Chap 32 PrepU, Pharm201 CH33, PrepU ch 31, Prep-U: Chapter 30, PrepU Chapter 29, Pharm Chapter 28

A nurse is caring for a client who has been diagnosed with Parkinson's disease. The client does not understand how the medication, carbidopa-levodopa, is going to help the condition. What is the correct response by the nurse?

"Carbidopa-levodopa increases the activity of dopamine in your body, which will decrease your symptoms."

A nurse is caring for a patient who has just been diagnosed with Parkinson's disease. The patient does not understand how the medication ordered, carbidopa-levodopa, is going to help the condition. What is the correct response by the nurse?

"Carbidopa-levodopa increases the activity of dopamine in your body, which will decrease your symptoms."

A client reports having difficulty finding the over-the-counter (OTC) decongestant that the client used in the past. What assessment question should the nurse ask to help address the client's concern?

"Did the medication contain pseudoephedrine?" The use of OTC products containing pseudoephedrine to manufacture methamphetamine has increased at an alarming rate. Most states have passed laws placing these products behind pharmacy counters to restrict sales.

A 25-year-old female client presents at the clinic with bronchitis. The health care provider orders guaifenesin. Which instruction should the clinic nurse offer when teaching the client about the medication?

"Drink at least two liters of fluids each day."

A nurse has been invited to speak to a support group for Parkinson's disease clients and families. Which statement addresses the chronic nature of the disease and the relevant drug therapies?

"Drugs do not cure these disorders; they instead enhance quality of life."

A patient with Parkinson's disease has been prescribed entacapone (Comtan). The patient asks how this medication works. Which response is most appropriate?

"Entacapone inhibits COMT to metabolize dopamine in the brain."

A client is prescribed ethacrynic acid to treat edema secondary to heart failure. After teaching the client about this drug, the nurse determines that additional teaching is needed when the client states which of the following?

"I need to avoid eating foods that contain potassium."

After teaching a patient about the action of spironolactone, the nurse determines that the teaching was successful when the patient states:

"I need to make sure I don't eat too many high potassium foods."

You have just finished teaching your 15-year-old patient how to use his inhaler to treat his asthma. What statement, made by your patient, suggests that he understands what you've taught him?

"I need to shake the inhaler well before taking the medication."

You have just finished teaching your 15-year-old patient how to use his inhaler to treat his asthma. What statement, made by your patient, suggests that he understands what you've taught him?

"I need to shake the inhaler well before taking the medication."

Which statement by a client who is prescribed triamcinolone indicates the need for additional teaching?

"I should see some results in about 3 to 4 days."

The nurse provides client teaching about use of levodopa for treatment of Parkinson's disease. What statement by the client would indicate a good understanding of levodopa?

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

The patient has just gone through patient teaching with the nurse regarding their Parkinson's disease. What statement by the patient would indicate to the nurse that the patient has a good understanding of levodopa as a drug therapy?

"I should take this drug with meals to avoid gastrointestinal upset."

A client needs further teaching about medication prescribed for muscle spasms and cramping when making which statements?

"I take my medicine with three to four beers each evening."

A 11-year-old male client has been diagnosed with epilepsy. He is to be sent home on phenytoin 100 mg bid PO. What statement by the client's mother leads the nurse to believe that she has understood the teaching?

"I will make sure he has routine visits to the dentist."

A 15-year-old male client receiving phenytoin for treatment of epilepsy is being discharged from the hospital. What statement by Richard's mother leads you to believe she has understood your teaching related to his care and drug administration?

"I will make sure he has routine visits to the dentist."

The nurse is teaching a 62-year-old client about hydrochlorothiazide, which the health care provider has prescribed for treatment of hypertension. What statement, made by the client, suggests that the client understands the teaching?

"I will need to stand slowly."

After teaching a patient about an upcoming procedure that will use a nondepolarizing neuromuscular junction (NMJ) blocking agent, the nurse would recognize a need for further instruction if the patient said:

"I will not be awake during the procedure."

A male client has been ordered spironolactone (Aldactone) for hypertension. Which statement by the client indicates a need for further education?

"I will take the medication when my blood pressure is elevated."

Which statement by the client leads the nurse to believe that the client needs additional instruction regarding the nasal decongestant? "I will blow my nose before instilling the nasal spray." "I will report any dizziness, drowsiness, or rapid pulse." "I will drink 2,000 to 3,000 mL of fluid daily." "I will use it only when I have nasal discharge."

"I will use it only when I have nasal discharge."

Which statement by the client leads the nurse to believe that the client needs additional instruction regarding the nasal decongestant?

"I will use it only when I have nasal discharge." Decongestants decrease the overproduction of secretions by causing local vasoconstriction to the upper respiratory tract. This vasoconstriction leads to a shrinking of swollen mucus membranes and tends to open clogged nasal passages, providing relief from the discomfort of a blocked nose and promoting drainage of secretions and improved air flow.

The nurse is teaching a client newly diagnosed with asthma about triggers. Which statement by the client indicates the teaching plan has been effective?

"I will use my air conditioner." It is important that the client use the air conditioner if triggers are allergens, because of molds and pollens.

The client has been prescribed cromolyn (Intal) for the treatment of asthma, and the nurse is evaluating the client's understanding of the medication. Which of the following statements by the client indicate the need for further education?

"I will use this medication when I am having an asthma attack."

Which statement by a 62-year-old patient indicates that the patient understands the nurse's teaching about diuretics?

"I will weigh myself daily and report significant changes."

The nurse has taught a client to self-administer a topical decongestant. What statement made by the client should the nurse follow up with further education?

"I'll squeeze the bottle to get the medication up into my sinuses."

The nurse is caring for a client with cystic fibrosis who is receiving dornase alfa by nebulizer to help thin secretions. What statement by the client indicates a need for further instruction?

"I'm glad that this medication will address all of my symptoms." Cystic fibrosis clients who receive dornase alfa should be cautioned about the need to continue all therapies for their cystic fibrosis because dornase alfa is only a palliative therapy that improves respiratory symptoms, and other therapies, such as coughing, postural drainage and enzymes, are still needed. This medication will not relieve all of the client's symptoms.

A client has told the nurse that she has been invited to a work colleague's house where she and some of her peers will be able to receive Botox injections. What is the nurse's best response?

"It's safest to have these injections performed under medical supervision."

A 56-year-old woman with a diagnosis of multiple sclerosis has begun taking dantrolene. What client teaching should the nurse provide?

"Make sure to see your health care provider promptly if you develop yellowish skin or eyes."

A patient with myoclonic seizures has been prescribed clonazepam as an adjunctive treatment by the neurologist. What teaching point should the nurse prioritize when explaining this new drug regimen to the patient?

"Make sure you don't stop taking this abruptly because that might bring on a seizure."

After teaching a group of students about NMJ blockers, the instructor determines that the students have understood the teaching when they state:

"Most of the drugs do not alter pain perception and consciousness."

When describing Parkinson's disease to a client with a new diagnosis, what statement made by the nurse would be accurate?

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

A client has been prescribed baclofen and will be taking the drug on an outpatient basis. The client asks the nurse if it is still okay to drink wine with meals or end the day with a "nightcap." What is the nurse's best response?

"The combination of baclofen and alcohol could depress your nervous system to a dangerous level."

A patient recovering from a procedure that involved succinylcholine (Anectine) reports muscle soreness and asks the nurse for an explanation. What will the nurse tell the patient?

"The drug triggers receptors to cause prolonged muscle contraction."

A client with Parkinson's disease has been prescribed apomorphine (Apokyn) to treat episodes of hypomobility. What should the nurse teach the client regarding administration of the drug?

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

The nurse is preparing to administer the client's first dosage of trihexyphenidyl. What should the nurse tell the client about the dosage?

"The initial dose is usually 1 to 2 mg and then dosage is gradually increased." Trihexyphenidyl is given 1 to 2 mg orally daily initially and then titrated up to 6 to 10 mg/d with a maximum of up to 15 mg/d to control symptoms. Trihexyphenidyl is an adjunctive therapy to levodopa in treatment of parkinsonism but it can be used alone for the control of drug-induced extrapyramidal disorders.

A female patient has expressed anxiety to the nurse surrounding the thought of being awake but unable to move or express pain during surgery. The patient states that she recently saw a movie that addressed this phenomenon and that she is consequently fearful about her impending surgery. How should the nurse reassure this patient?

"The whole surgical team will be monitoring you very closely throughout the procedure to make sure that things like this don't happen."

A client in the clinic complains of depression (secondary to chronic back pain) and of not being able to "get around as good as I used to." The client has just been prescribed a skeletal muscle relaxant. What is the nurse's most therapeutic response?

"Therapy may take weeks or longer before you feel optimal relief."

A patient who is receiving chlorzoxazone reports that his urine is somewhat orange in color. Which response by the nurse would be most appropriate?

"This discoloration sometimes occurs with this drug."

During an in-service, the charge nurse explains to the licensed vocational nurse (LVN) that there are six categories of anticonvulsants with different mechanisms of action. The LVN demonstrates understanding of the action of the miscellaneous drug, gabapentin, by stating which of the following?

"This drug is a gamma-aminobutyric acid (GABA) agonist."

What statement by a 61-year-old client who is to take an antitussive with codeine indicates that the teaching has been effective?

"This medication can cause drowsiness, so I will avoid driving while I use it."

A client who is experiencing lower back pain has been prescribed cyclobenzapine. The nurse should provide what health education in order to ensure safe and effective treatment?

"This will likely make you drowsy, so don't take it before doing anything that would require alertness."

What information should the nurse discuss with the client considering pregnancy regarding the use of a diuretic during pregnancy?

"Typically, women on diuretics prior to becoming pregnant can remain on the medication during their pregnancy."

When evaluating an asthmatic client's knowledge of self-care, the nurse recognizes that additional instructions are needed when the client makes which of the following statements?

"When I am short of breath, I will increase the use of my fluticasone."

A female patient has been prescribed ropinirole (Requip). She states, "I don't know why they are giving me this medicine. I don't have restless leg syndrome." What is the nurse's best response in teaching this patient with newly diagnosed Parkinson's disease about ropinirole (Requip)?

"You are right about ropinirole, but it is also used in early Parkinson's disease."

A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium). In light of this new addition to her drug regimen, what teaching point should the woman's nurse provide?

"You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity."

A male college student has presented to the campus medical clinic reporting cold symptoms that he has been experiencing for the past 2 weeks. He tells the nurse that he has been taking OTC decongestants twice daily since the onset of the cold. What teaching point should the nurse provide to this student?

"You might find yourself more congested than ever as your body compensates for your use of these drugs."

What would be the nurse's best response if a client calls the clinic and reports a persistent cough for 2 weeks and then asks the nurse for a recommendation for a cough medicine?

"You should come to the clinic to be evaluated. A cough that lasts that long might be an indication of an underlying medical problem."

A client asks, "Why is my prescription is being switched from furosemide to spironolactone?" What is the nurse's best response?

"You will lose less potassium with spironolactone than with furosemide."

A patient is switched from furosemide (Lasix) to spironolactone (Aldactone). The patient asks the nurse why she has been switched to a new medicine. What is the best answer that will provide patient education regarding the change?

"You will lose less potassium with spironolactone than with furosemide."

A patient is receiving aminophylline orally. The nurse would expect this drug to begin acting within which time frame?

1 to 6 hours

A pediatric client with a complex health history has developed early signs of drug-induced parkinsonism. The client's provider has prescribed diphenhydramine 25 mg PO tid. The medication is available as an oral solution with a concentration of 12.5 mg/ 5mL. How many mL should the nurse administer for each dose?

10

A client is receiving baclofen at 8 AM. The nurse would monitor the client for evidence of maximum effect at which time?

10 AM

The nursing student is learning about therapeutic serum levels. The nurse is aware that the therapeutic serum level range for phenytoin (Dilantin) is between:

10 and 20 mcg/mL.

One of the factors that influence the drug prescribed to treat seizures is the therapeutic serum level. What is the therapeutic serum level for phenytoin?

10-20 mcg/mL

A client is receiving ipratropium as maintenance therapy for chronic obstructive pulmonary disease. The nurse would caution the client that up to how many inhalations may be used in 24 hours if needed?

12 With ipratropium, the usual dosage is 2 inhalations four times/day for a total of 8 inhalations. However, the client can use up to 12 inhalations if needed in 1 day.

A patient receives pancuronium. The nurse would expect the patient to feel the effects of the drug for which duration?

120 to 180 minutes

The nurse assesses the serum theophylline of a patient. Which finding would the nurse identify as being therapeutic?

15 mcg/mL Therapeutic theophylline levels range from 10 to 20 mcg/mL. A value of 15 mcg/mL would be considered therapeutic.

A client is using an inhaled bronchodilator as treatment for exercise-induced asthma. The nurse would instruct the client to use the inhaler at which time?

15 minutes before engaging in exercise

The nurse instructs a patient who is using albuterol for exercise induced bronchospasm to use the inhaler at which time?

15 minutes prior to exercising Albuterol for exercise induced bronchospasm should be administered 15 minutes prior to exercising.

A patient is receiving acetazolamide in a sustained release form. The nurse would anticipate the onset of drug action in approximately which time frame?

2 hours

The perioperative nurse is caring for a client who requires an umbilical hernia repair but who has a known family history of malignant hyperthermia. The client has been prescribed dantrolene 2.5 mg/kg IV one hour before surgery. The client weighs 121 lbs. The nurse reconstitutes a single-use vial as per the manufacture's instructions, yielding a solution with a concentration of 50 mg/mL. How many mL of the reconstituted dantrolene solution should the nurse add to the client's bag of intravenous fluid?

2.75 mL

A client who is experiencing anaphylaxis with severe wheezing receives a dose of epinephrine intravenously. The nurse would expect the drug to exert it full effects within which time frame?

20 minutes

A 10-year-old child has edema caused by a heart defect. The patient is taking furosemide (Lasix). The dosage is 6 mg/kg per day. The child weighs 76 pounds. How many mg does the child receive in each dose?

210 mg

When reviewing the results of a patient's serum phenytoin level, which level would indicate toxicity?

22 mcg/mL

A client is receiving theophylline intravenously. The nurse reviews the results of his serum drug levels and notifies the physician for which result?

25 mcg/mL

A patient is receiving digoxin (Lanoxin) and a potassium supplement. When monitoring daily laboratory values, what should the potassium level be for this patient?

3.5-5.0 mEq/L

A patient has been prescribed 200 mg of Lamictal orally twice a day in divided doses. On hand, availability of the drug is 25 mg tablets. How many tablets should the nurse administer the patient each time?

4 tablets

A nurse understands that succinylcholine lasts for approximately how long once it is administered?

4 to 6 minutes

A client with a traumatic head injury has developed increased intracranial pressure and prescribed an initial dose of mannitol 1.5 g/kg IV. The client weighs 130 pounds. The medication is available in pre-mixed 500 mL bags of 20 g/100 mL. How many mL of solution should the nurse administer? Provide your answer to the nearest mL.

443

A patient has been prescribed 3 mg of benztropine mesylate every day. The available drug is in the form of a 0.5 mg tablet. How many tablets should the nurse administer to the patient?

6 tablets

The nurse is caring for a group of clients who each received a nonpolarizing neuromuscular block agent and understands that which client is most at risk for recurarization?

79-year old male

A patient has been prescribed a daily dosage of 20 mg of torsemide for the treatment of acute pulmonary edema. The drug is available in the form of 10 mg tablets. How many tablets should the nurse get for the course of 4 days?

8

A patient who is prescribed ipratropium administers the drug at 9:15 AM. The patient should begin to notice the drug beginning to act at which time?

9:30 AM

A patient has been admitted to a healthcare facility with asthma. The nurse is advised to administer theophylline to the patient. To which of the following patients can the nurse safely administer theophylline?

A 65-year-old male patient with asthma

Which patient is at the greatest risk for developing skin breakdown following a procedure that uses a neuromuscular junction (NMJ) blocking agent?

A 73-year-old man with a history of hypertension

A 13-year-old patient is scheduled to receive pancuronium (Pavulon). Which healthcare provider should administer the medication?

A CRNA trained to use NMJ blockers

A registered nurse who oversees the care in a large long-term care facility cares for several clients with Parkinson's disease. When reviewing the assessment findings from the practical nurses at the facility, what finding should the RN prioritize for follow-up?

A client who began taking a dopaminergic three days ago and who is uncharacteristically disoriented.

The perioperative nurse provides care to a diverse group of clients. Which client is most likely to benefit from the administration of a neuromuscular junction (NMJ) blocker in order to prevent musculoskeletal injury?

