Pharm 2 Exam 4 Practice Questions

Which side effects are common in second-generation antipsychotic drugs? [Select all that apply]. A. Agranulocytosis B. Anticholinergic effects C. Extrapyramidal symptoms D. Postural hypotension E. Weight gain

A, B, D, E

First generation antipsychotics have the ability to block which of the following receptor types? [Select all that apply] A. Dopamine. B. Serotonin. C. Acetylcholine. D. Histamine. E. Norepinephrine.

A, C, D, E

An antidepressant is prescribed for a depressed older adult client. After 1 week, the client's son expresses concern that there does not seem to be much improvement. How should the nurse respond? A. "Antidepressants require several weeks of therapy before it becomes effective." B. "Antidepressant therapy will be more effective as the physical condition improves." C. "Additional medications may be required before behavioral changes will be observed." D. "Additional time is needed for the medication to become effective because of the prolonged depression."

A. "Antidepressants require several weeks of therapy before it becomes effective."

A nurse is interviewing a client in the mental health clinic. Which statement by the client indicates an irreversible adverse response to long-term therapy with an antipsychotic medication? A. "I can't seem to sleep at night." B. "My tongue seems to move by itself." C. "I don't have much of an appetite." D. "My mouth is always dry."

B. "My tongue seems to move by itself."

A patient is taking tamsulosin [Flomax] for benign prostatic hyperplasia (BPH). The nurse should explain that this medication has what effect? A. Decreases the size of the prostate gland B. Relaxes smooth muscle of the prostate gland C. Reduces the risk of prostate cancer D. Improves sexual performance during intercourse

B. Relaxes smooth muscle of the prostate gland

A 75 year old male who has recently been diagnosed with benign prostatic hyperplasia is given a new prescription for an alpha1-adrenergic antagonist. In reviewing his chart, you would be least concerned about which of the following: A. The patient takes nitroglycerin PRN. B. The patient is scheduled for cataract surgery next month. C. The patient currently takes an antihypertensive drug each day. D. The patient recently finished taking 10 days of erythromycin.

D. The patient recently finished taking 10 days of erythromycin.

A client is prescribed imipramine (Tofranil), a tricyclic antidepressant, for depression. The nurse assesses the client for adverse effects. Which adverse effect requires further assessment and possible medical intervention? A. Salivation. B. Weight gain. C. Diaphoresis. D. Urinary hesitancy.

D. Urinary hesitancy.

A young adult patient has been taking an antidepressant medication for several weeks and reports having increased thoughts of suicide and a concrete plan for committing suicide. The nurse questions the client and learns that the patient has attempted suicide more than once in the past. The nurse contacts the provider to discuss: A. requiring more frequent clinic visits for this patient. B. changing the medication to another drug class. C. discontinuing the medication immediately. D. hospitalizing the patient for closer monitoring.

D. hospitalizing the patient for closer monitoring.

A primary healthcare provider prescribes 0.25 mg of diazepam [Valium] by mouth three times a day for a client with anxiety and physical symptoms related to work pressures. For what most common side effect of this drug will the nurse monitor the client? A. Drowsiness B. Bradycardia C. Agranulocytosis D. Tardive dyskinesia

A. Drowsiness

The nurse instructs a nursing student about phenobarbital, a barbiturate, for suppression of seizures. Which statement, if made by the student, indicates an understanding of barbiturates: A. "Prolong use can result in physical dependence." B. "Barbiturates have little to no abuse potential." C. "It's safe to use this drug when drinking alcohol." D. "There is minimal risk for respiratory depression."

A. "Prolong use can result in physical dependence."

Which of these findings would be considered a medical emergency if it occured 4 hours after sexual activity in a patient who uses sildenafil [Viagra]? A. Diarrhea B. Priapism C. Headache D. Blood pressure 150/80 mm/Hg

B. Priapism

A patient receiving clozapine [Clozaril] is complaining of increased urination and thirst. What nursing intervention is essential for this patient? A. Holding the medication. B. Assessing blood pressure. C. Measuring potassium levels. D. Assessing blood glucose levels.

