Nokea
The nurse has completed health teaching about dietary restrictions for a client taking a monoamine oxidase inhibitor. The nurse will know that teaching has been effective by which of the following client statements?
- A. I'm glad I can eat pizza since it's my favorite food.
- B. I must follow this diet or I will have severe vomiting.
- C. It will be difficult for me to avoid pepperoni.
- D. None of the foods that are restricted are part of a regular daily diet.
Correct Answer: C
Rationale: Pepperoni contains tyramine, which must be avoided when taking MAOIs to prevent hypertensive crisis, indicating effective understanding of dietary restrictions.
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A patient with schizophrenia is being treated with olanzapine (Zyprexa) 10 mg daily. The patient asks the nurse how this medicine works. The nurse explains that the mechanism by which the olanzapine controls the patient's psychotic symptoms is believed to be
- A. Increasing the amount of serotonin and norepinephrine in the brain.
- B. Decreasing the amount of an enzyme that breaks down neurotransmitters.
- C. Normalizing the levels of serotonin, norepinephrine, and dopamine.
- D. Blocking dopamine receptors in the brain.
Correct Answer: D
Rationale: The major action of all antipsychotics, including olanzapine, is to block dopamine receptors in the brain, which helps control psychotic symptoms.
Which one of the following types of antipsychotic medications is most likely to produce extrapyramidal effects?
- A. Atypical antipsychotic drugs
- B. First-generation antipsychotic drugs
- C. Third-generation antipsychotic drugs
- D. Dopamine system stabilizers
Correct Answer: B
Rationale: First-generation antipsychotic drugs are potent antagonists of D2, D3, and D4 receptors, making them effective but producing many extrapyramidal side effects due to D2 receptor blockade. Atypical antipsychotics have a lower incidence of these effects.
A patient is being seen in the crisis unit reporting that poison letters are coming in the mail. The patient has no history of psychiatric illness. Which of the following medications would the patient most likely be started on?
- A. Aripiprazole (Abilify)
- B. Risperidone (Risperdal Consta)
- C. Fluphenazine (Prolixin)
- D. Fluoxetine (Prozac)
Correct Answer: A
Rationale: New-generation antipsychotics like aripiprazole are preferred for initial treatment of psychotic symptoms due to fewer side effects. Injectable antipsychotics like Risperdal Consta are used after stabilization, and fluoxetine is an antidepressant, not indicated for psychosis.
How should the nurse respond to a family member who asks how Alzheimer's disease is diagnosed?
- A. It is impossible to know for certain that a person has Alzheimer's disease until the person dies and his or her brain can be examined via autopsy.
- B. Positron emission tomography (PET) scans can identify the amyloid plaques and tangles of Alzheimer's disease in living clients.
- C. Alzheimer's disease can be diagnosed by using chemical markers that demonstrate decreased cerebral blood flow.
- D. It will be necessary for the patient to undergo positron emission tomography (PET) scans regularly for a long period of time to know if the patient has Alzheimer's disease.
Correct Answer: B
Rationale: Positron emission tomography (PET) scans can identify the amyloid plaques and tangles of Alzheimer's disease in living clients, allowing diagnosis without autopsy. Decreased cerebral blood flow is not specific to Alzheimer's, and regular PET scans are not necessary for diagnosis.
When the client asks the nurse how long it will take before the SSRI antidepressant medication will be effective, which of the following replies is most accurate and therapeutic?
- A. This is a good medication! It will be effective within 20 minutes of the first dose.
- B. You will have gradual improvement in symptoms over the next few weeks, but the changes may be so subtle that you may not notice them for a while. It is important for you to keep taking the medication.
- C. It will probably take months for the medication to work. In the meantime, you should work on improving your attitude.
- D. If you believe it will work, then it will. You have to have faith!
Correct Answer: B
Rationale: SSRIs typically take 2-3 weeks to show effectiveness, with gradual symptom improvement that may be subtle initially, requiring continued adherence.