Nokea
The nurse is educating a patient and family about strategies to minimize the side effects of antipsychotic drugs. Which of the following should be included in the plan?
- A. Drink plenty of fruit juice.
- B. Developing an exercise program is important.
- C. Increase foods high in fiber.
- D. Laxatives can be used as needed.
- E. Use sunscreen when outdoors.
- F. For missed doses, take double the dose at the next scheduled time.
Correct Answer: B,C,E
Rationale: Exercise and high-fiber foods help prevent constipation, and sunscreen is recommended due to photosensitivity. Fruit juice may contribute to weight gain, laxatives should be avoided, and doubling doses is incorrect.
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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 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.
A client with bipolar disorder has been taking lithium, and today his serum blood level is 1.8 mEq/L. The client reports nausea. Which of the following interventions by the nurse is indicated?
- A. Constipation and postural hypotension
- B. Fever, muscle rigidity
- C. Nausea
- D. None, the serum level is in therapeutic range
Correct Answer: C
Rationale: A lithium level of 1.8 mEq/L is above the therapeutic range (0.5-1.5 mEq/L) and indicates potential toxicity, with nausea being a common symptom. The nurse should notify the physician for further evaluation.
Which one of the following drugs should the nurse expect the patient to require serum level monitoring?
- A. Anticonvulsants
- B. Wellbutrin
- C. Lithium
- D. Prozac
Correct Answer: C
Rationale: Toxicity is closely related to serum lithium levels and can occur at therapeutic doses, necessitating periodic monitoring. Anticonvulsants also require monitoring, but lithium is the primary focus here.
When the client experiences facial flushing, a throbbing headache, nausea and vomiting after consuming alcohol while taking Disulfiram (Antabuse), the nurse is aware that this is due to which of the following?
- A. A mild side effect of the medication.
- B. The intended therapeutic result.
- C. An idiosyncratic reaction
- D. A severe allergy to the medication.
Correct Answer: B
Rationale: Disulfiram causes an adverse reaction when mixed with alcohol, producing symptoms like flushing, headache, nausea, and vomiting as the intended therapeutic effect to deter alcohol consumption.