NClEX Pharm Questions

The client has been taking an atypical antipsychotic medication for several years. During annual physical examinations, what assessment best addresses a likely adverse effect? A. Blood pressure B Assessment of passive range of motion C. Fasting blood glucose level D.Electrocardiogram

C Clients taking atypical antipsychotic drugs are at increased risk of developing diabetes and should be regularly screened. Clients taking typical antipsychotics are at risk for prolonged QT intervals, but this is less likely with atypical antipsychotics. Hypotension, specifically orthostatic hypotension, is a potential adverse effect of typical antipsychotic medications. Passive range of motion is unlikely to be affected.

A nurse is reviewing the indications for the use of fluoxetine. For what client would this drug be appropriate? A. A young adult client with bulimia B. An adult client who has bipolar disorder C. A client with generalized anxiety disorder D.A client who has trichotillomania

A. Fluoxetine is indicated for the treatment of bulimia. Escitalopram is indicated for the treatment of generalized anxiety disorder. Duloxetine is indicated for the treatment of diabetic neuropathic pain. Citalopram is indicated for the treatment of trichotillomania.

When assessing a client receiving a beta-specific adrenergic agonist, the nurse would identify what findings as adverse effects of the drug? Select all that apply. A. Headache B. Steatorrhea (fatty stools) C. Bradycardia D. Restlessness E.Pupil constriction

A,D Adverse effects of beta-specific adrenergic agonists include restlessness, tachycardia, headache, GI upset, muscle cramps, and pupil dilation. Steatorrhea is not a noted adverse effect.

A client has a diagnosis of Parkinson disease, a health problem that has effects on motor function and cognition. What neurotransmitter is most likely deficient in this client's CNS? A. Dopamine B. Acetylcholine C.Norepinephrine D. Gamma-aminobutyric acid (GABA

A . Dopamine levels are disrupted in Parkinson disease, as evidenced by the profound effects of motor function and cognition. Norepinephrine, acetylcholine, and GABA do not have this combination of motor and cognitive functions.

A client's nerve has been stimulated by pain and the resulting electrical action potential has reached the end of the axon. What will happen next? A. A neurotransmitter will be released into the synaptic cleft. B. The signal will revert back to the neuronal cell body C. .The adjacent nerve will be electrically stimulated. D. The signal will cross the synaptic cleft and continue via a new neuron.

A neurotransmitter will be released into the synaptic cleft. When the electrical action potential reaches the end of an axon, the electrical impulse comes to a halt. The transmission of information between two nerves or between a nerve and a gland or muscle is chemical. The nerve axon, called the presynaptic nerve, releases a chemical called a neurotransmitter into the synaptic cleft, and the neurotransmitter reacts with a very specific receptor site on the postsynaptic cell to cause a reaction. The signal does not revert back to the cell body

. When working with a client who is experiencing a stress response, the nurse should anticipate what effects? Select all that apply. A. Tachycardia B. Diaphoresis C. Hypotension D. Increased bowel sounds E. Pupil dilation

A, B,E In the stress response, tachycardia, pupil dilation, hypertension, decreased bowel sounds, and diaphoresis would be noted.

Acetylcholine is classified as a catecholamine. FALSETRUE

FALSE Acetylcholine is a neurotransmitter. Norepinephrine and epinephrine are considered catecholamines.

A client with schizophrenia will exhibit fluctuations in mood swings from depression to mania. FALSETRUE

FALSE Schizophrenia is characterized by hallucinations, paranoia, delusions, speech abnormalities, and affective problems. Bipolar disorder involves extremes of depression followed by hyperactivity and excitement (mania).

A client in cardiogenic shock has been prescribed a naturally occurring catecholamine. The nurse should prepare to administer what medication? A. Ephedrine B. Dobutamine C. Isoproterenol D. Dopamine

D. Dopamine is a naturally occurring catecholamine. Dobutamine is a synthetic catecholamine. Ephedrine is a synthetic catecholamine. Isoproterenol is a sympathomimetic.

. Dendrites route information away from the nerve cell, while axons bring information to the nerve. FALSE/TRUE

False Axons route information away from the nerve cells; dendrites bring information to the nerve.

Beta-receptors react with endorphins in the periphery to modulate pain transmission. FALSETRUE

False Beta-receptors react with enkephalins in the periphery to modulate pain transmission.

A client's past experience with pain has little impact on his or her perception of pain .FALSE/TRUE

False Past experience with pain has a large impact on how pain is perceived.

Tricyclic antidepressants are lipid insoluble. FALSETRUE

False Tricyclics are lipid soluble and highly bound to plasma proteins.

Nicotinic receptors are found in what location? A. Adrenal medulla B. Bladder C. Gastrointestinal tract D. Sweat glands

A Nicotinic receptors are found in the CNS, the adrenal medulla, the autonomic ganglia, and the neuromuscular junction. Muscarinic receptors are found in the sweat glands, bladder, and GI tract.

What drug would the nurse expect to be given to a client experiencing acute bronchospasm? A. Epinephrine B. Norepinephrine C. Ephedrine D. Dopamine

A Epinephrine would be used to treat bronchospasm. Dopamine is indicated for the treatment of congestive heart failure. Ephedrine is used to treat hypotensive episodes. Norepinephrine is used to treat shock and during cardiac arrest to promote sympathetic activity.

What is an alternative name for the parasympathetic nervous system?A. Lumbosacral B. Craniosacral C. Craniolumbar D.Thoracolumbar

B The parasympathetic system is sometimes called the craniosacral system because the CNS neurons that originate parasympathetic impulses are found in the cranium. The SNS is also called the thoracolumbar system because the CNS cells that originate impulses for this system are located in the thoracic and lumbar sections of the spinal cord. The other two options are distractors.

A client is taking a medication that is a monoamine oxidase inhibitor? The client's levels of what neurotransmitter may increase? A. GABA B. Norepinephrine C. Dopamine D.Acetylcholine

B MAO is an enzyme that breaks down norepinephrine to make it inactive. Inhibition of MAO.

A client asks the nurse, "I've always been told that once you lose brain cells, they're gone forever. Is that true?" What should the nurse teach the client about neuron regeneration? A.Neurons are the only body cells that are wholly incapable of healing or regenerating. B. Neurons regenerate but at a far slower rate than other body cells. C. Some regeneration can occur if the soma and axon hillock are intact. D. It was previously believed that neurons did not regenerate, but this has been found to not be the case.

C. Although nerves do not reproduce, they can regenerate injured parts if the soma and axon hillock remain intact.

A client in shock has been prescribed isoproterenol. The nurse determines to take which next action when preparing to administer the medication? A. Ensure that the client is capable of using an inhaler B. .Check the client's blood glucose level. C. Educate the client about expected adverse effects. D.Establish reliable intravenous access.

D. Isoproterenol is usually administered IV. It is not given by inhaler. There is no obvious need to check the client's glucose levels in relation to medication therapy. The client is in shock, so education is not a short-term priority.

