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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An older adult is complaining of anxiety is prescribed diazepam (Valium) by a family physician. The physician asks the office nurse to explain the problematic side effects of this medication to the patient. Which instruction would be most important for the nurse to emphasize about this drug?
- A. You may experience minor urine incontinence from time to time.
- B. You may find that you have temporary memory disturbances.
- C. You need to use this medication cautiously because it can cause dependence.
- D. You may feel dizzy and be prone to falls after taking this medication.
Correct Answer: D
Rationale: Diazepam, a benzodiazepine, poses a significant risk of dizziness and falls in older adults due to sedation and impaired coordination, which is critical to emphasize for safety. Incontinence is not a common side effect, memory disturbances are less immediate, and dependence, while important, is a longer-term concern.
A nurse is preparing a continuing education presentation for a group of psychiatric-mental health nurses about various psychopharmacologic agents. The nurse is planning to discuss selective serotonin reuptake inhibitors. Which agents would the nurse include in this group? Select all that apply.
- A. Fluoxetine
- B. Duloxetine
- C. Sertraline
- D. Venlafaxine
- E. Bupropion
- F. Amoxapine
Correct Answer: A,C
Rationale: SSRIs include fluoxetine (A) and sertraline (C), which selectively inhibit serotonin reuptake. Duloxetine and venlafaxine are SNRIs, bupropion is an NDRI, and amoxapine is a tricyclic antidepressant, not SSRIs.
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.
A hospitalized patient who has been taking an antipsychotic medication for 2 weeks begins pacing and walking throughout the unit. He tells the nurse that he cannot sit still. The nurse documents this finding as which of the following?
- A. Akinesia
- B. Dystonia
- C. Pseudoparkinsonism
- D. Akathisia
Correct Answer: D
Rationale: Akathisia is characterized by restlessness and an inability to sit still, common with antipsychotics. Akinesia involves reduced movement, dystonia causes muscle spasms, and pseudoparkinsonism mimics Parkinson?s symptoms like tremor, not restlessness.
A nurse is performing an admission assessment. The patient complains that it has been taking larger and larger amounts of medication to get the desired effect. Based on this information, the nurse interprets this as suggesting which of the following?
- A. Desensitization
- B. Tolerance
- C. Therapeutic index
- D. Toxicity
Correct Answer: B
Rationale: Tolerance occurs when a patient requires increasing doses of a medication to achieve the same effect, as described. Desensitization is a broader term, therapeutic index measures safety margins, and toxicity indicates harmful effects, not increased dose requirements.