Pharmacology 1301 Exam 2 Review

A client suffering from migraine headaches is prescribed sumatriptan. What is the action of the drug? a. Binding to phospholipids to diminish anxiety b. Interrupting the calcium intake in the neuron c. Binding to serotonin to produce vasoconstriction d. Reducing inflammation in the temporal arteries

c. Binding to serotonin to produce vasoconstriction

The nurse is assisting in the care of a client during surgery. The nurse will be prepared to administer which drug if the client develops malignant hyperthermia? a. Acetaminophen b. Toradol c. Dantrolene sodium d. Diazepam

c. Dantrolene sodium

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? a. Dexmethylphenidate will increase Scott's ability to understand information better. b. Dexmethylphenidate will stabilize Scott's mood so that he can concentrate. c. Dexmethylphenidate will improve Scott's attention span so that he will be able to complete a task. d. Dexmethylphenidate will improve Scott's memory.

c. Dexmethylphenidate will improve Scott's attention span so that he will be able to complete a task.

The nurse is educating a client diagnosed with Parkinson's disease about the dietary implications of prescribed treatment with levodopa/carbidopa. Which statement by the nurse demonstrated an understanding of the proper administration of this medication? a. "It's important to take this medication on a full stomach so that it doesn't make you nauseous." b. "Most people find that it's best to take this medication at bedtime, provided you haven't snacked in the evening." c. "If possible, try to eat extra protein when you're taking this medication." d. "Dairy products will make this medication ineffective, so make sure you don't take them at the same time."

a. "It's important to take this medication on a full stomach so that it doesn't make you nauseous. Exp: "Levodopa/carbidopa is administered with or just after food or following a meal to reduce nausea and vomiting. Levodopa/carbidopa is not administered with a high-protein diet. Dairy products do not interfere with pharmacokinetics.

The nurse is caring for a client who is prescribed a tricyclic antidepressant for depression. Which teaching will the nurse provide to the client about this medication? Select all that apply. a. "Report urinary retention." b. "Take the medication at bedtime." c. "A skin rash is a common side effect." d. "Expect to develop an irregular heartbeat." e. "Call the health care provider if you experience confusion."

a. "Report urinary retention." e. "Call the health care provider if you experience confusion." b. "Take the medication at bedtime."

A client's sudden change in status following administration of a local anesthetic has led the health care provider to conclude that the client is experiencing localized anesthetic systemic toxicity (LAST). The nurse should prepare for administration of what medication? a. 20% lipid emulsion b. naloxone c. protamine sulfate d. acetylcysteine

a. 20% lipid emulsion Exp: The use of lipid emulsion therapy with 20% lipid emulsion (lipid rescue therapy) is an effective antidote and should be started early in resuscitation process.

How does vecuronium induce paralysis required for the facilitation of intubation and balanced anesthesia? a. Antagonizing acetylcholine (ACh) receptors at neuromuscular junctions b. Potentiating the effects of acetylcholinesterase in synapses c. Crossing the blood-brain barrier and agonizing cerebellar function d. Binding with serotonin and inhibiting its neuromuscular effects

a. Antagonizing acetylcholine (ACh) receptors at neuromuscular junctions

A nurse is teaching a client about the prescription for acetaminophen to be taken at home. This medication consists of acetaminophen and what other likely drug that enhances the analgesic effect of acetaminophen? a. Codeine b. Acetylsalicylic acid c. Methadone d. Tramadol

a. Codeine Exp: Codeine is often given with acetaminophen for additive analgesic effects. None of the other medications are used in combination with acetaminophen.

The nurse is aware that sumatriptan-naproxen sodium has issued black box warnings because it increases the risk of what conditions? (Select all that apply.) a. GI bleeding b. Blindness c. Myocardial infarction d. Brain attack e. Skin breakdown

a. GI bleeding c. Myocardial infarction d. Brain attack

1. The sympathetic and the parasympathetic nervous systems are continuously at work in our bodies. This continual action provides a sense of balance to all parts of the body. What is the term used to represent this sense of balance? a. Homeostasis b. Eustress c. Power d. Strength

a. Homeostasis

A female client is prescribed fluoxetine during the third trimester of her pregnancy for depression. After birth, her child exhibits symptoms of neonatal withdrawal syndrome. When would the nurse expect the symptoms to abate? a. In a few days b. After 6 weeks c. In a few hours d. With administration of fluoxetine

a. In a few days

A nurse is caring for a client with depression. The client has been prescribed a tricyclic antidepressant. The nurse obtains the medical history of the client, which states that the client has also been receiving a monoamine oxidase inhibitor (MAOI) for 2 weeks. Which should the nurse identify as the possible effects of interaction between a tricyclic antidepressant and an MAOI? Select all that apply. a. Increased risk for hypertensive episodes b. Increased risk for severe convulsions c. Increased risk for hyperpyretic episodes d. Increased risk for respiratory system depression e. Increased risk for nervous system depression

a. Increased risk for hypertensive episodes b. Increased risk for severe convulsions c. Increased risk for hyperpyretic episodes

The health care provider has prescribed lorazepam to Mr. Jones for anxiety. Mr. Jones has a history of hepatitis C. Why would the provider prescribe lorazepam instead of a different drug in this class of medications? a. It is distributed quickly to the brain. b. It is highly protein bound. c. It is widely distributed in the body tissues. d. It is hepatically metabolized to an inactive substance.

a. It is hepatically metabolized to an inactive substance.

