Mental Health Chapter 7

During client teaching, the nurse must inform the client prescribed a tricyclic antidepressant (TCA) to not expect to see a difference in mood or anxiety level for up to:

2 to 3 weeks

A male client with the diagnosis of depression is taking a monoamine oxidase inhibitor (MAOI). Which is the most important teaching point the nurse must include in his care plan?

Avoid alcoholic beverages

A female client is 3-days postoperative and has been receiving meperidine (Demerol) for pain control. The family mentions to the nurse that the client has been taking phenelzine (Nardil) for years for her depression. The client did not list this medication on admission. What signs and symptoms should the nurse look for in case of reaction between these two medications?

Sedation, disorientation, and hallucinations

The nurse is aware that he or she may be administering the new antianxiety medication pregabalin (Lyrica) to clients without an anxiety disorder for the purpose of treating:

Neuropathic pain

Selective serotonin reuptake inhibitors (SSRIs) are most health care providers' drug of choice for the treatment of depression because:

The side effects are more manageable than with other antidepressants

In preparing discharge planning for a client who has been prescribed lithium for the treatment of bipolar disorder, the nurse must be sure that the client demonstrates an understanding of the need to monitor his or her diet for intake of:

Sodium

A female client calls the clinic for advice after forgetting to take her morning dose of twice-daily lithium 5 hours ago. Which instructions should the nurse give the client?

Eliminate the dose missed, and take the second dose at the normal time.

A female client who has had bipolar disorder for several years decides to stop all of her medications because she is tired of the side effects. She also cancels all appointments with her therapist, stating that it is just too difficult to plan the visits in her hectic schedule. This client is considered:

Noncompliant

A male client with schizophrenia lives in an assisted-living complex for individuals with mental health disorders. He is tired of the Parkinson-like symptoms he experiences with his antipsychotic medication and therefore stops taking his medication after much discussion with his treatment team. He is progressively withdrawing from reality but is not a safety risk at this point to himself or others. What is the best response of the nurse and treatment team?

Ensure that the client and those around him are safe, and monitor for additional symptoms of his schizophrenia while maintaining trust with the client.

An adult female client has been diagnosed recently with mild depression but opts not to take the medication prescribed by her physician after talking with the physician about the benefits, risks, possible outcomes, and side effects. She decides to investigate alternative treatments. This client is making this decision based on the premise of:

Informed consent

The nurse is administering medications to a client with a diagnosis of paranoid schizophrenia. The nurse would expect to see which medication ordered for this client?

Risperdal

Psychotropic medications can cause a parasympathetic and/or sympathetic response from the autonomic nervous system. Which of the following is considered a sympathetic response?

Pupil dilation

While completing the history portion of an admission assessment of a client with schizophrenia, the nurse notices that the client is continually moving in the chair and frequently stands and then sits back down. The nurse knows that this client most likely is experiencing the side effect of:

Akathisia

__________ is a side effect that can occur while a client is taking an antipsychotic medication, causing muscle rigidity, high fever, unstable vital signs, confusion, and agitation

Neuroleptic malignant syndrome (NMS)

The __________ constitute a class of drugs that are commonly prescribed for cardiac arrhythmias but also have been found to be effective treatment for social phobias.

Beta-blockers

Valium is administered to a client anxious about impending surgery. Which of the following side effects is the client at risk for?

Falls

When educating a client being treated with lithium, which item(s) in his or her diet should be monitored or avoided?

Hot dogs and ham

The CMA is administering an antianxiety medication to a client. Monitoring side effects is the responsibility of which member of the health care team?

Nurse

Careful assessment for changes in attitude and suicidal gestures should

be monitored in a client taking which medication?

Paxil (paroxetine)

Which of the following are basic responsibilities of nurses who administer psychotherapeutic drugs? (Select all that apply.)

Monitoring and evaluating the client's response to the medication

Continually assessing the client's condition

Assisting in the coordination of the client's care

Teaching clients about their medications

Administering prescribed medications

The nurse is developing a teaching plan for a client who has been diagnosed recently with a mental health disorder and has been prescribed a psychotropic medication. Which interventions regarding the medication should the nurse include in the teaching plan? (Select all that apply.)

Teach signs and symptoms of side effects and what to do if these occur

Provide written information regarding the purpose, dosage, route, and dosing schedule

Ask the client and significant other to verbally explain when it is necessary to contact the physician should side effects occur

Clients diagnosed with Type I-Positive Schizophreniasymptoms respond better to antipsychotic medications. Manifestations of Type I Schizophrenia include which of the following? (Select all that apply.)

Delusions

Hallucinations

Illusions

__________ side effects can occur when antipsychotic medications are taken that manifest as abnormal movements such as akathisia and pseudo-Parkinson symptoms.

Extrapyramidal

The four classes of psychotherapeutic medications include antianxiety agents, antidepressants, antimanics, and __________.

Antipsychotics

Lithium levels are considered toxic when they become higher than __________ mEq/L

1.5