Neuro Part II

The nurse is giving discharge instructions to a client who just had Botox A injections around their eyes. The nurse should caution the client about what potential adverse effects? Select all that apply. A) Development of respiratory infections B) Flu-like symptoms C) Droopy eyelids D) Blurred vision or diplopia E) Muscle spasms

A) Development of respiratory infections B) Flu-like symptoms C) Droopy eyelids

The nurse is caring for a client with Parkinson's disease who has severe dysphagia. What drug would be available for parenteral administration? A) Apomorphine B) Bromocriptine C) Levodopa D) Ropinirole

A) Apomorphine

A nurse is providing discharge teaching for a client who will be going home on cyclobenzaprine prescribed for acute musculoskeletal pain. What health education should the nurse provide? A) Avoid drinking any alcohol until the completion of treatment B) Take the medication in the morning to avoid nighttime awakenings because of diuresis C) Avoid taking acetaminophen concurrently with cyclobenzaprine D) Avoid any supplements that contain vitamin B6

A) Avoid drinking any alcohol until the completion of treatment

6. A female client has been experiencing increased muscle spasticity since being diagnosed with multiple sclerosis. What drug is most likely to meet this client's needs? A) Baclofen B) Cyclobenzaprine C) Metaxalone D) Orphenadrine

A) Baclofen

A client is newly diagnosed with Parkinson disease. What aspects of this client's health history rules out the safe and effective use of an anticholinergic drug? Select all that apply. A) Benign prostatic hypertrophy B) Macular degeneration C) Chronic bowel obstructions D) Atrial fibrillation E) Psoriasis

A) Benign prostatic hypertrophy C) Chronic bowel obstructions

The nurse is caring for a client who has a disorder of muscle contraction and relaxation. The nurse should prioritize the assessment of what laboratory value? A) Calcium B) Chloride C) Magnesium D) Potassium

A) Calcium

A client with a viral respiratory infection has an intense headache and cough. What drug will best address both of this client's symptoms? A) Codeine B) Hydromorphone C) Ibuprofen D) Acetaminophen

A) Codeine

A client has been diagnosed with multiple sclerosis and experiences spasticity in several muscle groups. What drug would the nurse anticipate will be ordered as the drug of choice to manage spasticity associated with neuromuscular diseases? A) Dantrolene B) Baclofen C) Carisoprodol D) Botulinum toxin type B

A) Dantrolene

A client has been prescribed benztropine as drug therapy for Parkinson disease. What assessment finding would suggest a therapeutic effect to the nurse? A) Decreased rigidity and tremors B) Increased level of consciousness C) Increased motivation and muscle strength D) Absence of seizure activity

A) Decreased rigidity and tremors

A client has developed drug-induced Parkinson disease following prolonged treatment with metoclopramide. The nurse should anticipate the use of what drug that is also classified as an antiviral? A) Amantadine B) Entacapone C) Diphenhydramine D) Ropinirole

A) Amantadine

The nurse is planning the care of a client diagnosed with Parkinson disease. What is the main purpose of this client's medication therapy? A) Adjust the balance of neurotransmitters in the client's CNS. B) Make the catechol-O-methyltransferase (COMT) inhibitors work better. C) Substitute monoamine oxidase inhibitors (MAOIs) for dopamine agonists. D) Increase the actions of acetylcholine in the brain.

A) Adjust the balance of neurotransmitters in the client's CNS.

A postsurgical client has been receiving morphine by patient-controlled analgesic for 2 days. What action by the nurse best addresses potential adverse effects? A) Administering a stool softener as prescribed B) Auscultating the client's lung for adventitious sounds C) Encouraging active range of motion exercises D) Applying calf compressors as prescribed

A) Administering a stool softener as prescribed

The nurse is preparing to administer the client's first dosage of trihexyphenidyl. What should the nurse tell the client about the dosage? A) "The initial dose is usually 1 to 2 mg and then dosage is gradually increased." B) "The initial dose is usually 6 mg to establish serum levels and then 1 mg is taken daily." C) "Generally, a 5-mg dose is taken orally twice a day starting with first dose." D) "You'll probably need to take 1 to 2 mg orally every day starting with first dosage.

A) "The initial dose is usually 1 to 2 mg and then dosage is gradually increased."

