EAQ Review: Exam 2

What is the goal of pharmacologic therapy in the treatment of Parkinson's disease (PD)? 1. Balance cholinergic and dopaminergic activity in the brain 2. Increase the amount of acetylcholine at the presynaptic neurons 3. Reduce the amount of dopamine available in the substantia nigra 4. Block dopamine receptors in presynaptic and postsynaptic neurons

1. Balance cholinergic and dopaminergic activity in the brain PD results from a decrease in dopaminergic (inhibitory) activity leaving an imbalance with too much cholinergic (excitatory) activity. With an increase in dopamine, the neurotransmitter activity becomes more balanced, and symptoms are controlled.

Which neurotransmitters are affected by amphetamines?

Dopamine, Norepinephrine DA and NE are the two neurotransmitters affected by amphetamines. 5-HT, EPI, and GABA are neurotransmitters, but they are not affected by amphetamines.

Which symptoms are associated with Parkinson's disease (PD)? Select all that apply. 1. Rigidity 2. Tremors 3. Seizures 4. Tachycardia 5. Bradykinesia

1. Rigidity 2. Tremors 5. Bradykinesia

Arrange the order of structures of the ear from external to internal.

1. .Ear pinna 2. Eardrum 3. Eustachian tube 4. Cochlea The structure of the ear is divided into four regions: external, outer, middle, and inner. The external auditory meatus, or the pinna, is the external projection of the ear. The middle ear is composed of the eardrum (tympanic membrane) and three bones, namely the incus (anvil), malleus (hammer), and stapes (stirrup). These structures are connected to the Eustachian tube. The middle ear is connected to the inner ear, which contains the cochlea and semicircular canals.

Which medications are part of the amphetamine family of drugs? Select all that apply. 1. Amphetamine 2. Lisdexamfetamine 3. Methamphetamine 4. Dystroamphetamine 5. Dextroamphetamine

1. Amphetamine 2. Lisdexamfetamine 3. Methamphetamine 5. Dextroamphetamine The medications included in the amphetamine family of drugs include amphetamine, lisdexamfetamine, methamphetamine, and dextroamphetamine. Dystroamphetamine is not a medication.

What is true about atomoxetine? Select all that apply. 1. Atomoxetine has a low potential for abuse. 2. Atomoxetine is a central nervous system stimulant. 3. Atomoxetine takes 1 to 3 weeks for maximal response. 4. Atomoxetine is given by means of a transdermal patch. 5. Atomoxetine may cause suicidal thinking in children and adolescents

1. Atomoxetine has a low potential for abuse. 3. Atomoxetine takes 1 to 3 weeks for maximal response. 5. Atomoxetine may cause suicidal thinking in children and adolescents Atomoxetine takes 1 to 3 weeks for maximal response and may cause suicidal thinking in children and adolescents. It has almost no potential for abuse because it is a nonstimulant. Atomoxetine is available only by mouth, not transdermal patch.

Which preventative measures will the nurse include in education regarding the prevention of acute otitis media in children? Select all that apply. 1. Avoid supine bottle feeding. 2. Breastfeed for at least 6 months. 3. Eliminate exposure to tobacco smoke. 4. Avoid childcare centers until early childhood. 5. Reduce pacifier use in the first 6 months of life.

1. Avoid supine bottle feeding. 2. Breastfeed for at least 6 months. 3. Eliminate exposure to tobacco smoke. In an effort to prevent acute otitis media, parents should avoid supine bottle feeding, breastfeed for at least 6 months if possible, and eliminate exposure to tobacco smoke. Parents should avoid childcare centers both in infancy as well as early childhood if possible, because these are the ages when respiratory infections are prevalent. Reducing the use of a pacifier in the second, not first, 6 months of life will help prevent acute otitis media.

The nurse is assessing a patient with suspected Parkinson disease. Which symptoms would support this diagnosis? Select all that apply. 1. Bradykinesia 2. Muscle rigidity 3. Tremors at rest 4. Cognitive decline 5. Postural instability

1. Bradykinesia 2. Muscle rigidity 3. Tremors at rest 5. Postural instability

Evidence shows that caffeine has which effects on the body? Select all that apply. 1. Bronchial dilation 2. Promotes diuresis 3. Low birth defect risk 4. Constriction of cerebral blood vessels 5. Restoration of mental function during intoxication with alcohol

1. Bronchial dilation 2. Promotes diuresis 3. Low birth defect risk 4. Constriction of cerebral blood vessels Evidence shows that effects of caffeine on the body include bronchial dilation, promotion of diuresis, low birth defect risk, and constriction of cerebral blood vessels. Despite popular belief, there is little evidence that caffeine can restore mental function during intoxication with alcohol, although it might delay an individual from passing out.

The nurse instructs a group of students about care of patients across the life span. Which statements are true regarding stimulant use across the life span? Select all that apply. 1. Caffeine citrate is used for neonatal apnea. 2. All stimulants are Pregnancy Risk Category C. 3. Dexmethylphenidate is used for neonatal apnea. 4. Stimulants should be avoided in patients with glaucoma. 5. A large loading dose is necessary for all stimulants to be effective.

1. Caffeine citrate is used for neonatal apnea. 4. Stimulants should be avoided in patients with glaucoma. Life span considerations regarding various stimulants include avoiding the use of stimulants in patients with glaucoma, and using caffeine citrate for neonatal apnea. Some stimulant medications are Pregnancy Risk Category C, but not all. Dexmethylphenidate is not a medication used for neonatal apnea. Gradually increasing the dose, rather than using a large loading dose, is often safer and recommended to help the patient tolerate side effects.

Which medications are approved for attention-deficit/hyperactivity disorder (ADHD)? Select all that apply. 1. Clonidine 2. Furosemide 3. Guanfacine 4. Propranolol 5. Guaifenesin

1. Clonidine 3. Guanfacine Two alpha 2 agonists— clonidine and guanfacine—are approved for ADHD. Propranolol may be used for blood pressure management, anxiety, and other uses, but it is not used or approved for ADHD. Guaifenesin helps thin mucus. Furosemide is a diuretic.

Which clinical findings support a diagnosis of acute otitis media? Select all that apply. 1. Earache 2. Acute onset of symptoms 3. Bulging tympanic membrane 4. Purulent drainage from the ear 5 Edema of the external auditory canal

1. Earache 2. Acute onset of symptoms 3. Bulging tympanic membrane 4. Purulent drainage from the ear Acute otitis media can manifest in earache, acute onset of symptoms, a bulging tympanic membrane indicating effusion, and purulent draining. External auditory canal edema is a manifestation of acute otitis externa.

