NUR 308 Chapter 21, 24, 25, 44, Ch 25 ttteeer

A client with muscular dystrophy has recently begun taking dantolene for the treatment of muscle spasms. When assessing for adverse effects, what assessment questions should the nurse include? Select all that apply.

"Do you find that the medication gives you an upset stomach?" "Are you getting any sudden or frequent urges to urinate?" "Have you experienced any new or unusual aches and pains since starting the medication?"

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

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

A client sustained a severe laceration to the right thumb and index finger that will require local anesthetic to facilitate suturing. Which statement should prompt the nurse to provide further client health education?

"I'm feeling pretty queasy about getting stitches, so I'm glad they'll be knocking me out."

The nurse is educating an adult male client diagnosed with erectile dysfunction about the prescribed sildenafil. Which statement made by the client establishes the need for further clarification?

"If I eat a fatty meal I will need to take two pills instead of one, so the drug will take effect faster."

A male clent has been diagnosed with impotence and is started on a regimen of androgens. Which statement by the client indicates that he has understood the teaching?

"If my skin appears yellow or my urine turns dark, I will contact my health care provider."

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 safest if you avoid drinking alcohol while you're taking this drug."

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 50-year-old woman has begun taking baclofen to treat her recently diagnosed multiple sclerosis (MS). What teaching point should the nurse provide to the patient about her new drug regimen?

"Make sure that you don't stop taking baclofen suddenly because it might cause your symptoms to rebound quite sharply."

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

"Make sure to see your doctor promptly if you develop yellowish skin or eyes."

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 has been prescribed methocarbamol (Robaxin) for fibromyalgia. The nurse has spent an hour educating the patient on the use of methocarbamol for muscle pain. Which of the following statements by the patient indicates that she has an understanding of at least one of the significant side effects of methocarbamol?

"My urine could be discolored while I take this drug."

A patient has been prescribed methocarbamol (Robaxin) for fibromyalgia. The nurse has spent an hour educating the patient on the use of methocarbamol for muscle pain. Which statement by the patient indicates that the patient has an understanding of at least one of the significant side effects of methocarbamol?

"My urine could be discolored while I take this drug."

The nurse is educating a young adult client diagnosed with androgen deficiency about the prescribed testosterone transdermal system, apply two systems (dose of 5 mg) nightly. Which statement made by the client establishes the need for further clarification?

"One transdermal patch is applied to my back, upper arm, or abdomen to dry, clean skin, and the other to my groin."

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."

female client's seizure disorder has been successfully controlled by AEDs for years. She and her husband decide that it is time to start a family. She asks the nurse if it is safe for the fetus for her to continue her AEDs as prescribed. What is the nurse's best response?

"They are considered teratogenic."

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

"This discoloration sometimes occurs with this drug"

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."

A client with myasthenia gravis has been prescribed dantrolene for the treatment of muscle spasticity. What education should the nurse provide to the client?

"You might experience some urinary frequency and urgency. Tell me promptly if it becomes problematic."

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."

Spasmolytics, or centrally acting muscle relaxants, block the reflexes in the central nervous system that lead to spasm. While a patient is taking one of these drugs, which of the following interventions should be implemented?

- Rest for the affected muscle - Heat to the affected area - Use of anti-inflammatory agents - Positioning to decrease pain and spasm

Muscle relaxants would be used in which of the following circumstances?

- To treat spasticity related to spinal cord injury - To treat spasticity that is related to toxins, such as tetanus - To treat spasticity that is a result of neuromuscular degeneration - To reduce the severity of head position associated with cervical dystonia - To reduce the appearance of frown lines (glabellar lines)

Bind directly to the receptor sites of motor nerve terminals and inhibit the release of acetylcholine, leading to local muscle paralysis

- botulinum toxins A and B - incobotulinumtoxin A

Baclofen is available in

- oral - intrathecal forms and can be administered via a delivery pump

A client is prescribed testosterone gel. Which would the nurse include in the teaching plan? Select all that apply.

-Allowing the application site to dry before getting dressed. -Applying the gel once daily in the morning. - Washing hands with soap and water after applying.

What adverse effects would a nurse more likely assess in a patient who is receiving a centrally acting skeletal muscle relaxant?

-Drowsiness -Dry mouth -Insomnia -Constipation

A nurse is preparing a teaching plan for a patient who is to receive botulinum toxin type A for frown lines. What adverse effects would the nurse inform the patient could occur?

-Respiratory infection -Headache -Drooping eyelids

The nurse reviews the patient's medical record before administering dantrolene. What factors would the nurse identify as placing the patient at risk for hepatocellular injury?

-She is 38 years old -She takes birth control pills containing estrogen

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

10 AM

A patient receives baclofen intrathecally at 8 A.M. The nurse would expect teh drug to peak at what time?

12 P.M.

A patient receives baclofen intrathecally at 8 AM. The nurse would expect the drug to peak at which time?

12 PM

A client who is receiving phenytoin has a serum drug level drawn. Which result would the nurse interpret as within the therapeutic range?

12 mcg/mL

A 36-year-old man has been taking extended-release carbamazepine for 1 year. He is in the clinic every 3 months for follow-up visits, which include a drug blood level. Which of the following carbamazepine blood levels would indicate a potential risk for adverse effects?

15 mcg/mL

The nurse is monitoring the serum carbamazepine level of a client. Which result would lead the nurse to notify the prescriber that the client most likely needs an increased dosage?

2 mcg/mL

A patient receives intrathecal baclofen at 10 AM. The nurse would expect to see the maximum effect of this drug at approximately what time?

3 PM

A client is to have an intravenous line inserted, and the nurse prepares to apply a dermal patch to provide local anesthesia to the area. The nurse would apply the patch at which time before initiating intravenous access?

30 minutes

AChE Inhibitors: Nursing Interventions - administer doses on time - take drug __________to _______ minutes __________ meals to reduce risk of _____________. If unable due to ______ distress, take with as _______ food as possible. - monitor drug effectiveness - Monitor for symptoms of _________/_______ dosing - Assess _________ reflexes, muscle strength, ____________ - have __________ available for __________ crisis - Encourage patient to wear medical identification

45, 60, before, aspiration, GI, little, over, under, neuro, gait, antidote, cholinergic

A nurse is instructing a client about vardenafil. The nurse would instruct the client to take the drug how many minutes before sexual stimulation?

60 min

A patient receives dantrolene via the oral route at 10 A.M. The nurse would expect the duration of action to extend until what time?

8 P.M.

A pt w/ spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered? A) Baclofen B) Cyclobenzaprine C) Chlorzoxazone D) Carisoprodol

A

hypotension.

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

Risk for Injury related to CNS depressant effects

A 40-year-old woman 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 when updating the nursing care plan for this patient?

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

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?

"Make sure that you don't stop taking baclofen suddenly because it might cause your symptoms to rebound quite sharply."

A 50-year-old woman has begun taking baclofen to treat her recently diagnosed multiple sclerosis (MS). What teaching point should the nurse provide to the patient about her new drug regimen?

What client is most likely to benefit from Botox (incobotulinumtoxin A) injections?

A 54 year-old client who suffers debilitating migraines two to three days per week

"Make sure to see your doctor promptly if you develop yellowish skin or eyes."

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

Select all that apply: What adverse effects would a nurse most likely assess in a pt who is receiving a centrally acting skeletal muscle relaxant? A) Constipation B) Dry mouth C) Urinary retention D) Drowsiness E) Insomnia

A B D E

Select all that apply: Spasmolytics, or centrally acting muscle relaxants, block the reflexes in the CNS that lead to spasm. While a pt is taking one of these drugs, which of the following interventions should be implemented? A) Rest for the affected muscle B) Heat to the affected area C) Ice packs to the affected area D) Use of anti-inflammatory agents E) Body temp check every 2 hrs to watch for malignant hyperthermia F) Positioning to decrease pain and spasm

A B D F

Select all that apply: Muscle relaxants would be used in which of the following circumstances? A) To treat spasticity related to spinal cord injury B) To treat spasticity that contributes to locomotion, upright position, or increase in function C) To treat spasticity that is related to toxins, such as tetanus D) To treat spasticity that is a result of neuromuscular degeneration E) To reduce the severity of head position associated w/ cervical dystonia F) To reduce the appearance of frown lines (glabellar lines)

A C D E F

Select all that apply: The nurse reviews the pt medical record before administering dantrolene. What factors would the nurse identify as placing the pt at risk for hepatocellular injury? A) She is 39 yrs old B) She has been diagnosed w/ rheumatic arthritis C) She is married w/ 3 children under 10 yrs of age D) She visits the gym daily to ride a stationary bicycle E) She takes birth control pills containing estrogen

A E

Liver function tests

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

A nurse who gives care on a neurological floor is working with several clients. Which client should the nurse prioritize for further assessment and possible interventions?

A client receiving pregablin who is not responsive to verbal stimuli

The nurse who is a case manager is overseeing the care of several clients, both inpatient and community-dwelling. Which client is most likely to benefit from the administration of baclofen?

A client who is undergoing rehabilitation following a spinal cord injury at C7

Dantrolene

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

Reduce the dose

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 physician to do?

Reduction of muscle spasm

A nurse is caring for a patient who is receiving cyclobenzaprine. Which of the following is the action of the drug on the patient?

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 of the following instructions?

• Drowsiness • Urinary frequency • Constipation

A nurse is preparing a teaching plan for a client who is receiving baclofen therapy. Which of the following would the nurse include as possible adverse effects?

increase self-care in activities of daily living.

A nurse is working with a 39-year-old patient who is experiencing muscle spasms associated with multiple sclerosis. The patient reports that she needs help with basic care and that her 15-year-old daughter has been helping bathe and dress her for a week. The patient's physician has prescribed baclofen (Lioresal). The nurse and the patient agree that an appropriate goal related to helping her maintain her self-worth would be to

Baclofen (Lioresal)

A nurse should not administer which of the following skeletal muscle relaxants to a patient with skeletal muscle spasms caused by systemic lupus erythematosus?

Decreased muscle spasms

A patient has been admitted to your unit for treatment of a multiple sclerosis exacerbation. The admission order indicates that the patient is taking baclofen (Lioresal). Which of the following outcomes would you expect to be associated with use of this medication?

"My urine could be discolored while I take this drug."

A patient has been prescribed methocarbamol (Robaxin) for fibromyalgia. The nurse has spent an hour educating the patient on the use of methocarbamol for muscle pain. Which of the following statements by the patient indicates that she has an understanding of at least one of the significant side effects of methocarbamol?

Fatal hepatitis

A patient has been started on dantrolene (Dantrium). What is the most serious adverse effect on which the patient should be instructed?

Drowsiness

A patient is administered cyclobenzaprine (Flexeril). Which adverse effect can you expect with this medication?

Hypotension

A patient is taking tizanidine (Zanaflex) to treat spasticity from multiple sclerosis. Which of the following adverse effects of muscle relaxants is most pronounced with this medication?

3 PM

A patient receives intrathecal baclofen at 10 AM. The nurse would expect to see the maximum effect of this drug at approximately what time?

Risk for Injury related to CNS depression

A patient who experienced a lower back injury while doing yard work 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 patient's drug regimen?

Baclofen

A patient with spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered?

he client is to have a spinal anethesisa for surgery. While educating the client, which statement by the nurse is correct regarding the insertion of the needle?

A small gauge needle will be inserted into the subarachnoid space and medication will be administered into the cerebrospinal fluid.

34-year-old man received a skin laceration while playing soccer that will require a few stitches. A local anesthetic will be used. Which medication would the nurse question for the use in this procedure?

A volatile liquid such as halothane or isoflurane (Fluothane)

For the patient who is taking acetaminophen, what should the nurse do? Select all that apply. A. Monitor routine liver enzyme tests B. Encourage the patient to check package labels of over-the-counter drugs to avoid overdosing C. Report side effects immediately, as toxicity can cause severe hepatic damage D. Teach the female patient that oral contraceptives can increase the effect of acetaminophen E. Teach the patient that caffeine decreases the effects of acetaminophen

A, B, C

Which are characteristic signs of inflammation? (Select all that apply.) a. Edema b. Erythema c. Heat d. Numbness e. Pallor f. Paresthesia

A, B, C

A patient present to his ophthalmologist with complaints of dry, itching eyes. He works as a landscaper. What option(s) does he have for treatment? A. Naphazoline (Clear eyes) B. Olopatadine (Patanol) C. Oxymetazoline (Ocuclear) D. Tetrahydrozoline (Opti-Clear) E. Tetracaine HCL (Pontocaine)

A, B, C, D

The patient has open-angle glaucoma and is being treated with latanoprost (Xalatan). What is/are priority teaching point(s) for this patient? Select all that apply. A. Permanent brown pigmentation B. Eyelids may darken C. Blurred vision may occur D. Eyes may feel itchy E. Pupils may get very small

A, B, C, D

A patient is taking infliximab and asks the nurse what side effects/adverse reactions to expect from this drug. The nurse lists which side effects? Select all that apply A. Fatigue B. Headache C. Chest pain D. Renal damage E. Severe infections

A, B, C, E

The patient has fallen off his mountain bike and sustained multiple abrasions to both of his knees. Which would be appropriate medication(s) for pain management for this patient? select all that apply A. Acetaminophen B. Aspirin C. Hydrocodone D. Ibuprofen E. Morphine

A, B, D

The patient has been involved in a motor vehicle collision and has been prescribed methocarbamol (Robaxin)for muscle spasms in her neck and back. What side effect(s) should the nurse discuss with the patient prior to discharge? Select all that apply A. Brown urine B. Diarrhea C. Drowsiness D. Increased appetite E. Tachycardia F. Urinary retention

A, C

The patient is receiving pilocarpine (Isopto Carpine) eyedrops for treatment of glaucoma. Which side effect(s) is/are most likely to occur? Select all that apply A. Blurred vision B. Brow ache C. Dry mouth D. Headache E. Nausea F. Vomiting

A, C

A patient has started on corticosteroids for an arthritic condition. What information should the nurse include in a health teaching plan? Select all that apply. A. Corticosteroids are used to control arthritic flare-ups in severe cases B. Corticosteroids have a short half-life C. Corticosteroids are usually administered once a day D. Corticosteroids are tapered over the course of 5-10 days E. Corticosteroids may not be taken with prostaglandin inhibitors

A, C, D

The nurse is teaching a patient about taking aspirin. Which are important points to include? Select all that apply. A. Advise the patient to avoid alcohol while taking aspirin B. Instruct the patient to take aspirin before meals on an empty stomach C. Instruct the patient to inform the dentist of the aspirin dosage before having dental work D. Instruct the patient to inform the surgeon of the aspirin dosage before having surgery E. Suggest that aspirin may be given to children for flu symptoms

A, C, D

Which instructions will the nurse include in the teaching plan for a patient who is taking pyridistigmine? Select all that apply A. Pyridistigmine must be taken on time B. Take the prescribed dose every other day C. Underdosing can result in myasthenic crisis D. Overdosing can result in cholinergic crisis E. Report the adverse effect of tachycardia to the health care provider

A, C, D

A patient who is taking NSAIDs for arthritis complains of persistent heartburn. What further question(s) should the nurse ask the patient about the heartburn? Select all that apply. A. "Do you take your medication with food?" B. "Have you been drinking an increased amount of water?" C. "Have you noticed a change in the color of your bowel movements? D. "What dosage of the NSAID are you taking?" E. "Where is the heartburn located?"

