Pharm UTH SON Exam 2 – Flashcards
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A nurse is assessing the effects of antimicrobial therapy in a patient with pneumonia. The nurse should establish which outcomes when planning care? (Select all that apply.) Potassium level of 4 mEq/dL Reduction of fever Sterile sputum cultures Oxygen saturation of 98% Elastic skin turgor
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Reduction of fever Sterile sputum cultures Oxygen saturation of 98%
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Which are examples of the improper use of antibiotic therapy? (Select all that apply.) Using surgical drainage as an adjunct to antibiotic therapy Treating a viral infection Basing treatment on sensitivity reports Treating fever in an immunodeficient patient Using dosing that results in a superinfection
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Treating a viral infection Using dosing that results in a superinfection
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A nurse should recognize that antibiotic prophylaxis is appropriate in patients with which medical conditions? (Select all that apply.) Aortic valve replacement Ruptured appendix Bronchitis Neutropenia Chickenpox
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Aortic valve replacement Neutropenia
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The nurse identifies appropriate use of antimicrobials to prevent infection in which situations? (Select all that apply.) Cardiac surgery Recurrent urinary tract infections in women Anemia Treatment of fever of unknown origin Hysterectomy
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Cardiac surgery Recurrent urinary tract infections in women Hysterectomy
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Which medications does the nurse identify as having antibacterial properties? (Select all that apply.) Rifampin Zidovudine Imipenem Amphotericin B Amantadine
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Rifampin, Imipenem Zidovudine and amantadine are antiviral drugs. Amphotericin B is an antifungal drug.
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Thirty minutes after receiving an intramuscular (IM) injection of penicillin G (Pfizerpen), a patient reports itching and redness at the injection site. Which action should the nurse take first? Elevate the lower legs. Place an ice pack on the site. Make sure the patient stays calm. Administer subcutaneous epinephrine.
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Administer subcutaneous epinephrine. IM so, the penicillin took time to cause effect, IV would be much faster reaction.
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Both IV ampicillin/sulbactam (Unasyn) and gentamicin (Garamycin) are ordered for a patient. When administering these medications, the nurse will do what? Ensure that separate IV solutions are used. Use two different peripheral IV sites. Administer the gentamicin first. There are no necessary precautions.
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Ensure that separate IV solutions are used Aminoglycosides end in Mycin! don't mix with pcn
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An immunocompromised patient who is receiving piperacillin/tazobactam (Zosyn) develops oozing and bleeding from the gums. Which additional data should the nurse determine? Whether the patient has a fever above 100.5°F Whether the patient reports any painful teeth The most recent platelet count The last time mouth care was given
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The most recent platelet count Piperacillin/tazobactam (Zosyn) is an extended-spectrum penicillin used primarily for infections caused by Pseudomonas aeruginosa in immunocompromised hosts. It can cause bleeding secondary to disrupting platelet function; therefore, the platelet count may be altered. High fever, painful teeth, and mouth care do not address the patient's bleeding gums.
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A patient is admitted to the hospital with a medical diagnosis of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). When taking the patient's history, a nurse recognizes which information as the most important? Plays a contact sport and is an athlete Currently resides in a long-term care facility Did not complete the last course of antibiotics Had gallbladder surgery in the previous month
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Plays a contact sport and is an athlete Risk Factors: Young, touching community things like sports equipment, not been in a hospital
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When performing a skin test for penicillin allergy, the nurse will do what? (Select all that apply.) Inject a tiny amount of the allergen subcutaneously. Observe for a local allergic response. Have epinephrine readily available. Have respiratory support readily available. Administer diphenhydramine (Benadryl) as the first-line agent should anaphylaxis occur.
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Observe for a local allergic response. Have epinephrine readily available Have respiratory support readily available Pcn test is injected intradermal, not SubQ
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Rx: acyclivir is used for what Dx?
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Dx: Herpes
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Dx: CMV- retina, what is the Rx?
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Rx: Gancyclovir
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Flouroquinolone Dx, MOA, AE, precautions
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UTI drug, inhibits enzyme gyrase, achilles tendon rupture, photosensitivity. Chelated by Metals in diet, which lowers effect of drug.
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Amphoterycin B
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Ampho-terrible! Blows hole through cell wall, Hypokalema, Renal Failure, Emesis, Fever
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Which laboratory result should a nurse monitor more frequently when a patient is receiving clarithromycin (Biaxin) and warfarin (Coumadin)? Activated partial thromboplastin time (aPTT) Platelet count Erythrocyte sedimentation rate (ESR) International normalized ratio (INR)
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International normalized ratio (INR) Clarithromycin is a macrolide similar to erythromycin and can inhibit hepatic metabolism of medications such as warfarin and theophylline. The INR is the blood test used to evaluate warfarin ranges. The aPTT is the blood test used in monitoring heparin. The platelet count and ESR are not affected by clarithromycin.
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A patient who has a vancomycin-resistant enterococci (VRE) infection is receiving linezolid (Zyvox). Which laboratory result indicates that the patient is having an adverse effect? White blood cell (WBC) count of 1200 units/L Hemoglobin (Hgb) level of 18 g/dL Potassium level of 3.0 mEq/dL Glucose level of 200 mg/dL
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White blood cell (WBC) count of 1200 units/L Linezolid can cause reversible myelosuppression, manifesting as anemia, leukopenia, or even pancytopenia. The potassium and blood glucose levels are not affected by linezolid.
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What does the nurse identify as an adverse effect of clindamycin (Cleocin) therapy? Cyanosis and gray discoloration of the skin Frequent loose, watery stools with mucus and blood Reduction in all blood cells produced in the bone marrow Elevated bilirubin, with dark urine and jaundice
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Frequent loose, watery stools with mucus and blood Clostridium difficile-associated diarrhea (CDAD) is the most severe toxicity associated with clindamycin and is characterized by profuse, watery stools. The cause is superinfection of the bowel with Clostridium difficile, an anaerobic gram-positive bacillus. Gray syndrome, which usually occurs in infants and those with aplastic anemia, is an adverse effect of chloramphenicol (Chloromycetin). Hepatotoxicity is associated most closely with telithromycin (Ketek).
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The nurse identifies which drug as a short-acting tetracycline? Sumycin Declomycin Vibramycin Minocin
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Sumycin Sumycin is a short-acting tetracycline. Declomycin is an intermediate-acting tetracycline, and Vibramycin and Minocin are long-acting tetracyclines.
