©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
NUR 422 Exam Testbank Practice
Questions and Answers
The nurse manager on the psychiatric unit was explaining to the new staff the differences between
typical and atypical antipsychotics. The nurse correctly states that atypical antipsychotics:
a. Remain in the system longer
b. Act more quickly to reduce delusions
c. Produce fewer extrapyramidal effects
d. Are risk free for neuroleptic malignant syndrome - Ans:✔✔-ANS: C
Atypical antipsychotics produce less D2 blockade; thus movement disorders are less of a
problem. No evidence suggests that the medication remains in the system longer nor that it actsmore
quickly to reduce delusions. The atypicals are not risk free for NMS.
The nurse would assess for neuroleptic malignant syndrome (NMS) if a patient on haloperidol(Haldol)
develops a:
a. 30 mm Hg decrease in blood pressure reading
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, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
b. Respiratory rate of 24 respirations per minute
c. Temperature reading of 104 F
d. Pulse rate of 70 beats per minute - Ans:✔✔-ANS: C
Increased temperature is the cardinal sign of NMS. This BP is not a significant feature of NMS.
There are no significant findings to support the options related to respirations or pulse rate.
Which behavior displayed by a patient receiving a typical antipsychotic medication would beassessed as
displaying behaviors characteristic of tardive dyskinesia (TD)?
a. Grimacing and lip smacking
b. Falling asleep in the chair and refusing to eat lunch
c. Experiencing muscle rigidity and tremors
d. Having excessive salivation and drooling - Ans:✔✔-ANS: A
TD manifests as abnormal movements of voluntary muscle groups after a prolonged period of
dopamine blockade. Movements may affect any muscle group, but muscles of the face, mouth,tongue,
and digits are commonly affected. Falling asleep is reflective of the sedative effect of these medications.
Muscle rigidity and drooling reflect EPS caused from imbalance between dopamine and acetylcholine.
Page 2/66
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
When the nurse realizes that a patient diagnosed with schizophrenia is not taking the prescribed oral
haloperidol (Haldol), which intervention would promote medication compliance?
a. Instructing the patient to have friends monitor his medications
b. Beginning administration of haloperidol (Haldol) decanoate
c. Writing instructions in detail for the patient to follow
d. Changing haloperidol to an atypical antipsychotic - Ans:✔✔-ANS: B
Haloperidol decanoate is a depot medication, given intramuscularly every 2 to 4 weeks. It is unknown
whether the patient has a support system. The patient probably received education, including written
instructions prior to discharge. Changing to
another classification of medication would not necessarily improve compliance.
When asked how tricyclic antidepressants affect neurotransmitter activity, the nurse should respond that
they:
a. Decrease available dopamine.
b. Increase availability of norepinephrine and serotonin.
c. Make available increased amounts of monoamine oxidase.
d. Increase the effects of the chemical gamma-aminobutyric acid. - Ans:✔✔-ANS: B
Page 3/66
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FIRST PUBLISH OCTOBER 2024
Tricyclic antidepressants block neurotransmitter uptake, increasing the amounts of norepinephrine and
serotonin available. Decreasing dopamine is the action of typical antipsychotic medication. Increasing
monoamine oxidase is not the action of tricyclics.Benzodiazepines, not tricyclics, increase the effects of
GABA.
Which of these statements made by a patient taking the MAOI phenelzine (Nardil) would warrant further
instruction?
a. I often forget to wear sunscreen when I go outside.
b. I need to restrict the amount of sodium in my diet.
c. I should not use over-the-counter cold medications.
d. I usually order liver and onions when my wife and I eat out. - Ans:✔✔-ANS: D
MAOIs require patients to observe a tyramine-free diet to prevent hypertensive crisis. Liver is a food that
contains large amounts of tyramine. The remaining options have no relevance for MAOI therapy.
Which statement made by a patient who will be maintained on lithium following discharge will require
further instruction by the nurse?
a. I will have my blood work done regularly.
b. When I get home, I may go on a salt-free diet.
c. I have learned not to restrict my intake of water.
