PSYCHIATRIC/MENTAL HEALTH PHARMACOLOGY
EXAM WITH VERIFIED ANSWERS AND WELL
DETAILED RATIONALE
The nurse understands that which medications are considered typical antipsychotics? Select all
that apply. One, some, or all responses may be correct. - ANSWER-Thioridazine, Chlorpromazine
Rationale: First-generation antipsychotic medications also are known as typical/conventional
antipsychotics. Thioridazine and chlorpromazine are typical antipsychotics. Asenapine,
lurasidone, and aripiprazole are atypical antipsychotics, also known as second-generation
antipsychotics.
Which medication acts as an antidote to benzodiazepine? - ANSWER-Flumazenil
Rationale: Flumazenil is a benzodiazepine receptor antagonist and is used to reverse conscious
sedation induced by benzodiazepines. Temazepam, suvorexant, and flumazenil are
benzodiazepines.
Which medication is contraindicated in a pregnant client? - ANSWER-Paroxetine
Rationale: Paroxetine is a selective serotonin reuptake inhibitor that should be avoided in a
pregnant client because it may cause birth defects. Sertraline, venlafaxine, and desipramine can
be safely prescribed to a pregnant client.
The nurse would identify which medication as a high-potency medication used to treat
schizophrenia? - ANSWER-Fluphenazine
Rationale: Fluphenazine is a high-potency medication used for schizophrenia. Loxapine and
perphenazine are medium-potency medications used to treat schizophrenia. Thioridazine is a
low-potency medication used to treat schizophrenia.
, An older adult living in a long-term care facility has been receiving 600 mg of lithium twice a day
for 3 weeks to ease manic behavior. The client is experiencing nausea and vomiting, diarrhea,
thirst, polyuria, slurred speech, and muscle weakness. Which intervention is appropriate? -
ANSWER-Withholding the next dose of lithium and drawing blood for a lithium level
Rationale: The client is displaying signs and symptoms of early lithium toxicity; older clients
should be monitored carefully and given smaller doses of lithium because its excretion from the
kidneys is slower than that in younger adults. There is no antidote to lithium. Coarse hand
tremor is an indication of advanced lithium toxicity; the lithium should be withheld. Although
antiepileptics are effective in 25% to 50% of clients with treatment-resistant bipolar disorder,
this is not the appropriate treatment for lithium toxicity.
A client with a diagnosis of schizophrenia is prescribed an antipsychotic medication. The nurse
understands which side effect of antipsychotic medications may be irreversible? -
ANSWER-Tardive Dyskinesia
Rationale: Tardive dyskinesia, an extrapyramidal response characterized by vermicular
movements and protrusion of the tongue, chewing and puckering movements of the mouth, and
puffing of the cheeks, is often irreversible, even when the antipsychotic medication is withdrawn.
Akathisia (motor restlessness), parkinsonian syndrome (a disorder featuring signs and symptoms
of Parkinson's disease such as resting tremors, muscle weakness, reduced movement, and
festinating gait), and dystonia (impairment of muscle tonus) usually can be treated with
antiparkinsonian or anticholinergic medications while the antipsychotic medication is continued.
The nurse is preparing to administer methylphenidate to an older adult with apathy and
depression. Which would the nurse include in the assessment to monitor for complications?
Select all that apply. One, some, or all responses may be correct. - ANSWER-Vision, Weight,
Heart Rate
Rationale: When methylphenidate is administered to older adults, the nurse will monitor the
client's vision for signs of glaucoma, as well as their weight, heart rate, and blood pressure. Skin
turgor and bowel sounds are not affected by methylphenidate.
EXAM WITH VERIFIED ANSWERS AND WELL
DETAILED RATIONALE
The nurse understands that which medications are considered typical antipsychotics? Select all
that apply. One, some, or all responses may be correct. - ANSWER-Thioridazine, Chlorpromazine
Rationale: First-generation antipsychotic medications also are known as typical/conventional
antipsychotics. Thioridazine and chlorpromazine are typical antipsychotics. Asenapine,
lurasidone, and aripiprazole are atypical antipsychotics, also known as second-generation
antipsychotics.
Which medication acts as an antidote to benzodiazepine? - ANSWER-Flumazenil
Rationale: Flumazenil is a benzodiazepine receptor antagonist and is used to reverse conscious
sedation induced by benzodiazepines. Temazepam, suvorexant, and flumazenil are
benzodiazepines.
Which medication is contraindicated in a pregnant client? - ANSWER-Paroxetine
Rationale: Paroxetine is a selective serotonin reuptake inhibitor that should be avoided in a
pregnant client because it may cause birth defects. Sertraline, venlafaxine, and desipramine can
be safely prescribed to a pregnant client.
The nurse would identify which medication as a high-potency medication used to treat
schizophrenia? - ANSWER-Fluphenazine
Rationale: Fluphenazine is a high-potency medication used for schizophrenia. Loxapine and
perphenazine are medium-potency medications used to treat schizophrenia. Thioridazine is a
low-potency medication used to treat schizophrenia.
, An older adult living in a long-term care facility has been receiving 600 mg of lithium twice a day
for 3 weeks to ease manic behavior. The client is experiencing nausea and vomiting, diarrhea,
thirst, polyuria, slurred speech, and muscle weakness. Which intervention is appropriate? -
ANSWER-Withholding the next dose of lithium and drawing blood for a lithium level
Rationale: The client is displaying signs and symptoms of early lithium toxicity; older clients
should be monitored carefully and given smaller doses of lithium because its excretion from the
kidneys is slower than that in younger adults. There is no antidote to lithium. Coarse hand
tremor is an indication of advanced lithium toxicity; the lithium should be withheld. Although
antiepileptics are effective in 25% to 50% of clients with treatment-resistant bipolar disorder,
this is not the appropriate treatment for lithium toxicity.
A client with a diagnosis of schizophrenia is prescribed an antipsychotic medication. The nurse
understands which side effect of antipsychotic medications may be irreversible? -
ANSWER-Tardive Dyskinesia
Rationale: Tardive dyskinesia, an extrapyramidal response characterized by vermicular
movements and protrusion of the tongue, chewing and puckering movements of the mouth, and
puffing of the cheeks, is often irreversible, even when the antipsychotic medication is withdrawn.
Akathisia (motor restlessness), parkinsonian syndrome (a disorder featuring signs and symptoms
of Parkinson's disease such as resting tremors, muscle weakness, reduced movement, and
festinating gait), and dystonia (impairment of muscle tonus) usually can be treated with
antiparkinsonian or anticholinergic medications while the antipsychotic medication is continued.
The nurse is preparing to administer methylphenidate to an older adult with apathy and
depression. Which would the nurse include in the assessment to monitor for complications?
Select all that apply. One, some, or all responses may be correct. - ANSWER-Vision, Weight,
Heart Rate
Rationale: When methylphenidate is administered to older adults, the nurse will monitor the
client's vision for signs of glaucoma, as well as their weight, heart rate, and blood pressure. Skin
turgor and bowel sounds are not affected by methylphenidate.