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Which statements about CDAD associated with clindamycin therapy does the nurse identify as true? (Select all that apply.) Leukopenia commonly occurs. It is a potentially fatal condition. Patients usually experience abdominal pain. Anticholinergics are effective in treating the diarrhea. Clindamycin therapy should be discontinued and vancomycin started.
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It is a potentially fatal condition. Patients usually experience abdominal pain Clindamycin therapy should be discontinued and vancomycin started. CDAD is a potentially fatal condition in which patients experience abdominal pain. If CDAD develops, clindamycin therapy should be stopped and vancomycin or metronidazole therapy started. Leukocytosis, not leukopenia, develops. Anticholinergics can make the diarrhea worse and therefore should be avoided.
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A nurse is administering a daily dose of tobramycin (Nebcin) at 1000. At which time should the nurse obtain the patient's blood sample to determine the trough level? 0800 0900 1130 1200
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0900 Trough levels determine the lowest level between doses. Blood is drawn just before the next dose is administered when a divided dose is used or 1 hour before the next dose if a single daily dose is used.
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A patient who is receiving an aminoglycoside (gentamicin) has a urinalysis result with all of these findings. Which finding should a nurse associate most clearly with an adverse effect of gentamicin? White blood cells (WBCs) Glucose Ketones Protein
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Protein Aminoglycoside-induced nephrotoxicity usually presents as acute tubular necrosis. Symptoms of concern are protein in the urine, dilute urine, and elevation of the serum creatinine and blood urea nitrogen (BUN) levels. WBCs, glucose, and ketones are not specifically related to gentamicin use.
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A nurse monitors a patient who is receiving an aminoglycoside (gentamicin) for symptoms of vestibular damage. Which finding should the nurse expect the patient to have first? Unsteadiness Vertigo Headache Dizziness
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Headache Gentamicin causes irreversible ototoxicity, which results in both impaired hearing and disruption of balance. Headache is the first sign of impending vestibular damage (balance) and may last 1 to 2 days. Unsteadiness, vertigo, and dizziness appear after headache
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The nurse knows that there is an increased risk of ototoxicity in a patient receiving an aminoglycoside if which level is high? Concentration Trough Peak Dose
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Trough When trough levels remain elevated, aminoglycosides are unable to diffuse out of inner ear cells, thus exposing the cells to the medication for an extended time. Prolonged exposure (i.e., high trough levels), rather than brief exposure to high levels, underlies cellular injury.
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A patient who is receiving an aminoglycoside develops flaccid paralysis and impaired breathing. Which medication does the nurse anticipate administering? Magnesium sulfate (Epsom salt) Potassium chloride (K-Dur) Sodium bicarbonate (Citrocarbonate) Calcium gluconate (Kalcinate)
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Calcium gluconate (Kalcinate) Flaccid paralysis and impaired breathing are signs of impaired neuromuscular transmission, which may occur with aminoglycosides, especially if they are administered concurrently with a neuromuscular blocking agent. Impaired transmission can be reversed with intravenous infusion of a calcium salt (calcium gluconate). Magnesium sulfate, potassium chloride, and sodium bicarbonate do not reverse impaired neuromuscular transmission caused by aminoglycosides.
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Before administering an aminoglycoside, it is most important for the nurse to assess the patient for a history of what? Myasthenia gravis Asthma Incorrect Hypertension Diabetes mellitus
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Myasthenia gravis Aminoglycosides can inhibit neuromuscular transmission, causing flaccid paralysis and potentially fatal respiratory depression. These drugs should be used with extreme caution in patients with myasthenia gravis.
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Which statements about ototoxicity and aminoglycosides does the nurse identify as true? (Select all that apply.) The risk of ototoxicity is related primarily to excessive peak levels. The first sign of impending cochlear damage is headache. The first sign of impending vestibular damage is tinnitus . Ototoxicity is largely irreversible. Use of aminoglycosides for less than 10 days is recommended to avoid ototoxicity.
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Ototoxicity is largely irreversible. Use of aminoglycosides for less than 10 days is recommended to avoid ototoxicity. Ototoxicity is largely irreversible. Use of aminoglycosides for less than 10 days is recommended to avoid ototoxicity.
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Which statements about serum drug levels does the nurse identify as true? (Select all that apply.) With once-daily dosing, only trough levels need to be drawn. Peak levels for intramuscular (IM) injections should be drawn 30 minutes after administration of the medication. The trough level ideally should be close to zero. For patients receiving once-daily doses, the sample should be drawn 2 hours before the next dose. For patients receiving divided doses, trough levels should be drawn 1 hour before the next dose. For patients receiving once-daily doses, the sample should be drawn 1 hour before the next dose.
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With once-daily dosing, only trough levels need to be drawn. Peak levels for intramuscular (IM) injections should be drawn 30 minutes after administration of the medication. The trough level ideally should be close to zero. For patients receiving divided doses, trough levels should be drawn immediately before the next dose. The other three statements are true.
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A patient is receiving local applications of mafenide (Sulfamylon) to burn areas. Before application, it is most important for the nurse to do what? Administer a pain medication. Obtain a set of vital signs. Auscultate the lung fields. Obtain a signed consent form.
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Administer a pain medication The sulfonamide mafenide (Sulfamylon) is used to suppress bacterial colonization in patients with burns. Local application frequently is painful. It is important to administer a pain medication before applying mafenide (Sulfamylon). Obtaining vital signs and a signed informed consent form and auscultating lung fields are not essential actions for mafenide application.
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When providing patient teaching for oral sulfonamide therapy, the nurse should instruct the patient to take the sulfonamide in what way? At mealtime, when food is available With soy or nonmilk products Between meals with a full cup of water On awakening before breakfast
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Between meals with a full cup of water Oral sulfonamides should be taken on an empty stomach and with a full glass of water. To minimize the risk of renal damage, adults should maintain a daily urine output of 1200 mL. Sulfonamides should not be taken with soy or nonmilk products or food or before breakfast without liquids.
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Before administering trimethoprim, it is most important for the nurse to assess the patient for a history of what? Heart failure Alcoholism Diabetes Emphysema
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Alcoholism Trimethoprim inhibits bacterial synthesis of folic acid. It is avoided in patients when folate deficiency is likely, such as in alcoholism, because bone marrow suppression may occur.
