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MODULE 12 EXAM:
PSYCHOTHERAPEUTIC AGENTS & DRUGS
OF ABUSE, 2025/2026 WITH
CORRECT/ACCURATE ANSWERS
ļ§ ACTIVIITY 1 NSG124.12.01.01 SCHIZOPHRENIA ETIOLOGY, PRESENTATION, & MANAGEMENT ļ· ACTIVITY 2 NSG124.12.01.02 FIRST-GENERATION ANTIPSYCHOTIC AGENTS ļ· ACTIVITY 3 NSG124.12.01.03 FIRST-GENERATION ANTIPSYCHOTIC NURSING CONSIDERATIONS ļ· ACTIVITY 4 NSG124.12.01.04 SECOND-GENERATION ANTIPSYCHOTIC AGENTS ļ· ACTIVITY 5 NSG124.12.01.05 SECOND-GENERATION ANTIPSYCHOTIC AGENT NURSING CONSIDERATIONS ļ· ACTIVITY 6 NSG124.12.02.01 BENZODIAZEPINES ļ· ACTIVITY 7 NSG124.12.02.02 BENZODIAZEPINE-LIKE AGENTS
ļ· ACTIVITY 8 NSG124.12.02.03 BARBITUATES ļ· ACTIVITY 9 NSG124.12.02.04 SLEEP, HYPNOTICS, & INSOMNIA NURSING MANAGEMENT ļ· ACTIVITY 10 NSG124.12.02.05 BENZODIAZEPINE NURSING CONSIDERATIONS ļ· ACTIVITY 11 NSG124.12.03.01 DRUG & SUBSTANCE ABUSE DISORDER ļ· ACTIVITY 12 NSG124.12.03.02 CONTROLLED SUBSTANCE ACT & HEALTHCARE IMPACT ļ· ACTIVITY 13 NSG124.12.03.03 ALCOHOL PHARMACOLOGY & ALCOHOL USE DISORDER ļ· ACTIVITY 14 NSG124.12.03.04 NICOTINE & SMOKING CESSATION ļ· ACTIVITY 15 NSG124.12.03.05 MAJOR DRUGS OF ABUSE, EFFECT, TOXICITY, DETOXIFICATION, & TREATMENT
The nurse is preparing to administer a first-generation antipsychotic to a patient. The nurse knows which of the following are correct? Select all that apply. Significant adverse effects of extrapyramidal symptoms (EPS) including acute dystonia, parkinsonism, and akathisia - tardive dyskinesia Death by overdose is extremely common Drugs block receptors for dopamine, acetylcholine, histamine, and norepinephrine Neuroleptic malignant syndrome (NMS) risk Significant adverse effects of extrapyramidal symptoms (EPS) including acute dystonia, parkinsonism, and akathisia - tardive dyskinesia Drugs block receptors for dopamine, acetylcholine, histamine, and norepinephrine Neuroleptic malignant syndrome (NMS) risk Positive symptoms (e.g., delusions, hallucinations) may respond somewhat better than negative symptoms. blockades at receptors are responsible for the major adverse effects of the antipsychotics ACTIVITY 3 NSG124.12.01.03 FIRST-GENERATION ANTIPSYCHOTIC NURSING CONSIDERATIONS The nurse is preparing to administer a first generation antipsychotic to a patient. The nurse knows which of the following nursing implications are correct? Select all that apply. Inform patients and their families about early EPS symptoms (e.g., muscle spasm of tongue, face, neck, or back; tremor; rigidity; restless movement), and instruct them to notify the prescriber if these appear.
