Which of the following side effects of lithium are frequent causes of noncompliance?
- A. Metallic taste in the mouth
- B. Weight gain
- C. Acne
- D. Thirst
- E. Lethargy
Correct Answer: B,E
Rationale: Lethargy and weight gain are difficult to manage and frequently lead to noncompliance with lithium therapy.
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Which of the following is a neuromodulator?
- A. Neuropeptides
- B. Glutamate
- C. Dopamine
- D. GABA
Correct Answer: A
Rationale: Neuropeptides are neuromodulators. Glutamate and dopamine are excitatory neurotransmitters. GABA is an inhibitory neurotransmitter.
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.
The nurse is preparing a patient for an MRI scan of the head. The nurse should ask the patient.
- A. Have you ever had an allergic reaction to radioactive dye?
- B. Have you had anything to eat in the last 24 hours?
- C. Does your insurance cover the cost of this scan?
- D. Are you anxious about being in tight spaces?
Correct Answer: D
Rationale: The person undergoing an MRI must lie in a small, closed chamber and remain motionless during the procedure, which takes about 45 minutes. Those who feel claustrophobic or have increased anxiety may require sedation before the procedure. PET scans, not MRIs, require radioactive substances. Fasting is not required for brain imaging studies, and verifying insurance is not a primary nursing role.
Which of the following is an inhibitory neurotransmitter?
- A. Dopamine
- B. GABA
- C. Norepinephrine
- D. Epinephrine
Correct Answer: B
Rationale: GABA is the major inhibitory neurotransmitter in the brain and has been found to modulate other neurotransmitter systems rather than to provide a direct stimulus. Dopamine, norepinephrine, and epinephrine are excitatory neurotransmitters.
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