A client with major depression who has been scheduled for electroconvulsive therapy (ECT)

What type of medication is given in conjunction with levodopa/carbidopa to lower the dosage of levodopa and provide more effective relief of symptoms?

A dopamine agonist Explanation: A dopamine agonist is usually given with levodopa/carbidopa. The combination provides more effective relief of symptoms and allows lower dosage of levodopa. Although available dopamine agonists are similarly effective, pramipexole, ropinirole, and rotigotine-transdermal cause less severe adverse effects than do ergots such as bromocriptine.

A client with a long-standing diagnosis of heart failure has been taking hydrochlorothiazide (HCTZ) for several weeks. The client reports experiencing moderate diuresis, but the care provider and the client agree that increased diuresis would be of benefit. However, the care provider has explained that the client is likely near the ceiling threshold of this drug. What is the main implication when a client prescribed hydrochlorothiazide (HCTZ) is told they are, "nearing the drug's ceiling threshold"?

A higher dose of HCTZ will not result in increased diuresis.

A male client presents to the emergency department in bronchospasm. He has a history of smoking two packs per day for 20 years and is prescribed phenytoin to control a seizure disorder that developed after a head injury 3 years ago. Based on the client's history, what would the nurse expect the physician to order?

A modified dose of aminophylline

Which patient is at greatest risk for toxicity if given a neuromuscular junction (NMJ) blocking agent?

A patient with chronic azotemia

A client has edema of the lower extremities and abdomen. What is the reason to administer a stronger diuretic than a thiazide diuretic to this client?

A thiazide diuretic will be ineffective when immediate diuresis is needed.

A client is taking tolcapone for Parkinson's disease. What blood test will the nurse perform often on this client?

ALT

A patient with acute respiratory symptoms is receiving a loading dose of theophylline. Which of the following signs of toxicity should alert the nurse to notify the primary health care provider immediately?

Abdominal cramps

In a person taking medications for a diagnosed seizure disorder, the most common cause of status epilepticus is:

Abruptly stopping the antiseizure medications.

Which assessment finding indicates that a neuromuscular junction (NMJ) blocking agent is effective?

Absent reflexes

A nurse demonstrates understanding of diuretics when identifying which medication as exerting its effect by inhibiting the enzyme carbonic anhydrase?

Acetazolamide

A patient with glaucoma has been prescribed a diuretic as treatment of her disease process. What drug does the nurse suspect that the patient will be prescribed?

Acetazolamide (Diamox)

After reviewing the events associated with the sliding filament theory of muscle contraction, a group of students demonstrate a need for additional study when they state:

Acetylcholine interacts with muscarinic receptors.

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?

Adding carbidopa to the client's medication regimen Explanation: When levodopa is used with carbidopa, the enzyme dopa decarboxylase is inhibited in the periphery, diminishing the metabolism of levodopa in the gastrointestinal (GI) tract and in peripheral tissues, thereby leading to higher levels crossing the blood-brain barrier. This can enhance the therapeutic effect. Sinemet is only available orally and vitamin B6 would exacerbate, not reduce, the client's symptoms. Substituting diphenhydramine would not be effective since it is an adjunct, not a mainstay of treatment.

What home remedies are effective for mouth dryness and cough? (Select all that apply.)

Adequate fluid intake Humidification of the environment Sucking on hard candy or throat lozenges

Kate is experiencing status epilepticus. The physician orders IV diazepam. What special precautions need to be taken by a nurse to administer IV diazepam?

Administer the drug very slowly, no faster than 5 mg/min.

A client has been diagnosed with Parkinson's disease and the primary health care provider has prescribed levodopa(100 mg)-carbidopa(10 mg) PO q8h. What is the nurse's best action?

Administer the medication as prescribed and monitor for therapeutic and adverse effects

A patient in status epilepticus has been brought to the emergency department by emergency medical services. The nurse in the emergency department should anticipate which of the following treatment measures?

Administration of intravenous lorazepam

A female client is prescribed systemic corticosteroids for her asthma. The nurse knows that the client is at risk for what problem?

Adrenal insufficiency Adrenal insufficiency is most likely to occur with systemic or high doses of inhaled corticosteroids.

When developing the teaching plan for a patient receiving an antihistamine, which would the nurse include? (Select all that apply.) Advising the patient to avoid alcohol consumption Using sugarless candies or lozenges to combat dry mouth Stopping the drug after 3 days if no relief is obtained Encouraging the patient to engage in usual activities such as driving

Advising the patient to avoid alcohol consumption Using sugarless candies or lozenges to combat dry mouth

A male client presents with symptoms of bronchospasm that occurred during a birthday party for his grandson. What medication would the nurse expect the physician to give him?

Albuterol

A male client presents with symptoms of bronchospasm that occurred during a birthday party for his grandson. What medication would the nurse expect the physician to give him?

Albuterol

The parents of a 7-year-old boy who has just been diagnosed with allergic asthma are being taught about their son's medication regimen by the nurse. The nurse is currently teaching the parent's about the appropriate use of a "rescue drug" for acute exacerbations of their son's asthma. What drug should the nurse suggests the parents to use in these situations?

Albuterol Albuterol is a rescue drug that should be used first for all acute symptoms of shortness of breath or wheezing.

The parents of a 7-year-old boy who has just been diagnosed with allergic asthma are being taught about their son's medication regimen by the nurse. The nurse is currently teaching the parent's about the appropriate use of a "rescue drug" for acute exacerbations of their son's asthma. What drug should the nurse suggests the parents to use in these situations?

Albuterol Albuterol is a rescue drug that should be used first for all acute symptoms of shortness of breath or wheezing.

Which of the following is an example of a short acting Beta 2 Agonist (SABA)? (Choose one)

Albuterol Albuterol is a SABA. Formoterol, Salmeterol, and Arformoterol are long acting Beta 2 Agonists (LABA)

During the summer, a female client experiences increased periods of acute symptoms of her asthma. The physician increases the dose frequency of which of her medications?

Albuterol Albuterol is the initial drug of choice for acute bronchospasm.

Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication?

Albuterol causes relaxation of the bronchial smooth muscles. The main result of albuterol binding to beta-2 receptors in the lungs is relaxation of bronchial smooth muscles.

The asthmatic client is being treated with two inhalers, albuterol and flunisolide. The nurse teaches the client that the two medications should be administered in what order?

Albuterol first, wait five minutes and then follow with flunisolide

The asthmatic client is being treated with two inhalers, albuterol and flunisolide. The nurse teaches the client that the two medications should be administered in what order?

Albuterol first, wait five minutes and then follow with flunisolide Albuterol is a bronchodilator and should be used first, given time to open the airways, and then the inhaled corticosteroid is administered.

You have been prescribed HydroDIURIL. What will the nurse tell you is considered a contraindication to the administration of hydrochlorothiazide (HydroDIURIL)?

Allergy to sulfa drugs

What would be a contraindication to the use of carbonic anhydrase inhibitors?

Allergy to sulfonamides

A client suffers from influenza A. Which medication will be prescribed to treat influenza A?

Amantadine (Symmetrel)

A patient suffers from influenza A. Which of the following medications will be prescribed to treat influenza A?

Amantadine (Symmetrel)

A patient has a left temporal brain tumor. He smells an odor of ammonia prior to experiencing rapid rhythmic jerking movements. What is the odor of ammonia?

An aura prior to the seizure activity

A patient has been diagnosed with parkinsonism related to the use of antipsychotic drugs. Which drug type can be used to treat parkinsonism in this patient?

Anticholinergic agents

The perioperative nurse is caring for a client who is undergoing abdominal surgery with the inclusion of succinylcholine in the client's anesthesia. The anesthesiologist tells the team that the client is exhibiting signs and symptoms suggestive of malignant hyperthermia. What is the nurse's best action?

Anticipate IV administration of dantrolene

Acetylcysteine may be used as a mucolytic agent. What is an additional indication for the drug?

Antidote for acetaminophen poisoning

A patient who has been taking valproic acid (sodium valproate) for a seizure disorder is asking the nurse about getting pregnant. Why is pregnancy discouraged in women who are being treated for seizure disorders?

Antiepilepsy drugs are teratogenic

A client reports a hacking cough. The client asks if taking an antihistamine would be helpful. The nurse's best response is: Antihistamines are not used for this issue. Antihistamines are recommended for extended use, as long as you monitor for adverse effects. Antihistamines are not recommended for this issue; only antibiotics are useful. Antihistamines are not recommended because they can dry lower respiratory secretions and worsen secretion retention and cough.

Antihistamines are not recommended because they can dry lower respiratory secretions and worsen secretion retention and cough

A student nurse is researching the charts of 25 patients with a diagnosis of chronic pharyngitis and what medication is most commonly prescribed. What type of medication would the nurse expect to find in the majority of the chart audits?

Antitussives

A client asks, "What is the difference between antitussive medications and expectorants?" What information should the nurse's response be based upon?

Antitussives suppress coughing while expectorants loosen bronchial secretions.

A client has presented to the day surgery unit and will be having a diagnostic procedure that will involve the use of a neuromuscular junction blocker. The client says to the nurse, "Let me get this straight: I won't be able to talk or move my muscles but I'll be awake?" The nurse's response should address the possibility of what nursing diagnosis?

Anxiety related to paralysis

The client who has Parkinson's disease is experiencing dysphagia. Which drug should the nurse have available for parenteral administration?

Apomorphine (Apokyn)

A patient who was recently prescribed spironolactone calls the clinic. The patient states that they aren't going to the bathroom any more than before they started talking the spironolactone. What would be an appropriate question to ask this patient?

Are you taking a salicylate?

A client experienced significant muscle pain after receiving an NMJ blocker for a procedure. Which would be most appropriate for the nurse to administer for pain relief?

Aspirin

A patient with a seizure disorder has had a recent change in medication ordered. In evaluating the new drug's control of the seizure disorder, what would the nurse do?

Assess for adverse effects

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?

Assessment of the client's bowel pattern

A nurse is providing patient teaching for a 62-year-old woman who is taking triamterene. The nurse will teach the patient to avoid what in her diet?

Avocados

Which instruction should the nurse specifically stress when administering drugs used for muscle spasm and cramping?

Avoid alcohol or other CNS depressants

Which instruction should the nurse specifically stress when administering drugs used for muscle spasm and cramping?

Avoid alcohol or other CNS depressants.

A client has been prescribed an antihistamine for the treatment of seasonal allergies. What dietary guidelines should the nurse provide to the client? Eat several small meals instead of three larger meals in case of GI upset Avoid drinking alcohol while taking antihistamines Avoid grapefruit juice until at least 48 hours after treatment is complete Increase intake of foods that are high in vitamin C

Avoid drinking alcohol while taking antihistamines

A patient is newly diagnosed with Parkinson's disease, and levodopa (Dopar) has been prescribed. What patient teaching information should be considered a high priority for this patient?

Avoid vitamin B6 intake, since a combination with levodopa may lead to decreased efficacy.

A nurse is preparing a presentation for a local elementary school parent group about over-the-counter cold medications and their use in children. Which would be most appropriate to include? (Select all that apply.)

Avoidance of use in children under age 2 Importance of reading the label for ingredients and dosage Need to follow the directions for how often to give the drug

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?

Baclofen (Lioresal) Baclofen is used for treatment of muscle spasticity associated with neuromuscular diseases such as multiple sclerosis. Cyclobenzaprine, metaxalone, and orphenadrine are used for relief of discomfort associated with painful, acute musculoskeletal conditions.

In a patient who is to be given vecuronium (Norcuron), anesthesia is induced before neuromuscular blockade is started. What is the reason for this?

Because it helps prevent the patient from undergoing the frightening experience of paralysis and the inability to breathe

Your client has a history of post-transfusion reactions. Her medical provider has ordered medication to prevent this. Which of the following medications would you anticipate being ordered for this client? Epinephrine Lasix Benadryl Tylenol

Benadryl

A client is newly diagnosed with Parkinson's disease. What condition in the client's health history rules out the safe and effective us of an anticholinergic drug? Select all that apply.

Benign prostatic hypertrophy Chronic bowel obstructions

Which agent would the nurse identify as providing local anesthesia to the respiratory passages? Benzonatate Ephedrine Hydrocodone Dextromethorphan

Benzonatate

A nurse caring for a client in the hospital is being discharged today with a prescription for benzonatate (Tessalon Perles) 200 mg one capsule 3 times daily. What would the nurse tell the client about this prescription during discharge counseling? (Select all that apply.) The client should drink plenty fluids. Consumption of alcohol is okay while taking benzonatate. Benzonatate capsules should be sucked on like a lozenge. Benzonatate can be taken more frequently than prescribed if needed. Benzonatate can cause GI upset and sedation.

Benzonatate can cause GI upset and sedation. The client should drink plenty fluids. Explanation: The adverse effects of benzonatate include sedation, headache, dizziness, constipation, nausea, GI upset, pruritus, and nasal congestion. It is recommended that patients with cough drink plenty of fluids (1500 to 2000 mL daily) unless fluids are contraindicate due to another disease state. Benzonatate should not be crushed or chewed due to a local anesthetic effect resulting in possible choking. Consumption of alcohol while taking benzonatate can increase CNS depression and increased sedation. The maximum daily dose of benzonatate is 600 mg daily.

Which of the following would a nurse identify as a surfactant?

Beractant

A patient is newly diagnosed with Parkinson's disease. The patient has been placed on an anticholinergic drug. Which symptom or symptoms would cause the greatest concern for the nurse?

Blurred vision

What sign is most indicative of dehydration in a patient taking diuretics?

Body weight

A client has a new order for carbamazepine (Tegretol). Which condition is a contraindication to administration of carbamazine?

Bone marrow depression

The nurse is documenting the history of a patient who is to be initiated in carbamazepine therapy. In which condition is carbamazepine contraindicated?

Bone marrow depression

A patient has been diagnosed with cervical dystonia. The nurse would expect which medication to be ordered for this patient?

Botulinum toxin type B

A client is prescribed oxymetazoline. Which assessment data would indicate that the drug is effective?

Breathing pattern is regular and without difficulty.

The nurse is caring for a client who has been prescribed hydrochlorothiazide for the management of hypertension. The medical history of the client states that the client is sensitive to tartrazine. The nurse would assess the client for which finding as a possible adverse reaction?

Bronchial asthma

Your patient, an elderly woman, insists her asthma is exacerbated by her least favorite television show. While explaining that her dislike for the show's host may be a contributing factor, you explain that an asthma attack is caused by substances released from mast cells, which cause:

Bronchoconstriction and inflammation. When lung tissues are exposed to causative stimuli, mast cells release substances that cause bronchoconstriction and inflammation.

Your patient, an elderly woman, insists her asthma is exacerbated by her least favorite television show. While explaining that her dislike for the show's host may be a contributing factor, you explain that an asthma attack is caused by substances released from mast cells, which cause:

Bronchoconstriction and inflammation. When lung tissues are exposed to causative stimuli, mast cells release substances that cause bronchoconstriction and inflammation.

A client asks the nurse how his COMT inhibitor medication works to treat his Parkinson's disease. Which of the following statements explains how COMT inhibitor medications work?

COMT inhibitor medications prolong the effect of levodopa by blocking the enzyme that eliminates dopamine.

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?

Calcium

A patient suffers from trigeminal neuralgia. What antiepileptic agent is used to treat trigeminal neuralgia?

Carbamazepine (Tegretol)

A patient taking which of the following anticonvulsant medications will need to be observed closely for toxicity due to increased serum concentrations after the initiation of a protease inhibitor such as lopinavir/ritonavir (Kaletra) for the treatment of HIV? (Choose one)

Carbamazepine (Tegretol)

A group of nursing students are preparing for a class presentation to discuss drugs used to treat Parkinson disease. Which drug would the group include when discussing dopaminergic agents?

Carbidopa

Which drug is classified as a dopaminergic agent that treats Parkinsonism by supplementing the amount of dopamine in the brain?

Carbidopa (Lodosyn)

An older adult with a history of chronic obstructive pulmonary disease (COPD) is prescribed diazepam (Valium) for seizure control. The nurse should closely monitor for which age-related effect when administering this medication?

Cardiac arrest

A 71-year-old man with a history of heart disease and diabetes has had an antihistamine prescribed. The nurse is concerned with this prescription because of the risk for: Severe constipation Increased salivation and choking Insomnia Cardiac arrhythmias

Cardiac arrhythmias

When providing health education to an adult who is taking an over-the-counter (OTC) combination cold and cough remedy, the nurse should encourage the client to implement what intervention to best assure medication safety?

Carefully read the label and adhere to the guidelines for use.