Low-caffeine food sources (less than 20 mg) include which foods? Select all that apply. 1. Herbal tea (8 oz) 2. Brewed tea (8 oz) 3. Orange soda (12 oz) 4. Instant coffee (8 oz) 5. Milk chocolate bar (1.5 oz)

1. Herbal tea (8 oz) 5. Milk chocolate bar (1.5 oz) Low-caffeine food sources (less than 20 mg) include herbal tea (8 oz), which has 0 mg of caffeine; and a 1.5 oz milk chocolate bar, which has 10 mg caffeine. Eight ounces of brewed tea has 35 mg to 40 mg of caffeine. Twelve ounces of orange soda has 40 mg, and eight ounces of instant coffee has 30 mg to 120 mg of caffeine.

The nurse is reviewing the care of patients with Alzheimer's disease (AD). Which factors are associated with the pathophysiology of this disease? Select all that apply. 1. Neurofibrillary tangles and tau 2. Beta-amyloid and neuritic plaques 3. Autoimmune changes in the myelin sheath 4. Dilation and inflammation of cranial blood vessels 5. Neuronal degeneration and decreased acetylcholine 6. Firing of hyperexcitable neurons throughout the brain

1. Neurofibrillary tangles and tau 2. Beta-amyloid and neuritic plaques 5. Neuronal degeneration and decreased acetylcholine

The nurse is assessing a child with attention deficit hyperactivity disorder (ADHD) who is prescribed amphetamine aspartate. The nurse instructs the parent to give medications 5 to 6 hours before bed. Why did the nurse give this instruction? 1. To prevent insomnia 2. To prevent gastric ulcer 3. To prevent hyperglycemia 4. To prevent nutrition deficiency

1. To prevent insomnia The child who is diagnosed with ADHD is usually prescribed amphetamine aspartate, a stimulant drug that causes alertness and insomnia. Therefore, the nurse would suggest giving the medication 5 to 6 hours prior to sleep. Giving the medicine at least 5 to 6 hours before sleep helps reduce the effect of the drug, so the child does not stay awake for a longer period of time. The medication given for ADHD does not show adverse effects on the gastrointestinal system, so there is no risk of gastric ulcer. ADHD medications are usually central nervous system (CNS) stimulants and do not alter the levels of blood glucose. ADHD drugs do not affect nutritional balance, as they are CNS stimulants and affect CNS receptors directly.

The healthcare provider orders donepezil 10 mg by mouth (PO) every day. The tablets available are donepezil 5 mg. How many tablets will the patient receive?

10 mg needed/5 mg available = 2 tablets. Two 5-mg tablets will equal the 10-mg dose ordered.

The healthcare provider orders donepezil [Aricept] 10 mg PO every day. The tablets available are donepezil 5 mg. How many tablets will the patient receive?

10mL The available concentration of amantadine is 10 mg/mL. The ordered dose of 100 mg would equal 10 mL of syrup; 100 mg/10 = 10 mL.

The healthcare provider orders memantine syrup 20 mg by mouth (PO) daily in two divided doses. The concentration available is memantine 2 mg/mL. How many milliliters will the patient receive for each dose? 1. 2 mL 2. 5 mL 3. 10 mL 4. 20 mL

2. 5 mL Each dose will be 5 mL. The total of 20 mg is divided into two doses of 10 mg. The concentration is 2 mg/mL. Divide 10 mg by 2 mg to equal 5 mL.

Which factors are associated with antibiotic-resistant acute otitis media? Select all that apply. 1. Exposure to antibiotics 2. Attendance at day care 3. History of chronic illness 4. Age younger than 2 years 5. Winter and spring seasons

2. Attendance at day care 4. Age younger than 2 years 5. Winter and spring seasons The factors that are associated with antibiotic-resistant acute otitis media include age younger than 2 years, winter and spring seasons, and attendance at day care. Exposure to antibiotics in general is not a risk factor for antibiotic-resistant acute otitis media, though exposure to antibiotics in the prior one to three months is. A history of chronic illness does not predispose a patient to antibiotic-resistant otitis media.T

Which systemic adverse effect is possible with administration of the beta-adrenergic blocking agent timolol for the treatment of open-angle glaucoma? 1. Skin rash 2. Bradycardia 3. Hypertension 4. Muscle cramping

2. Bradycardia Systemic absorption of beta-adrenergic blocking agents can impact the cardiovascular system resulting in bradycardia. Skin irritation is not likely with timolol. Hypotension, not hypertension, can occur with beta-adrenergic blocking agents. Muscle cramping is not a common systemic effect of beta-adrenergic blocking agents.

A patient with a history of numbness, weakness, and blurred vision recently was diagnosed with multiple sclerosis (MS). What does the nurse understand to be the underlying pathophysiology for these symptoms? 1. An imbalance of dopamine and acetylcholine in the CNS 2. Inflammation and myelin destruction in the central nervous system (CNS) 3. A high-frequency discharge of neurons from a specific focus area of the brain 4. An inability of serotonin to bind to its receptors in the chemoreceptor trigger zone

2. Inflammation and myelin destruction in the central nervous system (CNS) The underlying pathophysiology of MS is related to myelin destruction and slowing of axonal conduction related to inflammation within the CNS. The demyelination leads to the characteristic neurologic symptoms associated with MS.

A primary healthcare provider has prescribed a monoamine oxidase inhibitor (MAOI) to a patient, along with levodopa/carbidopa. What should the nurse anticipate as the reason for suggesting this combination therapy with an MAOI? 1. It increases the safety of levodopa/carbidopa. 2. It increases the efficacy of levodopa/carbidopa. 3. It decreases the urinary retention associated with levodopa/carbidopa. 4. It decreases the gastrointestinal upset associated with levodopa/carbidopa.

2. It increases the efficacy of levodopa/carbidopa. Levodopa/carbidopa is prescribed for the treatment of Parkinson's disease. During long-term levodopa therapy, patients may become insensitive to the medications. Therefore, to increase the efficacy of the treatment, MAOIs are prescribed as an adjuvant drug. MAOIs do not affect the gastrointestinal effects of levodopa/carbidopa, do not enhance the metabolism and elimination of levodopa/carbidopa, and may not affect the safety of the drug. MAOIs have no effect on the urinary system and may not decrease the risk for urinary retention associated with levodopa/carbidopa.

For what circumstances are central nervous system (CNS) stimulants indicated? Select all that apply. 1. Insomnia 2. Narcolepsy 3. Seizure disorder 4. Hypothyroid disorder 5. Attention-deficit/hyperactivity disorder (ADHD)

2. Narcolepsy 5. Attention-deficit/hyperactivity disorder (ADHD) Central nervous system stimulants are indicated for two primary situations: ADHD and narcolepsy. They can cause convulsions, seizures, and insomnia because they are CNS stimulants. Thyroid hormones are indicated for hypothyroid disorder.