The nurse receives a prescription for morphine sulfate 8 mg IV every hour as needed for pain. For what client should the nurse question this order? A) A 78-year-old with osteoarthritis B) A 45-year-old, 1-day postoperative mastectomy C) A 28-year-old with a fractured tibia D) A 17-year-old, 1-day postoperative appendectomy

A) A 78-year-old with osteoarthritis

What clients should the nurse recognize as having a health problem that could result in muscle spasm? Select all that apply. A) A client who overstretched a muscle during a vigorous workout B) A client who sustained an accidental gunshot injury to his leg C) A client who tore a leg tendon in a soccer game D) A school-aged client who fractured their radius on the playground E) An older adult client with Parkinson disease

A) A client who overstretched a muscle during a vigorous workout C) A client who tore a leg tendon in a soccer game

A client is experiencing pain. What are being stimulated in this client? Select all that apply. A) A-delta fibers B) D-delta sensory nerves C) Mu receptors D) Sigma-receptors E) C fibers

A) A-delta fibers E) C fibers

The nurse is caring for a client who is having a pump placed to deliver intrathecal baclofen and another client who will receive dantrolene as a muscle relaxant. What nursing diagnosis would be appropriate for both care plans? Select all that apply. A) Acute pain related to GI effects of drug B) Risk for injury related to central nervous system (CNS) effects C) Disturbed body image related to muscle pain D) Disturbed thought processes related to CNS effects E) Deficient knowledge related to procedure

A) Acute pain related to GI effects of drug B) Risk for injury related to central nervous system (CNS) effects D) Disturbed thought processes related to CNS effects

A client is newly diagnosed with parkinsonism and has been prescribed levodopa. After several weeks, no appreciable reduction in symptoms has been noted. The nurse should anticipate what change in the client's medication regimen? A) Adding carbidopa to the client's medication regimen B) Addition of vitamin B6 to the client's medication regimen C) Substitution of diphenhydramine for levodopa D) Temporary change in levodopa route from oral to intravenous

A) Adding carbidopa to the client's medication regimen

The nurse is admitting a client to the postsurgical unit from the postanesthetic care unit. The client is in pain so the nurse administers 4 mg morphine IV as prescribed. After administering the drug, the PACU nurse calls to say a dose of morphine was given and not documented. What actions should the nurse perform? Select all that apply. A) Ensure naloxone is readily available. B) Inform the client's healthcare provider. C) Administer buprenorphine as prescribed. D) Document the event. E) Monitor the client's respiratory rate closely. F) Arrange for cardiac monitoring.

A) Ensure naloxone is readily available. B) Inform the client's healthcare provider. D) Document the event. E) Monitor the client's respiratory rate closely.

The nurse is reviewing the medication administration record (MAR) of a client with Parkinson's disease. The nurse reads that the client is prescribed Stalevo t.i.d. Stalevo is a combination of drugs? Select all that apply. A) Entacapone B) Selegiline C) Carbidopa D) Levodopa E) Benztropine

A) Entacapone C) Carbidopa D) Levodopa

A client comes to the clinic to receive a Botox injection in their forehead. The client has adult acne across their forehead. What is the nurse's priority action? A) Hold the injection and consult the healthcare provider. B) Cleanse the area well with an antibacterial soap. C) Apply a topical antibiotic after administering the Botox. D) Provide client information about post-Botox injection care.

A) Hold the injection and consult the healthcare provider.

A client is newly diagnosed with Parkinson disease, and levodopa has been prescribed. What health education should the nurse provide? A) Identifying foods and supplements high in vitamin B6 B) The need for weekly laboratory blood work for the first 6 weeks C) The fact that adverse effects will subside when the body adjusts to the drug D) Matching doses to the daily severity of symptoms

A) Identifying foods and supplements high in vitamin B6

An older adult client was diagnosed with Parkinson disease 2 years ago, and the client's symptoms have gradually worsened. What nursing diagnoses are likely to apply to this client? Select all that apply. A) Impaired physical mobility related to extrapyramidal symptoms B) Risk for autonomic dysreflexia related to CNS disruptions C) Disturbed thought processes related to low dopamine levels D) Self-care deficit: dressing/grooming related to ataxia E) Acute pain related to nociceptor stimulation

A) Impaired physical mobility related to extrapyramidal symptoms D) Self-care deficit: dressing/grooming related to ataxia

The nurse is explaining the therapeutic effects of levodopa to a client with Parkinson disease. What characteristics of levodopa and dopamine should the nurse describe? Select all that apply. A) Levodopa is a precursor of dopamine B) Levodopa crosses the blood-brain barrier C) Levodopa is converted to dopamine D) Levodopa stimulates the brain to synthesize dopamine E) Dopamine reverts levodopa for metabolism

A) Levodopa is a precursor of dopamine B) Levodopa crosses the blood-brain barrier C) Levodopa is converted to dopamine

The nurse admits a child diagnosed with tetanus after stepping on some old barbed wire fencing. What medication should the nurse expect to administer? A) Methocarbamol B) Baclofen C) Dantrolene D) Cyclobenzaprine

A) Methocarbamol

The client in labor receives morphine every 2 hours to manage labor pain. After 22 hours of labor, the woman delivers a healthy neonate. What is the nurse's priority action related to the newborn? A) Monitor for opioid effects. B) Administer naloxone. C) Monitor for withdrawal syndrome. D) Assess for congenital anomaly

A) Monitor for opioid effects.