A client is being treated for Parkinson's disease and has been prescribed both levodopa (L-dopa) and carbidopa. Why is this course of treatment most effective? Select all that apply a. Levodopa restores dopamine, and carbidopa decreases peripheral breakdown of levodopa. b. Levodopa decreases the toxic effects of carbidopa to reduce the extrapyramidal reaction. c. Carbidopa increases the peripheral breakdown of levodopa to hasten its onset and peak. d. The combination allows a lower dose of levodopa than if levodopa were administered alone.

a. Levodopa restores dopamine, and carbidopa decreases peripheral breakdown of levodopa. d. The combination allows a lower dose of levodopa than if levodopa were administered alone.

The nurse at an urgent care clinical is reviewing local anesthetics. What drug should the nurse recognize as an amide? a. Lidocaine b. Procaine c. Tetracaine d. Benzocaine

a. Lidocaine Lidocaine is an amide local anesthetic. The others are ester local anesthetics.

What should the nurse include as a possible adverse effect when teaching a client about phenytoin? a. Liver toxicity b. Diarrhea c. Increased white blood cell count d. Physical dependence

a. Liver toxicity

A nurse may be asked to administer which drug prior to a colonoscopy in order to help the client relax? a. Midazolam b. Meperidine c. Lidocaine d. Fentanyl

a. Midazolam Exp: An antianxiety drug such as midazolam prior to a colonoscopy will help the client relax.

The nurse is monitoring for adverse effects in a client who has been prescribed chlorpromazine. What interventions should the nurse incorporate into the plan of care? Select all that apply. a. Monitor white blood cell (WBC) count. b. Take and record daily weight. c. Monitor urinary output. d. Assess for hallucinations. e. Monitor for facial edema.

a. Monitor white blood cell (WBC) count.• b. Take and record daily weight.• c. Monitor urinary output. Exp: The nurse assesses the fluid and electrolyte status for a possible fluid volume deficit, making it necessary to measure the client's weight daily and assess for signs of dehydration. In addition, the nurse assesses for increased anticholinergic effects, such as diminished fluid status and urinary retention. The nurse assesses for aspiration related to depressed cough reflex. It is important to monitor renal and hepatic function along with the complete blood count. A depression in white blood cell count requires discontinuation of the medication. Excessive fluid volume is not associated with this medication. The medication is prescribed to eliminate hallucinations.

The nurse administers a medication that only stimulates nicotinic receptors. What effects would the nurse expect to occur? Select all that apply. a. muscle contraction b. release of epinephrine from adrenal medulla c. signs and symptoms of a stress reaction d. slowing heart rate e. increased bladder contraction

a. Muscle contraction b. release of epinephrine from adrenal medulla c. signs and symptoms of a stress reaction Feedback: Stimulation of nicotinic receptors causes muscle contractions, autonomic responses such as signs and symptoms of a stress reaction, and release of norepinephrine and epinephrine from the adrenal medulla. Stimulation of muscarinic receptors causes pupil constriction, increased gastrointestinal (GI) motility and secretions (including saliva), increased urinary bladder contraction, and a slowing of the heart rate.

A patient is prescribed naloxone for the treatment of postoperative acute respiratory depression after a kidney transplant operation. Which of the following should the nurse identify as the action of naloxone? a. Naloxone stops internal bleeding. b. Naloxone restores respiratory function. c. Naloxone restores reflexes of limbs. d. Naloxone helps the patient overcome pain.

a. Naloxone restores respiratory function.

The nurse is caring for a patient who is receiving an opioid analgesic. What would be a priority assessment by the nurse? a. Pain intensity and blood glucose level b. Level of consciousness and respiratory rate c. Respiratory rate and electrolytes d. Urine output and pain intensity

a. Pain intensity and blood glucose level

The nurse is caring for a woman who is 35 weeks gestation with severe eclampsia. The nurse knows that magnesium is administered to this client for what reason? a. Prevent seizures b. Reduce pain of headache c. Lessen edema d. Eliminate protein in urine

a. Prevent seizures

A male client is prescribed an anticholinergic drug by his health care provider. He likes to hike with his grandchildren. The home care nurse instructs the client that anticholinergic medications have which effect? a. Increased sweating and the risk for heat stroke and dehydration b. Postural hypotension and increased risk for falls and from exposure to the elements c. Bradycardia in older adults, which increases the risk for falls and from exposure to the elements d. Prevents sweating and heat loss and increasing the risk of heat stroke

