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9. A factor that might place a young person in a high-risk category for

1. When planning care for a client using paranoid ideation, the nurse should substance abuse is:
realize the importance of: a. Curiosity with a daring attitude
a. Not placing demands on the client b. Occasional periods of depression
b. Removing stress so that the client can relax c. Loss of a parent through death or separation
c. Giving the client difficult tasks to provide stimulation d. Typical stresses associated with adolescence
d. Providing the client with activities in which success can be
achieved 10. A 20-year-old carpenter falls from a roof and incurs fractures of the right
femur and left tibia. The client reveals a history of substance abuse.
2. During a one-to-one interaction with a client with schizophrenia, A primary consideration for the nurse who is caring for this client
paranoid type, the client says to the nurse, “I figured out how would be to:
foreign agents have infiltrated the news media. They want to shut a. Confront the client about substance abuse
me up before I spill the beans.” This statement can best be b. Communicate in the same speech pattern that the client uses
described as: c. Avoid upsetting the client by calling attention to the drug
a. A nihilistic delusion abuse
b. A delusion of grandeur d. Realize that this client will need more pain medication
c. An auditory hallucination than a nonabuser
d. An overvaluation of the self
11. The nurse is aware that the defense mechanism commonly used by
3. A disturbed client is admitted to the hospital for psychiatric evaluation. clients who are alcoholics is:
When taking the client’s history, the nurse asks why the client came a. Denial
to the hospital. The client states, “They lied about me. They said I b. Projection
murdered my mother. You killed her. She died before I was born.” c. Displacement
The nurse recognizes that the client is experiencing: d. Compensation
a. Ideas of grandeur
b. Confusing illusions 12. A client, with the diagnosis of alcoholism, explains to the nurse that
c. Persecutory delusions alcohol has a calming effect and states, “I function better when I’m
d. Auditory hallucinations drinking than when I’m sober.” The nurse recognizes that the
client is using the defense mechanism of:
4. A nursing approach that may be helpful when planning the care of clients a. Sublimation
diagnosed with schizophrenia of the paranoid type is: b. Suppression
a. Exploring prominent life events c. Compensation
b. Limiting exploration to recent situations d. Rationalization

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c. Providing a nonthreatening environment
d. Exploring the content of their delusions 13. Within a few hours of alcohol withdrawal, the nurse should assess a
client for the presence of:
5. The nurse planning to establish a trusting relationship with a client who a. Irritability and tremors
is using a paranoid ideation should begin by: b. Yawning and convulsions
a. Seeking the client out frequently to spend long blocks of time c. Disorientation and paranoia
together d. Fever and profuse diaphoresis
b. Sitting in the unit and observing the client’s behavior
throughout the day 14. A client is admitted too an alcohol rehabilitation center. On the fourth
c. Being available on the unit continuously and waiting for the day after a admission, the nurse detects a strong odor of alcohol on
client to approach the client’s breath. The first action by the nurse should be to:
d. Calling the client into the office to establish a contract for a. Locate and remove the alcohol substance
regular therapy sessions b. Ask directly where the client got the alcohol
c. Convey the staff’s disappointment in this behavior
6. A client with schizophrenia, paranoid type is delusional, withdrawn, and d. Notify the physician that the client has been drinking
negativistic. The nurse should plan to:
a. Invite the client to play a game of Ping-Pong 15. A 42-year-old with a long history of alcohol abuse seeks help with the
b. Explain to the client the benefits of a group activity problem in one of the local hospitals. The nurse is aware that the
c. Encourage the client to become involved in group activities major underlying factor for success in an alcohol treatment program
d. Mention to the client that the psychiatrist has ordered increased will be the client’s:
activity a. Family
b. Motivation
7. A client refuses to eat and states, “The food is poisoned.” The nurse c. Psychiatrist
should: d. Self-esteem
a. Ask the client what foods are desired so they can be ordered 16. A 65-year-old male is admitted to a mental health facility with a
b. Encourage the client’s family to bring favorite foods from diagnosis of substance-induced persisting dementia resulting from
home chronic alcoholism. When conducting the admitting interviews, the
c. Suggest going to the cafeteria and selecting foods the client nurse determines that the client is using confabulation. The nurse
feels safe eating recognizes that this is caused by the client’s:
d. Go with the client to the cafeteria and taste the food to show a. Ideas of grandeur
that it is not poisoned. b. Marked memory loss
c. Need to get attention from others
8. Lunch is being served, and the clients must walk to the dining room. The d. Difficulty in accepting the diagnosis
nurse finds one client sitting alone with the head slightly tilted as if
listening to something. The nurse should state: 17. The nurse’s plan of care for a client with substance-induced persisting
a. “I know you’re busy. However, it’s lunchtime.” dementia resulting from chronic alcohol ingestion should take into
b. “Lunchtime, let’s go! We don’t want to miss it.” consideration that this disorder is thought to be caused by:
c. “It’s lunchtime. I’ll walk with you to the dining room.” a. An increase in serotonin
d. “Those voices bothering you again! I’ll help you get ready for b. A reduction in iron intake
lunch.” c. The malabsorption of riboflavin
d. The deficiency of thiamine in the diet

