ISPN & CGFNS Psychopharmacology for Psychiatric Nurses 1 — Questions and Answers
Question 1: Which class of medications is considered first-line treatment for major depressive disorder in US psychiatric practice?
- Selective serotonin reuptake inhibitors (SSRIs) (Correct answer)
- Monoamine oxidase inhibitors (MAOIs)
- Typical antipsychotics
- Benzodiazepines
Correct answer: Selective serotonin reuptake inhibitors (SSRIs)
SSRIs are the first-line pharmacological treatment for major depressive disorder due to their efficacy and favorable side effect profile compared to older antidepressants.
Question 2: A patient taking lithium for bipolar disorder reports nausea, tremor, and polyuria. Which nursing action is the priority?
- Check the serum lithium level immediately (Correct answer)
- Administer an antiemetic and reassure the patient
- Withhold the next dose without notifying the provider
- Increase fluid restriction to reduce polyuria
Correct answer: Check the serum lithium level immediately
These symptoms suggest possible lithium toxicity; checking the serum lithium level immediately is the priority to determine if toxicity is occurring.
Question 3: Which antipsychotic side effect requires the psychiatric nurse to regularly monitor for abnormal involuntary movements?
- Tardive dyskinesia (Correct answer)
- Hypertensive crisis
- Serotonin syndrome
- Agranulocytosis
Correct answer: Tardive dyskinesia
Tardive dyskinesia — repetitive, involuntary movements — is a serious long-term side effect of antipsychotic medications requiring regular monitoring with tools like the AIMS.
Question 4: Which laboratory value must be monitored regularly in patients taking clozapine (Clozaril)?
- Absolute neutrophil count (ANC) (Correct answer)
- Serum potassium
- Blood glucose
- Thyroid-stimulating hormone (TSH)
Correct answer: Absolute neutrophil count (ANC)
Clozapine can cause agranulocytosis; regular ANC monitoring is mandatory and patients must be enrolled in a Risk Evaluation and Mitigation Strategy (REMS) program.
Question 5: What dietary restriction must a patient taking a monoamine oxidase inhibitor (MAOI) follow?
- Avoid tyramine-rich foods such as aged cheeses, cured meats, and red wine (Correct answer)
- Avoid all dairy products
- Limit water intake to 1 liter per day
- Avoid vitamin C-containing foods
Correct answer: Avoid tyramine-rich foods such as aged cheeses, cured meats, and red wine
MAOIs inhibit the breakdown of tyramine; consuming tyramine-rich foods can trigger a hypertensive crisis, making dietary restriction essential for patient safety.
Question 6: Which benzodiazepine property is most important for psychiatric nurses to teach patients regarding long-term use?
- Physical dependence and the risk of withdrawal seizures if stopped abruptly (Correct answer)
- Permanent cure of anxiety disorders after 6 months of use
- No risk of interaction with other CNS depressants
- Improved cognitive function over time
Correct answer: Physical dependence and the risk of withdrawal seizures if stopped abruptly
Benzodiazepines cause physical dependence, and abrupt discontinuation after prolonged use can trigger life-threatening withdrawal seizures, requiring gradual tapering.
ISPN & CGFNS Psychopharmacology for Psychiatric Nurses 1
Which class of medications is considered first-line treatment for major depressive disorder in US psychiatric practice?