Which is the enzyme responsible for the breakdown of dopamine and is used as a target in the therapy on parkinsonism?

Catechol-O-methyltransferase

A nursing instructor is describing Parkinsonism to a group of nursing students. When discussing the underlying cause of the symptoms, the instructor explains the depletion of dopamine in which of the following?

Central nervous system

A patient is prescribed a thiazide diuretic that is to be administered intravenously. Which agent would this most likely be?

Chlorothiazide

A patient is given theophylline to treat acute asthma symptoms. Which of the following foods should the patient avoid?

Chocolate Chocolate contains caffeine and is also a xanthine; thus chocolate should be avoided when the patient is taking theophylline.

A patient is experiencing toxicity and prolonged paralysis after using a nondepolarizing neuromuscular junction (NMJ) blocking agent. Which type of medication will be used to reverse this condition?

Cholinesterase inhibitor

A nurse would expect to increase the dosage of theophylline if the client has a current history of which of the following?

Cigarette smoking Nicotine increases the metabolism of xanthines; therefore, an increased dosage would be necessary.

After reviewing the various NMJ blockers, a group of students demonstrate understanding of the information when they identify which agent as having the longest duration?

Cisatracurium

When instructing a client in how to use a topical nasal spray, what would the nurse emphasize to do first?

Clear the nasal passages.

Which agent acts directly on the medullary cough center?

Codeine

A nurse is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The nurse will question the patient about her intake of which of the following?

Coffee

The nurse is caring for a client who is receiving IV theophylline for treatment of severe bronchospasm. The nurse will ensure that which item on the client's food tray will be held while the client is receiving theophylline?

Coffee

The nurse is caring for a client who is receiving IV theophylline for treatment of severe bronchospasm. The nurse will ensure that which item on the client's food tray will be held while the client is receiving theophylline?

Coffee

The client's theophylline levels are increased. The nurse questions the client about his intake of which of the following?

Coffee Xanthines are found in colas, coffee, chocolate, and charcoal prepared foods.

Which statement accurately describes the pharmacodynamics of nondepolarizing neuromuscular junction (NMJ) blocking agents?

Compete with acetylcholine for receptor sites

A client comes to the clinic for a follow-up visit. The client is prescribed lamotrigine for seizure control. The nurse suspects that the client may be experiencing Stevens-Johnson syndrome based on which of the following? Select all that apply.

Complaints of muscle pain Lesions on the mucous membranes Blisters on the face and neck

A client in the clinic with a history of epilepsy has just tested positive for pregnancy. What is the nurse's next action?

Consult with the primary health care provider.

A client is prescribed lamotrigine (Lamictal) for control of partial seizures. What is the most important medication teaching information the nurse should emphasize from the plan of care?

Contact the health care provider immediately if rash appears.

When a depolarizing NMJ agent is used, what occurs?

Continuous sustained muscle contraction

A patient is having an allergic reaction to mold. The patient describes chest tightness and difficulty breathing. Which of the following body effects are occurring? Contraction of smooth muscle in the bronchi Suppression of the vagus nerve endings producing tachycardia Decreased permeability of the veins and capillaries Decreased secretion of the mucous glands

Contraction of smooth muscle in the bronchi

The nurse has been educating the client on the self-administration of phenytoin. Which statement made by the client demonstrates an understanding of the medication? "I'll only take the drug when I feel an impending seizure." "I'll stop taking the drug if I don't have a seizure for 8 weeks." "I'll make sure to take the drug with food." "I'll reduce my dose if I remain seizure free."

Correct response: "I'll make sure to take the drug with food." Explanation: Phenytoin should be taken with food to reduce the chance of stomach upset. It should be taken on a regular basis and not only when a seizure occurs. The client should not arbitrarily reduce the dose of phenytoin. Abrupt cessation can cause seizures.

A 30-year-old female client is diagnosed with seizure disorder, and the provider is considering the use of carbamazepine. What assessment question best addresses the safety and effectiveness of the medication regimen? "Have you been vaccinated against hepatitis A or B recently?" "Is there any chance that you could be pregnant?" "Will paying for your medication present any challenges?" "When did you last have your eyesight assessed?"

Correct response: "Is there any chance that you could be pregnant?" Explanation: Carbamazepine is contraindicated during pregnancy. A female client of this age should be assessed for pregnancy prior to starting to take the drug. The client's history of hepatitis vaccinations does not have a major bearing on treatment. Visual changes are unlikely and there are not known optic conditions that contraindicate use. It is appropriate to assess the client's ability to pay but this does not directly relate to client safety.

A client has been diagnosed with partial seizures and has been prescribed carbamazepine. When providing health education about the safe and effective use of this medication, what should the nurse teach the client? "It's important to take a dose as soon as possible if you feel a seizure is coming." "I'll be showing you how to safely self-inject this drug." "I'll explain the foods that you should avoid while you're taking this drug." "It's safest if you avoid drinking alcohol while you're taking this drug."

Correct response: "It's safest if you avoid drinking alcohol while you're taking this drug." Explanation: Use of alcohol during treatment with carbamazepine is contraindicated due to the potential for CNS depression. Carbamazepine is taken on an ongoing basis to prevent partial seizures; it is not a treatment for impending seizure activity. It is administered orally, not by injection, and it does not necessitate significant dietary changes.

Question 13 of 20 A client diagnosed with Parkinson's disease asks if there are any holistic herbs or exercises that may help her balance. Which of the following would be the nurse's best response, based on previous clients' success using this approach? "Aerobic exercises will help keep your cardiovascular system healthy." "Frequent dancing to music with a quick rhythm has been shown to help improve balance in clients with Parkinson's disease." "There are many herbs that help Parkinson's disease." "Tai chi has been shown to help clients diagnosed with Parkinson's disease improve their balance."

Correct response: "Tai chi has been shown to help clients diagnosed with Parkinson's disease improve their balance." Explanation: Tai chi has been shown to improve balance in clients diagnosed with Parkinson's disease. No herbs are known to increase balance in clients with Parkinson's disease. Neither aerobic exercises nor dancing have been shown to improve balance in clients with Parkinson's disease.

Question 5 of 5 A client who is experiencing lower back pain has been prescribed cyclobenzapine. The nurse should provide what health education in order to ensure safe and effective treatment? "Make sure to avoid grapefruit juice and fresh grapefruit until treatment is complete." "If you experience sedation, seek care promptly since it could be a sign of a serious drug reaction." "Don't use this for more than five consecutive days to prevent damage to your liver." "This will likely make you drowsy, so don't take it before doing anything that would require alertness."

Correct response: "This will likely make you drowsy, so don't take it before doing anything that would require alertness." Explanation: Cyclobenzaprine causes drowsiness because of CNS depression. There is no absolute prohibition against using the drug for more than five days; it is metabolized in the liver but is not noted to be highly hepatotoxic. Sedation is an anticipated adverse effect, not a sign of a serious drug reaction.

Question 5 of 5 The neurological nurse cares for several clients who have seizure disorders. Which client should the nurse monitor most closely for indications of drug dependence? A client with a history of myoclonic seizures who takes valproic acid A client receiving IV phenytoin to prevent seizures post-neurosurgery A client with a history of tonic-clonic seizures who takes phenobarbital A client receiving ethosuximide for the prevention of absence seizures

Correct response: A client with a history of tonic-clonic seizures who takes phenobarbital Explanation: Barbiturates, such as phenobarbital, have an associated risk for dependence. This is not true of the other listed drugs.

The nurse is preparing to administer a scheduled dose of baclofen and notes that the client's most recent oral temperature was 100.9° (38.3°C). What is the nurse's best action? Perform a focused respiratory assessment Administer the medication as prescribed and monitor the client Hold the baclofen, administer antipyretics as prescribed and reassess the client in one hour Report this assessment finding promptly to the care provider

Correct response: Administer the medication as prescribed and monitor the client Explanation: A fever is not necessarily an indication that the client's baclofen should be held. Administering the drug as prescribed does not pose any clear safety risk in the presence of a fever. The nurse will need to follow up the client's fever, but there is no obvious need to report it.

A client has been admitted to the emergency department and is experiencing tonic-clonic seizures. What intervention should the nurse prioritize? Administration of phenytoin IV as prescribed Administration of gabapentin PO as prescribed Assessment of the client's renal and hepatic function Establishing a therapeutic relationship with the client

Correct response: Administration of phenytoin IV as prescribed Explanation: Active seizure activity is an emergency and the client's immediate physiological needs supersede the importance of therapeutic relationship. Phenytoin IV is among the most common treatments for tonic-clonic seizures; gabapentin PO is not typically used for this purpose, and PO administration of any type is unsafe due to the risk for aspiration. Treatment would not be withheld pending assessment of renal and hepatic function.

An 18-year-old client has been taking phenytoin for the past 6 months for epileptic seizures. The client's phenytoin levels routinely fall within the therapeutic range. The client contacts the health care provider reporting nausea, headache, and diarrhea. What would be the most appropriate intervention based on the assessment of the client's symptoms and laboratory results? Advise the client to double the dose for 24 hours because the client is experiencing the symptoms of drug withdrawal. Advise the client to have his blood redrawn today to ensure that it is not at a toxic level. Advise the client that these are normal reactions to the medication and he should continue the medication as ordered. Advise the client to decrease the dose because the client is getting too much of the medication.

Correct response: Advise the client to have his blood redrawn today to ensure that it is not at a toxic level. Explanation: Clients may demonstrate adverse effects even if the serum level of phenytoin is "normal"; it is important to adjust the dose to the clinical response of the client, not the serum level.

A nurse notes that a client who has been given several doses of an antiemetic is having extrapyramidal symptoms. The nurse knows that what class of drug would most likely be given to the client? COMT inhibitor Anticholinergic Antivirals Dopamine receptor agonists

Correct response: Anticholinergic Explanation: Anticholinergic medications are used to treat drug-induced extrapyramidal symptoms. COMT inhibitors are used in combination with levodopa for the treatment of Parkinson's disease. Dopamine receptor agonists are used to treat Parkinson's disease and restless leg syndrome. Antivirals treat viral infections, not Parkinson-like symptoms in a client taking an antiemetic.

The nurse is working in collaboration with a nurse anesthetist to assess a preoperative client. When addressing the client's risk for malignant hyperthermia as a result of neuromuscular junction blockers, what assessment should be prioritized? Assessing for a family history of malignant hyperthermia Assessing for a history of febrile seizures in childhood Assessing the client's allergy status Assessing for any history of cytochrome P450 dysfunction

Correct response: Assessing for a family history of malignant hyperthermia Explanation: Family history is the most salient risk factor for malignant hyperthermia. This adverse effect is physiologically unrelated to childhood febrile seizures and does not result from cytochrome P450 dysfunction. Malignant hyperthermia is not a hypersensitivity response.

A nurse is caring for a hospital client who has just been prescribed phenytoin for a seizure disorder. What assessment should the nurse prioritize when assessing for adverse effects? Assessment of urinary output and urine appearance Assessment of respiratory rate and oxygen saturation Assessment for chest pain or shortness of breath Assessment of level of consciousness

Correct response: Assessment of respiratory rate and oxygen saturation Explanation: The most common adverse effects of hydantoins are related to CNS depression, which would cause a decrease in LOC. Urine output and respiratory function are rarely affected. Chest pain or shortness of breath would signal a severe hypersensitivity reaction, but this is not common.

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? Assessment of the client's blood pressure following administration Assessment for headaches following peak blood levels Assessment of bowel sounds and pattern of bowel movements Monitoring the client's creatinine clearance rate

Correct response: Assessment of the client's blood pressure following administration Explanation: Tizanidine has been associated with hypotension, which could be a safety risk especially if the client is also taking an antihypertensive drug. Constipation and headaches are common adverse effects that do not pose as direct a safety risk. Creatinine levels are not normally affected, and these do not pose a safety risk.

Which medication would the nurse expect to administer if prescribed to achieve skeletal muscle relaxation? Hydroxychloroquine Baclofen Allopurinol Alendronate

Correct response: Baclofen Explanation: Baclofen is an example of a skeletal muscle relaxant. Allopurinol would be administered to treat gout. Alendronate would be administered to treat osteoporosis. Hydroxychloroquine would be used to treat rheumatoid arthritis.

A client with spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered? Cyclobenzaprine Chlorzoxazone Carisoprodol Baclofen

Correct response: Baclofen Explanation: Baclofen is used for the treatment of muscle spasticity associated with spinal cord injuries. Carisoprodol is used for the relief of discomfort of acute musculoskeletal conditions. Chlorzoxazone is used for the relief of discomfort of acute musculoskeletal conditions. Cyclobenzaprine is used for the relief of discomfort of acute musculoskeletal conditions.

A 45-year-old client has been diagnosed with liver failure. The nurse knows that which class of medications is contraindicated for this client? COMT inhibitors Beta blockers Anticholinergics ACE inhibitors

Correct response: COMT inhibitors Explanation: COMT inhibitors are contraindicated for clients in liver failure. Anticholinergic medications are contraindicated for clients with glaucoma, pyloric or duodenal obstruction, peptic ulcers, prostatic hypertrophy, achalasia, myasthenia gravis, and megacolon. Liver failure is not a contraindication for ACE inhibitors and beta blockers.

A client taking medication to treat an acute attack of gout should do which of the following? Expect pain relief in two to three weeks. Drink just enough water to swallow the pills. Take the medication an hour before meals. Contact the health care provider if a mild skin rash appears.

Correct response: Contact the health care provider if a mild skin rash appears. Explanation: When using drugs to treat gout, a client should: drink 10 glasses of water a day until the acute attack has subsided; avoid driving or hazardous tasks if drowsiness occurs; notify the health care provider if pain is not relieved in a few days or if a skin rash occurs; take the medication with meals to minimize GI upset.

A clent has been admitted to the unit for treatment of a multiple sclerosis exacerbation. The admission order indicates that the client is taking baclofen. Which outcome would the nurse expect to be associated with use of this medication? Decreased muscle spasms Increased muscle strength Decreased severity and duration of exacerbations Reduction in the appearance of new lesions in magentic resonance imaging (MRI) studies

Correct response: Decreased muscle spasms Explanation: Baclofen, a GABA agonist, is used in the treatment of spasms. It can be administered orally or by intrathecal injection. Avonex and betaseron reduce the appearance of new lesions in MRI studies. Corticosteroids limit the severity and duration of exacerbations. Anticholinesterase agents increase muscle strength in the upper extremities.

A client has been prescribed benztropine as drug therapy for Parkinson's disease. What assessment finding would suggest a therapeutic effect to the nurse?

Correct response: Decreased rigidity and tremors Explanation: Benztropine should cause a decrease in rigidity and tremors. It does not affect LOC, motivation, strength or seizure risk.

The client is taking baclofen. What would be the most important safety instruction for the nurse to give to this client? Discontinue the use of alcohol. Do not walk or drive after taking the drug. Learn to self-administer the drug. Take a laxative when needed.

Correct response: Discontinue the use of alcohol. Explanation: In a client experiencing spasticity, the nurse should advise the client to stop drinking alcohol. Alcohol consumption may increase the adverse effect of sedation, causing sleepiness, dizziness, and blurred vision. The client should not drive or walk after taking the drug; the client should learn to self-administer the drug; and constipation is a concern. However, the most important safety concern is to avoid alcohol.

A 76-year-old client has been prescribed an oral antihistamine. What adverse effect presents a priority safety concern for older adult clients? Drowsiness Dry mouth Nonproductive cough Nasal burning

Correct response: Drowsiness Explanation: Older adults are more likely to experience anticholinergic effects (dryness of mouth, nose, throat), dizziness, sedation, hypotension, and confusion from the use of antihistamines. Drowsiness and sedation present the greatest safety concerns compared to other effects such as dry mouth and nonproductive cough. Nasal burning may occur due to nasal spray use.

The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which is not one of these effects? Dry mouth Drowsiness Excessive salivation Blurred vision

Correct response: Excessive salivation Explanation: Adverse effects of first-generation antihistamines include urinary retention or frequency, sedation, dry mouth, blurred vision, and gastrointestinal distress.

An older adult resident of a long-term care facility is experiencing muscle spasticity and has just been prescribed a centrally acting skeletal muscle relaxant. The client has comorbidities of early stage Alzheimer's disease and chronic obstructive pulmonary disease (COPD). What nursing action should the nurse prioritize for adding to the client's care plan? Deep breathing and coughing exercises Falls prevention measures Seizure precautions Continuous pulse oximetry

Correct response: Falls prevention measures Explanation: The client's combination of CNS depression from the muscle relaxant and an underlying cognitive deficit creates a risk for falls. This combination is not associated with seizures and will not likely exacerbate the client's COPD; respiratory assessments and interventions would not likely need to be amended.

