Pharm Neuro N-Clex

Phenytoin (Dilantin), 100 mg orally three times daily, has been prescribed for a client for seizure control. The nurse reinforces instructions regarding the medication to the client. Which statement by the client indicates an understanding of the instructions?

" I will use a soft toothbrush to brush my teeth"

The nurse is reinforcing instructions to an adolescent who has a history of seizures and is taking an anticonvulsant medication. Which statement indicates the client understands the instructions?

"I can't drink alcohol while I am taking my medication."

Amantadine hydrochloride (Symmetrel) 100 mg orally twice daily has been prescribed for a client with Parkinson's disease, and the nurse teaches the client about the medication. Which statement by the client indicates a need for further teaching?

"I'll take this medication early in the morning and just before I go to bed."

The nurse is reinforcing instructions to an adolescent who is taking phenytoin (Dilantin) for the control of seizures. Which statement by the adolescent indicates a need for further teaching regarding the medication?

"If my gums become sore, I need to stop the medication."

The nurse is reinforcing instructions to a client taking phenytoin (Dilantin) for seizure control. Which statement should the nurse make to the client regarding the administration of this medication?

"If you develop a sore throat, it is necessary to notify the health care provider."

The nurse is reinforcing instructions to the family of a client with Alzheimer's disease regarding tacrine (Cognex). Which statement by the family would indicate an understanding of the side/adverse effects related to this medication?

"Increased urination may be an indication of an adverse effect.

A client taking carbamazepine (Tegretol) asks the nurse what to do if he misses one dose. Which response should the nurse give?

"Take the medication as long as it is not immediately before the next dose."

A client with myasthenia gravis is being discharged on pyridostigmine bromide (Mestinon). The nurse reinforces medication instructions with the client and makes which statement to the client?

"Take the medication before activities such as eating.

Mannitol (Osmitrol) is being administered to a client with increased intracranial pressure following a head injury. The nurse assisting in caring for the client knows that which indicates the therapeutic action of this medication?

Induces diuresis by raising the osmotic pressure of glomerular filtrate, thereby inhibiting tubular reabsorption of water and solutes

A hospitalized client is having the dosage of clonazepam (Klonopin) adjusted. The nurse should plan to implement which action?

Instituting seizure precautions

Carbamazepine (Tegretol) is prescribed for a client with a diagnosis of psychomotor seizures. The nurse reviews the client's health history knowing that this medication is contraindicated if which disorder is present?

Liver disease

The nurse is caring for a client with severe back pain, and codeine sulfate has been prescribed for the client. Which should the nurse include in the plan of care while the client is taking this medication?

Monitor bowel activity.

The nurse is caring for a hospitalized child with a history of seizures who is receiving oral phenytoin sodium (Dilantin). Which should be included in the plan of care for this child?

Providing oral hygiene, especially care of the gums

Morphine sulfate is being administered to a client with cancer. The nurse is monitoring the client for signs of overdose related to this medication therapy. Which finding noted in the client should require the need to notify the registered nurse?

Respirations of 10 breaths per minute

Ibuprofen (Advil) is prescribed for a client. Which instructions should the nurse give the client about taking this medication?

Take with 8 oz of milk

A health care provider initiates carbidopa/levodopa (Sinemet) therapy for the client with Parkinson's disease. A few days after the client starts the medication, the client complains of nausea and vomiting. What should the nurse tell the client regarding how to avoid side effects when taking the medication, carbidopa/levodopa (Sinemet)?

Taking the medication with food will help to prevent the nausea.

A client who is receiving carbamazepine (Tegretol) daily has a white blood cell (WBC) count of 2800 cells/mm3, blood urea nitrogen (BUN) of 17 mg/dL, sodium of 141 mEq/L, and uric acid of 5 mg/dL. The nurse makes which interpretation based on these laboratory values?

The WBC count is low, indicating a blood dyscrasia

The nurse reviews the laboratory results of a client with trigeminal neuralgia who is being treated with carbamazepine (Tegretol) 400 mg orally daily. The client's white blood cell (WBC) count is 3000 cells/mm3, blood urea nitrogen (BUN) is 15 mg/dL, sodium is 140 mEq/L, and uric acid is 5 ng/dL. Which laboratory result should the nurse report to the health care provider?

The WBC is low, indicating a blood dyscrasia.

The nurse is assisting in caring for a pregnant client who is receiving intravenous magnesium sulfate for the management of preeclampsia and notes that the client's deep tendon reflexes are absent. On the basis of this data, the nurse reports the finding and makes which determination?

The client is experiencing magnesium toxicity.

The nurse is caring for a client who is taking phenytoin (Dilantin) for control of seizures. During data collection, the nurse notes that the client is taking birth control pills. Which information should the nurse provide to the client?