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d. “I will talk to your family and friends about their behavior if
18. The nurse understands that for individuals who are alcoholics, alcohol is you want me to.”
a substance that is used to:
a. Blunt reality 27. The nurse spent time to talk to Mrs. Meneses’s son. She gathered
b. Precipitate euphoria that the son is the primary care giver. To explore and to prevent burn-
c. Promote social interaction out in the son, which of the following nursing actions must the nurse
d. Stimulate the central nervous system
do?
19. The nurse is planning care for a client who is an alcoholic. The nurse A. Assess degree of understanding of family systems
must be aware that the most serious, life-threatening symptoms
from alcohol withdrawal usually occur how many hours after the and coping mechanisms.
last drink? B. Explore individual dynamic and personal
a. 8 to 12 coping.
b. 12 to 24 C. Explore the support system available for Mrs.
c. 24 to 72
Meneses’s son.
d. 72 to 96
D. Identify the spiritual support system of the family.
20. A salesman with a history of heavy drinking is on a detoxification unit.
He asks the nurse’s permission to skip the Alcoholics Anonymous
28. A man has completed an alcohol detoxification program and is setting
(AA) meeting held daily. The nurse’s initial response should be:
goals for rehabilitation. When setting goals it is important for this
a. “What are your feelings about going to AA?”
client to understand the need to:
b. “What is it that you dislike about going to AA?”
a. Plan to avoid people who drink
c. “It’s all right to wait until you feel like going to AA.”
b. Develop new social drinking skills
d. “An important part of your treatment is attending AA
c. Restructure his life without alcohol
meetings.”
d. Accept that he is a fragile person
21. A client with a history of heavy drinking is brought to a psychiatric
29. Which of the following symptoms of Schizophrenia are likely to be
facility in a stupor. On the day after admission the client is
confused, disoriented, and delusional. The nurse should be aware responsive to medications?
that the client may be developing alcoholic: A. Hallucinations C. Apathy
a. Amnesia B. Social withdrawal D. Anhedonia
b. Hallucination
c. Withdrawal delirium
d. Uncomplicated dementia 30. A 19-year-old waitress is admitted to the emergency department with a