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? Monitor vital signs hourly while the client is awake Implement falls precautions Make a referral to occupational therapy Maintain the client on bed rest

Correct response: Implement falls precautions Explanation: 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.

The nurse is formulating a care plan for a client with a seizure disorder. Which intervention would be an appropriate for the nurse to include? Informing the client and family that excessive frustration is to be expected Informing the client and family that seizure control is gained immediately Informing the client and family that seizure control is not gained immediately Informing the client and family that unrealistic expectations can occur

Correct response: Informing the client and family that seizure control is not gained immediately Explanation: The nurse should inform the client and family that seizure control is not gained immediately when drug therapy is started. The goal is to avoid unrealistic expectations and excessive frustration while drugs and dosages are being changed in an effort to determine the best regimen for the client.

A client has been suffering from repeated sinus infections. The client is diagnosed with allergic rhinitis. The client is prescribed a daily antihistamine. What is the mechanism of action in the antihistamine medications? It raises the seizure threshold by impairing vitamin D. It catalyzes the enzymatic oxidation of uric acid. It prevents histamine from acting on target tissues. It depletes norepinephrine and serotonin.

Correct response: It prevents histamine from acting on target tissues. Explanation: Antihistamines prevent histamine from acting on target tissues. Antihypertensive agents deplete norepinephrine and serotonin. Antigout medications catalyze the enzymatic oxidation of uric acid. Antiseizure medications, such as primidone, impair vitamin D metabolism.

An older adult is prescribed a skeletal muscle relaxant for reports of neck pain. What is the top priority of care for the nurse to teach the family? Give the medication at the same time each day. Administer the medication with meals. Instruct on how to assess client's pain level. Monitor the client before ambulating.

Correct response: Monitor the client before ambulating. Explanation: Safety is the top priority concern, because skeletal muscle relaxants can cause drowsiness. Administering the medication with meals can reduce GI distress but is not the top priority safety concern. Checking the client's pain level is important but not the top priority safety concern. Giving the medication at the same time each day may help the caregivers remember it, but is not the top priority safety concern.

A client is taking allopurinol for gout. The client exhibits an "itchy" skin rash on the neck and both arms. What is the nurse's top priority action? Notify the healthcare provider. Recommend the client trim fingernails. Apply a moisturizing lotion. Document the finding as a common side effect.

Correct response: Notify the healthcare provider. Explanation: A rash while taking allopurinol should be reported to the healthcare provider, because it may precede a serious adverse reaction known as Stevens-Johnson syndrome. Applying a lotion may relieve itching, but notifying the healthcare provider is top priority as a safety precaution. Trimming the fingernails can help prevent further skin damage from scratching, but the healthcare provider needs to be notified as well.

A client who has been receiving long-term levodopa therapy tells the nurse, "I was making good progress and then it was like the drug stopped working." The nurse interprets this as which of the following?

Correct response: On-off phenomenon Explanation: The on-off phenomenon may occur in clients taking levodopa. In this condition, the client may suddenly alternate between improved clinical status and loss of therapeutic effect. Drug holiday is what would be used to address the client's situation where the drug is completely withdrawn for 5 to 14 days and then gradually restarted with a lower dose. Bradykinesia refers to the slow movement seen with Parkinson disease. Choreiform movements refer to the involuntary muscular twitching of the limbs and facial muscles.

Certain bisphosphonates can be utilized in the treatment of which of the following conditions? (Choose one) Graves' disease Parkinson's disease Huntington's disease Paget's disease

Correct response: Paget's disease Explanation: Certain bisphosphonates can be utilized in the treatment of Paget's disease.

Question 5 of 5 After teaching a group of nursing students about seizures, the instructor determines that the teaching was successful when the group identifies seizures that do not impair consciousness but can involve the senses or motor ability as which type? Partial seizures Tonic-clonic seizures Generalized seizures Myoclonic seizures

Correct response: Partial seizures Explanation: Seizures that do not impair consciousness but can involve the senses or motor ability are classified as partial seizures. Generalized seizures involve loss of consciousness during the seizure. Tonic-clonic seizures are a type of generalized seizure involving alternate contraction and relaxation of the muscles, loss of consciousness, and abnormal behavior. Myoclonic seizures involve sudden, forceful contractions of single or multiple groups of muscles.

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? Prepare to administer Carisoprodol Contact the care provider to question the treatment plan Prepare to administer baclofen Ensure that the client has patent venous access

Correct response: Prepare to administer baclofen Explanation: Baclofen is available in oral and intrathecal forms and can be administered via a delivery pump for the treatment of central spasticity. Soma cannot be delivered in this manner and there is no obvious reason to question such an order. The client likely needs venous access for other fluids and medications, but it is not necessary for intrathecal administration.

A client has been prescribed phenytoin for the treatment of seizures. How should the nurse most accurately determine whether the client has therapeutic levels of the medication? Review the client's laboratory blood work Assess the client's cognitive status Assess the client carefully for adverse effects Monitor the client for seizure activity

Correct response: Review the client's laboratory blood work Explanation: Measuring serum drug levels evaluates whether the therapeutic range of circulating drug can be found in the serum. It does not directly evaluate effectiveness of therapy, however, which can only be evaluated by determining whether the drug is having the desired effect of reducing number of seizures. Short term absence of seizures does not necessarily indicate that drug is within therapeutic range.

A client has been prescribed a subcutaneous medication to treat rheumatoid arthritis (RA). The nurse should teach the client to do which? Pinch the skin over the deltoid before injection. Aspirate the syringe before injecting the medication. Pull the skin to the side when injecting to prevent skin irritation. Rotate sites when administering the injections.

Correct response: Rotate sites when administering the injections. Explanation: The nurse should teach the client about rotating subcutaneous injection sites. The deltoid is a muscle, not a subcutaneous injection site. Pulling the skin to the side describes the Z-track method used with intramuscular injections. Aspirating is not recommended with subcutaneous injections.

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?

Correct response: The client has begun drooling while he eats Explanation: Drooling is a characteristic sign of Parkinson's disease, and a new onset of this would suggest the progression of the disease. Impatience and loss of interest would suggest a worsening mood and affect, which may or may not be related to the client's Parkinson's disease. Neutropenia would likely be unrelated to the disease or its treatment.

When reviewing the medical record of a client receiving levodopa, what client factors should alert the nurse to the need for closer monitoring after administering the drug? The client has peptic ulcer disease and takes bronchodilators for the treatment of asthma The client had cataract surgery last year and has hypertension The client has taken calcium and vitamin D supplements for many years to prevent osteoporosis The client is obese and has usually led a sedentary lifestyle

Correct response: The client has peptic ulcer disease and takes bronchodilators for the treatment of asthma Explanation: Levodopa should be used cautiously in clients with peptic ulcer disease, or asthma, both of which could be exacerbated by dopamine receptor stimulation. None of the other listed client factors contraindicates the use of levodopa or necessitates close monitoring.

A 21 year-old male client is distraught about the implications of his recent diagnosis of seizure activity. When addressing this client's most likely psychosocial needs, what topic should the nurse address? The consequences of needing bed rest during stressful times Loss of libido and sexual performance The consequences of quitting college The client's loss of his driver's license

Correct response: The client's loss of his driver's license Explanation: The client is likely to lose his driver's license, which for many clients has serious and varied implications. However, the client will not likely need to quit college or have frequent times of bedrest. Sexual activity is less likely to be impacted than mobility.

A client's health care provider has prescribed baclofen in an effort to treat neuropathic cancer pain. What education should the nurse prioritize when teaching the client about this new medication? The importance of ensuring safety related to possible sedation The importance of maintaining a sterile central venous catheter The need to maintain a diet that is high in iron and folic acid The importance of regularly scheduled liver function testing

Correct response: The importance of ensuring safety related to possible sedation Explanation: Baclofen carries a risk of CNS depression and a consequent threat to safety. The use of baclofen does not necessitate regular liver function testing or dietary changes. Baclofen is administered orally or intrathecally, not intravenously.

For which patient would cyclobenzaprine not be prescribed for muscle spasms? The patient who underwent a lumbar laminectomy and is having back spasms The patient who strained a quadriceps muscle playing baseball The patient who is having muscle spasms in the left leg after a fracture The patient who is having muscle spasms because of cerebral palsy

Correct response: The patient who is having muscle spasms because of cerebral palsy Explanation: Cyclobenzaprine is used to manage muscle spasms associated with acute musculoskeletal disorders, such as low back strain, muscle tenderness, or movement restriction due to musculoskeletal conditions. It is also used as supportive therapy in patients with tetanus or fibromyalgia. Cyclobenzaprine is ineffective for treating spasticity associated with cerebral or spinal cord disease or in children with cerebral palsy.

The nurse is caring for an older adult client who has been diagnosed with Parkinson's disease and who will soon begin drug therapy. What nursing action will best promote safe and effective drug therapy?

Correct response: Thorough client and family teaching, supplemented with written materials Explanation: Thorough and individualized client education is necessary to ensure safe and effective treatment. There is not normally a need for frequent blood pressure monitoring for most clients, and drug doses are not changed to address short-term symptoms. The symptoms of Parkinson's disease are not attributable to normal, age-related physiologic changes.

A nurse is to administer an anticonvulsant drug. The nurse understands that this drug is classified as an oxazolidinedione. Which drug would the nurse most likely be preparing to administer? Diazepam Levetiracetam Trimethadione Gabapentin

Correct response: Trimethadione Explanation: Trimethadione is classified as an oxazolidinedione. Diazepam is classified as a benzodiazepine. Gabapentin is classified as a miscellaneous anticonvulsant. Levetiracetam is classified as a miscellaneous anticonvulsant.

Which assessment finding should prompt the nurse to suspect that the resident is experiencing an anticholinergic effect of diphenhydramine? urticaria tinnitus blurry vision wheezing on expiration

Correct response: blurry vision Explanation: Anticholinergic effects are produced by the inhibition of cholinergic neurotransmission at muscarinic receptor sites. First-generation H1 receptor antagonists are associated with anticholinergic effects such as dry mouth, urinary retention, constipation, and blurred vision. Wheezing, urticaria, and tinnitus are not anticholinergic effects since they are not related to the cholinergic neurotransmission at muscarinic receptor sites.

What are the classic symptoms associated with Parkinson's disease? Select all that apply. muscle rigidity urinary retention bradykinesia worsening eyesight resting tremors

Correct response: bradykinesia muscle rigidity resting tremors Explanation: Classic symptoms of Parkinson's disease include resting tremor, bradykinesia, rigidity, and postural instability.

After administering gabapentin, the nurse should assess the client for what possible adverse effect? paradoxical seizures hypersensitivity tetany central nervous system (CNS) depression

Correct response: central nervous system (CNS) depression Explanation: The most common adverse effects of gabapentin are associated with CNS depression and include dizziness, somnolence, insomnia, and ataxia. The drug has not been noted to cause tetany, hypersensitivity reactions, or paradoxical seizures.

What is a common side effect of anticholinergic drug therapy? Select all that apply. dry mouth urinary retention skin rash papillary constriction blurred vision

Correct response: dry mouth blurred vision urinary retention Explanation: Anticholinergic drugs may cause blurred vision, dry mouth, tachycardia, and urinary retention. They also decrease sweating and may cause fever or heatstroke. When centrally active anticholinergics are given for Parkinson's disease, agitation, mental confusion, hallucinations, and psychosis may occur.

A client has developed symptoms of rigidity and bradykinesia. Which medication has been linked to the development of such symptomology? furosemide haloperidol valproic acid psyllium hydrophilic mucilloid

Correct response: haloperidol Explanation: Drugs that deplete dopamine stores or block dopamine receptors, including the older antipsychotic drugs (phenothiazines and haloperidol), reserpine, and metoclopramide, can produce movement disorders such as secondary parkinsonism. Neither furosemide, psyllium, nor valproic acid depletes dopamine stores.

A 32-year-old female client is taking tizanidine (Zanaflex) for spasticity related to her multiple sclerosis. The nurse will inform the client and her husband that the adverse effect that poses the greatest safety risk to the client is: constipation. fatigue. dry mouth. hypotension.

Correct response: hypotension. Explanation: Tizanidine (Zanaflex) has been associated with hypotension, which could be a safety risk, especially if the client is also taking an antihypertensive drug. Constipation, dry mouth, and fatigue are common adverse effects that do not pose a safety risk.

A health care provider has asked the nurse to educate a client with Parkinson disease regarding the client's medication regimen. Because the client is taking carbidopa-levodopa, the nurse will assess the client's existing medication regimen for: tricyclic antidepressants. beta-blockers. NSAIDs. potassium-wasting diuretics.

Correct response: tricyclic antidepressants. Explanation: Carbidopa-levodopa can interact substantially with hydantoins, MAOIs, phenothiazines, or tricyclic antidepressants. It does not interact appreciably with NSAIDs, diuretics, or beta-blockers.

A client is experiencing an acute asthmatic attack. Which agent would be most effective?

Correct response: Beta-2 selective adrenergic agonist

A group of students are reviewing the various drugs that affect inflammation. The students demonstrate understanding when they identify which agent as a mast cell stabilizer?

Cromolyn

A patient is experiencing an acute asthma attack. Which of the following medications are contraindicated for the treatment of acute asthma?

Cromolyn (Intal)

The client is taking cyclobenzaprine for muscle spasms secondary to an injury to the lumbar spine that occurred while lifting a motor at work. The client is being seen for a follow-up visit by the health care provider. The client reports dry mouth, blurred vision, and constipation. Why is the client having these side effects from cyclobenzaprine?

Cyclobenzaprine produces an anticholinergic response

The nurse is caring for a client with peripheral edema who has just begun taking a diuretic. What assessments should the nurse use to evaluate the effectiveness of this medication? Select all that apply.

Daily weights Inspection of lower legs and feet Urine output

A client with a history of malignant hyperthermia is scheduled for surgery. Which agent would the nurse most likely expect to administer?

Dantrolene

A patient develops malignant hyperthermia after receiving a NMJ blocker? Which would the nurse expect to be given?

Dantrolene

A patient is being treated for intractable muscle spasticity with a peripherally acting spasmolytic. The nurse should anticipate administering which medication?

Dantrolene

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:

Dantrolene

A patient receiving succinylcholine (Anectine) experiences malignant hyperthermia. What drug is used to treat this condition?

Dantrolene (Dantrium)

Which medications can be used to treat or prevent malignant hyperthermia?

Dantrolene (Dantrium)

A client comes to the clinic with what appears to be a cold. What group of upper respiratory drugs cause local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow?

Decongestants

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?

Decreased adverse effects

When carbidopa is given with levodopa, the dosage of levodopa must be reduced. What would the reduction of levodopa cause?

Decreased adverse effects

A nurse is assessing a patient with Parkinson's disease. The nurse determines that the patient's drug therapy is effective when the patient exhibits:

Decreased tremors

What indicates to the nurse that a patient has recovered from neuromuscular junction (NMJ) blocking anesthesia?

Deep tendon reflexes 2+

A client with advanced Parkinson's disease has undergone diagnostic testing and diagnostic imaging. What are the results most likely to reveal?

Degeneration of dopamine-producing nerve cells

The staff educator in the ICU is talking with a group of new nurses about osmotic diuretics. The educator would tell the new nurses that osmotic diuretics act upon which site in the nephron?

Descending limb of loop of Henle

A 45-year-old female client is being seen in the health care provider's office for a dry, hacking cough that is keeping her up at night. The provider prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan?

Dextromethorphan works in the medulla to suppress the cough reflex.

The nurse would caution clients with which disorders to avoid the use of over-the-counter pseudoephedrine? (Select all that apply.)

Diabetes Cardiovascular disorders Glaucoma

Which medication is classified as an antianxiety medication but is also used to treat muscle spasms?

Diazepam (Valium)

Ropinirole is a dopamine agonist. How does this drug work in Parkinson's disease?

Directly stimulates postsynaptic dopamine receptors

While writing a care plan for a patient newly diagnosed with generalized seizures you know to include what appropriate nursing diagnosis?

Disturbed thought processes related to CNS effects

Diuretics increase the production and output of urine. Which statement helps explain how diuretics achieve these effects?

Diuretics reduce the reabsorption of water in the kidneys.

A client has been prescribed hydrochlorothiazide for hypertension. The nurse is giving the client discharge instructions. Which adverse effects would the nurse caution the client about? Select all that apply.

Dizziness Nocturia Muscle cramps

What is the most important teaching from the plan of care, to emphasize, when a client is prescribed a skeletal muscle relaxant?

