Pharm II Exam II PrepU
The nurse is providing education to a client who has been prescribed clozapine. The nurse should emphasize the importance of what monitoring routine during teaching?
Regular CBCs
When does a client with spinal cord injury-associated spasticity require treatment for this condition?
Safety, mobility, and activities of daily living are impaired.
A client has been prescribed phenelzine sulfate. When providing teaching, which food should the nurse instruct the client to avoid eating?
Salami
A client enters the emergency department with reports of visual changes, drowsiness, and tinnitus. The client is found to be confused and hyperventilating. These signs and symptoms may be attributable to which condition?
Salicylism
A psychiatric nurse is discussing the advantages of atypical antipsychotics with the parents of a teenager who has been diagnosed with schizophrenia. When comparing these drugs with the older, typical antipsychotics, what advantage should the nurse cite?
Reduced adverse effects
A client is ordered to receive an nonsteroidal anti-inflammatory drug (NSAID) for pain. The client states that NSAIDs are taken only to decrease inflammation. The nurse instructs the client that these medications are also used for which?
decreased body temperature
A 30-year-old client is taking phenelzine 30mg PO tid. The nurse knows that at that dosage, the client will need to be carefully monitored for which?
dizziness
A client is being discharged following an allergic reaction after ingesting aspirin. When providing client education about the allergy, the nurse would provide the client with what information?
do not take any NSAIDs
Which client would the nurse identify as being opioid naive?
one who does not routinely take opioids
A client is to receive a tricyclic antidepressant. The nurse is reviewing the client's medical record. What would alert the nurse to a possible contraindication?
recent MI
The nurse is planning care for a client who has been prescribed a CNS stimulant. What should the nurse establish as the primary goal of therapy?
relieve the symptoms for which they were prescribed.
A nurse is administering a prescribed dose of chlordiazepoxide to a client. The nurse should closely assess the client for what adverse reaction?
respiratory depression
An 11-year-old client is having a cavity filled in the left mandibular first molar. The health care provider has prescribed aspirin for pain relief after the procedure. The nurse discovers upon assessment that the child is suffering from a flulike illness. The nurse contacts the health care provider about the prescribed medication for pain. What is the risk if aspirin is administered to this client?
reye syndrome
A client, who has been diagnosed with schizophrenia and is taking an antipsychotic medication, reports constant thirst, frequent urination, and feeling nauseous. The nurse knows that the client may:
have undiagnosed diabetes
A 10-year-old boy is taking dextroamphetamine (Dexedrine) daily for ADHD. At each clinic visit, the nurse must assess the child. The priority assessment since he is on this medication would be which?
height and weight
Dantrolene should be avoided in all patients who are 35 or older because of the increased risk of
hepatocellular disease
A nurse should not administer an opioid antagonist to a client with which finding?
hypersensitivity to naloxone
The nurse is providing education to a client who has been prescribed tizanidine. What adverse effect should the nurse mention during teaching?
hypotension
A nurse is caring for a client who has just been diagnosed with rheumatoid arthritis. What first-line treatment should the nurse anticipate?
ibuprofen
A salicylate is contraindicated in clients who have had surgery within the past week for which reason?
increased risk for bleeding
A nurse is caring for a patient who is taking haloperidol. The patient has orders for a new drug, and the nurse notes that it is highly protein bound. The nurse will plan care based on a(n):
increased risk for toxic effects of haloperidol therapy
A client who is on long-term acetaminophen therapy has been taking etodolac for joint pain. The nurse would be alert to which effect that may occur because of an interaction between the two drugs?
increased risk of renal impairment
A black box warning alerts health care providers to risks in young adults 18 to 24 years of age when taking antidepressant medications. Which symptoms of concern should be included?
statements or resignation and futility and a desire to die
The nurse is educating an African-American client about the safe and effective use of anti-inflammatories. In order to address the known ethnic factors relating to this client's drug therapy, the nurse should do what?
teach the client about the heightened risk for GI adverse effects
A client has developed a fever. What aspect of the client's health history would contraindicate the safe and effective use of acetaminophen?
the client has hepatic C and abuses alcohol
The nurse is providing education to a client who has been prescribed eszopiclone. What information should the nurse include?
the importance of taking the drug immediately before going to bed
A nurse is assigned to care for a patient with arthritis in a health care facility. The patient has been prescribed celecoxib. Celecoxib is contraindicated in clients with:
allergy to sulfonamides
While providing client teaching relative to inflammatory disorders, the nurse would explain the presence of inflammation as:
an attempt by the body to remove the damaging agent and repair the damaged tissue.
