ISPN & CGFNS Psychopharmacology for Psychiatric Nurses 2 — Questions and Answers
Question 1: Which medication is FDA-approved for the treatment of opioid use disorder by blocking opioid receptors?
- Naltrexone (Vivitrol) (Correct answer)
- Clonazepam (Klonopin)
- Quetiapine (Seroquel)
- Valproate (Depakote)
Correct answer: Naltrexone (Vivitrol)
Naltrexone is an opioid antagonist FDA-approved for treating opioid use disorder and alcohol use disorder by blocking the euphoric effects of opioids.
Question 2: A patient on an SSRI develops agitation, hyperthermia, diaphoresis, and muscle rigidity. Which condition should the nurse suspect?
- Serotonin syndrome (Correct answer)
- Neuroleptic malignant syndrome
- Alcohol withdrawal delirium
- Lithium toxicity
Correct answer: Serotonin syndrome
The combination of agitation, hyperthermia, diaphoresis, and rigidity is the classic triad of serotonin syndrome, a dangerous reaction to serotonergic drugs.
Question 3: Which mood stabilizer requires monitoring of serum levels and is associated with teratogenic risk including neural tube defects?
- Valproate (Depakote) (Correct answer)
- Lithium
- Lamotrigine
- Carbamazepine
Correct answer: Valproate (Depakote)
Valproate is associated with neural tube defects and requires serum level monitoring; it is contraindicated in pregnancy due to high teratogenic risk.
Question 4: Which medication is used as a 'prn' (as-needed) oral intervention for acute agitation in psychiatric inpatient settings?
- Lorazepam (Ativan) (Correct answer)
- Sertraline (Zoloft)
- Lithium carbonate
- Fluoxetine (Prozac)
Correct answer: Lorazepam (Ativan)
Lorazepam, a benzodiazepine, is commonly administered on a PRN basis for acute agitation in inpatient psychiatric settings due to its rapid onset.
Question 5: A patient taking an atypical antipsychotic gains 15 pounds and develops hyperglycemia. These findings are characteristic of which side effect syndrome?
- Metabolic syndrome (Correct answer)
- Tardive dyskinesia
- Serotonin syndrome
- Stevens-Johnson syndrome
Correct answer: Metabolic syndrome
Atypical antipsychotics are associated with metabolic syndrome, which includes weight gain, hyperglycemia, dyslipidemia, and increased cardiovascular risk.
Question 6: Which patient teaching point is most important for a patient starting bupropion (Wellbutrin)?
- Report any seizures immediately, as bupropion lowers the seizure threshold (Correct answer)
- Avoid sunlight completely while taking this medication
- Take it only at bedtime due to sedation
- It is safe to combine with MAOIs without risk
Correct answer: Report any seizures immediately, as bupropion lowers the seizure threshold
Bupropion lowers the seizure threshold, making seizure risk a critical safety teaching point; dose-related seizure risk increases at higher doses.
ISPN & CGFNS Psychopharmacology for Psychiatric Nurses 2
Which medication is FDA-approved for the treatment of opioid use disorder by blocking opioid receptors?