Do not drive or operate machinery until individual drug effects are known.

What is the most important teaching point to emphasize from the plan of care when a client is prescribed a skeletal muscle relaxant?

Do not drive or operate machinery until individual drug effects are known.

Under the supervision of the registered nurse, the licensed practical nurse (LPN) is administering diazepam (Valium) intravenously. The LPN should do which of the following?

Do not give the medication if precipitate is seen in the syringe.

One of the neurotransmitters can become decreased in the area of the corpus striatum. This results in the manifestations of Parkinson's disease. Which neurotransmitter will cause this?

Dopamine

A nurse administers carisoprodol to a client for the treatment of an acute musculoskeletal condition. The nurse would be alert for which adverse effect after administering the drug?

Drowsiness

The use of centrally acting antitussives, such as codeine, increase the risk for injury related to which conditions? (Select all that apply.)

Drowsiness Dizziness

A nurse is listing adverse reactions to a client who is taking an anticholinergic medication. Which would be correct for the nurse to list? (Select all that apply.)

Dry mouth Blurred vision

What type of diet should a patient taking diuretics have?

Eat potassium-rich or low-potassium diet as appropriate

After teaching a group of students about adjunctive therapy used to treat Parkinson's disease, the instructor determines that the teaching was successful when the students identify which agent as affecting catecholaimine-O-methyl transferase (COMT)?

Entacapone

Which would a nurse identify as an adjunctive agent for treating Parkinson's disease?

Entacapone

The nurse is reviewing the medication administration record (MAR) of a client with Parkinson's disease. The nurse reads that the client is prescribed the combination medication Stalevo t.i.d. The nurse should recognize that the client is receiving which medications? Select all that apply.

Entacapone Carbidopa Levodopa

Which drug is classified as a catechol-O-methyltransferase (COMT) inhibitor?

Entacapone (Comtan)

A patient is admitted to the emergency room with inspiratory stridor and air hunger after a bee sting. Which of the following medications will the nurse prepare for administration?

Epinephrine (Adrenalin) Epinephrine may be injected subcutaneously in an acute attack of bronchoconstriction.

A nurse is caring for a client who is prescribed an antiparkinsonism drug. Before administering the drug, which nursing action would the nurse include in the preadministration assessment?

Evaluating the client's current mental condition

Isoproterenol is an anticholinergic agent.

False

Second generation antihistamines are associated with a higher risk of sedation than first generation antihistamines. True False

False

The first step in treating obstructive pulmonary disorders involves medication therapy.

False

A client who is scheduled for a diagnostic procedure has learned that the procedure will take place with a neuromuscular junction blocker rather than with a general anesthetic. The nurse should describe what benefit of this approach?

Fewer effects of central nervous system depression

Second-generation antihistamines were developed to remove the sedation of first generation drugs. Which of the following antihistamines is a second-generation drug? Dexchlorpheniramine Chlorpheniramine Fexofenadine Diphenhydramine

Fexofenadine

A nurse encourages a patient who is receiving a diuretic to maintain his fluid intake to prevent the risk for developing:

Fluid rebound

Michael, 8 years old, comes to see you complaining of shortness of breath, cough, and chest tightness when he participates in gym class. He is seen by the physician in the clinic and diagnosed with exercise-induced asthma. What inhaled drug therapy is the physician most likely to prescribe for him?

Formoterol (Foradil), a highly selective beta-2 agonist

A patient is brought in to the Emergency Department by ambulance in status epilepticus. What drug may be used for this patient?

Fosphenytoin

After teaching a group of students about anti-seizure agents, the instructor determines that the teaching was successful when the students identify which agent as being administered intravenously?

Fosphenytoin

After teaching a group of nursing students about diuretics, the instructor determines that the teaching was successful when the group identifies which as a loop diuretic?

Furosemide

An elderly patient with a history of congestive heart failure has been admitted to hospital with failure to thrive and admission blood work reveals a hemoglobin level of 6.9 g/dL. The care team has consequently administered two units of packed red blood cells, but auscultation of the client's lungs now reveals diffuse crackles. Administration of what drug is likely to resolve the patient's pulmonary edema?

Furosemide

Which is an example of a loop diuretic?

Furosemide (Lasix)

Tonic-clonic seizures and myoclonic seizures are classified as what type of seizures?

Generalized seizures

Which type of seizures involves a loss of consciousness?

Generalized seizures

Which concurrent medication promotes prolonged muscle paralysis in a patient receiving rocuronium (Zemuron)?

Gentamicin (Garamycin)

A patient is scheduled for surgery using a neuromuscular junction (NMJ) blocking agent. Which assessment from the patient's history is of greatest priority for the nurse to report to the physician?

Glomerulonephritis

A female client presents at the clinic with a dry, nonproductive cough. The client is diagnosed with bronchitis, and it is determined that she will need help thinning sputum so that the cough can become productive. What does the nurse expect will be prescribed for the client?

Guaifenesin

A group of nursing students are reviewing information about expectorants. The students demonstrate understanding when they identify which medication as an example?

Guaifenesin

A client presents at the clinic with a dry, non-productive cough. The client is diagnosed with bronchitis, and it is determined that the client needs help thinning the sputum so the cough can become productive. What does the nurse expect the health care provider will prescribe?

Guaifenesin (Mucinex)

When preparing the teaching plan for a male client who is prescribed spironolactone, the nurse would alert the client to the possibility of which of the following?

Gynecomastia

Your patient recently began taking theophylline for treatment of asthma. Which of the following changes in the patient's lifestyle would suggest that he understands proper use of the drug and management of his disease?

He avoids caffeine. Some bronchodilating drugs, such as theophylline, can cause tachycardia, dysrhythmias, palpitations, agitation, and insomnia.

A nurse is required to educate a patient prescribed albuterol on the adverse effects associated with the drug. Which of the following symptoms, if experienced, should the nurse instruct the patient to report to the health care provider?

Headache and flushing

What factors contribute to elderly clients being at higher risk of injury while taking antihistamines? Select all that apply: Hearing loss Steady gait Diabetes Hypertension Visual impairment

Hearing loss Visual impairment

The nurse is preparing to administer phenytoin (Dilantin) to a client. The nurse should notify the health care provider before administration based on which assessment finding?

Heart rate 50 beats per minute on cardiac monitor.

What is the main purpose of the drugs used to treat Parkinson's disease?

Help adjust the balance of neurotransmitters

A nurse should review a client's medical conditions prior to administering a dantrolene (Dantrium) as its use is contraindicated in clients with which issues? (Select all that apply.)

Hepatic disease Lactation

Signs and symptoms of what would necessitate discontinuation of dantrolene therapy?

Hepatic dysfunction

Which assessment finding from a patient's history is significant for the nurse to report to the physician before surgery using a neuromuscular junction (NMJ) blocking agent?

Hepatitis

As part of a class presentation, a nursing student is describing the actions of the different diuretics. Which medication would the student include as exerting its diuretic effect by inhibiting the reabsorption of sodium and chloride ions in the ascending portion of the loop of Henle and the early distal tubule of the nephron?

Hydrochlorothiazide

A 91-year-old client, who is being prepared for discharge, has been prescribed the diuretic spironolactone. While teaching the client about the drug, what major adverse effect should the nurse be sure to mention?

Hyperkalemia

A 91-year-old patient is being discharged on the diuretic spironolactone (Aldactone). What is the major adverse effect of this type of medication?

Hyperkalemia

After reviewing information about thiazide diuretics, a group of students demonstrate the need for additional teaching when they identify what as a possible adverse effect?

Hypocalcemia

A client comes to the clinic for a 1-month follow-up appointment. The client states taking chlorothiazide (Diruil) for the month it has been prescribed and now has leg cramps and "feels tired all the time." What will the nurse consider as the cause of the patient's symptoms?

Hypokalemia

The nurse assesses the client for which of the following symptoms that may indicate that the client has excessive potassium loss?

Hypotension

Which adverse effect of a neuromuscular junction (NMJ) blocking agent is the highest priority for the nurse to treat?

Hypotension

The client has been taking hydrochlorothiazide for hypertension. Which manifestations would indicate the client is experiencing hyponatremia? Select all that apply.

Hypotension Confusion Tachycardia

A patient is receiving bumetanide. The nurse would instruct the patient to be alert for what issues? (Select all that apply.)

Hypotension Dizziness Weakness Muscle cramps

A client is newly diagnosed with Parkinson's disease and levodopa (Dopar) has been prescribed. What health education should the nurse provide?

Identifying foods and supplements high in vitamin B6

A nurse is making a care plan for a client with Parkinson's disease and has started on an antiparkinson medication. Which nursing diagnosis would be appropriate for this client's care plan? (Select all that apply.)

Imbalanced Nutrition: Less than Body Requirements Altered Bowel Movements: Constipation Risk for Injury

A client receiving a dopaminergic agent has recently experienced nausea, vomiting, and dysphagia. Which nursing diagnosis would be most appropriate for this client?

Imbalanced nutrition: less than body requirements

A patient receiving a dopaminergic agent reports nausea, vomiting, and dysphagia. Which nursing diagnosis would be most appropriate for this patient?

Imbalanced nutrition: less than body requirements

Which nursing focus is the highest priority for the nurse caring for a patient receiving a neuromuscular junction (NMJ) blocking agent?

Impaired gas exchange

A nurse is writing a plan of care for a patient who is taking a diuretic. What would be an appropriate nursing diagnosis for this patient?

Impaired urinary elimination

The nurse is assessing a client who was prescribed levodopa one week earlier. What change in the client's status would suggest the effectiveness of drug therapy?

Improvement in handwriting

A client who smokes is receiving theophylline orally. Because of his history of smoking, the nurse expects the health care provider to do what with the theophylline dosing?

Increase

What non pharmacological recommendation should be made to the client to prevent pooling of secretions in the lungs during the administration of an antitussive? (Select all that apply) Increase fluid intake Change positions frequently Decrease fluid intake Remain in one position Refrain from trying to cough

Increase fluid intake Change positions frequently

A 29-year-old female client has sinusitis, so the health care provider orders a topical nasal decongestant. What instructions should be given?

Increase fluids to 2 L per day

A 29-year-old female client has sinusitis, so the physician orders a topical nasal decongestant. What instructions should be given? Avoid becoming pregnant during decongestant therapy Increase fluids to 2 L per day Restrict fluids to 500 mL per day Take the medication with meals

Increase fluids to 2 L per day

Concomitant administration of fluconazole (Diflucan) and phenytoin (Dilantin) can result in which of the following? (Choose one)

Increased levels of phenytoin (Dilantin)

A client takes digoxin and furosemide (Lasix), a potassium-wasting diuretic, for edema related to congestive heart failure. The nurse knows that hypokalemia has what effect on digoxin?

Increased risk of cardiac arrhythmias

A nurse is caring for a patient who has been prescribed entacapone for the treatment of Parkinson's disease. The patient informs the nurse that he is taking MAOI antidepressants for the management of depression. What effect of the interaction of the two drugs should the nurse anticipate in the patient?

Increased risk of toxicity of both drugs

A patient with asthma is administered zileuton along with theophylline. Which of the following drug interactions should the nurse monitor the patient for?

Increased serum theophylline

The pharmacology instructor is discussing drugs used for the treatment of partial seizures. What accurately describes the physiological action of carbamazepine?

Increases GABA activity and blocks sodium and calcium channels to stop action potentials

An instructor is preparing a teaching plan for a group of students about drugs used to treat Parkinson's disease. The nurse is planning to talk about amantadine. Which would the instructor include as an action?

Increases the release of dopamine

Hydrochlorothiazide works by what mechanism of action?

Increasing the excretion of sodium and chloride in the distal tubule

You are acting as the triage nurse in the emergency department when a 42-year-old patient with asthma presents for treatment. The patient's respiratory rate is 40 breaths per minute. Based on this objective data, what is the correct nursing diagnosis for this patient?

Ineffective breathing pattern The correct nursing diagnosis is Ineffective Breathing Pattern related to impaired airway as manifested by tachypnea.

Which intervention would be an appropriate part of a plan of care for a patient with a seizure disorder

Informing the patient and family that seizure control is not gained immediately

A nurse is administering levalbuterol to a client. The nurse would administer this drug by which route?

Inhalation

A patient is prescribed salmeterol. The nurse would expect this drug to be administered by which route?

Inhalation

A nurse is administering levalbuterol to a client. The nurse would administer this drug by which route?

Inhalation Levalbuterol is administered only as an inhalant by nebulizer.

A patient is instructed on the administration of inhaled corticosteroid agents to treat asthma. How do inhaled corticosteroid agents assist in the treatment of asthma?

Inhaled corticosteroid agents will reduce airway inflammation. Inhaled corticosteroid agents suppress the release of inflammatory mediators, block the generations of cytokines, and decrease the recruitment of airway eosinophils.

The nurse is caring for a client whose current medication regimen includes baclofen 60 mg PO daily. What assessment should the nurse nurse prioritize when assessing for therapeutic effects?

Inspection for muscle spasticity and range of motion assessment

Which would a nurse include when describing the action of dantrolene?

Interference with calcium release from the muscles

A physician recently ordered a change in medication for a patient with a seizure disorder. Which action would the nurse take in evaluating the new drug's control of the seizure disorder?

Interview and observe for adverse effects

A neonate is receiving beractant. The nurse understands that this agent is administered by which route?

Intratracheal

When caring for a client taking dantrolene, for what adverse effects should the nurse monitor the client? Select all that apply.

Jaundice Fatigue Drowsiness

A nurse has been assigned to patient who receives hydrochlorothiazide each morning for the treatment of primary hypertension. Which of the following components of the patient's morning blood work should prompt the nurse to temporarily hold the drug this morning and consult with the physician?

K+ 3.0 mEq/L

Which agents would the nurse identify as selectively and competitively blocking the receptors for the production of two substances that are components of SRSA?

Leukotriene receptor antagonists Leukotriene receptor antagonists selectively and competitively block or antagonize receptors for the production of leukotrienes D4 and E4, components of SRSA.

For a client diagnosed with Parkinson's and narrow angle glaucoma, what medication would be contraindicated?

Levodopa

The nurse is caring for a client diagnosed with Parkinson's disease who has been prescribed an anticholinergic drug. What factor most likely prompted the primary care provider to prescribe this drug?

Levodopa has not caused a sufficient therapeutic response

A patient is being treated for Parkinson's disease and has been prescribed both levodopa (L-dopa) and carbidopa (Lodosyn). Why is this course of treatment most effective?

Levodopa restores dopamine and carbidopa decreases peripheral breakdown of levodopa.

The most effective drug to treat major symptoms associated with Parkinson's is: a) Apomorphine. b) Amantadine. c) Levodopa. d) MAO inhibitors.

Levodopa.

Which would be most important for the nurse to monitor when administering valproic acid?

Liver function studies

A client has received a prescription for baclofen. The home care nurse would schedule which laboratory tests to monitor this client?

Liver function tests

A patient, newly diagnosed with a seizure disorder, has been prescribed valproic acid. What is an adverse effect of valproic acid that the nurse should include in the medication teaching plan?

Liver toxicity

What would the nurse include as possible adverse effects when teaching a patient about phenytoin?

Liver toxicity

A patient with vasomotor rhinitis has been prescribed an antihistamine. The patient is eager to know whether the prescribed antihistamine may cause excessive sedation. Which of the following antihistamines has very little sedative effect? Brompheniramine Clemastine Chlorpheniramine Loratadine

Loratadine - 2nd gen antihistamine (claritin)

Status epilepticus is a life-threatening condition that needs immediate treatment. What is the drug of choice in treating status epilepticus?

Lorazepam

A client is experiencing status epilepticus. Which medication should the nurse prepare to administer?

Lorazepam (Ativan)

A patient is admitted to the emergency room with uncontrolled tonic-clonic seizures. What medication is administered intravenously to assist in reducing seizure activity?

Lorazepam (Ativan)

Which is the drug of choice in the treatment of status epilepticus, an emergency characterized continual seizure activity with no interruptions?

Lorazepam (Ativan)

The drug of choice to stop status epilepticus seizure activity is:

Lorazepam given intravenously.

The nurse understands that the action of most diuretics typically results in which effects? (Select all that apply.)

Loss of water Loss of chloride

Which of the following medications, if administered with pseudoephedrine, could increase risk of cardiac dysrhythmia? MAO inhibitors Beta blockers Calcium-channel blockers Thiazide diuretics

MAO inhibitors

A male client is prescribed montelukast and uses it successfully to manage his asthma. He develops hepatitis C. What would the nurse expect the physician to do?

