Chapter 22: Drugs for Depression, Anxiety, and Psychosis Nursing School Test Banks

Workman: Understanding Pharmacology

Chapter 22: Drugs for Depression, Anxiety, and Psychosis

Test Bank

MULTIPLE CHOICE

1. Which statement about depression is true?
a. Depression does not affect the way a person interacts with others.
b. Men are twice as likely to experience depression as women.
c. Many older adults with depression are undiagnosed and untreated.
d. Women are less likely than men to seek treatment for depression.
ANS: C
Because depression is often mistaken for a normal part of aging, many older adults with depression may be undiagnosed and untreated. Depression affects the way people feel about themselves and how they interact with others. Women are twice as likely as men to experience depression and women are also more likely than men to seek treatment.

PTS: 0 DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 391 TOP: Nursing Process Step: N/A MSC: Client Needs Category: N/A

2. Which statement about psychiatric disorders is true?
a. The underlying cause of most mental illness is genetic.
b. The incidence of anxiety and depression decreases with age.
c. Childrens psychiatric issues are usually short term and mild.
d. Mental illnesses are a common reason for seeking health care.
ANS: D
Major mental illnesses are the most common cause of disability in the United States. About 23% of North American adults experience a clinically diagnosable mental illness each year. Between 9% and 13% of children younger than age 18 experience serious emotional disturbance with functional impairment, whereas 5% to 9% have serious emotional disturbance with extreme functional impairment caused by a mental illness. Only a small percentage of mental illnesses have a genetic origin. Anxiety and depressive disorders tend to increase with age.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)
REF: p. 391 TOP: Nursing Process Step: N/A
MSC: Client Needs Category: Psychosocial Integrity

3. Which characteristic is typical of bipolar disorder?
a. Severe highs and severe lows
b. Increased risk for suicide
c. Persistently low moods
d. Lack of pleasure in life
ANS: A
Bipolar disorder, also called manic-depression, is characterized by cycling moods from severe highs (mania) and severe lows (depression). Increased risk for suicide and lack of pleasure in life are characteristics of major depression. Persistently low moods are characteristic of both major depression and dysthymia.

PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 392 TOP: Nursing Process Step: Assessment
MSC: Client Needs Category: Psychosocial Integrity

4. A patient with depression has all of the following symptoms. For which symptom is he or she likely to receive treatment at an inpatient facility rather than as an outpatient?
a. Expressing anger at a situation or person
b. Suggesting a plan to hurt oneself
c. Crying off and on for several hours or days
d. Sleeping for 12 hours or longer daily
ANS: B
Most patients with depression are treated as outpatients; however, when a person has suicidal thoughts (also called suicidal ideation) and particularly if the person has a suicide plan, hospitalization may be required.

PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 393 TOP: Nursing Process Step: N/A
MSC: Client Needs Category: Psychosocial Integrity

5. Which theory about the cause of depression is supported by research?
a. Heredity or genetics
b. Altered neuroendocrine function
c. Psychosocial factors
d. Neurotransmitter level imbalance
ANS: D
Research suggests that depression may be caused by an imbalance of brain chemicals called neurotransmitters (e.g., serotonin, dopamine, and norepinephrine). Communication between neurons in the brain occurs by the movement of these chemicals across a small gap called a synapse. Neurotransmitters are released from one neuron and cross the synapse where they may be accepted by the receptor sites on the next neuron. When neurotransmitter levels decrease or become imbalanced, the neurons may be less able to communicate with each other, which may lead to depression and other mood changes.

PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 393 TOP: Nursing Process Step: N/A MSC: Client Needs Category: N/A

6. A patient who was prescribed citalopram (Celexa) 1 week ago for depression reports feeling no different now from 1 week ago and wants to stop taking the drug. What is the nurses best response?
a. Treatment for depression is highly individual and this may not be the right drug for you.
b. Most drugs for depression take at least 2 weeks to start making you feel better.
c. Are you certain that you are taking the drug exactly the way it was prescribed?
d. Be sure to stop smoking because cigarette smoking inactivates this drug.
ANS: B
Citalopram is a selective serotonin reuptake inhibitor (SSRI). SSRIs work by increasing the amount of serotonin in the brain by inhibiting reuptake. This drug begins inhibiting the reuptake of serotonin immediately but the patients symptoms often do not respond for 2 to 8 weeks. In order to know whether this is an effective drug for a particular patient, he or she needs to take the drug daily for at least 8 weeks.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Psychosocial Integrity

7. A patient is prescribed bupropion (Wellbutrin SR) 100 mg twice daily. It is time for the second dose today and the drug sent up from the pharmacy is Wellbutrin 100 XL. What is the nurses best action?
a. Administer the Wellbutrin XL tablet in place of the Wellbutrin SR tablet.
b. Cut the Wellbutrin XL tablet in half and then administer it.
c. Call the pharmacy and obtain a Wellbutrin SR 100 mg tablet.
d. Hold the dose and notify the prescriber.
ANS: C
An order for Wellbutrin SR can be confused with Wellbutrin XL. Both drugs are norepinephrine and dopamine reuptake inhibitors used to treat depression. But Wellbutrin SR is a slow-release form of the drug given twice a day, whereas Wellbutrin XL is an extended-release form of the drug given once a day. Because of their absorption and differences in onset of action, these drugs are not interchangeable.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Safe and Effective Care Environment

8. Which statement by a patient with chronic depression who is prescribed fluoxetine (Prozac) indicates to the nurse the need for additional teaching?
a. It may take from 2 to 8 weeks for my depression to improve.
b. If I have suicidal thoughts, I will contact my prescriber immediately.
c. I will check my pulse every day and report irregular rhythms to my prescriber.
d. When I am feeling better and no longer depressed, I will stop taking the Prozac.
ANS: D
When depression is chronic, patients must continue to take antidepressants even when they have no symptoms to keep the depression from returning. Patients should be taught that antidepressants can control the symptoms but will not cure depression.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Assessment MSC: Client Needs Category: Psychosocial Integrity

9. Which assessment is most important for the nurse to measure or perform before administering the first dose of amitriptyline (Elavil) to a patient?
a. Heart rate and rhythm
b. Core body temperature
c. Level of consciousness
d. Blood pressure in the sitting position
ANS: A
Amitriptyline is a tricyclic antidepressant that can cause unstable ventricular dysrhythmias. Therefore heart rate and rhythm are most important to assess to establish a baseline and determine possible adverse effects of this drug. Although the drug can also lower blood pressure and increase drowsiness, changes in heart rhythm can be life threatening.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Physiological Integrity

10. The parents of a 12-year-old who was prescribed fluoxetine (Prozac) inform the nurse that their child is having trouble sleeping. What is the nurses best response?
a. This is a normal expected side effect of fluoxetine.
b. We may need to ask the prescriber to order something to help your child sleep.
c. Children are more sensitive to the effects of this drug and may need a lower dose.
d. Before bedtime be sure that your child does not eat or drink anything with caffeine.
ANS: C
Because children are more sensitive to the effects of fluoxetine, the drug may cause unusual excitement, restlessness, irritability, or trouble sleeping. The prescriber should be notified if these side effects occur because a lower dose or a different drug may be needed to control the childs depression symptoms.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Health Promotion and Maintenance

11. A patient has been taking mirtazapine (Remeron) for the last 3 months. Which blood laboratory result from the patient does the nurse report to the prescriber?
a. Lactate dehydrogenase 122 mg/dL
b. International normalized ratio (INR) 1.3
c. White blood cell count (WBC) 2100/mm3
d. Platelet count 356,000/mm3
ANS: C
Mirtazapine can suppress bone marrow production of WBCs (neutropenia) which can greatly increase the patients risk for infection. The normal WBC range is 5000 to 10,000/mm3. This patients WBC count is low and drug dosage adjustment or drug changes are needed.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Physiological Integrity