A, C, D, E

For the patient who is taking nalbuphine, what should the nurse do? A. Monitor any changes in respirations B. Instruct the patient to report bradycardia C. Administer intravenous nalbuphine undiluted D. Explain to the patient to expect an excessive amount of urine output E. Instruct the patient to avoid alcohol when taking nalbuphine to avoid respiratory depression

A, C, E

A client with myasthenia gravis is experiencing a cholinergic crisis. Which symptoms are associated with this condition? (Select all that apply.) a. Bradycardia b. Rash c. Vomiting d. Fever e. Drooling f. Weakness

A, C, E, F

Which solution(s) is/are commonly used to irrigate the ear? Select all that apply A. Acetic acid B. Boric acid C. Cyclopentolate HCL D. Hydrogen peroxide 3% E. Hypotonic HCL solution 10%

A, D

A patient with a complicated medical history including hypertension, atrial fibrillation, and arthritis call the health care provider's office to speak with a nurse about "all of these bruises I have all of a sudden." Which potential drug interaction should concern the nurse with these symptoms? A. Aspirin and warfarin B. Sulfasalazine and acetaminophen C. Tolmetin and propranolol D. Meloxicam and amlodipine

A. Aspirin and warfarin

What emergency medication will be administered to a patient exhibiting the signs of cholinergic crisis? A. Atropine B. Diazepam (Valium) C. Edrophonium (Tensilon) D. Pyridostigmine (Mestinon)

A. Atropine

The patient has returned to the floor from surgery after a hip arthroplasty. For the first 48 hours postoperatively, meperedine (Demerol) is ordered for pain control. During the time the patient is taking meperedine, frequent monitoring of what is required? A. Blood pressure B. Pulse C. temperature D. Urine output

A. Blood pressure

A patient is admitted to the hospital with an acute gout attack. The nurse expects that which medication will be ordered to treat acute gout? A. Colchicine B. Allopurinol C. Probenecid D. Sulfinpyrazone

A. Colchicine

A baby is born vaginally to a mother with gonorrhea and has ophthalmia neonatorum. What is the medication of choice for treatment? A. Gentamicin sulfate B. Silver nitrate 1% C. Sulfacetamide D. Tetracycline HCL

A. Gentamicin sulfate

The camp nurse is reviewing the shopping list of supplies needed for the upcoming camping season. Which product will the nurse purchase to prevent and treat cerumen impaction? A. Hydrogen peroxide B. Rubbing alcohol C. Charcoal D. Clove oil

A. Hydrogen peroxide

The nurse is providing medication instructions to a patient with acute muscle spasms who has been prescribed cyclobenzaprine. Which statement indicates to the nurse that the patient understands the instructions? A. I plan to take this medication with a glass of milk B. Cyclobenzaprine should be taken once daily at bedtime C. I will only drink one glass of wine per day D. I will be able to take this drug with grapefruit juice

A. I plan to take this medication with a glass of milk

A patient has been switched to the immunomodulator etanercept (Enbrel) for severe rheumatoid arthritis/ What is the mechanism of action for etanercept? A. It neutralizes tumor necrosis factor (TNF) thereby delaying the inflammatory disease process B. It inhibits IL-1 from binding to interleukin receptor sites in cartilage and bone C. It blocks COX-2 receptors, which are needed for biosynthesis of prostaglandins D. It promotes uric acid reabsorption

A. It neutralizes tumor necrosis factor (TNF) thereby delaying the inflammatory disease process

Ibuprofen is a frequently prescribed anti-inflammatory, analgesic, and antipyretic. What is a positive aspect of this drug in relation to other NSAIDs? A. It tends to cause less GI irritation B. It may be taken between meals C. It has a long half-life of 20-30 hours D. It has no drug-drug interactions

A. It tends to cause less GI irritation

Assessing a patient following intravenous morphine administration, the nurse notes cold, clammy skin; a pulse of 40 beats/min; respirations of 10 breaths/min; and constricted pupils. Which medication will the patient likely need next? A. Naloxone B. Meloxicam C. Pentazocine D. Propoxyphene

A. Naloxone

A patient is taking aspirin for arthritis. Which adverse reaction should the nurse teach the patient to report to the health care provider? A. Tinnitus B. Seizures C. Sinusitis D. Palpitations

A. Tinnitus

A patient is having a migraine attack. The should know that which drugs are used to treat migraine attacks? A. Triptans B. Anticonvulsants C. Tircyclic antidepressants D. Beta-adrenergic blockers

A. Triptans

By which action does colchicine relieve the symptoms of gout? A. it inhibits the migration of leukocytes to the inflamed area B. It blocks reabsorption of uric acid C. It blocks prostaglandin D. It inhibits uric acid synthesis

A. it inhibits the migration of leukocytes to the inflamed area

A pt sustained a musculoskeletal injury to his left leg that resulted in occasional spasticity. What should the nurse expect the health care provider to prescribe? A) Cyclobenzaprine B) Baclofen C) Botulinum toxin type B D) Dantrolene

A; Used to treat discomfort from acute conditions

After teaching a group of students about abortifacients, the instructor determines that the teaching was successful when students identify which condition as a contraindication to their use?

Active pelvic inflammatory disease

A client in status epilepticus has been brought to the emergency department. The nurse should anticipate which treatment measures?

Administration of intravenous lorazepam

Which of the following would a nurse identify as increasing a client's risk for hepatic disease with dantrolene use?

Age over 35 years

Carisoprodol

An older patient with a history of renal dysfunction is to receive a centrally acting skeletal muscle relaxant. Which agent would be most appropriate?

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?

The nurse instructs a client to use benzocaine to soothe the itching and pain related to an insect bite. Benzocaine is considered to be what type of dermatologic agent?

Anesthetic

The nurse is aware that a client receiving which category of medication will not be prescribed vardenafil?

Antidysrhythmics

What is one of the registered nurse's primary roles in the administration of general anesthetic?

Assessing the client's status during recovery from anesthetic

A client has been administered phenobarbital during seizure activity. When assessing for adverse effects what should the nurse prioritize?

Assessment of orientation

What occurs during andropause?

Atrophy of the seminiferous tubules

Which agent would a client most likely be prescribed for penile erectile dysfunction if the client is very sexually active and the timing of sexual stimulation is not known?

Avanafil

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

Avoid alcohol or other CNS depressants

A client has a history of seizures of which the client takes phenytoin on a regular basis. What should the nurse teach the client in order to ensure safety?

Avoid ginkgo supplements

A pt receives baclofen intrathecally at 0800. The nurse should expect the pt serum levels of the drug to peak at what time? A) 1400 B) 1200 C) 1600 D) 1000

B

Dantrolene is being considered for the treatment to a pt w/ spasticity. Which aspect of the pt current health status is most likely to contraindicate the use of this med? A) The pt takes opioid analgesics regularly B) The pt spasticity is due to rheumatoid arthritis C) The pt adherence to drug therapy has been irregular D) The pt has type 1 diabetes and takes insulin regularly

B

The nurse is preparing to administer a pt scheduled dose of baclofen and notes that the pt most recent oral temp was 100.9. What is the nurse's best action? A) Perform a focused respiratory assessment B) Administer the med as prescribed and monitor the pt C) Hold the baclofen, administer antipyretics as prescribed, and reassess the pt in 1 hr D) Report this assessment finding promptly to the care provider

B

What pt is most likely to benefit from botulinum toxin type A injections? A) A 68 yr old pt who has chronic lumbar and thoracic pain following a workplace accident B) A 54 yr old pt who suffered debilitating migraines 2-3 days per week C) A 16 yr old pt w/ cerebral palsy whose upper body spasticity has worsened in recent months D) A 60 yr old pt who was diagnosed w/ myasthenia gravis 18 months ago

B

Select all that apply. The nurse is preparing a teaching plan for a pt who is to receive botulinum toxin type A for frown lines. What adverse effects should the nurse inform the pt that could possibly occur? A) Abnormal hair growth B) Drooping eyelids C) GI upset D) HA E) Respiratory infections

B D E

The 72-year-old patient is scheduled to have major surgery. In his preoperative evaluation, his daughter shares with the nurse that she is concerned he will not have his pain relieved. What does the nurse tell the patient and his daughter regarding postoperative pain control? Select all that apply A. "You will only be able to receive acetaminophen because you are over age 70" B. "We will be able to adjust your pain medication to an appropriate dose for your age" C. "Please let us know when you are having pain so we can work together to stay on top of it" D. "Older patients do not have pain as much as middle-aged patients do" E. "You will be able to help him push the button for his patient-controlled analgesics (PCA) device to control his pain"

B, C

The nurse asks a parent to demonstrate administration of eardrops on a toddler. Which steps by the parent indicate the need for additional education? Select all that apply. A. Position with the affected ear upward B. Pull the ear backward and upward C. Instill one drop of medication at a time allowing 3 to 5 minutes between each drop D. Apply gently pressure to the flap (tragus) over the ear canal E. Keep the ear positioned upward for 5 minutes

B, C

A patient is beginning to take cyclobenzaprine for treatment of acute back spasms. Which interventions will the nurse include in the care of this patient? Select all that apply. A. Advise the patient to take this drug on an empty stomach B. Inform the patient not to abruptly stop taking the muscle relaxant. The dose should be tapered down. C. Tell the patient to report dizziness and double vision to the health care provider D. Advise the patient to avoid alcohol E. Taking narcotics at the same time can cause serious side effects

B, C, D, E

The nurse is planning teaching regarding antigout medication. What information should be included?Select all that apply A. Include large doses of vitamin C supplements B. Increase fluid intake C. Avoid alcoholic beverages D. Avoid foods high in purine E. Take medication with food F. Avoid direct sunlight

B, C, D, E

What information should the nurse include in a teaching plan for a patient who is being discharged home after knee surgery with a prescription for hydrocodone? Select all that apply A. Dietary restrictions while taking hydrocodone B. Instructions not to exceed recommended dosage C. Instructions not to use alcohol or CNS depressants while taking hydrocodone D. Instructions on how to prevent constipation E. Side effects reported

B, C, D, E

The nurse is concerned that the patient is experiencing side effects of opioid agonist-antagonists/ What might he nurse assess for if this patient is experiencing side/adverse effects? select all that apply A. Cardiac standstill B. Constipation C. Dysuria D. Hypertension E. Nausea and vomiting F. respiratory depression

B, C, F

What will the nurse do to be more successful in treating pain in an 8-year-old patient who fell from a tree and broke his arm? Select all that apply A. Assume the child hurts and administer pain medication B. Discuss the child's typical response with the caregivers C. Only utilize nonpharmacologic pain control methods D. Use a pain scale appropriate for children such as the ouch scale E. Utilize developmentally appropriate communication techniques

B, D, E

When preparing discharge teaching for a patient who has been prescribed ibuprofen for arthritis, how does the nurse explain the mode of action? A. "Ibuprofen is a COX-2 inhibitor, so it blocks prostaglandin synthesis." B. "Ibuprofen inhibits prostaglandin synthesis" C. "Ibuprofen binds with opiate receptor sites" D. "Ibuprofen promotes vasodilation to increase blood flow"

B. "Ibuprofen inhibits prostaglandin synthesis"

A 35-year-old female patient has been prescribed ibuprofen 400 mg t.i.d. for arthritis. What statement by the patient would indicate a need for further education? A. "This medication should cause less GI upset than other NSAIDs" B. "Now I won't have to drink so much water" C. "I know this medicine might cause some diarrhea" D. "I will need to stop taking this medication if I get pregnant"

B. "Now I won't have to drink so much water"

The patient has been taking oxycodone (OxyContin) for 8 weeks for a back injury he sustained at work. He has stopped taking his medication. How many hours after he last takes his medication does the nurse anticipate his withdrawal symptoms will begin? A. 6-12 hours B. 24-48 hours C. 48-72 hours D. 72-96 hours

B. 24-48 hours

A patient states during a medical history that he takes several acetaminophen tablets throughout the day for acute pain. The nurse teaches the patient that the dosage should not exceed which amount? A. 1 g/day B. 3 g/day C. 4 g/day D. 6 g/day

B. 3 g/day

When the nurse explains the pathophysiology of myasthenia gravis to a patient, which is the best explanation? A. Degeneration of cholinergic neurons and a deficit in acetylcholine lead to neuritic plaques and neurofibrillary tangles B. A decreased amount of acetylcholine to cholinergic receptors produces weak muscles and reduced nerve impulses C. Myelin sheaths of nerve fibers in the brain and spinal cord develop lesions or plaques D. An imbalance of dopamine and acetylcholine leads to degeneration of neurons in midbrain and extrapyramidal motor tasks

B. A decreased amount of acetylcholine to cholinergic receptors produces weak muscles and reduced nerve impulses

The patient is taking morphine after a procedure. The patient has made his third request for pain medication in the past 4 hours. The patient's vital signs are temperature 36.4 C, the heart rate 88 beats/min, respiratory rate 12 breaths/min, blood pressure 104/60 mm Hg, and oxygen saturation 98%. He rates his pain as an 8 on a scale of 1-10. Assuming that a dose of the medication is due, what is the nurse's best action? A. Administer the dose and contact the health care provider about his respiratory rate B. Administer the dose and contact the health care provider about his pain control C. Hold the dose and contact the health care provider regarding his respiratory rate D. Hold the dose and contact the health care provider about his pain control

B. Administer the dose and contact the health care provider about his pain control

A patient is about to undergo a diagnostic eye exam. The opthalmologist asks the nurse to prepare to assist in the administration of tetracaine, fluorescein stain, and atropine. Before assisting in the procedure, it is most important for the nurse to inform the opthalmologist if the patient has a history of: A. Cataracts B. Angle-closure glaucoma C. Open-angle glaucoma D. Macular degeneration

B. Angle-closure glaucoma

The patient has frequent cerumen buildup. Which medication does the nurse anticipate the health care provider will suggest for this patient? A. Bimatoprost (Lumigan) B. Carbamide peroxide (debrox) C. Echothiphate (Phospholine Iodide) D. Proparacaine (Alcaine)

B. Carbamide peroxide (debrox)

The nurse is completing the medication reconciliation for the patient who will be discharged home with a prescription for oxycodone and acetaminophen (Percocet). Which medication that the patient is currently taking raises a concern to the nurse? A. Ampicillin B. Cholestyramine C. Furosemide D. Propranolol

B. Cholestyramine

The nurse is administering medication to her patient on a medical-surgical floor. Which medication order should the nurse question before administration? A. Dantrolene sodium (Dantrium) for a 50-year-old with muscle spasms B. Diazepam (Valium) for a 60-year-old who also has glaucoma C. Edrophonium (Tensilon) for a 30-year-old who is undergoing diagnostic D. Chorzoxazone (Parafon Forte DSC) for a 33-year-old with muscle trauma

B. Diazepam (Valium) for a 60-year-old who also has glaucoma

Which nursing assessment would be least important when monitoring a patient who is receiving hydromorphone? A. Bowel sounds B. Fluid intake C. Pain scale D. Vital signs

B. Fluid intake

The nurse is teaching a patient recently diagnosed with multiple sclerosis about the disease. Which statement is not correct concerning multiple sclerosis? A. The disease has period of exacerbations and remissions B. Goals of treatment are to decrease the inflammation in the nervous system C. Patients experience muscle weakness, vision problems, and fatigue D. Multiple sclerosis is an autoimmune disorder that cause plaque to develop in the spinal cord

B. Goals of treatment are to decrease the inflammation in the nervous system

Uricosuric agents such as probenecid (Benemid) are used in the treatment of gout/ What is the mechanism of action? A. Retention of urate crystals in the body B. Inhibition of the reabsorption of uric acid C. Promotion of uric acid removal in the ureters D. Increased release of uric acid

B. Inhibition of the reabsorption of uric acid

The patient is receiving treatment for MG with pyridostigmine (Mestinon). The nurse is assessing the patient. While clinical manifestations would be noted if the medication is working? A. Increased salivation B. Maintenance of muscle strength C. Miosis D. tachycardia

B. Maintenance of muscle strength

A patient is admitted to the emergency department with signs of respiratory depression following self-injection with hydromorphone. The admitting nurse knows that which drug will reverse respiratory depression caused by opioid overdose? A. Fentanyl B. Naloxone C. Butorphanol D. Sufenta

B. Naloxone

The patient is brought to the emergency department with a reported overdose of morphine. Which drug does the nurse anticipate will be prescribed? A. Butorphanol (Stadol) B. Naloxone (narcan) C. Flumazenil (Romazicon) D. Pentazocine (Talwin)

B. Naloxone (narcan)

The patient is receiving treatment for MG with an acetylchonisterase inhibitor. The nurse observes that the patient is drooling, her eyes are tearing, and she is diaphoretic. What will concern the nurse about the patient exhibiting these clinical manifestations? A. She is having an anaphylactic reaction B. She is having a cholinergic crisis C. She is in the early stages of myasthenic crisis D. She is having a vascular spasm

B. She is having a cholinergic crisis

The patient has MS and is experiencing muscle spasms. How will centrally acting muscle relaxants improve his status? A. They affect mu receptors to decrease pain B. they decrease pain and increase range of motion C. They decrease inflammation of the peripheral nerves D.They speed conduction to improve flexibility

B. they decrease pain and increase range of motion

The nurse administers a pt scheduled dose of dantrolene P.O. at 10:00. The nurse should expect the duration of action to extend until approximately what time? A) 15:00 B) 20:00 C) 17:00 D) 13:00

B; Duration of action is 8-10 hours

What pt is using his or her pyramidal tract to the largest extent? A pt who is: A) Reaching to flush the toilet B) Filling out the dietary preferences card for the next day C) Walking to the dining room D) Rising from a sitting to a standing position

B; pyramidal tract controls precise intentional movement such as writing

estrogen

BLACK BOX WARNING: it increases risk of cancer, MI, and blood clots

When providing follow-up care for a client prescribed an oral contraceptive several months ago, the nurse must be certain to prioritize what assessment?