The potential for decreased effectiveness of the birth control pills exists while taking phenytoin (Dilantin).

A client who was started on anticonvulsant therapy with clonazepam (Klonopin) tells the nurse of increasing clumsiness and unsteadiness since starting the medication. The client is visibly upset by these symptoms and asks the nurse what to do. The nurse's response is based on which understanding of these symptoms?

These are expected effects during initial therapy and decrease or disappear with long-term use.

The client is receiving meperidine hydrochloride (Demerol) for pain. Which are side/adverse effects of this medication? Select all that apply.

Tremors Drowsiness Hypotension

A client is taking trihexyphenidyl for the treatment of Parkinson's disease. The nurse should monitor for which side effect of this medication?

Urinary retention

Meperidine hydrochloride (Demerol) is prescribed for the client with pain. Which should the nurse monitor as a side effect of this medication?

Urinary retention

The nurse has administered a dose of meperidine hydrochloride (Demerol) to a client. The nurse carefully monitors this client for which side effect?

Urinary retention

The nurse is assisting in preparing a plan of care for a client with renal colic receiving meperidine hydrochloride (Demerol) for pain. The nurse includes in the plan of care to monitor for which side effect of this medication?

Urinary retention

The nurse is reading the laboratory results for a client being treated with carbamazepine (Tegretol) for prophylaxis of complex-partial seizures. The nurse interprets that which value is consistent with an adverse effect to this medication?

White blood cell count 3200 cells/mm3

A client is receiving anticonvulsant therapy with phenytoin (Dilantin). The nurse plans to monitor the results of which laboratory test closely?

Complete blood cell count

A client with cancer is receiving morphine sulfate. When writing the plan of care for this client, the nurse should assign priority to which intervention?

Encourage the client to cough and deep breathe.

The nurse employed in a health care provider's office is collecting data on a client who is taking ergotamine tartrate (Cafergot). The nurse evaluates the effectiveness of therapy by asking which question?

"Are the headaches relieved?"

A client who was started on anticonvulsant therapy with clonazepam (Klonopin) tells the nurse of increasing clumsiness and unsteadiness since starting the medication. The client is visibly upset by these manifestations and asks the nurse what to do. How should the nurse respond to the client's concerns?

"Clumsiness and unsteadiness are worse during initial therapy and decrease or disappear with long-term use."

The client is taking phenytoin (Dilantin) for seizure control, and a blood sample for a serum drug level is drawn. Which laboratory finding indicates a therapeutic serum drug result?

15 mcg/mL

The nurse is caring for a client with myasthenia gravis who has received edrophonium (Enlon) intravenously to test for myasthenic crisis. The client asks the nurse how long the improvement in muscle strength will last. The nurse's response is based on the understanding that the duration is usually how many minutes?

30

The nurse is caring for a child receiving carbamazepine (Tegretol) who has a carbamazepine level drawn. Which result indicates a therapeutic level?

6 mcg/mL

A client with trigeminal neuralgia tells the nurse that acetaminophen (Tylenol) is taken on a frequent daily basis for relief of generalized discomfort. The nurse reviews the client's laboratory results and determines that which indicates toxicity associated with the medication?

A direct bilirubin level of 2 mg/dL

The nurse reviews the phenytoin level of a client who is taking phenytoin (Dilantin). The nurse notes that the plasma drug level is 9 mcg/mL. Which does the nurse anticipate to be prescribed for the client?

An increase in the present dosage

A client with narcolepsy has been prescribed a central nervous system (CNS) stimulant. The client complains to the nurse that he cannot sleep well anymore at night and does not want to take the medication any longer. Before making any specific comment, the nurse plans to investigate whether the client takes the medication at which time schedule?

At least 6 hours before bedtime

A client taking phenytoin (Dilantin) has a serum phenytoin level of 30 mcg/mL. The nurse would expect to note which signs and symptoms on data collection of the client? Select all that apply

Ataxia Nausea Diplopia Nystagmus

A client taking phenytoin (Dilantin) has a serum phenytoin level of 30 mcg/mL. The nurse should expect to note which signs and symptoms on data collection? Select all that apply

Ataxia Nausea Restlessness Respiratory rate of 9 breaths per minute

The client with trigeminal neuralgia is being treated with carbamazepine (Tegretol). Which laboratory result indicates that the client is experiencing an adverse effect of the medication?

Blood urea nitrogen (BUN) level, 15 mg/dL

Neuroleptic malignant syndrome is suspected in a client who is taking chlorpromazine. Which medication should the nurse prepare in anticipation of the prescription to treat this adverse effect related to the use of chlorpromazine?

Bromocriptine (Parlodel)

A client on the nursing unit has a prescription for a central nervous (CNS) stimulant orally daily. The nurse collaborates with the dietitian to limit the amount of which item on the client's dietary trays?