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fractured femur. The client’s history reveals multiple drug abuse
22. The nurse is aware that the reason some alcoholics relapse even though for the past 8 months. When caring for this client, the nurse is
they attend AA meetings is that they: aware that the most serious life-threatening symptoms during
a. Enjoy the feeling caused by drinking alcohol withdrawal usually result from:
b. Are trying drastically to alter a long-standing habit a. Heroin
c. Physiologically require the substance in their body b. Methadone
d. Often have a character defect that defeats their willpower c. Barbiturates
d. Amphetamines
23. When working with a client who is in an alcohol detoxification program,
it would be most important for the nurse to: 31. When planning care for a client who has just completed withdrawal
a. Accept the client as a worthwhile person from multiple drug abuse, the nurse should take into consideration
b. Provide nurturing because the client needs it that this client probably is:
c. Discuss the negative effects of alcohol with the client a. Unable to give up drugs
d. Promote compliance by gently prodding the client b. Unconcerned with reality
c. Unable to delay gratification
24. To give clients with long histories of alcohol abuse greater d. Unaware of the danger of drug addiction
responsibility for self-control, the nurse initially should plan to:
a. Tell them about detoxification programs 32. A 37-year-old male high school principal has been remanded by the
b. Confront them with their substance patterns court to the drug rehabilitation unit of a psychiatric facility for
c. Assist them too adopt more healthful coping patterns treatment of cocaine addiction. When obtaining a history from this
d. Administer their medications according to the prescribed client, the nurse expects that he would report that he:
schedule a. Sleeps a great deal
b. Has sedentary habits
25. Two days after admission to the detoxification program, a client with a c. Has lost considerable weight
long history of alcohol abuse tells the nurse, “I don’t know why I d. Noted recent speech difficulties
came here.” The nurse’s best response is:
a. “You feel you don’t need this program?” 33. As a client addicted to cocaine withdraws from the drug, the nurse
b. “You did admit yourself into the program.” should expect to observe behavior related to:
c. “You realize you are trying to avoid your problem.” a. Delirium
d. “Don’t you remember why you decide to come here?” b. Suspicion
c. Depression
26. A 40-year-old client has a long history of alcohol abuse. After an d. Hyperactivity
automobile accident the client is arrested for driving while
intoxicated and is admitted to the hospital. When the client 34. The nurse is aware that a serious effect of inhaling cocaine is:
becomes angry and blames others, the nurse can be most therapeutic a. Esophageal varices
by stating: b. Acute electrolyte imbalances
a. “You know you are to blame for your alcohol abuse.” c. Extrapyramidal tract symptoms
b. “You need help now or you are going to get even sicker.” d. Deterioration of the nasal passages
c. “I can see that you are upset and I want to help you feel
better.”

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35. When a recently hospitalized client has a tentative diagnosis of opiate a. Counseled by the staff psychiatrist
addiction, the nurse should assess the client for adaptations related b. Dismissed from the job immediately
to opiate withdrawal. These adaptations include: c. Forced to promise to abstain from drugs
a. Drowsiness d. Referred to the employee assistance program
b. Hypotension
c. Pupillary dilation 44. During a family meeting a client with a substance abuse disorder
d. Muscle twitching accuses his wife of contributing to his substance abuse. The nurse
evaluates that the psychoeducation the client and family received
36. After a binge with cocaine, the individual is found unconscious and is was ineffective because the client is:
admitted to the hospital with acute cocaine toxicity. Initial nursing a. Confronting his wife about her lack of support
action should be directed toward: b. Verbalizing negative feelings toward a family member
a. Being understanding c. Having difficulty recalling that a change in one person
b. Maintaining a drug-free environment affects the entire family
c. Providing the necessary physical care d. Creating an environment in which family members cannot
d. Establishing a therapeutic relationship learn about his problem