Which statements are true about modafinil? Select all that apply. 1. It is a Schedule II substance. 2. Physical withdrawal has not been reported. 3. Physical dependence has not been reported. 4. Approved uses are for insomnia and hyperthyroidism 5. Modafinil has many off-label uses, such as for the treatment of jet lag and attention-deficit/hyperactivity disorder (ADHD).

2. Physical withdrawal has not been reported. 3. Physical dependence has not been reported 5. Modafinil has many off-label uses, such as for the treatment of jet lag and attention-deficit/hyperactivity disorder (ADHD). Modafinil is a Schedule IV substance, and withdrawal and physical dependence have not been reported. Modafinil—a unique, nonamphetamine stimulant—is approved for promoting wakefulness in patients with excessive sleepiness associated with three disorders: narcolepsy, shift-work sleep disorder, and obstructive sleep apnea/hypopnea syndrome. Although the drug has only these three approved uses, most prescriptions (95%) are written for off-label uses, including fatigue, depression, ADHD, jet lag, and sleepiness caused by medications. Investigational uses include ADHD and fatigue associated with multiple sclerosis. Insomnia and hyperthyroid disorders already have wakefulness issues, so this medication would not be used for those conditions.

Which statements are true about central nervous system (CNS) stimulants? Select all that apply. 1. They decrease the activity of CNS neurons. 2. They can elevate mood by causing excitation. 3. They have the potential to cause convulsions. 4. They increase the blood pressure and heart rate. 5. They are primarily used for bradycardia and narcolepsy.

2. They can elevate mood by causing excitation. 3. They have the potential to cause convulsions. 4. They increase the blood pressure and heart rate. Central nervous system stimulants can elevate mood and cause excitation. They increase the blood pressure and heart rate and have the potential to cause convulsions in high doses. They increase the activity of the CNS neurons and have two primary indications: attention-deficit/hyperactivity disorder and narcolepsy.

What is the clinical use of doxapram? 1. To maintain alertness 2. To stimulate respiration 3. To reduce blood pressure 4. To reduce blood glucose level

2. To stimulate respiration Doxapram is a central nervous system stimulant used for the treatment of respiratory depression. Doxapram does not have hypoglycemic and hypotensive effects. It is not indicated for alertness, although this may be a side effect.

The nurse is discussing treatment options with the family of a patient with Alzheimer's disease (AD) who has recently been losing weight due to loss of appetite. The family also reports that the patient has had several instances of bladder incontinence and is having difficulty with speech. The family asks the nurse if there is any medication that might help the patient. Which response by the nurse provides the most accurate information? 1. "Four drugs are approved for treatment of AD, and all can be used regardless of severity." 2. "Rivastigmine and galantamine can both be used to treat the level of dementia your parent is experiencing." 3. "Memantine may improve cognitive and day-to-day function and would be indicated for your parent's level of Alzheimer's severity." 4. "Luckily, your parent's symptoms are considered moderate, so there are several options for treatment."

3. "Memantine may improve cognitive and day-to-day function and would be indicated for your parent's level of Alzheimer's severity." This patient is displaying symptoms of severe AD, so memantine can be used for this patient. Memantine can improve both cognitive function and physical symptoms. Four drugs are available to treat AD, but only two (memantine and donepezil) are indicated for severe AD. The parent's symptoms indicate severe, not moderate, AD. Rivastigmine and galantamine are only indicated for mild and moderate AD.

Which medications are widely used pharmacologic stimulant drugs? Select all that apply. 1. Ampicillin 2. Methotrexate 3. Amphetamines 4. Methylxanthines 5. Methylphenidate

3. Amphetamines 4. Methylxanthines 5. Methylphenidate Amphetamines, methylxanthines, and methylphenidate are stimulant medications. Ampicillin is an antibiotic, and methotrexate is an antirheumatic drug.

A young child is prescribed medications for attention-deficit/hyperactivity disorder (ADHD). The mother is having difficulty getting her child to take the medication. What can help promote oral ingestion of methylphenidate? 1. Encourage use of a transdermal administration. 2. Encourage taking the medication with large amounts of caffeine. 3. Have the mother try sprinkling the medication on soft food such as applesauce. 4. Try reasoning with the child and giving him or her the option of taking the medication at bedtime.

3. Have the mother try sprinkling the medication on soft food such as applesauce. To help promote oral ingestion of methylphenidate, the nurse can have the mother try sprinkling the medication on soft food such as applesauce. The medication is not available in a transdermal patch. Use of large amounts of caffeine and taking the medication at bedtime is not recommended due to the stimulant side effects.

What information does the nurse understand is true regarding lisdexamfetamine? Select all that apply. 1. Lisdexamfetamine is classified as a Schedule IV drug. 2. A patient taking lisdexamfetamine should be closely monitored for respiratory depression and weight gain. 3. Lisdexamfetamine has a lower abuse potential than other forms of amphetamine. 4. Hypertension and tachycardia are side effects of lisdexamfetamine. 5 Due to the vasodilation side effects, a person taking lisdexamfetamine must be monitored closely.

3. Lisdexamfetamine has a lower abuse potential than other forms of amphetamine. 4. Hypertension and tachycardia are side effects of lisdexamfetamine. 5 Due to the vasodilation side effects, a person taking lisdexamfetamine must be monitored closely. The true statements about lisdexamfetamine are that hypertension and tachycardia are side effects of lisdexamfetamine, and lisdexamfetamine has a lower abuse potential than other forms of amphetamine. Lisdexamfetamine is classified as a Schedule II and not a Schedule IV drug. Lisdexamfetamine does cause vasoconstriction, tachypnea, and weight loss.

Natalizumab is a very effective agent for treating multiple sclerosis. Which problem is associated with the administration of this drug that makes it a second-line agent? 1. Increased risk for sudden cardiac death 2. Documented reports of necrotizing colitis 3. Rare cases of dangerous brain infections 4. Increased risk of Stevens-Johnson syndrome

3. Rare cases of dangerous brain infections Soon after natalizumab was released on the market, there were three reports of progressive, multifocal leukoencephalopathy. All patients who developed this problem were taking natalizumab in combination with another immunosuppressant. The drug now is available only through a specialized, carefully controlled prescribing program.

