Pharm2 CNS/PNS quiz 2
A nurse is caring for a child who has epilepsy and is scheduled to receive a dose of phenytoin. The nurse notes the child's serum phenytoin level is 14 mcg/mL. Which of the following actions should the nurse take? A. Administer the dose B. Administer half the dose C. Do not administer the dose D. Clarify the dose with the provider
A. Administer the dose
Which of the following information should a healthcare professional include when talking to a patient about taking baclofen (Lioresal)? A. Avoid driving until drug effects are evident B. Stop taking the drug immediately if headache occurs C. Take the drugs PRN for spasticity D. Take the drugs with antacids to reduce gastric effects
A. Avoid driving until drug effects are evident
A nurse is teaching a client who is taking levodopa/carbidopa to treat Parkinson's disease. Which of the following instructions should the nurse include? A. Change position slowly to prevent orthostatic hypotension. B. Eat a high-protein snack to increase absorption. C. Take the drug at bedtime to avoid daytime drowsiness. D. Expect eye twitching to develop with long-term therapy.
A. Change position slowly to prevent orthostatic hypotension.
A nurse is collecting data from a client who takes an MAOI for the treatment of depression. Which of the following findings is the priority for the nurse to report to the provider? A. Elevated blood pressure B. Weight gain C. Muscle twitching D. 2+ peripheral
A. Elevated blood pressure
A nurse is caring for a patient who overdosed on benzodiazepines. What is the antidote to reverse the effects of benzodiazepines? A. Flumazenil B. Zolpidem C. Valium D. Pregalbalin
A. Flumazenil
A nurse is caring for a client who has schizophrenia and a prescription for chlorpromazine. For which of the following adverse effects should the nurse monitor? A. Orthostatic hypotension B. Diarrhea C. Urinary frequency D. Bradycardia
A. Orthostatic hypotension
A nurse is reinforcing teaching with a client who has a new prescription for phenytoin. Which of the following adverse effects can occur with the abrupt withdrawal of phenytoin? A. Status epilepticus B. Bleeding gums C. Disorientation D. Severe nausea
A. Status epilepticus
A nurse is reinforcing teaching with a client who has obsessive-compulsive disorder and a new prescription of paroxetine. Which of the following instructions should the nurse include? A. " It can take several weeks before you feel like medication is helping." B. " Take the medication just before time to promote sleep." C ."You should take the medication when needed for obsessive urges." D. "Monitor for weight gain while taking this medication."
ANSWER: A. Rationale: Paroxetine can take 1 to 4 weeks before the client reaches full therapeutic benefit.
A HCP is caring for a patient who is receiving thiopental (Pentothal). For which of the following should the healthcare professional monitor? A) cardiac excitability B) respiratory depression C) hyperthermia D) Hypotension
ANSWER: B. RESPIRATORY DEPRESSION. Ratyionale: Thiopental, a short-acting barbiturate causes respiratory depression. Mechanical ventilation and continuous monitoring are essential for patients receiving the drug.
A HCP is caring for a patient who is about to begin taking dantrolene for skeletal muscle spasms. The HCP should recognize that which of the following lab tests requires monitoring A.Serum potassium B.Liver function C.Serum sodium D.Thyroid function
Answer B. - Liver toxicity is a serious adverse effect of dantrolene. The healthcare professional should monitor liver function prior to treatment and at regular intervals, and advise patients to report jaundice or abdominal pain.
During and immediately following IV administration of chlorpromazine to a patient who has schizoaffective disorder, the health-care professional should monitor which of the following? A. Cardiac output B. Blood pressure C. Urine specific gravity D. Oxygen saturation
Answer B. Blood pressure Rationale:Patients receiving chlorpromazine are at risk for hypotension during and immediately after IV administration. They should remain supine for 30 min while the health care professional monitors their blood pressure. It is essential to infuse the chlorpromazine solution slowly and not to mix it with other drugs.
Soon after taking fluoxetine (Prozac), a patient is admitted to the emergency department with agitation and confusion. The health-care professional should suspect which of the following? A. Neuroleptic malignant syndrome B. Stevens-Johnson syndrome C. Extrapyramidal symptoms D. Serotonin syndrome
Answer D: Rationale: Serotonin syndrome can begin 2 to 72 hr after beginning to take fluoxetine, a selective serotonin reuptake inhibitor. Manifestations include mental confusion, difficulty concentrating, and agitation.
Which of the following information should a healthcare professional include when talking to a patient about taking baclofen (Lioresal) ? A. Avoid driving until drug effects are evident B. Stop taking the drug immediately if headache occurs C. Take the drugs PRN for spasticity D. Take the drugs with antacids to reduce gastric effects
Answer [A]. Rationale: Baclofen, a centrally-acting muscle relaxant, causes CNS depression. Patients taking the drug should avoid alcohol and other CNS depressants and should not drive a vehicle until they know how the drug will affect them.
Anesthetists often administer Midazolam (Versed) during induction of anesthesia because of which pharmacological actions? A. Produces analgesia B. Induces muscle paralysis C. Dries secretions D. Causes amnesia
Answer [D]. Rationale: Midazolam, a benzodiazepine, is appropriate during induction because of its anti-anxiety and amnesiac properties.
