pharm eaq bs

which characteristic identifies the reason that methadone is useful in the treatment of opioid addiction? its nonaddictive effect of longer duration does not produce a cumulative effect carries little risk of psychological dependence

effect of longer duration

which adverse effect would a nurse monitor for in a client taking clopidogrel? nausea epistaxis chest pain elevated temp

epitaxis

which condition would a nurse monitor for in a client who is prescribed bumetanide? hypokalemia hyperchloremia hypernatremia hypoglycemia

hypokalemia

which condition would be prevented by the addition of spironolactone to the med regimen of a pt with cirrhosis of the liver who has been taking chlorothiazide? hyponatremia hypokalemia ascites peripheral neuropathy

hypokalemia

which complication will a nurse monitor for before replacement steroid therapy is regulated fully in a client who has had an adrenalectomy? hypotension hypokalemia hypernatremia Hyperglycemia

hypotension

which antipsychotic med has the highest risk of causing tardive dyskinesia? (select all) loxapine quetiapine haloperidol ziprasidone olanzapine

loxapine, haloperidol

which med would the nurse instruct a pt to avoid while taking alprazolam? (select all) opioids alcohol barbiturates antidepressants 1st gen antipsychotics

opioids alcohol barbiturates

which behavior would haloperidol most effectively treat? depression overactive withdrawn manipulative

overactive

which med would be used to treat a pt with severe motor tics, barking cries, and outbursts of obscene language? loxapine pimozide thiothixene thioridazine

pimozide

a pt is to begin lithium carbonate therapy. which baseline lab work will the nurse ensure is completed before med administration? renal studies cardiac enzyme studies adrenal function studies pulmonary function studies

renal studies

which condition would the nurse monitor for in the client on aminoglycoside therapy and skeletal muscle relaxants? stroke resp. arrest MI and discomfort

resp. arrest

which adverse effect will the nurse monitor for in a pt who has been administered a neuromuscular block agent before electroconvulsive therapy? seizures vomiting loss of memory resp. depression

resp. depression

which monoamine oxidase inhibitor would the nurse identify as being used to treat parkinson dz? selegiline phenelzine isocarboxazid tranylcypromine

selegiline

which meds are used as the first-line tx for PTSD? (select all) sertraline paroxetine phenelizine venlafaxine amitriptyline

sertraline paroxetine

which complication will occur as the result of administering sildenafil to a client who takes isosorbide dinitrate? constipation protracted vomiting resp. distress severe hypotension

severe hypotension

antacids should be administered at least __ hr before or ___ hr after famotidine

1, 2

which time period correctly identifies how long after the last dose the nurse will schedule to have a pts blood drawn to evaluate serum lithium level? 2-4 hrs 4-6 hrs 6-8 hrs 10-12 hrs

10-12 hrs

which length of time is the max that a nurse would allow an IV bag of solution to infuse?

24 hr

which outcome would the nurse use to determine the effectiveness of SL nitroglycerin? Relief of anginal pain improved cardiac output decrease bp ease in resp. effort

Relief of anginal pain

which meds are used to treat generalized anxiety disorder? (select all) duloxetine venlafaxine clonazepam escitalopram clomipramine

duloxetine, venlafaxine, escitalopram

which substance would a pt taking acetaminophen routinely be advised to avoid? alcohol caffine diphenhydramine ibuprofen

alcohol

a pt who is on haloperidol therapy has developed akathisia and acute dystonia. which med would be used to manage extra pyramidal effects? (select all) bupropion duloxetine benztropine amitriptyline truhexyphenidyl

benztropine, truhexyphenidyl

which class of med is used to reduce tremors caused by lithium therapy? diuretics betablockers anticholinergics nonsterodial anti-inflammatory drugs

betablockers

which therapy is indicated for a pt admitted to the hospital after general paresis develops as a complication of syphilis? Penicillin therapy major tranquilizers behavior modification electroconvulsive therapy

