Nokea
A group of nursing students are reviewing information related to drug therapy for mood disorders. The students demonstrate understanding of the information when they identify which agent as the gold standard for treating bipolar disorder?
- A. Carbamazepine
- B. Lithium
- C. Valproate
- D. Lamotrigine
Correct Answer: B
Rationale: Lithium is the gold standard for bipolar disorder due to its proven efficacy in stabilizing mood and preventing manic episodes. Carbamazepine, valproate, and lamotrigine are used but are not considered the primary standard.
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The nurse observes an older adult patient who has been taking antipsychotic medications for 8 months. The patient is smacking her lips and blinking her eyes rapidly. The nurse also observes a protruding tongue. Which action by the nurse would be most appropriate?
- A. Ask if the patient has been experiencing side effects.
- B. Contact the patient?s physician for a different medication order.
- C. Document the patient?s symptoms of tardive dyskinesia.
- D. Instruct the patient to begin tapering off the medication.
Correct Answer: C
Rationale: Lip smacking, rapid blinking, and tongue protrusion indicate tardive dyskinesia, a serious side effect of long-term antipsychotic use. Documenting these symptoms is the most appropriate initial action to ensure accurate reporting and prompt physician review. Asking about side effects is vague, contacting the physician follows documentation, and tapering is premature without medical orders.
A patient receiving an antipsychotic agent develops acute extrapyramidal symptoms. Which response by the nurse would be most appropriate?
- A. These symptoms are not real; the medication makes your brain think they are real.
- B. You have developed an allergy to the medication, so we need to change it.
- C. These are the results of the drug that can be treated; your illness is not getting worse.
- D. The sunlight together with the medication has caused these symptoms; just stay indoors.
Correct Answer: C
Rationale: Extrapyramidal symptoms (EPS) are treatable side effects of antipsychotics, not indicative of worsening illness. The nurse?s response should reassure the patient and explain that EPS can be managed. Denying symptoms, suggesting an allergy, or blaming sunlight are incorrect and nontherapeutic.
A nurse administers a prescribed dose of lithium at 8 PM. The nurse would schedule a specimen to be obtained for a blood level at which time?
- A. 10:00 PM
- B. 12:00 AM
- C. 4:00 AM
- D. 8:00 AM
Correct Answer: D
Rationale: Lithium levels are typically drawn 12 hours after the last dose to measure trough levels, ensuring steady-state concentration. A dose at 8 PM would require a blood draw at 8 AM. Earlier times (10 PM, 12 AM, 4 AM) do not align with this timing.
A nursing instructor is teaching a class on the pharmacodynamics of psychiatric medications. The instructor determines that additional teaching is needed when the students identify which of the following as a site of action?
- A. Receptor
- B. Ion channels
- C. Neurotransmitters
- D. Enzymes
Correct Answer: C
Rationale: Pharmacodynamics involves how drugs act on the body, typically at receptors, ion channels, or enzymes. Neurotransmitters are chemicals that transmit signals, not sites of drug action, indicating a need for further teaching.
A patient has been prescribed clozapine for treatment of schizophrenia. Which of the following would the nurse include in the teaching plan for this patient and family?
- A. You may experience hypertension while taking this medication.
- B. One of the side effects of this medication is breast engorgement.
- C. People taking this medication often experience dermatitis.
- D. You may experience noticeable weight gain while taking this medication.
Correct Answer: D
Rationale: Clozapine is associated with significant weight gain, a common side effect that should be included in patient education. Hypertension, breast engorgement, and dermatitis are not typical side effects of clozapine.