A nurse is preparing to administer benztropine 8 mg PO daily in 2 divided doses to a client who has Parkinson's disease. The amount available is benztropine 2 mg tablets. How many tablets should the nurse administer with each dose? (Fill in the blank with the numeric value only. Round the answer to the nearest whole number. Use a leading zero if applicable but do not use a trailing zero.)
Answer: 2 tablets
A nurse in a provider's office is reinforcing teaching with a female client who has a new diagnosis of seizures and a prescription for valproic acid. Which of the following pieces of information should the nurse provide? A "This medication can cause changes in your mood and behavior." B. "Valproic acid is one of the few seizure medications that can be taken during pregnancy." C. "You can expect this medication to cause you to lose weight." D. Valproic acid should be taken every morning on an empty stomach>"
Answer: A "This medication can cause changes in your mood and behavior." Rationale: All anti-seizure medications can cause an increased risk of suicidal thoughts and behavior. The nurse should inform the client of this adverse effect and instruct her to notify the provider if depression, anxiety, panic, or thoughts of dying occur.
A patient who is taking LAMOTRIGINE reports the appearance of a new rash. What is your best action? a. repot the rash to the hcp immediately b. Add the reaction to the patients list of allergies in his/ her record c. instruct the patient to take the drug with a substantial meal or snack d. Suggest that the pt apply a cortisone containing cream to the area
Answer: A Call the HCP Rationale: lamotrigine can cause life-threatening rashes (including Stevens Johnson syndrome and toxic epidermal necrolysis). If rash occurs discontinue treatment and report to HCP.
A nurse is collecting data from a client who has schizophrenia and is taking chlorpromazine. In which of the following manifestations should the nurse expect the most improvement? (Select all that apply) A. Disorganized speech B. Bizarre behavior C. Impaired social interactions D. Hallucinations E. Decreased motivation
Answer: A, B, D Rationale: A. A client who takes a conventional antipsychotic medication, such as chlorpromazine, should have the greatest improvement in positive symptoms such as disorganized speech. B. A client who takes a conventional antipsychotic medication such as chlorpheniramine, should have the greatest improvement in positive symptoms such as bizarre behavior. D. A client who takes a conventional antipsychotic medication, such as chlorpheniramine, should have the greatest improvement in positive symptoms such as hallucinations.
A nurse is reviewing a new prescription for oxcarbazepine with a female client who has partial seizures. Which of the following instructions should the nurse include? (Select all that apply) A. "Use caution if the doctor prescribes a diuretic medication." B. "Consider using another form of birth control if you are taking oral contraceptives." C. "Chew gum to increase saliva production." D. "Avoid driving until you see how the medication affects you." E. Notify the doctor if you develop a skin rash."
Answer: A, B, D, E Rationale: Taking diuretic medications when taking oxcarbazepine requires caution because of the high risk for hyponatremia Patients taking oxcarbazepine should use an alternative form of contraception because oxcarbazepine decreases oral contraceptive levels. The client should avoid driving if CNS effects of dizziness, drowsiness, and double vision develop. The client should notify the provider if a skin rash occurs because life-threatening skin disorders can develop.
A nurse is caring for a client who has a new prescription for valproic acid (Depakote). The nurse should instruct the client that while taking this medication he will need to have which of the following laboratory tests completed periodically? (Select all that apply.) A. Thrombocyte count B. Hematocrit C. Amylase D. Liver function tests E. Potassium
Answer: A, C, E Rationale: Treatment with valproic acid can result in thrombocytopenia, pancreatitis (amylase needs monitoring for this), and potassium.
A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity due to overdose. Which of the following actions is the nurse's priority? A. administer flumazenil B. Identify the clients LOC C. Infuse IV fluids D. Prepare the client for gastric lavage
B. Identify the clients LOC
A nurse is caring for a client who has multiple sclerosis and is receiving interferon beta-1a. The nurse should identify which of the following client statements indicates a potential adverse effect of the medication? A. "My body aches all over." B. "I have abdominal cramping." C. "My hair seems to be thinning." D. "It hurts when I urinate."
Answer: A. "My body aches all over." Rationale: The adverse effects of interferon beta-1a can include flu-like symptoms such as general body and muscle aches.
A nurse is collecting data from a client who takes an MAOI for the treatment of depression. Which of the following findings is the priority for the nurse to report to the provider? a. Elevated blood pressure b. Weight gain c. Muscle twitching d. 2+ peripheral
Answer: A. Rationale: The nurse should identify that the greatest risk to the client is an elevated blood pressure, which increases his risk for a hypertensive crisis that can result from taking an MAOI. The nurse should apply safety and risk reduction priority-setting framework when collecting data from this client.
A nurse is teaching a client who is taking levodopa/carbidopa to treat Parkinson's disease. Which of the following instructions should the nurse include? a. Change position slowly to prevent orthostatic hypotension. b. Eat a high-protein snack to increase absorption. c. Take the drug at bedtime to avoid daytime drowsiness. d. Expect eye twitching to develop with long-term therapy.
