Psychiatric Medications NCLEX Practice
Quiz: 75 Questions
1. 1. Question
Jose is diagnosed with amphetamine psychosis and was admitted to
the emergency room. Nurse Ronald would most likely prepare to
administer which of the following medication?
o A. Librium
o B. Valium
o C. Ativan
o D. Haldol
Incorrect
Correct Answer: D. Haldol
The nurse would prepare to administer an antipsychotic medication
such as Haldol to a client experiencing amphetamine psychosis to
decrease agitation & psychotic symptoms, including delusions,
hallucinations & cognitive impairment. Haloperidol is a first-generation
(typical) antipsychotic medication that is used widely around the world.
Food and Drug Administration (FDA) approved the use of haloperidol is
for schizophrenia, Tourette syndrome (control of tics and vocal
utterances in adults and children), hyperactivity (which may present as
impulsivity, difficulty maintaining attention, severe aggressivity, mood
instability, and frustration intolerance), severe childhood behavioral
problems (such as combative, explosive hyperexcitability), intractable
hiccups. It is a typical antipsychotic because it works on positive
symptoms of schizophrenia, such as hallucinations and delusions.
Option A: Chlordiazepoxide is a long-acting benzodiazepine and
is an FDA approved medication for adults with mild-moderate to
severe anxiety disorder, preoperative apprehension and anxiety,
and withdrawal symptoms of acute alcohol use disorder. It is also
FDA approved for pediatric patients greater than six years old for
, anxiety. Chlordiazepoxide has anti-anxiety, sedative, appetite-
stimulating, and weak analgesic actions.
Option B: Diazepam is an anxiolytic benzodiazepine, first
patented and marketed in the United States in 1963. It is a fast-
acting, long-lasting benzodiazepine commonly used in the
treatment of anxiety disorders, as well as alcohol detoxification,
acute recurrent seizures, severe muscle spasm, and spasticity
associated with neurologic disorders. In the setting of acute
alcohol withdrawal, diazepam is useful for symptomatic relief of
agitation, tremor, alcoholic hallucinosis, and acute delirium
tremens.
Option C: Lorazepam has common use as the sedative and
anxiolytic of choice in the inpatient setting owing to its fast (1 to
3 minute) onset of action when administered intravenously.
Lorazepam is also one of the few sedative-hypnotics with a
relatively clean side effect profile. Lorazepam is FDA approved for
short-term (4 months) relief of anxiety symptoms related to
anxiety disorders, anxiety-associated insomnia, anesthesia
premedication in adults to relieve anxiety, or to produce
sedation/amnesia, and treatment of status epilepticus.
2. 2. Question
Which of the following liquids would nurse Leng administer to a female
client who is intoxicated with phencyclidine (PCP) to hasten excretion
of the chemical?
A. Shake
B. Tea
C. Cranberry Juice
D. Grape juice
Incorrect
Correct Answer: C. Cranberry Juice
An acid environment aids in the excretion of PCP. The nurse will
definitely give the client with PCP intoxication cranberry juice to acidify
the urine to a ph of 5.5 & accelerate excretion. PCP begins to cause
symptoms at a dose of 0.05mg/kg, and a dose of 20 mg or more can
cause seizures, coma, and death. It is mainly metabolized by the liver,
and 10% is excreted in the kidneys. Inhalation (the most common
, route of administration) and intravenous routes of administration
produce symptoms in 2 to 5 minutes. Oral ingestion produces
symptoms in 30 to 60 minutes.
Option A: Most patients survive PCP intoxication with supportive
care. Airway, breathing, circulation, and hemodynamic
monitoring are essential to the care of patients with PCP toxicity.
Intubation with ventilatory support may be required for airway
protection. Sedation with medication and physical restraints may
be required to control agitation, violent behavior, and psychosis
due to PCP intoxication. Placing the patient in a calm
environment such as a quiet room with the lights dimmed may be
helpful. Benzodiazepines are the preferred medication for
chemical sedation in patients with PCP toxicity.
Option B: Patients with mild symptoms can be discharged one to
2 hours after they become symptom-free and have no other
medical complications or behavioral issues that need to be
addressed. Patients with severe symptoms or medical
complications should be admitted to a monitored bed. Patients
who are asymptomatic who present to the emergency
department after PCP use should be observed for at least 6 hours
before being discharged.
Option D: PCP is available as a powder, crystal, liquid, and
tablet. It produces both stimulation and depression of the CNS.
PCP is a non-competitive antagonist to the NMDA receptor, which
causes analgesia, anesthesia, cognitive defects, and psychosis.