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A patient who has acquired immunodeficiency syndrome (AIDS) is receiving trimethoprim/sulfamethoxazole (Bactrim). Which response should a nurse expect if the medication is achieving the desired effect? Increase in CD4 T cells Increased appetite and weight gain Resolution of pneumonia Decrease in joint pain
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Resolution of pneumonia Trimethoprim/sulfamethoxazole is the treatment of choice for Pneumocystis pneumonia (PCP), an infection caused by Pneumocystis jiroveci (formerly thought to be Pneumocystis carinii). PCP is an opportunistic pneumonia caused by a fungus that thrives in immunocompromised hosts. It does not increase the number of CD4 T cells, the targeted cells of the human immunodeficiency virus (HIV), nor does it affect joint pain. Increased appetite and weight gain are not therapeutic actions of trimethoprim/sulfamethoxazole.
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When caring for a patient receiving mafenide (Sulfamylon) for treatment of a severe burn, it is most important for the nurse to monitor which laboratory value? Blood glucose level Acid-base status Sodium level Peak mafenide level
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Acid-base status Mafenide (Sulfamylon) therapy is associated with the development of acidosis. Peak mafenide levels are not obtained. The blood glucose and sodium levels are not affected by mafenide.
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The nurse identifies which statements about Stevens-Johnson syndrome as true? (Select all that apply.) Patients with Stevens-Johnson syndrome have a mortality rate of about 25%. Toxemia is associated with Stevens-Johnson syndrome. Short-acting sulfonamides do not induce Stevens-Johnson syndrome. Patients with Stevens-Johnson syndrome usually are hypothermic. Lesions of the mucous membranes are a characteristic of Stevens- Johnson syndrome.
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Patients with Stevens-Johnson syndrome have a mortality rate of about 25% Toxemia is associated with Stevens-Johnson syndrome. Lesions of the mucous membranes are a characteristic of Stevens- Johnson syndrome. Short-acting sulfonamides do induce Stevens-Johnson syndrome on rare occasions, and patients with Stevens-Johnson syndrome usually are hyperthermic. The other three statements are true.
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Which manifestations does the nurse associate with the development of hemolytic anemia? (Select all that apply.) Urticaria Fever Pallor Jaundice Diarrhea
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Fever Pallor Jaundice Urticaria and diarrhea are not associated with the development of hemolytic anemia. Fever, pallor, and jaundice are associated with the development of hemolytic anemia.
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A nurse is teaching a patient who is scheduled to start taking itraconazole (Sporanox). Which statement by the patient would indicate understanding of the teaching? "I'll take diphenhydramine (Benadryl) before this medication so I don't have a reaction." "It's important to remember to wear sunscreen while taking this medicine." "I'll avoid citrus foods, such as oranges and grapefruits, while taking this medication." "If I notice my skin turning yellow or feel any nausea, I'll notify my healthcare provider.
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"If I notice my skin turning yellow or feel any nausea, I'll notify my healthcare provider. Itraconazole may cause liver injury, and although a causal link has not been identified, patients need to be informed about symptoms to report. These include jaundice, nausea, and right upper abdominal pain. It is not necessary to take diphenhydramine, wear sunscreen, or avoid citrus products while taking itraconazole.
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A patient is scheduled to receive intravenous amphotericin B. Which medication should a nurse administer as pretreatment before the infusion? 10 units of regular insulin intravenously 20 mg famotidine (Pepcid) in 50 mL of 5% dextrose 50 mg of diphenhydramine (Benadryl) and 650 mg of acetaminophen 1 g of calcium gluconate in 100 mL of normal saline
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50 mg of diphenhydramine (Benadryl) and 650 mg of acetaminophen Almost all patients given intravenous amphotericin B develop fever, chills, and nausea. Pretreatment with diphenhydramine and an analgesic, such as acetaminophen, can minimize or prevent these adverse effects. It is not beneficial to administer calcium gluconate, insulin, or famotidine as pretreatment.
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Which antifungal agent is used as a one-time oral dose to treat vaginal yeast infections? Nystatin (Mycostatin) Caspofungin (Cancidas) Voriconazole (Vfend) Fluconazole (Diflucan)
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Fluconazole (Diflucan)
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A nurse is administering an oral dose of itraconazole (Sporanox) to a patient at 10:00 AM. The nurse should administer a prescribed dose of famotidine (Pepcid) at which time? 9:00-9:30 AM 10:00 AM 10:30 AM 11:00 AM
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9:00-9:30 AM Medications that lower gastric acidity, such as famotidine (Pepcid), can reduce absorption of oral itraconazole (Sporanox) Those agents should be given at least 1 hour before itraconazole or 2 hours after. The other time administrations would interfere with absorption of itraconazole.
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It is most important for the nurse to assess a patient taking itraconazole (Sporanox) for the development of what? Hair loss Skin rash Pedal edema Joint pain
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Pedal edema Itraconazole (Sporanox) has negative inotropic actions and may cause a transient decrease in the ventricular ejection fraction, thus precipitating heart failure. Pedal edema is a symptom of heart failure, and the nurse should assess for it. Skin rash, hair loss, and joint pain are unrelated to the use of itraconazole.
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A patient is receiving amphotericin B. It is most important for the nurse to monitor which laboratory result? Serum pH Protein level Glucose level Creatinine level
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Creatinine level Amphotericin B is toxic to cells of the kidneys. To evaluate renal injury, the plasma creatinine level should be monitored every 3 or 4 days, as well as intake and output. It is not necessary to monitor the serum protein or glucose levels or the serum pH in patients taking amphotericin B.
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When providing teaching for a patient starting flucytosine (Ancobon) therapy, the nurse identifies what as the priority concern? "You will have weekly blood draws to monitor your liver function." "Another very strong medication may be needed in addition to this one." "You'll need to report any symptoms of bruising, fever, and fatigue." "The dose is 10 pills, so take a few at a time over a 15-minute interval."
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"You'll need to report any symptoms of bruising, fever, and fatigue." Flucytosine (Ancobon) is used for serious infections caused by Candida and Cryptococcus neoformans. Bone marrow suppression may cause fatal agranulocytosis, so symptoms of bruising, fever, and fatigue could indicate life-threatening conditions. The other statements are true; however, they are not the priority concern. Flucytosine (Ancobon) is usually combined with amphotericin B. Treatment may require ingestion of 10 capsules 4 times per day. Taking these pills for a short time helps to reduce nausea. Hepatotoxicity is mild and reversible; liver function is monitored while the patient is receiving treatment.
