LYCEUM OF THE PHILIPPINES UNIVERSITY

COLLEGE OF NURSING
Name: _________________________________________

Score: _______/40

Date: ______________________

INTENSIVE COACHING FOR JUNE 2016 NURSE LICENSURE EXAMINATION

NURSING PSYCHOPHARMACOLOGY
Prepared by: ROBERT C. REA, RN, MD

Sedatives / Anxiolytics
1.

A client is admitted to the mental health unit with a

diagnosis of panic disorder. The nurse anticipates that the
physician will prescribe a benzodiazepine and checks the
physicians prescription sheet for which medication
prescription?
A. Alprazolam (Xanax)
B. Doxepin (Sinequan)
C. Imipramine (Tofranil)
D. Bupropion (Wellbutrin)

2.

A nurse provides instructions to the client taking

clorazepate (Tranxene) for the management of an anxiety
disorder. The nurse tells the client that:
A. Dizziness is a side effect.
B. If drowsiness occurs, call the physician.
C. Smoking increases the effectiveness of the
medication.
D. If gastrointestinal disturbances occur, discontinue the
medication.

3.

A nurse has administered a dose of diazepam (Valium) to

the client. The nurse should take which most important
action before leaving the clients room?
A. Draw the shades closed.
B. Give the client a bedpan.
C. Turn the volume on the television set down.
D. Raise a side rail on the bed and instruct the client not
to get out of bed without assistance.

4.

5.

6.

7.

A nurse is caring for a hospitalized client who is having a

prescribed dosage of clonazepam (Klonopin) adjusted.
Because of the adjustment in the medication that is being
made, the nurse should plan to:
A. Weigh the client daily.
B. Observe for ecchymoses.
C. Institute seizure precautions.
D. Monitor blood glucose levels.
Clonazepam (Klonopin) has been prescribed for the client,
and the nurse teaches the client about the medication.
Which statement by the client indicates that further
teaching is necessary?
A. If I experience slurred speech, it will disappear in
about 8 weeks.
B. My drowsiness will decrease over time with
continued treatment.
C. I should take my medicine with food to de- crease
stomach problems.
D. I can take my medicine at bedtime if it tends to make
me feel drowsy.
A nurse has a prescription to administer hydroxyzine
(Vistaril) to a client by the intramuscular route. Before
administering the medication, the nurse tells the client
that:
A. Excessive salivation is a side effect.
B. There will be some pain at the injection site.
C. There will be relief from nausea within 5 minutes.
D. The client will have increased alertness for about 2
hours.
A client with anxiety disorder is taking buspirone (BuSpar)
orally. The client tells the nurse that it is difficult to swallow
the tablets. The nurse provides which instruction to the
client to promote compliance?
A. Crush the tablets before taking them.
B. Mix the tablet uncrushed in applesauce.
C. Call the physician for a change in medication.
D. Purchase the liquid preparation with the next refill.

To God be the Greatest Glory!

8.

Buspirone hydrochloride (BuSpar) is prescribed for a client

with an anxiety disorder. The nurse instructs the client
regarding the medication and tells the client that:
A. The medication is addicting.
B. Dizziness and nausea may occur.
C. Tolerance can occur with the medication.
D. The medication can produce a sedating effect.

9.

The emergency department nurse is assessing a client

who abruptly discontinued benzodiazepine therapy and is
experiencing withdrawal symptoms. Which symptoms of
withdrawal would the nurse expect to note? Select all that
apply.
I. Tremors
II. Sweating
III. Lethargy
IV. Agitation
V. Nervousness
VI. Muscle weakness
A. All are correct
B. All except III
C. All except III and VI
D. I, IV, and V only

10. An intravenous dose of lorazepam (Ativan) is prescribed

for a client. Which of the following facts from the clients
history would indicate the need to consult with the
physician before administering the medication?
A. History of glaucoma
B. History of hypothyroidism
C. History of diabetes mellitus
D. History of coronary artery disease
11. A home care nurse is providing instructions to a client who
is taking zolpidem (Ambien) for insomnia. To produce a
maximal effect of the medication, the nurse tells the client
to take the medication:
A. With milk or an antacid
B. At bedtime with a snack
C. Following the evening meal
D. With a full glass of water on an empty stomach

Antidepressant Medications
12. Fluoxetine hydrochloride (Prozac) is prescribed for a client
with depression. The nurse provides instructions to the
client regarding the administration of the medication.
Which statement by the client indicates an understanding
about administration of the medication?
A. I should take the medication with my evening meal.
B. I should take the medication at noon with an antacid.
C. I should take the medication in the morning when I
first arise.
D. I should take the medication right before bedtime
with a snack.
13. Fluoxetine hydrochloride (Prozac) daily is prescribed for a
client, and the nurse provides instructions to the client
regarding the administration of the medication. Which
statement by the client indicates an understanding
regarding the administration of the medication?
A. I should take the medication with food only.
B. It is best to take the medication in the morning.
C. I should take the medication at bedtime with a
snack.
D. I should take the medication at noontime with an
antacid.

