NUR326 PSYCH EXAM 2

A nurse is providing teaching to a client who has schizophrenia and is to begin taking haloperidol. Which of the following information should the nurse include in the teaching? A. "You may experience dizziness upon standing when taking this medication" B. "This medication will decrease your symptoms of OCD" C. "This medication may cause excess salivation" D. "You can stop taking the medication if the adverse effects are bothersome" - A- Haloperidol can cause orthostatic hypotension B- used for schizophrenia, not OCD C- may cause dry mouth, not excess salvation D- do not discontinue abruptly A nurse is caring for a client who has severe manifestations of schizophrenia and is medication PRN for agitation with haloperidol. The nurse should assess the client for which of the following adverse effects? A. Dysrhythmias B. Cataracts C. Pancreatitis D. Bleeding - A- dysrhythmias are a risk for a client taking antipsychotics B- risk for glaucoma, but not cataracts C- risk for hepatitis, but not pancreatitis D- not true A nurse is assessing a client who has schizophrenia and is taking risperidone. Which of the following findings should the nurse expect? A. Weight gain B. Dependent edema C. Nightmares D. Bradycardia - A- this is an expected adverse effect B- not an adverse affect C- not an adverse effect D- tachycardia is a potential adverse effect, not bradycardia A nurse is caring for a client who has schizophrenia and is taking haloperidol. The nurse should monitor for which of the following adverse effects of this med? A. Extrapyramidal symptoms B. Fever C. Intractable hiccups D. Excessive salivation - A- associated with typical antipsychotics (movement disorders) B- not an adverse effect C- not an adverse effect D- not an adverse effect A nurse is caring for a client who has schizophrenia and a new prescription for fluphenazine. Which of the following information should the nurse provide? A. "This medication might turn your urine orange" B. "Sleepiness should subside within a week" C. "Stop the medication if hypotension occurs" D. A low-grade fever is expected with the first doses" - B- first-gen antipsychotics can cause sedation with early treatment A- might turn urine pink to reddish brown C- rise slowly but do not stop med abruptly D- med can cause leukopenia or agranulocytosis; notify provider immediately if having sore throat, fever, or malaise A nurse is caring for a client who has schizophrenia and a new prescription for risperidone. Which of the following statements should the nurse include in the teaching? A. Increase fluid and fiber intake to prevent constipation B. Have blood pressure checked frequently for hypertension C. Expect to have blood checked weekly for serum electrolyte imbalances D. Increase caloric intake to prevent weight loss - A- constipation is common adverse effect B- orthostatic hypotension is common, not hypertension C- changes in electrolytes are not expected; CBC and liver function will be checked monthly D- weight gain, dyslipidemia, and increases in blood glucose are common adverse effects of this medication A nurse is caring for a client who is experience acute manifestations of withdrawal from alcohol. Which of the following medications should the nurse expect to administer to the client? A. Diazepam B. Acamprosate C. Naltrexone D. Disulfiram - A- benzos used for acute alcohol withdrawal B- helps manage and maintain abstinence in clients following acute withdrawal from alcohol C- for opioid withdrawal D- used to maintain alcohol abstinence A nurse in a substance abuse clinic is assessing a client who recently started taking disulfiram. The client reports having discontinued the medication after experiencing severe nausea and vomiting. Which of the following reasons should the nurse suspect to be a likely cause of the client's distress? A. The client had an allergic response B. The client experienced a common side effect C. The client consumed alcohol D. The client took an overdose of the medication - C- Disulfiram is given to avoid alcohol intake in clients with addiction to alcohol; it causes a highly unpleasant reaction A nurse is caring for a client who has Wernicke-Korsakoff psychosis as a result of chronic alcohol use disorder. Which of the following interventions should the nurse anticipate? A. Lab analysis of cardiac enzymes B. Monitor for presence of esophageal varices C. Administration of thiamine D. Place client in protective isolation - C- Thiamine is given to client with this psychosis due to hepatic dysfunction A nurse is caring for a client who has schizophrenia and is experiencing a variety of hallucinations. Which of the following hallucinations is the priority for the nurse to address? A. Command hallucinations B. Tactile hallucinations C. Olfactory hallucinations D. Visual hallucinations - A A client with schizophrenia is agitated and states, "The FBI is coming to get me! I know they are listening to everything I say!" The best response by the nurse is: A. "What if the FBI is trying to protect you?" B. "That sounds very frightening" C. "I do not think the FBI is coming to get you" D. "Why would the FBI be listening to you?" - B A nurse overhears a client who has schizophrenia talking to herself. The client keeps stating, "The flakalas are here. The flakalas are here." The nurse correctly recognizes the client's use of the word flakala as an example of which of the following alterations in speech? A. Neologism B. Echolalia C. Clang association D. Word salad - A- neologism is where new phrases/words are invented by client A nurse is caring for a client who has schizophrenia and tells the nurse "I know not everyone can understand what it is like for me. Not everyone has superpowers". The nurse knows that the client is displaying: A. delusions of grandeur B. ideas of reference C. avolition D. somatic delusions - ? A nurse is caring for a client who is experiencing acute alcohol withdrawal. Which of the following findings should the nurse expect? A. Hand tremors B. Stuporous LOC C. Hypotension D. Bradycardia - A A nurse is caring for a client who has a history of alcohol use disorder and has been hospitalized for detoxification. The nurse enters the room and finds the client shouting in a terrified voice, "Get these bugs off of me!" Which of the