(Test Bank) Prescriber’s Guide- Stahl’s Essential Psychopharmacology

Stahl, 6

Nursing

Test Bank

6th Edition

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Test Bank for Prescriber’s Guide- Stahl’s Essential Psychopharmacology, The downloadable file consists of 398 pages, and the total size of the file is 1.36 MB. Purchase now only for highly discounted price.

Author(s): Stahl

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Study Note Preview

Prescriber's Guide - Stahl's Essential Psychopharmacology 6th Edition Test Bank Chapter Questions on Alcohol abstinence/Alcohol dependence/Alcohol withdrawal 1. A client has been prescribed naltrexone (Trexan) for treatment of alcohol dependence. The nurse has explained the drugs purpose to the client. The nurse determines that the client has understood the instructions when the client identifies which of the following about the drug? A) Causes itching if alcohol is consumed B) Produces the euphoria of alcohol C) Reduces the appeal of alcohol D) Improves appetite and nutritional status 2. An adolescent client tells the nurse that he or she occasionally sniffs airplane glue. When discussing the effects of long -term use of inhalants, which of the following would the nurse most likely include? A) Tremors and CNS arousal B) Enhanced normal heart rhythms C) Enhanced attention focus and memory D) Brain damage and cognitive abnormalities 3. A client tells the nurse that he is committed to trying to quit smoking. When teaching the client about smoking cessation, which of the following would the nurse include? A) Success usually involves more than one type of intervention. B) Relapse is fairly rare within the first year of quitting. C) Ear acupressure is a highly proven method for quitting. D) Education is key for smoking cessation. 4. The nurse is completing the admission of a client who is seeking treatment for alcoholism. He tells the nurse that the last time he had any alcohol to drink was at 10:00 AM before he left for the hospital. The nurse closely monitors the client. Which of the following would lead the nurse to suspect that the client is experiencing stage 1 of alcohol withdrawal syndrome? Select all that apply. A) Slight diaphoresis B) Hand tremors C) Intermittent confusion D) Heart rate of 135 beats/min E) Normal blood pressure 5. A nurse is talking with a 57 -year-old client who has been a heavy drinker for many years. The client is being treated for alcoholism, and this is her second week as an inpatient on the psychiatric unit. It is 5:00 AM, and the clie nt has been having difficulty sleeping. The client is an orthopedic nurse, and although she is clothed in a hospital -issued gown and robe, she is wearing a stethoscope around her neck that the nurse recognizes as belonging to one of the staff nurses. When the nurse asks her why she is wearing the stethoscope and where she got it, the client gives her a long and involved reply that basically describes how her nursing supervisor came to visit and gave it to her to wear so shed remember to get well. The nurse suspects that the client may be experiencing which of the following? A) Wernickes syndrome B) Delirium tremens C) Korsakoffs psychosis D) Malignant hyperthermia 6. A nurse is using motivational therapy with a female client with alcoholism. The client, who is unwilling to consider changing her drinking behavior, emphatically states, I am not an alcoholic; you cant make me stop drinking. Which response by the nurse would be most appropriate? A) You have to stop drinking and driving; you could kill someone. B) Youre right; youre not an alcoholic. C) You should consider what you are doing to your marital relationship. D) Youre the only one who can make yourself stop drinking. 7. A 52 -year-old male client who has a history of alcohol dependence is admitted to a detoxification unit. He has tremors, he is anxious, his pulse has risen from 98 to 110 beats/min, his blood pressure has risen from 140/88 to 152/100 mm Hg, and his temperature is six tenths of a degree above normal. He is slightly diaphoretic. Which nursi ng diagnosis would be the priority? A) Disturbed Thought Processes B) Risk for Injury C) Ineffective Coping D) Ineffective Denial 8. A nurse is working with a client who is addicted to heroin. The nurse engages in harm reduction by teaching the client about which of the following? A) Using bleach solution to disinfect dirty needles B) Problem solving C) Healthy coping skills D) Proper use of naltrexone (Trexan) 9. A 20 -year-old man arrives at the emergency department by ambulance. He is unconscious, with slow respirations and pinpoint pupils. There are tracks visible on his arms. The friend who came with him reports that the client had just shot up heroin when he be came unconscious. Which medication would the nurse most likely expect to administer? A) Naloxone B) Naltrexone C) Bupropion D) Varenicline 10. A nurse is obtaining a history from a client who drinks about 6 cups of coffee and several diet cola drinks per day. The client states, I just cut down my coffee and soda intake to one per day. Which of the following would the nurse most likely expect to assess? Select all that apply. A) Headache B) Fatigue C) Yawning D) Flushing E) Diuresis 11. A group of nursing students is reviewing information about substances that are abused. The students demonstrate understanding of the information when they identify which of the following as stimulants? Select all that apply. A) Alcohol B) Cocaine C) Heroin D) Nicotine E) Phencyclidine 12. client is receiving methadone maintenance therapy. After teaching the client about this treatment, the nurse determines that the teaching was successful when the client states which of the following? A) I can have a glass of wine with dinner if I choose. B) I should eat small frequent meals if I get nauseated. C) I should take the drug on an empty stomach. D) I might experience diarrhea with this drug. 13. A client with a history of alcohol abuse is participating in a 12-step Alcoholics Anonymous (AA) program. The nurse determines that the client is at step two when he states which of the following? A) Ive admitted to myself and others the wrongdoings Ive done. B) I realize that there is a higher power that can help me. C) I know now that I am powerless over alcohol. D) I am making amends to all those that Ive harmed. 