NUR 2488MH exam2.
• Question 1
1 out of 1 points
You are the nurse responsible for assessing for extrapyramidal side effects
in a patient who has been taking chlorpromazine. Which of the following
may be side effects for this medication? (Select all that apply.)
Akathisia
Acute dystonia
Tardive
Dyskinesia
Answer Amenorrhea
s:
Akathisia
Acute dystonia
Tardive
Dyskinesia
Response
Feedback: Extrapyramidal side effects of the central nervous system
include involuntary motor movements, resulting in possible
dystonia, akathisia or dyskinesia. Amenorrhea is a possible side
effect of chlorpromazine, but is not an extrapyramidal side
effect.
• Question 2
1 out of 1 points
An adult with depression has been treated with medication and cognitive
behavioral therapy. The patient now verbalizes that being passive and
letting others make decisions for her contributed to the depression. What
referrals could the nurse make to help this patient prevent recurrence of
depression?
Selected
Answer: Social skills training
Answers: Social skills training
Use of complementary
therapy
,NUR 2488MH exam2.
Relaxation training classes
Learning desensitization
techniques
Response Social skills training is helpful in treating and preventing the
Feedback
:
recurrence of depression. Training focuses on assertiveness and
coping skills that lead to positive reinforcement from others.
Use of complementary therapy refers to adjunctive therapies
such as herbals. Assertiveness would be of greater value than
relaxation training because passivity has been identified as a
concern. Desensitization is used in treatment of phobias
• Question 3
1 out of 1 points
A patient with suicidal impulses is placed on the highest level of suicide
precautions. Which measures should be incorporated into the plan of care
by the nurse caring for the patient? (Select all that apply.)
Selected
Answers: Maintain arm’s-length distance, institute one-on-one nursing
observation around the clock
Allow no glass or metal on meal trays
Remove all potentially harmful objects from the patient’s
possession
Answers: Maintain arm’s-length distance, institute one-on-one nursing
observation around the clock
Allow no glass or metal on meal trays
Keep patient within visual range while awake, but only check
every 15 to 30 minutes while the patient is sleeping
Only check the patient’s whereabouts every 15 minutes and
make frequent verbal contacts.
Remove all potentially harmful objects from the patient’s
possession
Response
Feedback One-on-one observation is necessary for anyone who has
: limited control over suicidal impulses. Plastic dishes on trays
and the removal of potentially harmful objects from the
patient’s possession are measures included in any-level suicide
precautions. The remaining options are used in less stringent
levels of suicide precautions.
• Question 4
0 out of 1 points
Which statement indicates a patient with major depression’s most likely
outlook on life during the acute phase of the illness?
Selected
Answer: “If I ignore this, it will go away.”
, NUR 2488MH exam2.
Answers: “It’s just a matter of time and
I’ll be well.”
“I deserve to be this way.”
“I can fight this and get better.”
“If I ignore this, it will go away.”
Response Patients with depression feel worthless and often believe they
Feedback:
deserve to have “bad” things happen. Patients with depression
are usually hopeless and would not respond optimistically.
Patients with depression usually feel helpless and unable to
fight.
• Question 5
0 out of 1 points
The nurse knows that sedation is a side effect of many antipsychotics.
Which of the following medications should the nurse question if ordered
for a patient taking antipsychotics?
Selected
Answer: hydrochlorothia
zide
Answers: hydrochlorothia
zide
diphenhydrami
ne
acetaminophen
verapamil
Response Diphenhydramine is an antihistamine that is likely to cause
Feedback:
drowsiness and enhance the sedative effect of an antipsychotic.
Hydrochlorothiazide (diuretic), acetaminophen (antipyretic and
pain reliever) and verapamil (antihypertensive) do not cause
sedation.
• Question 6
1 out of 1 points
The nurse is caring for a patient who experiences orthostatic hypotension
related to taking chlorpromazine. The nurse should suggest which of the
following interventions for managing this side effect?
Selected
Answer: Sit on the side of the bed before
standing up.
Answers: Stay in bed for an hour after taking the
medication.