Maintain the same dose of the montelukast Montelukast and zafirlukast produce higher blood levels and are eliminated more slowly in clients with hepatic impairment.

A client is prescribed oxymetazoline, a decongestant, for the treatment of hay fever. What should the nurse evaluate to assess the efficacy of therapy?

Maintenance of effective airway clearance

A nurse assessing a postoperative patient who received a neuromuscular blocking (NMJ) agent during the procedure notes extreme muscle rigidity, pyrexia, and acidosis. What family history predisposed the patient to this event?

Malignant hyperthermia

An operating room nurse is assisting the anesthesiologist in the preparation of an intravenous dose of dantrolene. What emergent issue most likely prompted the need to give the patient dantrolene?

Malignant hyperthermia

The nurse is caring for a client who is experiencing elevated intracranial pressure following neurosurgery. The health care provider orders an osmotic diuretic to reduce pressure. Which medication would the nurse expect to be ordered?

Mannitol

When teaching a class about diuretics, a nursing instructor describes a class of drugs that increases the density of the filtrate in the glomerulus. Which medication would the instructor cite as an example?

Mannitol

The nurse is caring for a patient with a severe head injury. An osmotic diuretic is ordered. Which drug is an osmotic diuretic?

Mannitol (Osmitrol)

The nurse is caring for a client immediately prior to the administration of anesthesia. The nurse knows that what equipment must be available when the anesthesiologist administers vecuronium?

Mechanical ventilation

Which of the following is used to treat acute air flow obstruction? (Choose one)

Metaproterenol (Alupent)

Which anticonvulsant elicits its effects by depressing the motor cortex and creating a higher threshold before nerves react to the convulsive stimuli?

Methsuximide (Celontin)

A female client calls the pediatrician's office for a suggestion regarding the best over-the-counter cough and cold medicine for her 6-month-old child. The pediatrician advises against the medication for what reason?

Misuse could result in overdose.

An 8-year-old child with an acute asthmatic attack is receiving metaproterenol via nebulizer. Which of the following would be most appropriate?

Mix the drug with saline. Metaproterenol is mixed with saline in the nebulizer chamber for administration.

Following a referral from the client's optometrist, a client has been assessed and diagnosed with open-angle glaucoma. When administering the client's subsequent medications, the nurse should prioritize what action?

Monitor the client's potassium levels

A client who has multiple sclerosis has experienced a fall and requires open reduction and internal fixation of a femoral fracture. The anesthesiologist has informed the perioperative nurse that the client will be given a neuromuscular junction (NMJ) blocker to facilitate anesthesia. What is the nurse's best action?

Monitor the client's status before, during, and after surgery as per usual protocol.

The client has been diagnosied with Parkinson's disease and begun on levodopa. What should the nurse include in the care plan? Select all that apply.

Monitor the client's vital signs each shift Monitor the client's urine output each shift Auscultate the client's bowel sounds once per shift Monitor the client's creatinine clearance whenever available

A client with Parkinson's disease is experiencing fewer therapeutic benefits of carbidopa-levodopa in recent weeks so the provider has prescribed selegiline 5 mg PO b.i.d. In addition to assessing for therapeutic effects on the client's Parkinson's symptoms, the nurse should prioritize what assessment?

Monitoring blood pressure

Which statement best reflects the action of NMJ blockers?

Most do not affect pain perception and consciousness.

A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions?

Mucolytic

The nurse is preparing a patient for an endoscopic procedure that will use a nondepolarizing neuromuscular junction (NMJ) blocking agent. Which condition in the patient's history will require a change in anesthetic medication?

Myasthenia gravis

A client has been prescribed a nasal steroid. The client asks the nurse about the infection that the nasal steroid has been prescribed for. What would be an appropriate response by the nurse? Nasal steroids are used only for a sinus infection. Nasal steroids are contraindicated in the presence of an acute infection. Nasal steroids are used for an infection in the adenoids. Nasal steroids are used for all acute upper respiratory infections.

Nasal steroids are contraindicated in the presence of an acute infection.

The client uses his sympathomimetic inhaler frequently. The nurse evaluates the client for which of the following symptoms related to frequent use of the sympathomimetic inhaler?

Nervousness Frequent use of sympathomimetic inhalers can cause nervousness, hypertension, tachycardia, and anxiety.

A client with COPD takes theophylline. The nurse identifies that the client is still experiencing severe dyspnea. Upon review of labs, the theophylline level remains nontherapeutic. The nurse evaluates the client for which of the following drugs that may cause decreased theophylline levels?

Nicotine When combined with nicotine, theophylline levels are decreased. Allopurinol, cimetidine, and corticosteroids can increase theophylline levels.

A client asks the nurse about the cause of idiopathic seizures. What is the nurse's best response?

No known cause

Based on the nurse's understanding of the adverse effects associated with succinylcholine and the development of muscle pain, the nurse would expect what to be used before administering succinylcholine?

Nondepolarizing NMJ blocker

A client with restless leg syndrome is prescribed ropinirole. The nurse identifies this drug as which of the following?

Nonergot dopamine receptor agonist

The nurse is caring for a young adult client in the emergency department (ED) requiring rapid sequence induction and placement on mechanical ventilation. The client has no known allergies; takes no medications, over-the-counter (OTC) drugs, herbals, or alcohol; and has no history of chronic conditions. The nurse administered the prescribed intravenous (IV) succinylcholine. Which best action would the nurse take when the client remains paralyzed 30 minutes after the intubation?

Notify the emergency department health care provider.

Pseudoephedrine (Sudafed) is prescribed for a client suffering from nasal and sinus congestion. What is the most important assessment the nurse should complete before the client leaves the clinic to purchase the medication? Ask about history of hay fever. Observe for swelling in nasal passages. Ask about nausea and vomiting. Obtain the client's blood pressure.

Obtain the client's blood pressure.

A client is prescribed benztropine. The nurse would anticipate administering this drug by which route?

Oral

A patient is prescribed methsuximide. The nurse would expect to administer this drug by which route?

Oral

Which would the nurse expect to administer as a nasal spray?

Oxymetazoline

Which is classified as a decongestant?

Oxymetazoline (Afrin)

The nurse would expect to administer tiludronate to a client with which condition?

Paget disease

A client with Alzheimer's disease and Parkinson's disease has been receiving benztropine since experiencing worsened tremor activity. The client is not verbally communicative and has been experiencing adverse effects of the anticholinergic in recent days. The client is uncharacteristically agitated this morning, so the nurse should perform what assessment for anticholinergic effects?

Palpate the client's bladder and assess urine volume with a bladder scanner

A nurse is caring for a client receiving diuretic therapy for the treatment of ascites due to malignancy. The nurse suspects that the client is developing hypomagnesemia based on which of the following? Select all that apply.

Paresthesias Tachycardia Tremors

A 60-year-old male patient has developed a tremor of the right hand with a pill rolling motion. Upon interviewing the patient, he states he sustained several head injuries playing football. Based on this information, what do you suspect the patient is suffering from?

Parkinson's disease

A nurse is preparing a plan of care for a patient with Parkinson's disease. What is an appropriate goal for this patient's plan of care?

Patient will experience relief of excessive salivation

A patient has been prescribed furosemide (Lasix). Because this drug causes potassium loss, what will the nurse instruct the patient to eat?

Peaches

While reviewing a client's history, an allergy to which of the following would alert the nurse to a possible problem with the use of ipratropium?

Peanuts

Which anticonvulsant elicits its effects by stabilizing the hyperexcitability postsynaptically in the motor cortex of the brain?

Phenytoin (Dilantin)

A patient is being treated for a seizure disorder with phenytoin (Dilantin). He is admitted to the emergency room with sinus bradycardia. What action will occur regarding his antiepileptic agent?

Phenytoin (Dilantin) will be discontinued

A child experiencing edema as a result of a congenital heart defect is prescribed a thiazide diuretic. The nurse should closely monitor which of the client's clinical characteristics? (Select all that apply.)

Potassium level Daily weight Blood pressure Appetite

The nurse is caring for a patient in the Emergency Department (ED) who is in pulmonary edema. The patient is treated with furosemide (Lasix). What should the nurse monitor?

Potassium levels

The pharmacology instructor is discussing the differences among the various diuretic agents. Which would the instructor cite as a difference between spironolactone and hydrochlorothiazide?

Potassium losses are greater with hydrochlorothiazide than with spironolactone.

A nurse is caring for a client who has been prescribed diphenhydramine for the treatment of Parkinson disease in an older adult. The client reports diplopia and blurred vision. Which intervention would be most appropriate?

Provide proper assistance with ambulation.

A nurse is caring for a patient who has been prescribed diphenhydramine for the treatment of allergies. The nurse observes that the patient has developed diplopia and the patient reports blurred vision. What nursing intervention should the nurse perform when caring for this patient?

Provide proper assistance with ambulation.

A client has just begun therapy with furosemide (Lasix). The nurse is instructing the client about the need to consume foods high in potassium in the diet. Which foods should the nurse recommend? Select all that apply.

Prunes Watermelon Lima beans

A patient is advised to take a decongestant drug to relieve nasal congestion associated with hay fever. The patient is not comfortable with a nasal spray or drops and prefers an oral tablet. Which oral decongestant drugs can be administered to the patient? Xylometazoline Pseudoephedrine Ephedrine Tetrahydrozoline

Pseudoephedrine

A patient is advised to take a decongestant drug to relieve nasal congestion associated with hay fever. The patient is not comfortable with a nasal spray or drops and prefers an oral tablet. Which oral decongestant drugs can be administered to the patient?

Pseudoephedrine - hypertensive patients should NOT take this

A female client self-administers pseudoephedrine for relief of her symptoms associated with seasonal allergies. She phones the office reporting restlessness and insomnia. The nurse explains to the client that these are expected side effects of the medication. What is the reason for these side effects? Pseudoephedrine is a stimulant and causes stimulation of the central nervous system. Pseudoephedrine produces a sympathomimetic effect. Pseudoephedrine causes an adverse response in the CNS. Pseudoephedrine causes an anticholinergic response.

Pseudoephedrine produces a sympathomimetic effect.

A female client self-administers pseudoephedrine for relief of her symptoms associated with seasonal allergies. She phones the office reporting restlessness and insomnia. The nurse explains to the client that these are expected side effects of the medication. What is the reason for these side effects? Pseudoephedrine is a stimulant and causes stimulation of the central nervous system. Pseudoephedrine causes an anticholinergic response. Pseudoephedrine causes an adverse response in the CNS. Pseudoephedrine produces a sympathomimetic effect.

Pseudoephedrine produces a sympathomimetic effect.

A client is receiving levodopa as treatment for Parkinson disease. The nurse would instruct the client to avoid foods high in which vitamin to prevent a reduction in the effect of levodopa?

Pyridoxine (vitamin B6)

A nurse should counsel patients receiving levodopa to avoid foods high in which vitamin as it reduces the effect of levodopa?

Pyridoxine (vitamin B6)

A patient has an order for the monoclonal antibody adalimumab (Humira). The nurse notes that the patient does not have a history of cancer. What is another possible reason for administering this drug?

RA

After teaching a male patient who is receiving lamotrigine about possible adverse effects, the nurse determines that the patient has understood the teaching when the patient states that he will notify his health care provider immediately if he develops:

Rash

Dilantin has several side effects. When teaching the patient about these side effects, which symptom would indicate a life-threatening condition and should be reported to the health care provider immediately?

Rash with itching

What is an adverse reaction commonly experienced by people taking nasal decongestants?

Rebound congestion

A male client routinely takes baclofen as a skeletal muscle relaxant for a neuromuscular disorder. His last lab results indicate that he is experiencing renal insufficiency. Based on these data, what would the nurse expect the health care provider to do?

Reduce the dose

While taking the vital signs of a hospitalized client admitted for seizure control due to epilepsy, the nurse notices a bloody toothbrush on the client's bedside table and scattered bruising over the client's extremities. What is the nurse's best action?

Report the findings to the primary health care provider immediately.

A client is describing the following symptoms to a nurse. "I just can't keep my legs still. They always need to be moving and it is keeping me up at night." The nurse knows that what term is used for these symptoms?

Restless leg syndrome

The nurse notices a client is constantly moving the legs while sleeping. The nurse knows that what term is used for these symptoms?

Restless leg syndrome

A male client is diagnosed with chronic bronchitis. What would the nurse expect to be one of his physical reports?

Retention of secretions

The nurse is teaching a client how to prevent Candida infections. Which of the following would the nurse include in the instructions?

Rinse mouth with water after each use.

The nurse is teaching a client how to prevent Candida infections. Which of the following would the nurse include in the instructions?

Rinse mouth with water after each use. The client should be taught to rinse his mouth out with water after using oral inhalers to prevent a Candida oral infection.

A 77-year-old man with a long history of absence seizures has been treated with ethosuximide for many years. The man is now in the process of moving to a long-term care facility and a nurse is creating a plan of care. The nurse understands the potential adverse effects of this drug and would consequently prioritize which nursing diagnoses?

Risk for Falls

A 40-year-old client with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing diagnosis should the nurse prioritize for the nursing care plan for this client?

Risk for Injury related to CNS depressant effects

A 29-year-old client who experienced a lower back injury has seen his range of motion decrease and his pain increase over the past several weeks. As a result, he has been prescribed cyclobenzaprine. What nursing diagnosis should the nurse prioritize in light of the client's drug regimen?

Risk for Injury related to CNS depression

Which nursing diagnosis would be most important for a nurse to include in the plan of care for a patient who is receiving an anti-seizure agent and experiencing orthostatic hypotension?

Risk for injury

The nurse is evaluating the education of a client that uses albuterol for an acute asthma attack. The nurse knows that the lesson has been effective when the client states that albuterol is which of the following types of medication?

SABA

A female client presents to the emergency department with acutely deteriorating asthma. Her husband shows the nurse salmeterol when the nurse asks what medications his wife takes at home. He then tells the nurse that he gave her three extra puffs when she became ill. What statement is correct in this situation?

Salmeterol is contraindicated based on his wife's condition. The FDA has issued a black box warning that initiating salmeterol in people with significantly worsening or acutely deteriorating asthma may be life threatening.

The Client is a 54-year-old client who has been prescribed selegiline (Eldepryl), an MAOI. The nurse is providing client teaching about this medication. Which statement by the client would indicate the need for additional teaching?

Selegiline will increase the breakdown of dopamine in the tissues.

A nurse is teaching a patient about phenytoin (Dilantin), his newly prescribed drug for a seizure disorder. Which will the nurse alert the patient to as a serious adverse effect of this drug?

Skin rash

A 15-year-old patient is prescribed an antihistamine for allergic rhinitis. However, antihistamines used to treat allergic reactions may themselves cause allergy. The nurse needs to educate the patient to be aware of symptoms suggesting allergy. Which of the following is an allergic reaction to antihistamines? Dryness of mouth Drowsiness and sedation Skin rash and urticaria Disturbed coordination

Skin rash and urticaria

When describing the action of mast cell stabilizers, which of the following would the nurse include as being inhibited?

Slow-reacting substance of anaphylaxis

You are teaching a patient newly diagnosed with asthma how to manage his disease. What should you encourage this patient to stop doing?

Smoking cigarettes

Cough syrups serve as vehicles for antitussive drugs and also may exert antitussive effects of their own by doing what?

Soothing irritated pharyngeal mucosa

The nurse is planning patient education for a patient on antiseizure medications. The nurse should inform the patient that abrupt withdrawal from the medications can precipitate which problem?

Status epilepticus

The nurse is providing patient education for a patient newly prescribed antiseizure medications. What would the nurse be sure to teach the patient that abrupt withdrawal of antiseizure agents may precipitate?

Status epilepticus

Xanthine derivatives elicit their effect by which of the following mechanisms? (Choose one)

Stimulation of the central nervous system Stimulation of the central nervous system is the mechanism of action for xanthine derivatives.

A patient is using an albuterol (Proventil) inhaler, which is a bronchodilator. Which of the following patient teaching interventions is important for the patient who is experiencing shortness of breath related to constriction of airways?

Stop smoking due to the bronchoconstriction

A 6-year-old child has been brought to the emergency department in apparent status asthmaticus. The care team recognizes the need to intubate the client, who is inconsolably agitated. The nurse should anticipate a STAT prescription for what medication?

Succinylcholine

A nurse is monitoring a client closely for malignant hyperthermia because the client received which NMJ blocker?

Succinylcholine

A patient that has a history of glaucoma is to receive a NMJ blocker. Which agent would the nurse identify as being most problematic for this patient?