The nurse correctly identifies which medications used in the treatment of pain
analgesics
A nurse is aware that a client prescribed meloxicam is most likely being treated for what health problem?
arthritis
A nurse is working with a client who is taking an MAOI. What would be the most important instruction to the client?
avoid use of soy sauce in the diet -tyramine
A client has been administered an opioid. For what effect should the nurse regularly assess?
Level of consciousness (LOC)
Anticonvulsive medications are sometimes used in the treatment of bipolar disorder. What other drug is used to treat bipolar disorder?
Lithium
A client is to receive a narcotic cough syrup. The nurse would expect this preparation to contain:
Codeine
The nurse should not administer sedatives or hypnotic drugs to which client?
Comatose client
A woman who is in the second trimester of her first pregnancy has been experiencing frequent headaches and has sought advice from her nurse practitioner about safe treatment options. What analgesic can the nurse most safely recommend?
Acetaminophen
A child has symptoms of influenza, including a fever. Which medication should not be administered to the child because of the risk of Reye's syndrome?
Acetylsalicylic acid
When diagnostic testing reveals a bone fracture, what type of pain is the client experiencing?
Acute somatic pain
A tricyclic antidepressant has been prescribed to a 77-year-old client whose current medication regimen includes omeprazole, captopril, calcium carbonate, alendronate, and warfarin. What assessment should the nurse prioritize when monitoring the client for drug-drug interactions?
Monitor the client closely for bleeding and review coagulation indices when available
The nurse notes a respiratory rate of 6 breaths/min in a client in the postanesthesia recovery unit. Which drug would the nurse anticipate being given immediately?
Naloxone
A nurse has been taught to observe for adverse reactions whenever administering a medication. One non-nervous system reaction after giving a sedative is:
Nausea
A client with a history of migraines has been prescribed sumatriptan. What education should the nurse provide about the safe and effective use of this drug?
Take your medication as soon as you first sense a migraine coming.
A 24-year-old client is being seen in the emergency department because of a high fever and cannot move the right arm. During the history-taking process, The nurse discovers the client is being treated with an antipsychotic medication for schizophrenia. The nurse knows that what may be happening with this client?
The client may be having a neuroleptic malignant syndrome reaction to his antipsychotic medication and needs treatment immediately.
A young client has been prescribed an antipsychotic agent to relieve psychotic symptoms. Which goal of care is the priority?
The client will remain safe
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
To best assure client safety, what information should the nurse provide to a client whose fluoxetine therapy has been discontinued?
The dosage of the medication will be gradually reduced over a period of 6 to 8 weeks.
Acetaminophen overdose has the potential to cause fatal:
liver damage
Antipsychotic drugs are contraindicated in clients with:
liver damage, coronary artery disease, severe hypertension, bone marrow depression, or cerebrovascular disease.
An adult client is brought to the emergency department after deliberately overdosing on acetaminophen. The care team should prioritize interventions based on the client's risk for which adverse reaction?
liver failure
The nurse is giving instructions to a client who has just been prescribed sumatriptan for the treatment of migraine headaches. The client will be instructed to take this medication at what time?
At the onset of migraine symptoms
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
Which skeletal muscle relaxant is also available in intrathecal form?
Baclofen
The nurse is caring for a client who is receiving an intravenous barbiturate. What assessment should the nurse prioritize?
Blood pressure
The nurse is preparing to give prescribed haloperidol to an acutely dehydrated client. After administration, the nurse should prioritize what nursing assessment?
Blood pressure
The nurse is preparing to medicate a client for migraines. The nurse teaches the client that migraine headaches frequently occur due to what reason?
Vasodilation
A nurse is teaching a client about musculoskeletal medication that has been prescribed. The client needs further teaching about the medication when making which statements?
"I take my medicine with three to four beers each evening."
A client is receiving a barbiturate intravenously. The nurse would monitor the client for:
Bradycardia
A patient is receiving an antidepressant that helps to decrease addictive behavior. Which drug most likely would be prescribed?
Venlafaxine
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."
In addition to relieving agitation and anxiety, what is a rationale for using benzodiazepines in the treatment of a critically ill client?
Decreased cardiac workload
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 client on NSAIDs is experiencing congestive heart failure. The healthcare provider has ordered a diuretic to the treatment plan. The nurse evaluates the client for what reaction?
Decreased effectiveness of the diuretic
A client has been admitted to the unit for treatment of a multiple sclerosis exacerbation. The admission order indicates that the client is taking baclofen. Which outcome would the nurse expect to be associated with use of this medication?
