Download Pharmacology - Psychiatric Medications MCQs

MCQs on
Pharmacology:
Psychiatric Medications
1. A nurse provides instructions to a patient taking fluoxetine (Prozac) a selective serotonin
reuptake inhibitors (SSRI) antidepressant. The nurse tells the patient to take the medication:
A. Early in the morning.
B. During lunch time.
C. At snack time.
D. At bedtime.
The answer is : A.
Early in the morning.
Fluoxetine is used to treat major depressive disorder, bulimia
nervosa obsessive-compulsive disorder, panic disorder, and premenstrual
dysphoric disorder (PMDD). It is taken early in the morning to prevent
interference with sleep.
2. The risk of experiencing serotonin syndrome when SSRI’s are given with monoamine oxidase
inhibitors such as phenelzine (Nardil). Serotonin syndrome is best characterized in which of the
following?
A. Hypotension and urinary retention.
B. Muscle rigidity and high fever.
C. A productive cough and vomiting.
D. Tea-colored urine and constipation.
The answer is : B.
Muscle rigidity and high fever.
Serotonin syndrome symptoms include high body temperature, agitation,
muscle rigidity, tremor, sweating, dilated pupils, and diarrhea.
3. A patient with depression who has been taking amitriptyline for three months returns to the
clinic for a follow-up. The nurse observes the patient in which of the following symptoms?
A. Suicidal thoughts.
B. Lack of energy.
C. Loss of interest in personal appearance.
D. Neglect of responsibilities.
The answer is :A.
Suicidal thoughts.
patients may have thoughts about suicide when taking an antidepressant
such as amitriptyline, especially patients younger than 24 years old.
Options B, C, and D are signs of depressions but are most likely improved as
the treatment goes on.
4. A patient is prescribed with sertraline (Zoloft). To guarantee a safe administration of the
medication, a nurse would administer the dose:
A. As needed only for depressions.
B. Early in the morning.
C. Take on an empty stomach.
D. At bedtime.
The answer is : D.
At bedtime.
Sertraline (Zoloft) is an antidepressant. It may be administered in the
morning or evening, but giving it in the evening is more favored since
drowsiness is one of the side effects.
5. A patient arrives in the emergency room with a tricyclic antidepressant overdose. Which of the
following measures should the nurse do, except?
A. Maintain a patent airway.
B. Administration of sodium bicarbonate.
C. Gastric lavage with activated charcoal.
D. Obtain an electrocardiogram.
E. Administration of an antipyretic.
The answer is : E. Administration of an antipyretic.
One of the signs and symptoms of a tricyclic antidepressant overdose is hypothermia, so an
administration of an antipyretic will not help in the treatment.
Option A: Maintain a patent airway by providing measures such as oxygen.
Option B: Sodium bicarbonate resolves metabolic acidosis and cardiovascular complications.
Option C: Gastric lavage with activated charcoal is done for GI decontamination.
Option D: An ECG is done to check for dysrhythmias.
6. A newly admit patient has started taking bupropion (Wellbutrin). The nurse monitors in which
of the following side effects that would indicate an overdosage of the medication?
A. Headache.
B. Dizziness.
C. Constipation.
D. Seizure.
The answer is : D.
Seizure.
Wellbutrin (bupropion) is an antidepressant medication used to treat major
depressive disorder and seasonal affective disorder. Overdose symptoms
may include seizure, muscle stiffness, hallucinations, fast or uneven
heartbeat, shallow breathing, or fainting.
Options A, B, and C are the common side effects of the medication.
7. A nurse is giving discharge instructions to a patient who is prescribed with
isocarboxazid (Marplan). The nurse will tell the patient to anticipate which of the following side
effects of this medication?
A. Weight loss.
B. Dry skin.
C. Dizziness.
D. Fever.
The answer is : C.
Dizziness.
Isocarboxazid is a monoamine oxidase (MAO) inhibitor. Dizziness,
drowsiness, tiredness, weakness, problems sleeping, constipation, and dry
mouth may occur while taking it.
Options A, B, and D are not side effects related to the medication.
8. A patient with depression is taking phenelzine (Nardil). The nurse advises the patient to avoid
consuming which foods while taking the medication
A. Crackers.
B. Vegetable salad.
C. Oatmeal.
D. Yogurt.
The answer is : D.
Yogurt.
Phenelzine (Nardil) is a monoamine oxidase (MAO) inhibitor. The patient
should avoid eating tyramine-rich foods such as chocolate, alcoholic
beverages, aged cheese, yogurt, processed meats, and fruits such as raisins,
avocados, bananas, or figs.
9. Patients taking MAOIs have the tendency to experience hypertensive crisis especially during
an interaction with other drugs such as epinephrine. Which of the following is a sign of
hypertensive crisis?
A. Orthostatic hypotension.
B. Diplopia.
C. Delay in ejaculation.
D. Hair loss.
The answer is : B. Diplopia.