A hospital client has been prescribed morphine for the treatment of postsurgical pain. The client tells the nurse, "I'm determined to push through my pain if I can, because there's no way I want to end up addicted to narcotics." What should the nurse teach the client? A. The client's need for pain control should be a higher priority than the fear of addiction. B. Any addiction that the client develops can be treated prior to discharge from the hospital C. .Narcotics used in healthcare settings are nonaddictive and are unrelated to drugs used recreationally E..It is extremely unlikely that the client would become addicted to narcotics used for this purpose.

E. A client's risk of becoming addicted to narcotics that are used for medical purposes is exceedingly low. However, the drugs themselves are capable of causing addiction and many have a potential for abuse. It is paternalistic to state that a client must prioritize pain control over a fear of addiction.

During periods of dehydration, the client is at risk for lower serum lithium levels. FALSETRUE

False During periods of sodium depletion or dehydration, the kidney reabsorbs more lithium into the serum, often leading to toxic levels.

sest to the effector cell in a muscle. At what location is this signal? A signal has reached the terminus of a client's nerve and is in the space where the nerve is closest to the effector cell in a muscle. At what location is this signal? A. Soma B. Schwann cell C. Neuron D. Synapse

Synapse The synapse refers to the junction between a nerve and an effector such as a gland, muscle, or other nerve. The neuron is the basic structural unit of the nervous system. Soma refers to the cell body of a neuron. A Schwann cell is a specialized insulating cell on nerve axons.

Tricyclic antidepressants reduce the reuptake of serotonin and norepinephrine .FALSETRUE

TRUE The tricyclic antidepressants (TCAs), including the amines, secondary amines, and tetracyclics, all reduce the reuptake of 5HT and NE into nerves.

The circle of Willis distributes blood to the brain as needed. TRUE/FALSE

TRUE Two arteries—the carotids—branch off the aortic arch and go up into each side of the brain at the front of the head, and two other arteries—the vertebrals—enter the back of the brain to become the basilar arteries. These arteries all deliver blood to a common vessel at the bottom of the brain called the circle of Willis, which distributes the blood to the brain as it is needed.

GABA plays an important role in preventing overexcitability. TRUEFALSE

TRUE Gamma-aminobutyric acid (GABA), which is found in the brain, inhibits nerve activity and is important in preventing overexcitability or stimulation such as seizure activity.

. Beta-specific adrenergic agonists are primarily used to treat obstructive pulmonary conditions. FALSETRUE

True Beta-specific agonists are used primarily to treat obstructive pulmonary conditions; alpha- and beta-agonists are often used to treat hypotensive states.

Mania is characterized by extreme overactivity and excitement. TRUEFALSE

True Mania is characterized by periods of extreme overactivity and excitement (at the opposite pole from depression) and occurs in individuals with bipolar disorder who experience a period of depression followed by a period of mania. The cause of mania is not understood, but it is thought to be an overstimulation of certain neurons in the brain.

Typical antipsychotics block dopamine receptors. FALSE/TRUE

True The antipsychotic drugs, which are essentially dopamine receptor blockers, are used to treat disorders that involve thought processes.

The adverse effects of selective serotonin reuptake inhibitors are less than other antidepressants. FALSETRUE

true Selective serotonin reuptake inhibitors (SSRIs), the newest group of antidepressant drugs, specifically block the reuptake of 5HT, with little to no known effect on NE. Because SSRIs do not have the many adverse effects associated with TCAs and MAOIs, they are a better choice for many clients.

The nurse is caring for a client who has bipolar disorder and who receives lithium therapy. When reviewing the client's medication administration record, what drug would cause an increase in the client's risk of lithium toxicity? A. Indomethacin B. Levothyroxine C. Vitamin B12 D. Calcium carbonate

A Indomethacin and lithium, when combined, increase the risk of lithium toxicity. Psyllium interferes with the absorption of lithium leading to nontherapeutic levels. Antacids, like calcium carbonate, when combined with lithium, lead to a decrease in lithium effectiveness. Levothyroxine and vitamins would not be contraindicated.

The nurse just administered chlorpromazine to a client by intramuscular injection. The nurse should instruct the client to: A. stay in bed for the next half hour. B. perform deep breathing and coughing exercises. C. expect urinary urgency for the next few hours. D.report any new onset of chest pain promptly.

A After administering parenteral forms of antipsychotic agents, the nurse should keep the client recumbent in bed for approximately 30 minutes to reduce the risk of orthostatic hypotension. Urinary urgency and chest pain are not anticipated adverse effects, so would not need to be addressed. There is no obvious need for the client to perform deep breathing and coughing exercises.

What does a nurse keep readily available should a client who is receiving morphine experience significant respiratory depression? A. Naloxone B. Nalbuphine C. Ergotamine D.Buprenorphine

A. Naloxone is a narcotic antagonist that is used to reverse the effects of narcotics such as morphine. Buprenorphine is a narcotic agonist-antagonist that is used for moderate to severe pain relief. Ergotamine would be used to prevent and treat migraine attacks. Nalbuphine is used to provide pain relief during labor and delivery and as an adjunct to general anesthesia, as well as to treat moderate to severe pain in adults.

The nurse is providing drug teaching for a client newly prescribed a typical antipsychotic medication. What teaching points will the nurse include while talking with this client? Select all that apply. A. Never drink alcohol while taking this medication. B. Increased appetite can cause obesity, so take care to eat a healthy diet. C. Avoid use of the herb evening primrose.Inform all health providers of the medications you take. D. Spending time outside in the sunshine will improve your mood.

A , C ,D The herb primrose can worsen symptoms and increase hyperexcitability, so it should be avoided. There are several drugs that are contraindicated including beta-blockers and anticholinergics, so the client should be sure to consult with the provider or pharmacist before taking any over-the-counter or newly prescribed medications. Alcohol is contraindicated because it worsens CNS effects of the drug. Decreased appetite or anorexia is more likely that an increase in appetite, so the client should be taught how to increase calorie intake. Photophobia is a common adverse effect, so client should be taught to avoid sunlight or wear dark glasses.

A client's nerve impulse is being conducted rapidly between Schwann cells. What component of the neurologic system is facilitating this rapid conduction? A. Nodes of Ranvier B. Postsynapse C. Soma D. Neurotransmitters

A Schwann cells are insulating cells found on myelinated nerve axons. Between the Schwann cells are areas of uncovered nerve membrane called the nodes of Ranvier. So-called leaping nerve conduction occurs along these exposed nerve fibers. Soma is the nerve cell "body." Neurotransmitters are the chemical messengers that allow for communication between neurons.

The nurse has entered the room of a client who is being treated with regular doses of morphine. The client is unresponsive to voice but responsive to touch, with a respiratory rate of 6 breaths/min. In addition to informing the care team, what is a priority action? A. Administration of naloxone as prescribed B. Auscultating the client's lungs C. Cardiac monitoring D.Administration of acetylcysteine as prescribed

A. Naloxone reverses the effects of opioids and should be administered to this client. Acetylcysteine is an antidote to acetaminophen overdose. Careful monitoring of the client's status is necessary, but administration of naloxone is a priority.