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A patient is receiving amphotericin B. The nurse identifies which medication as useful in preventing adverse effects of amphotericin B? Furosemide (Lasix) Insulin Vitamin K Potassium
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Potassium Renal injury from amphotericin B may cause severe hypokalemia. Serum potassium levels should be monitored more frequently and potassium supplements given to correct low plasma levels. Furosemide, insulin, and vitamin K do not prevent any adverse effects of amphotericin B.
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e nurse identifies terbinafine (Lamisil) as useful for treating which conditions? (Select all that apply.) Onychomycosis Tinea corporis Oropharyngeal candidiasis Vulvovaginal candidiasis Tinea pedis
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Onychomycosis Correct Tinea corporis Correct Tinea pedis Terbinafine (Lamisil) is highly active against dermatophytes and is used to eradicate fungal infection of the nails (onychomycosis) and as topical therapy for ringworm infections (tinea corporis, tinea pedis). It is not effective against oropharyngeal and vulvovaginal candidiasis.
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Which approach should a nurse take to administer intravenous (IV) acyclovir (Zovirax) to an immunocompromised patient? Infuse IV fluids during administration of the dose and for 2 hours afterward. Administer IV acyclovir diluted in 20 mL normal saline (NS) over 10 minutes. Only infuse the drug if the white blood cell (WBC) count is above 2500/mm3 . Ask the provider to change the route to subcutaneous (subQ) injection.
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Infuse IV fluids during administration of the dose and for 2 hours afterward. Acyclovir can cause renal damage, and hydration of the patient during the infusion and for 2 hours afterward minimizes this risk. Acyclovir is not given by IV bolus or by intramuscular (IM) or subQ injection. It is used to treat infections in immunocompromised patients, but the dose is not changed or affected by the WBC count.
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A nurse is preparing to administer ganciclovir (Cytovene) to a patient for treatment of Cytomegalovirus (CMV) pneumonitis. Which laboratory result should the nurse recognize as a contraindication to use of this drug? Neutrophil count below 500/mm3 Platelet count of 350,000/mm3 Serum calcium level of 9.5 mg/dL Reduced forced vital capacity (FVC)
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Neutrophil count below 500/mm3 Ganciclovir is used to treat and prevent CMV infection in immunocompromised patients. Bone marrow suppression is a dose-limiting toxicity of ganciclovir; therefore, the drug is contraindicated in patients with neutrophil counts below 500/mm3 or platelet counts below 25,000/mm3. It does not affect the serum calcium level or FVC, a measure of lung function in patients who have airflow-restrictive disorders.
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A patient is receiving weekly subcutaneous injections of peg-interferon-alfa-2a (Pegasys) for chronic hepatitis C. A nurse teaches the patient that which adverse effect will diminish with continued therapy? Black, sticky, tarry stools Lower leg muscle weakness Dyspnea and wheezing Flulike symptoms
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flulike symptoms The most common adverse side effect of peg-interferon-alfa-2a, a long-acting interferon used to treat chronic hepatitis C, is flulike symptoms characterized by fever, fatigue, myalgia, headache, and chills. Symptoms are likely to diminish with continued therapy over time. Black, tarry stools; lower leg muscle weakness; dyspnea; and wheezing are not adverse effects of peg-interferon-alfa-2a.
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What is the priority instruction a nurse gives to a male patient who is scheduled to receive ribavirin (Rebetol) combined with peg-interferon-alfa-2a for treatment of hepatitis C? "Combining these two medications will greatly increase response rates." "An antidepressant can be prescribed to alleviate symptoms of depression." "If you are sexually active, use two reliable forms of birth control to prevent pregnancy." "It is very important that you have blood counts checked every 2 weeks."
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"If you are sexually active, use two reliable forms of birth control to prevent pregnancy." Because ribavirin is embryolethal when taken by female patients and causes sperm abnormalities when taken by males, it is a priority that pregnancy be avoided during its use. Pregnancy must be avoided both by female patients and by female partners of men taking ribavirin. Couples should use two reliable forms of birth control during treatment and for 6 months afterward. It is less important that the patient know that ribavirin is not effective against hepatitis C unless it is combined with interferon alfa.
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A nurse should recognize that for maximum therapeutic effects against the influenza virus, oseltamivir (Tamiflu) should be taken when? Two days or more after symptom onset When lung crackles are present Within 12 hours of symptom onset Only when fever is above 102°F
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Within 12 hours of symptom onset Oseltamivir is a neuraminidase inhibitor that is effective against the influenza A and influenza B viruses. Its benefits decline greatly when treatment is delayed. Dosing must begin early—no later than 2 days after symptom onset. If treatment is started within 12 hours of symptom onset, symptom duration is reduced by more than 3 days. Specific symptoms, such as lung crackles and fever above 102°F, are not criteria for receiving oseltamivir.
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A nurse administering flu vaccines at an annual clinic should recognize that which individuals should be vaccinated, as recommended by the Advisory Committee on Immunization Practices (ACIP)? (Select all that apply.) Women who will be pregnant during flu season Correct All children 6 months and older and older adults Correct Those who report severe allergy to chicken eggs Those who have a history of Guillain-Barré syndrome Those 6 months to 18 years old receiving aspirin therapy Correct
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The ACIP recommends flu vaccination for all children 6 months and older and for older adults. Individuals at high risk of complications from the flu who also should be vaccinated include women who will be pregnant during flu season and children receiving long-term therapy with aspirin (to prevent Reye's syndrome). Influenza vaccines are produced from viruses grown in eggs and should be avoided in persons with allergies to chicken eggs. Influenza vaccine may carry a small risk of Guillain-Barré syndrome, a paralyzing neuromuscular disorder, and should be avoided in those who have experienced it.
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A patient has been diagnosed with respiratory syncytial virus. The nurse anticipatates administration of which drug(s)? (Select all that apply._ Ganciclovir Oseltamivir Ribavirin (inhaled) Correct Palivizumab Correct Entecavir
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Ribavirin (inhaled) and Palivizumab are used for the treatment of RSV. Ganiciclovir is useful in the treatment of cytomegalovirus. Oseltamivir is used for the treatment of Influenza A and B. Entacavir is a nucleoside analog used in the treatment of HBV.
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A patient has been prescribed efavirenz (Sustiva). The nurse should instruct the patient to use which administration approach to minimize central nervous system (CNS) adverse effects? The drug should be taken in divided doses throughout the day. Bedtime dosing is most effective. Correct The drug should be mixed only with an acidic beverage.
