C HAPTER 03: P SYCHOBIOLOGY AND
P SYCHOPHARMACOLOGY
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. A drug causes muscarinic receptor blockade. The nurse will assess the
patient for:
a. dry mouth.
b. gynecomastia.
c. pseudoparkinsonism.
d. orthostatic hypotension.
ANS: A
Muscarinic receptor blockade includes atropine -like side effects, such
as dry mouth, blurred vision, and constipation. Gynecomastia is
associated with decreased prolactin levels. Movement defects are
associated with dopamine blockade. Orthostatic hypotension is
associated with a1 antagonism.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 57 TOP: Nursing Process: Assessment MSC:
Client Needs: Physiological Integrit y
2. A patient begins therapy with a phenothiazine medication. What teaching
should the nurse provide related to the drugs strong dopaminergic effect?
, a. Chew sugarless gum.
b. Increase dietary fiber.
c. Arise slowl y from bed.
d. Report changes in muscle movement.
ANS: D
Phenothiazines block dopamine receptors in both the limbic system and
basal ganglia. Movement disorders and motor abnormalities
(extrapyramidal side effects), such a s parkinsonism, akinesia,
akathisia, dyskinesia, and tardive dyskinesia, are likel y to occur earl y
in the course of treatment. They are often heralded by sensations of
muscle stiffness. Early intervention with antiparkinsonism medication
can increase the patients comfort and prevent dystonic reactions. The
distracters are related to anticholinergic effects.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 58 TOP: Nursing Process: Implementation
MSC: Client Needs: Physiological Integrity
3. A patient tells the nurse, My doctor prescribed Paxil (paroxetine) for m y
depression. I assume Ill have side effects like I had when I was taking
Tofranil (imipramine). The nurses repl y should be based on the knowledge
that paroxetine is a(n):
a. selective norepinephrine reuptake inhibitor.
b. tricyclic antidepressant.
c. MAO inhibitor.
d. SSRI.
ANS: D
, Paroxetine is an SSRI and will not produce the same side effects as
imipramine, a tricyclic antidepressant. The patient will probably not
experience dry mouth, constipation, or orthostatic hypotension.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 54 TOP: Nursing Process: Planning MSC:
Client Needs: Physiological Integrit y
4. A nurse can anticipate anticholinergic side effects are likel y when a
patient takes:
a. lithium (Lithobid).
b. buspirone (BuSpar).
c. imipramine (Tofranil).
d. risperidone (Risperdal).
ANS: C
Imipramine (Tofranil) is a tricyclic antidepressant with strong
anticholinergic properties, resulting in dry mouth, blurred vision,
constipation, and urinar y retention. Lithium therapy is more often
associated with fluid - balance problems, including pol ydipsia,
pol yuria, and edema. Risperidone therapy is more often associated with
movement disorders, orthostatic hypotension, and sedation. Buspirone
is associated with anxiet y reduction without major side effects.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 54 TOP: Nursing Process: Planning MSC:
Client Needs: Physiological Integrit y
P SYCHOPHARMACOLOGY
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. A drug causes muscarinic receptor blockade. The nurse will assess the
patient for:
a. dry mouth.
b. gynecomastia.
c. pseudoparkinsonism.
d. orthostatic hypotension.
ANS: A
Muscarinic receptor blockade includes atropine -like side effects, such
as dry mouth, blurred vision, and constipation. Gynecomastia is
associated with decreased prolactin levels. Movement defects are
associated with dopamine blockade. Orthostatic hypotension is
associated with a1 antagonism.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 57 TOP: Nursing Process: Assessment MSC:
Client Needs: Physiological Integrit y
2. A patient begins therapy with a phenothiazine medication. What teaching
should the nurse provide related to the drugs strong dopaminergic effect?
, a. Chew sugarless gum.
b. Increase dietary fiber.
c. Arise slowl y from bed.
d. Report changes in muscle movement.
ANS: D
Phenothiazines block dopamine receptors in both the limbic system and
basal ganglia. Movement disorders and motor abnormalities
(extrapyramidal side effects), such a s parkinsonism, akinesia,
akathisia, dyskinesia, and tardive dyskinesia, are likel y to occur earl y
in the course of treatment. They are often heralded by sensations of
muscle stiffness. Early intervention with antiparkinsonism medication
can increase the patients comfort and prevent dystonic reactions. The
distracters are related to anticholinergic effects.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 58 TOP: Nursing Process: Implementation
MSC: Client Needs: Physiological Integrity
3. A patient tells the nurse, My doctor prescribed Paxil (paroxetine) for m y
depression. I assume Ill have side effects like I had when I was taking
Tofranil (imipramine). The nurses repl y should be based on the knowledge
that paroxetine is a(n):
a. selective norepinephrine reuptake inhibitor.
b. tricyclic antidepressant.
c. MAO inhibitor.
d. SSRI.
ANS: D
, Paroxetine is an SSRI and will not produce the same side effects as
imipramine, a tricyclic antidepressant. The patient will probably not
experience dry mouth, constipation, or orthostatic hypotension.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 54 TOP: Nursing Process: Planning MSC:
Client Needs: Physiological Integrit y
4. A nurse can anticipate anticholinergic side effects are likel y when a
patient takes:
a. lithium (Lithobid).
b. buspirone (BuSpar).
c. imipramine (Tofranil).
d. risperidone (Risperdal).
ANS: C
Imipramine (Tofranil) is a tricyclic antidepressant with strong
anticholinergic properties, resulting in dry mouth, blurred vision,
constipation, and urinar y retention. Lithium therapy is more often
associated with fluid - balance problems, including pol ydipsia,
pol yuria, and edema. Risperidone therapy is more often associated with
movement disorders, orthostatic hypotension, and sedation. Buspirone
is associated with anxiet y reduction without major side effects.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 54 TOP: Nursing Process: Planning MSC:
Client Needs: Physiological Integrit y
