NURS 354 Exam 2(100% Accurate)
Anti-anxiety drugs are called minor tranquilizers and ____________________ -
ANSWERSAnxiolytics
Which of the following instructions regarding lithium therapy should be included in a
nurse's discharge teaching? (Select all that apply.)
1. Avoid excessive use of beverages containing caffeine.
2. Maintain a consistent sodium intake.
3. Consume at least 2,500 to 3,000 mL of fluid per day.
4. Restrict sodium content.
5. Restrict fluids to 1,500 mL per day. - ANSWERSANS: 1, 2, 3
Rationale: The nurse should instruct the client taking lithium to avoid excessive use of
caffeine, maintain a consistent sodium intake, and consume at least 2,500 to 3,000 mL
of fluid per day. The risk of developing lithium toxicity is high because of the narrow
margin between therapeutic doses and toxic levels. Fluid or sodium restriction can
impact lithium levels.
A nurse is administering risperidone (Risperdal) to a client diagnosed with
schizophrenia spectrum disorder. Which of the following client symptoms would most
likely decrease because of the therapeutic effect of this medication? (Select all that
apply.)
1. Somatic delusions
2. Social isolation
3. Gustatory hallucinations
4. Flat affect
5. Clang associations - ANSWERSANS: 1, 3, 5
Rationale: The nurse should expect that risperidone would be effective treatment for the
positive symptoms of somatic delusions, gustatory hallucinations, and clang
associations. Risperidone is an atypical antipsychotic that has been effective in the
treatment of the positive symptoms of schizophrenia and in maintenance therapy to
prevent exacerbation of schizophrenic symptoms.
A client is prescribed phenelzine (Nardil). Which of the following statements by the client
should indicate to a nurse that discharge teaching about this medication has been
successful? (Select all that apply.)
1. "I'll have to let my surgeon know about this medication before I have my
cholecystectomy."
2. "I guess I will have to give up my glass of red wine with dinner."
3. "I'll have to be very careful about reading food and medication labels."
4. "I'm going to miss my caffeinated coffee in the morning."
5. "I'll be sure not to stop this medication abruptly." - ANSWERSANS: 1, 2, 3, 5
Rationale: The nurse should evaluate that teaching has been successful when the client
states that phenelzine should not be taken in conjunction with the use of alcohol or
, foods high in tyramine and should not be stopped abruptly. Phenelzine is an MAOI that
can have negative interaction with other medications. The client needs to tell other
physicians about taking MAOIs, because of the risk of drug interactions.
Which of the following medications that have been known to precipitate delirium?
(Select all that apply.)
1. Antineoplastic agents
2. H2-receptor antagonists
3. Antihypertensives
4. Corticosteroids
5. Lipid-lowering agents - ANSWERSANS: 1, 2, 3, 4
Rationale: Medications that have been known to precipitate delirium include
anticholinergics, antihypertensives, corticosteroids, anticonvulsants, cardiac glycosides,
analgesics, anesthetics, antineoplastic agents, antiparkinson drugs, H2-receptor
antagonists (e.g., cimetidine), and others. There have been no reports of delirium
ascribed to the use of lipid-lowering agents.
Which of the following symptoms should a nurse associate with the development of
increased levels of thyroid-stimulating hormone (TSH) in a newly admitted client?
(Select all that apply.)
1. Depression
2. Fatigue
3. Increased libido
4. Mania
5. Hyperexcitability - ANSWERSANS: 1, 2
Rationale: The nurse should associate depression and fatigue with increased levels of
TSH. TSH is only increased when thyroid levels are low, as in the diagnosis of
hypothyroidism. In addition to depression and fatigue, other symptoms, such as
decreased libido, memory impairment, and suicidal ideation are associated with chronic
hypothyroidism.
A nurse prepares to assess a client using the Abnormal Involuntary Movement Scale
(AIMS). Which side effect of antipsychotic medications led to the use of this assessment
tool?
1. Dystonia
2. Tardive dyskinesia
3. Akinesia
4. Akathisia - ANSWERSANS: 2
Rationale: The AIMS is a rating scale that was developed in the 1970s by the National
Institute of Mental Health to measure involuntary movements associated with tardive
dyskinesia.
A client began taking lithium carbonate (Lithobid) for the treatment of bipolar disorder
approximately 1 month ago. The client asks if it is normal to have gained 12 pounds in
this time frame. Which is the appropriate nursing response?
1. "That's strange. Weight loss is the typical pattern."