Penicillin therapy

sertraline brand name

Zoloft

which client problem would decrease in response to administration of serum albumin to a client with ascites? confusion ouput abd girth serum ammonia level

abd girth

which med is often contraindicated when taking warfarin? atenolol ferrous sulfate chorpromazine acetylsalicylic acid

acetylsalicylic acid

a pt who is taking haloperidol has developed tardive dyskinesia. which therapy is beneficial for the client? administering benzodiazepines providing anticholinergic therapy administering nonsteroidal anti-inflammatory drugs switching to other 1st gen antipsychotic meds

administering benzodiazepines

a pt with schizophrenia who has been taking clozapine is to start on 10 mg olanzapine instead. which adverse effect will be avoided by substituting olanzapine for clozapine? hypotension gastric upset agranulocytosis metabolic syndrome

agranulocytosis

a client receiving high doses of haloperidol tells the nurse "i just cant sit still, and feel jittery". which side effect would the nurse suspect the client is experiencing? akathisia torticollis tardive dyskinesia parkinsonian syndrome

akathisia

administering of which med in relation to changes in fluid intake can help prevent complications related to uric acid nephropathy in a client with lymphosarcoma is receiving allopurinol and methotrxate? allopurinol and restricting fluid intake methotrexate and restricting fluid intake allopurinol and encouraging increased fluid intake methotrexate and encouraging increased fluid intake

allopurinol and encouraging increased fluid intake

which manifestation is an adverse effect of IV lorazepam? (select all) amnesia drowsiness sleep driving blurred vision resp. depression

amnesia drowsiness sleep driving blurred vision resp. depression

at a follow-up visit, a client receiving tx for depression reports blurred vision and constipation. which med is suspected as being responsible for these adverse effects? (select all) phenelizine amoxapine maprotiline desipramine amitriptyline

amoxapine desipramine amitriptyline

possible complication with clozapine

argranulocytosis

which med would the nurse anticipate the provider will prescribe to relieve the pain experienced by pt with rheumatoid arthritis? aspirin hydromorphone meperidine alprazolam

aspirin

adverse effects of mirtazapine? asthenia dyskinesia drowsiness gynecomastia abnormal dreams

asthenia drowsiness abnormal dreams

which med would be most beneficial for the child dx with inattention, hyperactivity, and impulsivity? modafinil doxapram armodafinil atomoxetine

atomoxetine

pt on fluphenazine decanoate develops dystonia. which med would be given to reverse this side effect? nafarelin fluoxetine trandolapril benzotropine

benzotropine

which tissue affected by chemotherapy will the nurse consider when formulating a response to a client receiving cancer chemotherapy who asks the nurse why an antibiotic was prescribed? liver blood bone marrow lymph nodes

bone marrow

which pt condition would contraindicate the use of clozapine? seizures glaucoma dysrhythmias bone marrow depression

bone marrow depression

which med is contraindicated for clients with eating and seizure disorders? buprppion trazodone amitriptyline lithium citrate

bupropion

the nurse advises the pt to refrain from skin contact of the prescribed liquid formulation. which antipsychotic med is prescribed to the pt? loxapine asenapine alprazolam chlorpromazine

chlorpromazine

which med is contraindicated in clients with blood dyscrasias? duloxetine buproprion mirtazapine chlorpromazine

chlorpromazine

Which toxic effect would the nurse find in a client who has overdosed on isocarboxazid? mydriasis bradycardia hypothermia circulatory collapse

circulatory collapse

which antidepressant is a 2nd gen med? doxepin citralopram protriptyline trimipramine

citralopram

the health care provider prescribes alprazolam 5 mg by mouth 3x d for a client with anxiety. which intervention will the nurse take before administering this prescription? assess apical pulse check bp encourage the ventilation of feelings clarify the prescription with the health care provider

clarify the prescription with the health care provider

a pt is admitted for tx of OCD that is interfering with ADLs. which med is indicated for treatment of this condition? benztropine amantadine clomipramine diphenhydramine

clomipramine

sumatriptan is contraindicated in people with

coronary artery dz

indicated use of naltrexone to treat opiod OD block systemic effect of cocaine decrease the recovering alcoholics desire to drink prevent severe withdraw sx for antianxiety agents

decrease the recovering alcoholics desire to drink

which assessment finding indicates an improvement when the nurse is evaluating the results of tx with erythropoietin? 2+ pedal pulses decreased pallor decreased jaundice 2+ deep tendon reflexes

decreased pallor, this drug stimulates RBC production

for which reason would clients who receive IV fluids rather than TPN for gastrointestinal problems lose weight? lack pf bulk in diet deficient carbohydrate intake insufficient intake of water-soluble vitamins increasing concentrations of electrolytes in the cells

deficient carbohydrate intake

a pt using st. johns wort "to feel more like myself" would be assessed for? depression sleep disturbance diminished cognitive ability sensory disturbance

depression, st. johns wort is a natural way to improve mood

the PCP is concered that a pt receiving haloperidol may be developing neuroleptic malignant syndrome. which clinical manifestations would the nurse monitor for in this pt when assessing for this syndrome? jaundice and malaise tremors and seizures diaphoresis and hyperpyrexia dry skin and hyperbilirubinemia