Answer: A. Change position slowly to prevent orthostatic hypotension. Rationale: Levodopa/carbidopa can cause orthostatic hypotension. High-protein foods can reduce the effectiveness of levodopa/carbidopa. Clients typically take this drug in divided doses during the day. Muscle twitching indicates drug toxicity which is an adverse effect that the client should report.
A nurse is reinforcing teaching with a client who has schizophrenia about strategies to cope with anticholinergic effects of fluphenazine. Which of the following strategies should the nurse include? A. Take medication in the morning to prevent insomnia . B. Chew sugarless gum to moisten the mouth . C. Use cooling measures to decrease fever. D. Take an antacid to relieve nausea.
Answer: B Rationale: Chewing sugarless gum can help the client cope with dry mouth, which is a potential anticholinergic effect of fluphenazine
A nurse is reinforcing teaching with a male client who has schizophrenia and is taking risperidone. Which of the following statements should the nurse include? a. "Add extra snacks to your diet to prevent weight loss." b. "Notify the provider if you develop breast enlargement." c. "You may begin to have mild seizures while taking this medication." d. "This medication is likely to increase your libido."
Answer: B Rationale: Gynecomastia (breast enlargement) and galactorrhea can occur due to an increase in prolactin levels while taking risperidone. The client should inform the provider if these manifestations occur.
A healthcare professional is caring for a patient who is taking zolpidem (Ambien). The patient has a history of benzodiazepine abuse and reports insomnia. The healthcare professional should caution the patient that the drug can cause a. Hearing loss b. Memory impairment c. Joint pain d. constipation
Answer: B Rationale: zolpidem, a non-benzodiazepine, can cause anterograde amnesia, or memory impairment, particularly an inability to recall activities patients carry out just before or during sleep.
A nurse is reinforcing teaching with a newly licensed nurse about metoclopramide. The nurse should include in the teaching that which of the following conditions is a contraindication to this medication? A. Hyperthyroidism B. Intestinal Obstruction C. Glaucoma D. Low blood pressure
Answer: B Intestinal Obstruction Rationale: Metoclopramide reduces nausea and vomiting by increasing gastric motility and promoting gastric emptying. It is contraindicated for a client who has an intestinal obstruction or perforation.
A healthcare professional is caring for a patient who is taking venlafaxine to treat major depression. The healthcare professional should recognize which of the following drugs can cause serotonin syndrome when patients take it concurrently with venlafaxine? A) Pilocarpine (Isopto Carpine) B) Phenelzine (Nardil) C) Alprazolam (Xanax) D) Phenytoin (Dilantin)
Answer: B) Phenelzine (Nardil) Rationale: Patients should not take venlafaxine, a serotonin norepinephrine reuptake inhibitor, within 14 days of taking phenelzine, other MAOIs, or serotonergic drugs. Serotonin syndrome is a life-threatening complication characterized by anxiety, confusion, hallucinations, and fever.
A nurse is planning to reinforce with a female client who has bipolar disorder and a new prescription for carbamazepine. Which of the following statements should the nurse include? (Select all that apply) A. "This medication can safely be taken during pregnancy" B. "Eliminate grapefruit juice from your diet" C. "You will need to have your blood count monitored periodically" D. "Notify your provider if you develop a rash" E. "Avoid driving for the first few days after starting this medication"
Answer: B, C, D, E Rationale: B; Grapefruit juice affects carbamazepine metabolism and should be avoided C; Carbamazepine blood levels and the CBC should be monitored during therapy. The client is at risk for bone marrow depression while taking carbamazepine and should notify the provider of a sore throat or other manifestations of an infection. D; Carbamazepine can cause Stevens-Johnsons syndrome, which can be fatal. The client should notify the provider promptly if a rash occurs. E; CNS effects (drowsiness, dizziness) can occur early in treatment with carbamazepine. The client should avoid activities requiring alertness until these effects subside.
A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity due to overdose. Which of the following actions is the nurse's priority? a. administer flumazenil b. Identify the clients LOC c. Infuse IV fluids d. Prepare the client for gastric lavage
Answer: B. Rationale: the first action the nurse should take when using the nursing process is to assess the client. Identifying the client's level or orientation is the priority action.
A nurse is caring for a client with Alzheimer's disease who has a new prescription for memantine. Which of the following laboratory results should the nurse identify as increasing the client's risk for decreased clearance of the medication? a) Alanine aminotransferase (ALT) 30 units/L b) Creatinine clearance 35 mL/min c) HbA1c 5% d) BMI 31
Answer: B. Creatinine clearance 35 mL/min Rationale: Creatinine clearance is an estimate of the glomerular filtration rate (GFR) and the kidney's ability to filter waste. A creatinine clearance of 35 mL/min is below the normal expected reference range of 87 to 139 mL/min and indicates moderate renal impairment. The kidneys excrete memantine, and decreased clearance occurs with moderate renal impairment.
A nurse is reinforcing teaching with the client who has a new prescription for levodopa/carbidopa for Parkinson's disease. Which of the following instructions should the nurse include? A- increase intake of protein rich foods B- Expect muscle twitching to occur C- take this medication with food D- Anticipate relief of manifestations in 24 hrs.