Monoamine Oxidase Inhibitor Toxicity symptoms include hypertension,
tachycardia, diplopia, nausea, dilated pupils, palpitations, constricting
chest pain and altered mental status.
Options A and C are a common side effect of monoamine oxidase inhibitor.
Option D is not a related symptoms of hypertensive crisis.
10. During a hypertensive crisis, the nurse make sure which of this medicine is readily available?
A. Lithium citrate.
B. Diazepam.
C. Phentolamine.
D. Phenobarbital sodium.
The answer is : C.
Phentolamine.
In a hypertensive emergency, the first goal is to bring down the blood pressure as quickly as possible with
intravenous (IV) blood pressure medications to prevent further organ damage. Phentolamine Mesylate
(phentolamine mesylate) is used as an antidote for a hypertensive crisis.
Option A: Lithium citrate is a mood stabilizer.
Option C: Diazepam is a benzodiazpepines.
Option D: Phenobarbital sodium is a barbiturate and sedative hypnotics.
11. A patient 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:
A. Normal level.
B. Toxic level.
C. Below normal level.
D. Above normal level.
The answer is : B.
Toxic level.
The therapeutic drug serum level of lithium is 0.6 to 1.2 mEq/L.
12. A nurse is giving instructions to a patient receiving lithium citrate. The nurse tells the patient
to do which of the following to prevent lithium toxicity:
A. Avoid becoming dehydrated during exercise.
B. Instruct the patient to change positions slowly.
C. Restrict salt intake in the diet.
D. Limit fluid intake.
The answer is : A.
Avoid becoming dehydrated during exercise.
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 patient should maintain a fluid intake of 6-8 glasses of water a
day and an adequate salt intake to prevent lithium toxicity.
13. Which of the following symptoms is classified as a mild lithium toxicity:
A. Confusion and ataxia.
B. Muscle fasciculations and oliguria.
C. Tinnitus and blurred vision.
D. Apathy and Lethargy.
The answer is : D.
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.
14. A nurse is giving instructions to a patient taking risperidone (Risperdal). The nurse advise the
patient to which of the following?
A. Take it on an empty stomach.
B. Change position slowly.
C. Get a daily source of sunlight.
D. Discontinue medication once the symptoms went away.
The answer is : B.
Change position slowly.
Risperidone (Risperdal) can cause orthostatic hypotension so instruct the patient 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.
15. A nurse notes that a patient with schizophrenia and receiving an antipsychotic medication is
having uncontrolled movement of the lips and tongue. The nurse determines that the patient is
experiencing?
A. Hypertensive crisis.
B. Parkinsonism.
C. Tardive dyskinesia.
D. Neuroleptic malignant syndrome.
The answer is : C.
Tardive dyskinesia.
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 characterize 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.
16. A patient with schizophrenia has been started on medication therapy with clozapine
(Clozaril). A nurse assesses the results of which laboratory study to monitor for adverse effect
related to this medication?
A. White blood cell.
B. Platelet count.
C. Liver function studies.
D. Random blood sugar.
The answer is : A.
White blood cell.
Agranulocytosis my experience by the patient 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.
17. 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?
A. Deep tendon reflex.
B. Intake and output.
C. Temperature and breath sound.
D. Height and weight.
The answer is :D.
Height and weight.
Methylphenidate (Ritalin) may cause slow growth. The nurse will need to
keep track of the patient’s height and weight to make sure that there is a
normal growth and development.
18. Which of the following medications that treat Alzheimer’s disease causes slowing of the heart
rate and fainting episodes?
A. Tacrine (Cognex).
B. Galantamine (Razadyne).
C. Donepezil (Aricept).
D. All of the above.
The answer is : D.
All of the above.
Tacrine (Cognex), Galantamine (Razadyne), and Donepezil (Aricept) are antiAlzheimer drugs known to provoke slower heart rates and fainting
episodes.
19. A patient 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?
A. Feelings of panic, fear, and uneasiness.
B. Thought broadcasting or delusions.
C. Paranoid and suicidal thought process.
D. Alcohol withdrawal symptoms.
The answer is : A.
Feelings of panic, fear, and uneasiness
Buspirone (BuSpar) is used to treat symptoms of anxiety, such as fear, tension,
irritability, dizziness, pounding heartbeat, and other physical symptoms.
20. A patient is giving discharge instructions to a patient who will be taking phenobarbital
(Luminal). The nurse would educate the patient in which of the following that directly correlates
with the safety of the patient?
A. Take the medication at the same time each day.
B. Take the medication with meals only.
C. Avoid using sleep aids while taking the medication.
D. Decrease the dosage once with symptoms of dizziness and lightheadedness.
The answer is : C. Avoid using sleep aids while taking the medication.
Phenobarbital (Luminal) is an anticonvulsant and hypnotic drug. The patient 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.
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