Nokea
A nurse can anticipate anticholinergic side effects are likely to occur when a patient is prescribed what medication?
- A. Lithium
- B. Buspirone
- C. Risperidone
- D. Fluphenazine
Correct Answer: D
Rationale: Fluphenazine, a first-generation antipsychotic medication, exerts muscarinic blockade, resulting in dry mouth, blurred vision, constipation, and urinary retention. Lithium therapy is more often associated with fluid balance problems, including polydipsia, polyuria, and edema. Risperidone therapy is more often associated with movement disorders, orthostatic hypotension, and sedation. Buspirone is associated with anxiety reduction without major side effects.
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On the basis of current knowledge of neurotransmitter effects, a nurse anticipates that the treatment plan for a patient with memory difficulties may include medications designed to do what?
- A. Inhibit GABA production.
- B. Increase dopamine sensitivity.
- C. Decrease dopamine at receptor sites.
- D. Prevent destruction of acetylcholine.
Correct Answer: D
Rationale: Increased acetylcholine plays a role in learning and memory. Preventing the destruction of acetylcholine by acetylcholinesterase results in higher levels of acetylcholine, with the potential for improved memory. GABA is known to affect anxiety level rather than memory. Increased dopamine causes symptoms associated with schizophrenia or mania rather than improves memory. Decreasing dopamine at receptor sites is associated with Parkinson disease rather than improving memory.
A nurse prepares to administer an antipsychotic medication to a patient diagnosed with schizophrenia. Additional monitoring of the medication's effects and side effects will be most important if the patient is also diagnosed with which health problem? (Select all that apply.)
- A. Parkinson disease
- B. Graves' disease
- C. Osteoarthritis
- D. Epilepsy
- E. Diabetes
Correct Answer: A,D,E
Rationale: Antipsychotic medications may produce weight gain, which complicates the care of a patient with diabetes, or lowers the seizure threshold (or both), which complicates the care of a patient with epilepsy. Parkinson disease involves changes in transmission of dopamine and acetylcholine; therefore, these drugs also complicate the care of a patient with the disorder. Osteoarthritis and Graves' disease should have no synergistic effect with this medication.
The therapeutic action of monoamine oxidase inhibitors (MAOIs) blocks neurotransmitter reuptake, causing what effect?
- A. Increased concentration of neurotransmitters in the synaptic gap
- B. Decreased concentration of neurotransmitters in serum
- C. Destruction of receptor sites
- D. Limbic system stimulation
Correct Answer: A
Rationale: If the reuptake of a substance is inhibited, then it accumulates in the synaptic gap and its concentration increases, permitting the ease of the transmission of impulses across the synaptic gap. Normal transmission of impulses across synaptic gaps is consistent with a normal rather than a depressed mood. The other options are not associated with blocking neurotransmitter reuptake.
The parent of an adolescent diagnosed with schizophrenia asks a nurse, 'My child's doctor ordered a positron-emission tomography (PET) scan. What is that?' What is the nurse's best response?
- A. PET uses a magnetic field and gamma waves to identify problems areas in the brain. Does your teenager have any metal implants?
- B. It's a special type of x-ray image that shows structures of the brain and whether a brain injury has ever occurred.
- C. PET is a scan that passes an electrical current through the brain and shows brain wave activity. PET can help diagnose seizures.
- D. PET is a special scan that shows blood flow and activity in the brain.
Correct Answer: D
Rationale: The parent is seeking information about PET scans. It is important to use terms the parent can understand. The correct option is the only reply that provides factual information relevant to PET scans. The incorrect responses describe magnetic resonance imaging (MRI), computed tomographic (CT) scans, and electroencephalography (EEG).
A patient asks a nurse, 'What are neurotransmitters? My doctor says mine are out of balance.' What is the nurse's best response?
- A. You must feel relieved to know that your problem has a physical basis.
- B. Neurotransmitters are chemicals that pass messages between brain cells.
- C. It is a high-level concept to explain. You should ask the doctor to tell you more.
- D. Neurotransmitters are substances we eat daily that influence memory and mood.
Correct Answer: B
Rationale: Stating that neurotransmitters are chemicals that pass messages between brain cells gives the most accurate information. Neurotransmitters are messengers in the central nervous system. They are released from the axon terminal, diffuse across the synapse, and attach to specialized receptors on the postsynaptic neuron. The incorrect responses do not answer the patient's question, are demeaning, and provide untrue and misleading information.