Quiz 4

29. The nurse has completed education to the parents of a child newly diagnosed with tonic-clonic seizures. Which comments made by the parents would the nurse evaluate as indicating need for further education? Select all that apply. a. "I know he will outgrow these seizures with time." b. "He just needs to focus more to prevent these attacks." c. "I hope we can help our son identify his seizure aura." d. "Some of the times when I thought he was ignoring me may have actually been seizure activity." e. "We will watch for the development of status epilepticus."

a. "I know he will outgrow these seizures with time." b. "He just needs to focus more to prevent these attacks."

10. A client is receiving phenytoin (Dilantin) to control seizures. What statement by the client to the nurse indicates an understanding regarding administration of this medication? a. "I will probably need to take this medication all my life" b. "I will be able to stop this medication in about a year" c. "I need to take more of my Dilantin when I am having a stressful day" d. "I will never have another seizure if I take this medication"

a. "I will probably need to take this medication all my life"

4. The client tells the nurse that she has been taking phenytoin (Dilantin) for 2 years and is still having too many side effects. She wants to stop taking it. What is the best response by the nurse? a. "Please do not stop the medication abruptly, as you will have withdrawal seizures." b. "You have probably been on the medication long enough; I'll let your doctor know you are stopping it." c. "This is the best medication for you; we can add another medication to decrease the side effects associated with phenytoin (Dilantin)." d. "Side effects are a problem, but they are not as bad as the seizures you were having."

a. "Please do not stop the medication abruptly, as you will have withdrawal seizures."

28. The nursing instructor teaches the student nurses about the nervous system. The instructor determines that learning has occurred when the students make which statement(s)? Select all that apply. a. "The central nervous system includes the brain and spinal cord." b. "The peripheral nervous system has mainly sensory functions." c. "The nervous system helps us react to environmental changes." d. "The somatic nervous system gives us voluntary control over moving." e. "The somatic nervous system gives us voluntary control over our gastrointestinal (GI) tract."

a. "The central nervous system includes the brain and spinal cord." c. "The nervous system helps us react to environmental changes." d. "The somatic nervous system gives us voluntary control over moving."

7. The patient is diagnosed with Parkinson's disease. The patient's wife asks the nurse how taking medicine will help her husband. What is the best response by the nurse? a. "The medications will help your husband to eat and walk." b. "The medications will boost your husband's appetite and energy." c. "The medications will help prevent muscle wasting in your husband." d. "The medications will balance serotonin and acetylcholine in your husband's brain."

a. "The medications will help your husband to eat and walk."

22. Prior to administrating benztropine (Cogentin) to a client, the nurse assesses of adverse effects of previous doses and decides to withhold the current dose. What did the nurse assess in the client? a. Absent bowel sounds b. A temperature of 100.2 degrees F c. A blood pressure reading of 88/60 mmHg d. A respiratory rate of 14

a. Absent bowel sounds

24. Which of the following would most likely be an initial treatment for a patient with Alzheimer's disease? a. Donepezil hydrochloride (Aricept) b. Benztropine mesylate (Cogentin) c. Haloperidol (Haldol) d. Levodopa (Larodopa)

a. Donepezil hydrochloride (Aricept)

21. Pharmacotherapy for Parkinson's disease is intended to have which of the following actions? a. Increase the amount of dopamine and reduce the amount of acetylcholine b. Reduce the amount of dopamine and acetylcholine c. Increase the amount of dopamine and acetylcholine d. Reduce the amount of dopamine and increase the amount of acetylcholine

a. Increase the amount of dopamine and reduce the amount of acetylcholine

25. When caring for the client who is receiving phenytoin (Dilantin), the nurse emphasizes meticulous oral hygiene to the client. This nursing intervention is based on the nurse's knowledge that phenytoin has what effect on oral tissue? a. It causes hyperplasia of the gums b. It erodes and destroys tooth enamel c. It promotes bacterial growth at the gum lines d. It increases alkalinity of the oral secretions

a. It causes hyperplasia of the gums

18. Which of the following seizure drugs is most likely to be administered IV and result in soft tissue damage following extravasation? a. Phenytoin (Dilantin) b. Ethosuximide (Zarontin) c. Phenobarbital (Luminal) d. Clonazepam (Klonopin)

a. Phenytoin (Dilantin)

