NCLEX Pharmacology Quiz: Psychiatric Medications

1. A nurse notes that a client with schizophrenia receiving an antipsychotic medication is having uncontrolled movement of the lips and tongue. The nurse determines what the client is experiencing.

Hypertensive crisis.

Parkinsonism.

Tardive dyskinesia.

Neuroleptic malignant syndrome.

Tardive dyskinesia is characterized by uncontrollable involuntary movements of the body and extremities (especially of the face. lips. mouth. tongue. arms or legs).Option A: Hypertensive crisis occurs from the use of MAOIs.Option B: Parkinsonism is characterized by tremor. slow movement. impaired speech or muscle stiffness.Option D: Neuroleptic malignant syndrome is a life-threatening condition caused by an adverse reaction to antipsychotic drugs. Symptoms include high fever. sweating. unstable blood pressure. stupor. muscular rigidity. and autonomic dysfunction.

Explanation

Tardive dyskinesia is characterized by uncontrollable involuntary movements of the body and extremities (especially of the face. lips. mouth. tongue. arms or legs).Option A: Hypertensive crisis occurs from the use of MAOIs.Option B: Parkinsonism is characterized by tremor. slow movement. impaired speech or muscle stiffness.Option D: Neuroleptic malignant syndrome is a life-threatening condition caused by an adverse reaction to antipsychotic drugs. Symptoms include high fever. sweating. unstable blood pressure. stupor. muscular rigidity. and autonomic dysfunction.

2. A client taking lithium carbonate (Lithobid) started complaining of nausea. vomiting. diarrhea. drowsiness. muscle weakness. tremor. blurred vision and ringing in the ears. The lithium level is 2 mEq/L. The nurse interprets this value as:

Normal level.

Toxic level.

Below normal level.

Above normal level.

The therapeutic drug serum level of lithium is 0.6 to 1.2 mEq/L.

Explanation

The therapeutic drug serum level of lithium is 0.6 to 1.2 mEq/L.

3. A nurse is giving instructions to a client receiving lithium citrate. The nurse tells the client to do which of the following to prevent lithium toxicity:

Avoid becoming dehydrated during exercise.

Instruct the client to change positions slowly.

Restrict salt intake in the diet.

Limit fluid intake.

Lithium toxicity usually occurs during chronic treatment because of reduced drug excretion (dehydration. worsening renal function. concurrent infections. and drug interactions).Option B is not a related intervention to prevent lithium toxicity.Options C and D: The client should maintain a fluid intake of 6-8 glasses of water a day and an adequate salt intake to prevent lithium toxicity.

Explanation

Lithium toxicity usually occurs during chronic treatment because of reduced drug excretion (dehydration. worsening renal function. concurrent infections. and drug interactions).Option B is not a related intervention to prevent lithium toxicity.Options C and D: The client should maintain a fluid intake of 6-8 glasses of water a day and an adequate salt intake to prevent lithium toxicity.

4. A nurse is giving instructions to a client taking risperidone (Risperdal). The nurse advises the client to which of the following?

Take it on an empty stomach.

Change position slowly.

Get a daily source of sunlight.

Discontinue medication once the symptoms went away.

Risperidone (Risperdal) can cause orthostatic hypotension so instruct the client to change positions slowly to avoid it.Option A: The medication is taken with food or milk to decrease gastric upset.Option C: Sunlight should be avoided while taking the medication.Option D: The medication is to be reduced gradually to avoid sudden recurrence of psychotic symptoms.

Explanation

Risperidone (Risperdal) can cause orthostatic hypotension so instruct the client to change positions slowly to avoid it.Option A: The medication is taken with food or milk to decrease gastric upset.Option C: Sunlight should be avoided while taking the medication.Option D: The medication is to be reduced gradually to avoid sudden recurrence of psychotic symptoms.

5. A client with schizophrenia has been started on medication therapy with clozapine (Clozaril). A nurse assesses the results of which laboratory study to monitor for adverse effects related to this medication.

White blood cell.

Platelet count.

