Nokea
A client who is taking paroxetine (Paxil) reports to the nurse that he has been nauseated since beginning the medication. Which of the following actions is indicated initially?
- A. Instruct the client to stop the medication for a few days to see if the nausea goes away.
- B. Reassure the client that this is an expected side effect that will improve with time.
- C. Suggest that the client take the medication with food.
- D. Tell the client to contact the physician for a change in medication.
Correct Answer: C
Rationale: Taking SSRIs like paroxetine with food usually eliminates nausea, making this the initial recommended action.
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A patient with bipolar disorder takes lithium 300 mg three times daily. The nurse evaluates that the dose is appropriate when the patient reports
- A. Feeling sleepy and less energetic.
- B. Weight gain of 7 pounds in the last month.
- C. Minimum mood swings.
- D. Increased feelings of self-worth.
Correct Answer: C
Rationale: Mood-stabilizing drugs like lithium aim to minimize mood swings in bipolar disorder. Weight gain and lethargy may occur but are not indicators of appropriate dosing, and inflated self-worth is a symptom that should diminish with treatment.
A client has a lithium level of 1.2 mEq/L. Which of the following interventions by the nurse is indicated?
- A. Call the physician for an increase in dosage.
- B. Do not give the next dose, and call the physician.
- C. Increase fluid intake for the next week.
- D. No intervention is necessary at this time.
Correct Answer: D
Rationale: A lithium level of 1.2 mEq/L is within the therapeutic range (0.5-1.5 mEq/L), so no intervention is necessary.
In planning for a client's discharge, the nurse must know that the most serious risk for the client taking a tricyclic antidepressant is which of the following?
- A. Hypotension
- B. Narrow-angle glaucoma
- C. Seizures
- D. Suicide by overdose
Correct Answer: D
Rationale: Tricyclic antidepressants are potentially lethal in overdose, posing a significant suicide risk. Other side effects like hypotension and glaucoma are concerning but less severe.
A patient with schizophrenia is being treated with olanzapine (Zyprexa) 10 mg daily. The patient asks the nurse how this medicine works. The nurse explains that the mechanism by which the olanzapine controls the patient's psychotic symptoms is believed to be
- A. Increasing the amount of serotonin and norepinephrine in the brain.
- B. Decreasing the amount of an enzyme that breaks down neurotransmitters.
- C. Normalizing the levels of serotonin, norepinephrine, and dopamine.
- D. Blocking dopamine receptors in the brain.
Correct Answer: D
Rationale: The major action of all antipsychotics, including olanzapine, is to block dopamine receptors in the brain, which helps control psychotic symptoms.
Which of the following is a neuromodulator?
- A. Neuropeptides
- B. Glutamate
- C. Dopamine
- D. GABA
Correct Answer: A
Rationale: Neuropeptides are neuromodulators. Glutamate and dopamine are excitatory neurotransmitters. GABA is an inhibitory neurotransmitter.