A client has received a narcotic agonist for pain relief. The nurse should monitor the client for what? A. Pupil constriction B. Tachypnea C. Hypertension D. Diarrhea

A. Narcotics are associated with pupil constriction, constipation, orthostatic hypotension, and respiratory depression with apnea.

What component would be included when describing the parasympathetic nervous system structure and function? Select all that apply. A. Muscarinic and nicotinic receptors are found in the parasympathetic nervous system. B. Adrenergic receptors are found in the parasympathetic nervous system. C. Ganglia are located close to or within the effector tissue. D. The system is primarily involved in responding to stress. E. The preganglionic fibers are short.

A, C Parasympathetic ganglia are located close to or within effector tissue. The parasympathetic nervous system contains both nicotinic and muscarinic receptors. The preganglionic fibers of the parasympathetic nervous system are long. The sympathetic nervous system is the stress response; the parasympathetic nervous system helps the body recuperate from the stress response. Cholinergic receptors are found in the parasympathetic nervous system.

The nurse administers a medication that slows the reuptake of serotonin. What actions will this drug likely have? Select all that apply. A. Regulating the sleep and wake cycle B. Inhibits nerve activity C. Maintaining a healthy mood and affect D. Enhancing motivation E. Facilitating the "fight-or-flight" response

A, C, D Serotonin, which is also found in the limbic system, is important in arousal and sleep, as well as in preventing depression and promoting motivation. Serotonin does not contribute to the fight-or-flight response, which most involves epinephrine and norepinephrine. Gamma-aminobutyric acid (GABA) inhibits nerve activity.

The nurse is conducting a comprehensive assessment of a new client. The nurse would confirm that the client is having a sympathetic response when noting what manifestations? Select all that apply. A. Pupils dilated B Increased respiratory rate C. Need to urinate frequently D. Increased bowel sounds E. Increased heart rate

A,B, E When stimulated, cardiovascular activity increases, as do blood pressure, heart rate, and blood flow to the skeletal muscles. Bronchi dilate and the respiratory rate increases. Pupils dilate, sweating increases, bowel sounds decrease, and blood is diverted from the kidneys.

The nurse teaches the client about a newly prescribed selective serotonin reuptake inhibitor (SSRI) and determines further teaching is needed when the client makes what statements? Select all that apply. A. "I should begin to feel much better by the end of the week. B. ""I do not have to take time off from my work as a train engineer." C. "I can continue to take St John's wort with this medication." D. "It's possible I'll lose weight on this drug and get down to my normal weight." E. "I will use condoms to prevent pregnancy until I stop taking this medication."

A,B,C St John's wort is contraindicated because it can result in serotonin syndrome and photosensitivity if taken with an SSRI, so this statement indicates the need for further teaching. Clients should avoid driving or operating heavy equipment until they can determine what types of CNS effects they experience. The client who wants to continue driving a truck without taking time off at the start of treatment would need further teaching. Peak effects often take 4 weeks, so the client who expects to feel better within 48 hours may need gentle guidance, while not removing hope of feeling better. Weight loss is an effect of this drug, and barrier methods should be used to prevent pregnancy. Both of these are accurate statements.

What client is being treated with a typical antipsychotic? A. An agitated client who was given haloperidol during acute psychosis B. A client who recently began taking ziprasidone C.A client with schizophrenia who received paliperidone 6 mg PO daily D. A client whose thought disorder requires clozapine 25 mg PO b.i.d.

A. Haloperidol is a typical antipsychotic. Ziprasidone, clozapine, and paliperidone are atypical antipsychotics.

A client is found to have insufficient levels of acetylcholinesterase. The nurse should recognize what likely consequence? A. Effector cells would continue to be stimulated. B. The effector cell would remain polarized. C. The ganglia would continue to be stimulated. D. The nerve cell would be unable to depolarize

A. The destruction of ACh is carried out by the enzyme acetylcholinesterase. This enzyme reacts with the ACh to form a chemically inactive compound. The breakdown of the released ACh is accomplished in 1/1,000 second, and the receptor is vacated, allowing the effector membrane to repolarize and be ready for the next stimulation. The nerve cell would remain depolarized in the absence of acetylcholinesterase.

The nurse is interviewing the client who is to receive a tricyclic antidepressant. Which client statement should alert the nurse to a likely contraindication?" A. I had a myelogram yesterday." B. "My kidneys aren't functioning like they should." C. "My doctor says that I have an enlarged prostate." D. "I've had glaucoma for several years.

A. A myelogram given within the previous 24 hours or to be given in the next 48 hours is a contraindication for the use of tricyclic antidepressants because of possible drug-drug interaction with the dyes used for the study. A history of glaucoma would require cautious use of the drug. Prostatic hypertrophy would require cautious use of the drug. Renal dysfunction would require cautious use of the drug and often requires dose adjustment.

The nurse is caring for a client suspected of having a seizure disorder. What test might be ordered for this client to test brain function? A. Electroencephalogram B. Serum calcium levels C> Serum phenytoin level D> Electrocardiogram

A. An electroencephalogram (EEG) would be ordered to test brain function because it shows the electrical functioning within brain tissue. An electrocardiogram (ECG) measures electrical activity in the heart. Serum phenytoin levels would indicate therapeutic levels of the antiepileptic drug, but they do not test brain function. Serum calcium levels have no relationship to brain function.

An instructor is preparing a teaching plan about adrenergic agonists for a group of students. What drug would the nurse include as an alpha- and beta-adrenergic agonist? A. Epinephrine B. Phenylephrine C. Terbutaline D. Albuterol

A. Epinephrine is an alpha- and beta-adrenergic agonist. Phenylephrine is an alpha-specific adrenergic agonist. Albuterol is a beta-specific adrenergic agonist. Terbutaline is a beta-specific adrenergic agonist.

The nurse is caring for a client who is prescribed haloperidol long term. What assessment should the nurse prioritize? A Assessment for involuntary movements B. Assessment of the client's skin integrity C. Monitoring the client's white cell differential D, Monitoring the client's CD4 T-cell count

A. Haloperidol is associated with the greatest increased risk of extrapyramidal adverse effects. Leukopenia is less common, and there is no obvious threat to skin integrity. The client's T-cell levels will not be affected.

A client who takes lithium for the treatment of bipolar disorder has been experiencing occasional constipation. What should the nurse teach the client about safely managing this problem? A. A.void taking psyllium supplements. B. Occasional constipation is inevitable during lithium therapy. C. Do not take OTC stool softeners under any circumstances. D. Avoid foods that are high in soluble fiber.