PCP blocks the uptake of dopamine and norepinephrine, leading
to sympathomimetic effects such as hypertension, tachycardia,
bronchodilation, and agitation. PCP can also cause sedation,
muscarinic, and nicotinic signs by binding to acetylcholine
receptors and GABA receptors. Sigma receptor stimulation by PCP
causes lethargy and coma.
3. 3. Question
When developing a plan of care for a female client with acute stress
disorder who lost her sister in a car accident. Which of the following
would the nurse expect to initiate?
A. Facilitating progressive review of the accident and its
consequences.
B. Postponing discussion of the accident until the client brings it up.
, C. Telling the client to avoid details of the accident.
D. Helping the client to evaluate her sister’s behavior.
Incorrect
Correct Answer: A. Facilitating progressive review of the
accident and its consequences
The nurse would facilitate progressive review of the accident and its
consequence to help the client integrate feelings & memories and to
begin the grieving process. Help patients reframe any destructive
cognitions (eg, beliefs that they acted terribly and are terrible people
or are weak for being so distraught, that life is hopeless or worthless,
or that the world is totally unsafe).
Option B: Support self-esteem; help patients understand that
their reaction to the trauma is a normal reaction to an abnormal
situation, not a sign of weakness or psychopathology. Reassure
and help survivors concerning immediate needs, such as rest,
food, shelter, social support, or a sense of belonging to a
community (some feel cut off and detached).
Option C: Promote coping mechanisms. Avoid prompting
discussion of issues that cannot be resolved; avoid abreaction in
groups and the resulting contagion effect; respect defenses, and
do not force reality on people who cannot handle it yet; keep in
mind that debriefing may be harmful. Discuss the experience
with patients who want to talk about it, and avoid pressuring
those who do not wish to discuss it.
Option D: Check to see if children feel that they somehow
caused the death or disaster or if they have other
misunderstandings, and take pains to reassure them or correct
any misunderstanding; do not assume children are fine just
because they are not saying anything. Let them know it is all
right to talk about unpleasant feelings (including sadness and
anger) and listen to them; sharing personal feelings of sadness
with them is all right as well.
4. 4. Question
The nursing assistant tells nurse Ronald that the client is not in the
dining room for lunch. Nurse Ronald would direct the nursing assistant
to do which of the following?
Quiz: 75 Questions
1. 1. Question
Jose is diagnosed with amphetamine psychosis and was admitted to
the emergency room. Nurse Ronald would most likely prepare to
administer which of the following medication?
o A. Librium
o B. Valium
o C. Ativan
o D. Haldol
Incorrect
Correct Answer: D. Haldol
The nurse would prepare to administer an antipsychotic medication
such as Haldol to a client experiencing amphetamine psychosis to
decrease agitation & psychotic symptoms, including delusions,
hallucinations & cognitive impairment. Haloperidol is a first-generation
(typical) antipsychotic medication that is used widely around the world.
Food and Drug Administration (FDA) approved the use of haloperidol is
for schizophrenia, Tourette syndrome (control of tics and vocal
utterances in adults and children), hyperactivity (which may present as
impulsivity, difficulty maintaining attention, severe aggressivity, mood
instability, and frustration intolerance), severe childhood behavioral
problems (such as combative, explosive hyperexcitability), intractable
hiccups. It is a typical antipsychotic because it works on positive
symptoms of schizophrenia, such as hallucinations and delusions.
Option A: Chlordiazepoxide is a long-acting benzodiazepine and
is an FDA approved medication for adults with mild-moderate to
severe anxiety disorder, preoperative apprehension and anxiety,
and withdrawal symptoms of acute alcohol use disorder. It is also
FDA approved for pediatric patients greater than six years old for
, anxiety. Chlordiazepoxide has anti-anxiety, sedative, appetite-
stimulating, and weak analgesic actions.
Option B: Diazepam is an anxiolytic benzodiazepine, first
patented and marketed in the United States in 1963. It is a fast-
acting, long-lasting benzodiazepine commonly used in the
treatment of anxiety disorders, as well as alcohol detoxification,
acute recurrent seizures, severe muscle spasm, and spasticity
associated with neurologic disorders. In the setting of acute
alcohol withdrawal, diazepam is useful for symptomatic relief of
agitation, tremor, alcoholic hallucinosis, and acute delirium
tremens.
Option C: Lorazepam has common use as the sedative and
anxiolytic of choice in the inpatient setting owing to its fast (1 to
3 minute) onset of action when administered intravenously.
