Question

A nurse is collecting data from a group of clients who have anxiety disorders and have prescriptions for various psychotropic medications. The nurse should recognize which of the following clients as having an increased risk for suicide?

Answer 1

Correct Answers:

A client who has an obsessive-compulsive disorder and takes fluoxetine.

Rationale :

🔷 Fluoxetine, an SSRI, increases serotonin levels, but during initial therapy, it may cause activation syndrome, characterized by restlessness and increased impulsivity.

🔷 This heightened activation can trigger suicidal ideation, especially in younger adults and those with coexisting psychiatric conditions.

🔷 Clients with OCD often have underlying anxiety and depressive symptoms, which may worsen temporarily before therapeutic effects begin.

🔷 Close monitoring during the first weeks of therapy is essential to prevent self-harm.

🔷 Nurses should provide frequent mental health assessments and education on reporting mood changes immediately.

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Answer 2

Correct Answers:

Slurred speech
Involuntary movements of the tongue

Rationale :

Slurred speech

💎 Tardive dyskinesia (TD) is a late-onset extrapyramidal side effect of haloperidol, resulting from chronic dopamine receptor blockade in the basal ganglia.

💎 Involvement of the orofacial muscles leads to difficulty in articulating words, presenting as slurred speech.

💎 Slurred speech in TD is persistent and involuntary, distinguishing it from transient dysarthria caused by other conditions.

💎 Early recognition is critical because TD symptoms can become irreversible if not promptly addressed.

💎 Nurses should report these findings immediately for possible medication adjustment or discontinuation.

Involuntary movements of the tongue

💎 Involuntary tongue thrusting, lip-smacking, and chewing movements are hallmark signs of TD.

💎 These movements occur due to supersensitivity of dopamine receptors after long-term antipsychotic use.

💎 TD can severely affect speech, swallowing, and social interactions, reducing quality of life.

💎 Identifying early orofacial TD signs allows for timely intervention, such as switching to atypical antipsychotics or using VMAT2 inhibitors.

💎 Continuous assessment for TD is a critical nursing responsibility when caring for clients on typical antipsychotics.

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Answer 3

Correct Answers:

Bipolar disorder

Rationale :

💎 Valproic acid is a mood stabilizer primarily used to treat bipolar disorder, especially for managing acute manic episodes and rapid cycling.

💎 It works by increasing GABA activity, which decreases neuronal excitability and stabilizes mood.

💎 It is also sometimes used as an adjunct in schizoaffective disorder, but bipolar disorder is its primary psychiatric indication.

💎 Nurses must monitor liver enzymes and platelet counts due to the risk of hepatotoxicity and thrombocytopenia.

💎 Consistent medication adherence helps prevent mood swings and relapse in bipolar disorder.

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Answer 4

Correct Answers:

Taking nonsteroidal anti-inflammatory drugs (NSAIDs)
Consuming a low-sodium diet

Rationale :

Taking NSAIDs

♦️ NSAIDs reduce renal clearance of lithium, increasing serum levels and toxicity risk.

♦️ Clients should be educated to consult healthcare providers before taking over-the-counter pain relievers.

♦️ Acetaminophen is usually a safer alternative for mild pain relief in clients on lithium.

♦️ Nurses must assess renal function regularly when lithium is used with other nephrotoxic drugs.

Consuming a low-sodium diet

♦️ A low-sodium diet causes the kidneys to retain lithium in place of sodium, leading to elevated levels.

♦️ Nurses should emphasize consistent sodium intake to maintain therapeutic lithium levels.

♦️ Educating on avoiding excessive sweating or dehydration, which mimics low sodium states, is also crucial.

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Answer 5

Correct Answers:

Attention-Deficit/Hyperactivity Disorder (ADHD)

Rationale :

💎 Amphetamine/dextroamphetamine sulfate is a CNS stimulant primarily prescribed for ADHD to improve focus, attention span, and impulse control.

💎 It works by increasing dopamine and norepinephrine levels in the prefrontal cortex, enhancing executive functioning.

💎 It is also used for narcolepsy, but ADHD remains the primary psychiatric indication.

💎 Nurses should monitor for insomnia, decreased appetite, and potential cardiovascular effects in clients.

💎 Regular assessment of growth in children and monitoring for misuse or dependency is essential.

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Answer 6

Correct Answers:

Treatment of major depression
Management of Parkinson's disease

Rationale :

Treatment of major depression

🔷 Selegiline, in its transdermal form, is approved for major depressive disorder when other antidepressants are ineffective.

🔷 It is a selective MAO-B inhibitor at low doses but affects MAO-A at higher doses, increasing dopamine, norepinephrine, and serotonin availability.

🔷 Dietary precautions are needed to avoid hypertensive crisis from tyramine-rich foods at higher doses.

🔷 It is typically used in resistant depression cases due to its interaction risks.

Management of Parkinson's disease

🔷 Selegiline slows dopamine breakdown in the brain, improving motor function in Parkinson's.

🔷 It is often used with levodopa/carbidopa to enhance and prolong their effects.

🔷 Early initiation can delay the need for higher doses of dopaminergic medications.

🔷 Nurses must monitor for orthostatic hypotension and hallucinations in older adults.

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Answer 7

Correct Answers:

1.5

Rationale :

💎 Lithium has a narrow therapeutic range (0.6–1.2 mEq/L), and levels above 1.5 mEq/L indicate toxicity.

💎 Early signs of toxicity include nausea, vomiting, diarrhea, fine tremors, and confusion.