D. Assessing blood glucose levels.

It is a priority to assess if a male patient has taken sildenafil [Viagra] within the past 24 hours if you are preparing to administer which medication? A. Cimetidine [Tagamet] B. Doxazosin [Cardura] C. Finasteride [Proscar] D. Sodium nitroprusside [Nitropress]

D. Sodium nitroprusside [Nitropress]

You are caring for a patient who reports a mild fever, sore throat and nasal congestion. You review the chart and see that the patient is taking clozapine [Clozaril]. It is a priority that the patient is assessed for which condition? A. Agranulocytosis B. Anticholinergic reactions C. Allergy to clozapine D. Failed antipsychotic therapy

A. Agranulocytosis

A patient who has been taking alprazolam [Xanax] to treat generalized anxiety disorder (GAD) reports recently stopping the medication after symptoms have improved, but reports having feelings of panic and paranoia. Which initial action by the nurse is correct? A. Ask the patient if the medication was stopped abruptly. B. Instruct the patient to resume taking full doses of the alprazolam (Xanax). C. Notify the provider that the patient is experiencing abuse symptoms from taking too much of the medication. D. Suggest that the patient discuss taking buspirone [Buspar] with the provider.

A. Ask the patient if the medication was stopped abruptly.

A patient with Type II DM is diagnosed with schizophrenia and the provider prescribes a first generation antipsychotic. The nursing student asks the nurse why the provider hasn't ordered a second generation antipsychotic like olanzapine [Zyprexa]. Which response by the nurse is the most important reason that this patient is not receiving olanzapine [Zyprexa]? A. "Olanzapine causes more metabolic side effects than thioridazine." B. "Thioridazine has fewer side effects than olanzapine." C. "Olanzapine is more expensive than thioridazine." D. "Thioridazine has a faster onset of action than olanzapine."

A. "Olanzapine causes more metabolic side effects than thioridazine."

A nurse is providing education to a male patient who has just received a prescription for sildenafil [Viagra]. The nurse includes all of the following in his teaching except: A. "Priapism is a common adverse effect of Viagra." B. "Grapefruit juice should be avoided when taking Viagra." C. "When taken with high fat meals, Viagra may not work as quickly." D. "Viagra only enhances an erectile response in the presence of a stimuli."

A. "Priapism is a common adverse effect of Viagra."

A nurse is explaining the potential adverse effects of sildenafil [Viagra] to a student nurse. The student nurse demonstrates an understanding by which of the following statements? [Select all that apply] A. "Patients may experience a small decrease in blood pressure when taking Viagra." B. "Common adverse effects of Viagra are headache and flushing." C. "Taking Viagra with grapefruit juice may prolong the effects of Viagra." D. "It is safe to take nitroglycerin and Viagra as long as they aren't taken simultaneously."

A, B, C

Neuroleptic Malignant Syndrome (NMS) is a rare, but potentially fatal condition associated with first generation antipsychotics. Fatalities from NMS have dramatically decreased from 30% to 40% due to early identification and treatment. Which of the following are signs/symptoms of NMS? [Select all that apply] A. High fever. B. "Lead pipe" rigidity. C. Fluctuating blood pressure. D. Opisthotonus.

A, B, C

Which should the nurse assess to determine whether a patient has metabolic effects from their second generation antipsychotic medication? [Select all that apply]. A. Weight B. Lipid profile C. Fasting Blood Glucose D. Complete Blood count

A, B, C

A patient who has been taking an SSRI tells the nurse that the drug has caused reduced sexual performance, weight gain, and sedation. Based on these ADRs, the nurse will suggest that the patient ask the provider about switching to which drug? A. Bupropion [Wellbutrin] B. Imipramine [Tofranil] C. Isocarboxazid [Marplan] D. Trazodone [Oleptro]

A. Bupropion [Wellbutrin]

A patient is taking finasteride [Proscar] for benign prostatic hyperplasia (BPH). The nurse should explain that this medication has what effect? A. Decreases the size of the prostate gland B. Relaxes smooth muscle of the prostate gland C. Increases nocturia D. Improves sexual performance during intercourse

A. Decreases the size of the prostate gland

The nurse should instruct a patient prescribed sildenafil [Viagra] to avoid taking this medication with what? A. Grapefruit juice B. Milk C. Crackers D. Eggs

A. Grapefruit juice

SD is a 75 year old male who has recently been diagnosed with benign prostatic hyperplasia has been given a new prescription for an alpha-adrenergic antagonist. In reviewing his chart, you would be least concerned about which of the following: A. SD recently finished taking 10 days of erythromycin. B. SD takes nitroglycerin PRN. C. SD currently takes an antihypertensive drug each day. D. SD is scheduled for cataract surgery next month.

