NUR 327 Exam 6 Mood & Affect Questions And
Answers
A nurse in an ED is assessing a patient who has been taking haloperidol for 3 months. The patient has
a temperature of 39.5 C (103.4 F), blood pressure of 150/110 mmHg, and muscle rigidity. Which of
the following complications should the nurse expect?
a. Agranulocytosis
b. Neuroleptic malignant syndrome
c. Akathisia
d. Tardive dyskinesia ANS b. Neuroleptic malignant syndrome
Neuroleptic malignant syndrome (NMS) is a rare and potentially fatal adverse effect of antipsychotic
medications that requires emergency medical intervention. Manifestations of NMS are sudden and
include changes in LOC, seizures, and stupor.
A nurse is caring for a patient who was admitted with acute psychosis and is being treated with
haloperidol. The nurse should suspect that the patient may be experiencing tardive dyskinesia when
the patient exhibits with of the following? Select all that apply.
a. Find hand tremors and pill rolling
b. Tongue thrusting and lip smacking
c. Facial grimacing and eye blinking
d. Urinary retention and constipation
e. Involuntary pelvic rocking and hip thrusting movements ANS b. Tongue thrusting and lip
smacking, c. Facial grimacing and eye blinking, & e. Involuntary pelvic rocking and hip thrusting
movements
Symptoms of tardive dyskinesia can include repetitive, uncontrollable movements such as tongue
thrusting, lip smacking, facial grimacing, eye blinking, and irregular involuntary movements of the
head, neck, trunk, and extremities.
,A nurse is developing a care plan for a patient who has schizophrenia and is taking chlorpromazine.
Which of the following actions should the nurse include in the plan?
a. Monitor the patient's respirations every 4 hours
b. Administer an antacid with the medication to decrease nausea
c. Weigh the patient daily
d. Monitor the patient for signs of bleeding ANS a. Monitor the patient's respirations every 4
hours
Chlorpromazine can cause respiratory depression, dyspnea, and laryngospasm.
A nurse is providing discharge teaching to a patient who has bipolar disorder and will be discharged
with a prescription for lithium. The nurse should teach the patient that which of the following factors
puts her at risk for lithium toxicity?
a. The patient runs 4 miles outdoors every afternoon
b. The patient drinks 2 liters of liquids daily
c. The patient eats 2 to 3 grams of sodium-containing foods daily
d. The patient eats foods high in tyramine ANS a. The patient runs 4 miles outdoors every
afternoon
Strenuous exercise in outdoor heat, which can lead to dehydration, puts the patient at risk for lithium
toxicity. Mild to moderate exercise will not lead to lithium toxicity, but if the patient engages in
strenuous exercise during hot weather, she should take care to replace any water and sodium that
have been lost through profuse sweating. This also applies to other factors that can cause the patient
to become dehydrated, such as having diarrhea or taking diuretics.
A nurse is assessing for the presence of extrapyramidal side effects (EPS) in a patient who is taking
chlorpromazine. Which of the following findings should the nurse recognize as EPS? Select all that
apply.
a. Muscle spasms of the neck
b. Blurred vision
,c. Tremors of the hands
d. Fidgeting behavior
e. Sexual dysfunction ANS a. Muscle spasms of the neck, c. Tremors of the hands, & d.
Fidgeting behavior
Muscle spasms, fidgeting behavior (akathisia), and hand tremors are manifestations of EPS
associated with conventional antipsychotics.
A nurse is caring for a patient who has a serum lithium level of 2.0 mEq/L. Which of the following is
the priority action for the nurse to take?
a. Notify the primary provider the result indicates toxicity
b. Continue to monitor this expected maintenance level
c. Request the provider increase the patient's medication does
d. Check the patient for manifestations of hypernatremia ANS a. Notify the primary provider the
result indicates toxicity
The therapeutic reference range for lithium in 0.8-1.4 mEq/L. The nurse should recognize the patient
could require hospitalization and report the finding to the provider. The nurse should check the
patient for findings associated with advanced to severe lithium toxicity like vision changes,
neurological impairment, and hypotension.
A nurse is providing medication teaching for a patient who has a new prescription for phenelzine.