Decreased muscle spasms
A female client asks why she must consult with the health care provider when she uses cold products for her children. What is the nurse's best response?
"There is a risk of overdose, because acetaminophen is a very common ingredient in OTC cold, flu, fever, and pain remedies."
A new mother asks her nurse about the safety of taking St. John's wort for postpartum depression. What would be the nurse's best response?
"There is insufficient evidence to support the use of St. John's wort, and drug interactions may be extensive."
A hospitalized client asks the nurse why the health care provider prescribed an anxiolytic medication. What is the nurse's best response?
"This type of medication is typically prescribed to treat excess anxiety that interferes with daily activities."
A client who has been prescribed sumatriptan as abortive therapy for migraines reports, "I took that pill about an hour-and-a-half ago, but I feel like a headache is returning. Can I take another pill?" How should the nurse respond?
"Wait at least half-an-hour before you take another pill."
The daughter of an older adult client asks the nurse if her father should be aware of any special precautions while taking lorazepam (Ativan). What is the nurse's best response?
Monitor for increased signs of confusion or forgetfulness
The extra pyramidal tract is made up of cells from which areas?
Cerebral cortex
A black, male client routinely takes haloperidol to manage his psychosis. Recently, he presented to the health care provider's (HCP's) office with signs of tardive dyskinesia, and his HCP modified the drug regimen over time. The client will now take the drug olanzapine and discontinue the haloperidol. What will the nurse tell the client to help decrease his anxiety about the new drug regimen?
"When compared with haloperidol, olanzapine has been associated with fewer extrapyramidal reactions in black clients."
A community health nurse follows many clients, several of whom have depression and who are taking antidepressants. What assessment finding should the nurse prioritize for reporting to the care provider?
A client who began taking escitalopram two weeks ago says her mood has worsened since starting the drug
A male client is taking aspirin 81 mg by mouth each day for prevention of recurrent myocardial infarction. He makes a dentist appointment for a tooth extraction. He calls the health care provider's office and asks the nurse if he is at risk for bleeding. Which response is correct?
"Yes, low doses of aspirin may increase your risk of bleeding; I will call you with your new prescriber's orders."
The community health nurse is conducting a class for parents of preschoolers. One of the parents asks if a child with ADHD will always have problems with hyperactivity. What is the nurse's best response?
"ADHD usually starts in childhood and may persist through adulthood."
A female client reports a mild headache and is prescribed acetaminophen 325 mg, two tablets by mouth every 4 to 6 hours. The client states that she usually takes ibuprofen for her headaches and asks why the health care provider ordered acetaminophen. Which explanation would the nurse give?
"Acetaminophen is often the initial drug of choice for relieving mild to moderate pain."
A client prescribed allopurinol denies any current symptoms of gout. What response should the nurse provide when the client asks why the medication has been prescribed?
"Allopurinol is used to prevent or treat hyperuricemia, which commonly occurs with gout."
The nurse is caring for a client who has been prescribed oxazepam. What statement by the client would suggest an increased risk of CNS depression to the nurse?
"I take an over-the-counter antihistamine each day for my allergies."
A client is prescribed sumatriptan. Which statement should be included in the teaching plan regarding how the medication works?
"It produces vascular constriction of cranial blood vessels."
A client has been prescribed baclofen and will be taking the drug on an outpatient basis. The client asks the nurse if it is still okay to drink wine with meals or end the day with a "nightcap." What is the nurse's best response?
"The combination of baclofen and alcohol could depress your nervous system to a dangerous level."
A 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."
What effects are exerted by aspirin? (Select all that apply.)
-Analgesic -Antipyretic -anti-inflammatory
A 21-year-old female is admitted after taking 25 aspirin tablets at one time. She is admitted with tinnitus, nausea, and vomiting. The health care provider diagnoses the client with salicylate poisoning. What can be used as a treatment for salicylate poisoning? Select all that apply.
-Gastric emptying -administration of activated charcoal -life support, if indicated
The nurse suspects that a client receiving olanzapine is developing type 2 diabetes. Which finding would help support the nurse's suspicion? Select all that apply.
-Increased thirst -weight gain -increased urination
A client who has been prescribed long-term lithium therapy reports taking the medication only erratically since starting a new job. What assessments should the nurse prioritize? Select all that apply.
-Manic behavior -Mood swings
A nurse monitoring a client receiving naloxone (Narcan) should be cognizant for the development of which adverse reactions? (Select all that apply.)