A. SD recently finished taking 10 days of erythromycin.

Ki is a 43 year-old baker at Harris Teeter. She has been followed by her primary care provider for depression for the past 4 months and has been doing well on a selective serotonin reuptake inhibitor called fluoxetine. However, one issue arises during her visit that provides a clue that she's experiencing a common side effect of fluoxetine. Which side effect do you suspect: A. She has gained about 7 pounds. B. She describes that she is uninterested in sex with her husband. C. She states that she has a pounding headache after she drinks red wine. D. She has a resting tremor.

A. She has gained about 7 pounds.

A female patient who takes a benzodiazepine, lorazepam [Ativan], for anxiety tells the nurse that she plans to become pregnant. What is the best instruction for the nurse to give the patient? A. "Eat a well-balanced diet that includes milk." B. "Discuss tapering the drug with the provider before conception." C. "Stop taking the drug and form another plan to manage anxiety." D. "Visit an obstetrician to determine the correct dose of lorazepam during pregnancy."

B. "Discuss tapering the drug with the provider before conception."

Your patient complains of having recent episodes of insomnia and would like a prescription for a hypnotic drug such as zolpidem (Ambien). Which statement made by the patient would concern the nurse? A. "I was recently diagnosed with sleep apnea and just started using a CPAP machine at night." B. "I work full-time and in the past, I've experienced some day-time drowsiness when taking zolpidem (Ambien)." C. "I have stopped drinking wine while taking this medication." D. "I'm on birth control and plan on notifying my provider if I plan on getting pregnant."

B. "I work full-time and in the past, I've experienced some day-time drowsiness when taking zolpidem (Ambien)."

A client who is feeling lonely and who is extremely depressed has been prescribed a tricyclic antidepressant. The client asks the nurse, "how will this medication help me feel better?" What is the nurse's best response: A. "This drug will help you forget why you're lonely and depressed." B. "The medication could increase your appetite and elevate your mood." C. "You'll start to feel much better after taking this medication for 2 or 3 days." D. "You will feel less depressed when you take this with a monoamine oxidase inhibitor."

B. "The medication could increase your appetite and elevate your mood."

A client takes a nitroglycerine routinely for angina. The client states, "I would like to start taking sildenafil (Viagra) for erectile dysfunction. I was told I can't take sildenafil and the nitrate at the same time." The nurse explains that taking both of these medications concurrently may result in severe: A. Tachypnea B. Hypotension C. Constipation D. Nausea

B. Hypotension

A nurse provides teaching about the administration of alprostadil to a patient who has erectile dysfunction. Which of the following would the nurse teach the patient regarding the correct route of administration: A. Sublingual. B. Insertion into the urethra. C. Subcutaneous. D. Oral.

B. Insertion into the urethra.

The nurse instructs a young adult patient about treatment options for post traumatic stress disorder (PTSD) symptoms. Which drug does the nurse anticipate administering to the patient: A. Bupropion. B. Paroxetine. C. Buspirone. D. Trazodone.

B. Paroxetine.

A patient with depression has been prescribed fluoxetine [Prozac]. Which statement made by the patient indicates an understanding of the medication teaching? A. "Disorientation and hallucinations are common." B. "The drug may enhance my interest in sex." C. "It may take 3 to 4 weeks before my mood is elevated." D. "I can stop this medication when I feel less depressed."

C. "It may take 3 to 4 weeks before my mood is elevated."

A patient has been prescribed sildenafil [Viagra] for erectile dysfunction. Which instruction should the nurse include in the teaching plan? A. Take the medication on an empty stomach. B. Drink plenty of fluids to prevent priapism. C. Avoid taking nitroglycerin with this drug. D. Constipation is a common adverse effect.

C. Avoid taking nitroglycerin with this drug.

Which answer best describes the mechanism of action of Finasteride [Proscar]? A. Finasteride inhibits phosphodiesterase 5 to preserve the levels of cGMP. B. Finasteride binds with a hormonal complex inside the cell to promote synthesis of mRNA. C. Finasteride inhibits the conversion of testosterone to stop the growth of epithelial cells in the prostate. D. Finasteride acts on the receptors of the smooth muscles of the bladder neck.