following responses by the nurse is appropriate? A. "I do not see anything. This is part of withdrawal process" B. "I do not see any bugs, but you seem very frightened" C. "Tell me more about the bugs that you see in your room" D. "Im sure that the bugs you see will not harm you" - B A client states, "I just don't know what to do about my partner's drinking. Every time I see him drinking beer, I start to feel extremely anxious." Which of the following is the most therapeutic response by the nurse? A. "The next time your partner starts drinking, what is something you might do to decrease your anxiety?" B. "I think you should attend an Al-Anon meeting. It is a support group for people who are troubled by another person's drinking". C. "Tell me more about your son. Is he still causing problems with you?" D. "At one time you told me you were drinking regularly with him. Are you continuing to do that?" - A A nurse is collecting a health history on a client who has a diagnosis of Wernicke- Korsakoff syndrome. Which of the following is an expected finding? A. Family history of Alzheimers B. Current rehab for opioids C. Personal history of alcohol use disorder D. Undergoing HIV treatment - C A nurse is assessing a client who has a history of opioid use disorder. Which of the following questions should the nurse include to determine how the use of opioids affects the client's psychosocial behaviors? A. "Do you receive treatment for any mental health disorders?" B. "Has opioid use affected your work performance?" C. "At what age did you begin using opioids?" D. "Have you received prior treatment for substance use disorder?" - B A nurse is reviewing the medical record of a client who reports drinking three to four glasses of wine each night and taking 3,000 mg of acetaminophen daily. Which of the following laboratory values is the priority for the nurse to assess? A. Amylase B. ADH C. AST D. Creatinine - C what drug class is chlorpromazine - conventional/typical antispsychotic what drug class is Haloperidol - conventional/typical antipsychotic therapeutic use of Haloperidol - suppresses symptoms of schizophrenia acute manic phase of bipolar relieves nausea and vomiting intractable hiccups complications of Haloperidol - akathisia Parkinson-like symptoms acute dystonia anticholinergic effects decreased sex drive dysrhythmias neuroleptic malignant syndrome contraindications of Haloperidol - alcohol withdrawal bone marrow suppression CNS depression pregnancy and lactation caution w hypertension, diabetes medication administration of Haloperidol - incompatible in IV form with many other drugs keep client recumbent 30 mins after IV/IM interactions with Haloperidol - CNS depressants antacids/antidiarrheals client education for Haloperidol - notify if inner restlessness, signs and symptoms of Parkinsons chew gum for dry mouth increase fluids and fiber urinate before dose wear gloves when handling avoid sun exposure what drug class is risperidone - atypical antipsychotic what drug class is olanzepine (Zyprexa) - atypical antipsychotic what drug class is Abilify, Seroquel, Latuda - atypical antipsychotic expected action of conventional/typical antipsychotics - blocks CNS and non-CNS receptors (norepinephrine, acetylcholine, dopamine, histamine) expected pharmacologic action of atypical antipsychotics - blocks receptors for dopamine and serotonin therapeutic use of atypical antipsychotics - treats positive and negative symptoms of schizophrenia treats bipolar manages irritability in autistic patients complications of atypical antipsychotics - drowsiness, insomnia, dizziness extrapyramidal effects Parkinson's symptoms weight gain new onset diabetes contraindications of atypical antipsychotics - prolonged QT psychosis related to dementia sunlight exposure lactation children client education with atypical antipsychotics - report CNS effects report extrapyramadial effects increase exercise, low sugar/fat/calories report polydipsia and polyuria monitor glucose in diabetics what drug class is benzotropine - anticholinergic what is the brand name of benzotropine - Cogentin expected action of benzotropine - blocks Ach receptors blocks dopamine reuptake therapeutic use of benzotropine - treats extrapyramidal side effects of antipsychotics tremors, stiffness Parkinson's what are some extrapyramidal side effects - inability to sit still, involuntary muscle contraction, tremors, stiff muscles, and involuntary facial movements complications of benzotropine - nausea, vomiting, dry mouth CNS effects depression, hallucinations tachycardia/palpitations urinary retention paralytic ileus contraindications of benzotropine - urinary retention tachycardia closed angle glaucoma patients under 3 alcoholism with CNS depression client education for benzotropine - avoid driving until CNS effects known report vision problems, GI, urinary retention decreased sweating take with food what drug class is clonidine - antihypertensive expected action of clonidine - relaxes blood vessels in brain blocks chemicals in brain that trigger SNS activity therapeutic use of clonidine - hypertension opioid withdrawal ADHD Tourette's menstrual cramps complications of clonidine - headache, dizziness, drowsiness mood swings dry mouth constipation insomnia depression cardiac problems contraindications for clonidine - pregnancy recent heart attack stroke cardiac conditions interactions with clonidine - other heart/BP meds antidepressants antihistamines alcohol and marijuana sleep drugs what drug class is buprenorphine - opioid partial agonist-antagonist expected action of buprenorphine - binds to opioid receptors partial antagonist properties for opioid withdrawal alters perception/response to pain therapeutic use of buprenorphine - decreases pain severity decrease withdrawal symptoms in detox from opioids complications of buprenorphine - dizziness, drowsiness respiratory depression slow heartbeat and weak pulse chest pain decreased cortisol liver problems constipation insomnia increased sweating contraindications for buprenorphine - breathing issues sleep apnea liver/kidney disease head injury/brain tumor alcoholism mental illness hallucinations pregnancy and lactation interactions with buprenophrine - alcohol benzos opioids drugs affecting serotonin drugs that alter breathing