A client who is 84 years old is experiencing chronic lower back that has not responded to NSAIDs. The provider has prescribed a transdermal fentanyl patch. What should the nurse do to ensure safe and effective care? Select all that apply. A) Monitor the client's respiratory status closely. B) Keep the client's bed in the lowest position. C) Ensure the client has access to the call light. D) Monitor the client's temperature before and after administration. E) Avoid administering any other medications while the transdermal patch is in place

A) Monitor the client's respiratory status closely. B) Keep the client's bed in the lowest position. C) Ensure the client has access to the call light.

A client with a spinal cord injury has developed central spasticity, and the care provider wishes to administer a muscle relaxant intrathecally. What is the nurse's best action? A) Prepare to administer baclofen. B) Contact the care provider to question the treatment plan. C) Ensure that the client has patent venous access. D) Prepare to administer carisoprodol.

A) Prepare to administer baclofen.

The nurse is observing a client who is labeling the numbers on a drawing of a clock during a neurologic assessment. What should the nurse recognize that the client is using when making precise, intentional movements such as handwriting? A) Pyramidal tract B) Substantia nigra C) Broca's area D) Extrapyramidal tract

A) Pyramidal tract

The nurse is speaking to a group at the senior citizen's center about Parkinson disease. What should the nurse explain is importance to avoiding when taking an anticholinergic medication? A) Strenuous exercise in high environmental temperatures B) Salt substitutes and foods high in potassium C) Foods high in vitamin K such as dark green, leafy vegetables D) Over-the-counter medications containing acetaminophen

A) Strenuous exercise in high environmental temperatures

The client is brought to the emergency department in respiratory arrest after overdosing on heroin. The person accompanying the client says he has been using heroin for years. After being administered one dose of naloxone, the client begins to breathe spontaneously but remains nonresponsive to stimuli so another dose is prescribed. The nurse should monitor for what signs and symptoms of acute narcotic abstinence syndrome? Select all that apply. A) Tachycardia B) Hypertension C) Vomiting D) Bradypnea E) Sedation

A) Tachycardia B) Hypertension C) Vomiting

A client with a complex health history has developed severe spasticity. What aspect of the client's status would contraindicate the safe and effective use of dantrolene? A) The client has a history of fatty liver disease. B) The client has type 2 diabetes and takes oral antihyperglycemics. C) The client has asthma and occasionally uses an inhaled corticosteroid. D) The client requires partial assistance with activities of daily living.

A) The client has a history of fatty liver disease.

An older adult client began treatment for Parkinson's disease several months ago and the nurse is assessing the client. What assessment finding should suggest that the client's medications are becoming less effective? A) The client has begun drooling while they eat B) The client is increasingly impatient with their spouse and children C) The client has lost interest in their favorite foods D) The client's neutrophil count is gradually declining

A) The client has begun drooling while they eat

A client with a history of migraines has been prescribed sumatriptan and is experiencing relief. What physiologic response is the client most likely experiencing? A) Vasoconstriction of cranial blood vessels B) Increased synthesis and release of endorphins C) Stimulation of A-delta D) Stimulation of C fibers

A) Vasoconstriction of cranial blood vessels

The nurse provides client teaching about chlorzoxazone in preparation for the client's discharge to home. The nurse determines that the client understands potential adverse effects when the client makes what statement? A) "This drug can cause diarrhea, so I'll adjust my diet accordingly." B) "My urine might change color when I take this drug." C) "My skin may turn yellow but that will go away once my body adjusts to the drug." D) "After I take a pill it might take 2 to 3 hours before I feel the effects."

B) "My urine might change color when I take this drug."

A client attends a "Botox Party" and is injected with botulinum toxin type A to decrease frown lines between their eyebrows. Later that evening, the client is admitted to the emergency department and is distraught because they cannot move their eyebrows. What does the nurse explain the toxin causes? A) "The toxin causes muscle death, which smooths wrinkles in the area." B) "The toxin causes muscle paralysis, preventing movement and relieving wrinkles." C) "The drug is a toxin to nerves in the area." D) "The drug is a permanent muscle relaxant and the muscles will never move again."

B) "The toxin causes muscle paralysis, preventing movement and relieving wrinkles."

A client with a migraine took a prescribed dose of eletriptan, and 1-hour later, the headache is still intense. The client's spouse calls the clinic and asks the nurse what they should do. What is an appropriate nursing response? A) "Tell them to lie down in a quiet cool room and just wait it out. It will subside." B) "They can take another dose of the drug 2 hours after the initial dose if the headache continues." C) "Give them a dose of an ergot drug if you have it. It will decrease the intensity of the pain." D) "Ibuprofen may increase the action of the triptan."