BP

The health care provider has prescribed testosterone for a 77-year-old client with a low testosterone level. The nurse will evaluate this client for what condition that may develop in this client in response to this medication?

BPH

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

Baclofen

A patient with multiple sclerosis is admitted to the medical division for treatment of severe spasticity. What medication is used to treat spasticity and is administered intrathecally?

Baclofen

A patient with spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered?

Baclofen

Centrally Acting Skeletal Muscle Relaxant Prototype

Baclofen

Often used to relieve the muscle spasticity associated with cerebral palsy

Baclofen

The nurse is caring for a patient with an intrathecal catheter in place to treat muscle rigidity. What centrally acting skeletal muscle relaxant could the nurse administer intrathecally?

Baclofen

What centrally acting skeletal muscle relaxant is not metabolized but is excreted in the urine?

Baclofen

Which medication would the nurse expect to administer if prescribed to achieve skeletal muscle relaxation?

Baclofen

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)

A nurse should not administer which of the following skeletal muscle relaxants to a patient with skeletal muscle spasms caused by systemic lupus erythematosus? (Choose one)

Baclofen (Lioresal)

Which of the following is an example of a skeletal muscle relaxant?

Baclofen (Lioresal)

Which of the following is an example of a skeletal muscle relaxant? (Choose one)

Baclofen (Lioresal)

The health care provider has prescribed testosterone for a 77-year-old client with a low testosterone level. The nurse will evaluate this client for what condition that may develop in this client in response to this medication?

Benign prostatic hypertrophy

A client with a foreign body embedded in her hand requires local anesthesia for removal. What drug would be most appropriate?

Benzocaine (it is local)

A client has begun treatment for penile erectile dysfunction. What explanation should the nurse provide regarding the primary effect a prescribed phosphodiesterase type 5 inhibitor will have on this condition?

Blood flow to the penis will be improved

After reviewing information about skeletal muscle relaxants, a group of students demonstrate understanding of the material when they identify which drug as a direct-acting muscle relaxant?

Botulinum toxin type A

After teaching a group of student about skeletal muscle relaxants, the instructor determines a need for additional teaching when the students identify what as a centrally acting skeletal muscle relaxant?

Botulinum toxin type A

After teaching a group of students about skeletal muscle relaxants, the instructor determines a need for additional teaching when the students identify which of the following as a centrally acting skeletal muscle relaxant?

Botulinum toxin type A

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

Botulinum toxin type B

The nurse is aware that which medication will be used in the provision of local infiltrate anesthesia?

Bupivacaine (Marcaine)

The nursing instructor is teaching students about local anesthetics. The students demonstrate understanding when they identify which local anesthetics that can be given via epidural? Select all that apply.

Bupivacaine (Marcaine, Sensorcaine) Lidocaine (Dilocaine) Lidocaine (Xylocaine)

A muscle spasm often results from: A) Damage to the basal ganglia B) CNS damage C) Injury to the musculoskeletal system D) Chemical imbalance within the CNS

C

A pt has been prescribed baclofen and will be taking the drug on an outpatient basis. The pt asks the nurse if it's still okay to drink wine with meals or end the day with a margarita, the nurse should say what? A) "You're to permitted to drink alcohol while you are taking baclofen." B) "If you combine baclofen and alcohol, you could suffer a severe allergic-type rxn." C) "The combination of baclofen and alcohol could depress your nervous system to a dangerous level." D) "It's best to keep your alcohol intake to a low level when you're taking muscle relaxants."

C

A pt has been prescribed cyclobenzaprine for the treatment of injury-related muscle spasticity. The pt asks if it is safe to take ibuprofen while taking cyclobenzaprine. What should the nurse say? A) "Ask your care provider, but the combo might make you dangerously drowsy." B) "Confirm with your provider, but it would likely be quite hard on your liver." C) "Check w/ your care provider, but it's likely not a problem." D) "It would probably be unsafe because both drugs are from similar families."

C

Dantrolene is associated w/ potentially fatal cellular damage. If your pt condition is being managed w/ dantrolene, the pt should: A) Have repeated complete blood counts during therapy B) Have renal function tests done monthly C) Be monitored for signs of liver damage and have liver function tests done regularly D) Have a thorough eye examination before and periodically during therapy

C

The use of neuromuscular junction blockers may sometimes cause a condition known as malignant hyperthermia. The drug of choice for prevention or treatment of this condition is: A) Baclofen B) Diazepam C) Dantrolene D) Methocarbamol

C

The patient has a severe increase in intraocular pressure and requires mannitol (Osmitrol). What is/are side effect(s) that the nurse must be aware of? Select all taht apply A. Constipation B. Dizziness C. Electrolyte imbalance D. Headache E. Nausea

C, D, E

The patient is taking Vicoprofen after reconstructive knee surgery. Which statement by the patient indicates the need for more teaching? A. "I must take only what is prescribed for my pain" B. "I may need to take a laxative if I get constipated while I am taking this medication" C. "Having a few beers on the weekend will help me relax and ease the pain" D. "I should not take anything with ibuprofen in it while I am taking this medication"

C. "Having a few beers on the weekend will help me relax and ease the pain"

The patient has had MS for several years, during which he has had many remissions and exacerbations. He has been prescribed azathioprine (Imuran) and ineterferon- B (Betaseron). The patient inquires, "How will this help me feel better?" What is the nurse's best response? A. "These medications will help form new neurons and axons." B. "They will improve muscle strength." C. "they will reduce spasticity and improve muscular movement." D. "They will stop the progression of the disease."

C. "they will reduce spasticity and improve muscular movement."

The patient has had major surgery and has been prescribed oral ketorolac. What is the maximum length of time this medication should be taken? A. 24 hours B. 3 days C. 5 days D. 2 weeks

C. 5 days

When discontinuing steroid therapy, the dosage should be tapered over a period of how many days? A. no taper is necessary B. 1-4 days C. 5-10 days D. More than 10 days

C. 5-10 days

The patient with a history of asthma has been prescribed ibuprofen for arthritis. What can ibuprofen cause that should concern the nurse? A. Tachycardia B. Increased secretions C. Bronchospasm D. Fluid retention

C. Bronchospasm

A patient requires a nonopioid analgesic. The nurse knows that which medication will cause the least gastrointestinal distress? A. Aspirin B. Ketorolac C. Celecoxib D. Ibuprofen

C. Celecoxib

A patient has spasticity following a spinal cord injury/ The nurse anticipates that which drug will be prescribed to treat the patient's spasticity? A. Neostigmine B. Ropinirole C. Cyclobensaprine D. Pyridostigmine

C. Cyclobenzaprine

For the patient receiving periodic morphine via intravenous push, which of the following findings would be of concern to the nurse? A. Increased temperature B. Decreased bowel sounds C. Decreased respirations D. Increased red blood cells

C. Decreased respirations

The nurse is caring for a patient who has been diagnosed with myasthenia gravis. The patient is experiencing muscle weakness, dyspnea, bradycardia, and diaphoresis. The nurse anticipates that the health care provider will order which medication to distinguish between myasthenic crisis and cholinergic crisis? A. Adrenocorticotropic hormone B. Diazepam C. Edrophonium D. Mitoxantrone

C. Edrophonium

A patient is taking acetazolamide (Diamox) for acute closed-angle galucoma. The nurse will assess for which side effect associated with drugs in the group? A. Agitation B. Constipation C. Electrolyte imbalances D. Urinary retention

C. Electrolyte imbalances

When teaching a patient who is receiving allopurinol, what should the nurse encourage the patient to do? A. Eat more meat B. Increase vitamin C intake C. Have annual eye examinations D. Take medication 2 hours before meals

C. Have annual eye examinations

What advantage does piroxicam (Feldene) have over other NSAIDs? A. No GI irritation B. Few drug-drug interactions C. Long half-life D. Rapid onset

C. Long half-life

The patient presents to her health care provider with complaints of double vision, headache, and muscle weakness. She states that these symptoms come and go every few weeks, but her "spells" seem to be getting closer together. If her health care provider is considering a diagnosis of MS, what test is likely to be ordered? A. Angiography B. Computerized Tomography (CT) scan C. Magnetic resonance imaging (MRI) D. Myelogram

C. Magnetic resonance imaging (MRI)

The nurse is assessing a patient or a possible overdose of opioids. The pupils are pinpoint. What is this called? A. Diplopia B. Meiosis C. Miosis D. Mitosis

C. Miosis

The patient presents to her opthalmologist for aroutine eye examination. Prior to the exam, eyedrops are used to dilate her eyes. Such medication belong to which group of drugs? A. carbonic anhydrase inhibitors B. cerumenolytics C. Mydriatics D. osmotics

C. Mydriatics

A patient is taking ibuprofen. The nurse understands that COX-1 and COX-2 inhibitors are different in that ibuprofen is more likely than celecoxib to cause which adverse effect? A. Fever B. Constipation C. Peptic ulcer disease D. Metallic taste when eating

C. Peptic ulcer disease

When collecting a medication history from a patient with primary open-angle glaucoma, the nurse identifies several drugs that could exacerbate glaucoma. Which drug poses a priority concern for this particular patient? A. Cyclobenzaprine, an antispasmodic B. Oxymetazoline, a decongestant C. Prednisone, a corticosteroid D. Sulfamethoxazole-trimethoprim, a sulfonamide-antibiotic combination

C. Prednisone, a corticosteroid

The older adult patient has a fentanyl patch 50 mg for chronic pain from an injury. What does the nurse know regarding this medication for this patient? A. This patient should not have a fentanyl patch for chronic pain B. The dose may be too low C. The dose may be too high for this patient D. The dose is appropriate

C. The dose may be too high for this patient

The African-American patient has open-angle glaucoma. The nurse knows that which glaucoma medication is more effective in African-American patients? A. Bimatoprost (Lumigan) B. Latanoprost (Xalatan) C. Travoprost (Travatan Z) D. Tafluprost (Zioptan)

C. Travoprost (Travatan Z)

The nurse is reviewing a patient's medication history for a patient who has just been prescribed cyclobenzaprine for treatment of back spasms. The nurse plans to contact the health care provider if the patient is taking which of these? A. Atorvastatin B. Conjugated estrogen C. Valerian D. Pinicillin G Procaine

C. Valerian

When reviewing the med record of a pt who is to receive dantrolene, which condition would alert the nurse for the need of close monitoring? A) Has an infected surgical wound B) Is 67 years old C) Has respiratory depression from opioid analgesia D) Received a blood transfusion less than 24 hrs ago

C; It can increase muscular weakness and make respiratory depression worse

A pt w/ impaired liver function secondary to hepatitis C requires a centrally acting skeletal muscle relaxant for temporary pain relief. What med would put the lest metabolic burden on the pt liver? A) Orphenadrine B) Methocarbamol C) Baclofen D) Diazepam

C; It is not metabolized

A patient admitted to a health care facility for appendicitis surgery is administered methohexital as a general anesthesia. Which condition should the nurse observe in the patient as the effect of the administration of methohexital?

CNS depression

Skeletal Muscle Relaxants: Baclofen -_____ effects including ___________ and ____________ retention -Caution with _______ disorder - Can be _________ with implanted pump Chlorzoxazone -Monitor for _____________ reaction - May turn urine _______/________ - Monitor ________

CNS, constipation, urinary, seizure, intrathecal, hypersensitivity, red, orange, LFT

Skeletal Muscle Relexants: Interventions: - monitor _______ - Assess risk for injury - Assess joints and muscles for _____ and __________ - Monitor __________ function - Take __________ food - Avoid ETOH and other CNS depressants - Avoid _________ or __________

CNS, pain, mobility, renal, with, driving, machinery

Skeletal Muscle Relaxants: Diazepam - acts directly on _____ to suppress ___________- does not affect skeletal muscle ___________ - __________ Methocarbamol - contraindicated in ___________ impairment - Side effect - hypotension, bradycardia, siezures - can turn urine ___________ to _________

CNS, spasticity, directly, sedation, renal, brown, green

The nurse should review which lab result before advising a client about taking the first dose of ibandronate (Boniva)?

Calcium

An older adult patient with a history of renal dysfunction is to receive a centrally acting skeletal muscle relaxant. Which agent would be most appropriate?

Carisoprodol

An older client is to receive a centrally acting skeletal muscle relaxant. Which of the following would the nurse expect to be prescribed?

Carisoprodol

The centrally acting skeletal muscle relaxant of choice for older patients and for those with hepatic or renal impairment

Carisoprodol

Define extrapyramidal tract

Cells from the cortex and subcortical areas, including the basal ganglia and the cerebellum, which coordinate unconsciously controlled muscle activity; allows the body to make automatic adjustments in posture or position and balance

The extra pyramidal tract is made up of cells from which of the following areas?

Cerebral cortex

May discolor the urine, becoming orange to purple-red when metabolized and excreted

Chlorzoxazone

Administration of which class of medications can decrease secretions of the upper respiratory tract?

Cholinergic antagonists

A patient is receiving treatment for infertility and is receiving a drug that stimulates ovulation. Which drug would this most likely be?

Chorionic gonadotropin

Immediately before starting an IV infusion of oxytocin (Pitocin), what should the nurse assess? (Select all that apply.)

Client's blood pressure Fetal heart rate Client's respiratory rate

A client is taking androgens and warfarin (Coumadin). What effect will these two medications have on the client's coagulation?

Coagulation will be decreased

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.

