Pre-Assessment Test

Because protease inhibitors decrease the metabolism of many drugs, including midazolam, serious toxicity can develop when protease inhibitors are given with other medications. Midazolam should not be given to this patient. The other patient data are consistent with the patients diagnosis of panic attack and do not indicate an urgent need to communicate with the provider.

Antipsychotics act on the norepinephrine, dopamine, GABA, acetylcholine, and serotonin systems but not the epinephrine or cortisol systems.

The side effects of restlessness, apprehension, and irritability are referred to as akathisia. It is unrelated to other side effects, such as chorea, dystonia, or drug-induced Parkinsonism.

Antipsychotics can be used for schizophrenia, schizoid personality disorder, bipolar disorder with psychotic features, and borderline personality disorder. It cannot be used to treat avoidant personality disorder or dysthymia.

Tardive dyskinesia is an irreversible side effect of antipsychotic medications. Akathisia, dystonia, and drug-induced Parkinsonism are all reversible side effects.

Women age 21 or over should have annual Pap smears, regardless of sexual activity. African-American men should begin prostate-specific antigen testing at age 45. Colonoscopy and annual fecal occult blood testing are recommended for those with average risk starting at age 50. Annual mammograms are recommended for women over the age of 40. Women age 65 or older who have normal results on previous Pap tests may forego additional screenings for cervical cancer.

Of the above antipsychotics, Geodon and Risperdal are not considered to be sedating. The others are considered to be sedating antipsychotic medications.

Of the above choices of antipsychotics, only Clozaril (clozapine) is an atypical antipsychotic. The other choices represent typical antipsychotics.

Of the above antipsychotics, only Geodon (ziprasidone) has no risk of extra-pyramidal side effects. The others are high risk for the side effect.

When a client is on a typical antipsychotic, the nursing interventions would be to tell the client to stand up slowly to avoid orthostatic hypotension, tell the client to wear sunscreen because of photosensitivity, and monitor the client for extrapyramidal side effects. Hypertension is not a side effect of these drugs and the nurse does not need to monitor the clients intake and output.

The newer antidepressants have an advantage over the tricyclic antidepressants because they have fewer anticholinergic side effects. They are not better for pain, they do not act faster than older antidepressants, and they are not cheaper than the older antidepressants.

Patients taking immunosuppressive medications are at increased risk for development of cancer. A nontender swelling or lump may signify that the patient has lymphoma. The other data indicate that the patient is experiencing common side effects of the immunosuppressive medications.

A drug interaction between SSRI medications and MAO inhibitors can by hyperpyrexia. Other drug interactions include tachycardia, tachypnea, and mydriasis.

Antidepressants act on the serotonin and norepinephrine neurotransmitter systems. They do not act on the dopamine, GABA, or acetylcholine systems.

One of the major side effects of SSRI antidepressants is sexual dysfunction. They can also cause insomnia, headaches, and diarrhea. They do not cause hypersomnia, hypertension, or hyperglycemia.

Of the above antidepressants, only amitriptyline is a tricyclic antidepressant. The other choices are SSRI antidepressants.

The collection of data used to evaluate the therapeutic and adverse effects of medications is included in LPN/LVN education and scope of practice. Assessment, planning, and teaching are more complex skills that require RN education. Assistance with hygiene and activities of daily living should be delegated to the UAP.

Clients on a tricyclic antidepressant can suffer from weight gain, and must be monitored for overdose and cheeking. Tricyclic antidepressants do not cause serotonin syndrome. The client should be advised to chew gum to combat dry mouth.

Of the above antidepressants, only Wellbutrin is not an SSRI antidepressant. It is an SNRI antidepressant. The others are SSRI antidepressants.

The client should be told that the mechanism of action is that it is believed to prevent kindling. It does not act on the serotonin or norepinephrine syndrome and is metabolized by the kidneys and not the liver.

Side effects of lithium include a tremor, weight gain, and memory impairment. It does not cause weight loss or dehydration.