B) "They can take another dose of the drug 2 hours after the initial dose if the headache continues."

The nurse is preparing to administer an ergot drug to a client for the first time. What other medication that the client is taking should cause the nurse to question the order? A) An oral hypoglycemic B) A beta adrenergic blocker C) An oral contraceptive D) A selective serotonin reuptake inhibitors (SSRIs)

B) A beta adrenergic blocker

A palliative client is experiencing intense cancer pain that requires large and frequent doses of narcotics. The provider has prescribed methylnaltrexone to address the client's resulting constipation. What is a nursing responsibility related to methylnaltrexone administration? A) Administering one 2-mg tablet after each meal, as prescribed B) Administering the medication by daily subcutaneous injection C) Ensuring that the client's IV access is patent and reliable D) Encouraging fluid intake as much as possible

B) Administering the medication by daily subcutaneous injection

After administering a centrally acting skeletal muscle relaxant, what other independent nursing measures might the nurse implement to relieve pain and reduce spasm? A) Physical therapy for the affected muscle B) Application of heat to the affected region C) Deep tissue massage D) Administration of a nonsteroidal anti-inflammatory drug

B) Application of heat to the affected region

The nurse is caring for a client who has Parkinson disease and whose symptoms are worsening. The healthcare provider has added selegiline to the client's drug regimen. What is the nurse's priority assessment after this drug is administered? A) Apical heart rate B) Blood pressure C) Urine output and urine character D) Monitoring for hemorrhage

B) Blood pressure

A client with muscle spasticity has begun taking baclofen. What recent assessment findings should the nurse attribute to possible adverse effects? Select all that apply. A) Heart rate 61 beats/min, regular rhythm. B) Blood pressure 103/59 mm Hg. C) Client reports frequent urges to void. D) Client reports lightheadedness transitioning from lying to sitting. E) Most recent laboratory blood results suggest leukopenia.

B) Blood pressure 103/59 mm Hg. C) Client reports frequent urges to void. D) Client reports lightheadedness transitioning from lying to sitting.

A client has been taking levodopa (L-dopa) for the treatment of Parkinson's disease. What additional medication may decrease the amount of levodopa needed to reach a therapeutic level in the brain, thereby reducing adverse effects of levodopa? A) Bromocriptine B) Carbidopa C) Amantadine D) Trihexyphenidyl

B) Carbidopa

A 10-year-old client has been prescribed an antiparkinsonian drug due to changes in movement. Which treatment should the nurse expect as the first choice for this child? A) Benztropine B) Diphenhydramine C) Trihexyphenidyl D) Electroconvulsive therapy (ECT)

B) Diphenhydramine

A client has a long-standing diagnosis of Parkinson disease and has been taking Sinemet for 2 years. The nurse has observed that the client is experiencing less and less benefit from the Sinemet in recent months. What drug may reverse this trend? A) Pramipexole B) Entacapone C) Ropinirole D) Amantadine

B) Entacapone

When caring for a client taking dantrolene, for what adverse effects should the nurse monitor the client? Select all that apply. A) Bradycardia B) Jaundice C) Urinary retention D) Fatigue E) Drowsiness

B) Jaundice D) Fatigue E) Drowsiness

The nurse is caring for a client who is receiving morphine via patient-controlled analgesia (PCA). In addition to pain assessment, what assessments should the nurse prioritize? A) Apical heart rate and temperature B) Level of consciousness and respiratory rate C) Respiratory rate and fluid balance D) Urine output and inspection of the IV site

B) Level of consciousness and respiratory rate

The nurse is teaching a new client with Parkinson disease about levodopa (L-dopa). What should the nurse instruct the client to avoid using concurrently with L-dopa? A) Over-the-counter calcium carbonate tablets B) Multivitamin-mineral preparations C) Foods that are high in tyramines D) Topical corticosteroid ointments

B) Multivitamin-mineral preparations

What are the simplest nerve pathways in the body? A) Arc reflexes B) Spinal reflexes C) Afferent nerve reflexes D) Spindle gamma loop

B) Spinal reflexes

The nurse is caring for a client who has experienced little pain relief. The care team is considering the use of pentazocine. What aspect of the client's current status would necessitate cautious use of pentazocine? A) The client has diverticulosis. B) The client had a myocardial infarction 18 months ago. C) The client takes over-the-counter laxatives and stool softeners regularly. D) The client has smoked cigarettes for four decades.

B) The client had a myocardial infarction 18 months ago.

The nurse administers hydromorphone IV to the postoperative client as prescribed. What is the best method for the nurse to evaluate the client's response to the medication? A) Observe the client's behavior without the client's awareness, 30 minutes after administration. B) Use a pain assessment tool before and 30 minutes after administration. C) Assess the client's vital signs before and after drug administration. D) Ask the client if the medication has been effective

B) Use a pain assessment tool before and 30 minutes after administration.