A client sustained a musculoskeletal injury to his left leg that has resulted in occasional spasticity. What should the nurse expect the health care provider to prescribe

Cyclobenzaprine

A patient sustained a musculoskeletal injury to his left leg. What would the nurse expect the health care provider to order?

Cyclobenzaprine

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 patient is taking cyclobenzaprine for muscle spasms secondary to an injury to his lumbar spine that occurred while lifting a motor at work. He is being seen for a follow-up visit by the physician. He is complaining of dry mouth, blurred vision, and constipation. Why is the patient having these side effects from cyclobenzaprine?

Cyclobenzaprine produces an anticholinergic response, resulting in these side effects.

A pt presents to the clinic seeking info about having botulinum toxin type A injections to reduce eye wrinkles. What should the nurse teach the pt about this treatment? A) "You would need to be sedated so you're able to stay perfectly still during the injections." B) "Some pt have adverse effects of botulinum toxin type A involving muscle spasticity." C) "The effectiveness of botulinum toxin A injections has been greatly overstated in the media." D) "This isn't a permanent solution. It has to be repeated in 3 months."

D

A pt w/ a recent history of muscle spasticity has been prescribed baclofen. What finding on the pt most recent lab report should prompt the nurse to contact the care provider? A) Rise in blood urea nitrogen B) Decline in sodium C) Decline in neutrophils D) Rise in liver enzymes

D

Dantrolene differs from the other skeletal muscle relaxants because: A) It acts in the highest levels of the CNS B) It is used to treat muscle spasms as well as muscle spasticity C) It cannot be used to treat neuromuscular disorders D) It acts directly within the skeletal muscle fiber and not within the CNS

D

Muscle spasticity is the result of: A) Direct damage to a muscle cell B) Over-stretching of a muscle C) Tearing of a ligament D) Damage to neurons within the CNS

D

The nurse is assessing a pt for possible risk factors for the development of hepatotoxicity with the use of dantrolene. What situations would the nurse identify as requiring cautious use of the drug? A) Cirrhosis B) Spasticity contributing to locomotion or upright position C) Age less than 30 yrs D) Female gender

D

The nurse is caring for a pt w/ an intrathecal catheter in place to treat muscle rigidity. What centrally acting skeletal muscle relaxant could the nurse administer intrathecally? A) Chlorzoxazone B) Cyclobenzaprine C) Carisoprodol D) Baclofen

D

When reviewing the medical record of a pt who is to receive dantrolene, which condition would alert the nurse for the need of close monitoring? The client: A) Has an infected surgical wound B) Received a blood transfusion less than 24 hrs ago C) Is 67 yrs old D) Has respiratory depression from opioid analgesia

D

The patient has been prescribed infliximab (Remicade) for severe rheumatoid arthritis. Her spouse calls the clinic and states his wife has a fever of 101.9 F, chills, nausea and vomiting, and is very dizzy. What will the nurse advise the patient's spouse to do? A. Nothing. These are common side effects of infliximab. B. Have the patient take a cool bath C. Wait 24 hours and if symptoms continue, call back D. Bring the patient to the emergency department or clinic for further evaluation

D. Bring the patient to the emergency department or clinic for further evaluation

The nurse anticipates that the health care provider will prescribe which medication to treat a patient with relapsing remitting multiple sclerosis? A. Ambenonium B. Pyridostigmine C. Mitoxantrone D. Glatiramer Acetate

D. Glatiramer Acetate

A patient is taking oral acetazolamide, a carbonic anhydrase inhibitor, to decrease intraocular pressure. When providing drug education, what will the nurse advise the patient to anticipate? A. Increased weight B. Light sensitivity C. Burning or stinging of the eyes D. Increased urine output

D. Increased urine output

The patient has been receiving pyrdiostigmine (mestinon). Which medication when ordered by the health care provider should the nurse question before administering to the patient? A. histamine2 blocker B. Proporanolol C. Cephalosporin D. Tetracycline

D. Tetracycline

A patient who has frequent cerumen impaction has had his ears irrigated at the clinic. To determine the results of the irrigation, what structure must be visualized? A. Auricle B. External auditory canal C. Semicircular canals D. Tympanic membrane

D. Tympanic membrane

Which factor is most relevant to the relief of chronic pain? A. Administration of drugs at patient's request B. Opioid analgesics C. Use of injectable medications D. Use of drugs with long half-lives

D. Use of drugs with long half-lives

What occurs during the vascular phase of inflammation? A. Leukocyte and protein infiltration into inflamed tissue B. Vasoconstriction with leukocyte infiltration into inflamed tissue C. Vasoconstriction and fluid influx in the interstitial space D. Vasodilation with increased capillary permeability

D. Vasodilation with increased capillary permeability

what day does ovulation occur?

DAY 14

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

Dantrolene

A client with amyotrophic lateral sclerosis is experiencing muscle spasticity. Which of the following drugs would the nurse expect the physician to order?

Dantrolene

Acts within skeletal muscle fibers, interfering with the release of calcium from the muscle tubules

Dantrolene

Direct-Acting Skeletal Muscle Relaxant Prototype

Dantrolene

Most muscle relaxants drugs are CNS depressants. Which of the following medications acts only on the muscle?

Dantrolene

Used to treat upper motor neuron spasticity in children

Dantrolene

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

Dantrolene (Dantrium)

A patient is having surgery to repair a ruptured Achilles tendon. The patient develops severe muscle contractions and hyperthermia. Which medications will be administered?

Dantrolene sodium (Dantrium)

The use of neuromuscular junction blockers may sometimes cause a condition known as malignant hyperthermia. The drug of choice for prevention or treatment of this condition is

Dantrolene.

A patient has been admitted to your unit for treatment of a multiple sclerosis exacerbation. The admission order indicates that the patient is taking baclofen (Lioresal). Which of the following outcomes would you expect to be associated with use of this medication?

Decreased muscle spasms

Which results with the administration of testosterone?

Decreased protein catabolism

he nurse is administering phenytoin to a client who is also receiving a continuous nasogastric enteral feeding and is aware of what possible effect?

Decreasing the absorption of the AED

When fluoxymesterone is administered to a 14-year-old male, what is the expected result?

Development of sexual organs

A client is brought to the emergency department in the midst of acute alcohol withdrawal accompanied by seizure activity. What drug is most likely to meet this client's needs?

Diazepam (Valium)

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

Diazepam (Valium)

Which of the following medications is classified as an antianxiety medication but is also used to treat muscle spasms?

Diazepam (Valium)

Patients receiving chlorzoxazone (Paraflex) should be cautioned that which of the following will occur with administration?

Discoloration of urine

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

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.

The nurse is reviewing the results of a hospital client's serum phenytoin level, which has just become available. The results indicate that the client's phenytoin level is 17.5 mcg/mL. What is the nurse's best action?

Document the fact that the nurse checked the client's phenytoin levels

A client is receiving botulinum toxin type A as treatment for her frown lines. The nurse would instruct the client about which of the following?

Drooping eyelids

A nurse administers carisoprodol to a patient for the treatment of an acute musculoskeletal condition. What adverse reaction of the administration of carisoprodol should the nurse monitor for in this patient?

Drowsiness

A patient is administered cyclobenzaprine (Flexeril). Which adverse effect can you expect with this medication?

Drowsiness

Which of the following is the most common adverse reaction to carisoprodol (Soma) that the nurse should discuss with the patient? (Choose one)

Drowsiness

Which adverse effects would a nurse most likely assess in a client who is receiving a centrally acting skeletal muscle relaxant? (Select all that apply.)

Drowsiness Insomnia Dry mouth Constipation

A man with no significant medical history is being prepared for outpatient surgery under general anesthesia. As part of the preparation for surgery, the anesthesiologist administers atropine, a anticholinergic agent. What is the purpose of administering this medication at this time?

Dry up secretions in the respiratory tract.

The patient has been diagnosed with dry age-related degeneration (ARMD). What medication(s) is/are available for treatment? Select all that apply. A. Aflibercept (Eylea) B. Bevacizumab (Avastin) C. Pegaptanib (Macugen) D. Ranibizumab (Lucentis) E. There is no treatment for dry ARMD

E. There is no treatment for dry ARMD

A client alerts the nurse she has been in menopause for a couple of months. The nurse teaches the client how menopause occurs. Which statement reflects the teaching has been effective?

Estrogen and Progesterone diminish

After describing the process of spermatogenesis to a group of students, the instructor determines that the teaching was successful when the students identify what as being responsible?

FSH- follicle stimulating hormone

A client presents to the emergency department with severe pain and receives methocarbamol by injection. As part of the nurse's safety care plan, the nurse should instruct the client that she may experience which common adverse reaction?

Fainting, incoordination, and hypotension

Muscle spasticity is the result of damage to peripheral structures rather than to injured neurons.

False

The pyramidal tract is located primarily within the basal ganglia.

False

True or False: The pyramidal tract is located primarily within the basal ganglia.

False; Located in the CNS

True or False: Muscle spasticity is the result of damage to peripheral structures rather than to injured neurons.

False; Muscle spasticity is the result of damage to neurons within the CNS rather than injury to peripheral structures

A patient has been started on dantrolene (Dantrium). What is the most serious adverse effect on which the patient should be instructed?

Fatal hepatitis

The nurse is assessing a patient for possible risk factors for the development of hepatotoxicity with the use of dantrolene. What situations would the nurse identify as requiring cautious use?

Female gender

The pharmacology instructor is discussing the differences between monotherapy and therapy that includes AEDs. What would the instructor cite as an advantage of monotherapy?

Fewer drug-drug interactions

Define pyramidal tract

Fibers within the CNS that control precise, intentional movement

After describing the process of spermatogenesis to a group of students, the instructor determines that the teaching was successful when the students identify what as being responsible?

Follicle stimulating hormone

The nurse has a patient demonstrate self-administration of eyedrops. Place the steps in the order in which the patient will perform them. A. Pull the lower lid away from the eye so that a pouch is formed B. Gently shake the bottle to evenly distribute the drug C. Press a finger against the inner corner of the eye for 2 to 3 minutes D. Remove the cap E. Tilt the head backward, and look upward F. Place the dropper just above the pouch without touching the tip to the eye or finger G. Wash hands H. Gently squeeze one drop of medicine into the pouch

G, B, D, E, A, F, H, C

A 28-year-old patient has a history of malignant hyperthermia following anesthesia. Today, this patient is on the operating room schedule for a D&C;. Which method of anesthesia would not be acceptable for this patient?

General anesthesia with an inhalation agent

When reviewing a journal article about seizure disorders, the nurse would expect to find tonic-clonic seizures and myoclonic seizures being classified as which type of seizures?

Generalized seizures

Which type of seizures involves a loss of consciousness?

Generalized seizures

After teaching a group of students about hormonal secretion of the reproductive system, the instructor determines that the teaching was successful when the students identify what as initiating hormone secretion from the ovaries and testes?

Gonadotropin releasing hormone

Which hormone would be initially responsible for hormone secretion from the ovaries and testes?

Gonadotropin-releasing hormone

Signs and symptoms of which of the following would necessitate discontinuation of dantrolene therapy?

Hepatic dysfunction

Dantrolene should be avoided in all patients who are 35 or older because of the increased risk of which of the following?

Hepatocellular disease

What is the best position for the client after the administration of a bisphosphonate medication?

High Fowler's

The nurse is obtaining a history from a 23-year-old man. The nurse suspects that the client may be using DHEA if he displays which symptom?

Hirsutism

The nurse is obtaining a history from a 23-year-old man. The nurse suspects that the client may be using DHEA if he displays which symptom?

Hirtuism (hair growth)

A patient comes to a clinic for a botox injection around his eyes. While collecting admission assessment data, the nurse learns that the patient is taking a polymyxin antibiotic for a skin infection involving the eyes. What is the nurse's priority action?

Hold the injection and consult the provider

Fertilization of the ovum and implantation in the uterine wall result in the production of what hormone?

Human chorionic gonadotropin

A patient is taking tizanidine (Zanaflex) to treat spasticity from multiple sclerosis. Which of the following adverse effects of muscle relaxants is most pronounced with this medication?

Hypotension

When teaching a group of high school students about using anabolic steroids, the nurse would include information that these drugs are classified as which class of controlled substances?

III

A female client is prescribed estradiol cypionate for treatment of severe vasomotor symptoms associated with menopause. The nurse would expect to administer this drug by which route?

IM

The nurse knows there are certain effects with the use of epidural anethesia. When a client is receiving epidural anesthesia, which will help to reduce the potential for a headache caused by the epidural? Select all that apply.

IV hydration Lying supine

Which is associated with an increase in gonadotropin-releasing hormone secretion?

Increased light exposure

The client is about to undergo surgery. The circulating nurse knows that methohexital (Brevital) is used for which purposes? Select all that apply.

Induction of anesthesia Supplement to other anesthetics Depress the central nervous system to produce hypnosis

A male client informs his physician that sildenafil therapy is not working for him. What is most likely to be the reason for this and needs to be carefully assessed for by the nurse?

Ingestion of high-fat meal along with the drug

What represents routes in which general anesthesia is most commonly achieved? (Select all that apply.)

Inhalation, IV

What teaching points would a nurse include when describing the action of tizandine to peers?

Inhibition of presynaptic motor neurons in the CNS

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

Interference with calcium release from the muscles

When caring for a patient receiving estrogen therapy, which action would be an appropriate part of the evaluation process?

Interviewing the patient and observing for therapeutic and adverse effects

A client with spastic hypertonia resulting from cerebral palsy has not responded appreciably to oral baclofen. During the client's care conference, the nurse should anticipate a discussion about what possible treatment?

Intrathecal baclofen infusion

In clients with spinal cord injury, spasticity requires treatment when:

It impairs safety, mobility, or the ability to participate in activities of daily living.

What stimulates the production of testosterone by the Leydig cells located in the testes?

LH

When teaching an adolescent about ovulation, the nurse would include that ovulation is initiated by a surge in:

LH

Gonadotropin-releasing hormone (GnRH) stimulates the anterior pituitary to release which hormones?

LH, FSH

Damage to what component of the male reproductive system would result in a lack of testosterone?

Leydig cells

Which cells in the testes produce testosterone?

Leydig cells

The nurse at an urgent care clinical is reviewing local anesthetics. What drug should the nurse recognize as an amide?

Lidocaine

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 client comes to the emergency department. The client has a small wound that requires suturing. The nurse would anticipate which type of anesthesia?

Local infiltration anesthesia

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

Lorazepam

Define basal ganglia

Lower area of the brain, associated w/ coordination of unconscious muscle movements that involve movement and position

Define cerebellum

Lower portion of the brain, associated w/ coordination of muscle movements, including voluntary motion, as well as extrapyramidal control of unconscious muscle movements

A 30-year-old client is to receive tetracaine (Pontocaine) via spinal anesthesia for an abdominal procedure. What should the nurse do to prevent side effects of this type of anesthesia?

Maintain the client in a supine position following the procedure.

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

An otherwise healthy surgical client has developed sharply increased muscle tone and rapid increase in heart rate and core body temperature. The operating room (OR) team should proceed with assessments and interventions that address what health problem?

Malignant hyperthermia

A woman who has been prescribed high doses of anabolic steroids should be instructed on which effects?

Masculinization

Baclofen is not

Metabolized

The drug of choice if a child needs to be treated for tetanus

Methocarbamol

What agent would the nurse identify as also being used to treat tetanus?

Methocarbamol

Which agent would the nurse identify as also being used to treat tetanus?

Methocarbamol

Which is the drug of choice in children who need to be treated with tetanus?

Methocarbamol (Robaxin)

Which of the following is the drug of choice in children who need to be treated with tetanus?

