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During the stabilization phase of drug therapy for a patient who is hospitalized with a psychiatric disorder, which action would be most appropriate?
- A. Discussing the timing of tapering the medication
- B. Instructing the patient about relapse prevention
- C. Determining if the medication is losing its effect
- D. Assessing the patient for target symptoms and side effects
Correct Answer: D
Rationale: The stabilization phase focuses on optimizing medication to control symptoms while monitoring for side effects. Assessing target symptoms and side effects ensures efficacy and safety. Tapering, relapse prevention, and loss of effect are addressed in later phases, such as maintenance or discontinuation.
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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 hospitalized patient who has been taking an antipsychotic medication for 2 weeks begins pacing and walking throughout the unit. He tells the nurse that he cannot sit still. The nurse documents this finding as which of the following?
- A. Akinesia
- B. Dystonia
- C. Pseudoparkinsonism
- D. Akathisia
Correct Answer: D
Rationale: Akathisia is characterized by restlessness and an inability to sit still, common with antipsychotics. Akinesia involves reduced movement, dystonia causes muscle spasms, and pseudoparkinsonism mimics Parkinson?s symptoms like tremor, not restlessness.
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.
A nurse is performing an admission assessment. The patient complains that it has been taking larger and larger amounts of medication to get the desired effect. Based on this information, the nurse interprets this as suggesting which of the following?
- A. Desensitization
- B. Tolerance
- C. Therapeutic index
- D. Toxicity
Correct Answer: B
Rationale: Tolerance occurs when a patient requires increasing doses of a medication to achieve the same effect, as described. Desensitization is a broader term, therapeutic index measures safety margins, and toxicity indicates harmful effects, not increased dose requirements.
The nurse observes an older adult patient who has been taking antipsychotic medications for 8 months. The patient is smacking her lips and blinking her eyes rapidly. The nurse also observes a protruding tongue. Which action by the nurse would be most appropriate?
- A. Ask if the patient has been experiencing side effects.
- B. Contact the patient?s physician for a different medication order.
- C. Document the patient?s symptoms of tardive dyskinesia.
- D. Instruct the patient to begin tapering off the medication.
Correct Answer: C
Rationale: Lip smacking, rapid blinking, and tongue protrusion indicate tardive dyskinesia, a serious side effect of long-term antipsychotic use. Documenting these symptoms is the most appropriate initial action to ensure accurate reporting and prompt physician review. Asking about side effects is vague, contacting the physician follows documentation, and tapering is premature without medical orders.