The nurse provides client teaching about use of levodopa for treatment of Parkinson disease. What statement by the client would indicate a good understanding of levodopa? A) "I'll know within about a year whether this drug has cured my Parkinson disease." B) "I should avoid exercising while taking this drug so that I don't get injured." C) "I should take this drug with food to avoid an upset stomach." D) "I will take multivitamins to ensure that I have good nutrition."

C) "I should take this drug with food to avoid an upset stomach."

A client with migraine headaches is changed from an ergot to a prescription for a triptan. The nurse has provided health education related to the new medication. What statement would indicate that the client has a clear understanding of the new medication? A) "I'll keep a close watch for any changes in the color of my urine." B) "I can resume my normal driving habits because this medication isn't sedating." C) "I shouldn't experience as many adverse effects from my new medication." D) "I can take my medication every hour when I have a headache."

C) "I shouldn't experience as many adverse effects from my new medication."

When describing Parkinson disease to a client with a new diagnosis, what statement made by the nurse would be accurate? A) "Parkinson disease can be cured if medication is taken regularly as prescribed." B) "Degeneration of the neurons can be halted if medications are begun as early as possible." C) "Symptom management through drug therapy is the current mainstay of treatment." D) "Surgery has become the most effective intervention for Parkinson disease over the past decade."

C) "Symptom management through drug therapy is the current mainstay of treatment."

A client with Parkinson disease has been prescribed apomorphine to treat the client's episodes of hypomobility. What should the nurse teach the client regarding administration of the drug? A) "The drug will likely be injected intramuscularly three times a day in a range of 1.0 to 1.5 mL." B) "The drug will probably be prescribed intravenously, 50 mg every third day." C) "The drug will probably be injected three times a day with a dosage range of 2 to 6 mg." D) "The drug is usually taken orally, 20 mg three times a day."

C) "The drug will probably be injected three times a day with a dosage range of 2 to 6 mg."

What order for naloxone would be appropriate for the nurse to administer for reversal of opioid effects? A) 1 mg IV repeat every 2 to 3 minutes B) 5 mg IV repeat every 5 minutes C) 0.1 mg IV repeat every 2 to 3 minutes D) 0.4 mg IV repeat every 3 minutes

C) 0.1 mg IV repeat every 2 to 3 minutes

The nurse is caring for four clients. Which client would have the highest risk for hepatotoxicity from dantrolene? A) A man who is taking a cardiac glycoside B) A man who is taking an antipsychotic drug C) A woman who is on hormone replacement therapy D) A woman who is taking a loop diuretic

C) A woman who is on hormone replacement therapy

A client has been taking morphine PO for several months following a back injury. The care team is working with the client to wean the client off morphine. The client reports he is getting minimal relief from the pain with the new nonopioid medication he is receiving. What should the nurse suspect is causing this client's pain? A) Administer a higher dose of morphine, as prescribed. B) Assess the client for further signs of addiction. C) Assess the client for further signs of withdrawal syndrome. D) Monitor the client for hypersensitivity

C) Assess the client for further signs of withdrawal syndrome.

A hospital client's pain is rated at 9/10, and the nurse is preparing to administer 4 mg hydromorphone PO as prescribed. What are the appropriate interventions by the nurse prior to administering the medication? A) Ensure the client is aware of NSAID alternatives to this narcotic. B) Assess the client's apical heart rate for 1 minute. C) Assess the client's baseline respiratory rate. D) Ensure that there is naloxone available at the bedside

C) Assess the client's baseline respiratory rate.

A client, newly diagnosed with Parkinson's disease, has been prescribed an anticholinergic drug. What assessment should the nurse perform when monitoring for adverse effects of anticholinergic agents used for the treatment of Parkinson's disease? A) Monitoring of laboratory results for blood dyscrasias B) Focused respiratory assessment C) Assessment of the client's bowel pattern D) Monitoring of prothrombin time and international normalized ratio (INR)

C) Assessment of the client's bowel pattern

The nurse is caring for a client who is being discharged home from the rehabilitation unit. Baclofen will be discontinued, and the client will begin taking carisoprodol as an outpatient. What is the nurse's primary consideration when discontinuing the client's baclofen? A) The client's dose of baclofen should be gradually withdrawn over 4 to 6 weeks to prevent rebound spasticity. B) "The client will be prescribed alternate doses of baclofen and carisoprodol over 10 days to prevent symptoms of baclofen withdrawal." C) Baclofen must be tapered down over 1 to 2 weeks to prevent psychoses and hallucinations. D) "Carisoprodol will be administered while continuing baclofen until the carisoprodol level is established.

C) Baclofen must be tapered down over 1 to 2 weeks to prevent psychoses and hallucinations.

