Pharm- Neuro

The nurse is reinforcing instructions to the spouse of a client who is taking tacrine 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 primary health care provider."

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?

10 breaths per minute

A client with a history of simple partial seizures is taking clorazepate, and asks the nurse if there is a risk of addiction. The nurse's response is based on which fact?

Tx leads to dependence with prolonged high dose therapy

A client is receiving anticonvulsant therapy with phenytoin. The nurse plans to monitor the results of which laboratory tests closely? Select all that apply.

UA Ca2+ alk. PO4 CBC

A client with trigeminal neuralgia tells the nurse that acetaminophen 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 biliruben level of 2

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

inhibits NE transport and reuptake

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

cool numb fingers and toes

The nurse is caring for a client with myasthenia gravis who has received edrophonium 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?

30ish

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?

RR 10 breaths per minute

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

A client began taking amantadine approximately 2 weeks ago. A decrease in which should the nurse expect to see if the medication is having a therapeutic effect?

rigidity and akinesia

A client with epilepsy is taking the prescribed dose of phenytoin 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 providing instructions to a client beginning medication therapy with divalproex sodium for the treatment of absence seizures. The nurse instructs the client that which is the most frequent side effect of this medication?

n/v

A client taking phenytoin 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 is admitted to the hospital because of complaints of vomiting and abdominal pain. During data collection, the client tells the nurse that he is taking entacapone. Based on this finding, the nurse elicits information from the client regarding the presence of which condition?

parkinson's

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?

TCDB

A client is receiving phenytoin. Which findings would indicate that the client is experiencing side/adverse effects related to this medication? Select all that apply.

constipation bleeding gums decreased wbc decreased plt

A client with Parkinson's disease has begun therapy with carbidopa/levodopa. The nurse determines that the client understands the action of the medication if the client verbalizes that results may not be apparent for which length of time?

2-3 wks

A client has a prescription for valproic acid orally once daily. How should the nurse plan to administer the medication?

admin same time each day1

A client being seen in the clinic is taking phenytoin. 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 primary health care provider notification and possible discontinuation of the medication?

diffuse body rash

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

dry mouth

A client with a history of seizures is taking phenytoin 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?

lab value is low end of therapeutic range

Carbamazepine 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

A client receiving morphine by the epidural route complains of itching. The nurse should anticipate which prescription to relieve the itching?

low dose infusion of naloxone

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

are the headaches relieved

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

increased urination may be an adverse effect

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 hr before bedtime

A client taking phenytoin 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 bradypena

The client with myasthenia gravis is receiving pyridostigmine. The nurse monitors for signs and symptoms of cholinergic crisis caused by overdose of the medication. The nurse checks the medication supply to ensure that which medication is available for administration if a cholinergic crisis occurs?

atropine sulfate

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

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

A client has been given a prescription for chloral hydrate for short-term use. The nurse includes which nursing intervention in caring for this client?

call for help when getting OOB

A client who was started on anticonvulsant therapy with clonazepam 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 with long term use

Mannitol 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 diruesis by raising osmotic pressure of glomerular filtrate

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

elevated white blood cell count

A client who was started on anticonvulsant therapy with clonazepam 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?

expected effects that decrease over time

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 ethosuximide carbamazepine

A client receiving therapy with carbidopa/levodopa is upset and tells the nurse that his urine has turned a darker color since he began to take the medication. The client wants to discontinue its use. In formulating a response to the client's concerns, how does the nurse interpret this development?

harmeless side effect

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

have a snack

The nurse is caring for an older client with a diagnosis of myasthenia gravis and has reinforced self-care instructions. Which statement by the client indicates a need for further teaching?

i can change the time of the bed on mornings that i feel strong

Amantadine hydrochloride 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 can take the med early in the morning and right before bed

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 should not stop taking my med even if seizures go away

The nurse has reinforced instructions to a client with Parkinson's disease who is taking carbidopa/levodopa. Which statement by a client indicates the need for further teaching?

i will eat foods high in B6

A registered nurse (RN) asks a licensed practical nurse (LPN) to obtain a vial of mannitol 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

Ibuprofen is prescribed for a client. Which instruction should the nurse give the client about taking this medication?

take with 8oz milk

A client with a closed head injury is receiving phenytoin, 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 platelets

A client is placed on hydrate sedative-hypnotic for short-term treatment. Which nursing action indicates an understanding of the major side effect of this medication?

instruct for ambulation help

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?

mag. toxicity

The client with myasthenia gravis becomes increasingly weak. The primary health care provider (PHCP) prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or increasing severity of the disease (myasthenic crisis). An injection of edrophonium is administered. Which change in condition indicates that the client is in cholinergic crisis?

temporary worsening of the condition

The nurse is caring for a client who is taking phenytoin for control of seizures. During the assessment, the nurse notes that the client is taking birth control pills. Which information should the nurse include in the teaching plan?

there is potential of decreased effectiveness of birth control pills

The client with myasthenia gravis is suspected of having cholinergic crisis. Which sign/symptom indicates this crisis is taking place?

Hypertension

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?

TCDB

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

Urinary retention

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

caffeine

The nurse is caring for a client in the emergency department who has been diagnosed with Bell's palsy. The client has been taking acetaminophen, and acetaminophen overdose is suspected. Which antidote should the nurse prepare for administration if prescribed?

acetylcystine

A client with Parkinson's disease is beginning treatment with carbidopa/levodopa. Which statement made by the client indicates the need for further teaching?`

i should take my med after a full meal

The client is receiving meperidine hydrochloride for pain. Which signs/symptoms are side and adverse effects of this medication? Select all that apply.

tremor drowsiness hypotension

Meperidine has been prescribed for a client to treat pain. Which side and adverse effects should the nurse monitor for? Select all that apply.

tremor 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 is prescribed for the client with pain. Which should the nurse monitor as a side effect of this medication?

urinary retention

Phenytoin, 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 tooth brush

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

if the gums become sore i should stop the med

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

instituting seizure precautions

A primary health care provider initiates carbidopa/levodopa 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 this combination medication?

take with food to prevent nausea

The nurse is caring for a client who has been prescribed carbidopa/levodopa. The nurse should monitor the client for which side effects? Select all that apply.

urinary retention, orthostatic hypotension

Entacapone is prescribed for a client with a diagnosis of Parkinson's disease. The nurse reinforces medication instructions to the client and instructs on which frequent side effect?

urine discoloration

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

15

The nurse has given medication instructions to a client beginning anticonvulsant therapy with carbamazepine. The nurse determines that the client understands the use of the medication if the client knows to perform which activity?

use sunscreen

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

6

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

per policy put up siderails

The nurse is caring for a client who is taking phenytoin 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?

potential for decreased effectiveness of birth control pill

The nurse reviews the laboratory results of a client with trigeminal neuralgia who is being treated with carbamazepine 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 primary health care provider?

low wbc

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

provide oral hygiene, esp gum care

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

slurred speech

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

take before eating

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

take the med as long as it is not immediately before the next dose

Carbidopa-levodopa is prescribed for a client with Parkinson's disease, and the nurse monitors the client for adverse effects of the medication. Which sign/symptom indicates the client is experiencing an adverse effect?

impaired voluntary movement

The nurse is assisting in the care of a client with Parkinson's disease who is receiving carbidopa/levodopa. The nurse plans to monitor the client for which adverse effect, which could appear with elevated serum levels of this medication?

impaired voluntary movement

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

increase the present dosage

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

elevated wbc

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

if you get a sore throat notify pcp

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?

increased fluid intake