14. Sertraline (Zoloft) is prescribed for a client in the treatment

of depression. Before administering the medication, the
nurse reviews the clients record and consults with the
physician if which of the following were noted?
A. A history of diabetes mellitus
B. Use of phenelzine sulfate (Nardil)
C. A history of myocardial infarction
D. A history of irritable bowel syndrome
15. The nurse monitors the client taking amitriptyline for which
common side effect of this medication?
A. Diarrhea
C. Hypertension
B. Drowsiness
D. Increased salivation
16. A client has been receiving imipramine (Tofranil). The
nurse notifies the health care provider if which adverse
client response to the medication is noted?
A. Increased appetite
B. Increased drowsiness
C. Reported decrease in anxiety
D. Increased sense of well-being
17. A nurse is providing medication instructions to a client who
is taking imipramine (Tofranil) daily. Which statement by
the client indicates a need for further instructions?
A. I need to avoid alcohol while taking the medication.
B. I need to take the medication in the morning before
breakfast.
C. The effects of the medication may not be noticed for
at least 2 weeks.
D. If I miss a dose, I need to take it as soon as possible
unless it is almost time for the next dose.
18. A client has been started on a monoamine oxidase
inhibitor (MAOI). Which of the following should the nurse
include when teaching the client about the medication?
A. This medication can cause severe drowsiness.
B. The client must avoid foods that contain tyramine.
C. The medication is associated with a high rate of
abuse.
D. The medication will begin to alleviate symptoms of
depression almost immediately.
19. Tranylcypromine (Parnate) is prescribed for a client with
depression. The nurse instructs the client to avoid which
food items? Select all that apply.
I. Figs
IV. Brocolli
II. Apples
V. Sauerkraut
III. Bananas
VI. Baked chicken
A. All should be avoided
B. I, III, and V only
C. II, IV, and VI only
D. II, and IV only
20. A nurse is developing a teaching plan for a client who will
be receiving phenelzine sulfate (Nardil). The nurse plans
to tell the client to avoid which of the following to prevent
adverse effects?
A. Vasodilators
B. Aged cheeses
C. Digitalis preparations
D. Cherries and blueberries
21. A client who is taking tranylcypromine sulfate (Parnate)
requests information about foods that are acceptable to
eat while taking the medication. The nurse tells the client
that it is safe to eat:
A. Yogurt
C. Raisins
B. Oranges
D. Smoked fish
22. Phenelzine sulfate (Nardil) is being administered to a
client with depression. The client suddenly complains of a
severe occipital headache radiating frontally, and neck
stiffness and soreness, and is vomiting. On further
assessment, the client exhibits signs of hypertensive
crisis. Which medication would the nurse pre- pare
anticipating that it will be prescribed as the antidote for
hypertensive crisis?
A. Vitamin K
B. Phentolamine
C. Protamine sulfate
D. Calcium gluconate

To God be the Greatest Glory!

Antipsychotic Medications
23. A nursing student is assigned to care for a client with a
diagnosis of Tourettes syndrome who is receiving
haloperidol decanoate (Haldol deaconate). The registered
nurse asks the student to describe the action of the
medication. The student responds correctly by stating that
this medication:
A. Is a serotonin reuptake blocker
B. Inhibits the breakdown of released acetylcholine
C. Blocks the uptake of norepinephrine and serotonin
D. Blocks the binding of dopamine to the post-synaptic
dopamine receptors in the brain
24. A nurse is reviewing the record of a client who was
admitted to the hospital for diagnostic studies after a
fainting spell. The nurse notes that the client is receiving
olanzapine (Zyprexa). Which disorder or condition would
the nurse suspect in the client?
A. History of schizophrenia
B. History of diabetes mellitus
C. History of diabetes insipidus
D. History of coronary artery disease
25. A client who is taking an antipsychotic is preparing for
discharge. When developing a health promotion plan for
the client, the nurse instructs the client to:
A. Avoid prolonged exposure to the sun.
B. Adhere to a strict tyramine-restricted diet.
C. Recognize the signs and symptoms of a relapse of
depression.
D. Have therapeutic blood levels drawn, because the
medication has a narrow therapeutic range.
26. A client hospitalized with a diagnosis of schizophrenia is
prescribed risperidone (Risperdal) for the treatment of this
disorder. Which laboratory study would the nurse
anticipate to be prescribed before the initiation of this
medication therapy?
A. Platelet count
B. Blood clotting tests
C. Liver function studies
D. Complete blood count
27. A client with a psychotic disorder is being treated with
haloperidol. The nurse monitors the client for which of the
following that indicates the presence of an adverse effect
of this medication?
A. Nausea
B. Hypotension
C. Blurred vision
D. Excessive drooling
28. An older client is given a prescription for an antipsychotic.
The nurse instructs the client and family to report any
signs of pseudoparkinsonism and tells the family to
monitor for:
A. Tremors and hyperpyrexia
B. Motor restlessness and aphasia
C. Stooped posture and a shuffling gait
D. Muscle weakness and decreased salivation
29. Neuroleptic malignant syndrome is suspected in a client
who is taking an antipsychotic medication. Which
medication would the nurse prepare in anticipation of
being prescribed to treat this adverse reaction related to
the use of the antipsychotic?
A. Protamine sulfate
B. Bromocriptine (Parlodel)
C. Phytonadione (Vitamin K)
D. Enalapril maleate (Vasotec)
30. The nurse is caring for a client with schizophrenia who is
taking haloperidol (Haldol). The client complains of
restlessness, cannot sit still, and has muscle stiffness. Of
the following PRN medications, which would the nurse
administer?
a. Haloperidol (Haldol), 5 mg PO
b. Benztropine (Cogentin), 2 mg PO
c. Propranolol (Inderal), 20 mg PO
d. Trazodone, 50 mg PO