The nurse is providing client teaching about a prescribed opioid analgesic. When monitoring the client for potential adverse effects, what assessment should the nurse prioritize? A) Coordination B) Visual acuity C) Blood pressure D) Heart rhythm

C) Blood pressure

When carbidopa is given with levodopa (L-dopa), the dosage of L-dopa may be reduced. What does the reduction in the dosage of L-dopa cause? A) Heightened levels of sedation B) Prolonged effect of medications C) Decreased adverse effects D) Decreased effectiveness of symptom control

C) Decreased adverse effects

The nurse is caring for a client who has Parkinson disease. What should the nurse anticipate for this client? A) Excessive gamma-aminobutyric acid (GABA) levels B) Hypoxia in the corpus striatum C) Deficient levels of dopamine D) Hypertrophy of the substantia nigra

C) Deficient levels of dopamine

The nurse is caring for a client diagnosed with Parkinson disease who has been prescribed an anticholinergic drug. What factor most likely prompted the primary care provider to prescribe this drug? A) The client has exhibited adverse effects of medications. B) The client has developed psychological dependence on dopaminergics. C) Levodopa has not caused a sufficient therapeutic response. D) The client's disease has been deemed incurable.

C) Levodopa has not caused a sufficient therapeutic response.

The nurse is providing care for a client recovering from spinal anesthesia. What action by the nurse will best reduce the client's risk for headache during recovery? A) Administer sumatriptan 50 mg sublingual, as prescribed. B) Administer morphine 2 to 4 mg IV, as prescribed. C) Maintain the client in the supine position. D) Place client in Trendelenburg position for up to 1-hour

C) Maintain the client in the supine position.

The pediatric nurse is providing care for several clients who are experiencing pain. The nurse should anticipate that clients may be ordered what narcotic analgesics? Select all that apply. A) Transdermal fentanyl B) Methadone C) Morphine D) Meperidine E) Hydrocodone

C) Morphine D) Meperidine E) Hydrocodone

An older adult with lumbar pain has been prescribed cyclobenzaprine. What nursing diagnosis should the nurse prioritize? A) Chronic confusion related to CNS depression B) Diarrhea related to GI stimulation C) Risk for falls related to CNS depression D) Risk for deficient fluid volume related to vomiting and diaphoresis

C) Risk for falls related to CNS depression

The perioperative nurse is caring for a surgical client whose skeletal muscles are relaxed, whose respirations are 20 breaths/min, and whose pupils are dilated. In what stage of anesthesia is this client? A) Stage 1: Analgesia stage B) Stage 2: Excitement stage C) Stage 3: Surgical anesthesia stage D) Stage 4: Medullary paralysis

C) Stage 3: Surgical anesthesia stage

What client characteristic may contraindicate the use of tramadol for the treatment of a client's pain following traumatic injuries? A) The client has developed a wound infection and is at risk of sepsis. B) The client is 48 hours postorthopedic surgery. C) The client has a history of crack cocaine addiction. D) The client required a transfusion of packed red blood cells on admission.

C) The client has a history of crack cocaine addiction.

The nurse is caring for an older adult client who has been diagnosed with Parkinson disease and who will soon begin drug therapy. What nursing action will best promote safe and effective drug therapy? A) Teaching the family to best match medication doses to the daily severity of the client's symptoms B) Detailed education about the need for outpatient blood pressure monitoring C) Thorough client and family teaching, supplemented with written materials D) Reassurance that many of the client's symptoms may be normal age-related changes rather than pathologic changes

C) Thorough client and family teaching, supplemented with written materials

An order is written for a drug that is an adjunctive therapy for Parkinson disease. The nurse reviews the order before administering the drug. What prescription should the nurse question? A) Levodopa 0.5 to 1 g/d orally in two divided doses B) Amantadine 200 mg orally b.i.d. C) Tolcapone 400 mg orally t.i.d. D) Selegiline 10 mg/d orally

C) Tolcapone 400 mg orally t.i.d.

A client is in the hospital recovering from surgery. The client's adult child tells the nurse they are concerned their parent will overdose on morphine because they keep pressing the button on the client-controlled anesthesia (PCA) pump. In addition to reassessing the client's pain, what is the nurse's best response? A) "I'll teach you some techniques to take their focus off the pain so they don't press the button so often." B) "If they follow the directions given, that will not happen." C) "I'll come and teach them again how to use the PCA safely and effectively." D) "The device has maximum limits programmed, so your parent cannot get more than a specific amount."

D) "The device has maximum limits programmed, so your parent cannot get more than a specific amount."