3. The nurse is preparing to administer medications to a group of patients. One of the medications is benztropine (Cogentin), an anticholinergic drug. This drug is contraindicated in which patient? a. The patient with tachycardia b. The patient with diarrhea c. The patient with a fractured femur d. The patient with an irritable colon

a. The patient with tachycardia

27. Carbidopa is added to Levodopa to: a. To boost the effectiveness of levodopa b. Increase the transmission of carbodopa into the CNS fluid c. To increase the GI absorption of levodopa d. To control the side effects of levodopa

a. To boost the effectiveness of levodopa

12. The nurse is assessing a client with Parkinson's disease to determine effectiveness of medication therapy. The nurse would determine that the medication is not working optimally if the client is demonstrating which characteristic? a. Toni-Clonic Seizures b. A flattened facial affect and monotone voice c. Decreased intelligence d. Changes in pain tolerance

b. A flattened facial affect and monotone voice

20. Which of the following adverse effects would most likely be associated with the use of phenytoin (Dilantin)? a. Vitamin B deficiency b. Hypoglycemia c. Bleeding d. Leg edema

b. Hypoglycemia

15. The nurse plans care for a patient with Parkinson's disease. What will the best plan by the nurse include? a. Monitor the patient for psychotic symptoms b. Monitor the patient for the ability to chew and swallow c. Check peripheral circulation for thrombophlebitis d. Limit exercise to decrease the possibility of fractures

b. Monitor the patient for the ability to chew and swallow

1. Muscle stiffness, pill-rolling activity, and bradykinesia are symptoms most likely associated with which disorder? a. Alzheimer's disease b. Parkinson's disease c. Multiple sclerosis d. Amyotrophic lateral sclerosis

b. Parkinson's disease

30. A medication regiment has controlled the seizures for an adult client for several days and includes the medication phenytoin (Dilantin). Prior to discharge, the nurse should place the highest priority on including which information in the teaching plan? Select all that apply. a. The client cannot drive a vehicle permanently b. Side effects may include confusion and headache c. Many seizure disorders will eventually stop on their own d. Lab work for drug levels will need to be done immediately e. Adherence to medication therapy is essential to avoid recurrence of seizures

b. Side effects may include confusion and headache d. Lab work for drug levels will need to be done immediately e. Adherence to medication therapy is essential to avoid recurrence of seizures

11. A client with Parkinson's disease asks the nurse why dopamine is not given as a neurotransmitter replacement. How should the nurse respond? a. "The risk for hypertension is too high with dopamine; therefore, more frequent cardiac monitoring would be required." b. "Exogenous dopamine must be administered via intravenous infusion, which usually requires a central line and continuous cardiac monitoring." c. "Exogenous dopamine cannot cross the blood-brain barrier and would be of little use." d. "In older clients, the effects of dopamine on urinary function can pose an unacceptable risk for renal failure."

c. "Exogenous dopamine cannot cross the blood-brain barrier and would be of little use."

