Chapter 18: Antipsychotic Drugs
1. A group of patients are being screened to see which patients would be the best
candidate for a psychotherapeutic drug trial that helps people concentrate longer on
activities. Which patient would be best suited for this trial?
A) A 28-year-old salesperson who alternates between overactivity and periods of
depression
B) A 32-year-old hyperactive nursing student who cannot focus long enough to take
a
test
C) A 55-year-old physician who suddenly falls asleep during the day without
warning
D) A 16-year-old youth who say he can make the light turn on by pointing at it and
hears voices
Ans: B
Feedback:
Attention-deficit disorders involve various conditions characterized by an inability to
concentrate on one activity for longer than a few minutes. The nursing student needing
accommodations has an attention-deficit disorder. The salesperson exhibits signs of
mania, which are characterized by periods of extreme overactivity and excitement
followed by extreme depression. The physician is experiencing narcolepsy, which is
defined as daytime sleepiness and sudden periods of loss of wakefulness. The teenager is
schizophrenic and is exhibiting paranoia, hallucinations, and delusions.
2. What nursing intervention is appropriate for a 70-year-old female patient receiving
lithium?
A) Instruct the patient to use barrier contraceptives.
B) Monitor blood glucose levels.
C) Monitor fluid and sodium intake.
D) Encourage the patient to check daily for weight loss.
Ans: C
Feedback:
, Older patients, and especially those with renal impairment, should be encouraged to
maintain adequate hydration and salt intake. Decreased dosages may also be necessary
with the elderly. A 70-year-old patient would not be concerned about the use of
contraceptives. These drugs alone do not affect glucose levels. Weight loss is usually not
associated with lithium use.
3. A nurse is caring for a patient who is taking lithium for mania. The nurses assessment
includes a notation of a lithium serum level of 2.4 mEq/L. The nurse anticipates
seeing what?
A) Fine tremors of both hands
B) Slurred speech
C) Clonic movements
D) Nausea and vomiting
Ans: C
Feedback:
Serum levels of 2 to 2.5 mEq/L may produce ataxia, clonic movements, possible
seizures, and hypotension. Fine hand tremors, slurred speech, and nausea and vomiting
are indicative of lithium levels less than 1.5 mEq/L.
4. The nurse administers chlorpromazine intramuscularly to the preoperative patient who
is extremely anxious about surgery in the morning. What priority teaching point will
the nurse provide this patient?
A) Remain recumbent for at least 30 minutes after the injection.
B) Do not eat for 1 hour after the drug is administered.
C) Encourage fluids with the goal of 3,000 mL/d.
D) Avoid eating avocados and oranges when taking this medication.
Ans: A
Feedback:
When giving a parenteral form of an antipsychotic, the patient should remain recumbent
to decrease the risk of injury if orthostatic hypotension occurs. Eating after drug injection
should not interfere with the drugs absorption and although adequate hydration should be
maintained there is no need to increase fluid intake. Avocados and oranges are not
contraindicated in patients receiving this medication.
5. The nurse is presenting an in-service at a childrens unit on hyperactivity. The nurse is
told that a 6-year-old on the unit is being treated with methylphenidate (Ritalin). The
, presenting nurse talks about discharge teaching for this patient and the importance of
monitoring what?
A) Long bone growth
B) Visual acuity
C) Weight and complete blood count
D) Urea and nitrogen levels
Ans: C
Feedback:
Methylphenidate is associated with weight loss, bone marrow suppression, and cardiac
arrhythmias. Weight, blood count, and cardiac function should be monitored regularly.
The drug is not associated with renal dysfunction, visual changes, or growth retardation,
so those values would not need to be regularly evaluated as part of drug therapy.
6. The nurse is caring for a patient taking an oral neuroleptic medication. What is the nurses
priority assessment to monitor for?
A) Urge incontinence
B) Orthostatic hypotension
C) Bradycardia
D) Tardive dyskinesia
Ans: D
Feedback:
The nurse would monitor for and teach the patient and family about tardive
dyskinesias because it is such a common adverse effect with continued use of the
drug. Oral neuroleptic agents do not cause urge incontinence, orthostatic
hypotension, or bradycardia.
7. A psychotic patient is admitted through the emergency department. The physician has
ordered chlorpromazine (Thorazine) 25 mg intramuscularly. After administration of
the medication, what is the nurses priority to evaluate?