Answer: C Rationale: the client should take this medication with food to reduce GI effects.
A nurse is reinforcing teaching with a client who has major depressive disorder and a new prescription for amitriptyline. Which of the following information should the nurse include? (Select All That Apply) A. Expect therapeutic effects in 24 to 48 hours. B. Discontinue the medication after a week of improved mood. C. Change positions slowly to minimize dizziness. D. Decrease dietary fiber intake to control diarrhea. E. Chew sugarless gum to prevent dry mouth.
Answer: C, E. Rationale C: Changing positions slowly helps prevent orthostatic hypotension, which is an adverse effect of amitriptyline. Rationale E: Chewing sugarless gum can minimize dry mouth, which is an adverse effect of amitriptyline.
A nurse is reviewing the medication of a client who has bipolar disorder and a new prescription for lithium. The nurse should identify that it is safe to administer which of the following medications while the client is taking lithium? a. Ibuprofen b. Haloperidol c. Valproic Acid d. Hydrochlorothiazide
Answer: C. Rationale: Valproic Acid and Lithium are both indicated for the treatment of bipolar disorder.
A nurse is caring for a client who is experiencing a seizure while in bed. Which of the following actions should the nurse take? A) Raise the head of the client's bed B) Restrain the client's arms and legs C) Turn the client's head to the side D) Insert a tongue blade into the client's mouth
Answer: C. Turn the client's head to the side. This will prevent the client's airway from becoming obstructed and keeps the airway patent.
For which of the following should a healthcare professional monitor a patient who is donepezil (Aricept) for Alzheimer's? A. Confusion B. Dry mouth C. Nausea D. Double vision
Answer: C. Rationale:The most common adverse effects of donepezil, a cholinesterase inhibitor, are nausea, vomiting, and diarrhea. Taking the drug with food can help minimize adverse effects.
The reduction of what chemical within the central nervous system causes Parkinson's Disease? A. Substantia nigra B. Acetylcholine C. Dopamine D. Serotonin
Answer: C. With Parkinson's Disease dopamine is reduced.
Which drug for MULTIPLE SCLEROSIS S is specifically prescribed to improve walking? a. Beta Interferon b. Daclizumab c. Dalfampridine d. Tecfidera
Answer: C. Dalfampridine Rationale: Dalfampridine (Ampyra) blocks potassium channels in unmyelinated nerves, helping them to continue to function. It is used to help improve the walking ability of patients with MS.
A nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle spasms. The nurse should instruct the client to report which of the following adverse effects? a. Slow heart rate b. Cough c. Diarrhea d. Hearing loss
Answer: C. Diarrhea. Rationale: Prolonged diarrhea can cause dehydration and other serious effects. Diarrhea, nausea, and vomiting are adverse effects of dantrolene. The client should report these effects so the nurse can monitor fluid balance and intervene accordingly.
A nurse is providing teaching for a client who has a new prescription for valproic acid to treat a seizure disorder. The nurse should instruct the client to monitor for which of the following adverse effects? a. Hirsutism b. Depression c. Jaundice d. Gum irritation
Answer: C. Jaundice Rationale: Valproic acid can cause hepatotoxicity, characterized by jaundice, abdominal pain, and nausea. Clients taking the drug should report these manifestations, and the nurse should monitor liver function studies prior to treatment and periodically during therapy.
A nurse is providing teaching to a client who has a new prescription for buspirone to treat anxiety. Which of the following information should the nurse include? a. "Take this medication on empty stomach" b. "Expect optimal therapeutic effects within 24 hrs" c. "Take this medication when needed for anxiety" d. "This medication has a low risk for dependency"
Answer: D Rationale: Buspirone has a low risk for physical or psychological dependence or tolerance.
At what point are cholinesterase inhibitors no longer effective in the treatment of Alzheimer disease? A. When the brain size shrinks and can no longer produce acetylcholinesterase B. When the number of neurotransmitters sufficiently decreases C. When the patient's ability to swallow is impaired D. When there are fewer intact neurons available to make acetylcholine
Answer: D. Cholinesterase inhibitors inhibit acetylcholine with less neurons making acetylcholine, cholinesterase inhibitors will no longer be effective.
A nurse is reinforcing teaching with a client who has hypertension and a new prescription for oral clonidine. Which of the following instructions should the nurse include in the teaching? a) Discontinue the medication if a rash develops b) Expect increased salivation during the first few weeks of therapy c) Minimize fiber intake to prevent diarrhea d) Avoid driving until the client's reaction to the medication is known
Answer: D. Rationale: Clonidine can cause drowsiness, weakness, sedation, and other CNS effects. Until the client's response to the medications is known, the nurse should instruct the client to avoid driving or handling other potentially hazardous equipment. Over time, these effects are likely to decrease.
A nurse in an acute mental health facility is reviewing the medication records for a group of clients. The nurse should expect a prescription for memantine for a client who has which of the following diagnoses? a. Depression b. Schizophrenia c. Obesity d. Alzheimer's disease
Answer: D. Rationale: The nurse should expect a prescription for memantine for a client who has moderate to severe Alzheimer's disease. Memantine, an NMDA receptor agonist, is shown to slow the progression of manifestations to improve cognitive function.