-Nausea -Tachycardia -Tremors
A client diagnosed with cluster headaches should be educated to expect which therapies for this condition?
-Oxygen -Subcutaneous injection of sumatriptan
What conditions are salicylates are effective in managing? (Select all that apply.)
-pain -fever -inflammation
When describing the onset of action of naloxone, the nurse would explain that the drug achieves its effect in which amount of time?
1-2 minutes
Aspirin increases the risk of bleeding and should generally be avoided for how many weeks before and after surgery?
1-2 weeks
The nurse is preparing to administer prescribed diazepam intravenously to a client. How soon after administration does the nurse expect to observe onset of action?
1-5 minutes
How long does a patient need to wait after stopping a phenelzine before starting paroxetine?
14 days
The client is experiencing some slurred speech and the nurse notices tremors. In reviewing the client's am lab results she focuses on the serum lithium level. Which finding would indicate that the client is experiencing lithium toxicity?
1.8 mEq/L
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 client is receiving an SSRI. The nurse would inform the client that the full benefits of the drug may not occur for which time period?
4 weeks
A client began taking acetylsalicylic acid several years ago to prevent platelet aggregation following a myocardial infarction. Which dose of aspirin is the client most likely taking daily?
81 mg
Several clients are prescribed sertraline therapy on the unit. Which client would require the closest monitoring by the nurse?
A 45-year-old man with liver impairment
A nurse is providing care on a psychiatric unit with many clients that take antidepressants. What client factor would the nurse have to consider when administering these medications?
A client has dysphagia
A male client has a history of hepatic dysfunction secondary to alcoholism. Based on the client's diagnostic history, what would the nurse expect his health care provider to order?
A lower dose of the antidepressant
A client's family asks why the nurse has placed suction equipment in the room immediately after administering a dose of naloxone. Which explanation by the nurse is correct?
Abrupt reversal of opioid-induced respiratory depression may cause vomiting
A parent has sought care from the nurse practitioner to treat a child's fever. The nurse practitioner is most likely to recommend what nonsalicylate drug?
Acetaminophen
A home care nurse is seeing a 66-year-old female who has just been released from the hospital after being treated for rotator cuff repair. The nurse knows that it is important to assess the client's knowledge of which area?
Adverse effect of NSAIDs
The nurse is caring for a client treated with flumazenil for benzodiazepine toxicity. After administering flumazenil what should the nurse carefully assess for?
Agitation, confusion, and seizures
When the nurse is engaging in teaching with clients taking anti-psychotic medications and their families, what would be important to include to decrease adverse effects of the medication?
Alcohol should be avoided
What client is being treated with a typical antipsychotic?
An agitated client who was given haloperidol during acute psychosis
Venlafaxine is an antidepressant that has become more popular with adults in treating their depression. Why has it become more popular?
An extended release form is available
A class of new nursing students is learning how to administer medications to clients. What should the instructor teach the students about giving opiates?
Assess the respiratory rate before giving a dose of opiates
The client reports using an over-the-counter (OTC) drug to treat insomnia. What classification of OTC medications is often used for this purpose?
Antihistamines
A male client's anxiety is interfering with his ability to perform basic activities of daily living and return to work. The nurse expects that which diagnosis will probably be made by his health care provider?
Anxiety disorder
A group of nursing students are reviewing information about antianxiety drugs. The students demonstrate understanding of the information when they identify which as another name for this group of drugs?
Anxiolytics
The nurse observes that a new client's medication regimen includes sumatriptan. What assessment should the nurse prioritize?
Assessing the client for migraine pain
The client reports to the nurse that the client is having ringing in the ears. The nurse questions the client on use of what medication?
Aspirin
Which drug is used to decrease the risk of myocardial infarction in patients with unstable angina or previous myocardial infarction?
Aspirin
A client with a history of chronic pain related to rheumatoid arthritis presents at the emergency department reporting dizziness, mental confusion, and difficulty hearing. What assessment is most appropriate?
Assess the client's use of salicylates
The nurse is caring for a client who is prescribed haloperidol long term. What assessment should the nurse prioritize?
Assessment for involuntary movements
Which instruction should the nurse specifically stress when administering drugs used for muscle spasm and cramping?
Avoid alcohol or other CNS depressants.
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
A client with a longstanding diagnosis of depression is being treated with phenelzine. The client reports the recent use of some over-the-counter flu and cold remedies and has consequently been admitted for observation and client teaching. What assessment should the nurse prioritize?