A. Patients being treated with lithium should be encouraged not to use the herbal therapy psyllium, which is used to treat constipation and to lower cholesterol levels. If this agent is combined with lithium, the absorption of the lithium may be blocked, and the patient will not receive therapeutic levels. There is no need to avoid soluble fiber, and OTC stool softeners are likely safe, with the approval of the healthcare provider. The nurse should not teach the client that constipation must be accepted as inevitable.

Nerve stimulation has caused the release of serotonin into many of a client's synaptic clefts, causing stimulation of the effector cell. How will the effector cell be returned to a resting state so that it can be stimulated again? A. Serotonin will be reabsorbed by the axon of the presynaptic nerve. B. Serotonin molecules will spontaneously break down in a fraction of a second. C. Dopamine will be released, which negates the effect of serotonin. D. Acetylcholine will be released, which has a contrary effect to serotonin.

A. Serotonin will be reabsorbed by the axon of the presynaptic nerve. To return the effector cell to a resting state so that it can be stimulated again, if needed, neurotransmitters must be inactivated. Neurotransmitters may be either reabsorbed by the presynaptic nerve in a process called reuptake (a recycling effort by the nerve to reuse the materials and save resources) or broken down by enzymes in the area. Other neurotransmitters do not perform this role.

A client has a serum lithium level of 2.2 mEq/L. The nurse should expect to assess what symptoms? Select all that apply A. .Full body rash B. Hyperreflexia C. Hypotension D. Seizures E. Epistaxis

B,C,D Hypotension, hyperreflexia, and seizures would be noted with a serum lithium level between 2.0 and 2.5 mEq/L. Rash and epistaxis are not associated with lithium toxicity.

A client is experiencing sympathetic stimulation in response to a stressful event. Which substance will most affect the client's sodium and water retention? A. Thyroid hormone B. Aldosterone C. Cortisol D.Glucose

B Aldosterone causes sodium and water retention and potassium excretion. Thyroid hormone increases metabolism and efficient use of energy. The release of adrenal hormones, including cortisol, suppresses the immune and inflammatory reactions to preserve energy during the fight-or-flight response. Glucose is formed by glycogenolysis to increase the blood glucose level and provide energy.

The nurse is caring for a woman who has taken phenytoin for many years to control her seizures. The woman now wishes to become pregnant and asks the nurse what she should do. What is the nurse's best response? A. Women with a seizure disorder cannot get pregnant and you will need to look into other alternatives, such as adoption. B. The risk to you and the fetus is greater when stopping the drug during pregnancy than the drug itself. C. The drugs will be stopped until you get pregnant and then resumed when you enter your second trimester D.It is important to prevent seizures during pregnancy so the doctor will likely change you to combination therapy.

B The risk of taking a woman with a seizure disorder off of an antiepileptic drug that has stabilized her condition may be greater than the risk of the drug to the fetus. Discontinuing the drug could result in status epilepticus, which has a high risk of hypoxia for the mother and the fetus. Women with a seizure disorder can have children, but it takes careful planning to reduce risks to both the mother and the fetus. Combination therapy increases risk because the fetus is exposed to more drugs.

A client has been prescribed hydrocodone for the treatment of pain. The client states, "Sometimes one dose doesn't work for me, so I have to take another an hour or two later." What is the nurse's best response?" A. That's dangerous, and you should never take a medication more often that it's prescribed." B. "Make sure to tell your provider about your need for more medication, because it's unsafe to take it that often." C. "Do you know what would happen if you accidentally overdosed?" E. "Make sure to let your care provider know about that at your next scheduled appointment."

B The nurse should explain that this practice is unsafe, since hydrocodone is an extended release medication. As well, the nurse should ensure that the client's unmet pain control needs are addressed with the care provider. The nurse must avoid reprimanding the client.

What is the defining criterion of an adrenergic nerve? A. The nurse is continuously stimulated. B. The nerve can produce epinephrine. C. The nerve arises from the adrenal medulla. D. The nerve promotes cardiac conduction.

B To be an adrenergic nerve, the nerve must contain all of the enzymes and building blocks necessary to produce norepinephrine. None of the other listed characteristics is associated with adrenergic nerves.

A client's left adrenal medulla has been injured in a motor vehicle accident. What is a possible implication of this injury? A Dopamine deficiency B. Disruptions in the levels of norepinephrine and epinephrine C. Impaired action potential D. Disruption of the sodium-potassium pump

B Disruptions in the levels of norepinephrine & epinephrine The adrenal medulla produces epinephrine and norepinephrine but not dopamine. Impaired adrenal medullary functions would be unlikely to affect action potentials or the function of the sodium-potassium pump throughout the nervous system.

The nurse administers a drug that stimulates the alpha1-receptors. What manifestations would indicate to the nurse that the drug is working? Select all that apply. A.Vasodilation B. Contracted piloerection muscles C. Pallor D. Thickened salivary secretions E. Increased blood pressure

B, D, E Stimulation of the alpha1-receptors results in vasoconstriction, increased peripheral resistance with increased blood pressure, contracted piloerection muscles, pupil dilation, thickened salivary secretions, closure of urinary bladder sphincter, and male sexual emissions. Pallor is not anticipated.

A client has a neurological disorder involving the dorsal root in the spinal cord. What physiological functions are likely to be affected? Select all that apply. A/ Stimulating muscles B. Sending messages to the CNS C. Communicating pain D. Regulating emotion E. Coordinating movement

B,C T he spinal cord is made up of 31 pairs of spinal nerves. Each spinal nerve has two components or roots. These mixed nerve parts include a sensory fiber (called the dorsal root) and a motor fiber (called the ventral root). Sensory nerves are afferent, in that they convey messages to the CNS from the periphery. Ventral roots cause movement and muscle activity. Emotion is exclusively regulated within the brain.

. The neurologic nurse is reviewing the role of catecholamines. Which neurotransmitters should the nurse review? Select all that apply. A. Acetylcholine B. Dopamine C. Serotonin D.Calcium E. Norepinephrine

B,C, E Norepinephrine belongs to a group of structurally related chemicals called catecholamines that also includes dopamine, serotonin, and epinephrine. Acetylcholine is a neurotransmitter that is not considered a catecholamine. Calcium does not act as a neurotransmitter.

When assessing a client, what finding would the nurse interpret as indicating stimulation of the parasympathetic nervous system? Select all that apply. A. Increased level of consciousness B. Bronchoconstriction C. Pupil constriction D. Decreased GI secretions E. Vasoconstriction F. Decreased heart rate

B,C, F, Parasympathetic nervous system stimulation results in pupil constriction, increased tearing, bronchoconstriction, decreased heart rate, vasodilation, and increased GI secretions. Level of consciousness is not directly affected.

The nurse teaches a class on use of antidepressants in children at a local parent-teacher association meeting. What should the nurse teach these parents about the safe use of antidepressants in children? Select all that apply. A. The data from the FDA study clearly established a link between increased suicidal ideation and the use of antidepressants. B. Research does not indicate a high risk for suicide among pediatric clients taking antidepressants. C. Antidepressants are not particularly effective in major depressive disorders in children, except fluoxetine. D. A black box warning was added to all antidepressants, bringing attention to the increase in suicidality in children and adolescents.