Drug therapy for HIV infection requires taking medications very consistently. Failure to take the medications daily can lead to mutations and the emergence of more virulent forms of the virus. Although the other data indicate the need for further assessments or interventions, they will not affect the decision to initiate antiretroviral therapy for this patient.

Furosemide increases lithium toxicity. It has no drug interaction with Dyazide. It increases the toxicity of tricyclic antidepressants. It increases the risk of hypothermia with diazepam.

Alcohol increases CNS depression. It does not interact with furosemide and Valium will increase CNS depression. Cimetidine increases the effectiveness of the drug.

Lithium levels are important to draw periodically when taking the medication. Drug levels are not required on the other medications.

Explain that you are not chemotherapy certified so that the charge nurse can quickly rearrange the patient assignments. You can assess the patient, site, and infusion; however, you do not have the expertise to recognize the side effects of the medication or to give specialized care that may be needed. Asking the nurse to stay is not the best solution, because the care of the patient and the effects of the medication continue after the infusion has been completed. Looking up the side effects of the drug is okay for your own information, but you are still not qualified to deal with this situation. In addition, knowing how to properly discontinue the infusion and dispose of the equipment are essential for your own safety and the safety of others.

Anticonvulsants can be used in the treatment of bipolar disorder and anxiety disorders. They are not used in schizophrenia, schizoid personality disorder, or schizophrenia.

The client should take in consistent amounts of sodium to prevent edema, avoid sweating as it causes elevated concentrations of lithium. The client should take in 10-12 glasses of water each day to prevent dehydration.

Lamictal acts by stabilizing nerve cell membranes. It is not a CNS stimulant, it does not decrease kindling and it doesnt prevent the reuptake of serotonin.

The taking of Lamictal carries a risk of Stevens-Johnson syndrome. It does not lead to CNS stimulation, dehydration, or allergic rhinitis.

Morphine elixir is the therapy of choice because it is thought to reduce
anxiety and the subjective sensation of air hunger. It also increases venous capacitance.
End-of-life-care should not include aggressive measures such as intubation or
resuscitation. Support and comfort are always welcome, but in this case you should not
sit quietly because there is an option that would offer some physical relief for the patient.

Benzodiazepines are used for the treatment of restless legs syndrome, anxiety, and insomnia. They are not used typically for major depression or dysthymia

Benzodiazepines act on the GABA system and does not affect the serotonin system, norepinephrine system, or acetylcholine system.

Contraindications to taking stimulants include a history of anxiety and a history of heart disease. Liver disease, seizures, and urea cycle disorders are not contraindications of taking stimulants.

Of the above medications, only Secobarbital, diazepam, and zolpidem are considered sedative hypnotics. Fluoxetine is an SSRI medication and chlorpromazine is an antipsychotic medication.

Stimulants are often used in the management of narcolepsy, ADHD, and treatment resistant depression. Stimulants are typically not used in dysthymia or schizophrenia.

Stimulants act on the catecholamines at the post synaptic receptor sites in the brain. They do not prevent the reuptake of GABA in the synaptic cleft and dont prevent the reuptake of serotonin in the synaptic cleft. Stimulants do not stabilize the neuronal cell membranes within the brain as this is true of anticonvulsants.

Of the above choices, only hallucinations and delusional thinking are considered to be positive symptoms of psychosis. Anhedonia, blunted affect, and lack of motivation are negative symptoms of psychosis, and abnormal movements of the mouth are called tardive dyskinesia.

As weight gain can be a side effect of taking an antidepressant, the client should be encouraged to drink low calorie beverages. The medication can be taken with or without food and urinary retention can be a side effect. The client should be monitored for tachycardia when taking this drug.

Tumor lysis syndrome is an emergency involving electrolyte
imbalances and potential renal failure. A patient scheduled for surgery should be
assessed and prepared for surgery. A patient with breakthrough pain needs assessment,
and the physician may need to be contacted for a change of dosage or medication.
Anticipatory nausea and vomiting has a psychogenic component that requires
assessment, teaching, reassurance, and administration of antiemetics.

Adverse reactions to taking Seroquel include headache and dry mouth. Other side effects are hypotension, dry mouth, tachycardia, and tardive dyskinesia. Hypertension, bradycardia, and diarrhea are not considered side effects of the drug.