A patient is taking selegiline (Eldepryl) to treat Parkinson's Disease. The provider is considering the use of analgesics for the patient but should be aware that a drug interaction between selegiline and meperidine (Demerol) can result in which of the following? A.Frequent urination B.Jaundice C.Cellulitis D.Muscle rigidity
Answer: D. A drug interaction between selegiline and opioids, especially meperidine, can result in a serious reaction resulting in rigidity, stupor, agitation, hypertension, and fever.
A nurse is teaching the family of a client who has a new diagnosis of Alzheimer's disease about donepezil. Which of the following should the nurse included? A. Monitor for constipation. B. The dosage will be increased weekly to provide optimum therapeutic effect. C. Administering the drug first thing in the morning promotes effectiveness. D. Avoid the use of NSAIDs for pain.
Answer: D. Combining NSAIDs with donepezil can cause gastrointestinal bleeding. Therefore, the nurse should instruct the client's family to avoid the use of NSAIDs.
A nurse is reviewing the laboratory data for a client who is receiving clozapine for schizophrenia. The nurse should identify which of the following findings as a potential adverse effect of the medication? a) Fasting blood glucose 95 mg/dL b) Triglycerides 135 mg/dL c) Total cholesterol 175 mg/dL d) Absolute neutrophil count 1,200 mm^3
Answer: D. Absolute neutrophil count 1,200 mm^3 Rationale: The nurse should identify that an absolute neutrophil count of 1,200/mm^3 is less than the expected reference range of 2,500 to 8,000/mm^3. An adverse effect of clozapine can include agranulocytosis, which is a life-threatening conditioning in which WBCs (including neutrophils) are severely decreased.
A nurse is reinforcing discharge teaching with a client who has a new prescription for clozapine. Which of the following statements should the nurse include? A. you should have a high- carbohydrate snack between meals and at bedtime B. you are likely to develop hand tremors if you take this medication for a long period of time. C. You may experience temporary numbness of your mouth after each dose D. You should have your white blood cell count monitored every week
Answer: D: Due to risk for agranulocytosis, weekly monitoring of the clients WBC count is recommended while taking clozapine
A nurse is caring for a client who has a major depressive disorder and a new prescription for phenelzine. Which of the following findings should the nurse identify as an adverse effect of this medication? A. Orthostatic hypotension B. Hearing loss C. Gastrointestinal bleeding D. Weight loss
Answer:A Rationale:orthostatic hypotension...adverse effect of MAOI's including phenelzine
A HCP is caring for a patient who is about to begin taking pramipexole (mirapex) to treat Parkinson's disease. The HCP should recognize that which of the following labatory test requires monitoring? A. C-reactive protein B. Creatine Phosphokinase (CPK) C. Thyroid function D. CBC
Answer:B CPK is an enzyme found in the heart, brain, and skeletal muscles. Patients taking pramipexole can develop muscle weakness with a lack of energy, creating a situation that can be more problematic for patients than their original muscle dysfunction. Monitoring CPK can alert health care professionals to the possibility of skeletal muscle damage from the drug.
A nurse is collecting data from a client who recently began taking haloperidol. Which of the following findings should the nurse identify as the highest priority to report to the provider? a. Shuffling gait b. Neck spasms c. Drowsiness d. Sexual dysfunction
Answer:B Rationale: Neck spasms are an indication of acute dystonia, which is a crisis situation requiring rapid treatment. This is the greatest risk to the client and is therefore the priority finding.
A nurse is caring for an adolescent who has cystic fibrosis (CF) and has a prescription for high-dose ibuprofen daily. The nurse should identify which of the following is an expected outcome for the client receiving this medication? a) Thinned pulmonary secretions that are retained in the airways b) Slowed progression of pulmonary damage c) Potentiated action of bronchodilator therapy d) Decreased risk of fevers associated with CF
Answer:B Rationale: The nurse should identify that clients who have CF are prescribed high-dose Ibuprofen, which is an NSAID, to slow the progression of pulmonary damage by suppressing the inflammatory response that causes pulmonary damage. CF is a genetic disorder that primarily affects the lungs, pancreas, and sweat glands.
A nurse is teaching a pt who received a Rx for interferon beta-1a for the tx of multiple sclerosis. Which of the following information should the nurse include? a.) "Have kidney function tests done every month for a year." b.) "Take an extra dose if muscle aches occur." c.) "Store the drug at room temperature after mixing it." d.) "Administer the drug in your thigh or upper arm."
Answer:D. "Administer the drug in your thigh or upper arm." Rationale: Interferon beta-1a is administered via the SQ route. Therefore, the nurse should instruct the pt how to perform SQ injections for self-administration.