B,C,D FDA data did not establish effectiveness in major depressive disorder in children for any antidepressants, except fluoxetine. In 20 placebo-controlled studies involving these eight drugs and more than 4,100 pediatric clients, there were no reports of completed suicides. In 2006, a black box warning was added to all antidepressants to bring attention to the increase in suicidality, especially in children and adolescents, when these drugs were used. The data from these studies did not clearly establish a link between increased suicidal ideation and the use of these antidepressants.

A client taking lithium receives haloperidol. What data should indicate to the nurse that the client is experiencing encephalopathic syndrome? Select all that apply. A. The client's random blood glucose level is 145 mg/dL (8.0 mmol/L). B. The client's white cell count is greatly elevated. C. The client is much weaker than normal. D. The client is uncharacteristically disoriented. E. The client's hands are tremulous when at rest.

B,C,D,E A lithium-haloperidol combination may result in an encephalopathic syndrome, consisting of weakness, lethargy, confusion, tremors, extrapyramidal symptoms, leukocytosis, and irreversible brain damage. Glucose levels are not affected by encephalopathic syndrome.

A client who lives with chronic pain has just learned that she is pregnant. What narcotic analgesic is most appropriate for this client?A. Meperidine B. Oxycodone C.Fentanyl D.Sufentanil

B. Oxycodone is classified as a pregnancy category B drug. Fentanyl, meperidine, and sufentanil are classified as pregnancy category C drugs.

An older adult client has been prescribed an antiseizure medication and is experiencing central nervous system depression. What is the nurse's most appropriate action? A. Maintain the client on bed rest. B. Implement falls precautions. C. Make a referral to occupational therapy D. .Monitor vital signs hourly while the client is awake.

B. CNS depression creates a risk for falls, especially in older clients. There is no need to assess vital signs on an hourly basis and the harm of bed rest exceeds the benefits. Occupational therapy has no direct relationship with treating CNS depression.

What assessment finding should lead the nurse to suspect that a client receiving antipsychotic therapy is developing tardive dyskinesia? A. Urinary incontinence B. Lip smacking C. Abnormal eye movements D. Disorientation

B. Lip smacking is associated with tardive dyskinesia. Abnormal eye movements are associated with dystonia. Tardive dyskinesia is not associated with disorientation or urinary incontinence.

While caring for a client receiving antipsychotic therapy, the nurse observes cogwheel rigidity, tremors, and drooling. The nurse interprets this as what? A. Dystonia B. Pseudoparkinsonism C. Akathisia D. Tardive dyskinesia

B. Pseudoparkinsonism is manifested by muscle tremors, cogwheel rigidity, drooling, shuffling gait, and slow movements. Tardive dyskinesia involves abnormal muscle movements such as lip smacking, tongue darting, chewing movements, and slow aimless arm and leg movements. Dystonia is manifested by spasms of the tongues, neck, back, and legs.

A hospital client with obesity and diabetic retinopathy admits to feeling intensely anxious about his or her situation. What action by the nurse best addresses the effects of the client's stress? A. Assess the client's skin integrity often. B. Check the client's capillary glucose levels often. C. Place the client on cardiac monitoring. D. Monitor the client's oxygen saturation constantly.

B. Sympathetic stimulation causes increased blood glucose, and the nurse should monitor this closely. The nurse should monitor the client's vital signs as well, but cardiac monitoring and constant pulse oximetry are not likely necessary. The risk of hyperglycemia likely exceeds the risk of skin breakdown.

When the sympathetic nervous system is stimulated, what cells of the adrenal medulla secrete epinephrine and norepinephrine directly into the bloodstream? A. Axon B. Chromaffin C. Effector D. Dihydroxyphenylalanine

B. The chromaffin cells of the adrenal medulla also are adrenergic because they synthesize, store, and release norepinephrine, as well as epinephrine. Effector cells are those that are affected by the nerve impulse. Dihydroxyphenylalanine is produced by a nerve and is converted to dopamine.

A client is receiving a selective serotonin reuptake inhibitor (SSRI) and is being switched to a monoamine oxidase inhibitor (MAOI) due to lack of response. When would the nurse teach the client to begin the MAOI? A. The MAOI would start in 48 hours after weaning the client from the SSRI. B. The MAOI would be started 6 weeks after stopping the SSRI C. .The MAOI would be started as the SSRI is being tapered. D. The MAOI would be started immediately after stopping the SSRI.

B. The exact timing varies, but a period of 6 weeks after stopping the SSRI may be needed before beginning therapy with an MAOI to reduce the risk of serotonin syndrome.

A client's nerve cell is at rest. What is true of this nerve cell at this time? A. The cell is depolarizing. B. The membrane is permeable to potassium ions. C. Stimulus of sufficient strength is generated. D. Sodium ions are rushing into the cell.

B. The nerve cell membrane is permeable to potassium ions when the cell is at rest. Sodium ions rush into the cell when the neuron is stimulated. For an action potential to occur, a stimulus of sufficient strength must be present and the nerve membrane must be able to respond. That is when it has repolarized. Depolarization occurs when the neuron is stimulated and sodium ions rush into the cell.

A nurse is reviewing the parasympathetic nervous system prior to caring for a client with a neurologic disorder. What statement best described the parasympathetic nervous system? A. The cells typically have preganglionic fibers that are relatively short. B. Many of the cells originate in the sacral area of the spinal cord. C. The ganglia are located in chains running alongside the spinal cord. D. The system is often referred to as the thoracolumbar system.

B. The parasympathetic nervous system has neurons in the cranium and sacral area of the spinal cord. The sympathetic nervous system is referred to as the thoracolumbar system. The sympathetic nervous system consists of short preganglionic fibers. Sympathetic nerve ganglia are located in chains running alongside the spinal cord.

Which agent would the nurse expect to find in the ingredient list of over-the-counter allergy products? A. Dopamine B. Phenylephrine C. Midodrine D. Clonidine

B. Phenylephrine is found in many cold and allergy products because it is so effective in constricting topical vessels and decreasing the swelling and signs and symptoms of rhinitis. None of the other options are sold over the counter.

The neurologic nurse is aware that spinal nerves are classified as mixed nerves. This implies what characteristic of spinal nerves? The neurologic nurse is aware that spinal nerves are classified as mixed nerves. This implies what characteristic of spinal nerves? A. They have hydrophobic and hydrophilic components. B. They contain both motor and sensory components. C. They communicate with both the central and peripheral nervous system. D. They respond to more than one neurotransmitter.

B. They contain both motor and sensory components A spinal nerve is classified as a mixed nerve containing a sensory fiber (dorsal root) and a motor fiber (ventral root). This is unrelated to the presence of neurotransmitters or hydrophila or hydrophobia. Spinal nerves are components of the central nervous system.

