Nokea
The laboratory report for a patient taking clozapine indicates the patient is experiencing agranulocytosis. The nurse should implement which intervention first?
- A. Report the laboratory results to the health care provider.
- B. Give the next dose of the medication as prescribed.
- C. Administer aspirin and force fluids.
- D. Repeat the laboratory tests.
Correct Answer: A
Rationale: These laboratory values indicate the possibility of agranulocytosis, a serious side effect of clozapine therapy. These results must be immediately reported to the health care provider. The drug should be withheld because the health care provider will discontinue it. The health care provider may repeat the laboratory test, but, in the meantime, the drug should be withheld. Giving aspirin and forcing fluids are measures that are less important than stopping the administration of the drug.
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A nurse administers a hypnotic medication that potentiates the action of gamma-aminobutyric acid (GABA). Which finding would be expected?
- A. Reduced anxiety
- B. Improved memory
- C. More organized thinking
- D. Fewer sensory perceptual alterations
Correct Answer: A
Rationale: Increased levels of GABA reduce anxiety; thus, any potentiation of GABA action should result in anxiety reduction. Memory enhancement is associated with acetylcholine and substance P. Thought disorganization is associated with dopamine. GABA is not associated with sensory perceptual alterations.
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 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.
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.
A patient has taken many conventional antipsychotic drugs over the years. The health care provider, who is concerned about early signs of tardive dyskinesia, prescribes risperidone. A nurse planning care for this patient understands what fact about second-generation antipsychotics?
- A. They are less costly.
- B. They have a higher potency.
- C. They are more readily available.
- D. They produce fewer motor side effects.
Correct Answer: D
Rationale: Second-generation antipsychotic drugs often exert their action on the limbic system rather than the basal ganglia. The limbic system is not involved in motor disturbances. Atypical antipsychotic medications are not more readily available. They are not considered to be of higher potency; rather, they have different modes of action. Second generation antipsychotic drugs tend to be more expensive.