diaphoresis and hyperpyrexia

a health care provider prescribes divalproex for a client with the dx of bipolar 1 disorder, manic episode. which side effects of this med might the client report during a follow -up visit? dizziness, N/V photosensitivity, agitation, and restlessness abd cramps, tremor, muscle weakness weight gain, drowsiness, and diminished concentration

dizziness, N/V

the nurse administering hydroxyzine to a pt would monitor for which side effect? ataxia drowsiness vertigo slurred speech

drowsiness

the nurse is teaching a client about tricyclic antidepressants. which potential side effect would the nurse include? (select all) dry mouth drowsiness constipation severe hypertension othostatic hypotension

dry mouth drowsiness constipation othostatic hypotension

this 2nd gen antidepressant can worsen uncontrolled angle-closed glaucoma

duloxetine

which advice will the nurse provide about doxorubicin to a client with hodgkins dz? cease taking any med that contains vitamin D keep the doxorubicin in a dark place protected from light expect urine to turn red for a few days after taking this med take the doxorubicin on an empty stomach with large amounts of fluids

expect urine to turn red for a few days after taking this med

which drug can be given Q2-3 weeks for schizophrenia when a pt is bad about taking their meds?

fluphenazine

which high potency med is used to tx schizophrenia? loxapine perphenazine fluphenazine thiroidazine

fluphenazine

a pt with OCD has an anxiety level approaching panic level, the pt ritual is interfering with work and ADLs. which SSRI would be considered when preparing a teaching plan? haloperidol fluvoxamine imipramine benztropine

fluvoxamine

which nursing assessment finding would indicate that a pt receiving TPN has hyperglycemia? paralytic ileus rr below 16 fruity odor to the breath serum glucose of 105

fruity odor to the breath

which med is the most common cause of extrapyramidal side effects? cloazpine haloperidol risperidone aripiprazole

haloperidol

which antipsychotic med would be contraindicated for a 60 YO pt dx with dementia? (select all) quetiapine haloperidol aripiprazole risperidone chlorpromazine

haloperidol, chlorpromazine

a 65 YO pt is receiving amitriptyline. which recommendation will the nurse make to the pt concerning the med? obtain a complete cholesterol and lipid profile have an eye exam to check for glaucoma check you temp daily for nighttime increases watch for excessive sweating and possible weight loss

have an eye exam to check for glaucoma

which nursing action is appropriate when administering imipramine? warning the client not to eat cheese monitoring the client for increased tolerance having the client checked for increased intraocular pressure

having the client checked for increased intraocular pressure

if a pt has a low WBC and is taking clozapine what should you do?

hold the dose

which adverse effect of valsartan, an angiotensin II receptor antagonist, will a nurse monitor for when prescribed for a client? constipation hyperkalemia hypertension change in visual acuity

hyperkalemia

which s/sx would a nurse expect in a pt taking conventional antipsychotic meds that develops neuroleptic malignant syndrome? (select all) hyperpyrexia blurred vision increased muscle tone resp. depression buccolingual lip-smacking

hyperpyrexia increased muscle tone resp. depression

the nurse is interviewing a client in the mental health clinic, which statement by the client indicates an irreversible adverse response to long-term therapy with an antipsychotic med? my mouth is always dry i cant seem to sleep at night i dont have much of an appetite i cannot control my tongue movements

i cannot control my tongue movements

which client statement indicates understanding of the side effects of nitroglycerin ointment? i may experience a headache confusion is a common side effect a slow pulse rate is expected increased bp may occur

i may experience a headache

an 11 YO reports wetting the bed. which med would the nurse anticipate when developing a teaching plan? alprazolam imipramine lithium salts clomipramine

imipramine

which mechanism of action explains how hydrochlorothiazide increases urine output? increase excretion of Na increase the glomerular filtration rate decrease reabsorption of K increase renal perfusion

increase excretion of Na

which MOA explains how hydrochlorothiazide increases urine output? increase excretion of sodium increase glomerular filtration rate decrease the reabsorption of potassium increase renal perfusion

increase excretion of sodium

which mechanism is specifically responsible for the action of the med ranitidine? inhibit proton pumps promote release of gastrin regenerate the gastric mucosa inhibit the histamine at H 2 receptors

inhibit the histamine at H 2 receptors

which type of insulin would the nurse recognize as compatible with IV solutions when caring for a client with DM who is scheduled to receive an IV administration of 25 units of insulin in 250 ml normal saline? NHP insulin insulin lispro insulin detemir insulin glargine

insulin lispro

succinylcholine inhibits what muscles?