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A steroid medication should be used concurrently. Efavirenz frequently causes CNS symptoms of dizziness, impaired consciousness, drowsiness, vivid dreams, and nightmares. Bedtime dosing can minimize CNS effects, which typically resolve in 2 to 4 weeks. Mixing with an acidic beverage, using a steroid medication concurrently, and taking efavirenz in divided doses throughout the day are not effective means of minimizing CNS effects.
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A nurse should recognize that which laboratory result is used as a major factor in deciding when antiretroviral therapy is indicated for a patient infected with HIV? Plasma HIV RNA assay CD4 T-lymphocyte count Correct Western blot assay OralQuick Rapid HIV-1 Antibody Test
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The CD4 T-cell count is the principal indicator of how much immunocompetence remains when a patient is infected with HIV. It is used as a guide in the initiation, discontinuation, and resumption of medications for opportunistic infections. A plasma HIV RNA assay is a measure of viral load that indicates HIV replication and magnitude and accordingly is used to predict clinical outcomes. The Western blot assay and OralQuick Rapid HIV-1 Antibody Test, respectively, are used for initial screening and follow-up confirmation of HIV infection.
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A nurse should teach a patient who has Pneumocystis pneumonia (PCP) about the dosing and therapeutic effects of which medication? Trimethoprim/sulfamethoxazole (Bactrim) Correct Azithromycin (Zithromax) Acyclovir (Zovirax) Ganciclovir (Cytovene)
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PCP is a potentially fatal infection caused by Pneumocystis jiroveci. Among people with advanced HIV infection, it is the most common opportunistic infection. The preferred regimen for treatment and prophylaxis of PCP is trimethoprim/sulfamethoxazole. Azithromycin is used in the treatment of Mycobacterium avium infection. Cytomegalovirus (CMV) retinitis is treated with ganciclovir. Acyclovir is the preferred treatment of varicella-zoster virus, which causes chickenpox and herpes zoster.
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Which antiseptics should a nurse choose to prepare intact skin before an invasive procedure? (Select all that apply.) Chlorhexidine gluconate (Hibiclens) Correct Ethanol (ethyl alcohol) Correct Hydrogen peroxide (Durox) Povidone-iodine (Betadine) Correct Hexachlorophene (pHisoHex)
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Chlorhexidine gluconate, ethanol, and povidone-iodine can be used as topical antiseptic agents. Hydrogen peroxide and hexachlorophene can be caustic, causing burns of the skin or mucous membranes.
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The nurse has just administered the first dose of haloperidol (Haldol) to a patient with schizophrenia. Which finding, if present, is the most important for the nurse to report to the healthcare provider before administering the next dose of medication? Dry mouth Temperature of 101 °F Correct BP of 104/72 mm Hg Drowsiness
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Sudden high fever is a symptom of neuroleptic malignant syndrome, a rare but serious complication of high-potency, first-generation antipsychotics, such as haloperidol. The other findings are potential side effects of the drug but would not necessarily need to be reported to the healthcare provider.
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The nurse is caring for a patient receiving clozapine (Clozaril). Which assessment finding is most indicative of an adverse effect of this drug? Blood urea nitrogen level of 25 mg/dL Blood glucose level of 60 mg/dL Bilirubin level of 2.5 mg/dL
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White blood cell (WBC) count of 2000/mm3 Correct Clozapine, an atypical antipsychotic, carries a risk of fatal agranulocytosis. For this reason, the WBC count should be monitored and should be greater than 3500/mm3. Renal function (blood urea nitrogen) should not be affected by clozapine. Clozapine may cause metabolic effects, including diabetes, that would result in an increased blood glucose level (greater than 110 mg/dL). Elevated bilirubin indicates liver disease and is not commonly an adverse effect of clozapine.
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Which statement about aripiprazole would the nurse identify as true? It is the first representative of a unique class of antipsychotic drugs called dopamine system stabilizers . Correct It must be administered on an empty stomach. Gynecomastia is a common adverse effect. Incorrect It is safe to use in older adult patients with dementia-related psychosis.
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Aripiprazole is well absorbed in the presence and absence of food, and gynecomastia is not a side effect. Increased mortality is seen when aripiprazole is used in the treatment of older adult patients with dementia-related psychosis.
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A nurse is caring for several patients. In which patient is it appropriate to use the drug chlorpromazine (Thorazine)? (Select all that apply.) An 85-year-old man with Alzheimer's disease A 78-year-old man with intractable hiccups Correct A 76-year-old woman with severe dementia A 48-year-old woman with schizoaffective disorder Correct A 30-year-old man with anxiety and depression
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The primary indications for chlorpromazine, a first-generation antipsychotic agent, are schizophrenia and other psychotic disorders. It may also be used for schizoaffective disorder, bipolar disorder, suppression of emesis, and relief of intractable hiccups. Antipsychotics are not used for dementia because of increased mortality. Chlorpromazine is not a primary treatment for Alzheimer's disease or depression.
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The nurse is working with the multidisciplinary healthcare team to optimize the care of a patient with schizophrenia. Which concepts will guide the nursing care of this patient? (Select all that apply.) The second-generation antipsychotics generally are more effective than the first-generation agents. Most antipsychotic agents increase the risk of mortality in elderly patients with dementia. Correct Antipsychotic depot preparations carry a greater risk of neuroleptic malignant syndrome. The lipid levels of patients receiving second-generation antipsychotics should be monitored. Correct Schizophrenia is characterized by disordered thinking and loss of touch with reality. Correct
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The first- and second-generation antipsychotics are considered equally effective, even though the second-generation agents are more widely used today. Most antipsychotics should be avoided in elderly patients with dementia because of increased mortality. Antipsychotic depot preparations are effective for the long-term control of schizophrenia and do not have an increased risk of side effects. Second-generation antipsychotics may cause weight gain, diabetes, and dyslipidemia. Schizophrenia is characterized by disordered thinking and loss of touch with reality. Awarded 3.0 points out of 3.0 possible points.