Inform patients about signs of hypotension (light-headedness, dizziness) and advise them to sit or lie down if these occur. Inform patients that hypotension can be minimized by moving slowly when standing up. Instruct patients that drugs are highly addictive. Inform patients and their families about early signs (e.g., fine, worm- like movements of the tongue), and instruct them to notify the prescriber if these develop. Inform patients and their families about early EPS symptoms (e.g., muscle spasm of tongue, face, neck, or back; tremor; rigidity; restless movement), and instruct them to notify the prescriber if these appear. Inform patients about signs of hypotension (light-headedness, dizziness) and advise them to sit or lie down if these occur. Inform patients that hypotension can be minimized by moving slowly when standing up. Inform patients and their families about early signs (e.g., fine, worm- like movements of the tongue), and instruct them to notify the prescriber if these develop. Inform patients about early signs of infection (fever, sore throat), and instruct them to notify the prescriber if these develop. Continuously evaluate for successful treatment as indicated by improvement in psychotic symptoms. Evaluate for suppression of hallucinations, delusions, agitation, tension, and hostility, and for improvement in judgment, insight, motivation, affect, self-care, social skills, anxiety management, and patterns of sleeping and eating. ACTIVITY 4 NSG124.12.01.04 SECOND-GENERATION ANTIPSYCHOTIC AGENTS
asked to talk with Jimās family. His parents have questions about the side effects of chlorpromazine. While Jim is in a group session, you meet with his parents. The mother asks what Jimās physicians mean when they say chlorpromazine causes EPSs. She says that if these symptoms create problems, she wants to know what can be done to help the situation. How should you answer her questions? ANSWER & RATIONALE Answer: Early EPSs are characterized by muscle spasms of the tongue, face, neck, or back; tremor; rigidity; and restless movement. The patient should notify the prescriber if these occur. Treatment for EPSs includes the following: anticholinergic drugs, beta blockers, or benzodiazepines to diminish the EPSs; or the antipsychotic medication can be switched. Rationale: Antipsychotic drugs work to improve schizophrenia; however, they affect the motor system of the body, causing it to move in abnormal, involuntary ways. Jim's father asks about the long-term effects of taking antipsychotic drugs. He states, "I read that the extrapyramidal symptoms only get worse. How can they get worse than the ones you talked about? With all the research going on, what can be done to help this?" What is your response? Answer: After months or years of continuous therapy, tardive dyskinesia can develop. It is characterized by twisting, writhing, and wormlike movements of the tongue and face.
Rationale: Although there is no reliable treatment, discontinuation of all anticholinergic drugs, administration of benzodiazepines and discontinuation of the antipsychotic drug or reduction of the dosage can be effective for decreasing the symptoms. Jim's mother states that she is concerned. "I understand that Jim will need to take the medication for the rest of his life. How am I ever going to get him to take these pills if the side effects are so bad?" What is your response? Answer: You should inform Jimās mother that in the phase when she is responsible for Jim taking his medication, she should make sure he swallows it and does not place it in his cheek. Jimās mother and father should make sure that he is taking his medication as prescribed. Provide Jim and his family with written and verbal instructions on the dosage and the timing of medication administration to enhance compliance. Jim and his family should be informed that these medications do not cause addiction. Rationale: The patient may not remember to take medications; therefore, the parents will need to ensure adherence. Establishing a routine will prevent advancing symptoms such as hallucinations, paranoia, and behavioral disturbances. The nurse is preparing to administer the second-generation antipsychotic clozapine [Clozaril] to a patient. The nurse knows which of the following nursing implications are correct? Select all that apply. Drug should be started at the highest dose to begin to best control symptoms. Inform patients about early signs of infection (fever, sore throat, fatigue, mucous membrane ulceration), and instruct them to report
Three principal indications: anxiety, insomnia, and seizure disorders. Can cause physical dependenceābut the incidence of substantial dependence is low. Potentiate the actions of gamma-amino-butyric acid (GABA), an inhibitory neurotransmitter found throughout the CNS. ACTIVITY 7 NSG124.12.02.02 BENZODIAZEPINE-LIKE AGENTS The nurse is preparing to a benzodiazepine-like sedative hypnotic to a patient. The nurse knows which of the following are correct? Select all that apply. Patients should be warned against combining zolpidem [Ambien] with alcohol Eszopiclone [Lunesta] is recommended for no more than one week for insomnia Zolpidem [Ambien] has been associated with sleep driving and other sleep-related complex behaviors Zolpidem [Ambien] causes little or no respiratory depression Patients should be warned against combining zolpidem [Ambien] with alcohol. Zolpidem [Ambien] has been associated with sleep driving and other sleep-related complex behaviors. Zolpidem [Ambien] causes little or no respiratory depression. ACTIVITY 8 NSG124.12.02.03 BARBITUATES The nurse is preparing to administer a barbituate to a patient. The nurse knows which of the following are correct? Select all that apply.