A 31-year-old female client has been taking dantrolene for several years with good effect. The client has presented to the clinic because she has just had a positive home pregnancy test. In addition to referring the client to her primary care provider, the nurse should provide what teaching? A) "Your provider will likely want to discontinue the drug for the rest of your first trimester, since that when organs are forming." B) "Dantrolene is in pregnancy category A, which means it's been shown safe to use in pregnancy." C) "Your provider will likely choose an alternative muscle relaxant since dantrolene has been linked to spontaneous abortion." D) "You and your care provider will have to carefully consider whether it will be safe for you to continue taking dantrolene."

D) "You and your care provider will have to carefully consider whether it will be safe for you to continue taking dantrolene."

The nurse administers morphine 15 mg oral solution to a client with cancer pain at 09:30. What time should the nurse reassess the client for peak analgesic effect? A) 09:45 B) 10:00 C) 10:30 D) 11:00

D) 11:00

The healthcare provider prescribes codeine 20 mg PO q4h as an adjunctive therapy to a client's NSAID. What is the nurse's best action? A) Contact the care provider to question the dose. B) Contact the care provider to question the frequency of administration. C) Contact the care provider to question concurrent use of an NSAID and codeine. D) Administer the medication as prescribed and monitor the client's pain.

D) Administer the medication as prescribed and monitor the client's pain.

The nurse is preparing to administer a hospital client's scheduled dose of baclofen 20 mg PO. Prior to administering the medication, the nurse has performed an assessment which indicated the client's blood pressure is 151/98 mm Hg. What is the nurse's best action? A) Withhold the scheduled dose of baclofen and document the assessment findings. B) Contact the care provider immediately. C) Withhold the medication and reassess the client in 30 to 60 minutes. D) Administer the medication as prescribed.

D) Administer the medication as prescribed.

The nurse is working with a client who has been prescribed tizanidine for the treatment of muscle spasticity. When monitoring the client's risk for injury, what assessment should the nurse prioritize? A) Assessment of bowel sounds and pattern of bowel movements B) Assessment for headaches following peak blood levels C) Assessment of the client's creatinine clearance rate D) Assessment of the client's blood pressure following administration

D) Assessment of the client's blood pressure following administration

The nurse has developed a plan of care for an older adult client newly diagnosed with Parkinson disease. What outcome is most likely to be appropriate for this client? A) Client will demonstrate a full return to independent activities of daily living with 2 weeks of starting treatment. B) Client will return to prediagnosis levels of fine motor skill within 48 hours of beginning treatment. C) Client will be oriented to person, place, and time within 48 hours of beginning treatment. D) Client will demonstrate the ability to ambulate the length of the hall within 1 week of starting medication

D) Client will demonstrate the ability to ambulate the length of the hall within 1 week of starting medication

The nurse is caring for a client who has just been prescribed cyclobenzaprine 100 mg PO t.i.d. What is the nurse's best action? A) Confirm the client's identity and administer the medication as prescribed. B) Contact the prescriber to confirm the route. C) Contact the prescriber to confirm the frequency. D) Contact the prescriber to confirm the dose.

D) Contact the prescriber to confirm the dose.

A client with advanced Parkinson disease has undergone diagnostic testing and diagnostic imaging. What are the results most likely to reveal? A) Decreased enzyme dopa decarboxylase levels B) Increased gamma-aminobutyric acid (GABA) C) Brain infarcts D) Degeneration of dopamine-producing nerve cells

D) Degeneration of dopamine-producing nerve cells

The client reports pain caused by muscle spasms in their back. The nurse assesses the client as being very anxious due to intense psychosocial stressors and notes how the anxiety results in tensing of muscles. What medication would be most effective in treating this client? A) Baclofen B) Botulinum toxin type B C) Dantrolene D) Diazepam

D) Diazepam

The nurse assesses a newly admitted client and finds the muscle tone in their left leg has sustained muscle contraction and that the client is unable to relax the muscle even when prompted. What is the nurse's most appropriate action? A) Administer phenytoin as prescribed. B) Administer diphenhydramine as prescribed C) Document the fact that the client has atonic muscles D) Document the presence of muscle spasticity

D) Document the presence of muscle spasticity

The nurse is preparing to administer morphine IV to a client with multiple trauma. Before administering the morphine, what common adverse effect should the nurse inform the client about? A) Paresthesia in lower extremities B) Occipital headache C) Photophobia D) Drowsiness

D) Drowsiness

The nurse is caring for a client whose pain is being treated with pentazocine. What would be an appropriate nursing diagnosis for this client's care plan? A) Diarrhea related to adverse gastrointestinal effects B) Risk for autonomic dysreflexia related to central nervous system depression C) Risk for infection related to immune system depression D) Impaired gas exchange related to respiratory depression

D) Impaired gas exchange related to respiratory depression

The nurse is assessing a client who was prescribed levodopa 1 week earlier. What change in the client's status would suggest the effectiveness of drug therapy? A) Stability of mood B) Slower chewing of food C) Improved attention span D) Improvement in handwriting