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Which statement does the nurse include when teaching a patient about antipsychotic drug therapy? (Select all that apply.) "Restrict the use of antipsychotic drugs to 3 months to prevent the development of addiction." "Dilute oral preparations in fruit juice to improve their palatability." Correct "Store oral preparations in a dark area." Correct "Do not make skin contact with these drugs; flush the affected area with water if a spill occurs." Correct "Take an over-the-counter sleep aid if you have trouble falling asleep at night."
answer
Patients should be informed that antipsychotic drugs do not cause addiction and that they should be taken as prescribed. Patients should be instructed to avoid all drugs with anticholinergic properties, including the antihistamines and certain over-the-counter sleep aids to prevent drug interactions. All other statements are appropriate to include in teaching the patient about the use of antipsychotic medications
question
When teaching the patient and family about clozapine therapy, which statements should the nurse include? (Select all that apply.) "It is important for you to obtain ordered blood tests when taking this medication." Correct "Most patients who take this medication lose weight, so you should increase the number of calories you consume each day." "If you experience increased urination, increased thirst, or increasd appetite, contact your healthcare provider." Correct " Inform your healthcare provider if you are taking any medications to control seizures." Correct "Contact your healthcare provider if you experience any unexplained tiredness, shortness of breath, increased respirations, chest pain, or heart palpitations." Correct
answer
Clozapine can cause agranulocytosis. Patients should be taught that clozapine will not be dispensed without repeated proof of blood counts. Patients taking clozapine are at increased risk of weight gain and dyslipidemia; they should be taught about the risk of weight gain and encouraged to control caloric intake and get regular exercise. Patients should be informed about early signs of infection (fever, sore throat, fatigue, mucous membrane ulceration) and instructed to notify their healthcare provider immediately if these should develop. Patients taking clozapine are at increased risk for the development of diabetes mellitus; they should be taught about symptoms of diabetes (e.g., hyperglycemia, polyuria, polydipsia, polyphagia, dehydration) and instructed to contact the prescriber if these occur. Clozapine should be used with caution in patients with seizure disorders. In rare cases, clozapine causes myocarditis; patients should be informed about the signs and symptoms (e.g., unenplained fatigue, dyspnea, tachypnea, chest pain, palpitations) and advised to seek immediate medical attention if these develop. Clozapine should be withheld until myocarditis has been ruled out. If myocarditis is diagnosed, the drug should never be used again.
question
The nurse is planning care for a patient taking imipramine (Tofranil). Which finding, if present, would most likely be an adverse effect of this drug? Blood pressure of 160/90 mm Hg Incorrect Insomnia and diarrhea Sedation and dry mouth Correct Tachypnea and wheezing
answer
Anticholinergic effects (dry mouth, blurred vision, constipation, tachycardia, urinary retention) and sedation are potential adverse effects of the tricyclic antidepressants (TCAs), such as imipramine (Tofranil). The most serious common adverse effect is orthostatic hypotension; therefore, a blood pressure of 160/90 mm Hg probably is not caused by this drug. Respiratory problems are not commonly associated with the TCAs.
question
The nurse is caring for a patient receiving fluoxetine (Prozac) for depression. Which adverse effect is most likely associated with this drug? Sexual dysfunction Correct Dry mouth Orthostatic hypotension Bradycardia
answer
Fluoxetine (Prozac), a selective serotonin reuptake inhibitor (SSRI), does not cause anticholinergic effects, orthostatic hypotension, or cardiotoxicity, as do the tricyclic antidepressants. The most common adverse effects are sexual dysfunction, nausea, headache, and central nervous system stimulation.
question
The nurse is caring for a patient in the emergency department who reports the onset of agitation, confusion, muscle twitching, diaphoresis, and fever about 12 hours after beginning a new prescription for escitalopram (Lexapro). Which is the most likely explanation for these symptoms? Depressive psychosis Serotonin syndrome Correct Escitalopram overdose Cholinergic crisis
answer
Serotonin syndrome can occur within 2 to 72 hours after initiation of treatment with an SSRI. The symptoms include altered mental status, incoordination, myoclonus, hyperreflexia, excessive sweating, tremor, and fever.
question
The nurse is preparing to administer phenelzine (Nardil) to a patient with depression. Why is this drug considered a second- or third-line agent in the treatment of depression? It increases the risk of suicide in the early phase. It is less effective than the tricyclic antidepressants. It increases the risk of psychoses and parkinsonism. It has more side effects and drug interactions. Correct
answer
Phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI), is considered a second- or third-line treatment because of the risk of triggering hypertensive crisis when the patient eats foods high in tyramine. Also, an increased incidence of drug-drug interactions is seen with phenelzine. Phenelzine does not pose an increased risk for suicide, psychoses, or parkinsonism, and it is as effective as the tricyclic and SSRI antidepressants.
question
A nurse teaches a patient who takes an MAOI about important dietary restrictions. Which foods will the nurse caution the patient to avoid? Aged cheese and sherry Correct Grapefruit and other citrus juices Coffee, colas, and tea Potato and corn chips
answer
Foods that contain tyramine can produce a hypertensive crisis in individuals taking MAOI antidepressants. Many aged foods contain tyramines.
question
The nurse is caring for a group of patients being treated for depression. Why might an SSRI be chosen over a TCA? To reduce the risk of suicide with overdose Correct To avoid weight gain and other gastrointestinal (GI) effects To help prevent sexual dysfunction To prevent the risk of serotonin syndrome Incorrect
answer
The SSRIs may be chosen because they have fewer side effects and are safer with overdose. However, the SSRIs can cause sexual dysfunction and weight gain, and they carry a risk of serotonin syndrome.
question
The nurse identifies which most common serious adverse effect of TCA therapy? Sedation Orthostatic hypotension Correct Skin rash Sexual dysfunction Incorrect
answer
Orthostatic hypotension is the most common adverse effect of tricyclic antidepressant therapy.
question
The nurse is teaching a patient who has a new prescription for citalopram (Celexa). Which statement is appropriate to include in the teaching plan? (Select all that apply.) "This medication may cause some sexual side effects. Let your healthcare provider know about this if it occurs." Correct "When you stop taking this medication, you should not withdraw it abruptly." Correct "You will need to move slowly from a sitting to a standing position to prevent dizziness from low blood pressure." "This medication often causes drowsiness. You should take it at bedtime." Incorrect "Let your family or your healthcare provider know if you experience a worsening mood, agitation, or increased anxiety." Correct
answer
Citalopram (Celexa) and other SSRIs can cause sexual side effects that patients may be hesitant to report. SSRIs should be withdrawn slowly to prevent dizziness, headache, dysphoria, and/or other symptoms of withdrawal. The SSRIs do not generally cause orthostatic hypotension or drowsiness. All antidepressants initially increase the risk of suicide, and patients should be monitored for worsening mood and other signs of suicide risk.
