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A patient is prescribed medication for a psychiatric disorder. After 3 days, the patient tells the nurse that he or she has been constipated. Which instruction would the nurse give the patient?
- A. You need to eat more high-protein foods such as meat and peanut butter.
- B. You need to eat more fruits and vegetables and drink more water.
- C. Ask your psychiatrist to prescribe a stool softener for you.
- D. This side effect should disappear within a week or so.
Correct Answer: B
Rationale: Constipation, a common side effect of psychiatric medications, can be managed by increasing dietary fiber (fruits and vegetables) and hydration (water). High-protein foods may worsen constipation, a stool softener may be premature without dietary changes, and waiting for resolution dismisses the patient?s discomfort.
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A patient with depression asks the nurse about possible herbal supplements. Which of the following would the nurse identify as being commonly used?
- A. Valerian
- B. St. John?s wort
- C. Kava
- D. Melatonin
Correct Answer: B
Rationale: St. John?s wort is commonly used for mild to moderate depression due to its serotonergic effects. Valerian and melatonin are used for sleep, and kava for anxiety, not primarily for depression.
A hospitalized patient who has been taking an antipsychotic medication for 2 weeks begins pacing and walking throughout the unit. He tells the nurse that he cannot sit still. The nurse documents this finding as which of the following?
- A. Akinesia
- B. Dystonia
- C. Pseudoparkinsonism
- D. Akathisia
Correct Answer: D
Rationale: Akathisia is characterized by restlessness and an inability to sit still, common with antipsychotics. Akinesia involves reduced movement, dystonia causes muscle spasms, and pseudoparkinsonism mimics Parkinson?s symptoms like tremor, not restlessness.
An older adult is complaining of anxiety is prescribed diazepam (Valium) by a family physician. The physician asks the office nurse to explain the problematic side effects of this medication to the patient. Which instruction would be most important for the nurse to emphasize about this drug?
- A. You may experience minor urine incontinence from time to time.
- B. You may find that you have temporary memory disturbances.
- C. You need to use this medication cautiously because it can cause dependence.
- D. You may feel dizzy and be prone to falls after taking this medication.
Correct Answer: D
Rationale: Diazepam, a benzodiazepine, poses a significant risk of dizziness and falls in older adults due to sedation and impaired coordination, which is critical to emphasize for safety. Incontinence is not a common side effect, memory disturbances are less immediate, and dependence, while important, is a longer-term concern.
After teaching a patient who is prescribed imipramine about the drug, the nurse determines that the teaching was effective when the patient states which of the following?
- A. I need to be careful because the drug can make me sleepy.
- B. I don?t have to worry about getting dizzy when I get up from lying down.
- C. I might notice some excess saliva in my mouth at different times.
- D. I need to avoid foods with fiber because diarrhea can occur.
Correct Answer: A
Rationale: Imipramine, a tricyclic antidepressant, commonly causes sedation, so the patient?s statement about sleepiness indicates effective teaching. Dizziness (orthostatic hypotension) is a concern, dry mouth (not excess saliva) is typical, and constipation (not diarrhea) is a side effect, making other options incorrect.
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.