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A patient reports symptoms of acute anxiety related to the death of a parent in an automobile accident 2 hours earlier. The nurse should anticipate administering a medication from which group for a short-term therapy?
- A. Tricyclic antidepressants
- B. Atypical antipsychotics
- C. Anticonvulsants
- D. Benzodiazepines
Correct Answer: D
Rationale: Benzodiazepines provide anxiety relief but are losing favor among providers due tolerance, high levels of abuse and recent connects to dementia. Tricyclic antidepressants are used to treat symptoms of depression. Anticonvulsants are used to treat bipolar disorder or seizures. Antipsychotic drugs are used to treat psychosis.
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A patient prescribed a muscarinic-receptor blocker, will require assess for what side effect?
- A. Dry mouth
- B. Gynecomastia
- C. Pseudoparkinsonism
- D. Orthostatic hypotension
Correct Answer: A
Rationale: Muscarinic-receptor blockade includes atropine-like side effects such as dry mouth, blurred vision, and constipation. Gynecomastia is associated with decreased prolactin levels. Movement defects are associated with dopamine blockade. Orthostatic hypotension is associated with ?±??-receptor antagonism.
The therapeutic action of monoamine oxidase inhibitors (MAOIs) blocks neurotransmitter reuptake, causing what effect?
- A. Increased concentration of neurotransmitters in the synaptic gap
- B. Decreased concentration of neurotransmitters in serum
- C. Destruction of receptor sites
- D. Limbic system stimulation
Correct Answer: A
Rationale: If the reuptake of a substance is inhibited, then it accumulates in the synaptic gap and its concentration increases, permitting the ease of the transmission of impulses across the synaptic gap. Normal transmission of impulses across synaptic gaps is consistent with a normal rather than a depressed mood. The other options are not associated with blocking neurotransmitter reuptake.
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.
A patient begins therapy with a first-generation antipsychotic medication. What teaching should a nurse provide related to the drug's strong dopaminergic effect?
- A. Chew sugarless gum.
- B. Increase dietary fiber.
- C. Arise slowly from bed.
- D. Report muscle stiffness.
Correct Answer: D
Rationale: First generation antipsychotic medications block dopamine receptors in both the limbic system and basal ganglia. Dystonia is likely to occur early in the course of treatment and is often heralded by sensations of muscle stiffness. Early intervention with an antiparkinsonian medication can increase the patient's comfort and prevent dystonic reactions. The incorrect responses apply to potential anticholinergic effects of first-generation antipsychotic medications.
A patient taking an antipsychotic medication develops restlessness and an uncontrollable need to be in motion. A nurse can correctly analyze that these symptoms are related to which drug action?
- A. Anticholinergic effects
- B. Dopamine-blocking effects
- C. Endocrine-stimulating effects
- D. Ability to stimulate spinal nerves
Correct Answer: B
Rationale: Medications that block dopamine often produce disturbances of movement (extrapyramidal side effects) such as akathisia because dopamine affects neurons involved in both the thought processes and movement regulation. Anticholinergic effects include dry mouth, blurred vision, urinary retention, and constipation. Akathisia is not caused by endocrine stimulation or spinal nerve stimulation.