question
Which instruction does the nurse include when teaching a patient about phenelzine (Nardil) therapy? (Select all that apply.) "Take the medication as needed when you are feeling depressed." "If you experience a severe headache, inform your healthcare provider." Correct "Profuse sweating is an expected side effect of this medication and will diminish with time." Incorrect "Ginseng can be used to treat headache, which patients often experience when they first take phenelzine." "Avoid eating avocados when taking this drug." Correct
answer
Patients should be instructed to take MAOIs every day as prescribed—not PRN. They should be warned not to discontinue treatment once mood has improved, because doing so may result in relapse. Patients should be informed of the symptoms of hypertensive crisis--severe headache, tachycardia, hypertension, nausea, vomiting, confusion, and profuse sweating—and instructed to seek immediate medical attention if these develop. Patients should be forewarned of the hazard of hypertensive crisis and the need to avoid tyramine-rich foods, such as aged cheese, Chianti, and avocados. (Patients on low-dose transdermal selegiline need not avoid foods containing tyramine.) Patients taking MAOIs should not take ginseng, because headache, tremulousness, and maniclike reactions have occurred.
question
Which drug does the nurse identify as a selective serotonin reuptake inhibitor? (Select all that apply.) Bupropion (Wellbutrin) Imipramine (Tofranil) Fluoxetine (Prozac) Correct Desvenlafaxine (Pristiq) Sertraline (Zoloft) Correct
answer
Fluoxetine (Prozac) and sertraline (Zoloft) are selective serotonin reuptake inhibitors. Bupropion (Wellbutrin) is an atypical antidepressant. Imipramine (Tofranil) is a tricyclic antidepressant. Desvenlafaxine (Pristiq) is a serotonin/norepinephrine reuptake inhibitor (SNRI).
question
The nurse knows that which statements about postpartum depression are true? (Select all that apply.) About 80% of women experience depressive symptoms after giving birth. Correct Thyroid insufficiency has been indicated as a contributing factor in postpartum depression. Correct Monoamine oxidase inhibitors are the first-line agents of choice for the treatment of postpartum depression. Once a woman has had postpartum depression, it will not recur with future deliveries. Sertraline (Zoloft) is the drug of choice for treating postpartum depression in breast-feeding mothers. Correct
answer
The drug of choice for postpartum depression is an SSRI, such as sertraline (Zoloft), because these drugs are effective, well tolerated, and present little risk of toxicity if taken in overdose. If a woman has responded to another antidepressant in the past, that drug should be used first. The risk of relapse is high, as is the risk of postpartum depression with subsequent pregnancies. The statements in options C and D are false.
question
The nurse is caring for a patient with bipolar disorder (BPD) who is taking lithium (Lithobid). Which abnormal laboratory value is most essential for the nurse to communicate to the healthcare provider because this patient is taking lithium? Sodium level of 128 mEq/L Correct Prothrombin time of 8 seconds Blood urea nitrogen level of 25 mg/dL Potassium level of 5.6 mEq/L
answer
The sodium level is well below the normal range of 135 to 145 mEq/L. When the serum sodium level is reduced, lithium excretion also is reduced, and lithium accumulates. Because lithium has a narrow therapeutic index, this is a dangerous situation, which can result in symptoms of toxicity and even death.
question
The nurse is seeing several patients in the outpatient clinic today. Which patient most requires the nurse's immediate attention? A female patient with BPD who takes valproic acid (Depakene) and who reports nausea and vomiting. Incorrect A male patient with BPD who takes lithium and who has a lithium level of 1.6 mEq/L. Correct A male patient with depression who takes fluoxetine (Prozac) and who reports sexual dysfunction. A female patient with schizophrenia who takes haloperidol (Haldol) and who has a blood pressure of 102/72 mm Hg.
answer
Lithium levels above 1.5 mEq/L should be reported, because this level may indicate impending serious toxicity. The other findings may be side effects of the drugs the patients are taking, but they are not priority problems.
question
The nurse is caring for a patient taking lithium (Lithobid). The nurse understands that many drugs interact with lithium. Which agent is safe to administer with lithium? Ibuprofen (Motrin) for muscle pain Hydrochlorothiazide (HCTZ) for edema Aspirin (ASA) for mild headache Correct Diphenhydramine (Benadryl) for cold symptoms Incorrect
answer
Aspirin is safe to use as an analgesic with lithium. Other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can increase lithium levels by as much as 60%. Diuretics increase lithium levels by reducing the serum sodium level. Diphenhydramine has anticholinergic properties and can aggravate lithium-induced polyuria by causing urinary hesitancy.
question
The nurse identifies which drug as the principal mood stabilizer used in the treatment of bipolar disorder? (Select all that apply.) Lithium Correct Risperidone Incorrect Divalproex sodium (Valproate) Correct Carbamazepine Correct Venlafaxine (Effexor)
answer
Lithium, divalproex sodium (Valproate), and carbamazepine are the principal mood stabilizers used in the treatment of bipolar disorder. Risperidone is an antipsychotic used in the management of bipolar disorder. Venlafaxine (Effexor) is an antidepressant used in the treatment of bipolar disorder.
question
Which statement or statements about the treatment of bipolar disorder does the nurse identify as true? (Select all that apply.) Mood stabilizers are used to prevent recurrent manic-depressive episodes. Correct Antipsychotics are used to treat depressive episodes. Antidepressants should be used with mood stabilizers in the treatment of patients with bipolar depression. Correct Lithium and valproate are the preferred mood stabilizers for BPD. Correct A lithium level of 2.0 mEq/L is considered therapeutic Incorrect
answer
The statements in options A, C, and D are true. Antipsychotics are used to treat manic episodes. A lithium level above 1.5 mEq/L is considered to be above the therapeutic index.
question
The nurse is caring for a group of patients who have been prescribed sedative-hypnotic agents. Which agent has the greatest abuse potential? Diazepam (Valium) Triazolam (Halcion) Zolpidem (Ambien) Phenobarbital (Luminal Sodium)
answer
Phenobarbital is a barbiturate drug that carries a higher abuse potential than the benzodiazepine or benzodiazepine-like drugs.
question
Alprazolam (Xanax) is prescribed for an adult with panic attacks. The nurse recognizes that this drug exerts its therapeutic effect by interacting with which neurotransmitter? Norepinephrine Acetylcholine Serotonin (5-HT) Gamma-aminobutyric acid (GABA) Correct
answer
Alprazolam is a benzodiazepine; this class of drugs reduces anxiety by potentiating the action of GABA.