D) Improvement in handwriting

A client has been experiencing severe pain and is being treated with narcotics. What should the nurse include in the plan of care as a desirable and measurable outcome for this client? A) Reduced periods of time between requests for medication B) Reduced resting heart rate C) Maintaining one position for a prolonged period of time D) Increased independence with AM care

D) Increased independence with AM care

A client presents to the emergency department and states stepping on a rusty nail 2 days ago. Upon assessment, the client exhibits signs of muscle rigidity and contractions. The nurse should expect to administer which medication? A) Carisoprodol B) Cyclobenzaprine C) Metaxalone D) Methocarbamol

D) Methocarbamol

A client has been diagnosed with cerebral palsy accompanied by muscle spasticity. The nurse should identify what causative factor of this client's symptoms? A) Irreversible injury to muscle tissue B) Imbalances between neurotransmitter levels and the levels of enzymes that modulate their reuptake C) Inherited defects of the peripheral nervous system D) Nerve damage within the central nervous system

D) Nerve damage within the central nervous system

The nurse is caring for a client with an infusing IV who is allowed noting by mouth due to a paralytic ileus. What centrally acting medication could the nurse administer to this client? A) Chlorzoxazone B) Carisoprodol C) Cyclobenzaprine D) Orphenadrine

D) Orphenadrine

The pediatric nurse is preparing to administer an antiparkinsonism drug to a 14-year-old client. What is the most likely indication for this use of antiparkinsonian drugs? A) Early onset of Parkinson disease B) Development of parkinsonian effects from recreational drug use C) Parkinsonian effects secondary to a connective tissue disorder D) Parkinsonian symptoms arising from adverse medication effects

D) Parkinsonian symptoms arising from adverse medication effects

A geriatric client received a narcotic analgesic before leaving the postanesthesia care unit to return to the regular unit. What is the priority nursing intervention for the nurse receiving the client on the regular unit? A) Maintain the head of the client's bed at ≥ 45°. B) Encourage fluid intake. C) Create a restful, dark, quiet environment. D) Put side rails up and place bed in low position

D) Put side rails up and place bed in low position

The nurse is developing a plan of care for a client whose scheduled surgery will last approximately 3 hours. What intraoperative nursing diagnosis should the nurse prioritize? A) Impaired swallowing related to intubation and mechanical ventilation B) Risk for deficient fluid volume related to absence of oral intake C) Acute pain related to disruption of tissue during surgery D) Risk for impaired skin integrity related to immobility

D) Risk for impaired skin integrity related to immobility

The perioperative nurse has created a plan of care for a surgical client. What diagnosis should the nurse include that is directly related to safety during surgery? A) Deficient knowledge regarding drug therapy B) Acute confusion related to anesthesia C) Risk for powerlessness related to loss of consciousness D) Risk for injury related to central nervous system (CNS) depressive effects of drugs

D) Risk for injury related to central nervous system (CNS) depressive effects of drugs

A client is preoperative, and there is a need to decrease the client's sympathetic stimulation to ensure the client does not remember the procedure. The nurse should anticipate the use of what type of agent? A) Antihistamine B) Antiemetic C) Opioid agonist D) Sedative-hypnotic

D) Sedative-hypnotic

A client experiences short-lived, intense headaches that tend to occur in cycles, often with lengthy periods of remission. What medication is most likely to meet this client's needs? A) Almotriptan B) Frovatriptan C) Naratriptan D) Sumatriptan

D) Sumatriptan

The nurse is teaching a client newly-diagnosed with Parkinson disease about the appropriate use of levodopa-carbidopa (Sinemet). What should the nurse teach the client? A) Take the daily dose at bedtime to minimize sedative effects. B) Remain seated upright for 30 minutes after taking the medication, if possible. C) Use a moisturizing cream if a rash develops after beginning the medication. D) Take the drug three times each day, at the times that are specified.

D) Take the drug three times each day, at the times that are specified.

A home health nurse is visiting an older male adult client with Parkinson disease. The nurse should assess this client for which signs or symptoms related to common adverse effects? A) Skin lesions B) Increased dopamine activity C) Jaundice D) Urinary retention

D) Urinary retention

A client with Parkinsonism has been told that the levodopa prescribed is no longer controlling the disease. What drug should the nurse question if ordered as adjunctive therapy? A) Diphenhydramine B) Pramipexole C) Trihexyphenidyl D) Vitamin B6

D) Vitamin B6

General anesthetic has been administered to a surgical client, and the client has begun to exhibit signs and symptoms of malignant hyperthermia. The operating room nurse should prepare to assist with the administration of: A) orphenadrine. B) metaxalone. C) chlorzoxazone. D) dantrolene.

D) dantrolene.