Side effects of Zyprexa (olanzapine) include constipation, weight gain, insomnia, hypertonia, and urinary retention. Weight loss, loss of taste and Hypotonia are not side effects of taking the medication.

Remeron is a tetracyclic antidepressant used to treat major depression. It is a medication that must be placed on the tongue and should dissolve over 30 seconds. The client shouldnt drive or operate heavy machinery while on the drug and should be given in the evening. Nausea and vomiting are possible but there are not restrictions on food and caffeine consumption. Bloody diarrhea is not a complication of taking this drug.

Mouthwash should not include alcohol, because it has a drying action
that leaves mucous membranes more vulnerable. Insertion of suppositories, probes, or
tampons into the rectal or vaginal cavity is not recommended. All other options are
appropriate.

The client should wait 14 days before taking an MAO inhibitor after taking fluoxetine and it should not be taken with Mellaril (thioridazine). The client should be monitored for orthostatic hypotension and the drug may be taken with food.

The client on an antipsychotic might experience dry mouth for which chewing sugar free gum or drinking cool beverages might help. Drinking milk, avoiding drinking fluids, and drinking fluids in the morning does not help this problem.

Clients taking an antidepressant for depression can hoard the drug by cheeking the drug in an attempt to have enough drug for an overdose. While it takes 2 weeks to take effect and could cause orthostatic hypotension, these are not priorities over the risk of overdose. The drug can be taken with or without food.

Wellbutrin can lower the seizure threshold and should avoid taking the drug after a brain injury from closed head trauma, which could cause seizures. Liver failure, chronic gastrointestinal symptoms, and kidney failure are not contraindications of taking the medication.

The client should be fasting prior to taking a drug level as this can cause a drug-food interaction. They need to have a 12-hour period of time after the last dose in order to obtain a level. The morning dose shouldnt be taken on the day of the test.

The patients physical condition is currently stable, but emotional needs are
affecting his or her ability to receive the information required to make an informed
decision. The other diagnoses are relevant, but if the patient leaves the clinic the
interventions may be delayed or ignored.

The normal lithium level for lithium carbonate is 0.6 to 1.2 mEq/l. The other choices are either too high or too low levels of lithium.

Side effects of taking lithium include vomiting, diarrhea, salty taste in the mouth and tremor. Weight gain and a metallic taste in the mouth are not side effects from taking the drug.

Mellaril has the potential to cause agranulocytosis when the client takes the drug. Hyperkalemia, low levels of alkaline phosphatase, and hypocalcemia are not potential problems when taking the drug.

Common side effects from taking lithium carbonate include nausea, diarrhea, and dyspepsia. Restlessness and insomnia are not potential side effects from taking the drug

When taking a hypnotic, the client is at risk for falls when getting out of bed during the night and should ask for help. Hunger is not increased with the drug and moodiness/irritability are not part of taking the drug. Abnormal movements of the mouth are seen in antipsychotics and not hypnotics.

Dalmane (flurazepam) is a sedative hypnotic medication. Drinking alcohol may potentiate the effect so a glass of wine should not be used when taking the drug. Food can be taken with the drug and dry mouth is not expected. It is relatively short-acting so a hangover should not be expected upon awakening.

Nardil (phenylzine) is an MAO inhibitor and is difficult to take because the drug requires a strict diet to avoid food-drug interactions. It is effective in treating psychiatric disorders and can be taken once a day. It doesnt interact with many other drugs.

Pancreatic cancer is more common in African-Americans, males, and smokers.
Other associated factors include alcohol use, diabetes, obesity, history of pancreatitis,
exposure to organic chemicals, consumption of a high-fat diet, and previous abdominal
irradiation.

An anticonvulsant may be prescribed for bipolar disorder, anxiety disorders, and aggression. These drugs are not used for major depression or cognitive disorders.

Haldol, Thorazine, ahnd Clozaril are used to treat psychosis. Clozaril can be helpful in schizophrenic clients who are also suicidal.