Anti-anxiety drugs are called minor tranquilizers and ____________________ -
ANSWERSAnxiolytics
Which of the following instructions regarding lithium therapy should be included in a
nurse's discharge teaching? (Select all that apply.)
1. Avoid excessive use of beverages containing caffeine.
2. Maintain a consistent sodium intake.
3. Consume at least 2,500 to 3,000 mL of fluid per day.
4. Restrict sodium content.
5. Restrict fluids to 1,500 mL per day. - ANSWERSANS: 1, 2, 3
Rationale: The nurse should instruct the client taking lithium to avoid excessive use of
caffeine, maintain a consistent sodium intake, and consume at least 2,500 to 3,000 mL
of fluid per day. The risk of developing lithium toxicity is high because of the narrow
margin between therapeutic doses and toxic levels. Fluid or sodium restriction can
impact lithium levels.
A nurse is administering risperidone (Risperdal) to a client diagnosed with
schizophrenia spectrum disorder. Which of the following client symptoms would most
likely decrease because of the therapeutic effect of this medication? (Select all that
apply.)
1. Somatic delusions
2. Social isolation
3. Gustatory hallucinations
4. Flat affect
5. Clang associations - ANSWERSANS: 1, 3, 5
Rationale: The nurse should expect that risperidone would be effective treatment for the
positive symptoms of somatic delusions, gustatory hallucinations, and clang
associations. Risperidone is an atypical antipsychotic that has been effective in the
treatment of the positive symptoms of schizophrenia and in maintenance therapy to
prevent exacerbation of schizophrenic symptoms.
A client is prescribed phenelzine (Nardil). Which of the following statements by the client
should indicate to a nurse that discharge teaching about this medication has been
successful? (Select all that apply.)
1. "I'll have to let my surgeon know about this medication before I have my
cholecystectomy."
2. "I guess I will have to give up my glass of red wine with dinner."
3. "I'll have to be very careful about reading food and medication labels."
4. "I'm going to miss my caffeinated coffee in the morning."
5. "I'll be sure not to stop this medication abruptly." - ANSWERSANS: 1, 2, 3, 5
Rationale: The nurse should evaluate that teaching has been successful when the client
states that phenelzine should not be taken in conjunction with the use of alcohol or
, foods high in tyramine and should not be stopped abruptly. Phenelzine is an MAOI that
can have negative interaction with other medications. The client needs to tell other
physicians about taking MAOIs, because of the risk of drug interactions.
Which of the following medications that have been known to precipitate delirium?
(Select all that apply.)
1. Antineoplastic agents
2. H2-receptor antagonists
3. Antihypertensives
4. Corticosteroids
5. Lipid-lowering agents - ANSWERSANS: 1, 2, 3, 4
Rationale: Medications that have been known to precipitate delirium include
anticholinergics, antihypertensives, corticosteroids, anticonvulsants, cardiac glycosides,
analgesics, anesthetics, antineoplastic agents, antiparkinson drugs, H2-receptor
antagonists (e.g., cimetidine), and others. There have been no reports of delirium
ascribed to the use of lipid-lowering agents.
Which of the following symptoms should a nurse associate with the development of
increased levels of thyroid-stimulating hormone (TSH) in a newly admitted client?
(Select all that apply.)
1. Depression
2. Fatigue
3. Increased libido
4. Mania
5. Hyperexcitability - ANSWERSANS: 1, 2
Rationale: The nurse should associate depression and fatigue with increased levels of
TSH. TSH is only increased when thyroid levels are low, as in the diagnosis of
hypothyroidism. In addition to depression and fatigue, other symptoms, such as
decreased libido, memory impairment, and suicidal ideation are associated with chronic
hypothyroidism.
A nurse prepares to assess a client using the Abnormal Involuntary Movement Scale
(AIMS). Which side effect of antipsychotic medications led to the use of this assessment
tool?
1. Dystonia
2. Tardive dyskinesia
3. Akinesia
4. Akathisia - ANSWERSANS: 2
Rationale: The AIMS is a rating scale that was developed in the 1970s by the National
Institute of Mental Health to measure involuntary movements associated with tardive
dyskinesia.
A client began taking lithium carbonate (Lithobid) for the treatment of bipolar disorder
approximately 1 month ago. The client asks if it is normal to have gained 12 pounds in
this time frame. Which is the appropriate nursing response?
1. "That's strange. Weight loss is the typical pattern."