Succinylcholine

A surgical client is receiving a neuromuscular junction (NMJ) blocker. The nurse knows that the client cannot move because the client's acetylcholine receptor sites have been stimulated and the drug is remaining in the receptor sites, preventing repolarization. What medication is this client receiving?

Succinylcholine

Which agent would be associated with increased intraocular pressure?

Succinylcholine

Which neuromuscular blocking agent would a nurse expect to have the shortest duration of action?

Succinylcholine

When antihistamines result in dryness of the mouth, the nurse should recommend which actions to relieve the dryness? Select all that apply. Suck on sugarless hard candy. Administer intravenous fluid bolus. Offer ice chips. Take frequent sips of water. Use a dehumidifier in the home.

Suck on sugarless hard candy. Offer ice chips. Take frequent sips of water.

Clients taking levodopa should avoid what due to their ability to increase dopa decarboxylase action?

Supplemental vitamins

An instructor is describing topical decongestants as belonging to which class?

Sympathomimetics

A patient is started on albuterol (Proventil). What reaction should the patient be instructed on?

Tachycardia will occur. The symptoms of cardiac stimulation, including tachycardia, are noted with the administration of albuterol. The patient will not experience polydipsia, hypotension, or diarrhea.

What is the nurse's initial action after witnessing a seizure?

Take and document the vital signs of the client.

A nurse is assigned the responsibility of preparing a teaching plan for a patient on oxazolidinedione therapy. What should the nurse include in the teaching plan? Select all that apply.

Take protective measures, such as wearing sunscreens and protective clothing Due to risk of birth defects while taking trimethadione, notify primary healthcare provider immediately if pregnancy is suspected Notify primary healthcare provider if excessive drowsiness or dizziness occur

The nurse is teaching a client newly-diagnosed with Parkinson's disease about the appropriate use of levodopa-carbidopa (Sinemet). What should the nurse teach the client?

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

A 62-year-old client has been prescribed an antihistamine to alleviate vasomotor rhinitis. The client reports gastric irritation after taking the tablet. Which instructions should the nurse provide to help alleviate the client's condition? Drink ample water before taking the tablet. Take an antacid before the tablet. Take the tablet with food. Take the tablet one hour before food.

Take the tablet with food.

A client began taking hydrochlorothiazide one week ago and is reporting occasional dizziness when she stands up quickly from sitting or lying. What is the nurse's best action?

Teach the client about the blood pressure effects of the medication and relevant safety measures

For which assessment finding will the nurse intervene first when providing postoperative care to a patient who returned to the nursing unit 2 hours after receiving succinylcholine (Anectine)?

Temperature 40 degrees C (104 degrees F)

The operating room nurse has performed an assessment of a preoperative client and the client reports a family history of malignant hyperthermia. The nurse has confirmed with the anesthesiologist that this has been identified. The nurse should anticipate what consequence of this for the client's intraoperative care?

The anesthesiologist will exercise caution when giving the client neuromuscular junction blockers

The nurse is caring for a client who requires surgery following multiple trauma and internal bleeding from a motor vehicle accident. What aspect of this client's health status would contraindicate the use of succinylcholine during surgery?

The client has multiple bone fractures

When reviewing the medical record of a client who is to receive dantrolene, which condition would alert the nurse to the need for close monitoring?

The client has respiratory depression from opioid analgesia

A client with Parkinson's disease began treatment with dopaminergics two weeks ago and has now presented for a follow-up assessment. What finding best suggests to the nurse that the treatment is having a therapeutic effect?

The client is able to walk more briskly and stably than two weeks ago

The nurse is collaborating with the anesthetist in the assessment of a client who will soon receive succinylcholine to induce paralysis. What characteristic of this client creates a risk for prolonged paralysis and delayed return of muscle function?

The client is an Alaskan Eskimo

A client is scheduled for surgery, and it is planned that the client will receive pancuronium as an adjunct to general anesthesia. What should the nurse teach the client about this medication?

The client will be unable to move approximately five minutes after receiving the drug.

An adult client with a diagnosis of hypertension has been prescribed oral furosemide. What goal should the nurse identify when planning this client's medication teaching session?

The client will identify strategies for limiting sodium intake.

Entacapone has been recently added to the medication regimen of a client with Parkinson's disease. The nurse should recognize what likely rationale for this change in medication regimen?

The client's Sinemet was likely less effective than in the past Entacapone is an adjunctive agent used to treat Parkinson's disease. It is used with levodopa-carbidopa for clients who are experiencing "wearing off" of drug effects.

Which best reflects the rationale for administering levodopa with carbidopa?

The combination allows a lower dose of levodopa to be used to be effective.

The nurse can determine that the client taking uric acid inhibitors is drinking enough fluids when which of the following occurs?

The daily urine output is about two liters. Explanation: When taking uric acid inhibitors, the client should drink about 3000 mL per day, and the daily urine output should be about two liters. The client's weekly weight and lip condition are not the best assessments to evaluate adequate fluid intake (prevention of urate stone formation); they are acceptable methods to assess for dehydration.

A client is to receive a nondepolarizing NMJ blocker. The client also takes a calcium channel blocker. Which would most likely occur?

The dosage of the NMJ blocker will be less.

After teaching a group of students about inhaled steroids, the instructor determines that the teaching was successful when the students state which of the following?

The drugs are not for use during an acute attack.

A patient is prescribed topiramate. The nurse cautions the patient to avoid the intake of alcohol for which reason?

The patient is at risk for increased CNS depression.

A man who smokes one pack of cigarettes daily has been diagnosed with chronic bronchitis. He has been prescribed theophylline by his family doctor. What effect will the patient's smoking status have on the therapeutic use of theophylline?

The patient may require higher doses of theophylline than a nonsmoker Smoking cigarettes may decrease serum theophylline levels. In fact, some patients who smoke require an increase in theophylline dosage of up to 50%.

A client has been diagnosed with Parkinson's disease and the nurse is providing health education. The client asks the nurse, "Why can't I take a dopamine pill if that's what is lacking?" When responding, the nurse should address what topic? The structure and function of the blood-brain barrier The role of acetylcholinesterase The functioning of the sodium-potassium pump The differences in anatomy and physiology between the central nervous system and the peripheral nervous system

The structure and function of the blood-brain barrier Explanation: Dopamine cannot cross the blood-brain barrier, so exogenous supplements would have no therapeutic benefit. This is unrelated to the functions of acetylcholinesterase, sodium-potassium pumps or the CNS and PNS.

What statement best describes how the common cold is effected by and managed using medication therapy?

The tendencies to overmedicate and use antibiotics inappropriately with the common cold are widespread and pose significant risk for complications and drug resistance.

A client was using nicotine patch to stop smoking when he was started on theophylline for emphysema. He has successfully stop smoking and has stopped using his nicotine patch. Which of following would be warranted? (Choose one)

Theophylline dose should be decreased

A client was using nicotine patch to stop smoking when he was started on theophylline for emphysema. He has successfully stop smoking and has stopped using his nicotine patch. Which of following would be warranted? (Choose one)

Theophylline dose should be decreased Nicotine decreases theophylline levels. If a client is no longer using nicotine his/her theophylline levels will increase warranting a decrease in theophylline dose.

A 52-year-old male client is being treated for Parkinson's disease. The nurse is aware that Parkinson's disease results in muscle rigidity, tremor at rest, and postural instability. What occurs in the neurons that causes these symptoms?

There is an imbalance between dopamine and acetylcholine.

A 52-year-old male client is being treated for Parkinson's disease. The nurse is aware that Parkinson's disease results in several physical manifestations. What occurs in the neurons that causes these symptoms?

There is an imbalance between dopamine and acetylcholine.

Why would potassium-sparing diuretics be contraindicated for clients experiencing renal failure?

They may cause hyperkalemia.

A 27-year-old client has a history of frequent bladder infections. Which classification of diuretic would be contraindicated for this client?

Thiazide diuretics

A nurse obtains an allergy history from a client based on the understanding that which class is associated with a cross-sensitivity reaction with sulfonamides?

Thiazide diuretics

The nurse is caring for a client who has just been diagnosed with essential hypertension. The nurse should expect to administer what classification of diuretics as first-line therapy?

Thiazide diuretics

Expectorants elicit their effect by which mechanism?

Thinning respiratory secretions

A male patient is to begin treatment for pneumonia with an albuterol (Ventolin) inhaler. The nurse will advise the patient that he will most likely experience which of the following common adverse effects of the drug?

Throat irritation

A nurse is explaining about the diuretic the patient has just been ordered. Why would the nurse tell the patient to drink 8 to 10 glasses of water daily (unless it is counterindicated)?

To avoid rebound edema

A patient taking lamotrigine (Lamictal) for the past two weeks calls the clinic and reports to the nurse that she has developed a rash. What should the nurse tell her to do?

To discontinue the drug and return to the clinic

The mother of a child newly diagnosed with resistant epilepsy asks the nurse why two AEDs have been prescribed for her daughter. What would be the nurse's best answer?

To minimize seizures in resistant epilepsy

The nurse is providing discharge instructions to a 72-year-old patient who has been discharged home on a diuretic. What would the patient's instructions regarding the use of a diuretic at home include?

To weigh themselves on the same scale, at the same time of day, in the same clothing

A patient visits the clinic and is diagnosed with acute sinusitis. To promote sinus drainage what medication might be ordered?

Topical decongestants

A nurse is teaching a nursing student about loop diuretics. What drugs would the nurse include? Select all that apply.

Torsemide Ethacrynic acid Bumetanide

A nurse is performing a neuromuscular assessment on a client whose Parkinson's disease is being treated with medication. The nurse expects to see which symptom while performing the assessment? (Select all that apply.)

Tremors Drooling Monotone speech pattern Mask-like facial expression

A therapeutic theophylline level ranges from 10 to 20 mcg/mL.

True

Cromolyn should not be used during an acute asthmatic attack.

True

Leukotriene receptor antagonists are administered orally.

True

Levodopa is used as treatment for Parkinson's disease primarily acting as a replacement neurotransmitter.

True

Nondepolarizing NMJ blockers act as antagonists to acetylcholine at the neuromuscular junction.

True

Nondepolarizing NMJ blockers are metabolized in the serum.

True

When nondepolarizing NMJ blockers are given, histamine is also released, causing wheezing and bronchospasm.

True

A patient, newly diagnosed with Parkinson's disease, has been prescribed an anticholinergic drug. What is a common adverse effect of anticholinergic agents used for the treatment of Parkinson's disease?

Urinary retention

A patient is being assessed by the home care nurse on the administration of the inhalers. Which of the following will assist in proper administration of the inhaler?

Use of a spacer

A patient is being assessed by the home care nurse on theadministration of the inhalers. Which of the following will assist in proper administration of the inhaler?

Use of a spacer

A client is diagnosed with a viral upper respiratory tract infection. Which of the following is appropriate treatment for the client? Select all that apply:

Use of comfort measures. Increase of fluid intake. Use of antitussive for nonproductive cough.

A client is diagnosed with a viral upper respiratory tract infection. Which of the following is appropriate treatment for the client? Select all that apply: Administration of an antibiotic. Use of comfort measures. Decrease of fluid intake. Increase of fluid intake. Use of antitussive for nonproductive cough.

Use of comfort measures. Increase of fluid intake. Use of antitussive for nonproductive cough.

Which anticonvulsant elicits its effects by increasing levels of gamma-aminobutyric acid (GABA), which stabilizes cell membranes?

Valproic acid (Depakote)

When describing the action of decongestants, a nurse integrates knowledge of this class of drugs, identifying which mechanism?

Vasoconstriction of small blood vessels of the nasal membranes

A nurse knows that patients with a history of cardiac disorders are at greatest risk for hypotension and dysrhythmias if given which neuromuscular junction (NMJ) blocking agent?

Vecuronium (Norcuron)

A nurse is providing care to a client who is to receive acetazolamide for epilepsy. Before administering this drug, the nurse would assess which of the following?

Vital signs and weight

A patient is taking levodopa. What would the nurse caution the patient to avoid?

Vitamin B6

A patient has been prescribed an anticholinergic agent for treatment of Parkinson-related symptoms. What patient education should be provided?

Void before taking the medication.

A patient with glaucoma has been prescribed acetazolamide (Diamox). What adverse effects would the nurse caution the patient about? (Mark all that apply.)

Weakness Rash Anorexia

A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which instruction?

Wear appropriate clothing and sunscreen whenever he is in direct sunlight

A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which instruction?

Wear appropriate clothing and sunscreen whenever he is in direct sunlight.

A hospital client demonstrating peripheral edema has been prescribed furosemide. How should the nurse best determine the extent of the client's desired fluid loss?

Weigh the client daily.

The health care provider orders short-term skeletal muscle relaxants for an 11-year-old client. The nurse is responsible for the family education plan and teaches the parents that the medications should be used only under which condition?

When close supervision is available for monitoring drug effects

The physician orders short-term skeletal muscle relaxants for an 11-year-old client. The nurse is responsible for the family education plan and teaches the parents that the medications should be used only under which condition?

When close supervision is available for monitoring drug effects

A patient, newly diagnosed with a seizure disorder, asks the nurse why they are receiving a specific drug. What would be the best answer by the nurse?

When prescribing an AED, the physician takes into account the type of seizure the patient is having.

After teaching a group of students about drugs as bronchodilators, the instructor determines that the teaching has been successful when the students identify which group of drugs as once being first-line agents?

Xanthines

A patient is experiencing an acute asthma attack. What is the first-line therapy for relief of an acute asthma attack?

You selected: Beta2-adrenergic agonist

When educating a group of students on the mechanism of action of various anti-asthma drugs, the nurse identifies which of the following drugs as inhibiting the formation of leukotriene?

Zileuton Zileuton acts by inhibiting the formation of leukotriene.

A client with diagnoses of Parkinson's disease and hepatic disease is to begin tolcapone therapy. What monitoring intervention should be included in the client's plan of care?

a baseline liver function test

The nursing instructor is discussing over-the-counter cold remedies. According to the instructor, these products typically combine

a decongestant, an analgesic, and an antihistamine.

The client with bilateral pneumonia has been prescribed a mucolytic. The nurse correctly identifies a mucolytic as having which action?

a drug that breaks down thick, tenacious mucus in the lower portions of the lungs

a nurse is caring for a client who has been prescribed alendronate for the treatment of postmenopausal osteoporosis. the client informs the nurse that she is also taking antacids for the relief of gastric upset. based on the nurse's knowledge about both drugs, which effect would the nurse anticipate a) decreased effectiveness of alendronate b) increased risk of hypotension c) increased risk of hypoglycemia d) decreased effectiveness of antacids

a) decreased effectiveness of alendronate The nurse should anticipate decreased effectiveness of alendronate in the client due to the interaction between alendronate and antacids. The client should be advised to take alendronate and antacids at different times to promote the therapeutic effects of both medications. Increased risk of hypoglycemia is the effect of the interaction of a uric acid inhibitor with aluminum-based antacids and tolbutamide. Decreased effectiveness of antacids is not the effect associated with the interaction of alendronate and antacids. Increased risk of hypotension is the effect of the interaction of skeletal muscle relaxants with tizanidine.

a client reports that he uses an herbal product to treat his osteoarthritis. which of the following would the nurse most likely expect the client to use a) glucosamine b) kava c) valerian root d) cinnamon

a) glucosamine Glucosamine and chondroitin are herbal products a client might use to treat osteoarthritis. Kava is used in the treatment of anxiety, restlessness, and stress. Valerian root has been used for the treatment of insomnia and anxiety. Cinnamon is known to lower cholesterol, blood sugar, and helps relieve arthritis pain.

The client states that he/she once needed medication to liquefy secretions in the respiratory tract. However, the client cannot recall the name of the medication but states that the medication is added to a nebulizer. The nurse suspects the client is taking which medication?

acetylcysteine

A client has been started on cyclobenzaprine. For the duration of treatment with cyclobenzaprine, the nurse should teach the client to eliminate:

alcohol

A client was diagnosed with Parkinson's disease and the client's provider prescribed levodopa 400 mg PO b.i.d. The client has experienced a reduction in tremors and an improvement in gait but is having significant adverse effects. Consequently, the client's medication has been changed to Sinemet. When educating the client, the nurse should explain that this drug:

allows the client to benefit from levodopa while taking a lower dose.

An older adult client diagnosed with Parkinson's disease will soon begin treatment with levodopa, carbidopa, and entacapone. Prior to starting this course of treatment, the nurse must ensure the implementation of which intervention to ensure adequate function of which organ system?

assess renal function

A female client reports that her seizure was preceded by a brief warning, which she describes as an unusual smell. This is known as a(n):

aura.