14. nurse is preparing an inservice program about substance abuse and its etiology. Which of the following would the nurse most likely include in the presentation when discussing possible psychologic etiologies? A) Low self -esteem B) Genetic predisposition C) Dysfunctional family D) Peer influence 15. A client is brought into the emergency department because he was involved in an automobile accident. His blood alcohol level (BAL) is 0.10 mg %. Based on this finding, the nurse would expect to assess which of the following? A) Difficulty with coordinatio n B) Stupor C) Emotional lability D) Ataxia 16. A client with a history of opioid abuse is exhibiting manifestations of moderate withdrawal. Which of the following would the nurse expect to assess? A) Rhinorrhea B) Lacrimation C) Dilated pupils D) Dysphoria 17. A nurse is implementing a brief intervention with a client who is abusing alcohol. The nurse most likely would be involved with which of the following? A) Asking the client questions about alcohol use B) Negotiating a conversation with the client to reduce use C) Pointing out the inconsistencies in thoughts, feelings, and action D) Helping the client change the way he thinks about a situation 18. A client with a history of substance abuse is involved in a skills training group. Which of the following would the client be involved with to enhance intrapersonal coping skills? Select all that apply. A) Substance refusal skills B) Problem solving C) Anger awareness D) Emergency planning E) Social support networking 19. A client is brought to the emergency department after having overdosed on cocaine. When assessing the client, which of the following would the nurse expect to find? Select all that apply. A) Euphoria B) Seizures C) Cardiac arrhythmia D) Paranoia E) Dilated pupils 20. A client is prescribed disulfiram as part of his alcohol treatment program to prevent relapse. The client asks the nurse, How will this drug help me? Which response by the nurse would be most appropriate? A) It will help to cure your alcoholism. B) It can help to prevent you from drinking. C) It makes the withdrawal symptoms less troublesome. D) It helps to clear the alcohol out of your body. Answer Key 1. C 2. D 3. A 4. A, B, E 5. C 6. D 7. B 8. A 9. A 10. A, B, C 11. B, D 12. B 13. B 14. A 15. A 16. C 17. B 18. B, C, D 19. B, C 20. B Chapter Questions on Alzheimer disease 1. Which is the common underlying pathophysiology of both Alzheimers disease and Parkinsons disease? a. Both are neurodegenerative diseases. b. Both are forms of dementia. c. Both involve interrupted transmission of nerve impulses. d. Both are primarily caused and directly related to environmental factors. ANS: C Alzheimers disease is a form of dementia. Parkinsons disease is a neurodegenerative disease. Both illnesses involve interrupted nerve impulse transmissions. 2. Which symptom is often the earliest to occur in a patient with Alzheimers disease? a. Difficulty solving simple math problems b. Problems performing simple tasks c. Mild forgetfulness d. Inability to read ANS: C Alzheimers disease symptoms begin very slowly. In the early stage, the first symptom is mild forgetfulness, which is sometimes confused with age -related memory changes. 3. For which patient does the nurse watch most closely for symptoms of Alzheimers disease? a. 45-year-old with Down syndrome b. 50-year-old with a whiplash injury c. 60-year-old with hypertension d. 75-year-old with a smoking history ANS: D Age is the greatest risk factor for development of Alzheimers disease. A patient with Down syndrome has an increased risk by age 50 to 60 years. Whiplash and head injuries, hypertension, smoking, and high cholesterol all increase the risk for Alzheimers disease. 4. Which statement made by a patient with Alzheimers disease indicates to the nurse the need for additional teaching? a. When I have been taking donepezil for 6 weeks I should regain my memories. b. The only way to be sure that I have Alzheimers disease is by autopsy after I die. c. Even with medication, eventually I will need total care to prevent complications. d. The rivastigmine I am taking will slow down the progression of my symptoms. ANS: A No drug has been developed that will protect neurons from the changes that occur with Alzheimers disease. Drug treatments can temporarily slow the progression of symptoms in some patients. The drugs do not cure the disease and a patient should not expect to regain lost function. The only way to definitively diagnose this illness is by seeing the plaques and tangles in the brain on autopsy after death. 5. A newly admitted patient with Alzheimers disease who has been prescribed memantine (Namenda) has developed the symptoms of vomiting, drooling, heart rate of 56 beats per minute, and muscle weakness. What is the nurses best action? a. Contact the prescriber an d ask for an order for an as-needed antiemetic drug. b. Place the patient on a heart monitor and check the heart rate every 2 hours. c. Hold the drug dose and contact the prescriber immediately. d. Give the drug exactly as ordered. ANS: C Symptoms of drug overdose for memantine include upset stomach, vomiting, drooling, sweating, slow heart rate, difficulty breathing, muscle weakness, and seizures. The drug dose should be held and the prescriber notified immediately. 6. Which strategy best supports safe medication administration for patients with Alzheimers disease? a. Include the patie nts care provider when teaching about the patients drugs. b. Provide written guidelines about each drug to the patient. c. Create a chart listing the drugs, dosages, and times they should be taken. d. Suggest that the patient set up the drugs each week in labeled boxes. ANS: A Because patients with Alzheimers disease have difficulty with memory and cognition, the nurse should always include the person providing care in the home when doing any teaching about the disease, including drugs and dosages. 7. A patient with Alzheimers disease is prescribed rivastigmine (Exelon). What action does the nurse take to prevent a common side effect? a. Give the drug with a full glass of water. b. Administer the drug with meals twice a day.