8. A client with Parkinson's disease is prescribed a medication that affects a particular central nervous neurotransmitter. The nurse relates that this transmitter is which of the following? a. Gamma aminobutyric acid (GABA) b. An endorphin c. Acetylcholine d. Norepinephrine

c. Acetylcholine

6. When teaching a community course on health problems that the older adult might encounter, the nurse describes a disorder that is characterized by confusion, progressive memory loss, and the inability to think clearly. The nurse is describing symptoms consistent with which of the following? a. Schizophrenia b. Parkinson's disease c. Alzheimer's disease d. Huntington's chorea

c. Alzheimer's disease

16. The provider prescribes phenytoin (Dilantin) for a client to control tonic-Clonic seizures. The nurse explains in simple terms to the client which expected effect may occur with the use of the drug? a. Prevents depression of the central nervous system b. Produces an antispasmodic action on the muscles c. Delays the influx of sodium ions in neurons d. Alters the permeability of the cell membrane to potassium

c. Delays the influx of sodium ions in neurons

23. The patient receives levodopa and carbidopa (Sinemet). What will the best teaching by the nurse include as relates to this medication? a. Avoid drinking caffeinated beverages b. Take the medication with meals c. Take the medication on an empty stomach d. Take the medication with a protein food

c. Take the medication on an empty stomach

5. Which statement is the most accurate regarding acetylcholinesterase inhibitor when used for Alzheimer's disease? a. They intensify the effect of acetylcholine at the receptor b. They reverse the structural damage within the brain c. They increase synthesis of acetylcholine d. They increase enzymatic breakdown, leading to increased neuronal production

c. They increase synthesis of acetylcholine

14. An older client is receiving levodopa/carbidopa (Sinemet). Which side effect of the medication would cause the nurse the most concern? a. Dark urine b. Hypertension c. Urinary retention d. Diarrhea

c. Urinary retention

17. The patient receives levodopa/carbidopa (Sinemet). The nurse has compeleted medication education and determines that learning has occurred when the patient makes which statement? a. "I must avoid yellow vegetables in my diet" b. "I need to increase my daily intake of protein" c. "I need to check my pulse before taking the medication." d. "I should avoid ham, beef and egg yolks."

d. "I should avoid ham, beef and egg yolks."

9. The client is receiving carbamazepine (Tegretol) for control of seizures. The client tells the nurse she plans to become pregnant. What is the best response of the nurse? a. Your medication dose will need to be increased during your pregnancy." b. Your medication dose will need to be decreased during your pregnancy. c. "Please talk to your doctor; you will need a safer drug like valproic acid (Depakene)." d. "Please talk to your doctor; this drug is contraindicated in the pregnancy."

d. "Please talk to your doctor; this drug is contraindicated in the pregnancy."

2. The patient has been diagnosed with Alzheimer's disease. What is the best medication education the nurse gives to the patient's husband? a. "The medication has serious side effects if used for a long time." b. "Her symptoms should begin improving in a few days." c. "Her symptoms will improve as long as she takes the medication." d. "The medication may help her symptoms for a little while."

d. "The medication may help her symptoms for a little while."

13. A client is brought to the emergency department in the midst of a persistent tonic-Clonic seizure. Diazepam (valium) is administered intravenously. The nurse anticipates that in addition to decreasing the central neural activity, what other effect of diazepam will be occurring? a. Promoting amnesia of the seizure episode b. Dilation of tracheobronchial structures c. Slowing of cardiac contractions d. Relaxation of peripheral muscles

d. Relaxation of peripheral muscles

19. A client calls a clinic 1 week after beginning to use oral carbidopa-levodopa (Parocpa) stating that the medication has been ineffective in controlling the symptoms of Parkinson's disease. What nursing action is most appropriate? a. Contact the provider to change the dose of the medication b. Review the correct procedure for taking the medication c. Ensure that the client is eating a diet high in protein d. Remind the client that it may take 2 months to note any effects of the medications

d. Remind the client that it may take 2 months to note any effects of the medications

26. Because phenytoin (Dilantin) was ordered stat for a client who was just admitted to the nursing unit from the emergency department, which assessments are of highest priority of the nurse to perform? a. Electrolytes, serum osmolality, and leg edema b. BUN, creatinine and urine output c. Hydration status and emotional response to the seizure d. Seizure activity, mental status, and respiratory status

d. Seizure activity, mental status, and respiratory status