Liver function studies.

Random blood sugar.

Agranulocytosis my experience by the client taking clozapine which can be monitored by evaluating the white blood cell count.Options B. C. and D are not related specifically to the use of the medication.

Explanation

Agranulocytosis my experience by the client taking clozapine which can be monitored by evaluating the white blood cell count.Options B. C. and D are not related specifically to the use of the medication.

6. Which of the following medications that treat Alzheimer's disease causes slowing of the heart rate and fainting episodes?

Tacrine (Cognex).

Galantamine (Razadyne).

Donepezil (Aricept).

All of the above.

Tacrine (Cognex). Galantamine (Razadyne). and Donepezil (Aricept) are anti-Alzheimer drugs known to provoke slower heart rates and fainting episodes.

Explanation

Tacrine (Cognex). Galantamine (Razadyne). and Donepezil (Aricept) are anti-Alzheimer drugs known to provoke slower heart rates and fainting episodes.

7. A client who has been taking buspirone (BuSpar) for two months returns to the clinic for a follow-up. The nurse determines that the medication is effective if there is an absent display of?

Feelings of panic. fear. and uneasiness.

Thought broadcasting or delusions.

Paranoid and suicidal thought process.

Alcohol withdrawal symptoms.

Buspirone (BuSpar) is used to treat symptoms of anxiety. such as fear. tension. irritability. dizziness. pounding heartbeat. and other physical symptoms.

Explanation

Buspirone (BuSpar) is used to treat symptoms of anxiety. such as fear. tension. irritability. dizziness. pounding heartbeat. and other physical symptoms.

8. A nurse is giving discharge instructions to a client who will be taking phenobarbital (Luminal). The nurse would educate the client in which of the following that directly correlates with the safety of the client?

Take the medication at the same time each day.

Take the medication with meals only.

Avoid using sleep aids while taking the medication.

Decrease the dosage once with symptoms of dizziness and lightheadedness.

Phenobarbital (Luminal) is an anticonvulsant and hypnotic drug. The client should avoid drinking alcohol or use medicines that may cause drowsiness (eg. sleep aids. muscle relaxers).Option A: Taking the medication at the same time daily improves compliance and maintains more stable blood levels of the medication.Option B: The medication is taken without regard to meals.Option D: Decreasing the dosage is not done without the approval of the physician.

Explanation

Phenobarbital (Luminal) is an anticonvulsant and hypnotic drug. The client should avoid drinking alcohol or use medicines that may cause drowsiness (eg. sleep aids. muscle relaxers).Option A: Taking the medication at the same time daily improves compliance and maintains more stable blood levels of the medication.Option B: The medication is taken without regard to meals.Option D: Decreasing the dosage is not done without the approval of the physician.

9. Methylphenidate (Ritalin) is prescribed to an 8-year-old child for the treatment of attention deficit hyperactivity disorder (ADHD). The nurse will most likely monitor which of the following during the medication therapy?

Deep tendon reflex.

Intake and output.

Temperature and breath sound.

Height and weight.

Methylphenidate (Ritalin) may cause slow growth. The nurse will need to keep track of the client’s height and weight to make sure that there is a normal growth and development.

Explanation

Methylphenidate (Ritalin) may cause slow growth. The nurse will need to keep track of the client’s height and weight to make sure that there is a normal growth and development.

10. Which of the following symptoms is classified as a mild lithium toxicity:

Confusion and ataxia.

Muscle fasciculations and oliguria.

Tinnitus and blurred vision.

Apathy and Lethargy.

Mild toxicity has a lithium serum level of 1.5 mEq/L. Symptoms include apathy. lethargy. coarse hand tremors and slight muscle weakness.Options A and C are classified under moderate lithium toxicity.Option B is classified under severe lithium toxicity.

Explanation

Mild toxicity has a lithium serum level of 1.5 mEq/L. Symptoms include apathy. lethargy. coarse hand tremors and slight muscle weakness.Options A and C are classified under moderate lithium toxicity.Option B is classified under severe lithium toxicity.