BP monitoring
A patient with arthritis is on nonsteroidal anti-inflammatory drug (NSAID) therapy. What should be evaluated by the nurse to determine the effectiveness of NSAID therapy?
Better mobility
A client suffering from migraine headaches is prescribed sumatriptan. What is the action of the drug?
Binding to serotonin to produce vasoconstriction
The nurse is discussing ethnic differences in response to medication with nursing students. What group of people would the nurse tell the students have a decreased sensitivity to pain-relieving effects of anti-inflammatory drugs and should be educated concerning signs and symptoms of gastrointestinal bleeding from use of these drugs?
Black Americans
A nurse is preparing to administer an antidepressant that affects the neurotransmission of norepinephrine, serotonin, and dopamine. Which drug will the nurse administer?
Bupropion
A client with a high-pressure job temporarily requires an anxiolytic that has no sedative properties. What medication is most likely to meet this client's needs?
Buspirone
Which drug used to treat anxiety would be appropriate for a client who is a school teacher and is concerned about feeling sedated at work?
Buspirone
A student nurse asks the nurse why acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) help to reduce cancer pain. What is the nurse's best explanation?
Cancer often produces chronic pain from tumor invasion of tissues or complications of treatment. These drugs prevent sensitization of peripheral pain receptors by inhibiting prostaglandin formation.
The 56-year-old client is diagnosed with osteoarthritis and reports joint pain and stiffness. Which medication would be identified as appropriate for the client to take?
Celecoxib
The child is diagnosed with attention deficit hyperactivity disorder (ADHD). Which medication will most likely be administered in conjunction with treatment?
Central nervous system (CNS) stimulants
What aspect of a client's health is most likely to cause insomnia?
Chronic Pain
A client reports insomnia during a routine visit. What should the nurse assess first regarding the most likely cause?
Daily intake of caffeine-containing products
A client prescribed a selective serotonin reuptake inhibitor has begun taking St. John's wort daily. The nurse should teach the client that this combination may result in what adverse reaction?
Dangerous drug interactions
A client with amyotrophic lateral sclerosis is experiencing muscle spasticity. Which drug would the nurse expect the physician to order?
Dantrolene
Dexmethylphenidate has been prescribed to Scott, a 7-year-old boy who was diagnosed with ADHD. The mother asks how this medication will help her son. Which would be the most accurate description of the purpose of this medication?
Dexmethylphenidate will improve Scott's attention span so that he will be able to complete a task.
A client is prescribed risperidone for the treatment of schizophrenia. The client is voiding three times each night and is always thirsty. Based on the adverse effects of risperidone, what should the nurse suspect is triggering the client's reported polyuria and polydipsia?
Diabetes mellitus
A group of nursing students answers correctly if they identify which medication as the prototype benzodiazepine?
Diazepam
What is the prototype for the classification of drugs referred to as benzodiazepines?
Diazepam
A nurse has noted that a newly admitted client has been taking ramelteon for the past several weeks. The nurse is justified in suspecting that this client was experiencing what problem prior to starting this drug?
Difficulty falling asleep at night
The client is taking baclofen. What would be the most important safety instruction for the nurse to give to this client?
Discontinue the use of alcohol
The instructor is discussing psychosis with the nursing students. The instructor knows that teaching was effective when the students identify what behaviors are exhibited by people with psychosis?
Disorganized and often bizarre thinking
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 caring for a client who is receiving cyclobenzaprine for relief of muscle spasms. What adverse effect should the nurse assess for?
Drowsiness
When developing a teaching plan for a client who is to receive carisoprodol, which sign or symptom would the nurse include as a common adverse reaction?
Drowsiness
A client with a severe depression has been hospitalized, and the health care provider has ordered amitriptyline. What common adverse effect might this client have?
Dry mouth
A nurse is caring for a patient with depression. Which symptom should the nurse closely monitor for in the patient?
Extreme sadness
Clients taking benzodiazepines, especially older adult clients, are at high risk for which effect?
Falls
A client is to receive a narcotic that will be applied transdermally. The nurse identifies this as which agent?
Fentanyl
Which medication order should a nurse question?
Fentanyl PO 1 mg q 4 hours for a 6-year-old in severe pain after surgery
Which agent would a nurse identify as a selective serotonin reuptake inhibitor?
Fluvoxamine
A nurse is preparing to teach a client about the adverse effects of the prescribed NSAID therapy. Which system would the nurse include as being involved?
GI
A client receiving outpatient therapy with antipsychotic therapy experiences dizziness from time to time. Which suggestion by the nurse would be appropriate?