Which of the following statements should the nurse include in the teaching?
a. You should change positions slowly while taking this medication
b. This medication is prescribed to help overcome alcohol addiction
c. You should omit foods containing oxalates while taking phenelzine
d. You should avoid drinking liquids after your evening meal ANS a. You should change
positions slowly while taking this medication
, Patients should change positions slowly while taking an MAOI due to the risk of orthostatic
hypotension. Lightheadedness and fainting are common when taking phenelzine.
A nurse in an acute care mental facility is preparing to administer morning medication for a patient
who has been taking lithium for 2 weeks and has a current lithium level of 1.0 mEq/L. Which of the
following actions should the nurse take?
a. Prepare for gastric lavage due to an extremely elevated lithium level
b. Administer the morning dose of lithium
c. Check the patient's medication record to assess whether the patient has been refusing her lithium
d. Hold the medication and assess for early manifestations of toxicity ANS b. Administer the
morning dose of lithium
The nurse should administer the lithium dose since a lithium level of 1.0 mEq/L is within the
expected initial therapeutic range of 0.8-1.4 mEq/L. At a therapeutic level the patient might
demonstrate adverse effects of lithium, such as a fine hand tremor, thirst, and mild nausea, and the
nurse should note if any of these manifestations are present. The nurse should continue to monitor for
adverse effects and signs of toxicity, which usually occur at levels of 1.5 mEq/L or higher.
A nurse on a crisis hotline is speaking to a patient who says, "I just took an entire bottle or
amitriptyline." Which of the following responses should the nurse make?
a. I'm glad you called, and I want to send an ambulance to help you
b. You must have been feeling pretty depressed to do that
c. Do you know how many pills were in the bottle?
d. Were you trying to kill yourself by taking an overdose? ANS a. I'm glad you called, and I want
to send an ambulance to help you
Amitriptyline, a tricyclic antidepressant, is used to treat depression. This therapeutic statement shows
the nurse's concern for the patient's safety and responds to the patient's priority need. Maslow's
hierarchy of needs states that the patient's physical and safety needs come first. Therefore, the patient
needs to be evaluated immediately.
Answers
A nurse in an ED is assessing a patient who has been taking haloperidol for 3 months. The patient has
a temperature of 39.5 C (103.4 F), blood pressure of 150/110 mmHg, and muscle rigidity. Which of
the following complications should the nurse expect?
a. Agranulocytosis
b. Neuroleptic malignant syndrome
c. Akathisia
d. Tardive dyskinesia ANS b. Neuroleptic malignant syndrome
Neuroleptic malignant syndrome (NMS) is a rare and potentially fatal adverse effect of antipsychotic
medications that requires emergency medical intervention. Manifestations of NMS are sudden and
include changes in LOC, seizures, and stupor.
A nurse is caring for a patient who was admitted with acute psychosis and is being treated with
haloperidol. The nurse should suspect that the patient may be experiencing tardive dyskinesia when
the patient exhibits with of the following? Select all that apply.
a. Find hand tremors and pill rolling
b. Tongue thrusting and lip smacking
c. Facial grimacing and eye blinking
d. Urinary retention and constipation
e. Involuntary pelvic rocking and hip thrusting movements ANS b. Tongue thrusting and lip
smacking, c. Facial grimacing and eye blinking, & e. Involuntary pelvic rocking and hip thrusting
movements
Symptoms of tardive dyskinesia can include repetitive, uncontrollable movements such as tongue
thrusting, lip smacking, facial grimacing, eye blinking, and irregular involuntary movements of the
head, neck, trunk, and extremities.
,A nurse is developing a care plan for a patient who has schizophrenia and is taking chlorpromazine.
Which of the following actions should the nurse include in the plan?
a. Monitor the patient's respirations every 4 hours
b. Administer an antacid with the medication to decrease nausea
c. Weigh the patient daily
d. Monitor the patient for signs of bleeding ANS a. Monitor the patient's respirations every 4
hours
Chlorpromazine can cause respiratory depression, dyspnea, and laryngospasm.