intercostal and diaphragmatic

tardive dyskinesia

involuntary movements of the facial muscles, tongue, and limbs

which meds may cause an increase in the serum clozapine level? (Select all) rifampin phenytoin ketoconazole erthromycin bromocriptine

ketoconazole, erthromycin

although divalproex is an antiepileptic what can is also be prescribed to control?

manic phase of bipolar disorder

which circumstance would the nurse use the Z-track technique to administer meds? large volume of meds med is irritating to SQ tissue and skin depot of med is prescribed med is lipophilic

med is irritating to SQ tissue and skin

while caring for a client on phenelzine, the nurse notes an excess elevation of the persons temp. which med being taken concurrently by the client may be responsible for this condititon? meperidine desipramine amitriptyline amphetamine

meperidine

which effect of sodium bicarbonate is the nurse trying to prevent when teaching a client about the dangers of using it regularly? gastric distention metabolic alkalosis chronic constipation cardiac dysrhythmias

metabolic alkalosis

which med would the nurse identify as commonly used as an adjunct during conscious sedation for minor surgeries? diazepam midazolam lorazepam clonazepam

midazolam

which med is indicated to treat shift-work sleep disorder? caffien mondafinil atomoxetine methylphenidate

mondafinil

a pt is prescribed chlorpromazin. which action will prevent life threatening complication during admin when the pt is anxious and restless? provide adequate restraint monitor V/S protect against exposure to direct sunlight watch the pt for extrapyramidal side effects

monitor V/S

what is the medication of choice for MI

morphine

which pain relief med would the nurse expect to find in the MAR of a pt with a myocardial infarction? morphine diazepam midazolam oxycodone

morphine

which adverse effect is least likely to occur in a pt taking clozapine? seizures sedation akathisia myocarditis

myocarditis

an 80 YO pt with depression requires the prescription of antidepressant med. which tricyclic antidepressant med causes fewer complications in older clients? doxepin amoxapine nortriptyline trimipramine

nortriptyline

which response indicates that the client receiving TPN is experiencing hyperglycemia? (select all) polyuria polydipsia paralytic ileus RR of 26 Accu check: 105

polyuria polydipsia RR of 26

which med is unsafe to administer as an IV bolus? saline flush potassium chloride naloxone adenosine

potassium chloride

which reason would an IV infusion of 5% dextrose with .45% sodium chloride and 20 mEq of potassium be prescribed for a client with an NG tube set to low intermittent suction? prevent constipation prevent dehydration prevent vomiting prevent electrolyte imbalance

prevent electrolyte imbalance

which med action would the nurse identify as the purpose of azathioprine, cyclosporine, and prednisone given before receiving a kidney transplant? stimulate leukocytosis provide passive immunity prevent iatrogenic infection reduce antibody production

reduce antibody production

which MOA explains how diuretics reduce bp? facilitate vasodilation promote smooth muscle relaxation reduce the circulating blood volume block the sympathetic nervous system

reduce the circulating blood volume

what advice would be given to a pt taking olanzapine for a dx of bipolar, manic episode? sit up slowly report double vision expect increased salivation take med on an empty stomach

sit up slowly

which therapeutic effect is associated with digoxin prescribed to a client with heart failure? reduces edema increases cardiac conduction increases rate of ventricular contractions slows and strengthens cardiac contractions

slows and strengthens cardiac contractions

which action should be avoided by the client taking fluphenazine? eating cheese nighttime driving staying in the sun taking meds containing aspirin

staying in the sun

a client who is addicted to heroin has major surgery. afterward, the client receives methadone. which purpose does the methadone serve? allows sx free termination of opioid addiction switches the user from illicit opioid use to use of legal drug provides postop pain control without causing opioid dependence counteracts the depressive effects of long term opioid use on thoracic muscles

switches the user from illicit opioid use to use of legal drug

major reason why clients with severe psychiatric disorders are prescribed antipsychotic meds? improve judgment promote social skills eliminate neurotic tendencies sx management of psychosis

sx management of psychosis

the nurse is educating a pt who is taking clozapine to tx schizophrenia. which adverse effect of clozapine would the nurse emphasize as being important to report to the health care provider? inability to sit still tardive dyskinesia temp rise a high risk for falls

temp rise

which med is considered a typical antipsychotic? (select all) asenapine lurasidone aripiprazole thioridazine chlorpromazine

thioridazine, chlorpromazine

a pt dx with schizophrenia is started on an antipsychotic med, which purpose explains what this med is used to achieve? to keep the client quiet and relaxed to control the clients behavior and reduce stress to reduce the clients need for physical restraints to make the client more receptive to psychotherapy

