt. C. Severity and duration of symptoms. D. Patients gender and age. C. Severity and duration of symptoms. You are caring for an older adult who is recently widowed. She says, No one cares if I die. Everyone I ever loved is dead. What is the best response? A. I am sure that you still have people who care about you. B. You sound like you are feeling all alone. C. Boy, that is depressing. D. I dont believe that. B. You sound like you are feeling all alone. Your patient with major depression tells you he suffers from urinary retention. Which medication would be most likely to cause this? A. Amitriptyline B. Duloxetine C. Carbamazepine D. Ritalin A. Amitriptyline Which activity would be best for a depressed patient? A. A puzzle B. Drawing C. Crossword puzzles D. Television B. Drawing Which of the following meal choices indicates the patient understands the diet restrictions when taking an MAOI? A. Pepperoni pizza and beer B. Roast chicken, baked potato, and beer C. Fried fish, rice, and cola D. Pickled herring, eggs, and coffee C. Fried fish, rice, and cola Your patient with major depression sits in her room for hours staring out the window. Which of the following would be the most appropriate intervention? A. Sit with the patient and gently offer your availability to help. B. Keep encouraging the patient to go to exercise class. C. Offer the class once and then let the patient decide. D. Sit with the patient and ask her to list reasons for her depression. A. Sit with the patient and gently offer your availability to help. Which of the following drugs is a tricyclic antidepressant? A. Bupropion (Wellbutrin) B. Amitriptyline (Elavil) C. Fluoxetine (Prozac) D. Citalopram (Celexa) B. Amitriptyline (Elavil) Some medications such as tricyclics cause blurred vision. What is the cause of this effect? A. Hyperglycemia B. Anticholinergic effect C. Hypoxia D. Hypertension B. Anticholinergic effect Your patient has been taking a SSRI antidepressant for 6 weeks. On arrival at the clinic, which observation would indicate a positive outcome from the medication? A. Patient reports sleeping 12 hours a night. B. Patient reports sleeping 3 hours a night. C. Patient reports a weight loss of 10 pounds. D. Patient arrives neatly dressed. D. Patient arrives neatly dressed. Which response best describes how dysthymic disorder is different from major depression? A. More severe depression with psychotic features B. Chronic low level depression C. Mild depression with episodes of hypomania D. Depression with more anxiety symptoms B. Chronic low level depression Which of the following would be the most effective intervention for a depressed patient? A. Establish one small goal to accomplish today. B. Help the patient develop a goal to complete in the next month. C. Encourage the patient to talk about recent failures in his or her life. D. Let the patient guide what is the next best action. A. Establish one small goal to accomplish today. Which of the following is an important intervention for a patient taking nortriptyline? A. Make sure that CBC is ordered to monitor blood counts. B. Monitor for anticholinergic side effects. C. Ensure that the patients diet is gluten free. D. Push fluids to prevent dehydration. B. Monitor for anticholinergic side effects. A patient admitted to the mental unit has shown a deficit in providing self- care and has a medical diagnosis of major depression. The nursing diagnosis for this would be: A. Knowledge deficit related to personal choices. B. Self-care deficit related to impaired ability to provide personal hygiene. C. Risk for violence related to poor hygiene. D. Impaired social interaction related to poor hygiene. B. Self-care deficit related to impaired ability to provide personal hygiene. The study of the use of psychotropic medications in the treatment of psychiatric disorders: Psychopharmacology The study of what the body does to drugs: Pharmacokinetics The study of what the drugs does to the body: Pharmacodynamics Involves the absorption, distribution, metabolism and excretion of meds: First Pass Metabolism (C.Y.P. 450) Increase serum levels of other drugs that are substrates of that enzyme: Enzyme inhibitors will slow down metabolism causing toxic levels Decreases serum levels of other drugs that are substrates of that enzyme: Enzyme inducers cause fast metabolism and create subtherapeutic drug levels Part of the brain that regulates powerful emotions such as fear, rage, sexual desires: Amygdala The relay station for sensory information: Thalamus Essential for maintaining homeostasis, controls basic needs such as sleep- wake