A client's medication regimen includes lithium. What assessment finding would suggest a therapeutic effect? A. The client denies audio or visual hallucinations. B. The client denies severe depressive or manic episodes. C. The client refrains from aggressive or violent outbursts. D. The client states that he or she now have purpose and direction in life.

B> Lithium is used to treat bipolar disorder, which is characterized by manic and depressive episodes. Lithium is intended to interrupt this cycle. Hallucinations, violence, and hopelessness are not core characteristics of bipolar disorder.

A client who is being treated with a typical antipsychotic reports frequent nasal congestion are urinary hesitation. To what should the nurse most likely attribute these symptoms? A .Tardive dyskinesia B. Neuroleptic malignant syndrome C. Anticholinergic effects D> Extrapyramidal symptoms

C Nasal congestion and urinary hesitation are manifestations of anticholinergic effects. Neuroleptic malignant syndrome primarily affects the CNS. Tardive dyskinesia involves involuntary movements. Extrapyramidal symptoms are movement related.

A nurse administers a decongestant that stimulates alpha1-receptors. What would most likely occur? A. Decreased GI activitity B. Bronchodilation C. Pupil dilation D. Tachycardia

C Pupil dilation results from stimulation of alpha1-receptors. Increased heart rate occurs with beta1 stimulation. Bronchodilation results from stimulation of beta2-receptors. Decreased GI activity results from stimulation of beta2-receptors.

A group of students are reviewing the autonomic nervous system. The students demonstrate a need for additional review when they identify what as being involved with the sympathetic nervous system? A. Norepinephrine B. Adrenergic receptors C. Vagus nerve D. Monoamine oxidase

C, The vagus nerve, originating in the cranium, is one of the most important parts of the parasympathetic nervous system. The other answer options are involved with the sympathetic nervous system.

The nurse administered a scheduled dose of hydromorphone to a client and is now performing a follow-up assessment. The nurse should anticipate changes in what assessment parameters compared to preadministration? Select all that apply. A. Orientation to person, place, and time B. Temperature C.Respiratory rate D. Oxygen saturation E. Pain rating

C,E Narcotics such as hydromorphone should reduce the client's pain, and a certain degree of respiratory depression nearly always occurs. However, this should not affect the client's oxygen saturation level. Temperature is not normally affected. Drowsiness is very common, but the client would not be expected to become disoriented.

A client has anxiety and insomnia, and the healthcare provider believes that this may be a result of a deficiency of inhibitory neurotransmitters. This client may be lacking in what neurotransmitter? A. Dopamine B. Epinephrine C. Gamma-aminobutyric acid D. Acetylcholine

C. GABA inhibits nerve activity. Dopamine is a neurotransmitter involved with the coordination of motor and intellectual impulses and responses. Acetylcholine aids in communication between nerves and muscles. Epinephrine and norepinephrine are catecholamines released by nerves in the sympathetic branch of the autonomic nervous system and are classified as hormones when released by the adrenal medulla.

The nurse is caring for a client who is under psychological and physiological stress. During sympathetic stimulation, the nurse should identify which neurotransmitter as being released by the preganglionic nerves of the sympathetic nervous system? A. Epinephrine B. Norepinephrine C. Acetylcholine D. Dopamine

C. Acetylcholine is the neurotransmitter released by preganglionic nerves of the sympathetic nervous system and the pre- and postganglionic nerves of the parasympathetic nervous system. Dopamine is converted to norepinephrine in the adrenergic cells. Norepinephrine is involved in postganglionic activity of the sympathetic nervous system. Epinephrine is involved in the adrenergic response, being secreted directly into the bloodstream by the adrenal medulla.

The nurse is assessing a client who has urinary hesitation and occasional overflow incontinence. What adrenergic receptors may be overstimulated in this client? A. Alpha2 B. Beta2 C. Alpha1 D. Beta1

C. Alpha1-receptors are found in the blood vessels, iris, and urinary bladder. Alpha2-receptors are located on nerve membranes. Beta1-receptors are found in cardiac tissue. Beta2-receptors are found in the smooth muscle of the blood vessels, in bronchi, in the periphery, and in uterine muscle.

The nurse has administered a scheduled dose of clonidine, an alpha2-receptor agonist, to a client. The nurse should anticipate what effect? A. Agitation B. Increased heart rate and blood pressure C.Reduced norepinephrine stimulation D.Increased bowel motility

C. Alpha2-receptors are located on nerve membranes and act as modulators of norepinephrine release. Stimulation of these receptors is likely to cause sympatholytic effects such a reduced anxiety and blood pressure. Bowel motility is not likely to be affected. Agitation would decrease, not increase.

A client in distress has been given dobutamine, a medication intended to increase myocardial activity and heart rate. This medication likely stimulates what adrenergic receptor? A. Beta2 B. Alpha2 C. Beta1 D. Alpha1

C. Beta1 stimulation increases myocardial activity. Alpha1 stimulation leads to vasoconstriction and increased peripheral vascular resistance, resulting in a rise in blood pressure. Alpha2 stimulation prevents overstimulation of effector sites and moderate insulin release by the beta cells of the pancreas. Beta2 stimulation causes vasodilation and bronchodilation.

A client has been administered a beta1-receptor agonist. What assessment should the nurse prioritize in order to identify the desired therapeutic effect? A. Measure the client's blood glucose. B. Auscultate the client's lungs. C. Assess the client's heart rate. D. Assess the client's level of consciousness

C. Beta1-receptors are found in cardiac tissue, where they can stimulate increased myocardial activity and increased heart rate. Consequently, administration of a beta1-receptor agonist requires cardiac assessment. Respirations, blood glucose levels, and level of consciousness are less likely to be affected.

A client has been prescribed a beta2-receptor agonist by the care provider. What diagnosis may indicate the need for beta2-receptor stimulation? A. Cirrhosis B. Chronic heart failure C.Asthma D. Type 2 diabetes

C. Beta2-receptors cause dilation in the bronchi. Consequently, they are often used in the treatment of asthma. These receptors do not affect blood glucose levels, cardiac function, or liver function.

What action by the nurse best addresses a common adverse effect related to narcotic administration? A. Teach the client to perform deep breathing and coughing exercises. B. Teach the client to take antiemetics as prescribed. C. Encourage the client's fluid intake. E. Encourage the client to eat several meals daily.

C. Constipation is nearly ubiquitous in clients taking narcotics. Increasing fluid intake reduces the frequency and severity of constipation and may prevent it in some clients. There is not normally any need to eat frequent meals. Constipation is a more likely adverse effect than nausea. Deep breathing and coughing exercises do not directly address the respiratory depression than accompanies narcotic use.

