Nokea
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.
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The nurse knows that the client understands the rationale for dietary restrictions when taking MAOI when the client makes which of the following statements?
- A. I am now allergic to foods that are high in the amino acid tyramine such as aged cheese, organ meats, wine, and chocolate.
- B. Certain foods will cause me to have sexual dysfunction when I take this medication.
- C. Foods that are high in tyramine will reduce the medication's effectiveness.
- D. I should avoid foods that are high in the amino acid tyramine such as aged cheese, meats, and chocolate because this drug causes the level of tyramine to go up to dangerous levels.
Correct Answer: D
Rationale: MAOIs inhibit the enzyme that breaks down tyramine, leading to increased serum tyramine levels, which can cause severe hypertension and other symptoms. The correct statement reflects understanding of the need to avoid tyramine-rich foods to prevent dangerous reactions.
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.
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 bipolar disorder takes lithium 300 mg three times daily. The nurse evaluates that the dose is appropriate when the patient reports
- A. Feeling sleepy and less energetic.
- B. Weight gain of 7 pounds in the last month.
- C. Minimum mood swings.
- D. Increased feelings of self-worth.
Correct Answer: C
Rationale: Mood-stabilizing drugs like lithium aim to minimize mood swings in bipolar disorder. Weight gain and lethargy may occur but are not indicators of appropriate dosing, and inflated self-worth is a symptom that should diminish with treatment.
A client with severe and persistent mental illness has been taking antipsychotic medication for 20 years. The nurse observes that the client's behavior includes repetitive movements of the mouth and tongue, facial grimacing, and rocking back and forth. The nurse recognizes these behaviors as indicative of
- A. Extrapyramidal side effects
- B. Loss of voluntary muscle control
- C. Posturing
- D. Tardive dyskinesia
Correct Answer: D
Rationale: These behaviors are classic signs of tardive dyskinesia, a syndrome of permanent involuntary movements commonly caused by long-term use of conventional antipsychotic drugs.