Nokea
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.
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During the stabilization phase of drug therapy for a patient who is hospitalized with a psychiatric disorder, which action would be most appropriate?
- A. Discussing the timing of tapering the medication
- B. Instructing the patient about relapse prevention
- C. Determining if the medication is losing its effect
- D. Assessing the patient for target symptoms and side effects
Correct Answer: D
Rationale: The stabilization phase focuses on optimizing medication to control symptoms while monitoring for side effects. Assessing target symptoms and side effects ensures efficacy and safety. Tapering, relapse prevention, and loss of effect are addressed in later phases, such as maintenance or discontinuation.
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.
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 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 patient who has been taking clozapine for 6 weeks visits the clinic complaining of fever, sore throat, and mouth sores. The nurse notifies the patient?s physician because the nurse suspects which of the following?
- A. Severe anemia
- B. Neuroleptic malignant syndrome
- C. Encephalitis
- D. Agranulocytosis
Correct Answer: D
Rationale: Fever, sore throat, and mouth sores in a patient taking clozapine suggest agranulocytosis, a serious side effect involving a dangerous drop in white blood cells, requiring immediate medical attention. Anemia, neuroleptic malignant syndrome, and encephalitis have different symptom profiles.