A nurse is collecting data from a client who recently began taking haloperidol. Which of the following findings should the nurse identify as the highest priority to report to the provider? A. Shuffling gait B. Neck spasms C. Drowsiness D. Sexual dysfunction
B Neck Spasms
A HCP is caring for a patient who is about to begin taking dantrolene for skeletal muscle spasms. The HCP should recognize that which of the following lab tests requires monitoring? A. Serum potassium B. Liver function C. Serum sodium D. Thyroid function
B. Liver function
A healthcare professional is caring for a patient who is taking venlafaxine to treat major depression. The healthcare professional should recognize which of the following drugs can cause serotonin syndrome when patients take it concurrently with venlafaxine? A. Pilocarpine (Isopto Carpine) B. Phenelzine (Nardil) C. Alprazolam (Xanax) D. Phenytoin (Dilantin)
B. Phenelzine
A nurse in an acute mental health facility is reviewing the medication records for a group of clients. The nurse should expect a prescription for memantine for a client who has which of the following diagnoses? A. Depression B. Schizophrenia C. Obesity D. Alzheimer's disease
B. Schizophrenia
A nurse is collecting data on a client who is postoperative and received a dose of morphine 15 minutes ago. The client now has a respiratory rate of 8/min and is unresponsive. Which of the following medications should the nurse prepare to administer? A. Naproxen B. Nifedipine C. Naloxone D. Nebivolol
C. Naloxone
A nurse is caring for a client who is experiencing a seizure while in bed. Which of the following actions should the nurse take? A. Raise the head of the client's bed B. Restrain the client's arms and legs C. Turn the client's head to the side D. Insert a tongue blade into the clients mouth
C. Turn the client's head to the side
A nurse is caring for a client who took an overdose of acetaminophen. Which of the following medications should the nurse plan to administer? a. Acetylcysteine b. Celecoxib c. Finasteride d. meclizine
Correct Answer: A. Acetylcysteine Rationale: Acetylcysteine is a mucolytic that is used as an antidote for acetaminophen overdose. It can be administered orally or intravenously. The medication decreases the buildup of hepatotoxic metabolites and can prevent or lessen the liver damage that acetaminophen overdose can cause. Acetaminophen should be removed from the stomach by inducing emesis or gastric lavage prior to administering acetylcysteine.
A nurse is caring for a client who has schizophrenia and a prescription for chlorpromazine. For which of the following adverse effects should the nurse monitor? a. Orthostatic hypotension b. Diarrhea c. Urinary frequency d. Bradycardia
Correct Answer: A. Orthostatic hypotension Rationale: Orthostatic hypotension is an adverse effect of chlorpromazine. Other adverse effects include palpitations, tachycardia, constipation, sedation, and photosensitivity. Incorrect Answers: B. Constipation, not diarrhea, is an adverse effect of chlorpromazine due to its anticholinergic action. C. Urinary retention, not urinary frequency, is an adverse effect of chlorpromazine due to its anticholinergic action. D. Tachycardia, not bradycardia, is an adverse effect of chlorpromazine due to its anticholinergic action.
A nurse is reinforcing teaching with a client who has a new prescription for phenytoin. Which of the following adverse effects can occur with the abrupt withdrawal of phenytoin? a. Status epilepticus b. Bleeding gums c. Disorientation d. Severe nausea
Correct Answer: A. Status epilepticus Rationale: The nurse should reinforce with the client that abruptly discontinuing phenytoin can cause status epilepticus. Incorrect Answers: B. Abruptly discontinuing phenytoin will not cause bleeding gums. However, a common adverse effect of phenytoin therapy is gingival hyperplasia. C. Abruptly discontinuing phenytoin will not cause disorientation. However, phenytoin therapy can alter cognitive function. D. Abruptly discontinuing phenytoin will not cause nausea. However, phenytoin therapy can cause nausea and vomiting.
A nurse is reinforcing medication teaching to a client who has a new diagnosis of rheumatoid arthritis. Which of the following medications in the therapy regimen will take weeks to months to be effective? a. Ibuprofen b. Methotrexate c. Prednisone d. Celecoxib
Correct Answer: B. Methotrexate Rationale: Methotrexate is a disease-modifying anti-rheumatic drug (DMARD) That is prescribed to control symptoms and slow the progression of the disease. It can take weeks to months for DMARDs to show effectiveness, so clients are also placed on NSAID therapy for control of pain. After the DMARD takes effect, the NSAID therapy can be withdrawn.
A nurse is reinforcing teaching with the partner of a client who has moderate Alzheimer's disease about a new prescription for a rivastigmine transdermal patch. Which of the following information should the nurse provide? A.) The patch should be changed every 72 hours. B.) The patch provides higher drug levels than oral medications. C.) The old patch should be removed before a new patch is applied. D.) Allowing the patch to get wet will deactivate it.
Correct Answer: C. R: Before applying a new rivastigmine transdermal patch, the client should remove the old patch to prevent toxicity from occurring.
A nurse is reviewing the medical history of a client who has spasticity due to MS and a new prescription for tizanidine. Which of the following comorbidities should the nurse identify as increasing the client's risk for adverse effects while taking this medication? a. Pneumonia b. BPH (Benign prostatic hypertrophy) c. Hepatitis d. Diabetes Mellitus
Correct Answer: C. Rationale: Hepatitis; Tizanidine can cause liver damage. This medication should be used with extreme caution by a client who has a preexisting impairment of hepatic function.
