Nokea
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.
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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.
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 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.
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 is experiencing hallucinations and delusions. The nurse would expect the physician to order which class of drug?
- A. Mood stabilizer
- B. Antipsychotic
- C. Antianxiety agent
- D. Stimulant
Correct Answer: B
Rationale: Hallucinations and delusions are hallmark symptoms of psychosis, treated primarily with antipsychotics. Mood stabilizers address bipolar disorder, antianxiety agents treat anxiety, and stimulants are used for ADHD, not psychosis.