The pediatric nurse is caring for an adolescent with mild acne. Which class of medication is effective for the management of mild acne in adolescents? 1. An oral retinoid 2. An oral antibiotic 3. A topical antiseptic 4. A topical antimicrobial

4. A topical antimicrobial Mild acne can be treated with topical antimicrobials; this includes benzyl peroxide, dapsone, and clindamycin. Isotretinoin (an oral retinoid) is used for severe acne. Azelaic acid (a topical antiseptic) and oral antibiotics (including minocycline and doxycycline) are used for moderate acne.

Which statements about caffeine does the nurse identify as true?Select all that apply. 1. Caffeine can restore mental functioning during intoxication with alcohol. 2. Caffeine promotes constriction of cerebral blood vessels. 3. Caffeine promotes bronchodilation. 4. Caffeine is a diuretic. 5. Caffeine reduces the capacity for prolonged intellectual exertion.

4. Caffeine is a diuretic. 2. Caffeine promotes constriction of cerebral blood vessels. 3. Caffeine promotes bronchodilation. Caffeine is a diuretic, promotes bronchodilation, and constricts cerebral blood vessels. Caffeine increases the capacity for prolonged intellectual exertion. It is a myth that caffeine can restore mental functioning during alcohol intoxication, although it may delay one from passing out.

Which medication is most effective in treating the remission-exacerbation phase of multiple sclerosis (MS) in a patient? 1. Baclofen 2. Teriflunomide 3. Cyclophosphamide 4. Glatiramer acetate

4. Glatiramer acetate The remission-exacerbation phase of MS is characterized by spasticity. Glatiramer acetate relieves spasticity and is used to treat the remission-exacerbation phase of MS in a patient. Baclofen is used to treat muscle spasms associated with spasticity that are caused by MS and spinal cord injury. Teriflunomide is used to treat the acute attack phase of MS. Cyclophosphamide is used to treat the chronic progressive phase of MS.

The nurse identifies the mechanism of action of the amphetamines as what?Select all that apply. Causing the release of norepinephrine Causing the release of epinephrine Causing the release of dopamine Inhibiting the reuptake of norepinephrine Inhibiting the reuptake of dopamine

A,C,D,E The amphetamines act primarily by causing the release of norepinephrine and dopamine and partly by inhibiting the reuptake of both transmitters. These actions take place in the central nervous system and in peripheral nerves. Most pharmacologic effects result from the release of norepinephrine.

Which statement by the nursing student indicates a need for further instruction? A. "Artificial tears should not be used more than 4 times daily to avoid adverse effects." B. "Fluorescein may be applied to the surface of the eye to assess for corneal abrasions." C. "Phenylephrine is an adrenergic agonist that produces pupil dilation." D. "Oral carbonic anhydrase inhibitors, such as acetazolamide, may be used in the management of open-angle glaucoma refractory to preferred medications." Artificial tears are devoid of adverse effects and may be administered as long and as often as desired. Phenylephrine is an adrenergic agonist that produces pupil dilation. Fluorescein may be applied to the surface of the eye to assess for corneal abrasions. Oral carbonic anhydrase inhibitors, such as acetazolamide, may be used in the management of open-angle glaucoma refractory to preferred medications.

A. "Artificial tears should not be used more than 4 times daily to avoid adverse effects." Artificial tears are devoid of adverse effects and may be administered as long and as often as desired. Phenylephrine is an adrenergic agonist that produces pupil dilation. Fluorescein may be applied to the surface of the eye to assess for corneal abrasions. Oral carbonic anhydrase inhibitors, such as acetazolamide, may be used in the management of open-angle glaucoma refractory to preferred medications.

The nurse is teaching a class to new parents about the prevention of acute otitis media (AOM). Which strategies should the nurse include? Select all that apply. A. "Eliminate exposure to tobacco smoke." B. "Promote bottle feeding in an upright position." C. "Encourage the use of pacifiers after 6 months." D. "Use a topical antibiotic monthly after age 2 years." E. "Avoid day care and child care centers when respiratory infections are prevalent."

A. "Eliminate exposure to tobacco smoke." B. "Promote bottle feeding in an upright position." E. "Avoid day care and child care centers when respiratory infections are prevalent." The risk of acquiring AOM can be reduced by eliminating exposure to tobacco smoke, avoiding supine bottle feeding, and avoiding child care centers when respiratory infections are prevalent. Reducing pacifier use after age 6 months may be an additional benefit. Topical antibiotic use does not reduce the risk of acquiring AOM and is not recommended.

The nurse at a screening clinic for primary open-angle glaucoma (POAG) should assess patients for which major risk factors? Select all that apply. A. Black race B. Hypertension C. Advancing age D. Familial history E. Elevated intraocular pressure

A. Black race C. Advancing age D. Familial history E. Elevated intraocular pressure The risk factors for POAG include elevation of the intraocular pressure, black race, family history of POAG, and advancing age. Hypertension is not associated with the development of POAG.

The nurse instructs the nursing student to avoid administering cold ear drop solution to the patient. What rationale does the nurse give for this intervention? A. Cold solution may cause dizziness. B. The solution may be destabilized when cold. C. Cold solution may reduce coverage of the medication. D .The solution may lose its potency and efficacy when cold.

A. Cold solution may cause dizziness. Administration of ear drops that are too cold may cause a vestibular type of reaction with vomiting and dizziness. If the solution has been refrigerated, allow it to warm to room temperature. The ear drop medication may lose its potency at higher temperatures. Cooling the medication does not affect its coverage. Gentle massage to the tragus area of the ear may increase coverage of the medication. Exposure of the drug to high temperatures may destabilize the drug. Cooling does not affect the stability of ear drop solution.

The nurse prepares a patient for an intraocular examination by administering a topical anticholinergic agent intended to achieve which outcome? A. Dilation of the pupil B. Numbing of the eye C. Constriction of the iris D. Drainage of aqueous humor

A. Dilation of the pupil Anticholinergic medications produce mydriasis (dilation of the pupil) and cycloplegia (paralysis of the ciliary muscle). These actions facilitate diagnosis of and surgery for ophthalmic problems. Numbing of the eye, constriction of the iris, and drainage of aqueous humor are not therapeutic effects of anticholinergic agents.

Which bony structures are located in the middle ear? Select all that apply. A. Incus B. Stapes C. Malleus D. Cochlea E. Temporal

A. Incus B. Stapes C. Malleus The middle ear consists of three bony structures of the mastoid bone: the incus, stapes, and malleus. The cochlea is not a bony structure; it is the auditory portion of the inner ear. The temporal bone is not in the middle ear; it is part of the skull.

In which part of the ear are cochlea and semicircular canals located? A. Inner B. Outer C. Middle D. External

A. Inner The cochlea and semicircular canals are located in the inner part of the ear. The external auditory canal is in the outer part of the ear. The tympanic cavity is in the middle part of the ear. The pinna is part of the external ear.