Lorazepam is also one of the few sedative-hypnotics with a
relatively clean side effect profile. Lorazepam is FDA approved for
short-term (4 months) relief of anxiety symptoms related to
anxiety disorders, anxiety-associated insomnia, anesthesia
premedication in adults to relieve anxiety, or to produce
sedation/amnesia, and treatment of status epilepticus.
2. 2. Question
Which of the following liquids would nurse Leng administer to a female
client who is intoxicated with phencyclidine (PCP) to hasten excretion
of the chemical?
A. Shake
B. Tea
C. Cranberry Juice
D. Grape juice
Incorrect
Correct Answer: C. Cranberry Juice
An acid environment aids in the excretion of PCP. The nurse will
definitely give the client with PCP intoxication cranberry juice to acidify
the urine to a ph of 5.5 & accelerate excretion. PCP begins to cause
symptoms at a dose of 0.05mg/kg, and a dose of 20 mg or more can
cause seizures, coma, and death. It is mainly metabolized by the liver,
and 10% is excreted in the kidneys. Inhalation (the most common
, route of administration) and intravenous routes of administration
produce symptoms in 2 to 5 minutes. Oral ingestion produces
symptoms in 30 to 60 minutes.
Option A: Most patients survive PCP intoxication with supportive
care. Airway, breathing, circulation, and hemodynamic
monitoring are essential to the care of patients with PCP toxicity.
Intubation with ventilatory support may be required for airway
protection. Sedation with medication and physical restraints may
be required to control agitation, violent behavior, and psychosis
due to PCP intoxication. Placing the patient in a calm
environment such as a quiet room with the lights dimmed may be
helpful. Benzodiazepines are the preferred medication for
chemical sedation in patients with PCP toxicity.
Option B: Patients with mild symptoms can be discharged one to
2 hours after they become symptom-free and have no other
medical complications or behavioral issues that need to be
addressed. Patients with severe symptoms or medical
complications should be admitted to a monitored bed. Patients
who are asymptomatic who present to the emergency
department after PCP use should be observed for at least 6 hours
before being discharged.
Option D: PCP is available as a powder, crystal, liquid, and
tablet. It produces both stimulation and depression of the CNS.
PCP is a non-competitive antagonist to the NMDA receptor, which
causes analgesia, anesthesia, cognitive defects, and psychosis.
PCP blocks the uptake of dopamine and norepinephrine, leading
to sympathomimetic effects such as hypertension, tachycardia,
bronchodilation, and agitation. PCP can also cause sedation,
muscarinic, and nicotinic signs by binding to acetylcholine
receptors and GABA receptors. Sigma receptor stimulation by PCP
causes lethargy and coma.
3. 3. Question
When developing a plan of care for a female client with acute stress
disorder who lost her sister in a car accident. Which of the following
would the nurse expect to initiate?
A. Facilitating progressive review of the accident and its
consequences.
B. Postponing discussion of the accident until the client brings it up.
, C. Telling the client to avoid details of the accident.
D. Helping the client to evaluate her sister’s behavior.
Incorrect
Correct Answer: A. Facilitating progressive review of the
accident and its consequences
The nurse would facilitate progressive review of the accident and its
consequence to help the client integrate feelings & memories and to
begin the grieving process. Help patients reframe any destructive
cognitions (eg, beliefs that they acted terribly and are terrible people
or are weak for being so distraught, that life is hopeless or worthless,
or that the world is totally unsafe).
Option B: Support self-esteem; help patients understand that
their reaction to the trauma is a normal reaction to an abnormal
situation, not a sign of weakness or psychopathology. Reassure
and help survivors concerning immediate needs, such as rest,
food, shelter, social support, or a sense of belonging to a
community (some feel cut off and detached).
Option C: Promote coping mechanisms. Avoid prompting
discussion of issues that cannot be resolved; avoid abreaction in
groups and the resulting contagion effect; respect defenses, and
do not force reality on people who cannot handle it yet; keep in
mind that debriefing may be harmful. Discuss the experience
with patients who want to talk about it, and avoid pressuring
those who do not wish to discuss it.
Option D: Check to see if children feel that they somehow
caused the death or disaster or if they have other
misunderstandings, and take pains to reassure them or correct
any misunderstanding; do not assume children are fine just
because they are not saying anything. Let them know it is all
right to talk about unpleasant feelings (including sadness and
anger) and listen to them; sharing personal feelings of sadness
with them is all right as well.
4. 4. Question
The nursing assistant tells nurse Ronald that the client is not in the
dining room for lunch. Nurse Ronald would direct the nursing assistant
to do which of the following?
