Blockade of which of the following pairs of receptors likely mediated the adverse effect of olanzapine in the 37-year-old woman with a schizoaffective disorder?

Correct Answer: B

Rationale: The most likely receptors mediating the adverse effect of olanzapine in the 37-year-old woman are GABAergic and muscarinic receptors. Olanzapine, an atypical antipsychotic, can have side effects such as acute psychotic states and aggression, which may be due to its interaction with these receptors. Blocking GABAergic receptors can lead to disinhibition and agitation, while muscarinic receptor blockade can cause cognitive impairment and confusion, both of which could contribute to the patient's acute psychotic state and aggressive behavior.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Increased serotonergic activity. The adverse effect experienced by the 54-year-old woman is likely mediated by increased serotonergic activity in the enteric nervous system. Central nervous system stimulants can lead to increased serotonin levels, which can cause adverse effects such as gastrointestinal disturbances. Option A) Blockade of M receptors is incorrect because it refers to muscarinic receptors, which are not typically associated with adverse effects in the enteric nervous system related to CNS stimulants. Option C) Activation of beta receptors is incorrect as beta receptors are more related to the sympathetic nervous system rather than the enteric nervous system. Option D) Increased adrenergic activity is also incorrect because adrenergic activity is associated with the sympathetic nervous system and not typically involved in adverse effects in the enteric nervous system. Educationally, understanding the molecular actions of drugs on the enteric nervous system is crucial for healthcare professionals to anticipate and manage potential adverse effects in patients. This knowledge helps in providing safe and effective care to individuals receiving CNS stimulants and related drugs.

Correct Answer: A

Rationale: In this scenario, the most likely drug prescribed for the 48-year-old woman with depressive symptoms would be Amitriptyline (Option A). Amitriptyline is a tricyclic antidepressant commonly used to treat depression, especially in cases where there are associated symptoms of anxiety or insomnia. It works by increasing the levels of neurotransmitters like serotonin and norepinephrine in the brain, which helps improve mood and alleviate depressive symptoms. Trazodone (Option B) is another antidepressant but is typically used more for treating insomnia associated with depression rather than the primary depressive symptoms. Bupropion (Option C) is an antidepressant that is more commonly used for treating atypical depression or smoking cessation rather than typical depressive symptoms. Citalopram (Option D) is a selective serotonin reuptake inhibitor (SSRI) commonly used for treating depression, but in this case, Amitriptyline would be a more appropriate choice based on the symptoms described for the patient. Educationally, understanding the differences between various classes of antidepressants and their specific indications is crucial for nursing practice. It is essential for nurses to be able to differentiate between these medications to provide safe and effective care to patients with depression. Selecting the most appropriate medication based on the patient's symptoms and individual needs is a critical nursing skill that directly impacts patient outcomes.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Amitriptyline. Amitriptyline is a tricyclic antidepressant that is sometimes used off-label for its sedative effects, making it a likely choice for a patient experiencing heavy drowsiness. Option B) Lithium is a mood stabilizer used primarily in the treatment of bipolar disorder and is not typically associated with drowsiness as a side effect. Option C) Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression and anxiety, and it is not known to cause heavy drowsiness. Option D) Haloperidol is an antipsychotic medication used to treat psychotic disorders and agitation but is not usually associated with causing heavy drowsiness. In an educational context, understanding the side effects and primary uses of different drug classes is crucial for nurses and healthcare professionals to make appropriate clinical decisions. Knowing the specific indications and side effect profiles of various medications helps in providing safe and effective care to patients.

Correct Answer: A

Rationale: The correct answer is A. Increased synthesis of adenylyl cyclase. One of the leading hypotheses about the molecular mechanism of action of lithium is its ability to increase the synthesis of adenylyl cyclase. Adenylyl cyclase is an enzyme involved in the production of cyclic adenosine monophosphate (cAMP), which plays a role in cellular signaling pathways. By increasing the synthesis of adenylyl cyclase, lithium may help to regulate intracellular signaling and neurotransmitter release, contributing to its mood-stabilizing effects in bipolar disorder.