37. After a visit from several friends the nurse finds a client with a known 45. A client with the dual diagnosis of major depression and polysubstance
history of opiate addiction in a deep sleep and unresponsive to abuse has been attending group therapy. One day the client tells the
attempts at arousal. The nurse assess the client’s vital signs and nurse, “The things they talk about in group don’t really pertain to
determines that an overdose of opiates occurred if the findings me.” At this time it would be most appropriate for the nurse to:
showed a blood pressure of: a. Confront the client with realistic feedback
a. 70/40 mm Hg. a pulse of 120, and respirations of 10 b. Identify the client’s stress-coping tolerance
b. 120/80 mm Hg. a pulse of 84, and respirations of 20 c. Question what the client means by the statement
c. 140/90 mm Hg. a pulse of 76, and respirations of 28 d. Communicate that the client needs to get more involved
d. 180/100 mm Hg. a pulse of 72, and respirations of 18
46. A client who has been drinking heavily since the death of a child 3 years
38. The nurse, when planning care for a client recovering from an opiate ago is brought to the mental health unit in a stupor by the spouse.
overdose, should take into consideration that the client’s underlying Taking the client’s history into consideration, the nursing makes a
problem is probably a feeling of: tentative nursing diagnosis of:
a. Guilt with a rejection of reality a. Dysfunctional Grieving
b. Hostility with a need for acceptance b. Compromised Family Coping
c. Inferiority with strong dependency needs c. Substance Abuse, Alcohol
d. Anger with an overwhelming need for independence d. Disturbed Personal Identity

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39. The nurse is aware that opiates most commonly are used because the 47. A client with a long history of alcohol abuse is placed on a diet high in
individual: vitamin B1 (thiamine). The nurse evaluates that the diet is
a. Attempts to reduce stress understood when the client states, “I will select something for each
b. Desires to become independent meal from among:
c. Wants to fit in with the peer group a. Fish, aged cheese and breads.”
d. Enjoys the social interrelationships that occur b. Poultry, milk products and eggs.”
c. Lean pork, organ meat, and nuts.”
40. The nurse should know that the most common side effects of regular d. Leafy and green vegetables and citrus fruits.”
cocaine use include:
a. Attempts to reduce stress 48. A client being admitted for alcoholism reports having had alcoholic
b. Desires to become independent blackouts in the past. The nurse recognizes that an alcohol blackout
c. Wants to fit in with the peer group is best described as:
d. Enjoys the social interrelationships that occur a. Fainting spells followed by loss of memory
b. A fugue state resembling absence seizures
41. A client with a known history of opiate addiction is treated for multiple c. Absence of memory in relation to drinking episodes
stab wounds to the abdomen. After surgical repair the nurse notes d. Loss of consciousness lasting less than ten minutes
that the client’s pain is not relieved by the prescribed morphine
injections. The nurse recognizes that the failure to achieve pain 49. A client is admitted to the hospital for substance abuse. When assessing
relief from the morphine injections indicates that the client is the client the nurse should identify that there may be a history of
probably experiencing the phenomenon of: long-term, high-dose cocaine use when the client exhibits:
a. Tolerance a. Euphoria
b. Habituation b. Hypervigilance
c. Physical addiction c. Impaired judgment
d. Psychologic addiction d. Psychomotor retardation

42. At a staff meeting the question of a staff nurse returning to work after a 50. The physician orders venlafaxine (Effexor) for a client with the
drug rehabilitation program is discussed. The nurse manager helps diagnosis of major depressive disorder and who has been taking
the staff to decide that the most therapeutic way to handle the herbal medication. When discussing this medication with the client,
nurse’s return is to: the nurse should determine if the client has been taking:
a. Offer the nurse support in a direct, straightforward a. Ginseng
manner b. Valerian
b. Avoid mentioning the problem unless the nursing brings up c. Kava-kava
the topic d. St. John’s wort
c. Assign another staff member to keep the nurse close
observation 51. Methylphenidate (Ritalin) is prescribed to treat a 7-year-old child’s
d. Make certain the nurse is assigned to administer only attention-deficit-hyperactivity disorder (ADHD). Ritalin is used in
nonnarcotic the treatment of this disorder in children for its:
medication a. Diuretic effect
b. Synergistic effect
43. It is determined that a staff nurse has a drug abuse problem. As an c. Paradoxical effect
initial intervention the staff nurse should be: d. Hypotensive effect