A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to obtain prior to administering the medication? a. Hearing examination b. Glucose tolerance test c. Electrocardiogram d. Pulmonary function tests
Correct Answer: C. Electrocardiogram Rationale: Amitriptyline can cause tachycardia and ECG changes. An older adult client is at risk for cardiovascular effects while taking amitriptyline; therefore, an ECG should be performed prior to the start of therapy to obtain a baseline of the client's cardiovascular status. Incorrect Answers: A. Amitriptyline can cause blurred vision; however, it does not affect hearing. B. Amitriptyline does not cause hyperglycemia or alter glucose tolerance. D. Amitriptyline does not affect pulmonary function.
A nurse in an acute care facility is preparing to admit a client who has myasthenia gravis. Which of the following supplies should the nurse place at the client's bedside? A. Metered-dose inhaler B. Continuous passive motion machine C. External defibrillator pads D. Oral-nasal suction equipment
Correct Answer: D. Oral-nasal suction equipment Rationale: The client who has myasthenia gravis is at risk of aspiration due to progressive weakness of the oropharyngeal muscles. Myasthenia gravis causes muscle weakness due to an autoimmune disease that affects the acetylcholine receptors. The nurse should place oxygen and oral-nasal suction equipment at the bedside in the event of aspiration or respiratory distress.
A nurse is collecting data from a client who has increased intracranial pressure and has received intravenous mannitol. The nurse should identify which of the following findings indicates a therapeutic effect of this medication? A. Decreased blood glucose B. Decreased bronchospasms C. Increased urine output D. Increased temperature
Correct Answer:C. Increased urine output. Mannitol is an osmotic diuretic used to reduce intracranial pressure by mobilizing intracranial fluid and inhibiting the reabsorption of water and electrolytes in the kidneys. Increased urine output and decreased intracranial pressure are therapeutic effects of this medication. Incorrect Answers:A. A decrease in blood glucose is not a therapeutic effect of mannitol. The nurse should monitor the client for hyperkalemia and hypokalemia. B. A decrease in bronchospasms is not a therapeutic effect of mannitol. The nurse should monitor the client for pulmonary edema. D. An increase in temperature is not a therapeutic effect of mannitol. The nurse should monitor the client for renal failure.
While talking with a patient and his family about taking memantine (Namenda) for Alzheimer's disease, the healthcare professional should include which of the following instructions? A. Increase fluids to improve renal excretion B. Report memory loss or confusion C. Watch for signs of liver impairment, such as jaundice and abdominal pain D. Notify the healthcare professional before taking over-the-counter antacids
Correct answer: D Rationale: Antacids that contain sodium bicarbonate increase alkalinity and can decrease drug excretion, ultimately leading to toxicity.
A healthcare professional is talking to a patient who is newly diagnosed with Parkinson's disease about how levodopa/carbidopa (Sinemet) will help control her symptoms. With which of the following mechanisms is the drug effective in treating the disorder? A. Increases available acetylcholine in the brain B. Inhibits norepinephrine metabolism in the brain C. Inhibits serotonin metabolism in the brain D. Increases available dopamine in the brain
Correct answer: D. Rationale: Levodopa/carbidopa, a dopaminergic agent, can act by increasing dopamine in the extrapyramidal center of the brain, reducing involuntary motion.
A nurse is collecting data from a client who is receiving clozapine to treat schizophrenia. The nurse should identify that an increase in which of the following parameters is an early indication of agranulocytosis? A. Urine specific gravity B. Urine output C. Blood pressure D. Temperature
D. Temperature
A patient who is taking LAMOTRIGINE reports the appearance of a new rash. What is your best action? A. Add the reaction to the patients list of allergies in his/ her record B. instruct the patient to take the drug with a substantial meal or snack C. Suggest that the patient apply a cortisone containing cream to the area D. repot the rash to the health care provider immediately
D. repot the rash to the health care provider immediately
A nurse should identify that timolol is contraindicated for a client who has which of the following disorders? A)Asthma B)Seizure Disorder C)Diabetes Mellitus D)Rheumatoid Arthritis
Rational: A - Asthma is correct. Rationale: Timolol, a beta-adrenergic antagonist, can cause bronchospasm and difficulty breathing. Clients who have asthma or any disorder that compromises respiratory function should not use the drug.
A nurse is caring for a client who takes warfarin to treat chronic atrial fibrillation and has early manifestations of Alzheimers disease. The client's partner asks the nurse if the client would benefit from taking ginkgo biloba. Which of the following responses should the nurse provide? a. "Ginkgo biloba will probably interfere with the effectiveness of his other medications" b. "You should ask his provider if ginkgo biloba is safe" c. "Ginkgo biloba is most effective in the later stages of Alzheimer's disease" d. "People who have Alzheimer's disease should adhere to the medication regimen their provider prescribes"
Rationale - A. "Ginkgo biloba will probably interfere with the effectiveness of his other medications" - some experts believe that ginkgo biloba can delay the mental deterioration of Alzheimer's disease if taken in the early stages. Research, however, has not demonstrated this; more importantly, ginkgo biloba increases the client's risk for bleeding when taken with warfarin.