to make the client more receptive to psychotherapy

for which purpose would enoxaparin 40 mg SQ daily be prescribed for a client who had abd surgery? to control postop fever to provide constant source of mild analgesia to limit the postop inflammatory response to provide prophylaxis against postop thrombus formation

to provide prophylaxis against postop thrombus formation

which explanation would the nurse provide to a client with gastric ulcer dz who asks the nurse why the health care provider has prescribed metronidazole? to augment the immune response to potentiate the effect of antacids to treat helicobacter pylori infection to reduce hydrochloric acid secretion

to treat helicobacter pylori infection

term for acute dystonia that involves muscle spasms of head and neck

torticollis

which side effect would the nurse include when teaching the client (74 YO) about doxepin? (select all) diarrhea loss of appetite urine retention suicidal ideation photosensitivity

urine retention suicidal ideation photosensitivity

which med interaction complicates seizure therapy in a client who is prescribed warfarin and takes phenytoin for a seizure disorder? warfarin inhibits the metabolism of phenytoin warfarin decreases phenytoin absorption phenytoin competes with warfarin for receptor occupation warfarin promotes excretion of phenytoin

warfarin inhibits the metabolism of phenytoin

which action will the nurse take when a client receiving buspirone is admitted to the hospital with a diagnosis of possible Hepatitis? withhold meds give buspirone with milk reduce dosage of meds ensure the med can be given parenterally

withhold meds, Hepatitis prolongs elimination of the med and may result in toxicity

which assessment finding alerts the nurse to stop administering haloperidol to a client until further lab work is done? grimacing shuffling gait yellow sclerae photosensitivity

yellow sclerae

a pt with with schizophrenia is actively psychotic. which med will be the most helpful to manage the psychotic s/sx? citralopram ziprasidone benztropine

ziprasidone

a pt on antidepressant therapy develops hyponatremia. which med may be responsible for the pt electrolyte imbalance? phenelzine paroxetine imipramine amitriptyline

paroxetine

which physiological response is responsible for the therapeutic effect of dexamethasone prescribed for a client after a craniotomy for a brain tumor? reduced cell growth reduced cerebral edema increased renal reabsorption increase response to sedation

reduced cerebral edema

which MOA would the nurse identify for levodopa therapy prescribed to a client dx with parkinskon dz? blocks the effects of acetylcholine increase the production of dopamine restores the dopamine levels in the brain promotes the production of acetylcholine

restores the dopamine levels in the brain

which advice will the nurse give the client to avoid lipodystrophy when self administering insulin therapy? rotate injection site use z-track technique

rotate injection site

a health care provider prescribes clozapine to a client with schizophrenia. which parameter would the nurse assess before administering the med? (select all) prolactin level WBC count body mass index serum potassium levels absolute neutrophil count

WBC count body mass index absolute neutrophil count

which test would the nurse identify as specific for the dx of Myasthenia gravis? electromyography pyridostigmine test edrophonium chloride test hx of physical deterioration

edrophonium chloride test

a client is receiving haloperidol for agitation. which response identified by the nurse is unrelated to an extrapyramidal tract effect? akathisia opisthotonos oculogyric crisis hypertensive crisis

hypertensive crisis

which electrolyte abnormality will the nurse expect in a client who is experiencing both tingling of the extremities and tetany? hypokalemia hypocalcemia hyponatremia hypochloremia

hypocalcemia

which adverse effect would a nurse monitor for when caring for a client receiving furosemide to relieve edema? hypernatremia elevated blood urea nitrogen hypokalemia increase in urine specific gravity

hypokalemia

a pt with schizophrenia take ziprasidone. which condition in the client may indicate a need to discontinue the med? (select all) leukopenia tachycardia hypokalemia hypermagnesemia prolonged QT interval

leukopenia hypokalemia prolonged QT interval

which med may lead to bruxism? vilazodone isocarboxazid clomipramine levomilnacipran

levomilnacipran

which med would the nurse recognize as an effective mood-stabilizing med used with bipolar disorder for the acute tx of mania and prevention of recurrent mania and depressive episodes? doxepin amitriptyline clozapine lithium carbonate

lithium carbonate

sodium polystyrene sulfonate is used to ?

lower K

Which atypical antipsychotic is approved for longterm use to prevent recurrance of mood eps in clients with bipolar? (Select all) olanzapine quetiapine ziprasidone risperidone aripiprazole

olanzapine, ziprasidone, aripiprazole