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52. The physician orders alprazolam (Xanax) 0.25 mg PO three times a day C. Encouraging the patient to read
for a client with anxiety and physical symptoms related to work D. Talking to the patients
pressure. The nurse should assess the client for the most common
side effect of this medication, which is:
a. Drowsiness 61. A client has recently been prescribed a new neuroleptic drug. The nurse
b. Bradycardia observes extra-pyramidal symptoms and anticipates that the
c. Agranulcytosis physician will limit these side effects by prescribing:
d. Tardive dyskinesia a. Zolpidem (Ambien)
b. Hydroxyzine (Atarax)
53. The nurse determines that after administering alprazolam (Xanax) it is c. Dantrolene (Dantrium)
important to assess the client for side effects. Initially the nurse d. Benztropine mesylate (Cogentin)
should:
a. Measure urinary output 62. The nurse is aware that haloperidol (Haldol) is most effective for clients
b. Monitor the blood pressure who exhibit behavior that is:
c. Assess for abdominal distention a. Manic
d. Check the size of the pupils frequently b. Overactive
c. Depressed
54. A client’s family asks about the treatment of schizophrenia. Before d. Withdrawn
responding the nurse recalls that:
a. Electroconvulsive therapy is more effective in treating 63. A client who is taking lithium arrives at the mental health center for a
schizophrenia than mood disorders routine visit. The client has slurred speech, has an ataxic gait, and
b. Family therapy has not proven to be effective in the treatment complains of nausea. The nurse recognizes that these adaptations
of clients with schizophrenia are:
c. Insight therapy has proven to be highly successful in the a. Related to low lithium levels
treatment of clients with schizophrenia b. Associated with cyclic mood disorders
d. Drug therapy, although not eliminating the underlying c. Often related to therapeutic lithium levels
problem, reduces the symptoms of acute d. Probably associated with toxic levels of lithium
schizophrenia
64. The immediate treatment for a client who has ingested a tricyclic
55. A young adult being treated for substance abuse asks the nurse about antidepressant in an amount that is 20 to 30 times the daily
methadone. The nurse responds that methadone is useful in the recommended dose should include:
treatment of narcotic addiction because it: a. Dialysis or forced diuresis
a. Is a nonaddictive drug b. Administration of physostigmine
b. Has an effect of longer duration c. IM or IV administration of an anticholinergic

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c. Has no cumulative effect in the body d. Closer monitoring to prevent further suicidal attempts
d. Carries little risk of psychologic dependence
65. A noncompliant, suspicious client with schizophrenia is to be
56. To prevent life-threatening complications from the administration of the discharged. The client will live with an aging mother and attend an
neuroleptic drug chlorpromazine (Thorazine) to a disturbed, acting- outreach group. The nurse recognizes that the medication most
out client, it is important that the nurse: appropriate for this client would be:
a. Provide adequate restraint a. Amitriptyline (Elavil)
b. Monitor the client’s vital signs b. Tranylcypromine (Parnate)
c. Protect against exposure to direct sunlight c. Fluphenazine hydrochloride (Prolixin)
d. Watch the client for extrapyramidal side effects d. Fluphenazine decanoate (Prolixin Decanoate)
57. On the psychiatric unit, a client has been receiving high doses of 66. A client is started on fluphenazine decanoate (Prolixin Decanoate).
haloperidol (Haldol) for 2 weeks. The client states, “I just can’t sit When teaching about this drug, the nurse should emphasize that:
still and I feel jittery.” The nurse suspects that the client may be a. Driving is forbidden while taking this drug
experiencing the side effect known as: b. There will be a feeling of increased energy while on this medication
a. Akathisia b. Torticollis c. Sunscreen must be used for all outdoor activities on a year-
c. Tardive-dyskinesia d. Parkinsonian syndrome round basis
58. In addition to hydration during delirium tremens, the physician d. The client’s essential hypertension indirectly will be controlled by
prescribes parenteral administration of lorazepam (Ativan) for the this drug
client. The nurse understands that this drug is given during
detoxification primarily to: 67. For a client suspected of and demonstrating the symptoms associated
a. Prevent physical injury to the client when seizures occur with opiate overdose, the nurse should expect the physician to
b. Enable the client to sleep better during periods of agitation prescribe:
c. Quiet the client and encourage cooperation and acceptance of a. Naloxone
treatment b. Methadone
d. Reduce the anxiety-tremor state and prevent more serious c. Epinephrine
withdrawal symptoms d. Amphetamine
59. The physician orders routine lithium levels to be performed. How many 68. The nurse should teach a client receiving tranylcypromine (Parnate) that
hours after the last dose of lithium should the nurse obtain the blood failure to adhere to the dietary restrictions can result in:
specimen? a. Syncope
a. 2 to 4 b. Bradycardia
b. 4 to 6 c. Hypertensive crisis
c. 6 to 8 d. Hyperglycemic episodes
d. 8 to 12
469. A client has been receiving disulfiram (Antabuse) and will be
60. Which of the following methods can reduce the intensity of discharged tomorrow. The nurse recognizes that teaching regarding
auditory hallucinations? this medication has been effective when the client states:
A. Giving the patient amitrystyline a. “I must be careful to check over-the-counter medications.”
B. Advising the patient not to pay attention to the b. “I’ll never take this medication while taking an antibiotic.”
voices
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c. “I will not be able to eat cheese or aged products with this a. Jaundice and vomiting
medication.” b. Tardive dyskinesia and nausea
d. “It’s important to wait at least 8 hours after taking this pill c. Hiccups and postural hypotension
before drinking any alcohol.” d. Parkinsonism and agranulocytosis