Which otic preparations are recommended for a patient who has a perforated eardrum? Select all that apply. A. Ofloxacin B. Neomycin C. Polymyxin B D. Ciprofloxacin E. Hydrocortisone

A. Ofloxacin D. Ciprofloxacin Ofloxacin and ciprofloxacin are recommended for the patient with a perforated eardrum. These medicines are safe for the patient with a perforated eardrum. Neomycin, polymyxin B, and hydrocortisone are contraindicated in patients with a perforated eardrum because these drugs may cause permanent damage to the ear.

The nurse should teach a patient who is applying salicylic acid for acne to report which finding as a manifestation of systemic toxicity? A. Tinnitus B. Diarrhea C. Hypoglycemia D. Nausea and vomiting

A. Tinnitus Salicylic acid is readily absorbed through the skin, and systemic toxicity (salicylism) can result. Symptoms include tinnitus, hyperpnea, and psychologic disturbances. Nausea and vomiting, diarrhea, and hypoglycemia are not associated adverse effects of salicylic acid.

Which neurotransmitter level is decreased by as much as 90% in patients with severe Alzheimer's disease (AD)? 1. Serotonin 2. Dopamine 3. Acetylcholine 4. Norepinephrine

Acetylcholine Acetylcholine levels naturally decline by a small percentage with age. Patients with severe AD may have acetylcholine levels that are as much as 90% below normal. This is likely part of the explanation for the pathophysiology of AD. Alterations in serotonin, dopamine, and norepinephrine levels do not explain the pathophysiology of AD.

Which is true about topical medications to treat ear disorders? A. "Topical medications are effective in treating disorders of the middle ear." B. "Topical medications are effective in treating disorders of the external ear." C. "Topical medications are effective in treating disorders of the inner ear." D. "Topical medications are effective in treating disorders of the outer ear."

B. "Topical medications are effective in treating disorders of the external ear." Topical medications are effective for external ear disorders. Topical medications are not applicable in treating disorders of the inner, outer, or middle ear. Outer and middle ear disorders require antimicrobial agents or wax emulsifiers as a part of treatment plan. Disorders of the inner ear are complicated and done under the supervision of a primary health care provider.

The nurse should teach a patient at risk of developing progressive vision loss from dry age-related macular degeneration (ARMD) to increase the dietary intake of which nutrients? A. Potassium-rich foods B. Antioxidants and zinc C. Green, leafy vegetables D. Calcium and phosphorus

B. Antioxidants and zinc In patients with dry ARMD, prophylactic treatment with high-dose antioxidants and zinc may prevent the disease from progressing to the advanced stage. No evidence indicates that potassium-rich foods; green, leafy vegetables; and calcium and phosphorus reduce the effects of dry ARMD.

In which condition is the accommodation of the lens impaired due to the paralysis of the ciliary muscles? A. Cataract B. Cycloplegia C. Open-angle glaucoma D. Angle-closure glaucoma

B. Cycloplegia Cycloplegia is an ophthalmic disorder caused by paralysis of the ciliary muscles. This condition results in the loss of accommodation, which means the patient loses the ability to focus on objects near them. Cataract is the condition in which the patient has blurred vision due to clouding of the lens (loss of transparency). Open-angle glaucoma is a disorder caused by the accumulation of aqueous humor; it is caused by obstruction of the canal of Schlemm by tissue growth and protein accumulation. Angle-closure glaucoma is caused by narrowing of the anatomic angle between the lens and cornea.

A patient has been started on benzoyl peroxide as part of the treatment regimen. The nurse would recognize that this drug belongs to which drug class? A. Topical antibiotic B. Keratolytic agent C. Systemic antibiotic D. Topical vitamin A derivative

B. Keratolytic agent Benzoyl-peroxide is classified as a keratolytic agent and as such actually causes the outer layer of skin to loosen and shed. It is not used systemically, is not a topical antibiotic, and is not a vitamin A derivative.

Question 5 of 10The healthcare provider orders clonidine [Kapvay] 0.1 mg BID for a patient with ADHD. What will the total dose be for a 24-hour period? a. 0.1 mg b. 0.2 mg c. 0.4 mg d. 0.25 mg

BID means twice per day; 0.1 mg times 2 (2 doses in 1 day) equals 0.2 mg.

Melanin provides protection against ultraviolet radiation through which layer of the skin? A Dermis B Subcutaneous tissue C Basal layer of the epidermis D Cornified layer of the epidermis

C Basal layer of the epidermis Melanin is produced by the melanocytes, which are located in the basal layer of the epidermis, the outermost layer of the skin. The dermis underlies the epidermis and is mostly connective and collagen tissue. The subcutaneous tissue provides a layer of insulation and is mostly fat. The cornified layer of the epidermis has a high keratin content and is continuously shed.

A patient newly diagnosed with MS asks the nurse how a person gets this disease. Which response by the nurse is most accurate and appropriate? A. "Multiple sclerosis is a congenital condition that typically manifests itself in late adulthood." B. "Multiple sclerosis is a disease believed to be caused by exposure to drugs during a mother's pregnancy." C. "This is an autoimmune disease that occurs in people with certain genetic traits when they are exposed to some environmental trigger factor." D. "This disease is most often caused by an increase of rapidly dividing cells in the central nervous system."

C. "This is an autoimmune disease that occurs in people with certain genetic traits when they are exposed to some environmental trigger factor." Although the exact cause is unknown, MS is believed to have a genetic link. Susceptible individuals have an autoimmune response when exposed to environmental or microbial factors. It is more common among first-degree relatives of individuals who have the disease and is more prevalent among Caucasians. It also is more common in cooler climates, with increased incidence moving away from the equator. MS also may be associated with the Epstein-Barr virus, human herpes virus 6, and Chlamydia pneumoniae infection.

Which instruction does the nurse include in the teaching plan for a patient who is to be started on brimonidine ophthalmic drops? A. "A common side effect is an increase in salivation." B. "You may notice an increase in the length and thickness of your eyelashes." C. "Wait 15 minutes after instilling the eye drops before putting in your contact lenses." D. "The drug may cause an increase in brown pigmentation of your iris."

C. "Wait 15 minutes after instilling the eye drops before putting in your contact lenses." Brimonidine can be absorbed into contact lenses. Patients should wait at least 15 minutes between applying the eye drops and putting in their contact lenses. The drug can lead to dry mouth, not increased salivation. Changes in iris pigmentation and eyelash length and thickness are associated with the prostaglandin analogs.