Barbiturates have a high therapeutic index. Acute overdose of barbituates produces a classic triad of symptoms: respiratory depression, coma, and pinpoint pupils. Barbiturates are powerful respiratory depressants that can be fatal in overdose. Respiratory depression does not decrease with drug tolerance. Drugs bind to the GABA receptor-chloride channel complex which enhances the inhibitory actions of GABA and directly mimics the actions of GABA. Acute overdose of barbituates produces a classic triad of symptoms: respiratory depression, coma, and pinpoint pupils. Barbiturates are powerful respiratory depressants that can be fatal in overdose. Respiratory depression does not decrease with drug tolerance. Drugs bind to the GABA receptor-chloride channel complex which enhances the inhibitory actions of GABA and directly mimics the actions of GABA. ACTIVITY 9 NSG124.12.02.04 SLEEP, HYPNOTICS, & INSOMNIA NURSING MANAGEMENT T/F: Hypnotics are first line for insomnia. False. Hypnotics should be used only when insomnia cannot be managed by other means. Which of the following drugs are major hypnotics used for insomnia treatment? Select all that apply. Benzodiazepine-like Drugs - zaleplon [Sonata]
morning awakenings are factors; how long the sleeping problem has lasted; and possible underlying causes, such as medical illness, psychiatric illness, use of caffeine and other stimulants, poor sleep hygiene, and major life stressors. Rationale: Obtaining a good history helps to determine the best possible treatment for her sleep disturbance. Ms. L sees the primary care provider at the wellness center and is prescribed triazolam (Halcion) to help with her sleep disturbance. As Ms. L is leaving the wellness center, she says to you, "Well, now that I have the pill, I'll be on my way. This is all I need." How should you respond? Answer: You should inform Ms. L that it would be best for her not to rely on the drug alone to assist in her reestablishment of regular, undisturbed sleep patterns. It would be best to review the rules for sleep fitness found in Table 34-4. Rationale: Insomnia medications can be habit forming. Insomnia is a multifactorial problem. Also, it is important for the nurse to teach skills for good sleep hygiene. Doing so may alleviate the patientās need for medications. Ms. L has another question. She asks you, "Why wouldn't she (the prescriber) give me a refill on this prescription? These pills will only last me 10 days. Why do I have to come back?" How should you respond? Answer: It would be a good idea to inform Ms. L that insomnia is usually self-limiting. Drug therapy should be short term. Benzodiazepines, the pills she is taking, should be discontinued periodically to determine whether they are still required.
Rationale: She needs to return to the wellness center for further evaluation of her sleep disturbance. If insomnia is long term, a special effort should be made to identify underlying causes. The nurse is preparing to administer a benzodiazepine to a patient. The nurse knows which of the following are correct? Select all that apply. Therapeutic use to decrease anxiety and ease alcohol withdrawal Therapeutic use to promote sleep Drowsiness may be present the next day when benzodiazepines are used for insomnia. Patient can stop taking abruptly. Therapeutic use to decrease anxiety and ease alcohol withdrawal. Therapeutic use to promote sleep. Drowsiness may be present the next day when benzodiazepines are used for insomnia. Warn patients against abrupt discontinuation of treatment. ACTIVITY 11 NSG124.12.03.01 DRUG & SUBSTANCE ABUSE DISORDER TOLERANCE Results from regular drug use and can be defined as a state in which a particular dose elicits a smaller response than it did with initial use. As tolerance increases, higher and higher doses are needed to elicit desired effects. METHAMPHETAMINE Highly addictive, easily manufactured stimulant and is known as "crank," "ice," or "crystal." It can be sniffed, injected, smoked, or taken
Substances which cause euphoria and drowsiness. ACTIVITY 12 NSG124.12.03.02 CONTROLLED SUBSTANCE ACT & HEALTHCARE IMPACT SCHEDULE I DRUGS Opiods - Heroin Cannabis Derivatives - Marijuana SCHEDULE II DRUGS Opioids - Morphine Opioids - Hydromorphone Psychostimulants - Methamphetamine SCHEDULE III DRUGS Anabolic Steroids SCHEDULE IV DRUGS Benzodiazepines SCHEDULE V DRUGS Opiods - Diphenoxylate plus atropine ACTIVITY 13 NSG124.12.03.03 ALCOHOL PHARMACOLOGY & ALCOHOL USE DISORDER Which of the following are correct regarding the pharmacology of alcohol and alcohol substance abuse disorders? Select all that apply.