12. Which precaution is most important for the nurse to teach a patient who is prescribed any antidepressant drug?
a. Avoid drinking grapefruit juice while taking this drug.
b. Avoid drinking alcoholic beverages while taking this drug.
c. Be sure to wear sunscreen and a hat when going outdoors.
d. Drink at least 3 liters of fluid every day while taking this drug.
ANS: B
Most antidepressants cause some degree of drowsiness. Alcohol intensifies this action and can impair the patients physical strength and mental alertness.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Health Promotion and Maintenance

13. Although serotonin reuptake inhibitors (SSRIs) are used more commonly now to treat anxiety disorders than are benzodiazepines, for which patient situation does the nurse expect a benzodiazepine to be prescribed instead of an SSRI?
a. The patient is 18 years old.
b. Anxiety has been present daily for 6 months.
c. The patient has compulsive repetitive actions.
d. The anxiety attack is severe with hallucinations.
ANS: D
Benzodiazepines, even when given orally, act within 30 minutes of administration. SSRIs need to build up to a certain blood level and may take as long as 3 to 5 weeks to reduce anxiety. When an anxiety attack is sudden or severe, a benzodiazepine may be most helpful, even if it is just given once.

PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 401 TOP: Nursing Process Step: N/A
MSC: Client Needs Category: Psychosocial Integrity

14. A patient who has been prescribed clonazepam (Klonopin) for the last 3 months tells the nurse that he wants to stop this drug because he constantly feels like he is in a fog. What is the nurses best response?
a. Quit taking the drug today and I will have the prescriber change your medication to another drug category.
b. Continue to take this drug as prescribed because most patients eventually get used to the foggy sensation.
c. We will give you a final dose of this drug today intravenously and then start you on a different drug.
d. I will contact the prescriber but it will still be necessary to take this drug at a lower dosage for awhile.
ANS: D
Clonazepam is a benzodiazepine. Suddenly stopping drugs from this class can cause a potentially life-threatening reaction of withdrawal symptoms. This drug needs to be tapered slowly by gradually reducing the dosage before it can be safely stopped.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Health Promotion and Maintenance

15. Which statement about a common anxiety disorder is accurate?
a. Panic disorders develop over a period of hours to days.
b. Generalized anxiety disorder occurs when a person experiences excessive anxiety daily for 2 months.
c. Phobic disorders are recurrent persistent fears of certain objects or situations that can cause panic attacks.
d. Posttraumatic stress disorder is the result of frightening thoughts and dreams.
ANS: C
Panic disorders develop over a short period of time such as 10 minutes. Generalized anxiety disorder is when a person experiences excessive anxiety almost daily for more than 6 months. Posttraumatic stress disorder is caused by exposure to death or near-death experiences.

PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 400 TOP: Nursing Process Step: N/A MSC: Client Needs Category: N/A

16. What is the advantage of treating a patient with anxiety with a benzodiazepine drug rather than a selective serotonin reuptake inhibitor (SSRI)?
a. Benzodiazepines are not likely to cause patient dependence when used for an extended period of time.
b. Benzodiazepines have milder side effects and almost no adverse effect when compared with SSRIs.
c. Benzodiazepines control anxiety and allow patients to live a relatively normal lifestyle.
d. Benzodiazepines act to treat anxiety within 20 minutes and can be given on an as-needed basis.
ANS: D
Benzodiazepines have stronger side effects than SSRIs and are more likely to cause dependence in a patient who uses them for an extended period of time. Both benzodiazepines and SSRI drugs control anxiety and allow patients to live nearly normal lives. The major benefit of benzodiazepines is that they act within 30 minutes and can be taken as needed.

PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 401 TOP: Nursing Process Step: N/A MSC: Client Needs Category: N/A

17. What type of medication could be prescribed for a patient who experiences anxiety when speaking before a group?
a. A benzodiazepine drug
b. An SSRI drug
c. A beta blocker
d. A TCA drug
ANS: C
When a patient is facing an anxiety-producing event such as performing on stage or making a speech, beta blockers can be prescribed to control the symptoms of anxiety. Benzodiazepine drugs may cause dependence. SSRI drugs can take 3 to 5 weeks to control symptoms of anxiety. Tricyclic antidepressant (TCA) drugs are used to treat depression, not anxiety.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Health Promotion and Maintenance

18. A patient asks the nurse why the prescriber is changing his anxiety medication from lorazepam (Ativan) to sertaline (Zoloft). What is the nurses best response?
a. Sertraline is a stronger drug and will do a better job of controlling your anxiety.
b. Sertraline has milder side effects and a decreased risk for drug dependence.
c. Sertraline acts much faster to get the symptoms of your anxiety under control.
d. Sertraline can be taken only when needed to control symptoms of anxiety.
ANS: B
Sertraline is a selective serotonin reuptake inhibitor. This class of drugs has milder side effects and a much lower likelihood of developing drug dependence than benzodiazepines such as lorazepam. However, it takes 3 to 5 weeks for symptoms of anxiety to improve and must be taken on a daily basis.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Health Promotion and Maintenance

19. On admission to the acute care unit a patient tells the nurse that she stopped taking her prescribed clonazepam (Klonopin) 2 days ago. What is the nurses best first action?
a. Ask the patient why she stopped taking the clonazepam.
b. Administer a dose of clonazepam immediately.
c. Document this information as the only action.
d. Notify the prescriber and watch for seizures.
ANS: D
Clonazepam is a benzodiazepine drug. Suddenly stopping a drug from this class can cause potentially life-threatening withdrawal symptoms including nervousness, restlessness, tremulousness, weakness, and seizures.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Planning
MSC: Client Needs Category: Safe and Effective Care Environment

20. A patient who has been prescribed diazepam (Valium) reports taking the as-needed (PRN) drug more often to keep anxiety symptoms under control and does not want the prescriber to stop prescribing it. What is the nurses best interpretation of this information?
a. The patient may be developing signs of drug dependence.
b. The patient may be developing signs of drug tolerance.
c. The patients anxiety is becoming more severe.
d. The patient should stop taking the drug immediately.
ANS: A
The signs of developing dependence on benzodiazepines include a strong desire or need to continue taking the drug, a need to increase the dose to feel the effects of the drug, and withdrawal effects after the drug is stopped such as irritability, nervousness, and trouble sleeping. Drug tolerance is a condition that occurs when the body gets used to a medicine so that either more medicine is needed or a different medicine is needed.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Evaluation MSC: Client Needs Category: Psychosocial Integrity

21. A female patient who has been prescribed diazepam (Valium) for anxiety tells the nurse that she and her husband are planning to have a child. What is the nurses best response?
a. Before becoming pregnant your dosage of diazepam will need to be decreased.
b. You should always discuss any changes in your medications and lifestyle with your prescriber.
c. Consult with your prescriber because taking diazepam while pregnant has been associated with birth defects.
d. Diazepam may cause withdrawal effects when taken during pregnancy.
ANS: C
Benzodiazepines such as chlordiazepoxide (Librium) and diazepam have caused birth defects when used during the first trimester of pregnancy. Use of these drugs during pregnancy can also cause the fetus to become dependent and experience withdrawal symptoms after birth.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Health Promotion and Maintenance

22. How do the major antipsychotic drugs exert their effects to reduce psychotic episodes?
a. They block dopamine receptors and reduce neuronal impulse transmission.
b. They redirect nerve impulses away from excitatory areas of the brain and into brain inhibitory areas.
c. They enhance the breakdown of excitatory neurotransmitter chemicals so that impulse transmission is slower.
d. They block the reuptake of neurotransmitters so that the concentration of these chemicals is increased in the brain.
ANS: A
All antipsychotic drugs tend to block dopamine receptors in the dopamine pathways in the brain. The normal effect of releasing the neurotransmitter dopamine is decreased. Transmission of impulses is decreased which in turn decreases the symptoms of hallucinations, illusions, and delusions.