Methocarbamol (Robaxin)

A nurse may be asked to administer which drug prior to a colonoscopy in order to help the client relax?

Midazolam

A 22-year-old woman is in the clinic to end an early pregnancy. She takes three tablets of mifepristone (Mifeprex). Two days after she takes the medication, she returns to the clinic to see if she is still pregnant or if the medical abortion is complete. It is determined that she is still pregnant. The nurse will administer which drug?

Misoprostol

A client, newly diagnosed with a seizure disorder, has been prescribed valproic acid. When assessing for adverse effects, what assessment should the nurse prioritize?

Monitoring the client's liver enzyme levels

Dantrolene

Most muscle relaxants drugs are CNS depressants. Which of the following medications acts only on the muscle?

A client received fentanyl during a surgical procedure. The nurse will have what drug available to treat any possible respiratory depression associated with the use of fentanyl?

Naloxone: on hand to reverse the effects of the opioid that is causing respiratory depression.

Define interneuron

Neuron in the CNS that communicates w/ other neurons, not w/ muscles or glands

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

No known cause

A client in the ambulatory care clinic is experiencing shortness of breath, and facial and throat edema, while receiving a pegloticase infusion. What is the nurse's best action?

Notify emergency personnel

Insufficient levels of oxytocin would affect what event related to pregnancy?

Onset of labor contractions

What centrally acting skeletal muscle relaxant could the nurse administer IV?

Orphenadrine (Banflex)

After teaching a group of students about anabolic steroids, the instructor determines that the teaching was successful when the students identify which agent as an example?

Oxandrolone

After teaching a group of students about the events that occur with fertilization and implantation of an ovum, the instructor determines that the teaching has been effective when the students identify what as an endocrine structure?

Placenta

One of the adverse effects of dantrolene (Dantrium) includes:

Potentially fatal hepatitis.

A client is started on terbutaline therapy. What would indicate that the therapy has been successful?

Premature birth is avoided for at least 24 hours.

A 30-year-old debilitated client is receiving anabolic steroids. Which might the client experience?

Priapism

If an ovum is fertilized and implants into the uterine wall, which would occur next?

Production of human chorionic gonadotropin

what follows fertilization and implantation

Production of human chorionic gonadotropin

The client in the intensive care unit (ICU) is intubated and on a respirator. What drug would the nurse be told to give so that the client receives continuous sedation while intubated

Propofol

The nurse in the intensive care unit prepares to administer a medication that is used for induction and maintenance of anesthesia, but may also be used to continuously administer sedation to clients who are intubated. Which medication is it?

Propofol

The nurse is caring for a client in the post-anesthetic care unit (PACU). The client is disoriented and agitated, with an increased heart rate and respiratory rate. What is the nurse's best action?

Provide reassurance to the client while providing close monitoring

The nurse prepares to receive a client after a cesarian section who received isoflurane during general anesthesia. Based upon the drug's adverse effects, which measures would the nurse provide postoperatively? Select all that apply.

Provide warm blankets. Administer prescribed antiemetic. Assess for increased bleeding. Monitor oxygenation and vitals frequently.

What is responsible for controlling precise intentional movement?

Pyramidal tract

A client is receiving lamotrigine as treatment for partial seizures. Which assessment finding would lead the nurse to stop the drug immediately?

Rash

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 physician to do?

Reduce the dose

A nurse is caring for a patient who is receiving cyclobenzaprine. Which of is the action of the drug on the patient?

Reduction of muscle spasm

A nurse is caring for a patient who is receiving cyclobenzaprine. Which of the following is the action of the drug on the patient?

Reduction of muscle spasm

The nurse is aware that progestins will be prescribed with extreme caution in a client with which condition? (Select all that apply.)

Renal disease Epilepsy Asthma

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.

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

Respiratory depression

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

When reviewing a client's history, which condition would the nurse identify as contraindicating the use of a centrally acting skeletal muscle relaxant?

Rheumatic disorder

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 40-year-old woman 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 when updating the nursing care plan for this patient?

Risk for Injury related to CNS depressant effects

A patient who experienced a lower back injury while doing yard work 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 patient's drug regimen?

Risk for Injury related to CNS depression

After teaching a class on the female reproductive system, the nurse determines that the teaching was successful when the class identifies what as a primary function of the ovaries?

Secretion of estrogen and progesterone

Hepatic dysfunction

Signs and symptoms of which of the following would necessitate discontinuation of dantrolene therapy?

Define spindle gamma loop system

Simple reflex arcs that involve sensory receptors in the periphery that respond to stretch and spinal motor nerves and cause muscle fiber contraction: Responsible for maintaining muscle tone and keeping an upright position against the pull of gravity

What would be a contraindication for the use of a methocarbamol?

Spasm due to rheumatoid arthritis

True

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

Define hypertonia

State of excessive muscle response and activity

Define spasticity

Sustained muscle contractions

The human sexual response involves the activation of which system?

Sympathetic nervous system -follows the phase of stimulation, plateau, climax, resolution

A 29-year-old female client in labor has just received epidural anesthesia. Before the procedure her blood pressure was 120/78 and her pulse was 60 bpm. Now her blood pressure is 100/60 and her pulse is 80 bpm. She reports a metallic taste in her mouth, hears a ringing in her ears, and appears confused. What is this client most likely experiencing?

Systemic toxicity from local anesthesia

A nurse is preparing a class on the various drugs used to treat erectile dysfunction. Which would the nurse include?

Tadalafil

A client diagnosed with benign prostatic hypertrophy (BPH) is prescribe tamsulosin. The client communicates with the nurse about a friend that was prescribed sildenafil for his BPH. Which is the nurse's best response regarding the difference in the use of the two drugs for BPH?

Tamsulosin relaxes muscles in the prostate and bladder and increases ability to urinate.

How will the addition of nitrous oxide or IV anesthetics affect the minimum alveolar concentration (MAC) of isoflurane?

The MAC will decrease

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 60 year-old female client has multiple sclerosis accompanied by muscle spasticity. The client has responded well to dantrolene 200 mg PO daily in divided doses. What assessment finding should the nurse prioritize for communication to the client's provider?

The client's most recent laboratory results show an upward trend in AST and ALT levels

Dantrolene is being considered for the treatment of a client's spasticity. Which aspect of the client's current health status is most likely to contraindicate the use of this medication

The client's spasticity is due to rheumatoid arthritis

A male client is prescribed sildenafil for the treatment of erectile dysfunction. What mechanism of action of sildenafil causes a sustained erection?

The drug inhibits phosphodiesterase (PDE) type 5, consequently decreasing the metabolism of cGMP.

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

A patient's physician has prescribed baclofen in an effort to treat the patient's neuropathic cancer pain. What patient education should the nurse prioritize when teaching the patient about this new medication?

The importance of ensuring safety related to possible sedation

• "Rise carefully from a seated to a standing position." • "This medication may cause you to have to urinate more frequently." • "This medicine may give you a headache or make sleeping difficult."

The nurse's home care teaching for a client who takes baclofen will include which instructions?

Cyclobenzaprine produces an anticholinergic response, resulting in these side effects.

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

Which of the following patients is at greatest risk for experiencing status epilepticus?

The patient who suddenly stops drinking after consuming large amounts of alcohol for the past 5 years

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?

A 74-year-old woman states that many of her peers underwent hormone replacement therapy (HRT) in years past. The woman asks the nurse why her primary care provider has not yet proposed this treatment for her. What fact should underlie the nurse's response to the woman?

The risks of stroke and breast cancer are unacceptably high in women taking HRT

The nursing students are learning about synergistic effects of combined medications. Which is a desired effect of combining epinephrine with a local anesthetic? Select all that apply.

There is a lower risk of systemic toxicity. The local anesthetic stays in the desired tissues longer

The nurse is discussing infertility issues with a couple. What information should the nurse provide the couple concerning the effect of Sertoli cells of male sperm?

They produce inhibin a substance that in turn affects sperm production

When caring for a patient receiving estrogen replacement therapy for postmenopausal symptoms, the nurse documents a diagnosis related to impaired tissue perfusion. Which condition is the nurse referring to in the diagnosis?

Thromboembolism

An alpha-adrenergic agonist and is thought to increase inhibition of presynaptic motor neurons in the CNS

Tizanidine

When epinephrine is mixed with a local injectable anesthetic, it is done for what purpose?

To cause vasoconstriction

Centrally acting skeletal muscle relaxants lyse or destroy the spasm.

True

Muscle spasms are thought to arise from the flood of sensory impulses coming to the spinal cord from an injured area

True

Muscle spasms are thought to arise from the flood of sensory impulses coming to the spinal cord from an injured area.

True

Muscle spasms are thought to arise from the floor of sensory impulses coming to the spinal cord from an injured area.

True

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

True

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

True

True or False: Centrally acting skeletal muscle relaxants lyse or destroy the spasm.

True

True or False: Muscle spasms are thought to arise from the flood of sensory impulses coming to the spinal cord from an injured area.

True

True or False: Spinal reflexes are the simplest nerve pathways that monitor movement and posture.

True

A female client age 25 years is prescribed methotrexate to treat rheumatoid arthritis (RA). The nurse should teach the client to do which of the following?

Use an effective contraceptive.

Which vitamin supplements should the nurse recommend while a postmenopausal client is taking alendronate (Fosamax)?

Vitamin D and calcium

What would a nurse attribute to the effect of testosterone? (Select all that apply.)

Vocal cord thickening Increased hematocrit Facial hair growth

A client has received lidocaine (Xylocaine) 2% for a skin laceration repair. Before the repair begins, how would the nurse assess this client for adequate pain relief?

Wait 2 to 5 minutes and assess the area for pain and sensitivity to touch or pressure.

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 of the following instructions?

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.

What should a nurse's pre-administration assessment for a client about the receive oxymetholone (Anadrol-50) include? (Select all that apply.)

Weight Fasting lipid panel Hepatic function tests

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?

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

Coordination of position and posture

When describing the function of the extrapyramidal system, which of the following would the instructor include?

Baclofen (Lioresal)

Which of the following is an example of a skeletal muscle relaxant?

Drowsiness

Which of the following is the most common adverse reaction to carisoprodol (Soma) that the nurse should discuss with the patient?

Dantrolene (Dantrium)

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

Baclofen (Lioresal)

Which of the following skeletal muscle relaxants is also available in intrathecal form?

Spasm due to rheumatoid arthritis

Which of the following would be a contraindication for the use of a methocarbamol?

Discontinue the use of alcohol

Which of the following would be the most important safety-related instruction for a nurse to give to a patient taking baclofen (Lioresal)?

Which patient would likely have the highest risk for hepatotoxicity from dantrolene (Dantrium)?

a women on HRT

The nurse is teaching a female patient who will begin taking 2 tablets of 325 mg acetaminophen every 4 to 6 hours as needed for pain. Which statement by the patient indicates understanding of the teaching? a. "I may take acetaminophen up to 6 times daily if needed." b. "I should increase the dose of acetaminophen if I drink caffeinated coffee." c. "If I take oral contraceptive pills, I should use back-up contraception." d. "It is safe to take acetaminophen with any over-the-counter medications."

a. "I may take acetaminophen up to 6 times daily if needed."

The nurse is providing teaching to a patient who will begin taking aspirin to treat arthritis pain. Which statement by the patient indicates a need for further teaching? a. "I should increase fiber and fluids while taking aspirin." b. "I will call my provider if I have abdominal pain." c. "I will drink a full glass of water with each dose." d. "I will notify my provider of ringing in my ears."

a. "I should increase fiber and fluids while taking aspirin."

A patient who has osteoarthritis with mild to moderate pain asks the nurse about taking over-the-counter ibuprofen (Motrin). What will the nurse tell this patient? a. "It may take several weeks to achieve therapeutic effects." b. "Unlike aspirin, there is no increased risk of bleeding with ibuprofen." c. "Take ibuprofen twice daily for maximum analgesic benefit." d. "Combine ibuprofen with acetaminophen for best effect."

a. "It may take several weeks to achieve therapeutic effects."

Which patient may require a higher than expected dose of an opioid analgesic? a. A patient with cancer b. A patient with a concussion c. A patient with hypotension d. A patient 3 days after surgery

a. A patient with cancer

The nurse administers proparacaine HCl (Ophthaine) drops to a patient prior to an eye examination. What sign will the nurse look for to determine when the examination can begin? a. Absence of the blink reflex b. Blurred vision c. Drying of the corneal epithelium d. Photophobia

a. Absence of the blink reflex

The parent of a 5-year-old child asks the nurse to recommend an over-the-counter pain medication for the child. Which analgesic will the nurse recommend? a. Acetaminophen (Tylenol) b. Aspirin (Ecotrin) c. Diflunisal (Dolobid) d. Ibuprofen (Motrin)

a. Acetaminophen (Tylenol)

The nurse is caring for a patient who was admitted with a fractured leg and for observation of a closed head injury after a motor vehicle accident. The patient reports having pain at a level of 3 on a 1 to 10 pain scale. The nurse will expect the provider to order which analgesic medication for this patient? a. Acetaminophen (Tylenol) PO b. Hydromorphone HCl (Dilaudid) IM c. Morphine sulfate PCA d. Transdermal fentanyl (Duragesic)

a. Acetaminophen (Tylenol) PO

The nurse is preparing to administer olopatadine (Patanol) eyedrops to a patient who has allergic conjunctivitis. The patient tells the nurse that the drops have caused burning and stinging. What action will the nurse take? a. Administer the drops and reassure the patient that this is a normal side effect. b. Offer an over-the-counter eye lubricant to minimize this adverse effect. c. Request an order for antibiotic eyedrops. d. Withhold the medication and notify the provider.

a. Administer the drops and reassure the patient that this is a normal side effect.

The nurse is preparing to administer methocarbamol (Robaxin) to a patient who is experiencing acute muscle spasms. The nurse notes that the patient's urine has turned black. What will the nurse do? a. Administer the next dose of methocarbamol since this is a harmless side effect. b. Contact the provider to discuss changing to cyclobenzaprine (Flexeril). c. Obtain an order for a complete blood count to evaluate blood loss. d. Request an order for liver function tests since this indicates hepatotoxicity.

a. Administer the next dose of methocarbamol since this is a harmless side effect.

The nurse is caring for a patient who has multiple sclerosis. The patient is experiencing an acute attack. Which drug does the nurse anticipate the provider will order? a. Adrenocorticotropic hormone (ACTH) b. Cyclophosphamide (Cytoxan) c. Glatiramer acetate (Copaxone) d. Interferon-B (IFN-B)

a. Adrenocorticotropic hormone (ACTH)

Which antigout medication is used to treat chronic tophaceous gout? a. Allopurinol (Zyloprim) b. Colchicine c. Probenecid (Benemid) d. Sulfinpyrazone (Anturane)

a. Allopurinol (Zyloprim)

The nurse is performing a medication history on a patient who has glaucoma. The patient cannot remember the name of the drug prescribed but tells the nurse that the drug causes light sensitivity. The nurse knows that the drug is among which class of medications? a. Alpha-adrenergic agonists b. Beta-adrenergic blockers c. Cholinergic agonists d. Cholinesterase inhibitors

a. Alpha-adrenergic agonists

The nurse is administering timolol (Timoptic) eye drops to a patient who has glaucoma. To prevent bradycardia, the nurse will perform which action? a. Apply pressure to the lacrimal ducts. b. Have the patient sit up after instilling the drops. c. Prepare to administer an alpha-adrenergic agonist. d. Wait 5 minutes between drops.

a. Apply pressure to the lacrimal ducts.