31. A nurse caring for a client taking clozapine (Clozaril) for

the treatment of a schizophrenic disorder reviews the
laboratory studies that have been prescribed for the client.
Which lab- oratory study is the priority to monitor for an
adverse effect associated with the use of this medication?
A. Platelet count
B. Cholesterol level
C. Blood urea nitrogen
D. White blood cell count

Lithium Therapy
32. A nurse has provided home-care instructions to a client
who is taking lithium carbonate (Lithobid). Which client
statement indicates that the client understands the
prescribed regimen?
A. I will restrict my water intake.
B. I will make sure that my diet contains salt.
C. I will keep my medication in the refrigerator.
D. I will be careful to avoid eating foods high in
potassium.
33. A nurse provides home care instructions to a client who is
taking lithium carbonate (Lithobid). Which statement by
the client indicates a need for further instructions?
A. I need to take the lithium with meals.
B. My blood levels must be monitored very closely.
C. I need to decrease my salt and fluid intake while
taking the lithium.
D. I need to withhold the medication if I have excessive
diarrhea, vomiting, or diaphoresis
34. The signs of lithium toxicity include which of the following?
a. Sedation, fever, restlessness
b. Psychomotor agitation, insomnia, increased thirst
c. Elevated white blood cell count, sweating, confusion
d. Severe vomiting, diarrhea, weakness
35. A client is taking lithium carbonate (Lithobid) for the
treatment of bipolar disorder. Which assessment question
should the nurse ask the client to determine signs of early
lithium toxicity?
A. Do you have frequent headaches?
B. Have you noted excessive urination?
C. Have you been experiencing leg aches over the past
few days?
D. Have you been experiencing any nausea, vomiting,
or diarrhea?

36. A nurse notes that a clients lithium level is 3.9 mEq/L. The
nurse should implement which priority intervention?
A. Determining visual acuity
B. Assisting with ambulation
C. Monitoring intake and output
D. Instituting seizure precautions

Drugs used in Treatment of ADHD

37. A client with narcolepsy has been prescribed
dextroamphetamine (Adderall). The client complains to the
nurse that she cannot sleep well anymore at night and
does not want to take the medication any longer. The
nurse then asks the client if the medication is taken at
which appropriate time?
A. Before a bedtime snack
B. Just before going to sleep
C. Two hours before bedtime
D. At least 6 hours before bedtime
38. Methylphenidate (Ritalin) is prescribed for a child with a
diagnosis of attention deficit hyperactivity disorder
(ADHD). The nurse pro- viding information to the mother
regarding the administration of the medication instructs the
mother to administer the medication:
A. Before dinner and at bedtime
B. At the noontime and evening meals
C. In the morning after breakfast and at bedtime
D. Before breakfast and before the noontime meal

Aversion Therapy
39. Disulfiram (Antabuse) is prescribed for a client who is
seen in the psychiatric health care clinic. The nurse is
collecting data from the client and is providing instructions
regarding the use of this medication. Which data is
important for the nurse to obtain before beginning the
administration of this medication?
A. When the last full meal was consumed
B. When the last alcoholic drink was consumed
C. If the client has a history of hyperthyroidism
D. If the client has a history of diabetes insipidus
40. Disulfiram (Antabuse) has been prescribed for a client,
and the nurse provides instructions to the client about the
medication. Which statement by the client indicates the
need for further instructions?
A. I must be careful taking cold medicines.
B. I will have to check my aftershave lotion.
C. As long as I dont drink alcohol, Ill be fine.
D. I will have to be more careful with the ingredients I
use for cooking.

LYCEUM OF THE PHILIPPINES UNIVERSITY

COLLEGE OF NURSING
Name: _________________________________________

Score: _______/40

ID No.: 65620160_______

INTENSIVE COACHING FOR JUNE 2016 NURSE LICENSURE EXAMINATION

NURSING PSYCHOPHARMACOLOGY
Prepared by: ROBERT C. REA, RN, MD

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To God be the Greatest Glory!