What is the enzyme responsible for breaking down norepinephrine to make it inactive? A. Dopamine B. Epinephrine C. Monoamine oxidase D. Acetylcholinesterase

C. Enzymes are also in the area, as well as in the liver, to metabolize or biotransform any remaining norepinephrine or any norepinephrine that is absorbed into circulation. These enzymes are monoamine oxidase (MAO) and catechol-O-methyltransferase (COMT). Acetylcholinesterase breaks down acetylcholine to make it inactive. Epinephrine and dopamine are not enzymes; they are neurotransmitters.

A client receives a beta-specific agonist. What assessment findings would indicate to the nurse that the drug is taking effect? A. Resolution of glaucoma B. Increased level of consciousness C. Relief from shortness of breath D. Relief of pain

C. Most of the drugs that belong to the class of beta-specific adrenergic agonists, or beta-agonists, are beta2-specific agonists and are used to manage and treat bronchial spasm, asthma, and other obstructive pulmonary conditions. They are not used for pain relief or for treating decreased LOC or glaucoma.

The nurse would hold nalbuphine, if ordered, and consult the provider if the client is allergic to what? A. Penicillin B. Eggs C. Sulfites D. Aspirin

C. Nalbuphine should not be given to clients who are allergic to sulfites to avoid a cross-hypersensitivity reaction. There is no association between nalbuphine and aspirin, eggs, or penicillin.

A child with attention deficit hyperactivity disorder has been receiving methylphenidate for several years. The prescriber has explained a plan to temporarily discontinue the drug. What rationale for this action should the nurse explain? A. The drug must be occasionally stopped to prevent anticholinergic effects. B. The risk for cumulative adverse effects is greater if the child doesn't have a break. C. It needs to be determined if the child still has symptoms that require treatment. D. The drug likely needs to be switched to another agent that is less toxic.

C. Periodically the drug therapy needs to be interrupted to determine if the child experiences a recurrence of symptoms, which if they do occur, indicates the need for continued treatment. This is not done because the plan is to switch drugs if the current drug is effective or because of an increased risk. The absence of medicine will determine if he or she no longer needs the medication.

The nurse is conducting a comprehensive assessment of a client. What finding should the nurse attribute to the action of the parasympathetic nervous system? A. The client's heart rate is 88 beats/min. B. The client has polydipsia and requests water often. C. The client's pupils are constricted. D.The client's blood pressure is 136/86 mm Hg.

C. Pupil constriction is one of major parasympathetic effects. This client's heart rate and blood pressure are in the range of high normal, so are unlikely to be heavily affected by the parasympathetic nervous system. Polydipsia is not a direct effect of parasympathetic stimulation.

An electrical impulse is being transmitted along a nerve axon. What would resist electrical stimulation? A. Synapse B. Myelin C. Schwann cells D. Nodes of Ranvier

C. Schwann cells are myelinated areas along nerve axons that are resistant to electrical stimulation. The nodes of Ranvier are areas of uncovered nerve membrane that allow electrical impulses to "leap" or be conducted along the fiber. Myelin is a substance that speeds electrical conduction and protects the nerves from fatigue due to frequent formation of action potentials. Synapse is the area where nerves communicate with each other.

The nurse is assessing a client. What assessment finding is the clearest indicator of autonomic function? A. The client's muscle strength is equal bilaterally. B. The client's hearing is intact. C. The client's respiratory rate is 22 breaths/min. E. The client can discern hot sensation from cold.

C. The autonomic nervous system functions to regulate respirations. Voluntary motor function, hearing, and sensation are not primarily within the ANS.

The neurologic nurse cares for several clients who have seizure disorders. Which client should the nurse monitor most closely for indications of drug dependence? A. A client receiving IV phenytoin to prevent seizures postneurosurgery B. A client with a history of myoclonic seizures who takes valproic acid C. A client with a history of tonic-clonic seizures who takes phenobarbital D. A client receiving ethosuximide for the prevention of absence seizure

C. Barbiturates, such as phenobarbital, have an associated risk for dependence. This is not true of the other listed drugs.

The nurse is assessing a client who is experiencing significant central nervous system effects after receiving an alpha-specific adrenergic agonist. What finding is most likely? A. Tinnitus B. Disorientation C. Anxiety D. Respiratory depression

C. CNS effects of alpha-specific adrenergic agonists include feelings of anxiety, restlessness, depression, fatigue, strange dreams, and personality changes. Disorientation is less common, and these drugs do not normally lead to respiratory depression. Tinnitus is not usually experienced either, though visual changes can occur.

A client with depression began taking fluoxetine 10 days ago. The nurse should monitor the client for what adverse effect? A. Epistaxis (nosebleed) B. Urinary incontinence C. Priapism (prolonged erection) D> Anorexia

D Fluoxetine and the other SSRIs are associated with anorexia and weight loss in some clients. Some clients experience urgency, but incontinence is not expected. Epistaxis is not expected. Priapism is associated with trazodone, not SSRIs.

Stimulation of what type of receptor will cause increased GI motility? A. Nicotinic receptors B. Beta1-receptors C. Alpha1-receptors D.Muscarinic receptors

D Stimulation of muscarinic receptors results in pupil constriction, increased GI motility and secretions (including saliva), increased urinary bladder contraction, and a slowing of the heart rate. Stimulation of the other receptors will not have this effect.

All alpha- and beta-adrenergic agonists can be administered via what route? A. Subcutaneous B. IM C. PO D IV

D While some of the alpha- and beta-adrenergic agonists can be administered PO, subcutaneous, or IM, all of them can be administered IV, which is the normal route of administration during most emergencies.

A nurse reviews various methods for assessing pain. The nurse determines which method is the most reliable? A. Percussing or palpating the area where pain is identified B. Assessing the client's vital signs C. Asking a client to describe his or her pain D.Using a pain rating scale

D A pain rating scale is the most reliable method because it provides measurable evidence of pain severity. A client's description of pain is useful but does not provide objective or quantifiable data over time. Although percussing or palpating provides information, it would increase the client's pain and be inappropriate. Vital sign changes occur for numerous reasons and are not the best indicator of pain in clients who can speak.

A client has been diagnosed with depression and prescribed fluoxetine 200 mg PO daily to be taken in the morning. What is the nurse's best action upon receiving the client's prescription? A. Question the prescriber about the timing. B. Teach the client about possible anticholinergic effects. C. Question the prescriber about the frequency. D,Question the prescriber about the dose.

D Prozac is usually prescribed at 20 mg/d in the morning, with a ceiling of 60 mg/d. Consequently, the nurse should clarify the dose with the prescriber. Anticholinergic effects are not expected with SSRIs such as fluoxetine.

The nurse determines the client may be displaying extrapyramidal effects on the basis of what assessment findings? Select all that apply A.The client has been experiencing insomnia and early morning awakening. B. The client has an aversion to bright lights. C. The client has had uncharacteristic verbal outbursts. D. The client exhibits hand tremors. E. The client's gait is uncoordinated.

D, E Ataxia, parkinsonism, and tremors are signs and symptoms of extrapyramidal effects. Insomnia and photophobia are adverse effects of typical antipsychotic medications but are not indicative of extrapyramidal effects. Verbal outbursts are unlikely to be related to drug therapy.