The nurse is performing a health history on a patient who has arthritis. The patient reports tinnitus. Suspecting a drug adverse effect, the nurse will ask the patient about which medication? a. Aspirin (Bayer) b. Acetaminophen (Tylenol) c. Anakinra (Kineret) d. Prednisone (Deltasone)

a. Aspirin (Bayer)

A patient who takes high-dose aspirin to treat rheumatoid arthritis has a serum salicylate level of 35 mg/dL. The nurse will perform which action? a. Assess the patient for tinnitus. b. Monitor the patient for signs of Reye's syndrome. c. Notify the provider of severe aspirin toxicity. d. Request an order for an increased aspirin dose.

a. Assess the patient for tinnitus.

The nurse is caring for a patient who has increased intraocular pressure. The provider has ordered a cholinergic agonist. The nurse will perform a thorough health history to make sure the patient does not have a history of which condition? a. Asthma b. Diabetes c. Hypertension d. Renal disease

a. Asthma

The nurse is preparing to administer dipivefrin (Propine) drops as a mydriatic agent. Which assessment would cause the nurse to withhold the drug and notify the provider? a. Blood pressure of 140/90 mm Hg b. Heart rate of 60 beats per minute c. Respiratory rate of 12 breaths per minute d. Temperature of 37.9° C

a. Blood pressure of 140/90 mm Hg

A postoperative patient has a history of opioid abuse. Which analgesic medication will the nurse expect the provider to order for this patient? a. Buprenorphine (Buprenex) b. Butorphanol tartrate (Stadol) c. Naloxone (Narcan) d. Pentazocine (Talwin)

a. Buprenorphine (Buprenex)

A patient has symptoms that are characteristic of multiple sclerosis (MS). Which diagnostic tests are likely to be ordered to aid in the diagnosis of this patient? a. Cerebrospinal fluid (CSF) immunoglobulin G and magnetic resonance imaging (MRI) b. CSF proteins and an angiography c. Serum albumin and a computed tomography (CT) scan d. Serum anti-acetylcholine antibodies and x-rays

a. Cerebrospinal fluid (CSF) immunoglobulin G and magnetic resonance imaging (MRI)

The nurse is caring for a postoperative older patient who received PO hydrocodone with acetaminophen (Lortab) 45 minutes prior after reporting a pain level of 8 on a scale of 1 to 10. The patient reports a pain level of 4, and the nurse notes a respiratory rate of 20 breaths per minute, a heart rate of 92 beats per minute, and a blood pressure of 170/95 mm Hg. Which action will the nurse take? a. Contact the provider and request an order for a more potent opioid analgesic. b. Reassess the patient in 30 minutes. c. Request an order for ibuprofen to augment the opioid analgesic. d. Suggest that the patient use nonpharmacologic measures to relieve pain.

a. Contact the provider and request an order for a more potent opioid analgesic.

A patient is taking ibuprofen 400 mg every 4 hours to treat moderate arthritis pain and reports that it is less effective than before. What action will the nurse take? a. Counsel the patient to discuss a prescription NSAID with the provider. b. Recommend adding aspirin to increase the antiinflammatory effect. c. Suggest asking the provider about a short course of corticosteroids. d. Tell the patient to increase the dose to 800 mg every 4 hours.

a. Counsel the patient to discuss a prescription NSAID with the provider.

The nurse is assessing a patient who has gout who will begin taking allopurinol (Zyloprim). The nurse reviews the patient's medical record and will be concerned about which laboratory result? a. Elevated BUN and creatinine b. Increased serum uric acid c. Slight increase in the white blood count d. Increased serum glucose

a. Elevated BUN and creatinine

A patient who is 7 months pregnant and who has arthritis asks the nurse if she can take aspirin for pain. The nurse will tell her not to take aspirin for which reason? a. It can result in adverse effects on her fetus. b. It causes an increased risk of Reye's syndrome. c. It increases hemorrhage risk. d. It will cause increased gastrointestinal distress.

a. It can result in adverse effects on her fetus.

A nursing student asks the nurse to explain the role of cyclooxygenase-2 (COX-2) and its role in inflammation. The nurse will explain that COX-2 a. converts arachidonic acid into a chemical mediator for inflammation. b. directly causes vasodilation and increased capillary permeability. c. irritates the gastric mucosa to cause gastrointestinal upset. d. releases prostaglandins, which cause inflammation and pain in tissues.

a. converts arachidonic acid into a chemical mediator for inflammation.

A client who was prescribed vardenafil has a sustained erection and is being seen in the emergency department. What is the priority nursing diagnosis?

acute pain

where are the nicotinic receptors found

adrenal medulla

A nurse is caring for a male patient who has a spinal cord injury due to a motorcycle accident. He has been taking dantrolene (Dantrium) for 2 weeks. The nurse will monitor:

alanine aminotransferase and total bilirubin levels

Before the drugs are prescribed, a complete medical history, physical examination, pap test, urinalysis, and weight and blood pressure measurements are recommended.

all this crap before getting a prescription for contraceptives

Spasticity may result from

an increase in excitatory influences or a decrease in inhibitory influences within the CNS.

secondary male characteristics remain due to what?

androgen

The nurse instructs a client to use benzocaine to soothe the itching and pain related to an insect bite. Benzocaine is considered to be what type of dermatologic agent?

anesthetic

An older adult client's current medication regimen includes tamsulosin and sildenafil. The combination of these two medications should prompt what action by the nurse?

assessing the client regularly for signs of orthostatic hypotension

The nurse is closely following a client who began treatment with testosterone several months earlier. When assessing the client for potential adverse effects of treatment, the nurse should prioritize which assessment?

assessment of calcium levels

Multiple Sclerosis (MS) Pathophysiology: - _____________ disorder - Attacks __________ sheath of nerve fibers in _______ and _______ _______ - Causes __________ or __________ Characteristics: - remissions and __________ - Weakness - ______________ in extremities - ______________

autoimmune, myelin, brain, spinal cord, lesions, plaques, exacerbations, spasticity, diplopia

Myasthenia Gravis (MG) Pathophysiology: -___________ disorder - Lack of _________ impulses and ________ responses at __________ junction - ____________ secretion of acetylcholine - Loss of __________ because of an increase in the enzyme _______________ - ___________ gland

autoimmune, nerve, muscle, myoneural, inadequate, acetylcholine, acetylcholinesterase, thymus

A client with muscle spasticity has been prescribed baclofen. In order to promote the safe use of this medication, the nurse should encourage the client to:

avoid drinking alcohol for the duration of treatment.

Sildenafil has been prescribed to a client in his 60s, and the nurse is providing health education about the safe and effective use of the drug. The nurse should teach the client to:

avoid taking more than 1x in a 24 hour period

The circulating nurse knows that what is the most important nursing intervention during Stage II of general anesthesia?

avoid unnecessary noise in the operating room

The nurse provides teaching for a patient who will begin taking indomethacin (Inderal) to treat rheumatoid arthritis. Which statement by the patient indicates a need for further teaching? a. "I should limit sodium intake while taking this drug." b. "I should take indomethacin on an empty stomach." c. "I will need to check my blood pressure frequently." d. "I will take the medication twice daily."

b. "I should take indomethacin on an empty stomach."

The nurse provides teaching for a patient who will begin taking allopurinol. Which statement by the patient indicates understanding of the teaching? a. "I should increase my vitamin C intake." b. "I will get yearly eye exams." c. "I will increase my protein intake." d. "I will limit fluids to prevent edema."

b. "I will get yearly eye exams."

The nurse is teaching a group of nursing students about multiple sclerosis (MS). Which statement by the nurse is correct? a. "MS is characterized by degeneration of neurons and nerves in the brain and spinal cord." b. "MS is characterized by lesions or plaques on myelin sheaths of nerves." c. "MS is characterized by neuritic plaques and neurofibrillary tangles in the CNS." d. "MS is characterized by weak muscles and decreased nerve impulses caused by decreased ACh."

b. "MS is characterized by lesions or plaques on myelin sheaths of nerves."

The nurse is discussing celecoxib (Celebrex) with a patient who will use the drug to treat dysmenorrhea. What information will the nurse include in teaching? a. "Do not take the medication during the first 2 days of your period." b. "The initial dose will be twice the amount of subsequent doses." c. "Take this medication with food to minimize gastrointestinal upset." d. "Take the drug on a regular basis to prevent dysmenorrhea."

b. "The initial dose will be twice the amount of subsequent doses."

The nurse is teaching a patient about using high-dose aspirin to treat arthritis. What information will the nurse include when teaching this patient? a. "A normal serum aspirin level is between 30 and 40 mg/dL." b. "You may need to stop taking this drug a week prior to surgery." c. "You will need to monitor aspirin levels if you are also taking warfarin." d. "Your stools may become dark, but this is a harmless side effect."

b. "You may need to stop taking this drug a week prior to surgery."

The nurse is performing an admission assessment on a stable patient admitted after a motor vehicle accident. The patient reports having "bad pain." What will the nurse do first? a. Administer acetaminophen (Tylenol). b. Ask the patient to rate the pain on a 1 to 10 scale. c. Attempt to determine what type of pain the patient has. d. Request an order for an intravenous opioid analgesic.

b. Ask the patient to rate the pain on a 1 to 10 scale.

The nurse is preparing to care for a patient who has multiple sclerosis (MS). The nurse learns that the patient receives cyclophosphamide (Cytoxan). The nurse knows that this patient is in which stage of MS? a. Acute attack phase b. Chronic, progressive phase c. End-stage phase d. Remission-exacerbation phase

b. Chronic, progressive phase

The nurse is caring for a patient who has rheumatoid arthritis and who is receiving infliximab (Remicade) IV every 8 weeks. Which laboratory test will the nurse anticipate that this patient will need? a. Calcium level b. Complete blood count c. Electrolytes d. Potassium

b. Complete blood count

The nurse is caring for a patient who has myasthenia gravis (MG) and is receiving pyridostigmine bromide (Mestinon). The nurse notes ptosis of both eyelids and observes that the patient has difficulty swallowing. What action will the nurse perform next? a. Contact the provider to request an order for atropine sulfate. b. Contact the provider to request an order for edrophonium chloride (Tensilon). c. Report signs of cholinergic crisis to the provider. d. Report signs of myasthenic crisis to the provider.

b. Contact the provider to request an order for edrophonium chloride (Tensilon).

The nurse assesses an older patient 60 minutes after administering 4 mg of intravenous morphine sulfate (MS) for postoperative pain. The patient's analgesia order is for 2 to 5 mg of MS IV every 2 hours. The nurse notes that the patient is lying very still. The patient's heart rate is 96 beats per minute, respiratory rate is 14 breaths per minute, and blood pressure is 140/90 mm Hg. When asked to rate the level of pain, the patient replies "just a 5." The nurse will perform which action? a. Give 3 mg of MS at the next dose. b. Give 5 mg of MS at the next dose. c. Request an order for an oral opioid to give now. d. Request an order for acetaminophen to give now.

b. Give 5 mg of MS at the next dose.

A patient reports weakness of the extremities and diplopia. The nurse knows that these symptoms are characteristic of which condition? a. Cerebral palsy (CP) b. Multiple sclerosis (MS) c. Myasthenia gravis (MG) d. Parkinson's disease (PD)

b. Multiple sclerosis (MS)

The nurse checks on a patient who has received sumatriptan (Imitrex) for treatment of a migraine headache. The patient reports moderate improvement in headache pain and reports feeling dizzy. The nurse notes a blood pressure of 160/85 mm Hg. Which action by the nurse is correct? a. Notify the provider of the dizziness. b. Notify the provider of the increased blood pressure. c. Plan to administer a second dose in 1 hour. d. Request an order for intranasal sumatriptan.

b. Notify the provider of the increased blood pressure.

The nurse is caring for a patient who has been taking an NSAID for 4 weeks for osteoarthritis. The patient reports decreased pain, but the nurse notes continued swelling of the affected joints. The nurse will perform which action? a. Assess the patient for drug-seeking behaviors. b. Notify the provider that the drug is not effective. c. Reassure the patient that swelling will decrease eventually. d. Remind the patient that this drug is given for pain only.

b. Notify the provider that the drug is not effective.

Mixed opioid agonist-antagonists were developed in hopes of decreasing what problem? a. Chronic pain b. Opioid abuse c. Renal failure d. Respiratory depression

b. Opioid abuse

The nurse assumes care of a patient in the post-anesthesia care unit (PACU). The patient had abdominal surgery and is receiving intravenous morphine sulfate for pain. The patient is asleep and has not voided since prior to surgery. The nurse assesses a respiratory rate of 10 breaths per minute and notes hypoactive bowel sounds. The nurse will contact the surgeon to report which condition? a. Paralytic ileus b. Respiratory depression c. Somnolence d. Urinary retention

b. Respiratory depression

A nursing student asks how nonsteroidal antiinflammatory drugs (NSAIDs) work to suppress inflammation and reduce pain. The nurse will explain that NSAIDs a. exert direct actions to cause relaxation of smooth muscle. b. inhibit cyclooxygenase that is necessary for prostaglandin synthesis. c. interfere with neuronal pathways associated with prostaglandin action. d. suppress prostaglandin activity by blocking tissue receptor sites.

b. inhibit cyclooxygenase that is necessary for prostaglandin synthesis.

An adolescent female has dysmenorrhea associated with heavy menstrual periods. The patient's provider has recommended ibuprofen (Motrin). When teaching this patient about this drug, the nurse will tell her that ibuprofen a. may decrease the effectiveness of oral contraceptive pills. b. may increase bleeding during her period. c. should be taken on an empty stomach to increase absorption. d. will decrease the duration of her periods.

b. may increase bleeding during her period.

A client with impaired liver function secondary to hepatitis C requires a centrally acting skeletal muscle relaxant for temporary pain relief. What medication would put the least metabolic burden on the client's liver?

baclofen (not metabolized)

Dantrolene is associated with potentially fatal cellular damage. If your patient's condition is being managed with dantrolene, the patient should

be monitored for signs of liver damage and have liver function tests done regularly.

A woman experiencing menopausal symptoms asks the nurse about herbal products that might help. Which would the nurse include in the response?

black cohash

The patient has breast cancer and is in hospice care. She has been taking morphine for pain control. What is the duration of pain relief for controlled-release morphine? a. 1-2 hours b. 4-5 hours c. 8-12 hours d. 24-48 hours

c. 8-12 hours

The nurse is caring for a patient who has recurrent muscle spasms. The provider has ordered metaxalone (Skelaxin) to treat the spasms. The nurse learns that the patient has a history of drug and alcohol abuse. The nurse will contact the provider to discuss switching this patient to which medication? a. Carisoprodol (Soma) b. Chlorzoxazone (Parafon forte DSC) c. Cyclobenzaprine (Flexeril) d. Methocarbamol (Robaxin)

c. Cyclobenzaprine (Flexeril)

A patient is taking aspirin to help prevent myocardial infarction and is experiencing moderate gastrointestinal upset. The nurse will contact the patient's provider to discuss changing from aspirin to which drug? a. A COX-2 inhibitor b. Celecoxib (Celebrex) c. Enteric-coated aspirin d. Nabumetone (Relafen)

c. Enteric-coated aspirin

The nurse is caring for a 6-year-old child who had surgery that morning. The child is awake and lying very still in bed and won't respond when the nurse asks about pain. The nurse will perform which action? a. Ask the child to rate the pain on a scale of 1 to 10. b. Encourage the child to request pain medication when needed. c. Evaluate the child's pain using an "ouch" scale. d. Plan to administer pain medication if the child begins to cry.

c. Evaluate the child's pain using an "ouch" scale.