Get up slowly from bed or chair
Signs and symptoms of what would necessitate discontinuation of dantrolene therapy?
Hepatic dysfunction
A nurse has admitted a 10-year-old to the short-stay unit. The child reports chronic headaches, and his mother states that she gives the child acetaminophen at least twice a day. What will the nurse evaluate?
Hepatic function
The nurse is providing education to a client who has been prescribed dantrolene. What serious adverse effect should the nurse mention during teaching?
Hepatitis
A client is admitted to the emergency department with a suspected overdose of acetaminophen. What adverse effect is the most common in acute or chronic overdose of acetaminophen?
Hepatotoxicity
A client with schizophrenia is prescribed clozapine. For which information in the medical record will the nurse question giving this medication to the client?
History of seizures disorder
Parents bring a 15-year-old male into the clinic. The parents tell the nurse that there is a family history of schizophrenia and they fear their son has developed the disease. What is an appropriate question to ask the parents?
How ling has your son been exhibiting symptoms
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
A nurse is assessing a client who has been taking nonsteroidal anti-inflammatory drugs (NSAIDs) for many months. What statement by the client indicates to the nurse that the client has a good understanding of the use of this therapy?
I asked my doctor to check for blood in my stool regularly
A client, prescribed dextroamphetamine for attention deficit hyperactivity disorder (ADHD) has developed a common adverse effect of the medication since beginning therapy. Which initial intervention should the client be encouraged to implement?
Increase fiber intake
Although naloxone is given to counter opioid medication side effects such as respiratory depression, what additional issues (if any) may result from administration of an opioid antagonist?
Increase in the client's pain rating
The psychiatric nurse would recognize that venlafaxine's therapeutic effect is achieved by what means?
Increasing levels of both serotonin and norepinephrine
A nurse is caring for a patient who is prescribed flurazepam. Which is an effect of flurazepam?
Induces sleep
A male client is diagnosed with narcolepsy by his physician. He asks the physician to prescribe modafinil, because it works so well for his friend. The physician will not prescribe the medication because of what aspect of the client's history?
Ischemic changes on his electrocardiograms
A patient with muscle ache would like to use an over-the-counter nonsteroidal anti-inflammatory drug (NSAID). The patient informs a nurse that he is taking antihypertensive drugs for blood pressure control. Why should the nurse caution the patient against the use of an NSAID while on antihypertensive drug therapy?
It causes decreased effectiveness of the antihypertensive drug.
The client tells the nurse that the health care provider described a drug as having "no ceiling effect." How should the nurse respond when the client asks what that means?
It is a valuable drug to use because dosage can be increased to relieve pain when pain increases or tolerance develops.
A client has been taking fluoxetine (Prozac) for the last ten days. Today the client is reporting not feeling any better. What is the nurse's best response to this client?
It may take another two to three weeks before the medication is completely effective."
A client has been taking citalopram for 2 weeks and has expressed a desire to discontinue it, stating, "I don't feel any better than I did before I started these pills." What should the nurse teach the client?
It may take up to two more weeks before the client feels better
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
A client is undergoing inpatient addiction rehabilitation following many years or addiction to heroin. What medication would be the most useful adjunct to treatment?
Methadone
A female client relates that she is taking diazepam for a muscle relaxant and modafinil for treatment of narcolepsy. Additionally, she informs you that she takes a contraceptive. As part of client education, the nurse would include:
Modafinil may decrease the effects of her contraceptive, and she may need to use other protection
Prior to administering morphine, the nurse checks the client's medication history. The nurse will contact the health care provider and hold the morphine if the nurse notes the client is currently taking which medication?
Monoamine oxidase (MAO) inhibitor
A 40-year-old male client with arthritis of the knee joint has been prescribed an analgesic to relieve the pain. Which medication is a narcotic analgesic?
Morphine
A patient comes to the clinic for a botox injection around her eyes. While making an assessment, the nurse finds that the patient is taking polymyxin for an infection. What would the nurse do first?
Notify the physician
In light of current treatment modalities, the nurse should anticipate that the client newly diagnosed with schizophrenia will most likely be prescribed what drug?
Olanzapine
A 70-year-old male client asks why he is receiving a lower dose of zaleplon than his son. As part of the nurse's teaching plan, which explanation will the nurse give this client?
Older adults metabolize the drug more slowly, and half-lives are longer than in younger adults."
While reviewing the medication history of an older adult client, the nurse learns that the client is taking amitriptyline 25 mg three times per day. What adverse effect should the nurse prioritizewhen incorporating safety measures into the care plan?
