Nokea
Priority teaching for a patient taking clozapine should include which instruction?
- A. Report sore throat and fever immediately.
- B. Avoid foods high in polyunsaturated fat.
- C. Use water-based lotions for rashes.
- D. Avoid unprotected sex.
Correct Answer: A
Rationale: Clozapine therapy may produce agranulocytosis a rare but serious decrease in granulated white blood cells (WBCs); therefore, signs of infection should be immediately reported to the health care provider. In addition, the patient should have white blood cell levels measured weekly. The other options are not relevant to clozapine administration.
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An individual is experiencing problems associated with memory. Which cerebral structures are most likely to be involved in this deficit? (Select all that apply.)
- A. Prefrontal cortex
- B. Occipital lobe
- C. Temporal lobe
- D. Parietal lobe
- E. Basal ganglia
Correct Answer: A,C,D
Rationale: The prefrontal cortex, parietal, and temporal lobes of the cerebrum play a key role in the storage and processing of memories. The occipital lobe is predominantly involved with vision. The basal ganglia influence the integration of physical movement, as well as some thoughts and emotions.
A patient is hospitalized for major depressive disorder. A nurse can expect to likely provide the patient with teaching about which medication?
- A. Chlordiazepoxide
- B. Fluoxetine
- C. Clozapine
- D. Tacrine
Correct Answer: B
Rationale: Fluoxetine is a selective serotonin reuptake inhibitor (SSRI), an antidepressant that blocks the reuptake of serotonin with few anticholinergic and sedating side effects; clozapine (Clozaril) is an antipsychotic medication; chlordiazepoxide (Librium) is an anxiolytic drug; and tacrine (Cognex) is used to treat Alzheimer's disease.
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 patient has delusions and hallucinations. Before beginning treatment with a psychotropic medication, the health care provider wants to rule out the presence of a brain tumor. For which test will a nurse need to prepare the patient?
- A. Cerebral arteriogram
- B. Functional magnetic resonance imaging (fMRI)
- C. Computed tomography (CT) scan or magnetic resonance imaging (MRI)
- D. Positron emission tomography (PET) or single-photon emission computed tomography (SPECT)
Correct Answer: C
Rationale: A CT scan and an MRI visualize neoplasms and other structural abnormalities. A PET scan, SPECT scan, and fMRI, which give information about brain function, are not indicated. An arteriogram would not be appropriate.
The nurse will order a special diet for the patient taking what medication?
- A. Buspirone
- B. Haloperidol
- C. Trazodone
- D. Phenelzine
Correct Answer: D
Rationale: Patients taking phenelzine, an MAOI, must be on a tyramine-free diet to prevent hypertensive crisis. None of the other medication require dietary restrictions.