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The nurse is caring for a 70-year-old psychiatric patient who has been prescribed a number of medications. When teaching the patient about the medications, which explanation would be most appropriate?
- A. Your stomach empties more quickly as you age; therefore, you may feel the effect of your medications almost immediately.
- B. Your entire GI system speeds up, so your medications are digested much more quickly. Therefore, it is important that you not drive after you take your medications.
- C. Because of your age and related changes in liver functioning, you may have medication levels in your system with the potential to be toxic.
- D. Because of age-related circulation changes, your body will be able to deliver therapeutic doses of your medication to select body sites more quickly.
Correct Answer: C
Rationale: Aging reduces liver function, decreasing metabolism of medications, which can lead to higher drug levels and potential toxicity in older adults. Stomach emptying slows with age, the GI system does not speed up, and circulation changes do not enhance drug delivery as described.
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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 patient is experiencing hallucinations and delusions. The nurse would expect the physician to order which class of drug?
- A. Mood stabilizer
- B. Antipsychotic
- C. Antianxiety agent
- D. Stimulant
Correct Answer: B
Rationale: Hallucinations and delusions are hallmark symptoms of psychosis, treated primarily with antipsychotics. Mood stabilizers address bipolar disorder, antianxiety agents treat anxiety, and stimulants are used for ADHD, not psychosis.
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.
A nurse is reviewing information about a psychiatric medication that describes the amount of the drug that actually reaches systemic circulation unchanged. The nurse identifies this as which of the following?
- A. First-pass effect
- B. Bioavailability
- C. Solubility
- D. Biotransformation
Correct Answer: B
Rationale: Bioavailability is the proportion of a drug that reaches systemic circulation unchanged. The first-pass effect reduces bioavailability, solubility affects dissolution, and biotransformation is metabolism, not systemic delivery.
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.