Nokea
A patient is to receive an intravenous dose of lorazepam. The order reads, -Give lorazepam, 1 mg, IV push, now. Identify how many milliliters the nurse will administer for this dose. The medication vial contains 2 mg/mL.
Correct Answer: 0.5 mL
Rationale: 2 mg : 1 mL :: 1 mg : x mL; (2 * x) = (1 * 1); 2x = 1; x = 0.5 mL.
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When a patient is receiving a second-generation antipsychotic drug, such as risperidone, the nurse will monitor for which therapeutic effect?
- A. Fewer panic attacks
- B. Decreased paranoia and delusions
- C. Decreased feeling of hopelessness
- D. Improved tardive dyskinesia
Correct Answer: B
Rationale: The therapeutic effects of the antipsychotic drugs include improvement in mood and affect, and alleviation or decrease in psychotic symptoms (decrease in hallucinations, paranoia, delusions, garbled speech). Tardive dyskinesia is a potential adverse effect of these drugs. The other options are incorrect.
While monitoring a depressed patient who has just started SSRI antidepressant therapy, the nurse will observe for which problem during the early time frame of this therapy?
- A. Hypertensive crisis
- B. Self-injury or suicidal tendencies
- C. Extrapyramidal symptoms
- D. Loss of appetite
Correct Answer: B
Rationale: The U.S. Food and Drug Administration (FDA) has issued black box warnings regarding the use of all classes of antidepressants in both adult and pediatric patient populations. Data from the FDA indicated a higher risk for suicide in patients receiving these medications. As a result, current recommendations for all patients receiving antidepressants include regular monitoring for signs of worsening depressive symptoms, especially when the medication is started or the dosage is changed. The other options are incorrect.
Clozapine, an atypical antipsychotic, is prescribed for a patient. The nurse will monitor for which adverse effect during this drug therapy?
- A. Edema
- B. Photosensitivity
- C. Hypotension
- D. Severe neutropenia
Correct Answer: D
Rationale: Atypical antipsychotics may cause severe neutropenia. The other effects are adverse effects of conventional antipsychotics.
A patient with the diagnosis of schizophrenia is hospitalized and is taking a phenothiazine drug. Which statement by this patient indicates that he is experiencing a common adverse effect of phenothiazines?
- A. I can't sleep at night
- B. I feel hungry all the time.
- C. Look at how red my hands are.
- D. My mouth has been so dry lately.
Correct Answer: D
Rationale: Phenothiazines produce anticholinergic-like adverse effects of dry mouth, urinary hesitancy, and constipation.
The nurse is reviewing the food choices of a patient who is taking a monoamine oxidase inhibitor (MAOI). Which food choice would indicate the need for additional teaching?
- A. Grapefruit juice
- B. Salami sandwich
- C. Scrambled eggs
- D. Pancakes and maple syrup
Correct Answer: B
Rationale: Cured meats such as salami contain tyramine. Patients who are taking MAOIs need to avoid tyramine-containing foods because of a severe hypertensive reaction that may occur. The other foods listed do not contain tyramine.