The nurse is teaching a patient about taking colchicine to treat gout. What information will the nurse include when teaching this patient about this drug? a. Avoid all alcohol except beer. b. Include salmon in the diet. c. Increase fluid intake. d. Take on an empty stomach.

c. Increase fluid intake.

The parent of a toddler asks the nurse what can be done to prevent otitis media. What will the nurse recommend? a. Administer diphenhydramine when the child has a runny nose. b. Give phenylephrine (Neo-Synephrine Ophthalmic) to prevent congestion. c. Keep the child's immunizations up to date. d. Remove cerumen with carbamide peroxide (Auro Ear Drops).

c. Keep the child's immunizations up to date.

The nurse is caring for a postpartum woman who is refusing opioid analgesics but is rating her pain as a 7 or 8 on a 10-point pain scale. The nurse will contact the provider to request an order for which analgesic medication? a. Diclofenac sodium (Voltaren) b. Ketoprofen (Orudis) c. Ketorolac (Toradol) d. Naproxyn (Naprosyn)

c. Ketorolac (Toradol)

The nurse assumes care of a patient who has myasthenia gravis and notes that a dose of neostigmine (Prostigmin) due 1 hour prior was not given. The nurse will anticipate the patient to exhibit which symptoms? a. Excessive salivation b. Muscle spasms c. Muscle weakness d. Respiratory paralysis

c. Muscle weakness

The nurse is caring for a patient who has myasthenia gravis (MG) and takes pyridostigmine bromide (Mestinon) 60 mg every 4 hours. The patient's last dose was 45 minutes prior. The nurse notes severe muscle weakness, excess salivation, fasciculations of facial muscles, and pupil constriction. The nurse will perform which action? a. Assess the patient for signs of ptosis. b. Notify the provider to discuss an order for intravenous immune globulin (IVIG). c. Obtain an order for atropine sulfate. d. Request an order for an extra dose of pyridostigmine

c. Obtain an order for atropine sulfate.

Which muscle relaxant is used in surgery as a skeletal muscle relaxant? a. Baclofen (Lioresal) b. Chlorzoxazone (Parafon forte) c. Pancuronium bromide (Pavulon) d. Methocarbamol (Robaxin)

c. Pancuronium bromide (Pavulon)

The nurse is caring for an African-American patient who has been diagnosed with glaucoma. The nurse anticipates that which medication will be most effective for this client? a. Bimatoprost (Lumigan) b. Latanoprost (Xalatan) c. Travoprost (Travatan Z) d. Unoprostone (Rescula)

c. Travoprost (Travatan Z)

A patient who is taking aspirin for arthritis pain asks the nurse why it also causes gastrointestinal upset. The nurse understands that this is because aspirin a. increases gastrointestinal secretions. b. increases hypersensitivity reactions. c. inhibits both COX-1 and COX-2. d. is an acidic compound.

c. inhibits both COX-1 and COX-2

The nurse is performing an admission assessment on an adolescent who reports taking extra-strength acetaminophen (Tylenol) regularly to treat daily headaches. The nurse will notify the patient's provider and discuss an order for a. a selective serotonin receptor agonist (SSRA). b. hydrocodone with acetaminophen for headache pain. c. liver enzyme tests. d. serum glucose testing.

c. liver enzyme tests.

The nurse is counseling an adolescent patient who has recurrent otitis externa and who works as a lifeguard in the summer about preventing this condition. The nurse will teach this patient to a. avoid using ear plugs while swimming. b. request a prescription for prophylactic antibiotic eardrops. c. use a hair dryer to dry the ears after swimming. d. wear a medical alert bracelet.

c. use a hair dryer to dry the ears after swimming.

A nurse should monitor a client receiving oxytocin for which adverse effects?

cardiac arrhythmias

Extrapyramidal Tract

cells from the cortex and subcortical areas, including the basal ganglia and the cerebellum, which coordinate unconsciously controlled muscle activity; allows the body to make automatic adjustments in posture or position and balance

The extra pyramidal tract is made up of cells from which areas?

cerebral cortex

After 6 months of unsuccessfully trying to conceive, a 31-year-old woman and her husband have sought a referral to a fertility specialist in order to explore their options. A nurse at the clinic should recognize that the woman may benefit from:

chlophiene

After 6 months of unsuccessfully trying to conceive, a 31-year-old woman and her husband have sought a referral to a fertility specialist in order to explore their options. A nurse at the clinic should recognize that the woman may benefit from:

clomiphene

Cyclobenzaprine is available in

controlled release oral form for continual control of the discomfort without repeated dosings

If pregnancy does not occur during the menstrual cycle, the corpus luteum involutes and becomes the:

corpus albicans

The nurse administers nalbuphine (Nubain) to a patient who is experiencing severe pain. Which statement by the patient indicates a need for further teaching about this drug? a. "I may experience unusual dreams while taking this medication." b. "I may need to use a laxative when taking this drug." c. "I should ask for assistance when I get out of bed." d. "I should expect to have more frequent urination."

d. "I should expect to have more frequent urination."

The nurse is providing teaching for a patient who will begin using tobramycin ointment (Nebcin) 0.5 inches 3 times daily. The patient currently uses pilocarpine HCl (Isopto Carpine) drops to treat glaucoma. Which statement by the patient indicates a need for further teaching? a. "I should apply the third dose of tobramycin at bedtime each day." b. "I should instill the drops in the conjunctival sac of the lower eyelid." c. "I should not stop the medications without consulting my provider." d. "I should put the ointment on first and then instill the eyedrops."

d. "I should put the ointment on first and then instill the eyedrops."

The nurse provides teaching to a patient who will begin taking cyclobenzaprine (Flexeril) to treat muscle spasms. Which statement by the patient indicates a need for further teaching? a. "I may experience dizziness and drowsiness when I take this drug." b. "I should not consume alcohol while taking this medication." c. "I should take this medication with food to decrease stomach upset." d. "I will take this medication for three weeks and then stop taking it."

d. "I will take this medication for three weeks and then stop taking it."

A father presents to the emergency department with his 4-year-old son. The father explains that his son had a fever, so he gave the child baby aspirin to decrease the fever and it has not worked. What should concern the nurse about a 4 year-old receiving aspirin? a. Aspirin has the potential to cause gastrointestinal (GI) bleeding in children b. Aspirin has the potential to cause ringing in the ears in children. c. Aspirin has the potential to cause hyperglycemia in children. d. Aspirin has the potential to cause Reye's syndrome in children

d. Aspirin has the potential to cause Reye's syndrome in children

A patient has an infection of the eyelash follicles and in the gland on the eyelid margin. The nurse recognizes these symptoms as being consistent with which condition? a. Blepharitis b. Chalazion c. Endophthalmitis d. Hordoleum

d. Hordoleum

The nurse is performing a health history on a patient who has multiple sclerosis. The patient reports episodes of muscle spasticity and recurrence of muscle weakness and diplopia. The nurse will expect this patient to be taking which medication? a. Adrenocorticotropic hormone (ACTH) b. Cyclophosphamide (Cytoxan) c. Cyclobenzaprine (Flexeril) d. Interferon-B (IFN-B)

d. Interferon-B (IFN-B)

A patient exhibits ptosis of both eyes, and the provider orders edrophonium (Tensilon). The nurse notes immediate improvement of the ptosis. The nurse understands that this patient most likely has which disorder? a. Cerebral palsy b. Multiple sclerosis c. Muscle spasms d. Myasthenia gravis

d. Myasthenia gravis

A patient experiences severe muscle weakness, and the provider orders edrophonium bromide (Tensilon). The patient begins to show improved muscle strength within a few minutes after administration of this drug. The nurse anticipates the provider will order which drug? a. Atropine sulfate b. Edrophonium bromide (Tensilon) c. Intravenous immune globulin (IVIG) d. Pyridostigmine HCl (Mestinon)

d. Pyridostigmine HCl (Mestinon)

One hour after receiving intravenous morphine sulfate, a patient reports generalized itching. The nurse assesses the patient and notes clear breath sounds, no rash, respirations of 14 breaths per minute, a heart rate of 68 beats per minute, and a blood pressure of 110/70 mm Hg. Which action will the nurse take? a. Administer naloxone to reverse opiate overdose. b. Have resuscitation equipment available at the bedside. c. Prepare an epinephrine injection in case of an anaphylactic reaction. d. Reassure the patient that this is a common side effect of this drug.

d. Reassure the patient that this is a common side effect of this drug.

The nurse is evaluating a patient 2 hours after giving a dose of 30 mg of codeine with acetaminophen for postoperative pain after abdominal surgery. The patient reports a pain level of 7 on a scale of 1 to 10. The nurse notes a heart rate of 110 beats per minute, a respiratory rate of 28 breaths per minute, and a blood pressure of 180/90 mm Hg. Which action will the nurse take? a. Administer the next dose of codeine one hour early. b. Ask the provider if the codeine dose can be increased. c. Contact the provider to ask if a dose of ibuprofen may be given now. d. Request an order for oxycodone with acetaminophen (Percocet).

d. Request an order for oxycodone with acetaminophen (Percocet).

The nurse is preparing to care for a patient who has myasthenia gravis. The nurse will be alert to symptoms affecting which body system in this patient? a. Cardiovascular system and postural muscles b. Central nervous system (CNS), memory, and cognition c. Gastrointestinal system (GI) and lower extremity muscles d. Respiratory system and facial muscles

d. Respiratory system and facial muscles

The emergency department nurse is caring for a patient who has received morphine sulfate for severe pain following an injury. The nurse performs a drug history and learns that the patient takes St. John's wort for symptoms of depression. The nurse will observe this patient closely for an increase in which opioid adverse effect? a. Constipation b. Pruritis c. Respiratory depression d. Sedation

d. Sedation

The charge nurse observes a nurse administer undiluted intravenous pyridostigmine bromide (Mestinon) at a rate of 0.8 mg/min. The charge nurse will stop the infusion and perform which action? a. Administer atropine sulfate to prevent cholinergic crisis. b. Monitor the patient closely for respiratory distress. c. Suggest that the nurse dilute the medication with colloidal fluids. d. Tell the nurse to slow the rate of infusion of the pyridostigmine.

d. Tell the nurse to slow the rate of infusion of the pyridostigmine.

The nurse is performing an admission assessment on a patient who has been taking carisoprodol (Soma) for 3 weeks to treat muscle spasms. The patient reports that the muscle spasms have resolved. The nurse will contact the provider to discuss a. changing to cyclobenzaprine (Flexeril). b. continuing the carisoprodol for 1 more week. c. discontinuing the carisoprodol now. d. ordering a taper of the carisoprodol

d. ordering a taper of the carisoprodol

A 40-year-old woman is diagnosed with myasthenia gravis, and her provider recommends removal of her thymus gland. She asks the nurse why this would be helpful. The nurse will explain that removal of the thymus gland may a. increase binding of acetylcholine (ACh) molecules to ACh receptors. b. increase the amount of ACh available at neuromuscular junction sites. c. reduce the number of acetylcholine receptor sites. d. reduce the autoimmune destruction of ACh receptor sites.

d. reduce the autoimmune destruction of ACh receptor sites.

The nurse determines that teaching about testosterone therapy via a transdermal patch is effective when the male client states that he will change the patch in which time frame?

daily

Muscle spasticity is the result of

damage to neurons within the CNS.

While most muscle relaxants drugs are central nervous system (CNS) depressants, which medication acts only on the muscle?

dantrolen

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

dantrolene

Which medication will inhibit the release of calcium in skeletal muscle cells to minimize the development of muscle contractions?

dantrolene sodium

magnesium causes what?

depressed reflexes

Multiple Sclerosis (cont.) - No specific __________ test Laboratory tests that may suggest MS include: -elevated _____________ ___ in the cerebrospinal fluid - Increased _____/___________ ratio - Multiple ___________ observable through _______

diagnostic, immunoglobulin G, IgG, albumin, lesions, MRI

The drug of choice for a patient experiencing severe muscle spasms and pain precipitated by anxiety is

diazepam

Patients receiving chlorzoxazone (Paraflex) should be cautioned that what will occur with administration?

discoloration of urine

excessive eating

does not decease reproductivity

Cyclobenzaprine Interventions: - do not ______ or operate heavy machinery - Not usually taken for __________ than _____ weeks - Avoid ETOH and other depressants - Caution in ___________ and ___________ - Take __________ food - Monitor _______ - Check vital signs - Teach patient not to stop abruptly

drive, more, 3, pregnancy, nursing, with, LFT

A client is receiving botulinum toxin type A as treatment for frown lines. The nurse would instruct the client about:

drooping eyelids

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

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

AChE Inhibitors: Overdosing and Underdosing: - Similar symptoms - Muscle weakness, ___________ - ______________, abdominal _____________ - Drooling, increases __________, sweating - __________________ Myasthenia Crisis: _____________ Choliergic Crisis: _______________

dyspnea, dysphagia, cramping, tearing, bradycardia, underdosed, overdosed

What additional warnings or risks should the nurse include in the teaching plan of a client receiving estrogen?

endometrial cancer

Androgens may be prescribed to women to treat conditions related to the effects of the female sex hormones. Danazol is prescribed to prevent or treat fibrocystic breast disease and:

endometriosis

What is the most plausible rationale for a female client being prescribed danazol?

endometriosis

Menopause occurs when the the female body stops producing which hormones? (Select all that apply.)

estrogen and progesterone

What is the preferred treatment for the diagnosis of atrophic vaginitis?

estrogen preparations

A client on long term testosterone therapy is at risk for the development of hepatocellular cancer. The nurse explains to the client that a hepatic function test should be done and evaluated on what schedule during the therapy?

every 6 months

A female client began an infusion of oxytocin 2 hours ago and the nurse has been conducting regular assessments on her as well as monitoring the fetal heart rate closely. The nurse should prioritize which potential nursing diagnosis in the organization of the client's immediate care?

excess fluid volume...also water toxicity

Dinoprostone can be used to terminate a pregnancy after 20 weeks.

false

Testosterone is injected directly into the corpus spongiosum.

false

The anesthesiologist has informed the operating room nurse that opioids will be used to supplement anesthesia for a client undergoing a partial mastectomy. What opioid is most likely to be utilized?

fetanyol

What is a common risk for epileptic seizures during late infancy to early childhood?

fever

Pyramidal Tract

fibers within the CNS that control precise, intentional movement

Multiple Sclerosis Treatment: Immunomodulators: - _______-line treatment - slows disease progression and prevents __________ -Immunosupressants -Sphingosine 1-phosphate receptor ____________ - _____________ antibodies - corticosteroids - reduces ________ and acute ___________

first, relapses, relapses, modulator, monoclonal, edema, inflammation

Which is an example of an androgen that can be used to treat hypogonadism?

fluoxymesterone

An ovum is allowed to mature and is exposed to estrogen and progesterone in which endocrine gland like storage structure?

follicle

Baclofen should be tapered slowly to prevent

hallucinations

A 66-year-old man has made an appointment with his primary care provider to discuss his recent erectile dysfunction (ED) and has requested a prescription for tadalafil (Cialis) based on television commercials he has seen. What characteristic of this client would contraindicate the use of tadalafil for his ED?

has unstable angina and uses a nitroglycerin patch

Which would the nurse include in a teaching plan about the signs and symptoms of thrombophlebitis and thromboembolism that should be reported by a client taking estrogen?

headaches

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

hepatic dysfunction

A client prescribed dantrolene therapy requires monitoring for what serious adverse effect?

hepatitis

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

hepatitis

A 76-year-old woman has a complex medical history that includes emphysema, osteoporosis, malnutrition, and hypothyroidism. Recently, the woman fell outside her home as a result of weakness and suffered a fracture to her femoral head. The woman's subsequent hip-replacement surgery has been scheduled and the care team recognizes that the use of isoflurane will be most significantly influenced by

history of emphysema

What happens with the hormones associated with pregnancy once the fetus and the placenta have been expelled from the uterus?