PTS: 1 DIF: Cognitive Level: Comprehension (Understanding)
REF: p. 405 TOP: Nursing Process Step: N/A
MSC: Client Needs Category: Physiological Integrity

23. The family of a patient who was prescribed chlorpromazine (Thorazine) report that the patient continually rolls his tongue and smacks his lips. What is the nurses best action?
a. Reassure the patient and family that this response is an expected side effect of the drug.
b. Instruct the family to ensure that the patient drinks plenty of fluids and performs oral hygiene at least three times daily.
c. Instruct the family to hold the next dose of the drug and have the patient seen by the prescriber as soon as possible.
d. Emphasize to the family that this drug cannot be stopped quickly and to gradually reduce the dose over a 2- to 3-week period.
ANS: C
The patients behaviors of tongue rolling and lip smacking are symptoms of tardive dyskinesia associated with chlorpromazine therapy. This neurologic problem can become permanent if the patient remains on the drug long-term. Chlorpromazine is an older antipsychotic drug and the patient may respond better to a newer one. Although stopping the drug quickly can cause nausea, vomiting, and dizziness, these effects are not life threatening.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Physiological Integrity

24. An older patient taking lithium carbonate (Eskalith) for 2 months has all of the following conditions. Which symptom does the nurse report to the prescriber as a possible side effect that may require a change of drug or drug dosage?
a. Dry mouth
b. Increased belching after meals
c. Weight loss of 6 lb in 1 week
d. International normalized ratio (INR) of 1.1
ANS: C
Lithium can cause a type of diabetes insipidus in which the patient has an excessive urine output that can lead to dehydration. A 6-lb weight loss is significant and should be reported to the prescriber. The patient may be at risk for dehydration.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Evaluation MSC: Client Needs Category: Physiological Integrity

25. Four hours after receiving risperidone (Risperdal), the patient on the psychiatric unit has a temperature elevation of 2 F. What is the nurses best action?
a. Administer the next dose of the drug as prescribed.
b. Assess the patient for other signs and symptoms of infection.
c. Hold the next drug dose and notify the prescriber immediately.
d. Attempt to arouse the patient from sleep by gently shaking his or her arm.
ANS: C
A rapid temperature elevation is often the first sign of an adverse reaction called neuroleptic malignant syndrome. This reaction involves the autonomic nervous system and is potentially life threatening. Until the cause of the temperature elevation is identified, further drug dosages should be withheld.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Evaluation MSC: Client Needs Category: Physiological Integrity

26. Which food or beverage does the nurse teach a patient who is prescribed quietiapine (Seroquel) to avoid?
a. Coffee and caffeine
b. Fresh berries and vegetables
c. Aged cheese and smoked meat
d. Grapefruit and grapefruit juice
ANS: D
Grapefruit and grapefruit juice interact with the enzymes that metabolize quietiapine, causing the blood drug levels to increase. This action increases the risks for side effects and adverse reactions. Patients taking this drug should avoid grapefruit and grapefruit juice.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Health Promotion and Maintenance

27. Which safety precaution is most important for the nurse to teach an older adult who is prescribed chlorpromazine (Thorazine)?
a. Avoid going barefoot, even in the house.
b. Change positions slowly when rising to stand.
c. Drink plenty of water to avoid having to strain during a bowel movement.
d. Use a thermometer to check the temperature of your bath or shower water to avoid a scald injury.
ANS: B
Chlorpromazine can cause an unsafe drop in blood pressure when the patient moves from a lying or sitting position to a standing position. This can cause dizziness and an increased risk for falls, especially among older adults. Changing positions slowly reduces the rapid drop in blood pressure.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Health Promotion and Maintenance

