C HAPTER 03: P SYCHOBIOLOGY AND
P SYCHOPHARMACOLOGY
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9th Edition
MULTIPLE CHOICE
1. A drug causes muscarinic receptor blockade. The nurse will assess the
client for what sid e effect?
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 á1 antagonism.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Assessment MSC: Client Needs:
Physiological Integrity
,2. A client begins therapy with a phenothiazine medication. What teaching
should the nurse provide related to the drug’s strong dopaminergic effect?
a. Chew sugarless gum.
b. Increase dietary fiber.
c. Arise slowl y from bed.
d. Report changes in muscle movemen t.
ANS: D
Phenothiazines block dopamine receptors in both the limbic system and
basal ganglia. Movement disorders and motor abnormalities
(extrapyramidal side effects), such as parkinsonism, akinesia,
akathisia, dyskinesia, and tardive dyskinesia, are li kel 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 client’s comfort and prevent dystonic reactions. The
distracters are related to anticholinergic effects.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Physiological Integrit y
3. A client tells the nurse, “My doctor prescribed paroxetine for my
depression. I assume I’ll hav e side effects like I had when I was taking
imipramine.” The nurse’s repl y should be based on the knowledge that
paroxetine is included in what class of medication?
a. selective norepinephrine reuptake inhibitor (SNR I).
b. tricyclic antidepressant.
c. monoamine oxidase (MAO) inhibitor.
d. selective serotonin reuptake inhibitors (SSRIs)
, ANS: D
Paroxetine is an SSRI and will not produce the same side effects as
imipramine, a tricyclic antidepressant. The client will probably not
experience dry mouth, constipation, or orthostatic hypotension.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Planning MSC: Client Needs:
Physiological Integrity
4. A nurse can anticipate anticholinergic side effects are likel y when a client
is prescribed whi ch medication?
a. lithium.
b. buspirone.
c. imipramine.
d. risperidone.
ANS: C
Imipramine is a tricyclic antidepressant with strong anticholinergic
properties, resulting in dry mouth, blurred vision, constipation, and
urinary 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 si de effects.
P SYCHOPHARMACOLOGY
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9th Edition
MULTIPLE CHOICE
1. A drug causes muscarinic receptor blockade. The nurse will assess the
client for what sid e effect?
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 á1 antagonism.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Assessment MSC: Client Needs:
Physiological Integrity
,2. A client begins therapy with a phenothiazine medication. What teaching
should the nurse provide related to the drug’s strong dopaminergic effect?
a. Chew sugarless gum.
b. Increase dietary fiber.
c. Arise slowl y from bed.
d. Report changes in muscle movemen t.
ANS: D
Phenothiazines block dopamine receptors in both the limbic system and
basal ganglia. Movement disorders and motor abnormalities
(extrapyramidal side effects), such as parkinsonism, akinesia,
akathisia, dyskinesia, and tardive dyskinesia, are li kel 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 client’s comfort and prevent dystonic reactions. The
distracters are related to anticholinergic effects.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Physiological Integrit y
3. A client tells the nurse, “My doctor prescribed paroxetine for my
depression. I assume I’ll hav e side effects like I had when I was taking
imipramine.” The nurse’s repl y should be based on the knowledge that
paroxetine is included in what class of medication?
a. selective norepinephrine reuptake inhibitor (SNR I).
b. tricyclic antidepressant.
c. monoamine oxidase (MAO) inhibitor.
d. selective serotonin reuptake inhibitors (SSRIs)
, ANS: D
Paroxetine is an SSRI and will not produce the same side effects as
imipramine, a tricyclic antidepressant. The client will probably not
experience dry mouth, constipation, or orthostatic hypotension.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Planning MSC: Client Needs:
Physiological Integrity
4. A nurse can anticipate anticholinergic side effects are likel y when a client
is prescribed whi ch medication?
a. lithium.
b. buspirone.
c. imipramine.
d. risperidone.
ANS: C
Imipramine is a tricyclic antidepressant with strong anticholinergic
properties, resulting in dry mouth, blurred vision, constipation, and
urinary 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 si de effects.