Orthostatic hypotension
A nurse is caring for a client diagnosed with a migraine. The client received acetaminophen-aspirin-caffeine by mouth. Which method should be used to assess for the therapeutic effects of the medication?
Pain scale
A client is prescribed transdermal selegiline. What health education should the nurse provide?
Place the patch on dry skin on your torso that has no cuts or openings
A nurse is caring for a 49-year-old client in the intensive care unit. The client was in a motor vehicle accident and is in severe pain. The client has been given morphine. After 2 days in the unit, the nurse can detect nasal congestion when the client speaks to her. The nurse will monitor for which?
Pneumonia
A client has been taking a selective serotonin reuptake inhibitor (SSRI) for the treatment of depression. Which represents the action of the medication?
Prevent serotonin from being reabsorbed
A patient undergoing treatment with barbiturates is showing symptoms of barbiturate toxicity. Which intervention should the nurse perform?
Provide respiratory assistance
Which diffuse connective tissue disease is the result of an autoimmune reaction that results in phagocytosis, producing enzymes within the joint that break down collagen and cause edema?
Rheumatoid arthritis (RA)
A client appears very drowsy at bedtime and is difficult to arouse. The client is receiving Halcion 0.25 mg PO at bedtime. Based on these findings, what would be the best nursing diagnosis for this client?
Risk for injury
A nurse is planning the care of a client who has been diagnosed with schizophrenia and who will begin treatment with a typical antipsychotic. The nurse should identify what nursing diagnosis?
Risk for injury related to central nervous system depression
A client who was diagnosed with schizophrenia in 1962 was prescribed chlorpromazine. The client has been taking the medication for more than 40 years. What adverse effect will the client mostlikely experience?
Tardive dyskinesia
A nurse observes rhythmic, involuntary facial movements in a patient who has been administered antipsychotic drugs. The patient also makes chewing movements and, at times, his tongue protrudes. What is the most likely reason for the patient's behavior?
Tardive dyskinesia
The nurse is caring for a patient who is taking an oral neuroleptic medication. What would be important to include in the patient teaching?
Tardive dyskinesia
The nurse observes that a client with a long history of chlorpromazine therapy demonstrates lip smacking and appears to be chewing continually. The nurse should recognize that this client is likely experiencing what adverse effect of the medication?
Tardive dyskinesia
Three days after discontinuing diazepam with medical guidance, an older adult continues to demonstrate impaired memory and confusion. The nurse should consider what possible explanation for the client's current status?
The adverse effects of benzodiazepines can persist for several days after stopping the drug.
The nurse would question the health care provider who prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) for which client?
The client diagnosed with peptic ulcers
A client diagnosed with migraines expresses interest in taking an over-the-counter acetaminophen, aspirin, and caffeine combination drug. Which information presented in the client's history should prompt the nurse to discourage the client from taking the drug?
The client has a diagnosis of liver cirrhosis.
A female client has been diagnosed with depression. She also has a history of alcoholism. She has been sober now for 4 months, but at her last physical examination, the health care provider noted right-upper-quadrant tenderness and elevated liver enzyme levels. The provider has prescribed sertraline to treat the client's depression. Which factor would need to be considered prior to administering this medication?
The medication should be started at a lower dose due to liver dysfunction, and the client should be monitored for side effects.
A client admitted for a severe migraine reports taking ergotamine tartrate at home. What is mostessential information for the nurse to obtain?
The number of ergotamine tablets the client took at home
The client has been taking a sleep medication for the last 6 months. The client informs the primary care provider that she sleeps great now and wants to discontinue the drug. The provider informs the client that this is not a good idea. What is the best rationale for the providers advice?
The provider believes that stopping the drug abruptly may cause serious consequences for the client.
A male patient is being discharged home from the hospital after having pneumonia. At home, the patient will be taking the same drugs he was taking before he was hospitalized. These drugs include an anti-anxiety medication and a medication for insomnia. During the home care nurse's initial visit, what should the nurse review with the patient?
The risks of injuries if mental and physical responses are slowed by drugs
A nurse is preparing a presentation about the use of antidepressants in children and adolescents. What would the nurse need to keep in mind?
The smallest amount of drug that is feasible should be dispensed.
The nurse understands that the main goal of therapy with CNS stimulants is to relieve symptoms of the disorders for which they are given. What is a secondary goal for their use?
To have clients use the drugs appropriately
What disease process is haloperidol used to treat?
Tourette's syndrome
What is chrysotherapy?