A nurse is providing discharge teaching to a patient who has bipolar disorder and will be discharged
with a prescription for lithium. The nurse should teach the patient that which of the following factors
puts her at risk for lithium toxicity?
a. The patient runs 4 miles outdoors every afternoon
b. The patient drinks 2 liters of liquids daily
c. The patient eats 2 to 3 grams of sodium-containing foods daily
d. The patient eats foods high in tyramine ANS a. The patient runs 4 miles outdoors every
afternoon
Strenuous exercise in outdoor heat, which can lead to dehydration, puts the patient at risk for lithium
toxicity. Mild to moderate exercise will not lead to lithium toxicity, but if the patient engages in
strenuous exercise during hot weather, she should take care to replace any water and sodium that
have been lost through profuse sweating. This also applies to other factors that can cause the patient
to become dehydrated, such as having diarrhea or taking diuretics.
A nurse is assessing for the presence of extrapyramidal side effects (EPS) in a patient who is taking
chlorpromazine. Which of the following findings should the nurse recognize as EPS? Select all that
apply.
a. Muscle spasms of the neck
b. Blurred vision
,c. Tremors of the hands
d. Fidgeting behavior
e. Sexual dysfunction ANS a. Muscle spasms of the neck, c. Tremors of the hands, & d.
Fidgeting behavior
Muscle spasms, fidgeting behavior (akathisia), and hand tremors are manifestations of EPS
associated with conventional antipsychotics.
A nurse is caring for a patient who has a serum lithium level of 2.0 mEq/L. Which of the following is
the priority action for the nurse to take?
a. Notify the primary provider the result indicates toxicity
b. Continue to monitor this expected maintenance level
c. Request the provider increase the patient's medication does
d. Check the patient for manifestations of hypernatremia ANS a. Notify the primary provider the
result indicates toxicity
The therapeutic reference range for lithium in 0.8-1.4 mEq/L. The nurse should recognize the patient
could require hospitalization and report the finding to the provider. The nurse should check the
patient for findings associated with advanced to severe lithium toxicity like vision changes,
neurological impairment, and hypotension.
A nurse is providing medication teaching for a patient who has a new prescription for phenelzine.
Which of the following statements should the nurse include in the teaching?
a. You should change positions slowly while taking this medication
b. This medication is prescribed to help overcome alcohol addiction
c. You should omit foods containing oxalates while taking phenelzine
d. You should avoid drinking liquids after your evening meal ANS a. You should change
positions slowly while taking this medication
, Patients should change positions slowly while taking an MAOI due to the risk of orthostatic
hypotension. Lightheadedness and fainting are common when taking phenelzine.
A nurse in an acute care mental facility is preparing to administer morning medication for a patient
who has been taking lithium for 2 weeks and has a current lithium level of 1.0 mEq/L. Which of the
following actions should the nurse take?
a. Prepare for gastric lavage due to an extremely elevated lithium level
b. Administer the morning dose of lithium
c. Check the patient's medication record to assess whether the patient has been refusing her lithium
d. Hold the medication and assess for early manifestations of toxicity ANS b. Administer the
morning dose of lithium
The nurse should administer the lithium dose since a lithium level of 1.0 mEq/L is within the
expected initial therapeutic range of 0.8-1.4 mEq/L. At a therapeutic level the patient might
demonstrate adverse effects of lithium, such as a fine hand tremor, thirst, and mild nausea, and the
nurse should note if any of these manifestations are present. The nurse should continue to monitor for
adverse effects and signs of toxicity, which usually occur at levels of 1.5 mEq/L or higher.
A nurse on a crisis hotline is speaking to a patient who says, "I just took an entire bottle or
amitriptyline." Which of the following responses should the nurse make?
a. I'm glad you called, and I want to send an ambulance to help you
b. You must have been feeling pretty depressed to do that
c. Do you know how many pills were in the bottle?
d. Were you trying to kill yourself by taking an overdose? ANS a. I'm glad you called, and I want
to send an ambulance to help you
Amitriptyline, a tricyclic antidepressant, is used to treat depression. This therapeutic statement shows
the nurse's concern for the patient's safety and responds to the patient's priority need. Maslow's
hierarchy of needs states that the patient's physical and safety needs come first. Therefore, the patient
needs to be evaluated immediately.