hormone decreases

A 30-year-old pregnant woman has been prescribed administration of oxytocin. When assessing the patient's drug regimen, the nurse understands that the patient is taking vasopressors. Which risk is the patient most susceptible to if oxytocin is administered along with vasopressors?

hypertension

Which is NOT a common adverse effect of spinal anesthesia?

hypertension

A 30-year-old pregnant client is 5 cm dilated and has just received epidural anesthesia for pain relief. Which adverse effect is most likely?

hypotension

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:

hypotension

Which adverse effect of muscle relaxants is most pronounced when a client is prescribed tizanidine therapy?

hypotension

which adverse effect of muscle relaxants is most pronounced when a client is prescribed tizanidine therapy?

hypotension

A 63-year-old woman taking estrogen and progestin for several years has recently changed to estrogen alone. What medical event would prompt such a change in treatment?

hysterectomy

In older adult men, anabolic steroids may be prescribed for a deficiency condition. If hypertensive, what might be the cause for an increase in blood pressure?

increase fluid and sodium retention

A nurse administers methylergonovine (Methergine) to a client immediately after delivery of a normal, healthy baby boy. The nurse will advise her that she may experience which common adverse effect of the drug?

increase in BP

The increase in thickness of the endometrial layer during the first half of the menstrual cycle is controlled by the:

increase in level of estrogen

A nurse is working with a 39-year-old patient who is experiencing muscle spasms associated with multiple sclerosis. The patient reports that she needs help with basic care and that her 15-year-old daughter has been helping bathe and dress her for a week. The patient's physician has prescribed baclofen (Lioresal). The nurse and the patient agree that an appropriate goal related to helping her maintain her self-worth would be to

increase self-care in activities of daily living

In describing the effects of progesterone, which would be appropriate to include?

increased body temp

Which would a nurse expect to occur with the administration of anabolic steroids?

increased red blood cell mass

What represents routes in which general anesthesia is most commonly achieved? (Select all that apply.)

inhalation and IV

A muscle spasm often results from

injury to the musculoskeletal system

A perioperative nurse is explaining the process of general anesthesia in anticipation of the adult client's imminent bowel resection. When describing the phase of induction, the nurse should explain that this is usually achieved by what means?

intravenous administration of anesthetics

Dantrolene (Dantrium) differs from the other skeletal muscle relaxants because

it acts directly within the skeletal muscle fiber and not within the CNS

A male taking anabolic steroids may experience which side effects?

jaundice

Tensilon Test/ Endrophium Test - Endrophium IV - Can cause bronchospasm, _______________, hypotension, bradycardia, and ________ - have ___________ nearby for antidote - If MG, will show significant improvement within ____ to _____ seconds and lasting ______ to _________ min

laryngospasm, arrest, atropine, 30, 60, 4, 5

In the male, interstitial cell stimulating hormone is released. The nurse identifies this as:

lh

When teaching an adolescent about ovulation, the nurse would include that ovulation is initiated by a surge in:

lh

The nurse at an urgent care clinical is reviewing local anesthetics. What drug should the nurse recognize as an amide?

lidocaine

Andropause

like menopause, but for men

A nurse is teaching a class at the local high school on the abuse of anabolic steroids. Which potential adverse reaction should the nurse cite regarding the long-term use of these hormones?

liver tumors

Basal Ganglia

lower area of the brain, associated with coordination of unconscious muscle movements that involve movement and position

Cerebellum

lower portion of the brain, associated with coordination of muscle movements, including voluntary motion, as well as extrapyramidal control of unconscious muscle movements

The students are studying for an exam in pharmacology. They know several local anesthetics have been covered along with other forms. Which medication can they anticipate as being local anethetics on the exam? Select all that apply.

marcaine xylocaine novocain

If a child older than 12 years of age requires a skeletal muscle relaxant after an injury

metaxalone has an established pediatric dosage

Signs and symptoms of tetanus, which includes severe muscle spasm, are best treated with

methocarbamol.

A 22-year-old woman is in the clinic to end an early pregnancy. She takes three tablets of mifepristone (Mifeprex). Two days after she takes the medication, she returns to the clinic to see if she is still pregnant or if the medical abortion is complete. It is determined that she is still pregnant. The nurse will administer which drug?

mistoprolol

A nurse is caring for a 28-year-old patient who is taking exogenous testosterone for treatment of cryptorchidism. What statement by this patient would lead the nurse to believe that patient teaching has been ineffective?

my sperm count will increase

AChE Inhibitors: Caution: -___________ crisis may occur ____ to ____ hours after taking certain medications: aminoglycoside antibiotics, ___________ channel blockers, phenytoin, psychotropics

myasthenic, 3, 4, calcium

Acetylcholinsterase Inhibitors/Cholinesterase Inhibitors Acetylcholinesterase Inhibitors - _________________: short-acting - _________________: ulrashort-acting for ______________ - _________________: intermediate-acting -__________________: long-acting Action: - transmission of neuromuscular impulses by preventing destruction of ________ which relieves __________ weakness Use: - control, diagnose, and treat __________

neostigmine, edrophonium, pyridostigmine, ambenonium, acetylcholine, muscle, myasthenia gravis

A client with multiple sclerosis asks the nurse to explain why deep tissue massages do not relieve spasticity. The nurse should explain that spasticity is caused by:

nerve damage in the brain and spinal cord, and it is a permanent condition

A client with multiple sclerosis asks the nurse to explain why deep tissue massages do not relieve spasticity. The nurse should explain that spasticity is caused by:

nerve damage in the brain and spinal cord, and it is a permanent condition.

spinal motor neurons

nerves that regulate posture, balance, and movement are the result of a constantly fluctuating sequence of muscle contraction and relaxation

Interneuron

neuron in the CNS that communicates with other neurons, not with muscles or glands

A client has been prescribed vardenafil. Which medication in the client's history would the nurse be <b>most</b> concerned about?

nitroglycerin bc they affect smooth muscle

tyrosine is use to make what

norepinephrine

A nurse is reading a journal article about female hormones. Which would the nurse identify as a progestin?

norethindrone

A 16-year-old is prescribed estrogen therapy for hypogonadism. During therapy, what will the nurse monitor the client closely for?

normal sexual development and growth

A client is to receive ethotoin. The nurse would expect to administer this drug by which route?

oral

Methocarbamol is available in

oral and parenteral forms

Dantrolene is available in

oral or parenteral forms

Medroxyprogesterone is an effective form of birth control. Long-term use can cause what serious adverse effect?

osteoprosis

Myasthenia Gravis (cont) Cholinergic Crisis - results from __________ - Usually occurs within _____ to ______ minutes after taking anticholinergic medications Severe muscle weakness- - possible _________ paralysis and __________ (______________ and wheezing) - Abnormal ___________ constriction (_________) - ___________ secretions - Pallor, ___________ - _________ distress - ________________ and _____________ Worsens after _____________ chloride

overdosing, 30, 60, respiratory, arrest, bronchospasm, pupil, miosis, excess, vertigo, GI, bradycardia, hypotension, edrophonium

Gas anesthetics such as nitrous oxide must be combined with what element before they can be administered to the client?

oxygen

A 26-year-old client who delivered a baby 24 hours prior, reports cramping pain while breast-feeding. The nurse caring for the client understands that breast-feeding causes the release of which hormone, which can cause uterine cramping?

oxytocin

The nurse is preparing an outline for a class on the physiology of the male sexual response. Which event would the nurse identify as occurring first?

penile vasodilation

The production of estrogen during pregnancy would be negatively affected if which structure was not functioning effectively?

placenta

Clotting of the uterine lining during the menstrual cycle is prevented by high levels of

plasminogen

When stimulation levels off during the human sexual response, the person is said to be in which of the following phases?

plateau

Pitocin is given to prevent what condition?

postpartum bleeding

A teenage client who is using testosterone to treat a hormone deficiency calls the clinic to report acne-like skin eruptions on the face. How should the nurse counsel this client?

practice frequent and through skin cleansing

Patients Not Responding to Acetylcholinesterase Inhibitors - ____________ - _____________ exchange - ____________ _____________ ___________ (IVIG) or _______________ drugs (Azathioprine)

prednisone, plasma, intravenous immune globulin, immunosuppressive

hormone engages the rhythm of birth control

progesterone

When describing the menstrual cycle to a group of young women, the nurse explains that estrogen levels are highest during which phase of the endometrial cycle?

proliferative

A patient reports menstrual cramps. The nurse understands that this is due to:

prostaglandins

Myasthenia Gravis Sympptoms: Eye Muscles - drooping of one or both eyelids (___________) - Double vision (__________) Face and Throat Muscles - Altered speaking (____________) - Difficulty swallowing (____________) - Problems __________ - Limited ___________ expressions Neck and Limb Muscles - Weakness in arms, legs, neck, fingers, etc. - Weakness in the ______ muscles sometimes occurs. If this is severe, ____________ __________ may occur

ptosis, diplopia, dysarthria, dysphagia, chewing, facial, chest, myasthenic crisis

The release of gonadotropin releasing hormone by the hypothalamus signals the onset of:

puberty

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

The nurse monitors a patient receiving oxytocin for water intoxication based on the understanding that this condition is the result of:

release of antidiuretic hormones

A nurse is caring for a client with trigeminal neuralgia at a health care facility. The health care provider has prescribed carbamazepine. In which case is the use of carbamazepine contraindicated in clients with:

renal impairment.

Skeletal Muscle relaxants: Contraindications: - severe ________, ________, or ________ disease - With other ______ depressants (barbiturates, opites, ETOH, sedatives, hypnotics, TCA) Side effect: - Drowsinees and ________ weakness - Dizziness and ____________ - _______ mouth - _______ upset - Photosensitivity - ___________ toxicity

renal, liver, heart, CNS, muscle, dry, GI, liver

The post-anesthetic recovery unit nurse is caring for a client whose balanced anesthesia included midazolam. The nurse should prioritize assessments for what health problems?

respiratory depression and CNS suppression

During fetal development, the descent of the testes into what structure helps prevent injury to the sperm-producing cells?

scrotum

Dysfunction of which structure in the male reproductive system would result in ineffective sperm production?

seminiferous vesicles

Spindle Gamma Loop System

simple reflex arcs that involve sensory receptors in the periphery that respond to stretch and spinal motor nerves and cause muscle fiber contraction: responsible for maintaining muscle tone and keeping an upright position against the pull of gravity

A group of students are reviewing the drugs available for treating penile erectile dysfunction. The students demonstrate understanding when they identify which drug as a PDE5 inhibitor?

slidenafil

A patient who has suffered a crushing injury to his thumb and two fingers in an accident at a factory is relieved to be administered a local anesthetic prior to treatment. The drugs that were administered decrease the permeability of the nerve cell membrane to:

sodium

The induction of a local anesthetic would decrease the permeability of the nerve cell membrane to which element?

sodium

Skeletal Muscle Relaxants (cont.) Cyclobenzaprine -prototype Use: - alleviates muscle _______ associated with acute ___________ musculoskeletal conditions Side effects: - ______________ effects - drowsiness, dizziness - Headache - Fever - _______ distress - ___________ dysfunction Contraindicated with __________ within ______ days and with ___________ dysfunction, ____________

spasm, painful, anticholinergic, GI, erectile, MAOI, 14, cardiac, glaucoma

Skeletal Muscle Relaxants: Centrally acting muscle relaxants: - relieves muscle __________ and __________ - have ___________ effect - Examples include: _____________, ___________________, __________ Direct Acting Muscle relaxant: - ____________ - Decreases muscle spasm pain and increases _________

spasm, spasticity, sedative, carisoprodol, methocarbamol, metaxalone, dantrolene, ROM

The 35-year-old client has presented to the OB ward for her third delivery by cesarean section. The nurse who is caring for this client prepares for which type of anesthesia?

spinal

The nurse sprays the area with a medication to desensitize it. The nurse is administering which type of anesthesia?

spray is topical

A client is receiving general anesthesia and the client's skeletal muscles have begun to relax after being tense In what stage of anesthesia is this client?

stage 1

There are different stages of anethesia the client will go through in surgery. The circulating nurse is aware that extra caution is needed during which stage of general anesthesia, when the client may experience brief periods of delirium and excitement?

stage II

hallucination/delrium

stage II

A surgical nurse is documenting the different stages of anesthesia on a patient's chart. Which stage will the nurse describe in documentation just before the surgeon makes the incision?

stage III

Hypertonia

state of excessive muscle response and activity

The nurse is discussing the human response to sexual stimulation with a client experiencing an arousal problem. In which phase of sexual response should the client begin to feel the effects of the sympathetic nervous system?

stimulation

Spasticity

sustained muscle contractions

What is most important to tell the client who will be taking adrenergic blocking drugs for benign prostatic hypertrophy?

take at the same time every day

A client is using a transdermal system for androgen administration. Which drug would the client most likely be using?

testosterone

Which would the nurse expect to administer as a depot injection?

testosterone

A nurse is providing care for a patient who suffered extensive burns to the extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all the burns in order to achieve adequate pain control. When considering this order, the nurse should be aware that:

there is a risk of systemic absorption of the lidocaine through the patient's traumatized skin.

When caring for a patient receiving estrogen replacement therapy for postmenopausal symptoms, the nurse documents a diagnosis related to impaired tissue perfusion. Which condition is the nurse referring to in the diagnosis?

thromboembolism

When epinephrine is mixed with a local injectable anesthetic, it is done for what purpose?

to cause vasoconstriction

A client requires local anesthesia to be administered. The nurse identifies that the anesthetic may be administered by which route? Select all that apply.

topical, regionalized, local inflitration

Anabolic steroids are analogs of testosterone with increased protein-building effects.

true

Centrally acting skeletal muscle relaxants lyse or destroy the spasm

true

Myasthenia Gravis (cont.) Myasthenic Crisis -results from ______________ - severe muscle ___________- may involve ____________ and __________ muscles Triggers: -Inadequate ___________ - Infection - ____________ stress - ____________, pregnancy - Surgery, trauma - ______________, alcohol intake - Medication interactions Improves after ______________ and _____________

underdosing, weakness, diaphragm, intercostal, dosing, emotional, menses, hypokalemia, edrophonium, neostigmine

A nurse teaching a 57-year-old client about the factors that must be considered around the use of hormone replacement therapy (HRT) should discuss what increased risk associated with the therapy?

venous thromboembolism

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?

watching when ambulating

Myasthenia Gravis: Characteristics: - Muscular _________ and _________ - __________ muscle ___________, ptosis, difficulty ___________/____________

weakness, fatigue, respiratory, paralysis, chewing, swallowing

A young man has received a diagnosis of androgen deficiency and has been prescribed testosterone. At clinic follow-up appointments, the nurse should prioritize which assessment?

weight and BP

Premenopausal women are also at increased risk for the hepatotoxicity associated

with dantrolene

A nurse should administer skeletal muscle relaxants cautiously and monitor a client closely if they have which of the following medical conditions?

• Cerebrovascular accident • Epilepsy • Pregnancy • Parkinsonism

Which of the following adverse effects would a nurse most likely assess in a patient who is receiving a centrally acting skeletal muscle relaxant? Select all that apply.

• Constipation • Insomnia • Dry mouth • Drowsiness

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

• Hepatic disease • Lactation

Baclofen (Lioresal) is used in the treatment of muscle spasticity associated with which of the following disease processes?

• Spinal cord injury • Muscle rigidity • Multiple sclerosis