Pharmacology Ch. 13, Central Nervous System Stimulants and Related Drugs

Which statement by the nurse indicates understanding of the teaching about medication administration for patients with attention-deficit/hyperactivity disorder (ADHD)?

"I will give these drugs 30 to 45 minutes before meals to improve absorption."

Which statement made by the patient indicates further teaching is needed about amphetamine medications?

"It may decrease my heart rate."

Which is the dose regimen of methylphenidate (Ritalin) for a 6-year-old child with attention-deficit/hyperactivity disorder (ADHD)?

5 mg before breakfast and lunch

Which analeptic may cause gasping syndrome in a newborn?

Doxapram

A child has been taking methylphenidate for 2 months. The child's parent tells the nurse, "Each time I go to get my child's medication, the pharmacist asks me to get a new prescription. Why is this so?" Which answer will the nurse explain to the parent?

"This drugs has the risk of causing abuse."

Which statement is correct for the nurse to reply to the worried parents of a 7-year-old child who is highly impulsive and has not been attentive in school for the last two months?

"You should continue to observe the child's behavior for 4 months."

Which response is appropriate for a patient with insulin-dependent diabetes who asks how to reduce their weight?

"You should follow a nutrition and exercise regimen for weight management."

Which adverse effects will the nurse monitor in the patient who receives ergot alkaloid drugs for migraine headache? Select all that apply.

- Dizziness - Numbness - Nasal irritation

Which characteristics must be identified in the child's behavior before central nervous system stimulants are indicated? Select all that apply.

- Lack of ability to control impulses - Symptoms lasting at least 6 months - Short attention span for the child's age

Which signs and symptoms support a diagnosis of migraine headaches? Select all that apply.

- Photophobia - Phonophobia - Pulsating headache

How does caffeine work to ease neonatal apnea? Select all that apply.

- Relaxes the bronchial smooth muscle - Increases sensitivity to carbon dioxide - Supports a regular pattern of breathing - Blocks the action of cerebral adenosine

Which adverse effects may occur in an obese patient with attention-deficit/hyperactivity disorder (ADHD) who has been prescribed phentermine and dexmethylphenidate? Select all that apply.

- Seizures - Insomnia - Dysrhythmias

Which are the clinical uses of doxapram? Select all that apply.

- To increase the rate of respiration - To increase the depth of respiration

Which patients who have which conditions are contraindicated for anorexiant therapy? Select all that apply.

-Glaucoma -Drug allergies - Bulimia nervosa

Which drug is contraindicated in a patient with a peptic ulcer and who has chronic obstructive pulmonary disease (COPD)?

Caffeine

Which medication may be prescribed to minimize breathing difficulty an infant with dyspnea who is treated with high-pressure mechanical ventilation and who develops bronchopulmonary dysplasia?

Caffeine

Which disease process/condition may be exacerbated by using caffeine?

Cardiac dysrhythmias

Which is the primary action site for serotonin agonists?

Cerebrovascular system

Which common adverse effect does the nurse anticipate in a patient after standard drug therapy for a throbbing, pulsating headache on one side of the head with aura?

Chest congestion

Which of the following would be a reason that the health care provider has replaced dexmethylphenidate with atomoxetine?

Dexmethylphenidate has more addictive properties.

Which drug is used to treat attention-deficit/hyperactivity disorder (ADHD)?

Dextroamphetamine

Which adverse effect does the nurse anticipate in a patient who uses analeptics at high doses?

Diarrhea

Which is an adverse effect of orlistat therapy?

Fecal incontinence

Which drug does the nurse expect to be prescribed to the patient for a pulsating headache on one side for more than 8 hours who also has nausea and vomiting?

Frovatriptan

Which patient condition is a contraindication for administration of anorexiants?

Glucoma

Which assessment finding would the nurse expect after administering phentermine?

Increased blood pressure

Which side effect would the nurse monitor for in a patient taking analeptics?

Insomnia

Which intervention will the nurse encourage to reduce the gastrointestinal side effects of orlistat?

Limit dietary intake of fat to less than 30% of total calories.

Which class of drugs is prescribed to promote weight reduction for a patient who is obese?

Lipase inhibitors

Which drug should be used with caution with the herbal drug ginseng to prevent possible drug interactions?

Metformin

Which drug is indicated for the improvement of wakefulness in patients who have excessive daytime sleepiness?

Modafinil

Which combination of drugs will the nurse expect the provider to order for daytime sleepiness and frequent severe migraines?

Modafinil and sumatriptan

Which condition has the symptom of dysfunctional rapid eye movement (REM)?

Narcolepsy

Which drug did the nurse find in the patient's prescription that would cause the recommendation of consuming carrots regularly?

Orlistat

Which medication inhibits the pancreatic enzyme lipase?

Orlistat

A nurse is assessing four patients who are taking central nervous system stimulants. Based on the table, which does the nurse infer from these findings?

Patient A is taking atomoxetine therapy.

Which drug is an obese patient taking who is instructed to take it in the morning and to avoid taking it before going to bed?

Phentermine

Which drug will the nurse expect to be prescribed for a patient with cholestasis, consuming a high-fat diet, and with a body mass index (BMI) of 34?

Phentermine

Which drug would the nurse expect to be prescribed for a patient who is obese, frequently hungry, and eats to satisfy hunger?

Phentermine

Which treatment strategy will the nurse expect from the health care provider for a child on methylphenidate for attention-deficit/hyperactivity disorder (ADHD), who now reports they have had an improvement in school but cannot sleep at night?

Prescribe atomoxetine to the patient.

Which symptom does the nurse expect to find in a patient with narcolepsy?

Skeletal muscle weakness

Which is an important adverse effect to monitor in a child that has prescribed atomoxetine for attention-deficit/hyperactivity disorder (ADHD)?

Suicidal tendencies

Which does the nurse suggest to the parents who express concern about the addictive quality of stimulants their child was prescribed to treat attention-deficit/hyperactivity disorder (ADHD)?

Talk to the health care provider about instituting "drug holidays."

A patient with migraine headaches has been prescribed a combination of acetaminophen, barbiturate, and caffeine. The patient tells the nurse, "I don't think this drug is effective anymore, as I am not having as much pain relief as I had earlier." Which information may the nurse infer from this?

The patient has been taking this medication for a long time

Which reason would the health care provider discontinue phentermine for 2 weeks after reviewing a patient's medical history?

The patient is taking monoamine oxidase inhibitors (MAOIs).

Which characteristic of amphetamines is the most likely reason that these drugs are abused?

They induce euphoria.

Which information explains why the nurse would suggest taking amphetamine aspartate for attention-deficit/hyperactivity disorder (ADHD) 5 to 6 hours before bed?

To prevent insomnia

Which strategy would be used to complete an assessment of a patient with a health history of narcolepsy?

Use short, focused interview sessions with active participation by the patient.