• Question 1
1 out of 1 points
You are the nurse responsible for assessing for extrapyramidal side effects
in a patient who has been taking chlorpromazine. Which of the following
may be side effects for this medication? (Select all that apply.)
Akathisia
Acute dystonia
Tardive
Dyskinesia
Answer Amenorrhea
s:
Akathisia
Acute dystonia
Tardive
Dyskinesia
Response
Feedback: Extrapyramidal side effects of the central nervous system
include involuntary motor movements, resulting in possible
dystonia, akathisia or dyskinesia. Amenorrhea is a possible side
effect of chlorpromazine, but is not an extrapyramidal side
effect.
• Question 2
1 out of 1 points
An adult with depression has been treated with medication and cognitive
behavioral therapy. The patient now verbalizes that being passive and
letting others make decisions for her contributed to the depression. What
referrals could the nurse make to help this patient prevent recurrence of
depression?
Selected
Answer: Social skills training
Answers: Social skills training
Use of complementary
therapy
,NUR 2488MH exam2.
Relaxation training classes
Learning desensitization
techniques
Response Social skills training is helpful in treating and preventing the
Feedback
:
recurrence of depression. Training focuses on assertiveness and
coping skills that lead to positive reinforcement from others.
Use of complementary therapy refers to adjunctive therapies
such as herbals. Assertiveness would be of greater value than
relaxation training because passivity has been identified as a
concern. Desensitization is used in treatment of phobias
• Question 3
1 out of 1 points
A patient with suicidal impulses is placed on the highest level of suicide
precautions. Which measures should be incorporated into the plan of care
by the nurse caring for the patient? (Select all that apply.)
Selected
Answers: Maintain arm’s-length distance, institute one-on-one nursing
observation around the clock
Allow no glass or metal on meal trays
Remove all potentially harmful objects from the patient’s
possession
Answers: Maintain arm’s-length distance, institute one-on-one nursing
observation around the clock
Allow no glass or metal on meal trays
Keep patient within visual range while awake, but only check
every 15 to 30 minutes while the patient is sleeping
Only check the patient’s whereabouts every 15 minutes and
make frequent verbal contacts.
Remove all potentially harmful objects from the patient’s
possession
Response
Feedback One-on-one observation is necessary for anyone who has
: limited control over suicidal impulses. Plastic dishes on trays
and the removal of potentially harmful objects from the
patient’s possession are measures included in any-level suicide
precautions. The remaining options are used in less stringent
levels of suicide precautions.
• Question 4
0 out of 1 points
Which statement indicates a patient with major depression’s most likely
outlook on life during the acute phase of the illness?
Selected
Answer: “If I ignore this, it will go away.”
, NUR 2488MH exam2.
Answers: “It’s just a matter of time and
I’ll be well.”
“I deserve to be this way.”
“I can fight this and get better.”
“If I ignore this, it will go away.”
Response Patients with depression feel worthless and often believe they
Feedback:
deserve to have “bad” things happen. Patients with depression
are usually hopeless and would not respond optimistically.
Patients with depression usually feel helpless and unable to
fight.
• Question 5
0 out of 1 points
The nurse knows that sedation is a side effect of many antipsychotics.
Which of the following medications should the nurse question if ordered
for a patient taking antipsychotics?
Selected
Answer: hydrochlorothia
zide
Answers: hydrochlorothia
zide
diphenhydrami
ne
acetaminophen
verapamil
Response Diphenhydramine is an antihistamine that is likely to cause
Feedback:
drowsiness and enhance the sedative effect of an antipsychotic.
Hydrochlorothiazide (diuretic), acetaminophen (antipyretic and
pain reliever) and verapamil (antihypertensive) do not cause
sedation.
• Question 6
1 out of 1 points
The nurse is caring for a patient who experiences orthostatic hypotension
related to taking chlorpromazine. The nurse should suggest which of the
following interventions for managing this side effect?
Selected
Answer: Sit on the side of the bed before
standing up.
Answers: Stay in bed for an hour after taking the
medication.
