3. After the nurse has taught the client who is being discharged on lithium (Eskalith) about the drug, which of the following client statements would indicate that the teaching has been successful.

* A. "I need to restrict eating any foods that contain salt."
* B. "If I forget a dose, I can double the dose the next time I take it."
* C. "I'll call my doctor right away for any vomiting, severe hand tremors, or muscle weakness."
* D. "I should increase my fluid”

C. "I'll call my doctor right away for any vomiting, severe hand tremors, or muscle weakness."

5. Which of the following clinical manifestations would alert the nurse to lithium toxicity?

* A. Increasingly agitated behavior
* B. Markedly increased food intake
* C. Sudden increase in blood pressure
* D. Anorexia with nausea and vomiting

D. Anorexia with nausea and vomiting

7. The client is taking risperidone (Risperdal) to treat the positive and negative symptoms of schizophrenia. Which of the following negative symptoms will improve?

* A. Abnormal thought form
* B. Hallucinations and delusions
* C. Bizarre behavior
* D. Asocial behavior and anergia

D. Asocial behavior and anergia

8. A client comes to the outpatient mental health clinic 2 days after being discharged from the hospital. The client was given a 1-week supply of clozapine (Clozaril). The nurse reviews information about clozapine with the client. Which client statement indicates an accurate understanding of the nurses teaching about this medication?

* A.” I need to call my doctor in 2 weeks for a checkup."
* B. "I need to keep my appointment here at the hospital this week for a blood test."
* C. "I can drink alcohol with this medication."
* D. "I can take over-the-counter sleeping medication if I have trouble sleeping."

B. "I need to keep my appointment here at the hospital this week for a blood test."

9. Which of the following health status assessments must be completed before the client starts taking imipramine (Tofranil)?

* a. Electrocardiogram (ECG)
* b. Urine sample for protein
* c. Thyroid scan
* d. Creatinine clearance test

a. Electrocardiogram (ECG)

10. The nurse judges correctly that a client is experiencing an adverse effect from amitriptyline hydrochloride (Elavil) when the client demonstrates:

* A. An elevated blood glucose level
* B. Insomnia
* C. Hypertension
* D. Urinary retention

D. Urinary retention

11. The client has been taking clomipramine (Anafranil) for his obsessive-compulsive disorder. He tells the nurse, "I am not really better, and I have been taking the medication faithfully for the past 3 days just like it says on this prescription bottle." Which of the following actions would the nurse do first?

* A. Tell the client to continue taking the medication as prescribed because it takes 5 to 10 weeks for a full therapeutic effect.
* B. Tell the client to stop taking the medication and to call the physician.
* C. Encourage the client to double the dose of his medication.
* D. Ask the client if he has resumed smoking cigarettes.

A. Tell the client to continue taking the medication as prescribed because it takes 5 to 10 weeks for a full therapeutic effect.

13. Which of the following client a statement about clozapine (Clozaril) indicates that the client needs additional teaching?

* A. "I need to have my blood checked once every several months while I'm taking this drug."
* B. "I need to sit on the side of the bed for a while when I wake up in the morning."
* C. "The sleepiness I feel will decrease as my body adjusts to clozapine."
* D. "I need to call my doctor whenever I notice that I have a fever or sore throat."

D. "I need to call my doctor whenever I notice that I have a fever or sore throat."

14. The client has been taking the monoamine oxidase inhibitor (MAOI) phenelzine (Nardil), 10 mg bid. The physician orders a selective serotonin reuptake inhibitor (SSRI), paroxetine (Paxil), 20 mg given every morning. The nurse:

* A. Gives the medication as ordered
* B. Questions the physician about the order
* C. Questions the dosage ordered
* D. Asks the physician to order benztropine (Cogentin) for the side effects

B. Questions the physician about the order

15. A client is brought to the hospitals emergency room by a friend, who states, "I guess he had some bad junk (heroin) today." In assessing the client, the nurse would likely find which of the following symptoms-

* A. Increased heart rate, dilated pupils, and fever
* B. Tremulousness, impaired coordination, increased blood pressure, and ruddy complexion
* C. Decreased respirations, constricted pupils, and pallor
* D. Eye irritation, tinnitus, and irritation of nasal and oral mucosa

C. Decreased respirations, constricted pupils, and pallor

16. When caring for a client receiving haloperidol (Haldol), the nurse would assess for which of the following-

* A. Hypertensive episodes
* B. Extrapyramidal symptoms
* C. Hypersalivation
* D. Oversedation

B. Extrapyramidal symptoms

18. The client is taking sertraline (Zoloft), 50 mg q AM. The nurse includes which of the following in the teaching plan about Zoloft.

