Question

LPNS 1210 Holistic Nursing 2                    Name: _________________________________
Unit 1 Understanding Mental Health            Due Date: ______________________________
Directions: Select the correct answer to the following questions and provide a rationale for your selections in the spaces provided. Each question worth 10 points for a total of 100 points.
1. Your patient was started on BusSpar for anxiety disorder 3 days ago. The patient now calls the healthcare provider’s office stating that it “just isn’t working.” Your best response would be:
a. “BusSpar should give you immediate relief. I will notify the health care provider that this medication is not
       effective.”
b. “It may take several weeks for BuSpar to be fully effective.”
c. “You may need an increased dose of BuSpar for it to work.”
d. “You will need additional medication to ease your anxiety.”

Rationale:

2. While caring for a patient taking an antipsychotic drug, the nurse understands that:
a. Antipsychotic medications cure mental illnesses.
b. Some adverse effects of antipsychotic drugs can lead to noncompliance.
c. Antipsychotic medications are only administered when the patient is symptomatic
d. Antipsychotic drugs improve symptoms within hours of administration.

Rationale:

3. Family members of a patient diagnosed with schizophrenia are being educated on the adverse effects of phenothiazines. Which of the following would the nurse include? Select all that apply.
a. The patient may experience a sedative effect that usually diminishes with continued therapy.
b. Severe muscle spasms may occur early in therapy.
c. Tardive dyskinesia can occur with long-term therapy.
d. Medications can be given to help prevent some adverse effects.
e. Monitor the patient’s blood pressure because phenothiazines are known to because hypertension.

Rationale:

4. Which of the following symptoms is an anticholinergic effect of chlorpromazine?
a. Hallucination, illusion, paranoia
b. Hypertension, polyuria, increased salivation
c. Dry mouth, tachycardia, blurred vision
d. High fever, confusion, muscle rigidity

Rationale:

5. The patient on thioridazine (Mellaril) has developed muscle spasms, difficulty sleeping and a shuffling gait. The nurse recognizes this as:
a. Anticholinergic effects
b. Cholinergic effects
c. Extrapyramidal symptoms
d. Serotonin syndrome

Rationale:

6. The patient states that he has not taken his antipsychotic drug for the past 2 weeks because it was causing sexual dysfunction. The nurse explains that it is important to continue taking his medication as prescribed because:
a. Hypertensive crisis may occur with abrupt withdrawal.
b. Muscle twitching may occur
c. Non-compliance may bring on secondary parkinsonism
d. Symptoms of psychosis are likely to return.

Rationale:

7. A nurse is assisting with planning care for a patient with bipolar disorder and is experiencing a manic episode. Which of the following are appropriate nursing interventions? Select all ta apply.
a. Provide flexible patient behavior expectations
b. Offer concise explanations
c. Establish consistent limits
d. Disregard patient complaints
e. Use a firm approach with communication

Rationale:

8. The nurse understands that haloperidol (Haldol) may be ordered for which of the following reasons?
a. Seizures
b. Unprovoked aggressiveness
c. Severe mental depression
d. Alcoholism

Rationale:

9. The nurse is speaking to a patient diagnosed with schizophrenia and his family about the use of herbal supplements. She warns them about a possible interaction with conventional antipsychotic medication and which herbal supplement?
a. Echinacea
b. St. John’s sort
c. Black cohosh
d. Saw palmetto

Rationale:

10. A patient is taking aripiprazole (Abilify). Which patient effects should the nurse observe to determine whether the drug is having a therapeutic effect?
a. Elevated mood and coping skills
b. Orthostatic hypotension
c. Decreased delusional thinking and hallucinations
d. Improved sleep and dietary habits

Rationale:

Answer 1

1) Ans )b) It may take several weeks for BuSpar to be fully effective.
Rationale:Buspirone in general takes at least one to two weeks to have an initial effect and generally can take up to four to six weeks to actually have its full clinical effect.

2) ans) b) Some adverse effects of antipsychotic drugs can lead to noncompliance.
Rationale:
Adverse effects of antipsychotics often lead to noncompliance. Thus, clinicians should address patients' concerns about adverse effects and attempt to choose medications that will improve their patients' quality of life as well as overall health.Since the incidence and severity of specific adverse effects differ among the various atypicals, the clinician should carefully consider which side effects are most likely to lead to the individual's dissatisfaction and noncompliance before choosing an antipsychotic for a particular patient.

3)Ans ) 1. The patient may experience a sedative effect that usually diminishes with continued therapy.
2. Severe muscle spasms may occur early in therapy.
3. Tardive dyskinesia can occur with long-term therapy.
4. Medications can be given to help prevent some adverse effects.

4) ans)c.) Dry mouth, tachycardia, blurred vision

Chlorpromazine is a weaker antipsychotic agent with general CNS depressant activity. It has an antidopaminergic effect including Dry mouth, tachycardia, blurred vision extrapyramidal adverse effects, lethargy, and apathy with an EEG similar to that of normal sleep.In the GI tract, its anticholinergic effect causes a decrease in secretions and motility.

5)Ans)c) Extrapyramidal adverse effects

Extrapyramidal symptoms are caused by dopamine blockade or depletion in the basal ganglia; this lack of dopamine often mimics idiopathic pathologies of the extrapyramidal system.The patient on thioridazine (Mellaril) has developed muscle spasms, difficulty sleeping and a shuffling gait. The nurse recognizes this as Extrapyramidal adverse effects.

6)ans)d) Symptoms of psychosis are likely to return.
The patient states that he has not taken his antipsychotic drug for the past 2 weeks because it was causing sexual dysfunction.
And Symptoms of psychosis are likely to return.as nurse should educate about this.

7) ans) B. Offer concise explanations
C. Establish consistent limits
E. Use a firm approach with communication

Rationale: The nurse should establish consistent client behavior expectations to decrease the risk for client manipulation. Offering concise explanations improves the client's ability to focus and comprehend the information. Establishing consistent limits decreases the risk for client manipulation. The nurse should respond to valid client complaints to foster a trusting nurse-client relationship. Using a firm approach with client communication promotes structure and minimizes inappropriate client behaviors.

8) ans)Unprovoked aggressiveness

Haldol (haloperidol) is an antipsychotic drug that decreases excitement in the brain. Haldol is used to treat psychotic disorders like schizophrenia, to control motor (movement) and verbal (for example, Tourette's syndrome) tics and is used to treat severe behavior problems like Unprovoked aggressiveness

9) ans)b. St. John’s sort

10 ) ans) c)Decreased delusional thinking and hallucinations

Could you please thumb up if answer was helpful ? thank you