psychiatric mental health
nursing chapter 4 Exam
Questions and Correct
Solutions
1. When used in combination with anxiolytic medication, alcohol leads to ____ effects and caffeine leads
to ____ effects.
1. Increased; increased
2. Increased; decreased
3. Decreased; decreased
4. Decreased; increased - Correct Answers: 2. This is correct. Anxiolytic medications work by depressing
certain CNS functions. Alcohol is also a CNS depressant that potentiates (increases) effects of anxiolytics.
Caffeine is a CNS stimulant and inhibits (decreases) their effects.
2. A patient was recently admitted to the inpatient unit after a suicide attempt. During the
hospitalization, the patient was placed on a tricyclic antidepressant. Which action should the nurse
implement to maintain the patient's safety when the patient is discharged?
1. Provide the patient with a 6-month supply of medication.
2. Provide a 1-week supply of medication to be refilled after visiting the provider.
3. Instruct increased fluid intake to counteract the medication's side effects.
4. Provide education on fluid restrictions to prevent side effects. - Correct Answers: 2. This is correct.
Suicide risk often increases as antidepressant medication takes effect and the patient's level of
depression and mood improve. The patient may then have increased energy with which to implement a
suicide plan. Providing a 1-week supply to be refilled after visiting the provider may facilitate monitoring
of the patient's overall level of depression.
, 3. Which statement best describes how the perspective on psychopharmacological use of
phenothiazines has historically changed?
1. Phenothiazines were originally used as a preoperative medication and found to improve the client's
anxiety.
2. Phenothiazines were originally used for infection control and found to improve a client's treatment
compliance.
3. Phenothiazines were originally used for postoperative care and found to improve the client's ability to
recover from anesthesia. 4. Phenothiazines were originally used for diabetics to control their appetite
and blood sugars. - Correct Answers: 1. This is correct. Dr. Henri Laborit (1914 to 1995) found that the
clients benefited from the administration of phenothiazines prior to surgery, and this foretold of a
psychotropic use.
4. A patient was recently admitted to the inpatient unit after a suicide attempt and has not responded to
SSRIs or tricyclic antidepressants. The patient asks the nurse, "I heard about MAOIs (monoamine oxidase
inhibitors). Why can't they be added to what I am on now? Wouldn't adding one help?" Which is the
most appropriate nursing response?
1. "Electroconvulsive therapy (ECT) is your best option at this point."
2. "Combined use can lead to a life-threatening condition called a hypertensive crisis."
3. "There is no reason why an MAOI couldn't be added to your therapy."
4. "They can't be used together because their mechanisms of action are very different." - Correct
Answers: 2. This is correct. Concomitant use with MAOIs results in a potentially life-threatening
hypertensive crisis. Antidepressants can be safely taken while a patient receives ECT treatments
5. A patient began taking lithium for the treatment of bipolar disorder approximately 1 month ago and
asks why he has gained 12 pounds since then. Which is the most appropriate nursing response?
1. "It is surprising that you have gained; weight loss is the typical pattern when taking lithium."
2. "Your weight gain is more likely related to food intake and decreased activity than medication."
3. "Weight gain is a common but troubling side effect. Let's talk about some strategies for safely
improving your nutrition and exercise habits."
4. "There's not much you can do about the weight gain. It's better than being emotionally unstable
though." - Correct Answers: 3. This is correct. Weight gain is a common side effect of lithium. It may be