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Terms in this set (54)
Which correctly describes the primary effect of a selective serotonin reuptake inhibitor (SSRI) antidepressant drug?
Its ability to block the reuptake of serotonin
When responsible for the recovery care of a client receiving electroconvulsive therapy (ECT), the psychiatric nurse provides care until the client is ..
Oriented to person, place, and time
A client with a diagnosis of depression has not seen her mood and affect improve with the use of antidepressants, and the worsening of her symptoms has prompted her physician to order ECT. Which of the nurse's following teaching points about the procedure is most accurate?
"Even though the exact way that ECT helps depression isn't known, the therapy has been shown to be safe and effective."
A client is receiving clozapine. For which life-threatening disorder should the nurse be alert when assessing this client?
The nurse knows that the client understands the rationale for dietary restrictions when taking a monoamine oxidase inhibitor (MAOI) when the client makes which statement?
"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."
In the process of electroconvulsive therapy, what is electricity used to induce?
Which is a major difference between the atypical antipsychotics (such as clozapine) and the typical antipsychotics (such as haloperidol)?
Atypical antipsychotics block both serotonin and dopaminergic receptors.
In providing post-op care for the client who has just undergone ECT, which of the following findings would indicate that ECT has been effective and the client is displaying normal sequelae of this procedure?
The client cannot remember to which inpatient unit he or she is returning.
A nurse is leading a medication education group for clients with depression. A client states he has read that herbal treatments are just as effective as prescription medications. The best response
"We need to look at the research very closely to see how reliable the studies are."
A client is experiencing hallucinations and delusions. The nurse would expect the physician to order which class of drug?
What is electroconvulsive therapy the most effective treatment available for?
Major depression that has not responded to medication
Which are anticholinergic side effects that may occur with the use of antipsychotic drugs? Select all that apply.
During the stabilization phase of drug therapy for a client who is hospitalized with a psychiatric disorder, which action would be most appropriate?
Assessing the client for target symptoms and side effects
A client with schizophrenia is erratic in adhering to the antipsychotic regimen. What action best addresses this client's lack of adherence?
Changing the client's medication route to intramuscular depot
When teaching a client about restrictions for tranylcypromine, the nurse will tell the client to avoid which food?
A client has bipolar disorder and has just begun a regimen of lithium, 600 mg tid. Which is the most critical management issue for the client during the first 2 weeks of treatment?
Ensuring the client's blood levels reach a therapeutic and safe dose
Prior to undergoing ECT, brief general anesthesia is given to prevent which of the following?
Severe muscle contractions
The nurse caring for the client taking clozapine should advocate for monitoring using which diagnostic test?
white blood count
Mrs. Taylor's psychiatrist has explained the potential benefits of ECT in the treatment of her depression. Which of the following nursing diagnoses is most likely to apply to a client who is scheduled to soon begin ECT?
RISK FOR ANXIETY
An adult client has been taking citalopram for 4 months and notices a change in mood that is "better than it's been for years." The client has told the nurse, "I'm going to stop taking it, because I just don't think I need medication anymore." What is the nurse's best response?
"It's excellent that you're feeling better, but that's not a good idea because the drug is likely responsible for your improvement in mood."
Benzodiazepines work by the following mechanism of action:
They act directly on GABA receptors and are thought to increase the amount of GABA
The therapeutic level of lithium range includes what?
A client who has been admitted to the hospital after a suicide attempt has been diagnosed with major depression and the client's care team has recommended ECT. Which of the following teaching points should the nurse include in client education before the procedure?
"You might feel a bit confused or disoriented after your treatment, but this will pass."
Clients taking monoamine oxidase inhibitors (MAOIs) for depression must be placed on a diet that is low in:
A psychiatric-mental health nurse is conducting a review class on psychopharmacology as part of the orientation program at a community mental health center for a group of newly hired nurses. When describing the various classes of drugs commonly prescribed at the center, which agent would the nurse most likely include as a selective serotonin reuptake inhibitor? Select all that apply.
In the discharge instructions for a client who is taking alprazolam, the nurse should include what?
Sudden cessation of alprazolam can cause rebound insomnia and nightmares.
Dietary modifications are most likely necessary when a client is being treated with which antidepressant?
Monoamine oxidase inhibitors (MAOIs)
After being presented with the potential benefits of ECT, a client has replied, "I've seen enough movies to know there's no way I'm going to have any shock therapy." Which response by the nurse would be most appropriate to address the client's concerns?
"The movies often exaggerate things. ECT has been shown to be safe and very effective."
Which would not be included as a target symptom for antidepressant medications?
A client is receiving risperidone as part of the treatment plan for schizophrenia. Assessment reveals breast enlargement and evidence of galactorrhea. The nurse interprets this effect as due to which occurrence?