Caffeine

The nurse should instruct the client taking atomoxetine (Strattera) to avoid foods containing which substance?

Caffine

A client with a closed head injury is receiving phenytoin (Dilantin), an anticonvulsant medication. Which finding would indicate that the client is experiencing side/adverse effects related to this medication? Select all that apply.

Constipation Bleeding gums Decreased platelet count

A client with a closed head injury is receiving phenytoin (Dilantin), an anticonvulsant medication. Which would indicate that the client is experiencing side effects related to this medication? Select all that apply

Constipation Bleeding gums Hyperglycemia Decreased platelet count

A client with vascular headaches is taking ergotamine (Ergomar). Which client complaint should the nurse monitor?

Cool, numb fingers and toes

A client being seen in the clinic is taking phenytoin (Dilantin). The client's phenytoin blood level is within therapeutic range and the client's seizures are controlled. Which data collected by the nurse would require health care provider notification and possible discontinuation of the medication?

Diffuse body rash

A client with Parkinson's disease has been prescribed benztropine (Cogentin). The nurse monitors for which gastrointestinal (GI) side effect of this medication?

Dry mouth

A client who recently began medication therapy with levodopa (Larodopa) for Parkinson's disease complains of nausea. The nurse reminds the client to do which action to manage this problem?

Eat a snack before taking the medication

The nurse is caring for a client receiving morphine sulfate intravenously for pain. Because morphine sulfate has been prescribed for this client, which nursing action should be included in the plan of care?

Encourage the client to cough and deep breathe

The nurse is assisting in preparing a plan of care for a client with a diagnosis of cancer who is receiving morphine sulfate in an extended format by mouth. The nurse should include which priority nursing action in the plan of care for this client?

Encourage the client to cough and deep breathe.

A 16-year-old child is brought to the emergency department by his mother with a complaint that the child just experienced a tonic-clonic seizure. On arrival in the emergency department no apparent seizures were occurring. The mother states that her son is taking medication for the seizure disorder. The nurse plans care, knowing that which medications are used for long-term control of tonic-clonic seizures? Select all that apply

Gabapentin (Neurontin) Ethosuximide (Zarontin) Carbamazepine (Tegretol)

The nurse is reinforcing instructions to the spouse of a client who is taking tacrine (Cognex) for the management of moderate dementia associated with Alzheimer's disease. The nurse should tell the spouse which information?

If a change in the color of the stools occurs, notify the health care provider."

The nurse is providing instructions to a client who is taking codeine sulfate for severe back pain. Which action does the nurse instruct the client to do?

Increase fluid intake

Which instruction should the nurse reinforce for the client taking codeine sulfate?

Increase fluid intake.

The nurse is providing instructions to a client beginning medication therapy with divalproex sodium (Depakote ER) for the treatment of absence seizures. The nurse instructs the client that which is the most frequent side effect of this medication?

Nausea and Vomiting

The nurse has administered a dose of diazepam (Valium) to a client. The nurse should take which most important action before leaving the client's room?

Per agency policy, put up the side rails on the bed.

A registered nurse (RN) asks a licensed practical nurse (LPN) to obtain a vial of mannitol (Osmitrol) for administration to a client. The LPN notes that the vial contains a few small crystals. Based on this observation, which would the LPN expect the RN to do?

Place the vial in warm water until the crystals dissolve.

A licensed practical nurse (LPN) is assisting in the care of a pregnant teenaged client with preeclampsia receiving magnesium sulfate. The LPN plans to notify the registered nurse immediately if which sign of magnesium toxicity is noted?

Respiratory rate of 10 breaths per minute

A client began taking amantadine hydrochloride (Symmetrel) approximately 2 weeks ago. The nurse determines that the medication is having a therapeutic effect if the client exhibits a decrease in which finding?

Rigidity

A client with epilepsy is taking the prescribed dose of phenytoin (Dilantin) to control seizures. A phenytoin blood level is drawn, and the results reveal a level of 35 mcg/mL. Which symptom would be expected as a result of this laboratory result?

Slurred speech

The nurse is caring for a client who has been prescribed gabapentin (Neurontin) and is monitoring for adverse effects of the medication. Which finding indicates a potential adverse effect?

Slurred speech

A client with a history of seizures is taking phenytoin (Dilantin) for seizure control. The client arrives at the health care clinic, and a serum phenytoin drug level is drawn. The laboratory calls the nurse and reports a result of 10 mcg/mL. Which interpretation should the nurse make of this value?

The laboratory value represents a toxic level.

The parent of a client taking atomoxetine (Strattera) asks how the medication works to control attention deficit hyperactivity disorder (ADHD). The nurse's correct explanation is based on which fact?

The medication inhibits norepinephrine (NE) transport and reuptake