cycles: Hypothalamus This lobe is involved in executive functioning, high order planning, speech and motivation: Frontal Lobe/ Prefrontal cortex Derived from Tryptophan and made in the Ralphe Nuclei: Serotonin Made in the Locus Ceruleus and involved in the noradrenergic pathways: Norepinephrine 90% of serotonin receptors are found in the: GI tract Produced in the V.T.A. (Reward Pathway) and involved in the four major pathways: Dopamine Dopamine inhibits prolactin in this pathway: Tuberoinfundibular Increase dopamine in this pathway is associated with positive symptoms: Mesolimbic Pathway Decrease dopamine in this pathway is associated with negative symptoms: Mesocortical Pathway Decrease dopamine in this pathway produces motor symptoms: Nigrostriatal Pathway Main inhibitory neurotransmitter that induces calmness and relaxation: Gamma- aminobutyric acid (GABA), Off switch Main excitatory neurotransmitter: Glutamate, On Switch Major organ that breaks down drugs in the body: Liver Electrolyte imbalance commonly associated with psychotropic medication use: Hyponatremia The time needed to clear 50% if drugs from the plasma: Half-life The process of becoming desensitized and less responsive to a particular medication dose overtime necessitating an increase: Tolerance A ration describing toxic dose to effective dose: Therapeutic Index A chemical that binds to a receptor to produce a biologic response: Agonist A chemical that binds to a receptor but does not fully activate the receptor: Partial Agonist A chemical that binds to a receptor, blocking it to inhibit a biologic response: Antagonist An agent that binds to the same receptor as an agonist but induces an opposite biological response: Inverse Agonist A usually undesired but foreseeable effect that occurs regardless of dose and often resolves after continued therapy: Side Effects S/S opposite of what it was meant to treat: Paradoxical Reaction The four main dopamine pathways: Mesolimbic, mesocortical, nigrostriatal, tuberoinfundibular Symptoms of Schizophrenia are divided into BLANK and BLANK: positive and negative symptoms True or False: Antipsychotic polypharmacy can increase the risk of re-hospitalization, diabetes, E.P.S., sedation, seizures, metabolic effects, mortality, and sudden cardiac death: True Alogia, Anhedonia, Avolition and cognitive symptoms: Negative symptoms Delusions, hallucinations, hostility, grandiosity: positive symptoms Another name for 1st generation antipsychotics: Typical Another name for 2nd generation antipsychotics: Atypical First line treatment for Schizophrenia: Atypical This class is associated with fewer neurological side effects and effective for both positive and negative symptoms: Atypical This class is effective for only positive symptoms and can in fact worsen negative symptoms due to decrease DA in the Mesocortical pathway: Typical Associated with metabolic side effects: Atypical What are the metabolic side effects associated with Atypical Antipsychotics: Weight gain, Hyperlipidemia, diabetes, hypertension, cardiac and respiratory side effects. Includes medications such as Haloperidol, Chlorpromazine, Fluphenazine, Perphenazine: Typical Medications for acute agitation or psychosis: Haldol Includes medications such as Olanzapine, Quetiapine, Risperidone, Clozapine etc.: Atypical F.G.A. reduce dopamine transmission by blocking BLANK receptors. D2 S.G.A. block both BLANK and BLANK receptors. D2 and 5HT2A High incidence of Q.T.C. prolongation, Tardive dyskinesia, Neuroleptic Malignant Syndrome (N.M.S.), orthostatic hypotension: typical H1 blockade leads to symptoms of BLANK and BLANK sedation and weight gain Involuntary teeth grinding associated with antipsychotics: bruxism Safest and best tolerated anticonvulsant for patients taking clozapine who experience dose related seizures: topiramate Less incidence of antiadrenergic, anticholinergic and antihistaminic side effects but greater E.P.S.: high potency Greater incidence of antiadrenergic, anticholinergic and antihistaminic side effects but less E.P.S.: low potency Characterized by bradykinesia, masklike face, cogwheel rigidity, pill rolling tremor: pseudo-Parkinson's Characterized by torticollis, oculogyric crisis and can be life threatening if it affects the airway: acute dystonia Characterized by an internal and external restlessness, constant need to pace or walk: akathisia Onset of symptoms dystonia: hours to days Onset of symptoms Parkinsonism & Akathisia: days to months Onset of symptoms Tardive dyskinesia: months to years True or false: Medications for E.P.S. such as Cogentin, Benadryl