Nokea
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.
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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 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.
The nurse is reviewing the medical records of several patients receiving antipsychotic agents. Which factors, if noted, would the nurse identify as placing a patient at greater risk for tardive dyskinesia?
- A. Male gender
- B. Age 30 to 45 years
- C. History of depression
- D. Short duration of treatment
Correct Answer: None
Rationale: Tardive dyskinesia risk factors include older age, female gender, longer treatment duration, and certain conditions, not depression. None of the options (male gender, age 30?45, depression, short duration) are primary risk factors, suggesting a possible test error, but none apply.
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.
A group of nursing students are reviewing the various drug classes used to treat psychiatric disorders. The students demonstrate understanding when they identify which of the following as examples of antianxiety medications? Select all that apply.
- A. Selegiline
- B. Lorazepam
- C. Buspirone
- D. Zolpidem
- E. Methylphenidate
Correct Answer: B,C
Rationale: Lorazepam (B), a benzodiazepine, and buspirone (C), a non-benzodiazepine, are antianxiety medications. Selegiline is an MAOI, zolpidem is a sedative-hypnotic, and methylphenidate is a stimulant, not used for anxiety.