Treatment with gold salts
Muscle spasms are thought to arise from the flood 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
A female client tells the nurse that the first thing she does when she gets a headache is drink a caffeinated beverage. The nurse is aware that caffeine is known to decrease the pain of migraine headaches by what mechanism?
Vasoconstriction of blood vessels
For clients taking clozapine, it is necessary to monitor what lab test for the first 6 months
WBCs
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 assessment question would be most appropriate when providing care for a client newly prescribed chlordiazepoxide?
When did you have your last drink of alcohol?"
A client experiences intense knee pain due to arthritis and the use of a hyaluronidase derivative is being considered. What assessment finding must be considered?
Whether the client is comfortable having an injection into the knee joint
The nurse has just administered an opioid antagonist to a client who had been experiencing respiratory depression. How soon can the nurse expect to see improvement in the client's respiratory function?
Within one to five minutes, an effect may be seen
A nurse is caring for a patient who has been prescribed a monoamine oxidase inhibitor (MAOI). What should the nurse ask the patient to avoid?
Yogurt
A 70-year-old patient has just started taking lorazepam 10 days ago for anxiety issues related the death of her husband. She is staying with her daughter for a couple of weeks. The patient's daughter has noticed that her mother is having difficulty walking and seems to be confused at times and calls the clinic to report this to the nurse. The nurse will inform the daughter that:
a dose adjustment should be made if these symptoms persist.
A group of nursing students are reviewing information about nonopioid analgesics. The students demonstrate understanding of the information when they identify which drug as a nonsalicylate analgesic?
acetaminophen
A 60-year-old client tearfully explains to the nurse how her husband downplays her frequent migraines and tells her that she needs to "just push through a headache." She describes how her migraines have limited her ability to provide childcare for her young grandchildren and explains that she is unable to keep up her garden. The nurse should identify what nursing diagnosis when planning this client's care?
ineffective role performance related to migraine headaches
The nurse is aware that aspirin not only lowers the client's fever but can also reduce the pain the client is experiencing by:
inhibiting the production of prostaglandins
The client is taking NSAIDs for pain. The nurse explains to the client that NSAIDs act by which actions?
inhibiting the synthesis of prostaglandins
A client has been diagnosed with severe rheumatoid arthritis, and hylan G-F 20 has been ordered. How is this drug given
injected into the joint
A client has been diagnosed with severe rheumatoid arthritis, and hylan G-F 20 has been ordered. How is this drug given?
injected into the joint
A client is prescribed a tricyclic antidepressant. The nurse would anticipate administering this drug by which route?
oral
A client is receiving auranofin as treatment for rheumatoid arthritis. The nurse should expect this drug to be given by which route?
oral
What adverse effect could be related to a fall experienced by an older client prescribed amitriptyline?
orthostatic hypotension
The nurse gives a 68-year-old client diphenhydramine to help the client sleep the night before surgery. At midnight, the nurse notes the client is awake and agitated. What pharmacologic principle would be the cause of this reaction?
paradoxical excitement, which is the opposite reaction than what was expected
A patient enters the emergency room with reports of visual changes, drowsiness, and tinnitus. The patient is confused and hyperventilating. These symptoms may be attributable to:
salicylate intoxication
A client who was previously taking paroxetine is being switched to phenelzine due to a lack of response. The nurse would expect that the phenelzine will be started at which time?
several weeks after stoping the paroxetine
An older adult woman has been experiencing significant joint pain and has informed her primary care provider that she has begun taking aspirin two to three times each day. What aspect of this patient's medical history may contraindicate the use of aspirin?
the patient take an SSRI for depression
An 80-year-old man has been prescribed oxycodone for severe, noncancer, chronic pain. He tells the nurse that he has difficulty swallowing and asks if he can crush the tablet before swallowing. The nurse will advise the client that:
there is risk of an extremely high dose available all at once if the tablet is crushed
After teaching a local community group about the use of OTC anti-inflammatory agents, the nurse determines that the group needs additional teaching when they state:
these drugs are relatively safe since they dont have adverse effects
The client has been prescribed one aspirin a day. The nurse understands that is prescribed for which of the following?
to inhibit platelet aggregation
What is chrysotherapy?
treatment with gold salts
Which conditions would occur due to the administration of an opioid antagonist in a client who is physically dependent on opioids?
withdrawal symptoms
A client with an acute onset of disorganized thinking and hallucinations is prescribed an intramuscular dose of chlorpromazine. How soon after administration can the nurse assess for therapeutic effect?
within 20 minutes
