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 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 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.
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 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 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.
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