70. A client who is going home on a weekend pass has been receiving 77. A client with schizophrenia is given an antipsychotic drug. The nurse is
risperidone (Risperdal) 3 mg three times a day. The nurse should aware that of all the extrapyramidal effects associated with this type
inform the client that: of drug, the one causing the most concern is:
a. The dosage can be reduced if the client feels better at home a. Akathisia
b. The medication does not need to be taken during the time spent b. Tardive dyskinesia
at home c. Parkinsonian syndrome
c. Alcoholic beverages should not be consumed while taking d. Acute dystonic reaction
this medication
d. All the medication should be taken early in the day to be sure it 78. A 46-year0old mechanic has been hospitalized with schizophrenia,
is not paranoid type. The physician has prescribed a phenothiazine drug.
forgotten The hospital recreation department has planned a fishing trip. It is
71. When talking with a client who has been receiving paroxetine (Paxil), important that the nurse:
an antidepressant medication, the nurse diagnoses the presence of a a. Provide the client with a solar-defensive ointment
knowledge deficit when the client states: b. Give the client an extra dose of medication to take after lunch
a. “I will be a little drowsy in the mornings.” c. Caution the client about limiting undue exertion during the trip
b. “I’m expecting to feel somewhat better and won’t need other d. Take the client’s blood pressure before allowing participation in
therapy.” the activity
c. “I’ve been on the medication for 8 days now and I don’t
feel any better.” 79. A client with schizophrenia undifferentiated type, is receiving a typical
d. “I know I will probably have to take this medication for at least antipsychotic/ neuroleptic. The nurse should be alert for
a few months.” extrapyramidal signs and symptoms, which include:
a. Shuffling gait, tremors, and restlessness
72. A client has been taking amoxapine (Asendin) for the past 3 months b. Nausea, vomiting, and muscular cramps
with no improvement. The physician orders tranylcypromine c. Drowsiness, disorientation and slurred speech
sulfate (Parnate) to be given additionally. The nurse should: d. Tachycardia, urinary retention and constipation
a. Question the order and not administer the medication
b. Withhold the medication until CBC and enzymes have been 80. The physician orders haloperidol (Haldol) 10 mg PO twice a day for a
drawn client who is also receiving phenytoin (Dilantin) for control of
c. Ask the client about allergies to feathers before giving the first epilepsy. When planning the client’s care, the nurse should be