* A. Zoloft causes erectile dysfunction in men.
* B. Zoloft causes postural hypotension
* C. Zoloft increases appetite and weight gain
* D. It may take 3-4 weeks before client will start feeling better.

A. Zoloft causes erectile dysfunction in men.

19. A client was hospitalized with major depression with suicidal ideation for 1 week. He is taking venlafaxine (Effexor), 75 mg three times a day, and is planning to return to work. The nurse asks the client if he is experiencing thoughts of self-harm. The client responds, "I hardly think about it anymore and wouldn't do anything to hurt myself." The nurse judges:

* A. The client to be decompensates and in need have being readmitted to the hospital
* B. The client to need an adjustment or increase in his dose of antidepressant
* C. The depression to be improving and the suicidal ideation to be lessening
* D. The presence of suicidal ideation to warrant a telephone call to the client's physician

C. The depression to be improving and the suicidal ideation to be lessening

20. The client is taking Tofranil. The nurse should closely monitor the patient:

* a. Hypertension
* b. Hypothermia
* c. Increase Intra Ocular Pressure
* d. Increase Intra Cranial Pressure

c. Increase Intra Ocular Pressure

21. If a Patient complaints about vomiting, diarrhea, and restlessness after taking lithane, then the nurses initial intervention is:

* a. Recognize that this is a sign of toxicity and withhold the next medication.
* b. Notify the physician.
* c. Check V/S to validate patient's concerns
* d. Recognize that this is a normal side effect of lithium and continue the drug.

a. Recognize that this is a sign of toxicity and withhold the next medication.

22. The nurse should know that the normal therapeutic level of lithium is

* A. .6 to 1.2 meq/L
* B. 6 to 12 meq/L
* C. .6 to .12 cc/ml
* D. .6 to .12 cc3/L

A. .6 to 1.2 meq/L

24. A decision is made to discharge a client with obsessive-compulsive disorder. Of the following abilities the client has demonstrated, the one that probably most influenced the decision not to hospitalize him is his ability to:

* a. Hold a job.
* b. Relate to his peers.
* c. Perform activities of daily living.
* d. Behave in an outwardly normal

c. Perform activities of daily living.

26. A client with paranoid schizophrenia has persecutory delusions and auditory hallucinations and is extremely agitated. He has been given a PRN dose of Thorazine IM. Which of the following would indicate to the nurse that the medication is having the desired effect?

* A. Complains of dry mouth
* B. State he feels restless in his body
* C. Stops pacing and sits with the nurse
* D. Exhibits increase activity and speech

C. Stops pacing and sits with the nurse

27. In assessing a clients suicide potential, which statement by the client would give the nurse the highest cause for concern?

* A. My thoughts of hurting my self are scary to me
* B. I would like to go to sleep and not wake up
* C. I have thought about taking pills and alcohol until I pass out
* D. I would like to be free from all these worries

C. I have thought about taking pills and alcohol until I pass out

28. Client with a history of schizophrenia has been admitted for suicidal ideation. The client states "God is telling me to kill myself right now." The nurses best response is:

* A. I understand that god's voice is real to you, but I do not hear anything. I will stay with you.
* B. The voices are part of your illness; it will stop if you take medication
* C. the voices are all in your imagination, think of something else and till go away
* D. Do not think of anything right now, just go, and relax.

A. I understand that god's voice is real to you, but I do not hear anything. I will stay with you.

29. A client is admitted to the hospital. Twelve hours later the nurse observes hand tremors, hyperexicitability, tachycardia, diaphoresis, and hypertension. The nurse suspects alcohol withdrawal. The nurse should ask the client:

* A. At what time was your last drink taken?
* B. Why you have not told us you are a drinker?
* C. Do you drink beer or hard liquor?
* D. How long have you been drinking?

A. At what time was your last drink taken?

30. The type of anxiety that leads to personality disorganization is:

* A. Mild
* B. Moderate
* C. Severe
* D. Panic

D. Panic

31. Which of the following is not an example of alteration of perception?

* A. ideas of reference
* B. flight of ideas
* C. illusion
* D. hallucination

B. flight of ideas

32. The most effective treatment modality for persons if anti social PD is

* A. hypnotherapy
* B. gestalt therapy
* C. behavior therapy
* D. crisis intervention

C. behavior therapy

33. Which of the ff: is not a characteristic of PD?

* A. disregard rights of others
* B. loss of cognitive functioning
* C. fails to conform to social norms
* D. not capable of experiencing guild or remorse for their behavior

B. loss of cognitive functioning

35. Which of the following drugs needs a WBC level checked regularly?

* A. Lithane
* B. Clozaril
* C. Tofranil
* D. Diazepam

B. Clozaril