The nurse caring for a patient who is taking the prostaglandin analog latanoprost would document which finding as an adverse effect? A. Tachycardia and hypertension B. Ocular stinging and conjunctivitis C. Heightened brown pigment of the iris D. Headache, dry mouth, and altered taste

C. Heightened brown pigment of the iris Latanoprost is used to increase aqueous outflow in the treatment of open-angle glaucoma. Heightened brown pigmentation of the iris occurs as an adverse effect. Tachycardia and hypertension are associated with nonselective adrenergic agonists. Headache, dry mouth, and altered taste are associated with alpha-adrenergic agonists. Ocular stinging and conjunctivitis are seen with carbonic anhydrase inhibitors.

A patient infected with the human immunodeficiency virus is diagnosed with severe necrotizing otitis externa. Which would be the most appropriate treatment for this condition? A. Oral fluconazole B. Intramuscular ceftriaxone C. Intravenous imipenem/cilastatin D. 2% acetic acid solution to the external ear canal

C. Intravenous imipenem/cilastatin Patients with severe necrotizing otitis externa should receive intravenous antipseudomonal therapy with imipenem/cilastatin, meropenem, or ciprofloxacin. Fluconazole is an antifungal agent. Ceftriaxone given intramuscularly is an alternative to amoxicillin/clavulanate in the treatment of resistant acute otitis media. Topical acetic acid solution is used to treat acute otitis external

A patient with glaucoma has green eyes. The nurse observes that within 2 months the patient's eyes turned brown. Which antiglaucoma drug caused this adverse effect in the patient? A. Betaxolol B. Gentamicin C. Latanoprost D. Ciprofloxacin

C. Latanoprost Latanoprost is a prostaglandin agonist used in the treatment of glaucoma. In some patients, prostaglandin agonists turn hazel, green, or bluish eyes brown. This effect can be observed even after discontinuing the medication. Betaxolol is a beta-blocking drug used in the treatment of chronic open-angle glaucoma and ocular hypertension. On long-term use it may cause transient burning, discomfort, blurred vision, pain, photophobia, lacrimation, blepharitis, keratitis, and decreased corneal sensitivity. Ciprofloxacin is a quinolone antibiotic used for the treatment of bacterial keratitis. The adverse effects of quinolone antibiotics are white, crystalline precipitates in the cornea, corneal staining, and infiltrates. Gentamicin is an aminoglycoside used to treat infections caused by Pseudomonas, Proteus, and Klebsiella organisms. The adverse effects of gentamicin are swollen eyelids, mydriasis, and local erythema.

In which part of the ear is the tympanic cavity located? A. Inner B. Outer C. Middle D. External

C. Middle The tympanic cavity is in the middle ear. The tympanic cavity is the space that begins with the tympanic membrane and ends with the oval window. The cochlea and semicircular canals are located in the inner part of ear. The external auditory canal is in the outer part of the ear. The pinna is part of the external ear.

The premature infant has recurring episodes of apnea followed by bradycardia requiring vigorous stimulation. Which medication should the nurse request for this patient?

Caffeine citrate Premature infants frequently suffer from apnea of prematurity due to their immature nervous systems. Caffeine is administered to prevent apneic events. Iron sulfate is given to premature infants to prevent anemia of prematurity. Albuterol is rarely used in infants for bronchoconstriction. Methylphenidate is used to treat attention deficit disorder.

In which condition is the intraocular pressure increased due to accumulation of aqueous humor? A. Cataract B. Cycloplegia C. Angioneurotic edema D. Angle-closure glaucoma

D. Angle-closure glaucoma Angle-closure glaucoma is a condition in which the intraocular pressure increases due to the accumulation of aqueous humor. The aqueous humor can accumulate due to the closure of the anterior angle between the iris and the trabecular meshwork. Cataract is the loss of transparency of the lens, resulting in blurred vision. Cycloplegia is the paralysis of the ciliary muscles of the eye. Cycloplegia prevents the accommodation of the lens for variations in distance. Angioneurotic edema (angioedema) is a common adverse effect of ocular antibiotics. It is a caused by swelling of the dermis and the subcutaneous tissues.

Which inhibitory neurotransmitter is involved in Parkinson's disease (PD)? 1. Oxytocin 2. Dopamine 3. Adrenaline 4. Acetylcholine

Dopamine Dopamine is the inhibitory neurotransmitter involved in PD. The disease is characterized by low concentrations of dopamine. Acetylcholine is an excitatory neurotransmitter that counteracts the effects of dopamine. The adrenergic glands on the kidney release adrenaline. Oxytocin is released by the pituitary gland; it is a not a neurotransmitter.

Why is levodopa the mainstay of treatment for a patient with Parkinson's disease? 1. It enhances dopamine release. 2. It impairs dopamine breakdown. 3. It promotes dopamine synthesis. 4. It provides a dopamine precursor.

It provides a dopamine precursor. Levodopa is a biologic precursor of dopamine that must be combined with carbidopa so the brain can use it to synthesize dopamine; it is the only agent that acts in this manner. Other dopaminergic agents increase the brain's dopamine by stimulating its release, directly and indirectly; inhibiting enzymes that degrade it; and stimulating its synthesis.

A 6-year-old patient is being evaluated for attention deficit hyperactivity disorder (ADHD). Which characteristics must be identified in the child's behavior before central nervous system stimulants are indicated? Select all that apply.

Lack of ability to control impulses, Symptoms lasting at least 6 months, Short attention span for the child's age Primary symptoms of ADHD are a developmentally inappropriate ability to maintain attention span and/or the presence of hyperactivity and impulsivity. A clinical indicator of ADHD that must be present for at least 6 months and in two different settings is a short attention span for the child's age. Learning disabilities, mental illness, and familial tendencies are commonly associated with ADHD, but the diagnosis does not depend on the presence of these factors. ADHD usually begins before the age of 7 years.

Which drug used in the treatment of Alzheimer's disease blocks neuronal receptors for N-methyl-D-aspartate (NMDA)? 1. Donepezil 2. Memantine 3. Galantamine 4. Rivastigmine

Memantine Memantine blocks neuronal receptors for NMDA. Donepezil, galantamine, and rivastigmine are cholinesterase inhibitors, which prevent the breakdown of acetylcholine by acetylcholinesterase and thereby increase the availability of acetylcholine at cholinergic synapses.

Which medication is contraindicated in a patient receiving selegiline for Parkinson's disease? 1. Aspirin 2. Lisinopril 3. Ranitidine 4. Meperidine

Meperidine Concomitant administration of a monoamine oxidase-B (MAO-B) inhibitor such as selegiline with meperidine is contraindicated because it can cause serotonin syndrome as a result of enhanced serotonin activity in the brain. Administration of lisinopril, ranitidine, or aspirin is not contraindicated.

