Pharm Midterm

The nurse is caring for a young female client who is 5 weeks pregnant. What statement made by the nurse about the use of antidepressants during pregnancy is most accurate?

"Antidepressants are used very cautiously during pregnancy and only when benefit outweighs risk."

The nurse administers chlorpromazine intramuscularly to the preoperative client who is intensely anxious about surgery the next morning. What education should the nurse provide this client?

"Remain lying down for at least half an hour after the injection."

A client states that they were prescribed barbiturates many years ago for anxiety. The nurse explains that this is no longer done and should provide what rationales? Select all that apply.

- Adverse effects can be severe., - There is a high risk of physical tolerance., - There is a high risk of psychological dependence. - Hypersensitivity reactions can sometimes be fatal.

The nurse is caring for a client whose unpredictable emotions are due to an infarct in the limbic system. The nurse should be aware that this part of the brain contains high levels of what neurotransmitters? Select all that apply.

- Epinephrine - Serotonin - Norepinephrine

A client with depression has been prescribed a monoamine oxidase inhibitor (MAOI) What education should the nurse provide to this client? Select all that apply.

- Monitor blood pressure closely. - Do not take over-the-counter (OTC) drugs without talking to physician., - Avoid foods containing tyramines.

The nurse is preparing to perform a neurologic assessment of a new client. What provides required energy to the nerves? Select all that apply.

- Oxygen - Glucose

The client presents to the emergency department with a headache in the back of the head, diaphoresis, and neck stiffness. The client's blood pressure measures 180/124 mm Hg and heart rate is 168 beats/min. The spouse says the client is currently prescribed "something for depression" and denies any history of cardiac disease. The nurse should suspect the use of what medication?

A monoamine oxidase inhibitor (MAOI)

The nurse is caring for an older adult in the long-term care facility who has begun to display signs of anxiety and insomnia. What is the priority nursing action?

Assess the client for physical problems.

The nurse is caring for a child receiving a central nervous system (CNS) stimulant who was admitted to the pediatric intensive care unit following repeated seizures after a closed head injury. The provider orders phenytoin to control seizures and lorazepam to be administered every time the child has a seizure. What is the nurse's priority action?

Call the provider and question the administration of phenytoin.

A nurse is about to administer a parenteral benzodiazepine to a client in the hospital before the performance of an invasive diagnostic procedure. What action should the nurse prioritize before administration of the drug?

Help the client out of bed to the bathroom and encourage the client to void.

The nurse is preparing to administer methylphenidate to the child admitted to the pediatric unit after breaking a leg longboarding. Where should the nurse find the medication?

In the controlled substance cabinet

An older adult was diagnosed with depression several decades ago and has been taking tricyclic antidepressants (TCAs) ever since, with good effect. The nurse should recognize what therapeutic action of this client's medication?

Inhibiting reuptake of norepinephrine and serotonin

The client has been depressed since the client's father died 6 months ago and the health care provider has prescribed amitriptyline. What aspect of this client's health history should prompt the nurse to contact the health care provider?

Ischemic heart disease

A client, in the manic phase of bipolar disorder, is being discharged home on an antimanic drug. What antimanic drug will best provide long-term maintenance of the client's bipolar disorder?

Lamotrigine

A client has been diagnosed with depression. The nurse should be aware that the client's health problem may be the result of involvement in what areas of the brain? Select all that apply.

Limbic system Reticular activating system (RAS) Basal ganglia

An older adult client is brought to the emergency department by family members. The family states the client has been uncharacteristically confused and appears to have abnormal perception of movement. The nurse reviews the client's current medication regimen and suspects the client overdosed on what medication?

Lorazepam

The client is diagnosed with myasthenia gravis, a condition in which antibodies block, alter, or destroy the receptors for acetylcholine. What symptom would the nurse expect this client to display?

Muscle dysfunction

The sensory nerves enter the brain and react with related nerves to cause a reaction. What mediates this reaction?

Muscles or glands

A client has pheochromocytoma, which causes hypertension due to excessive hormone release from the adrenal medulla. This client's symptoms are due to disruptions in the level of what hormone?

Norepinephrine

The nurse is caring for a client who was referred to a psychiatrist for treatment of a severe anxiety disorder. What medication would the nurse consider appropriate for this client?

Paroxetine 10 mg once daily orally

A client is admitted with a presumed diagnosis of colon cancer. The health record indicates that the client takes a monoamine oxidase inhibitor for depression. What drug should the nurse keep on hand for this client in case of the onset of an adverse reaction?

Phentolamine

A resident of a long-term care facility is experiencing insomnia since being transferred to the facility. What antipsychotic would best help this client sleep?

Quetiapine

A client comes to the mental health clinic for a regular appointment. The client tells the nurse he has been taking oral fluoxetine 20 mg daily for the past 3 weeks and that he has lost 3 lbs during that time due to a loss of appetite. What action should the nurse take?

Reassuring the client that this is a common adverse effect with this medication.

The nurse is caring for a client who experiences anxiety and insomnia and is prescribed lorazepam. When developing the plan of care, what would be an appropriate nursing diagnosis related to potential adverse effects of the drug?

Risk for injury related to central nervous system (CNS) effects.

The nurse is caring for a client with meningitis who is not responding to the prescribed antibiotic and whose condition continues to deteriorate. The nurse should provide which rationale to explain why the client is not responding?

The blood-brain barrier prevents the antibiotics from crossing into the brain.

The nurse administers promethazine to the client before sending the client to the preoperative holding area. What outcome demonstrates therapeutic effects?

The client is conscious but drowsy

During initial admission assessment, a 79-year-old client's family mention the client's spouse died 4 months ago. One family member notes, "the healthcare provider had prescribed antidepressant medication" but the client is "talking to people who aren't there." What would the nurse suspect is happening to the client?

The client is having hallucinations as an adverse effect of antidepressant therapy.

The nurse is caring for a client who is taking lithium for the treatment of bipolar disorder. The client's most recent laboratory findings reveal a serum lithium level of 1.4 mEq/L. What assessment findings should the nurse attribute to the client's lithium level?

The client is lethargic and weak.

The nurse is caring for a client whose emotions often swing from one extreme to the other. The client's spouse tells the nurse these mood swings started when the client awoke from a coma following a serious head trauma. What area of the brain does the nurse suspect was damaged?

The limbic system

The nurse is caring for a client with bipolar disorder whose medication regimen includes lithium and who will soon be discharged. What health education should the nurse prioritize?

The need to have follow-up blood samples drawn on schedule