28. A patient who has been prescribed prochlorperazine (Compazine) calls the clinic and reports pink-tinged urine. What is the nurses best action?
a. Ask the patient whether grapefruit or grapefruit juice has been ingested within the last 24 hours.
b. Remind the patient to drink more water to prevent this drug from damaging the kidneys.
c. Reassure the patient that this is an expected side effect of the drug and needs no action.
d. Instruct the patient to hold the next drug dose and notify the prescriber immediately.
ANS: C
This drug usually changes urine color to pink or reddish-brown. It is not an indication of bleeding or of any kidney problem. No action needs to be taken other than reassuring the patient about this change.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Psychosocial Integrity

MULTIPLE RESPONSE

1. Which are common treatment methods for depression? (Select all that apply.)
a. Counseling
b. Surgery
c. Group meetings
d. Psychotherapy
e. Shock therapy
ANS: A, D
The most common treatments for depression include counseling or psychotherapy and antidepressants drugs.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)
REF: p. 393 TOP: Nursing Process Step: N/A MSC: Client Needs Category: N/A

2. A patient has been prescribed amitriptyline (Elavil). What does the nurse plan to include in the teaching plan for this patient? (Select all that apply.)
a. Smoking cigarettes can decrease the effectiveness of amitriptyline in treating your depression.
b. Check your pulse every day and report any irregular rhythms to your prescriber right away.
c. Amitriptyline should help to improve your depression symptoms within 7 to 14 days.
d. Avoid driving or operating dangerous equipment until you know how the drug will affect you.
e. Be sure to include foods with lots of fiber in your diet to prevent the side effect of constipation.
ANS: A, B, D, E
Amitriptyline is a tricyclic antidepressant (TCA). TCA drugs may take anywhere from 2 to 8 weeks to improve depression symptoms. Cigarette smoking can decrease the effectiveness of TCA drugs. Common side effects of TCAs include lethargy, sedation, drowsiness, fatigue, blurred vision, dry mouth, hypotension, and constipation. Additionally, an adverse effect of these drugs that can occur is abnormal heart rhythms.

PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)
REF: pp. 397-398 TOP: Nursing Process Step: Planning
MSC: Client Needs Category: Health Promotion and Maintenance

3. Which are common anxiety disorders? (Select all that apply.)
a. Dysthymia
b. Panic disorder
c. Bipolar disorder
d. Phobic disorder
e. Obsessive-compulsive disorder
ANS: B, D, E
Common anxiety disorders include panic disorder, generalized anxiety disorder, phobic disorder, obsessive-compulsive disorder, and posttraumatic stress disorder. Dysthymia and bipolar disorder are common forms of depression.

PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 398 TOP: Nursing Process Step: N/A MSC: Client Needs Category: N/A

4. A patient with anxiety is prescribed oxazepam (Serax). What safety measures must the nurse be sure to include in this patients plan of care? (Select all that apply.)
a. Call for help when getting out of bed.
b. Use a walker for ambulation.
c. Assess gait for steadiness.
d. Change positions slowly.
e. Take two tablets whenever a dose is missed.
ANS: A, C, D
Oxazepam is a benzodiazepine. Common side effects of these drugs include sedation, sleepiness, depression, light-headedness, ataxia, and unsteadiness. The patients gait must always be assessed for steadiness when these drugs are prescribed. Patients may need assistance getting out of bed, changing positions, or walking, but do not necessarily need a walker. Patients should be taught not to take double doses of any drug because this could cause drug overdose with severe side effects or adverse effects.

PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 403 TOP: Nursing Process Step: Planning
MSC: Client Needs Category: Health Promotion and Maintenance

ESSAY

1. A patient is prescribed 30 mg of chlorpromazine (Thorazine) intramuscularly. The drug available is 25 mg per 1 mL. How many milliliters does the nurse draw into the syringe?
_____ mL

ANS:
1.2 mL
Want 30 mg in X mL, Have 25 mg in 1 mL. 30/25 = 1.2 1 mL = 1.2 mL.

PTS: 1 DIF: Cognitive Level: Applying (Application) or higher
TOP: Nursing Process Step: Implementation
MSC: Client Needs Category: Safe and Effective Care Environment

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