A client's care provider has prescribed meperidine 75 mg PO q4h PRN for the client's chronic pain. What health education should the nurse provide to this client? A. "Have blood levels drawn in 1 week." B. "Eat small, frequent meals to reduce gastrointestinal upset." C. "Avoid sun exposure, or apply high-SPF sunscreen." D."Avoid drinking alcohol while taking meperidine."

D. Drinking alcohol during narcotic treatment can exacerbate CNS depression. Narcotics do not necessitate monitoring of serum levels, and they do not cause photosensitivity. Most clients do not experience significant dyspepsia; constipation is by far the most common GI effect.

A client with asthma is prescribed albuterol to dilate the bronchioles. The nurse understands that this drug is likely acting on which receptors? A. Alpha1 B. Alpha2 C. Beta1 D. Beta2

D. Bronchodilation occurs with stimulation of beta2-receptor sites. Vasoconstriction and increased peripheral vascular resistance occur with alpha1-receptor stimulation. Overstimulation of effector sites and moderate insulin release occur with alpha2 stimulation. Increased heart rate occurs with beta1-receptor stimulation.

A client is undergoing inpatient addiction rehabilitation following many years or addiction to heroin? What medication would be the most useful adjunct to treatment? A. Oxymorphone B. Oxycodone C. Tramadol D. Methadone

D. Methadone is used for detoxification and temporary maintenance treatment of narcotic addition. Oxycodone is used for the relief of moderate to severe pain in adults. Oxymorphone is used for the relief of moderate to severe pain in adults, preoperative medication, and obstetrical analgesia. Tramadol is used for the relief of moderate to moderately severe pain, and its use should be limited in clients with a history of addiction.

A client has been taking a tricyclic antidepressant for several weeks and has presented to the clinic feeling "unwell." What sign or symptom should the nurse most likely attribute to adverse drug effects? A Headaches B Blood-streaked stool C Vivid and disturbing dreams D. Urinary hesitancy

D. Rationale: The anticholinergic effects of TCAs include urinary hesitancy. Each of the other listed signs and symptoms warrants follow-up, but none is as likely to result from the client's medication regimen.

Stimulation of the nicotinic receptors will create what type of response in a client? A. Increased bowel motility B. Decreased level of consciousness C. A "rest and digest" reaction D. Increased heart rate and blood pressure

D. Stimulation of nicotinic receptors causes muscle contractions, autonomic responses such as signs and symptoms of a stress reaction, and release of norepinephrine and epinephrine from the adrenal medulla.

Which nursing diagnosis would be most important for a nurse to include in the plan of care for a client who is receiving an antiseizure agent and experiencing common adverse effects? A.Impaired skin integrity B. Ineffective coping C. Risk for imbalanced fluid volume D. Risk for injury

D. The CNS depression that accompanies many antiseizure agents could lead to injury. Therefore, risk for injury and safety measures would be the priorities. Imbalanced fluid volume would be appropriate if the client was experiencing vomiting or diarrhea or showing signs of dehydration. Impaired skin integrity might be appropriate if the client developed a rash. Ineffective coping would be appropriate if the client was verbalizing difficulties with his condition or therapy.

A nurse is reviewing the structure and function of the blood-brain barrier. This anatomical feature would have the greatest effect on what aspect of nursing care? A. Assessing a client's cranial nerve function B. Obtaining accurate electroencephalography readings C. Determining the site of damage after a traumatic brain injury D, Administering antibiotics to treat brain infections

D. The blood-brain barrier is a functioning boundary that keeps toxins, proteins, and other large structures out of the brain and prevents their contact with the sensitive and fragile neurons. It also makes it more difficult for medication to penetrate to locations beyond the barrier. It has not significant effect on assessing cranial nerve function, determining sites of injury, or performing EEGs

The nurse is developing a care plan for a client taking a hydrocodone to control pain. What nursing diagnosis would be appropriate if the client displayed the most common GI adverse effect? A. Acute pain related to gastritis B. Fluid volume deficit related to increased bowel motility C. Imbalanced nutrition: less than body requirements related to anorexia D. Constipation related to GI effects of medication

D. The most common GI adverse effect of narcotics is constipation, so the nursing diagnosis would be constipation related to GI effects of medication. The other options have no association with narcotic administration.

A nurse is reviewing a bipolar client's serum lithium level, which is 1.8 mEq/L. What is the nurse's best action? A. Contact the prescriber and request a supplementary dose of lithium. B. Facilitate a transfer to the intensive care unit. C. Inform the prescriber and perform a focused respiratory assessment. D. Inform the prescriber and monitor for GI and CNS effects.

D. Therapeutic serum lithium levels range from 0.6 to 1.2 mEq/L. A level of 1.8 mEq/L would be considered toxic but would be unlikely to warrant admission to intensive care. The nurse should report the finding and assess for common adverse effects of toxicity, which include GI and CNS effects more often than respiratory effects.

A nurse is planning the care of a client who has been diagnosed with schizophrenia and who will begin treatment with a typical antipsychotic. The nurse should identify what nursing diagnosis? A. Risk for impaired liver function related to hepatotoxicity B. Bowel incontinence related to gastrointestinal adverse effects C. Risk for imbalanced body temperature related to hypothalamic suppression D. Risk for injury related to central nervous system depression

D. Typical antipsychotics cause significant sedation, which creates a risk for injury. These drugs are not severely hepatotoxic and are not linked to bowel incontinence. Thermoregulatory disruptions are similarly unlikely.

The nurse is working with a 12-year-old client who has been diagnosed with attention deficit hyperactivity disorder and prescribed methylphenidate. What statement by the client would suggest the presence of adverse drug effects? A. "I fell asleep on the bus last week and missed my stop." B. "Sometimes I just feel so mad at my teacher or my coach." C. "I banged my shin last week and the bruise it still there." D. "I just don't feel hungry very much these days."

D> Anorexia is a common adverse effect of methylphenidate. Hypocoagulation, drowsiness, and aggression are not expected.

The development of diabetes mellitus is associated with the use of typical antipsychotics. FALSE/TRUE

FALSE All of the atypical antipsychotics include a warning that there is a risk for the development of diabetes mellitus when these drugs are used. ATYPICAL PSYCHOTICS ARE BIPOLAR, SCHIZOPHRENIA, typical psychotics: are acute mania and agitation

A client with diabetes who receives an alpha-specific adrenergic agonist is at risk for hypoglycemia. TRUEFALSE

FALSE Alpha-specific agents can cause glucose elevations in clients with diabetes.

Clients who are receiving alpha-specific adrenergic agents should not stop taking the drug abruptly. FALSETRUE

True Do not discontinue the drug abruptly because sudden withdrawal can result in rebound hypertension, arrhythmias, flushing, and even hypertensive encephalopathy and death; taper drug over 2 to 4 days.