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dose aware that anticonvulsants may interact with Haldol to:
d. Remind the client this medication should be taken with meals a. Mask its therapeutic effect
and milk b. Interfere with its absorption
products must be avoided c. Enhance its rate of metabolism
d. Potentiate its CNS depressant effect
73. The physician prescribes a tricyclic medication to decrease a suicidal
client’s depression. A precaution that the nurse must keep in mind 81. Bupropion (Wellbutrin) has a unique side effect not shared by most
when initiating treatment with this group of drugs it that: other drugs of its class. The nurse should assess the client for which
a. Eating cheese or drinking wine may cause a hypertensive crisis possible side effect of this drug?
b. The drug’s blood level may not be sufficient to cause a. Heart failure
noticeable b. Breast tumors
improvement for 2 to 3 weeks c. Tardive dyskinesia
c. They must be given with milk and crackers to avoid d. Generalized seizures
hyperacidity and abdominal discomfort
d. Blood specimens will need to be obtained weekly for 3 months 82. The nurse has completed a teaching session with a client starting mood-
to check for appropriate therapeutic drug levels stabilizing medications. The client comment that indicates to the
nurse that further teaching is needed is:
74. A 50-year-old divorced mother has become increasingly depressed, and a. “I realize that I will need to keep in touch with my doctor.”
the physician prescribes an antidepressant. After 20 days of therapy, b. “I know I won’t have to stay on this medication for too
she returns to the clinic. She appears relaxed and smiles at the long.”
nurse. The most significant conclusion the nurse can draw from this c. “Taking medication without using other forms of therapy may
behavior is that the client: not be as effective.”
a. Wants to please the staff d. “Taking the medication is better than experiencing the highs
b. Has resolved her conflicts and lows I have been having.”
c. May be in dental of her problems
d. Is responding to the antidepressant therapy 83. A client who is receiving an MAO inhibitor is going home on a weekend
pass. Considering this drug, the nurse plans to caution the client to
75. A client is extremely depressed, and the physician orders a tricyclic avoid:
antidepressant, imipramine hydrochloride (Tofranil). The client asks a. Pork, spinach, and fresh oysters
the nurse what the medication will do. The nurse’s best response is: b. Milk, peanut butter, and meat tenderizers
a. “This medication will help you forget why you are c. Cheese, beer and products with chocolate
depressed.” b. “The medication helps increase your appetite, d. Orange drinks, fresh apples and ice cream
making you feel better.”
c. “When you take this along with phenelzine [Hardill], you’ll feel 84. A client is receiving haloperidol (Haldol) for agitation. When
less depressed. observing the client for side effects, the nurse would recognize that
d. “You will begin to feel much better after taking this medication this side effect that is unrelated to extrapyramidal tract symptoms is:
for 2 to 3 days.” a. Akathisia
b. Opisthotonos
76. A client with an organic mental disorder becomes increasingly agitated c. Oculogyric crisis
and abusive. The physician orders haloperidol (Haldol). The nurse d. Hypertensive crisis
should assess the client for untoward effects including:

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85. The blocking of dopamine by antipsychotic drugs can cause 94. A client is prescribed sertraline (Zoloft), an antidepressant. When
extrapyramidal side effects such as akathisia. The nurse preparing a teaching plan about the side effects of this drug, the
understands that client behaviors that reflect akathisia include: nurse should include information about:
a. Acute muscle spasms and torticollis a. Seizures
b. Bizarre facial and tongue movements b. Agitation
c. Tremor, shuffling gait, drooling and rigidity c. Tachycardia
d. Motor restlessness, foot tapping and pacing d. Agranulocytosis