and benzos should not be co prescribed to prevent E.P.S. Why? false. They are associated with high anticholinergic side effects. First- line treatment for dystonia: Cogentin First -line treatment for akathisia: beta blockers. Propranolol Occurs due to D2 blockade in the Nigrostriatal pathway and is mostly irreversible: tardive dyskinesia Characteristics of Tardive Dyskinesia: lip smacking, fly catcher tongue, facial grimace, eye blinking, involuntary body movement. Atypical antipsychotic less likely to cause Tardive Dyskinesia: Clozaril Risk factors associated with Tardive Dyskinesia: older age, women, F.G.A. higher dose, African decent, longer duration Screening tool for Tardive Dyskinesia done before prescribing antipsychotic and every 3-6 months: AIMS test. F.D.A. approved medications for Tardive Dyskinesia: valbenazine and deutetrabenazine A life-threatening idiopathic reaction to antipsychotic medication that is considered a medical emergency if left untreated: Neuroleptic Malignant Syndrome or N.M.S. Characteristics of N.M.S. (Know Triad): fever, rigidity, excessive sweating F.G.A. which come in long acting injectables: Haldol, fluphenazine S.G.A. which come in long acting injectables: olanzapine, risperidone, abilify, paliperidone, lavroxil S.G.A. associated with greatest prolactin elevation: risperidone Weight neutral S.G.A. examples: ziprasidone, abilify Only S.G.A. shown to decrease S.I. risk: clozapine S.G.A. associated with agranulocytosis and 30 to 80% sialorrhea: clozapine Clozapine treatment should be interrupted when A.N.C. is below: 1,500 True or false: Patients started on Clozapine need to be registered in the Clozapine: True A patient newly started on Clozapine will require A.N.C. monitoring BLANK for BLANK months: monitoring weekly for 6 months Parameters that require monitoring at baseline and ongoing once a patient is started on an S.G.A.: weight, waist, blood pressure, hemoglobulin A1C, fasting lipids Symptoms of Gynecomastia, erectile dysfunction, galactorrhea, absence of menses are all indicative of D2 blockade in the BLANK pathway and suggestive of BLANK: tuberoinfundibular pathway and suggestive of hyperprolactin When should a provider consider long-acting antipsychotic injectables? non-compliance Blackbox warning associated with antipsychotic use in dementia: increased risk of death BLANK may occur when stopping or reducing an antipsychotic medication. What are the characteristics? withdrawal dyskinesia. Characteristics are similar to tardive dyskinesia Antipsychotic is helpful and improve symptoms of Tardive Dyskinesia: clozapine The primary management of patients who experience tardive dyskinesia: switch to atypical antipsychotic In obese patients seeking antipsychotic medications, the clinician should avoid medications that blocks BLANK: H1 Antipsychotics must occupy more than BLANK PERCENT of BLANK receptors to cause E.P.S. 80 percent of dopamine receptors Monoamines refer to: serotonin, norepinephrine, and dopamine According to the BLANK theory of depression, a deficiency in serotonin, norepinephrine and dopamine results in depression. Monoamine theory What are the major classes of antidepressants? S.S.R.I., S.N.R.I., N.D.R.I., S.P.A.R.I., T.C.A., M.A.O.I. Number 1 reason why some patients stop taking their antidepressant Medications: side effects (sexual dysfunction) Mechanism of action of S.S.R.I: inhibits reuptake of serotonin causing more available serotonin First-line treatment for Major Depressive Disorder: S.S.R.I. Advantage of S.S.R.I over the other classes of antidepressants: low incidence of side effects True or False: GI side effects associated with antidepressants are often transient lasting 1 to 2 weeks. True S.S.R.I with the longest half life: fluoxetine (Prozac) S.S.R.I that is F.D.A. approved for O.C.D.: Fluvoxamine (Luvox) S.S.R.I with the shortest half-life, significant side effects such as anticholinergic and sexual dysfunction: Paroxetine (Paxil) Class side effects of S.S.R.I include: sexual dysfunction, G.I. side effects S.S.R.I most lethal in overdose and associated with dose dependent Q.T.C prolongation in doses 40mg+ : Citalopram (celexa) S.S.R.I with the most G.I. side effects and should be given with food to increase bioavailability: Sertraline S.S.R.I considered to be generally favored during pregnancy and nursing: sertraline Duloxetine, Venlafaxine are all examples of which class of antidepressants: serotonin norepinephrine reuptake inhibitors ( S.N.R.I). Fluoxetine, Paroxetine, Sertraline, Citalopram are all examples of which class of antidepressants: S.S.R.I. Bupropion is