Increased prolactin levels
Excess tyramine caused by monoamine oxidase inhibitors (MAOIs) can result in what?
Which electrode placement during electroconvulsive therapy (ECT) is associated with the best outcomes?
Bilateral electrode placement on the client's temporal areas
A psychiatric-mental health nurse is reviewing the medication history of a client with depression who is receiving bupropion. When teaching the client about this medication, the nurse would integrate information about which neurotransmitter as being affected by this medication? Select all that apply.
An older adult resident of a group home has been receiving treatment for schizophrenia for several decades. The nurse who oversees care at the facility believes that the resident may be developing tardive dyskinesia. What assessment findings would support this suspicion? Select all that apply.
The client often smacks lips when at rest
The client makes repetitive movements with the fingers
A client is experiencing acute mania and started on lithium therapy. After several doses, the client has a serum lithium level drawn. Which result would the nurse identify as being outside the therapeutic range?
What is the difference between traditional and atypical antipsychotics?
Atypical antipsychotics work on dopamine-receptor and serotonin-receptor blockade, whereas traditional antipsychotics work on dopamine-receptor blockade.
The psychiatric-mental health nurse needs to have a basic understanding of information that is unique to individual medications. Which factors that affect pharmacokinetics should the nurse know? Select all that apply.
Indications for use
Food and drug interactions
When discussing the effects of a newly prescribed psychotropic drug with the client, the nurse explains the process of clearance as
How much of the drug is excreted out of the body in a specific period of time.
A 52-year-old woman is seeing a nurse therapist for moderate depression. The client has been taking fluoxetine (Prozac) for 3 weeks, but her mood has not improved. She states, "I need more than this to get better. I'm taking St. John's wort, too." Why does the nurse tell the client to immediately stop taking St. John's wort?
St. John's wort with fluoxetine may lead to serotonin syndrome.
When referring to the pharmacodynamics of a medication, what is the result of an agonistic effect?
The target receptors are stimulated
A drug that is an antagonist functions to do what?
Prevent natural or other substances from activating cell function
client has been recently diagnosed with schizophrenia and is just beginning treatment with olanzapine. What anticipatory guidance should the nurse provide to the client
Strategies for preventing and managing weight gain
A client comes to the clinic for an evaluation. During the interview, the client describes the frequent travel required by the job and feelings of being jet lagged all the time. The client asks, "Is there any supplement that I could use that might be helpful? Which suggestion would the nurse most likely include in the response?
A mental health nurse is teaching a client with depression about ECT. The nurse understands that treatments are typically given how often?
twice a week
when explaining the term "pharmacokinetics" to a client who is being educated on a newly prescribed medication, it would be appropriate to define it as
the way the body handles the medication
A 36-year-old client has been receiving a selective serotonin reuptake inhibitor for treatment of depression. The client is exhibiting manifestations of serotonin syndrome. The nurse should be aware of which symptom of this syndrome?
A client with a history of depression has been receiving outpatient treatment for several months but the client's partner has now brought the client to the emergency department. The partner states that the client had visual hallucinations earlier in the day. The client has an unstable gait and vomited on the way to the hospital. In addition to monitoring the client's vital signs, the care team should prioritize what action?
Discontinuing the client's SSRI
A client who is taking lithium is scheduled to come to the community mental health center to have a blood level obtained. The client takes the last dose of lithium each day at 10 p.m. The nurse tells the client to hold the morning dose. At which time would the nurse tell the client to come to the center to have the specimen drawn?
When a client who is considering electroconvulsive therapy (ECT) asks the nurse how this treatment will improve his depression, the most appropriate response is ...
"Although the exact way the therapy works isn't completely understood, the results have been very encouraging among clients with symptoms similar to yours."
Vagus nerve stimulation has been used as a treatment for ...
A client with a diagnosis of schizophrenia lacks insight into the illness. The client presents with significantly declined function and is consistently nonadherent with medications. Which medication administration route is best suited for optimal treatment of this client's condition?
When the client asks the nurse how long it will take before the selective serotonin reuptake inhibitor (SSRI) antidepressant medication will be effective, which reply is most accurate and therapeutic?
"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."
You are working with a 56-year-old female who is a candidate for ECT. The client states, "I would think about doing this ECT, but I heard that I won't remember anything after I wake up, and that scares me very much." The most therapeutic nursing response to the client's statement is what?
"I understand your concern. You may experience some short-term memory loss right after the procedure, but it is not a long-term effect."
During which phase of drug treatment does the prescriber adjust or titrate the medication dosage to achieve the maximum amount of improvement with a minimum of side effects?
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