86. A client who has schizophrenia is receiving a phenothiazine 95. A neuromuscular blocking agent is administered to a client before ECT
antipsychotic medication. The nurse should withhold this therapy. At this time, the nurse should monitor the client for:
medication if the client experiences which adaptation? a. Seizures
a. Akathisia b. Loss of memory
b. Yellow sclerae c. Nausea and vomiting
c. Shuffling gait d. Respiratory difficulties
d. Photosensitivity
96. Considering the anticholinergic-like side effects of many of the
87. A client is started on fluphenazine decanoate (Prolixin Decanoate). The psychotropic drugs, the nurse should encourage clients taking these
nurse is aware that the primary advantage of this medication is that: drugs to:
a. There are no side effects a. Suck on hard candy
b. It has a long-lasting effect b. Restrict their fluid intake
c. It is safe to use during pregnancy c. Eat a diet high in carbohydrates
d. There is less need for laboratory monitoring d. Avoid products that contain aspirin
88. A client receiving buspirone hydrochloride (BuSpar) is admitted to the
hospital with the diagnosis of possible hepatitis. The nurse identifies that the 97. A client who has been taking the prescribed dose of zolpidem (Ambien)
client’s sclerae look yellow. The nurse’s initial action should be to: for 5 days, returns to the clinic for a follow-up visit. When
a. Withhold the BuSpar interviewing the client, the nurse identifies that the medication has
b. Give the BuSpar with milk been effective when then the client says:
c. Reduce the dosage of the BuSupar a. “I have less pain.”
d. Assure the client that the BuSpar can be given parenterally b. “I have been sleeping better.”
c. “My blood glucose is under control.”
89. A client has been taking the prescribed dose of clozapine (Clozaril). The d. “My blood pressure is coming down.”
nurse should assess the client for which life-threatening side effect
of this drug? 98. When administering hydroxyzine hydrochloride (Vistaril), the nurse
a. Polycythemia should monitor the client for the common side effects of this drug,

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b. Agranulocytosis which include:
c. Hypertensive crisis a. Ataxia and confusion
d. Pseudoparkinsonism b. Drowsiness and dry mouth
c. Vertigo and impaired vision
90. The nurse understands that olanzapine (Zyprexa Zydis) has a distinct d. Slurred speech and headache
advantage over other antipsychotic because:
a. Extrapyramidal symptoms do not occur 99. The nurse is aware that the psychiatrist is concerned that one of the
b. Drug effects last 3 months after administration clients receiving haloperidol (Haldol) may be developing neuroleptic
c. Dopamine is increased at receptor sties, decreasing psychotic behavior malignant syndrome. When assessing for this syndrome, the nurse
d. Tablets disintegrate immediately in the mouth preventing should monitor the client for which signs and symptoms?
“checking” of tablets a. Jaundice and malaise
b. Tremors and seizures
91. The physician plans to have a client continue on lithium after discharge. c. Diaphoresis and hyperpyrexia
The nurse should recognize that the teaching about the medication d. Dry skin and hyperbilirubinemia
plan was understood when the client states, “I know that this
medication: 100. A client is receiving an antipsychotic medication. When assessing for
a. Should be stopped if illness is suspected.” signs and symptoms of pseudoparkinsonism, the nurse should
b. May need to be taken for the rest of my life.” monitor the client for:
c. Must be increased at the first sign of a manic episode.” a. Blurred vision
d. Causes no serious side effects when taken correctly.” b. Muscle tremors
c. Sensitivity to light
92. An antianxiety medication is prescribed for an extremely anxious client. d. Jittery movements
The client states, “I’m afraid to take these pills because I heard
they’re addicting.” The nurse’s response is based on the knowledge
that antianxiety medications.
a. Rarely cause dependence when dosage is controlled
b. Usually result in psychologic but not physiologic dependence
c. May require increased dosages but rarely cause dependence
d. Have the potential for physiologic and psychologic
dependence

93. A client is admitted to the hospital with a diagnosis of depression that has
not responded to tricyclic antidepressants or outpatient ECT. The
physician orders tranylcypromine (Parnate). The nurse would be
aware that the teaching about the drug was understood when the
client states, “While taking this medicine I should avoid eating:
a. “Red meat.”
b. “Fresh fish.”
c. Aged cheese.”
d. Citrus fruits.”

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