Page 4/66
FIRST PUBLISH OCTOBER 2024
NUR 422 Exam Testbank Practice
Questions and Answers
The nurse manager on the psychiatric unit was explaining to the new staff the differences between
typical and atypical antipsychotics. The nurse correctly states that atypical antipsychotics:
a. Remain in the system longer
b. Act more quickly to reduce delusions
c. Produce fewer extrapyramidal effects
d. Are risk free for neuroleptic malignant syndrome - Ans:✔✔-ANS: C
Atypical antipsychotics produce less D2 blockade; thus movement disorders are less of a
problem. No evidence suggests that the medication remains in the system longer nor that it actsmore
quickly to reduce delusions. The atypicals are not risk free for NMS.
The nurse would assess for neuroleptic malignant syndrome (NMS) if a patient on haloperidol(Haldol)
develops a:
a. 30 mm Hg decrease in blood pressure reading
Page 1/66
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
b. Respiratory rate of 24 respirations per minute
c. Temperature reading of 104 F
d. Pulse rate of 70 beats per minute - Ans:✔✔-ANS: C
Increased temperature is the cardinal sign of NMS. This BP is not a significant feature of NMS.
There are no significant findings to support the options related to respirations or pulse rate.
Which behavior displayed by a patient receiving a typical antipsychotic medication would beassessed as
displaying behaviors characteristic of tardive dyskinesia (TD)?
a. Grimacing and lip smacking
b. Falling asleep in the chair and refusing to eat lunch
c. Experiencing muscle rigidity and tremors
d. Having excessive salivation and drooling - Ans:✔✔-ANS: A
TD manifests as abnormal movements of voluntary muscle groups after a prolonged period of
dopamine blockade. Movements may affect any muscle group, but muscles of the face, mouth,tongue,
and digits are commonly affected. Falling asleep is reflective of the sedative effect of these medications.
Muscle rigidity and drooling reflect EPS caused from imbalance between dopamine and acetylcholine.
Page 2/66
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
When the nurse realizes that a patient diagnosed with schizophrenia is not taking the prescribed oral
haloperidol (Haldol), which intervention would promote medication compliance?
a. Instructing the patient to have friends monitor his medications
b. Beginning administration of haloperidol (Haldol) decanoate
c. Writing instructions in detail for the patient to follow
d. Changing haloperidol to an atypical antipsychotic - Ans:✔✔-ANS: B
Haloperidol decanoate is a depot medication, given intramuscularly every 2 to 4 weeks. It is unknown
whether the patient has a support system. The patient probably received education, including written
instructions prior to discharge. Changing to
another classification of medication would not necessarily improve compliance.
When asked how tricyclic antidepressants affect neurotransmitter activity, the nurse should respond that
they:
a. Decrease available dopamine.
b. Increase availability of norepinephrine and serotonin.
c. Make available increased amounts of monoamine oxidase.
d. Increase the effects of the chemical gamma-aminobutyric acid. - Ans:✔✔-ANS: B
Page 3/66
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Tricyclic antidepressants block neurotransmitter uptake, increasing the amounts of norepinephrine and
serotonin available. Decreasing dopamine is the action of typical antipsychotic medication. Increasing
monoamine oxidase is not the action of tricyclics.Benzodiazepines, not tricyclics, increase the effects of
GABA.
Which of these statements made by a patient taking the MAOI phenelzine (Nardil) would warrant further
instruction?
a. I often forget to wear sunscreen when I go outside.
b. I need to restrict the amount of sodium in my diet.
c. I should not use over-the-counter cold medications.
d. I usually order liver and onions when my wife and I eat out. - Ans:✔✔-ANS: D
MAOIs require patients to observe a tyramine-free diet to prevent hypertensive crisis. Liver is a food that
contains large amounts of tyramine. The remaining options have no relevance for MAOI therapy.
Which statement made by a patient who will be maintained on lithium following discharge will require
further instruction by the nurse?
a. I will have my blood work done regularly.
b. When I get home, I may go on a salt-free diet.
c. I have learned not to restrict my intake of water.
Page 4/66