When providing medication teaching about to a client prescribed spironolactone, what foods should the client be instructed to avoid?

bananas

An elderly client with a history of heart failure has presented to the emergency department in respiratory distress. Assessment reveals the presence of pulmonary edema, and an infusion of IV furosemide has been prescribed. For the duration of treatment, the nurse should prioritize assessments related to which expected age-related dysfunctions? Select all that apply.

cardiac function renal function hepatic function

The symptoms of parkinsonism are caused by the depletion of dopamine in the:

central nervous system.

A client has a diagnosis of Parkinson disease, and the health care provider will prescribe carbidopa-levodopa. Before drug therapy, the client should be carefully assessed for the presence of:

closed-angle glaucoma.

A patient has a diagnosis of Parkinson disease, and the physician will prescribe carbidopa-levodopa. Before drug therapy, the patient should be carefully assessed for the presence of

closed-angle glaucoma.

When reviewing the history of a patient who is to receive succinylcholine, the nurse would expect a prolonged drug action if the patient has a history of:

collagen disease

A 72-year-old man should be aware that the adverse effects of centrally acting anticholinergic drugs include:

confusion.

A surgical client has developed malignant hyperthermia. Which medication can be used to treat this health emergency?

dantrolene

What intervention should be included in the care plan of a client experiencing excessive respiratory tract secretions?

deep breathing and coughing exercises

The nurse is presenting an educational event to a local community group on Parkinson's disease. The nurse would tell the attendees that classic Parkinson's disease is probably a result of:

degeneration of dopamine-producing nerve cells.

A nurse is teaching a group of student nurses about Parkinson's disease. The nurse would teach the students that people with Parkinson's disease have an imbalance in:

dopamine and acetylcholine.

What adverse effect of most oral antihistamines presents a priority safety concern for older adult clients? Drowsiness Dry mouth Nasal burning Nonproductive cough

drowsiness

When developing a teaching plan for a client who is to receive carisoprodol, which sign or symptom would the nurse include as the most common adverse reaction?

drowsiness

Which adverse effect should the nurse assess for when administering cyclobenzaprine?

drowsiness

Common side effects of anticholinergics include:

dry mouth, urinary retention, constipation, and increased pulse rate.

A 49-year-old client reports frequent muscle cramps while on hydrochlorothiazide therapy. The nurse would advise the client to do which?

eat potassium-rich foods.

A client with a known cardiac history is being prepared for surgery. Safe use of neuromuscular junction blockers can be best promoted by:

ensuring the client does not take his prescribed amlodopine in the days before surgery.

The patient has serum drug levels of AEDs ordered. The patient asks the nurse what the rationale for drawing serum drug levels of AEDs is. The nurse answers that it is to:

evaluate therapeutic effectiveness.

A common cause of seizures for a client in late infancy to early childhood is:

fever.

The therapeutic goals for use of anticholinergic drugs in the treatment for parkinsonism is to decrease what symptomology? Select all that apply. dry mouth fine tremors muscle spasticity salivation urinary retention

fine tremors salivation muscle spasticity Explanation: Anticholinergic drugs are used in idiopathic parkinsonism to decrease salivation, spasticity, and tremors. The therapy would cause dry mouth and urinary retention.

Which diuretic will most likely be the initial drug of choice when a client demonstrates dyspnea related to pulmonary edema?

furosemide

A nurse is providing education to a 56-year-old man who is admitted to the emergency department with an acute asthma attack. The nurse's initial assessment reveals that the patient has a history of pneumonia, drinks large quantities of coffee, and eats a high-calorie diet. Albuterol is prescribed for him. The important consideration when the nurse is preparing a teaching plan will be that the patient

has a high coffee intake. Caffeine has sympathomimetic effects that may increase the risk for adverse effects with albuterol.

A hospital client with a diagnosis of liver failure has been prescribed a low dose of spironolactone in order to treat ascites. The nurse who is providing this client's care should prioritize assessments for the signs and symptoms of what health problem?

hepatic encephalopathy

When prescribed dantrolene, what is the most serious adverse effect the client should be instructed about?

hepatitis

A 68-year-old patient, an insulin-dependent diabetic, is to receive hydrochlorothiazide (HydroDIURIL). Prior to administering the dose, the nurse should inform the patient that:

her insulin dose may need to be increased.

The nursing instructor is teaching students about the administration of nasal sprays. According to the instructor, the correct patient position for administering the sprays is closest to

high Fowler's position.

An older adult client has a complex medical history that includes heart failure, type 1 diabetes, and diabetic nephropathy. The nurse has questioned a care provider's prescription for oral spironolactone because the client's health problems would contribute to a high risk of which adverse reaction?

hyperkalemia

Which adverse effect of muscle relaxants is most pronounced when a client is prescribed tizanidine therapy? eczema dark black urine excessive salivation hypotension

hypotension Hypotension is the most significant adverse effect of tizanidine. Dark black urine, excessive salivation, and eczema are not adverse effects of tizanidine.

A nurse is working with a 39-year-old client who is experiencing muscle spasms associated with multiple sclerosis. The client reports needing help with basic care The client's health care provider has prescribed baclofen (Lioresal). The nurse and the client agree that an appropriate goal related to helping to maintain self-worth would be to: take medication independently. experience improved motor function. increase self-care in activities of daily living. experience relief of pain.

increase self-care in activities of daily living Explanation: All of the options are goals that the nurse would like the client to achieve. However, the goal related to self-worth would be to increase self-care in activities of daily living. Loss of ability to dress oneself puts the client at risk for decreased self-esteem and feelings of low self-worth.

A nurse notes that a newly admitted client is currently prescribed both a loop diuretic as well as a thiazide diuretic. The nurse understands what primary rationale for the concurrent use of these two drugs?

increased diuretic effect

A health care provider has prescribed triamterene to a male client with renal disease. The client informs the nurse that he is taking potassium supplements to address some heart problems. The nurse would be alert for:

increased risk of hyperkalemia.

Which nursing diagnosis would provide the clearest indication for the administration of inhaled acetylcysteine?

ineffective airway clearance

A nurse is educating a client who has Parkinson's disease and family regarding possible adverse effects of carbidopa-levodopa. The nurse emphasizes which should be a closely monitored effect?

involuntary movements.

A nurse is educating a patient who has Parkinson's disease and her husband about the possible adverse effects of carbidopa-levodopa. The nurse should emphasize the need for the patient and her husband to monitor for any sudden increase in:

involuntary movements.

For a client diagnosed with both Parkinson's and narrow-angle glaucoma, what medication should cause the nurse concern?

levodopa Because levodopa can dilate pupils and raise intraocular pressure, it is contraindicated in narrow-angle glaucoma. The other listed medications are not necessarily contraindicated.

A client whose Parkinson's disease is being treated with tolcapone should concurrently take what drug?

levodopa/carbidopa

The client has been diagnosed with Parkinson's diesease. The nurse that cares for this client knows that the pathophysiology behind this disease is which?

loss of neurons in the substantia nigra.

A patient will be undergoing surgery, during which the anesthesiologist plans to administer vecuronium. The nurse will recognize that the administration of this drug creates a need for:

mechanical ventilation

A client who diagnosed with Parkinson's disease is being treated with levodopa/carbidopa. Which disorder will result in the discontinuation of this drug based on a disease-related contraindication?

narrow-angle glaucoma

A new patient has been prescribed an anticholinergic drug for their Parkinson's disease. Anticholinergic drugs are used primarily in people who have:

no longer a response to levodopa.

A client is unconscious and experiencing increasing intracranial pressure. What type of diuretic will the client most likely be prescribed?

osmotic diuretic

While providing patient education for a patient newly diagnosed with Parkinson's disease and their family, the nurse would explain that Parkinson's disease is characterized by

postural instability.

Adverse effects of dantrolene (Dantrium) include:

potentially fatal hepatitis.

An adult client with multiple chronic health problems has been prescribed furosemide in the management of hypertension. When reviewing this client's current medication administration record, what drug should signal the nurse to a potentially increased risk of hypokalemia?

prednisonev

an adverse effect of chondroitin

raises bp

A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his "puffers". In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to

rebound bronchoconstriction. Patients who self-administer albuterol may use their MDIs more frequently than recommended.

A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his "puffers". In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to

rebound bronchoconstriction. Patients who self-administer albuterol may use their MDIs morefrequently than recommended. This practice can result in rebound bronchoconstriction,

A client reports experiencing severe nasal congestion since starting to use an over-the-counter (OTC) nasal decongestant spray a week ago. This symptomology most supports what possible medical condition?

rebound congestion, Nasal decongestants are rapidly effective because they come into direct contact with nasal mucosa. However, if used longer than the recommended 3 days or in excessive amounts, these products may produce rebound nasal congestion that result from the irritation and swelling of the nasal mucosa.

A 71-year-old patient with a history of depression will be receiving vecuronium to prevent trauma during electroconvulsive therapy. Prior to the procedure, the care team must assess the patient's:

renal and hepatic status

A client will undergo an endoscopy with conscious sedation using midazolam. The nurse who is participating in this procedure should monitor the client closely for which sign of adverse reaction?

respiratory depression

The three major features of Parkinson's include:

rigidity, bradykinesia, and tremors.

A 76-year-old man with a history of heart disease has been prescribed an oral decongestant. The nurse is concerned with this prescription because of the risk for serious cardiovascular effects. increased salivation and choking. severe constipation. insomnia.

serious cardiovascular effects.

An elderly client's compromised nutritional status has necessitated the use of a nutritional formula. When reviewing this client's laboratory findings, the nurse should prioritize which value?

serum albumin

A 26-year-old woman has been prescribed the suspension form of phenytoin. The nurse will inform the patient that she should

shake the phenytoin suspension before pouring and measuring the dose.

The nurse is caring for a 26-year-old woman with partial seizures. The nurse has been prescribed oxcarbazepine (Trileptal) as monotherapy. It will be critical for the nurse to inform the patient that:

since she is taking oral contraceptives, she will need to use an additional form of birth control.

The nurse is listening to the respiratory therapist teaching a client about the proper use of respiratory equipment for administration of drugs such as expectorants and mucolytics when they are discharged home. The nurse knows the therapist will inform the client that the best position to do this is which?

sitting or in high Fowler's position

The FDA has issued a BLACK BOX WARNING for clients taking lamotrigine (Lamictal), instructing them to discontinue the medication immediately if they develop:

skin rashes.

What substance is reabsorbed in the ascending limb of the loop of Henle?

sodium

The seizure type that is characterized by generalized tonic-clonic convulsions lasting for several minutes during which the client does not regain consciousness is known as:

status epilepticus.

A 43-year-old man is taking pseudoephedrine (Sudafed) for sinusitis. He calls the clinic to report that it feels like his heart is racing and that he can "feel his heart beating fast." The nurse will instruct him to:

stop taking the medication and come to the clinic as ordered by the health care provider. Cardiovascular adverse effects such as palpitations, tachycardia, hypertension, and arrhythmias are possible with the administration of pseudoephedrine (Sudafed). If the client reports palpitations and tachycardia, the nurse should instruct him to stop the medication and come in to see his provider. This drug produces sympathomimetic effects and could aggravate any existing cardiovascular issues.

How is adalimumab administered?

subcutaneously 40 mg every other week

What assessment should the nurse make before administering the first dose of hydrochlorothiazide?

sulfonamide allergy

A patient is taking ethosuximide (Zarontin) for absence seizures. The client reports GI upset associated with the drug. The nurse will encourage the patient to:

take the drug with food.

A client reports gastrointestinal (GI) upset when taking phenytoin (Dilantin). The nurse should tell the client to:

take the medication with meals.

A client is about to undergo endoscopy and the nurse is describing the use of a neuromuscular junction blocker to the client, who has asked for detail on the procedure. When providing education to the client, the nurse should describe:

the role of acetylcholine in muscle stimulation.

A nurse is caring for a patient who is receiving mannitol. The nurse should be aware that the ongoing mannitol administration should be withheld if

the urine output is less than 30 mL/hour after the test dose.

Spinal reflexes are the simplest nerve pathways that monitor movement and posture.

true

A home health nurse is visiting an elderly patient with Parkinson's disease. The nurse should assess this client for:

urinary retention.

An adolescent taking oral contraceptives has been prescribed an anticonvulsant medication. The nurse should tell the client to:

use another form of birth control, such as condoms.

What instructions should a patient scheduled to have a procedure using the neuromuscular junction (NMJ) blocking agent succinylcholine (Anectine) receive? Select all that apply.

• "You may take aspirin for muscle aches after the procedure." • "Tell your primary care physician if you have glaucoma." • "You will not be able to move."

For which patients is use of the nondepolarizing neuromuscular junction (NMJ) blocking agent succinylcholine (Anectine) contraindicated? (Select all that apply.)

• A 19-year-old with a spinal cord injury • A 43-year-old with myasthenia gravis • A 72-year-old with a hip fracture

Tom, age 42, is prescribed ipratropium bromide as an anticholinergic agent for treating asthma. As the nurse caring for Tom, you need to develop a plan of care. What must be included in the plan? (Choose all that apply.)

• Advise the patient to avoid using ipratropium if allergic to soybeans, legumes, or soya lecithin. • Remind the patient that ipratropium must be taken daily, despite the absence of symptoms of asthma.

With theophylline, the home care nurse needs to assess the client and the environment for certain products that can cause what to occur? (Select all that apply.)

• Affect metabolism of theophylline • Decrease therapeutic effects • Increase adverse effects

A 5-year-old boy is brought to the ED with an asthma exacerbation, including wheezing (a high-pitched, whistling sound caused by turbulent airflow through an obstructed airway). Those who have asthma chronically present with what signs, even when they may appear symptom free? Select all that apply.

• Airway inflammation • Damaged airway mucosa

Which of the following would the nurse include as possible adverse effects when teaching a patient about albuterol? Select all that apply.

• Bronchospasm • Nervousness • Sweating

Which conditions place a patient receiving succinylcholine (Anectine) at high risk for prolonged paralysis after surgery? (Select all that apply.)

• Burns • Cancer • Thyrotoxicosis

The nurse should complete which of the following during acute breathing distress before initiation of a broncodilator? Select all that apply:

• Check blood pressure. • Check respiratory rate • Check pulse.

A client with gout is receiving allopurinol as part of the treatment plan. Which instruction would the nurse include in the teaching plan for this client? Select all that apply.

• Drinking at least 3 L of fluid per day • Taking the drug with meals • Reporting any evidence of skin rash

The nurse is caring for a client diagnosed with gout. The client is prescribed colchicine and allopurinol. The nurse should perform which assessments? Select all that apply.

• During acute gout attack assess every hour before administering colchicine for improvement of affected joints. • Assess intake and output to ensure at least 2 liters of non-caffeinated fluid intake and at least 3 liters of urine output in 24 hours. • Assess for development of a red rash, hold allopurinol and report it immediately to primary care provider for further orders. • Assess for pain in back, abdomen, or groin, hematuria, and pain upon urination, and presence of fever.

Your patient, a 27-year-old athlete with newly diagnosed asthma, presents at your office for patient education regarding situations that could precipitate an asthma attack. Your teaching includes that acute episodes of asthma may last minutes to hours. In your teaching, which of the following precipitants do you state may cause the asthma? Select all that apply.

• Exercise • Allergens • Pollutants

A patient, diagnosed with asthma, has been prescribed tiotropium. What should the nurse know about tiotropium? (Mark all that apply.)

• It is an anticholinergic • You only need to take it once a day • It has a rapid onset of action and a long duration

Which of the following would be most important to assess before administering calfactant? (Select all that apply.)

• Lung sounds • Oxygen saturation levels • Endotracheal tube placement

After teaching a group of students about zafirlukast, the students demonstrate understanding when they identify which of the following as possible adverse effects? Select all that apply.

• Myalgia • Dizziness • Vomiting

A history of an allergy to which of the following would be a contraindication to the use of anticholinergics? Select all that apply.

• Soy • Peanuts

The client is 73 years of age and has a history of coronary artery disease and COPD. She is being started on formoterol (Foradil). The nurse would assess the client for which of the following conditions? Select all that apply.

• Tachycardia • Hypertension

In children, high doses of nebulized albuterol have been associated with what conditions? (Select all that apply.)

• Tachycardia • Hypokalemia • Hyperglycemia

A client will be having surgery imminently and the nurse is aware that the client's anesthesia will be accompanied by the use of a neuromuscular junction (NMJ) blocker. The nurse should anticipate and ensure what assessments and interventions? Select all that apply.

• mechanical ventilation • insertion of an endotracheal tube • continuous cardiopulmonary monitoring