Which medications can be used to manage fatigue associated with multiple sclerosis (MS)? Select all that apply. 1. Modafinil 2. Clonazepam 3. Dalfampridine 4. Amantadine 5. Carbamazepine

Modafinil Amantadine

A patient with a history of migraine headaches tells the nurse, "I feel sleepy during the daytime and often fall asleep in the middle of activities." Which drug does the nurse expect to be prescribed for the patient?

Modafinil Patients with narcolepsy suddenly fall asleep while doing daily activities, such as driving. Modafinil should be the prescribed drug for the patient with narcolepsy. The drug is a central nervous system stimulant and improves wakefulness. Benzphetamine is an amphetamine drug prescribed to manage obesity. Atomoxetine is prescribed for attention-deficit/hyperactivity disorder (ADHD). Methylphenidate is prescribed to children with ADHD.

Which enzyme is inhibited by the antiparkinson drug selegiline? 1. Cholinesterase 2. Monoamine oxidase 3. Superoxide dismutase (SOD) 4. Catechol O-methyltransferase (COMT)

Monoamine oxidase Selegiline is the selective inhibitor of the monoamine oxidase enzyme. Selegiline does not show any action on the COMT enzyme. Selegiline does not bind to cholinesterase, the enzyme useful in breaking down cholinergic neurotransmitters. SOD is an enzyme that has antioxidant activity and is useful in the prevention of Alzheimer's disease. Selegiline does not alter levels of the SOD enzyme.

The primary healthcare provider has prescribed dimethyl fumarate to a patient. Which condition can be treated with this medication? 1. Myasthenic crisis 2. Myasthenia gravis 3. Remission-exacerbation phase of MS 4. Chronic progressive phase of multiple sclerosis (MS)

Remission-exacerbation phase of MS Dimethyl fumarate possesses immunomodulatory properties and is used to treat symptoms such as spasticity, which occur during the remission-exacerbation phase of MS. Oral administration of 120 to 240 mg of dimethyl fumarate twice daily is recommended for relieving symptoms. Neostigmine is used in the treatment of myasthenic crisis and also for controlling myasthenia gravis. Cyclophosphamide is an immunosuppressant used to treat the chronic progressive phase of MS.

A nurse working with patients who are diagnosed with attention deficit hyperactivity disorder (ADHD) is aware such patients often take central nervous system (CNS) stimulant drugs. These medications are potent, with a high potential for abuse and dependence. Based on this potential, how are these medications classified?

Schedule II CNS stimulants are the first-line drugs of choice for both ADHD and narcolepsy. They are potent drugs with a strong potential for tolerance and psychological dependence and are therefore classified as Schedule II drugs under the Controlled Substances Act.

Which drug is used as an adjunct therapy with levodopa/carbidopa to treat Parkinson's disease? 1. Selegiline 2. Entacapone 3. Benztropine 4. Amantadine

Selegiline Selegiline is a selective type B monoamine oxidase inhibitor that is useful as adjunct therapy with levodopa/carbidopa to decrease fluctuating symptoms. Amantadine is useful for reducing muscle tremors and rigidity. Benztropine is useful as a secondary drug for treating symptoms such as muscle tremors and rigidity. Entacapone is also used along with levodopa/carbidopa, but it is not used as an adjuvant drug. However, it is useful to cure the on-off phenomenon caused by levodopa/carbidopa therapy

The primary health care provider has prescribed atomoxetine for a child diagnosed with attention deficit hyperactivity disorder (ADHD). Which is an important adverse effect to monitor in this child?

Suicidal tendencies The U.S. Food and Drug Administration has issued a warning against the use of atomoxetine because it causes suicidal tendencies in adolescents and children. Atomoxetine has a very low risk of causing insomnia due to its effect on the sleep cycle. Atomoxetine is a norepinephrine reuptake inhibitor. It does not affect hormonal balance. Therefore, it does not cause mood swings. Unlike amphetamines, atomoxetine does not show addictive properties in children.

Which medication is most appropriate for a patient newly diagnosed with relapsing-remitting multiple sclerosis (MS)? 1. Fingolimod 2. Natalizumab 3. Teriflunomide 4. Mitoxantrone

Teriflunomide Teriflunomide is an immunomodulator and is most appropriate for someone with relapsing-remitting MS. Fingolimod can cause significant adverse effects and is commonly reserved for patients who cannot tolerate injections or who have not responded well to other immunomodulators. Natalizumab carries a risk of progressive multifocal leukoencephalopathy, a severe infection of the brain, and carries protective restrictions on who can prescribe, dispense, administer, and receive it. Mitoxantrone poses a significant risk of toxicity so is usually reserved for patients with worsening relapsing-remitting MS, secondary progressive MS, or progressive-relapsing MS who cannot be treated with safer agents.

The healthcare provider orders entacapone 400 mg by mouth (PO) every 6 hours. The nurse notes that the total dose given in a 24-hour period would be what amount? 1. 800 mg 2. 1400 mg 3. 1600 mg 4. 3200 mg

The answer "1600 mg" is correct because 24 hours divided by 6 doses equals 4 doses of 400 mg; 400 mg times 4 doses equals 1600 mg.

Which structure is found in the inner ear? A. Auricle B. Eardrum C. Auditory canal D. Semicircular canals

The inner ear is composed of semicircular canals. They are associated with the cochlea and supplied by several nerves. The nerves associated with the inner ear are the vestibular, facial, and cochlear nerves. The auricle, eardrum, and auditory canal are not structures of the inner ear. The auricle, or pinna, is part of the external region of the ear. The eardrum is a structure found in the middle region of the ear. The auditory canal forms the middle region of the ear.

A pediatric patient weighing 48 kg is prescribed atomoxetine to treat attention-deficit/hyperactivity disorder. What is the maximum safe dose that this patient may receive in a day?mg of atomoxetine per day

The prescribed oral dose of atomoxetine for a pediatric patient less than 70 kg is 0.5 to 1.2 mg/kg/day divided once or twice daily. The weight of the patient is 48 kg. The maximum safe dose can be calculated by multiplying the maximum dose by the weight of the patient and dividing by the number of times the dose has been administered. Therefore, the maximum safe dose of the drug that can be taken by this patient is equal to 1.2 mg × 48 mg/day or 57.6 mg/day.

Which eye assessment, if present in the patient, would prompt the nurse to document miosis in the patient's chart? A. Unequal pupil size B. Opaque, cloudy lens C. Small, constricted pupils D. Increased pigment in the iris

The term miosis refers to constricted pupils. An opaque, cloudy lens; unequal-sized pupils; and increased iris pigment are not associated with miosis or pupillary constriction.

