Nokea
A patient is hospitalized for major depressive disorder. A nurse can expect to likely provide the patient with teaching about which medication?
- A. Chlordiazepoxide
- B. Fluoxetine
- C. Clozapine
- D. Tacrine
Correct Answer: B
Rationale: Fluoxetine is a selective serotonin reuptake inhibitor (SSRI), an antidepressant that blocks the reuptake of serotonin with few anticholinergic and sedating side effects; clozapine (Clozaril) is an antipsychotic medication; chlordiazepoxide (Librium) is an anxiolytic drug; and tacrine (Cognex) is used to treat Alzheimer's disease.
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A patient presents with anxiety, increased heart rate, and fear. The nurse would suspect the presence of a high concentration of which neurotransmitter?
- A. GABA
- B. Histamine
- C. Acetylcholine
- D. Norepinephrine
Correct Answer: D
Rationale: Norepinephrine is the neurotransmitter associated with sympathetic nervous system stimulation, preparing the individual for the 'fight-or-flight' response. GABA is a mediator of anxiety level. A high concentration of histamine is associated with an inflammatory response. A high concentration of acetylcholine is associated with parasympathetic nervous system stimulation.
A patient is demonstrating signs of dementia. The health care provider wants to make a differential diagnosis between Alzheimer's disease and multiple infarctions. Which diagnostic procedure should a nurse expect to prepare the patient for first?
- A. Computed tomography (CT) scan
- B. Positron emission tomography (PET) scan
- C. Functional magnetic resonance imaging (fMRI)
- D. Single-photon emission computed tomography (SPECT) scan
Correct Answer: A
Rationale: A CT scan shows the presence or absence of structural changes, including cortical atrophy, ventricular enlargement, and areas of infarction-information that will be helpful to the health care provider. The other tests focus on brain activity and are more expensive; they may be ordered later.
A patient hospitalized with a mood disorder has demonstrated aggression, agitation, talkativeness, and irritability. A nurse begins the care plan based on the expectation that the health care provider is most likely to prescribe a medication from what classification?
- A. Anticholinergic
- B. Mood stabilizer
- C. Psychostimulant
- D. Tricyclic antidepressant
Correct Answer: B
Rationale: The symptoms describe a manic episode. Mania is effectively treated by the mood stabilizing medication, lithium and selected anticonvulsants such as carbamazepine, valproic acid, and lamotrigine. No drugs from the other classifications listed are effective in the treatment of mania.
An individual is experiencing problems associated with memory. Which cerebral structures are most likely to be involved in this deficit? (Select all that apply.)
- A. Prefrontal cortex
- B. Occipital lobe
- C. Temporal lobe
- D. Parietal lobe
- E. Basal ganglia
Correct Answer: A,C,D
Rationale: The prefrontal cortex, parietal, and temporal lobes of the cerebrum play a key role in the storage and processing of memories. The occipital lobe is predominantly involved with vision. The basal ganglia influence the integration of physical movement, as well as some thoughts and emotions.
A nurse administering psychotropic medications should be prepared to intervene when giving a drug that blocks the attachment of norepinephrine to ?±??-receptors because the patient may experience what effect?
- A. Increased psychotic symptoms
- B. Severe appetite disturbance
- C. Orthostatic hypotension
- D. Hypertensive crisis
Correct Answer: C
Rationale: Sympathetic-mediated vasoconstriction is essential for maintaining normal blood pressure in the uplink position. Blockage of ?±??-receptors leads to vasodilation and orthostatic hypotension. Orthostatic hypotension may cause fainting and falls. Patients should be taught ways of minimizing this phenomenon.