A) The patients ability to ambulate
B) Return of the patients appetite
1. A group of patients are being screened to see which patients would be the best
candidate for a psychotherapeutic drug trial that helps people concentrate longer on
activities. Which patient would be best suited for this trial?
A) A 28-year-old salesperson who alternates between overactivity and periods of
depression
B) A 32-year-old hyperactive nursing student who cannot focus long enough to take
a
test
C) A 55-year-old physician who suddenly falls asleep during the day without
warning
D) A 16-year-old youth who say he can make the light turn on by pointing at it and
hears voices
Ans: B
Feedback:
Attention-deficit disorders involve various conditions characterized by an inability to
concentrate on one activity for longer than a few minutes. The nursing student needing
accommodations has an attention-deficit disorder. The salesperson exhibits signs of
mania, which are characterized by periods of extreme overactivity and excitement
followed by extreme depression. The physician is experiencing narcolepsy, which is
defined as daytime sleepiness and sudden periods of loss of wakefulness. The teenager is
schizophrenic and is exhibiting paranoia, hallucinations, and delusions.
2. What nursing intervention is appropriate for a 70-year-old female patient receiving
lithium?
A) Instruct the patient to use barrier contraceptives.
B) Monitor blood glucose levels.
C) Monitor fluid and sodium intake.
D) Encourage the patient to check daily for weight loss.
Ans: C
Feedback:
, Older patients, and especially those with renal impairment, should be encouraged to
maintain adequate hydration and salt intake. Decreased dosages may also be necessary
with the elderly. A 70-year-old patient would not be concerned about the use of
contraceptives. These drugs alone do not affect glucose levels. Weight loss is usually not
associated with lithium use.
3. A nurse is caring for a patient who is taking lithium for mania. The nurses assessment
includes a notation of a lithium serum level of 2.4 mEq/L. The nurse anticipates
seeing what?
A) Fine tremors of both hands
B) Slurred speech
C) Clonic movements
D) Nausea and vomiting
Ans: C
Feedback:
Serum levels of 2 to 2.5 mEq/L may produce ataxia, clonic movements, possible
seizures, and hypotension. Fine hand tremors, slurred speech, and nausea and vomiting
are indicative of lithium levels less than 1.5 mEq/L.
4. The nurse administers chlorpromazine intramuscularly to the preoperative patient who
is extremely anxious about surgery in the morning. What priority teaching point will
the nurse provide this patient?
A) Remain recumbent for at least 30 minutes after the injection.
B) Do not eat for 1 hour after the drug is administered.
C) Encourage fluids with the goal of 3,000 mL/d.
D) Avoid eating avocados and oranges when taking this medication.
Ans: A
Feedback:
When giving a parenteral form of an antipsychotic, the patient should remain recumbent
to decrease the risk of injury if orthostatic hypotension occurs. Eating after drug injection
should not interfere with the drugs absorption and although adequate hydration should be
maintained there is no need to increase fluid intake. Avocados and oranges are not
contraindicated in patients receiving this medication.
5. The nurse is presenting an in-service at a childrens unit on hyperactivity. The nurse is
told that a 6-year-old on the unit is being treated with methylphenidate (Ritalin). The
, presenting nurse talks about discharge teaching for this patient and the importance of
monitoring what?
A) Long bone growth
B) Visual acuity
C) Weight and complete blood count
D) Urea and nitrogen levels
Ans: C
Feedback:
Methylphenidate is associated with weight loss, bone marrow suppression, and cardiac
arrhythmias. Weight, blood count, and cardiac function should be monitored regularly.
The drug is not associated with renal dysfunction, visual changes, or growth retardation,
so those values would not need to be regularly evaluated as part of drug therapy.
6. The nurse is caring for a patient taking an oral neuroleptic medication. What is the nurses
priority assessment to monitor for?
A) Urge incontinence
B) Orthostatic hypotension
C) Bradycardia
D) Tardive dyskinesia
Ans: D
Feedback:
The nurse would monitor for and teach the patient and family about tardive
dyskinesias because it is such a common adverse effect with continued use of the
drug. Oral neuroleptic agents do not cause urge incontinence, orthostatic
hypotension, or bradycardia.
7. A psychotic patient is admitted through the emergency department. The physician has
ordered chlorpromazine (Thorazine) 25 mg intramuscularly. After administration of
the medication, what is the nurses priority to evaluate?
A) The patients ability to ambulate
B) Return of the patients appetite