💎 Severe toxicity can progress to coarse tremors, ataxia, seizures, and coma, which may be life-threatening.

💎 Nurses should monitor lithium levels regularly, especially after dose changes or illness causing dehydration.

💎 Patient education should include maintaining adequate hydration and consistent sodium intake to prevent fluctuations in lithium levels.

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Answer 8

Correct Answers:

No less than 2 to 3 liters/day.

Rationale :

💎 Adequate hydration prevents dehydration-induced lithium reabsorption in the kidneys, lowering toxicity risk.

💎 Lithium is excreted through the kidneys, and dehydration can quickly lead to toxic accumulation.

💎 Nurses should encourage patients to increase fluid intake during hot weather, illness, or exercise.

💎 Monitoring for signs of dehydration (dry mouth, dizziness, decreased urine output) is essential.

💎 Education should stress avoiding diuretics unless prescribed, as they reduce fluid volume.

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Answer 9

Correct Answers:

True

Rationale :

💎 Diazepam, a benzodiazepine, is the drug of choice for acute alcohol withdrawal because it provides sedation and seizure prevention.

💎 It reduces CNS hyperexcitability by enhancing GABA activity, preventing progression to delirium tremens.

💎 Long-acting benzodiazepines like diazepam offer smoother withdrawal control.

💎 Nurses should monitor for respiratory depression and over-sedation, especially in older adults.

💎 Tapering is essential to prevent benzodiazepine dependence after withdrawal management.

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Answer 10

Correct Answers:

Lorazepam

Rationale :

💎 Lorazepam, a benzodiazepine, is the drug of choice for acute alcohol withdrawal due to its ability to reduce CNS hyperexcitability.

💎 It works by enhancing GABA activity, preventing seizures, tremors, and progression to delirium tremens.

💎 Lorazepam is preferred in older adults and those with hepatic impairment because it has no active metabolites.

💎 Close monitoring for sedation and respiratory depression is essential during administration.

💎 Gradual tapering after acute withdrawal is necessary to prevent benzodiazepine dependence.

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QLexNursing

1 :
A nurse is collecting data from a group of clients who have anxiety disorders and have prescriptions for various psychotropic medications. The nurse should recognize which of the following clients as having an increased risk for suicide?

2 :
A nurse is caring for a client who was admitted with acute psychosis and is being treated with haloperidol. The nurse should suspect that the client may be experiencing tardive dyskinesia when the client exhibits which of the following? (Select all that apply.)

3 :
What mental health disorder does valproic acid treat?

4 :
A nurse is caring for a client who has been hospitalized for treatment of bipolar disorder and will be discharged with a prescription for lithium. The nurse’s discharge teaching should include information cautioning against which of the following factors that may cause lithium toxicity?

5 :
What mental health disorder is amphetamine/dextroamphetamine sulfate used to treat?

6 :
What are the mental health therapeutic uses for selegiline?

7 :
Monitor serum lithium levels; should be below ------------mEq/L

8 : Instruct clients to drink no less than[blank1] liters of fluid/day to prevent dehydration when taking Lithium.

9 :
Acute alcohol withdrawal symptoms can be treated with diazepam. (Please enter True or False)

10 :
Which medication is commonly used to manage acute alcohol withdrawal symptoms?

QLexNursing

1 : A nurse is collecting data from a group of clients who have anxiety disorders and have prescriptions for various psychotropic medications. The nurse should recognize which of the following clients as having an increased risk for suicide?

2 : A nurse is caring for a client who was admitted with acute psychosis and is being treated with haloperidol. The nurse should suspect that the client may be experiencing tardive dyskinesia when the client exhibits which of the following? (Select all that apply.)

3 : What mental health disorder does valproic acid treat?

4 : A nurse is caring for a client who has been hospitalized for treatment of bipolar disorder and will be discharged with a prescription for lithium. The nurse’s discharge teaching should include information cautioning against which of the following factors that may cause lithium toxicity?

5 : What mental health disorder is amphetamine/dextroamphetamine sulfate used to treat?

6 : What are the mental health therapeutic uses for selegiline?

7 : Monitor serum lithium levels; should be below ------------mEq/L

8 : Instruct clients to drink no less than[blank1] liters of fluid/day to prevent dehydration when taking Lithium.

9 : Acute alcohol withdrawal symptoms can be treated with diazepam. (Please enter True or False)

10 : Which medication is commonly used to manage acute alcohol withdrawal symptoms?

1 :
A nurse is collecting data from a group of clients who have anxiety disorders and have prescriptions for various psychotropic medications. The nurse should recognize which of the following clients as having an increased risk for suicide?

2 :
A nurse is caring for a client who was admitted with acute psychosis and is being treated with haloperidol. The nurse should suspect that the client may be experiencing tardive dyskinesia when the client exhibits which of the following? (Select all that apply.)

3 :
What mental health disorder does valproic acid treat?

4 :
A nurse is caring for a client who has been hospitalized for treatment of bipolar disorder and will be discharged with a prescription for lithium. The nurse’s discharge teaching should include information cautioning against which of the following factors that may cause lithium toxicity?

5 :
What mental health disorder is amphetamine/dextroamphetamine sulfate used to treat?

6 :
What are the mental health therapeutic uses for selegiline?

7 :
Monitor serum lithium levels; should be below ------------mEq/L

9 :
Acute alcohol withdrawal symptoms can be treated with diazepam. (Please enter True or False)

10 :
Which medication is commonly used to manage acute alcohol withdrawal symptoms?