Nokea
A nurse is caring for a psychiatric patient who is receiving an antacid that contains aluminum salts. Which action by the nurse would be most appropriate?
- A. Give the antacid 1 hour before the antipsychotic medication.
- B. Give the antacid at the same time as the antipsychotic medication.
- C. Administer the antacid 1 hour after the antipsychotic medication.
- D. Administer the antacid just before the patient goes to sleep.
Correct Answer: A
Rationale: Aluminum-containing antacids can bind with antipsychotics in the gut, reducing absorption. Administering the antacid 1 hour before the antipsychotic ensures proper absorption of the medication. Giving them together or after may interfere, and bedtime administration is irrelevant to absorption timing.
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A nurse is reviewing information about a psychiatric medication that describes the amount of the drug that actually reaches systemic circulation unchanged. The nurse identifies this as which of the following?
- A. First-pass effect
- B. Bioavailability
- C. Solubility
- D. Biotransformation
Correct Answer: B
Rationale: Bioavailability is the proportion of a drug that reaches systemic circulation unchanged. The first-pass effect reduces bioavailability, solubility affects dissolution, and biotransformation is metabolism, not systemic delivery.
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 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.
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 is brought to the emergency department by her brother, who reports that the patient became very agitated and started hallucinating. Further assessment reveals tachycardia, incoordination, vomiting, and diarrhea. The brother states that the patient is taking paroxetine for depression. Which of the following would the nurse most likely suspect?
- A. Neuroleptic malignant syndrome
- B. Acute dystonic reaction
- C. Serotonin syndrome
- D. Hypothyroidism
Correct Answer: C
Rationale: Paroxetine, an SSRI, can cause serotonin syndrome, characterized by agitation, hallucinations, tachycardia, incoordination, vomiting, and diarrhea, especially if combined with other serotonergic agents. Neuroleptic malignant syndrome and dystonic reactions are linked to antipsychotics, and hypothyroidism presents differently.