A nurse is reinforcing teaching with a client who has a seizure disorder and a new prescription for carbamazepine. Which of the following statements should the nurse include in the teaching? a. "This medication will decrease the effectiveness of oral contraceptives." b. "Once you are seizure-free for a month, you will be able to stop taking the medication" c. "You can cut the dose in half if GI upset occurs" d. "This medication might initially increase the frequency of your seizures"
Rationale - A. "This medication will decrease the effectiveness of oral contraceptives." - the nurse should reinforce with the client that traditional antiepileptic drugs (AEDs) such as carbamazepine decrease the effectiveness of oral contraceptives.
A nurse is caring for a child who has epilepsy and is scheduled to receive a dose of phenytoin. The nurse notes the child's serum phenytoin level is 14 mcg/mL. Which of the following actions should the nurse take? a. Administer the dose b. Administer half the dose c. Do not administer the dose d. Clarify the dose with the provider
Rationale - A. administer the dose - a serum phenytoin level of 14mcg/mL is within the expected reference range of 10 to 20 mcg/mL. The nurse should administer the medication as prescribed.
A nurse is collecting data from a client who is receiving clozapine to treat schizophrenia. The nurse should identify that an increase in which of the following parameters is an early indication of agranulocytosis? a. Urine specific gravity b. Urine output c. Blood pressure d. Temperature
Rationale - D. Temperature - antipsychotic medications such as clozapine can cause agranulocytosis, which is the depletion of WBC's. That increases the client's risk of infection. A fever is an early indication that the client should have a WBC count check to detect agranulocytosis.
A healthcare professional is reviewing the medical record of a patient who has a newly diagnosed seizure disorder. The patient is to begin taking both valproic acid (Depakote) and phenytoin (Dilantin). The healthcare professional should recognize which of the following can occur as a result of a drug interaction between valproic acid and phenytoin? a. Hyperammonemia b. Phenytoin toxicity c. Hypertension d. Peptic ulcer disease
Rationale B. Valproic acid can cause an increase in phenytoin blood levels, causing phenytoin toxicity. The primary care provider should monitor serum phenytoin levels and reduce the dosage if levels begin to exceed the therapeutic range.
A nurse is collecting data on a client who is postoperative and received a dose of morphine 15 minutes ago. The client now has a respiratory rate of 8/min and is unresponsive. Which of the following medications should the nurse prepare to administer? a. Naproxen b. Nifedipine c. Naloxone d. Nebivolol
Rationale- C. Naloxone - the nurse should prepare to administer naloxone and opioid antagonist. Naloxone will reverse the over-sedation and respiratory depression the client is experiencing. However, with too large a dose the analgesia of the morphine will also be reversed cause the client to experience postoperative pain again.
A nurse is reinforcing teaching with a client who has early Parkinson's disease and new prescription for pramipexole. The nurse should instruct the client to monitor for which of the following adverse effects of this medications? A. Hallucinations B. Increased salivation C. Diarrhea D. Discoloration of urine
Rationale: A. Pramipexole can cause hallucinations within 9 months of the initial dose and might require discontinuation.
A nurse is caring for a client who has been taking sertraline for the past 2 days. Which of the following findings should alert the nurse to the possibility that the client is developing serotonin syndrome? A. Bruising B. Fever C. Tinnitus D. Rash
Rationale: B Fever is a manifestation of serotonin syndrome, which can result from taking a SSRI such as sertraline.
A nurse is reinforcing teaching with a client who has a new prescription for escitalopram for treatment of generalized anxiety disorder. Which of the following statements indicates that their client understands the teaching? A. "I should take the medication on an empty stomach." B. "I will follow a low-sodium diet while taking this medication." C. "I need to discontinue this medication slowly." D. "I should stop taking the medication if it causes me to have nausea."
Rationale: C. When discontinuing escitalopram, the client should taper the medication slowly according to a prescribed tapered dosing schedule for reduced risk of withdrawal syndrome.
A nurse is collecting data from a client who is suspected of having benzodiazepine toxicity. Which of the following findings should the nurse identify as the priority to report to the provider? A. Drowsiness B. Confusion C. Ataxia D. Hypotension
Rationale: D. When using the airway, breathing, circulation approach to client care, the priority finding is hypotension. The nurse should report this finding to the RN and provider and prepare to assist with treatment for benzodiazepine toxicity.
A nurse is caring for a patient who overdosed on benzodiazepines. What is the antidote to reverse the effects of benzodiazepines? a. Flumazenil b. Zolpidem c. Valium d. Pregalbalin
Rationale:A Flumazenil (Romazicon) competes with benzodiazepine receptor sites and blocks the effects.
A nurse in a primary care clinic is assessing a client who takes lithium carbonate (Lithotabs.) for the treatment of bipolar disorder. The nurse should recognize which of the following findings as a possible indication of toxicity to this medication? A. Severe hypertension B. Coarse tremors C. Constipation D. Urinary retention
Rationale:B Coarse tremors are an indication of toxicity.