question
Which agent is most likely to be prescribed today for short-term management of insomnia? Secobarbital (Seconal Sodium) Meprobamate (Miltown) Zolpidem (Ambien) Flumazenil (Romazicon)
answer
Zolpidem is a benzodiazepine-like drug that is widely used in the treatment of insomnia. It is safer than the barbiturates (secobarbital) or miscellaneous sedative-hypnotics (meprobamate). Flumazenil is a reversal agent for the benzodiazepines.
question
The nurse is caring for a patient with a seizure disorder who takes mephobarbital (Mebaral) at bedtime each night to control seizures. Which symptom, if present, would most likely indicate an adverse effect of this drug? Morning sedation Correct A respiratory rate of 30 breaths per minute Constipation A blood pressure of 160/88 mm Hg
answer
The adverse effects of the barbiturates include respiratory depression, risk of suicide, risk of abuse, and hangover (sedation, impaired judgment, and reduced motor skills).
question
The nurse in the emergency department is caring for a patient with a suspected overdose of diazepam (Valium). Which agent is most likely to be administered to reverse the effects of diazepam? Naloxone (Narcan) Flumazenil (Romazicon) Correct Acetylcysteine (Mucomyst) Vitamin K
answer
Flumazenil (Romazicon), a benzodiazepine receptor antagonist, is the treatment of choice for overdose of the benzodiazepine diazepam (Valium). Naloxone (Narcan) is used to reverse opioid overdose. Acetylcysteine (Mucomyst) is used to reverse acetaminophen (Tylenol) overdose. Vitamin K is used to reverse warfarin toxicity.
question
Which statement or statements about zaleplon (Sonata) does the nurse identify as true? (Select all that apply.) Zaleplon (Sonata) is a benzodiazepine. Incorrect Zaleplon (Sonata) is indicated for long-term management of insomnia. Zaleplon (Sonata) is used to maintain sleep throughout the night. Incorrect Zaleplon (Sonata) should not be administered with cimetidine (Tagamet). Correct Zaleplon (Sonata) interacts with the neurotransmitter GABA. Correct
answer
Zaleplon (Sonata) belongs to a new class of drugs called the pyrazolopyrimidines. It is indicated for short-term management of insomnia. Zaleplon has a rapid onset and short duration of action and therefore is beneficial for initiating sleep but not for maintaining it throughout the night. Zaleplon and cimetidine should not be administered together. Zaleplon interacts with the neurotransmitter GABA.
question
When comparing benzodiazepines to barbiturates, the nurse identifies which statement about benzodiazepines as true? (Select all that apply.) Benzodiazepines have a high safety profile. Correct Benzodiazepines have a significant ability to depress central nervous system (CNS) function. Benzodiazepines are associated with a high suicide potential. Benzodiazepines have a low ability to cause tolerance. Correct
answer
Benzodiazepines have a low abuse potential. Correct Statements A, D, and E are true. Compared to barbiturates, benzodiazepines have a low suicide potential and low ability to cause CNS depression.
question
The nurse is caring for a patient with severe generalized anxiety disorder. Which agent would be most effective for immediate stabilization? Venlafaxine (Effexor) Buspirone (BuSpar) Paroxetine (Paxil) Alprazolam (Xanax) Correct
answer
Alprazolam, a benzodiazepine, would provide the most rapid onset of relief. Buspirone, paroxetine, and venlafaxine are also first-line agents for the treatment of generalized anxiety disorder, but their onset is delayed. They are preferred for long-term management.
question
The nurse is caring for a patient receiving buspirone (BuSpar) for the treatment of anxiety. Which symptom is most likely explained as an adverse effect of this drug? Drowsiness Risk for abuse Dizziness Correct Weight gain Incorrect
answer
Buspirone is an antianxiety medication with few side effects. The most common effects are dizziness, nausea, headache, nervousness, lightheadedness, and excitement. Buspirone does not cause drowsiness, risk for abuse, or weight gain.
question
A distraught patient is admitted to the emergency department with symptoms of palpitations, tachycardia, chest pain, and shortness of breath. The physical examination reveals no physiologic basis for the symptoms. Which diagnosis therefore is most likely? Panic disorder Correct Bipolar disorder Generalized anxiety disorder Clinical depression
answer
Panic disorder is characterized by symptoms similar to those of a myocardial infarction (MI). Patients often fear losing control and dying and also may experience dizziness, nausea, depersonalization, and tingling or numbness in the hands. Generalized anxiety disorder is characterized by excessive worrying about events, but it also can include trembling, muscle tension, restlessness, palpitations, tachycardia, sweating, and clammy hands. Bipolar disorder is characterized by mood swings with periods of mania and depression.
question
The nurse is caring for a patient taking buspirone (BuSpar). Which statement by the patient indicates a need for further teaching about this drug? "This medication should not make me feel drowsy." "This medication should help me feel less anxious." "I will drink grapefruit juice instead of coffee with breakfast." Correct "I will take my medication three times per day."
answer
Grapefruit juice can greatly increase buspirone levels and should be avoided. The other statements are appropriate.
question
A patient has been diagnosed with performance anxiety. The nurse anticipates use of which drug to treat this psychologic disorder? Clonazepam (Klonopin) Alprazolam (Xanax) Propranolol (Inderal) Correct Sertraline (Zoloft) Incorrect
answer
Propranolol (Inderal) and other beta blockers can benefit patients with performance anxiety. When taken 1 to 2 hours before a scheduled performance, beta blockers can reduce symptoms caused by autonomic hyperactivity (e.g., tremors, sweating, tachycardia, palpitations). Doses are relatively small (e.g., only 10 to 80 mg for propranolol).
question
The selective serotonin reuptake inhibitors (SSRIs) are recommended therapy for a number of psychologic disorders. The nurse identifies the SSRIs as effective for the treatment of patients with which psychologic disorder or disorders? (Select all that apply.) Depression Correct Panic disorder Correct Social anxiety disorder Correct Post-traumatic stress disorder Correct Obsessive-compulsive disorder Correct
answer
Neither the SSRIs nor any other drugs, for that matter, have proved effective in the treatment of post-traumatic stress disorder. SSRIs are used to treat the other psychologic disorders listed.
question
The nurse identifies which antidepressant as effective in the treatment of generalized anxiety disorder (GAD)? (Select all that apply.) Fluoxetine (Prozac) Incorrect Venlafaxine (Effexor XR) Correct Paroxetine (Paxil) Correct Escitalopram (Lexapro) Correct Duloxetine (Cymbalta) Correct
answer
Fluoxetine (Prozac) is not approved for the treatment of generalized anxiety disorder. All the other medications listed are approved for the treatment of GAD.