C. Finasteride inhibits the conversion of testosterone to stop the growth of epithelial cells in the prostate.

Which drug gave rise to the era of antidepressants after it was "accidentally" found to have euphoric characteristics in the treatment of tuberculosis patients in the early 1900s? A. Doxycycline B. Tetracycline C. Isoniazid D. Penicillin

C. Isoniazid

A patient in the emergency department is given intravenous diazepam [Valium] for seizures. When the seizures stop, the nurse notes that the patient is lethargic and confused and has a respiratory rate of 10 breaths per minute. The nurse will expect to administer which of the following? A. Toxicology testing B. Flumazenil [Romazicon] C. Respiratory support D. Gastric lavage

C. Respiratory support

A patient has been taking high doses of clorazepate, a benzodiazepine, for several months for an anxiety disorder. The nurse assessing the patient observes that the patient is agitated, euphoric, and anxious. What will the nurse do? A. Request an order for a longer-acting benzodiazepine. B. Withhold the next dose until a drug level can be drawn. C. Suspect a possible paradoxical reaction to the clorazepate. D. Double-check the chart to make sure the last dose was given.

C. Suspect a possible paradoxical reaction to the clorazepate.

A patient is taking zolpidem [Ambien] for insomnia and tells the nurse that a recent telephone bill lists several calls to friends that the patient does not remember making. What is the nurse's next action? A. Ask the patient about any alcohol consumption in conjunction with the benzodiazepine. B. Reassure the patient that this is most likely caused by a paradoxical reaction to the benzodiazepine. C. Tell the patient that this is an example of anterograde amnesia that should be evaluated. D. Contact the prescriber to request an order for a benzodiazepine with a shorter duration.

C. Tell the patient that this is an example of anterograde amnesia that should be evaluated.

When used in combination with certain foods and drugs, monoamine oxidase inhibitors (MAOIs) can cause serious side effects. Which condition could occur in clients treated with MAOIs for depression when taken in combination with certain drugs or when eating certain foods high in tyramine? A. A significant increase in cholesterol levels B. A serious drop in blood pressure C. A significant increase in liver enzymes D. A serious increase in blood pressure

D. A serious increase in blood pressure

An agitated, extremely anxious patient is brought to the emergency department. The prescriber orders a benzodiazepine. The nurse understands that benzodiazepines are used in this clinical situation based on which principle? A. Benzodiazepines have a very short half-life. B. Benzodiazepines are known to cure generalized anxiety. C. Physical dependence is not a risk when taking benzodiazepines. D. Benzodiazepines have a rapid onset of action.

D. Benzodiazepines have a rapid onset of action.

A client is prescribed doxepin, a tricyclic antidepressant, for severe depression. Which most dangerous side effect of tricyclic antidepressants will the nurse monitor the client for? A. Breast hypertrophy B. Dry mouth C. Constipation D. Dysrhythmias

D. Dysrhythmias

The mechanism of action of sildenafil [Viagra] is best described as the selective ____________ of PDE5 which preserves and ____________ cGMP levels to prolong erection. A. Reuptake, increases B. Destruction, decreases C. Degradation, decreases D. Inhibition, increases

D. Inhibition, increases

A client has become increasingly depressed and is prescribed an antidepressant. After a few months of therapy, the client returns to the clinic and appears relaxed and smiles at the nurse. The most significant conclusion that the nurse can draw from this behavior is that the client: A. Has resolved any conflicts. B. Wants to please the staff. C. May be in denial of any problems. D. Is responding to the antidepressant therapy.

D. Is responding to the antidepressant therapy.

A client is prescribed a monoamine oxidase inhibitor (MAOI). Which of the following should the nurse teach the client: A. It is necessary to avoid the sun. B. Drowsiness is an expected side effect of this medication. C. The therapeutic and toxic levels of the drug are very close. D. Many prescribed and over-the-counter drugs cannot be taken with this medication.

D. Many prescribed and over-the-counter drugs cannot be taken with this medication.

A health care provider prescribes antipsychotic medication, and the nurse teaches the client about the possible side effects of the drug. The nurse concludes that the client needs further teaching about these side effects when he states that he should call the clinic if he experiences: A. Tremors B. Constipation C. Blurred vision D. Ringing in the ears

D. Ringing in the ears

A client with the diagnosis of schizophrenia is given one of the antipsychotic drugs. The nurse understands that antipsychotic drugs can cause extrapyramidal side effects. Which effect is cause for the greatest concern? A. Akathisia B. Acute dystonic reaction C. Parkinsonian syndrome D. Tardive dyskinesia

D. Tardive dyskinesia