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After teaching a patient who is receiving phenelzine, the nurse determines that the teaching was successful when the patient states the need to avoid which of the following?
- A. Fresh cottage cheese
- B. Cooked sliced ham
- C. Tap beers
- D. Soy milk
Correct Answer: C
Rationale: Phenelzine, an MAOI, requires avoiding tyramine-rich foods and drinks like tap beers, which can cause a hypertensive crisis. Fresh cottage cheese, cooked ham, and soy milk are generally safe, as they have low tyramine content.
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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.
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 patient receiving an antipsychotic agent develops acute extrapyramidal symptoms. Which response by the nurse would be most appropriate?
- A. These symptoms are not real; the medication makes your brain think they are real.
- B. You have developed an allergy to the medication, so we need to change it.
- C. These are the results of the drug that can be treated; your illness is not getting worse.
- D. The sunlight together with the medication has caused these symptoms; just stay indoors.
Correct Answer: C
Rationale: Extrapyramidal symptoms (EPS) are treatable side effects of antipsychotics, not indicative of worsening illness. The nurse?s response should reassure the patient and explain that EPS can be managed. Denying symptoms, suggesting an allergy, or blaming sunlight are incorrect and nontherapeutic.
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 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.