Which of the following statements about bupropion are true?Select all that apply. a. Bupropion can reduce behavioral symptoms of ADHD. b. Bupropion is more effective than stimulants. c. Bupropion lacks the adverse effects associated with tricyclic antidepressants. d. Bupropion poses a risk for seizures. e. Bupropion is considered a second-line drug for ADHD.

a. Bupropion can reduce behavioral symptoms of ADHD. c. Bupropion lacks the adverse effects associated with tricyclic antidepressants. d. Bupropion poses a risk for seizures. e. Bupropion is considered a second-line drug for ADHD. Bupropion can reduce behavioral symptoms of attention-deficit/hyperactivity disorder but is less effective than stimulants. The drug lacks the adverse effects associated with tricyclic antidepressants (eg, cardiotoxicity and anticholinergic effects) but does pose a risk of seizures.

Which assessment is essential before a patient receives a second dose of mitoxantrone [Novantrone]? (Select all that apply.) a. Pregnancy test b. Echocardiogram c. Complete blood count d. T3, T4, and TSH levels e. Ophthalmic examination d. Magnetic resonance imaging (MRI)

a. Pregnancy test b. Echocardiogram c. Complete blood count Mitoxantrone can cause a variety of adverse effects. Myelosuppression, cardiotoxicity, and fetal injury are the greatest concerns. Consequently, a pregnancy test and a complete blood count should be done, as well as an echocardiogram to determine the left ventricular ejection fraction. Thyroid function studies and MRI are not necessary. Ophthalmic examinations are necessary when the patient is experiencing macular edema, an adverse effect of fingolimod.

A patient is diagnosed with Parkinson's disease. The nurse finds that the patient is taking vitamin B 6 supplements. Which drug can be safely administered to the patient? a. Ropinirole b. Alprazolam [Xanax] c. Pilocarpine [Salagen] d. Carbidopa-levodopa [Sinemet]

a. Ropinirole

Question 6 of 10Which statement about tricyclic antidepressants for ADHD is true? a. TCA drugs decrease hyperactivity. b. TCA drugs decrease inattention. c. TCA drugs work rapidly. d. TCA drugs can be taken as needed (PRN).

a. TCA drugs decrease hyperactivity. TCA drugs decrease hyperactivity but have little effect on impulsivity and inattention. Responses develop slowly. Beneficial effects begin in 2 to 3 weeks and reach a maximum at around 6 weeks. Tolerance frequently develops within a few months. In contrast to the stimulants, which can be discontinued on weekends, antidepressants must be taken continuously.

A patient is diagnosed with attention deficit hyperactivity disorder (ADHD). Which drug is suitable for treatment of this disorder? 1. Orlistat 2. DoxapramIn 3. Sumatriptan 4. Atomoxetine

atomoxetine Atomoxetine is a nonstimulant drug used to treat ADHD. It is prescribed to children older than 6 years and to adults. Orlistat, doxapram, and sumatriptan are not used to treat ADHD. Orlistat is a drug that is used to treat obesity. Doxapram is an analeptic that is used to treat drug-induced respiratory depression. Sumatriptan is a serotonin receptor agonist and is indicated for acute migraine headache.

A patient with Parkinson's disease is treated with levodopa [Parcopa]. During the follow-up visit, the nurse finds that the patient is having an on-off phenomenon caused by the medication. Which findings would likely cause the nurse to come to this conclusion? a. Sudden increase in respiratory rate b. Uncontrollable voluntary movements c. Frequent delusions and hallucinations d. Suicidal intentions and aggressive behavior

b. Uncontrollable voluntary movements Many patients tend to have on-off phenomena when they are taking a dopamine medication such as levodopa. On-off phenomena are characterized by the increase and decrease of dopamine levels. This fluctuation causes dyskinesia, in which the patient has impaired voluntary movements. Levodopa does cause suicidal intentions and aggressive behavior, but this is not related to the on-off phenomenon. Levodopa does not alter the respiratory rate because it does not affect pulmonary function. The on-off syndrome is related to the efficacy of the drug; it is unrelated to delusions and hallucinations.

The nurse is caring for a patient who describes symptoms indicative of narcolepsy. The nurse recognizes that the physician is most likely to order which medication for the patient? a. Phentermine-topiramate (Qsymia) b. Diethylpropion HCl (Tenuate) c, Modafinil (Provigil) d. Benzphetamine HCl (Didrex)

c, Modafinil (Provigil) Modafinil is indicated for treatment of narcolepsy. The other medications are not.

A patient with Parkinson's disease is prescribed pramipexole [Mirapex] along with levodopa/carbidopa [Sinemet]. Which symptom is most likely a manifestation of an adverse effect of these drugs when given together? a. Diarrhea b. Wheezing c. Dyskinesia d. Headache

c. Dyskinesia When pramipexole is combined with the levodopa component in levodopa/carbidopa, patients are most likely to experience symptoms of dyskinesias, such as dyskinesia (head bobbing) and orthostatic hypotension. Diarrhea, wheezing, and headache are not common responses to these drugs.

What is the dose regimen of methylphenidate (Ritalin) for a 6-year-old child with attention deficit hyperactivity disorder (ADHD)? a. 20 mg after lunch b. 120 mg at each meal c. 50 mg as a single dose d. 5 mg before breakfast and lunch

d. 5 mg before breakfast and lunch Methylphenidate is a central nervous system stimulant prescribed for the treatment of ADHD. The dose prescribed for a 6-year-old child is 5 mg before breakfast and lunch. The dose prescribed to an adult is 20 mg after lunch. A patient on orlistat therapy is prescribed 120 mg at each meal. An adult on methylphenidate is prescribed 50 mg as a single dose.

The nurse is caring for a patient taking dextroamphetamine [Dexedrine]. Which symptom, if present, is most likely an adverse effect of this drug? a. Heart rate of 60 beats per minute b. Respiratory rate of 10 breaths per minute c. Weight gain d. Restlessness

restlessness The adverse effects of amphetamines include central nervous system stimulation (eg, insomnia, restlessness, and talkativeness), weight loss, cardiac stimulation (eg, dysrhythmias, angina, and hypertension), and psychosis (paranoia). Bradycardia and bradypnea are not associated with amphetamines.

What are the signs and symptoms of acute caffeine toxicity? Select all that apply.

tinnitus, tachypnea Signs and symptoms of acute caffeine toxicity include tinnitus and tachypnea. Excitation, restlessness, and insomnia are associated with caffeine toxicity. Lethargy, polyphagia, and narcolepsy are not expected symptoms of acute caffeine toxicity.