Consuming alcohol from cough syrups is harmless for patients taking Disulfiram [Antabuse] induces liver damage which can progress from fatty liver to hepatitis to cirrhosis Of the drugs used to facilitate alcohol withdrawal, benzodiazepines are the most effective There is evidence that relatively modest alcohol consumption (2 to 4 drinks a day) can cause fatal liver damage when combined with acetaminophen taken in normal therapeutic doses. Induces liver damage which can progress from fatty liver to hepatitis to cirrhosis. Of the drugs used to facilitate alcohol withdrawal, benzodiazepines are the most effective. There is evidence that relatively modest alcohol consumption (2 to 4 drinks a day) can cause fatal liver damage when combined with acetaminophen taken in normal therapeutic doses. Alcohol depresses respirations Disulfiram [Antabuse] helps individuals with AUD avoid drinking by causing unpleasant effects if alcohol is ingested. T/F: In patients with alcohol use disorder (AUD), the B vitamins are especially important to correct nutritional deficiencies, and a program of dietary modification and vitamin supplements should be implemented. True. ACTIVITY 14 NSG124.12.03.04 NICOTINE & SMOKING CESSATION
Nicotine-containing adhesive patches that, after application to the skin, slowly release their nicotine content. BUPROPION SR [ZYBAN, BUPROBAN] Drug is structurally similar to amphetamine; an atypical antidepressant, was the first non-nicotine drug approved as an aid to smoking cessation. VARENICLINE [CHANTIX] Partial agonist at nicotinic receptors, is our most effective aid to smoking cessation T/F: Smoking the largest preventable cause of premature death in America. True. ACTIVITY 15 NSG124.12.03.05 MAJOR DRUGS OF ABUSE, EFFECT, TOXICITY, DETOXIFICATION, & TREATMENT CASE STUDY You are the nurse manager in a drug and alcohol rehabilitation center. You are asked to give an educational seminar to a group of new hires on the treatment of drug abuse. You prepare your presentation and prepare to answer the following questions. What psychological and drug-related factors contribute to substance abuse? ANSWER & RATIONALE
Answer: Drug abuse is the end result of a progressive involvement with drugs. Taking psychoactive drugs is usually initiated out of curiosity. Rationale: From this initial involvement, the user can progress to occasional use. Occasional use can then evolve into compulsive use. What is the difference between physical and psychological dependence? Answer: Psychological dependence is an intense, subjective need for a particular psychoactive drug. Physical dependence is a state in which an abstinence syndrome will occur if drug use is discontinued. Physical dependence is not the same as addiction. Rationale: Physical dependence is a more severe substance use disorder than substance abuse. Although physical dependence is not the same as addiction (substance dependence), physical dependence can certainly contribute to addictive behavior. How does tolerance develop? Answer: Tolerance is a state in which a particular drug dose elicits a smaller response than it formerly did, requiring more medication to achieve the same effect. Rationale: Although tolerance and withdrawal are among the diagnostic criteria for substance dependence, they are neither necessary nor sufficient for a diagnosis. Which of the following are correct regarding the pharmacology of substance abuse disorders other than alcohol and nicotine? Select all that apply. In an effort to reduce OxyContin abuse, the controlled-release tablets