a. Prevents sweating and heat loss and increasing the risk of heat stroke

A client receiving clomipramine (Anafranil) is given a prescription for zolpidem (Ambien) QHS for sleep by a health care provider unaware the client was taking clomipramine. Which reaction might the nurse observe in a client taking both clomipramine and zolpidem? Select all that apply: a. Respiratory depression b. CNS depression c. Hypertensive crisis d. Easy bruising e. Hyperglycemia

a. Respiratory depression b. CNS depression

The post-anesthetic recovery unit nurse is caring for a client whose balanced anesthesia included midazolam. The nurse should prioritize assessments for what health problems? a. Respiratory depression and CNS suppression b. Myoclonic and tonic movements c. Nausea and vomiting d. Chills and hypotension

a. Respiratory depression and CNS suppression

The client has been prescribed diphenoxylate with atropine (Lomotil) for diarrhea. The nurse recognizes that this drug is effective against diarrhea because of which action? a. Slows peristalsis by acting on the smooth muscles of the intestine b. Anti-inflammatory effects allowing absorption of fluids c. Antimicrobial effects d. Decreases GI secretions

a. Slows peristalsis by acting on the smooth muscles of the intestine

A surgical client is receiving a neuromuscular junction (NMJ) blocker. The nurse knows that the client cannot move because the client's acetylcholine receptor sites have been stimulated and the drug is remaining in the receptor sites, preventing repolarization. What medication is this client receiving? a. Succinylcholine b. Pancuronium c. Atracurium d. Vecuronium

a. Succinylcholine

A client with acute migraines has been advised by the health care provider to use over-the-counter naproxen sodium. What education should the nurse provide? a. Take the medication with food to avoid GI complications. b. Take the medication at bedtime to reduce the effects of drowsiness. c. Avoid calcium supplements or antacids containing calcium. d. Complete liver testing before beginning treatment.

a. Take the medication with food to avoid GI complications.

A client who is experiencing acute alcohol withdrawal is being treated with intravenous lorazepam (Ativan). This drug achieves a therapeutic effect by: a. increasing the effects of the neurotransmitter GABA. b. inhibiting the action of monoamine oxidase. c. affecting the regulation of serotonin and norepinephrine in the brain. d. increasing the amount of serotonin available in the synapses.

a. increasing the effects of the neurotransmitter GABA.

A client with a complex medical history has been diagnosed with Parkinson's disease and prescribed carbidopa-levodopa. What aspect of this client's health status should most prompt the nurse to monitor the client closely? a. The client had a myocardial infarction ten months ago b. The client takes levothyroxine for the treatment of hypothyroidism c. The client has rheumatoid arthritis and takes celecoxib d. The client is obese, with a body mass index of 32.5

a. The client had a myocardial infarction ten months ago

While reviewing a client record, the nurse sees that the client has a history of chronic insomnia. What assumption can the nurse have regarding the client? a. The client has been experiencing dysfunctional sleep for more than 1 month. b. The client has periods of alternating deep and light sleep. c. The client needs pharmacological assistance to go to sleep. d. The client is experiencing an underlying serious illness.

a. The client has been experiencing dysfunctional sleep for more than 1 month.

A client has been prescribed a medication that antagonizes the beta receptors of the sympathetic nervous system. What assessment finding should the nurse attribute to the effects of this medication? a. The client's blood pressure is decreased b. The client's nausea is relieved c. The client denies shortness of breath d. The client denies feeling anxious

a. The client's blood pressure is decreased

What is essential for the nurse to assess prior to the patient taking sumatriptan-naproxen sodium (Treximet)? a. The patient's cardiac history b. If the patient is nauseous c. The patient's ability to administer an injection d. If the patient is able to eat with the medication

a. The patient's cardiac history

The nurse is assisting while the primary care provider is suturing a wound in the urgent care clinic. Local anesthesia is being provided with injection of lidocaine with epinephrine. The nurse should recognize what main benefits of adding epinephrine to the lidocaine? Select all that apply a. The sympathetic nervous system is stimulated, blocking pain. b. The onset and peak of lidocaine are hastened. c. The local effect of the lidocaine is increased. d. Systemic absorption of the anesthetic is decreased

a. The sympathetic nervous system is stimulated, blocking pain. c. The local effect of the lidocaine is increased.

The client is ordered bethanechol subcutaneously. After giving the client the injection of bethanechol, the nurse should make sure that what is available? a. Urinal, bed pan, and call light b. Magazine, book, or computer c. Sunglasses or eye mask d. Bowel or vomit bag

a. Urinal, bed pan, and call light

The nurse is preparing a client who is going to receive propofol for a surgical procedure. For which reason(s) will the nurse question the client receiving this intravenous anesthesia? Select all that apply. a. allergy to eggs b. allergy to sulfites c. allergy to soybeans d. history of bronchoconstriction e. history of deep vein thrombosis

a. allergy to eggs b. allergy to sulfites c. allergy to soybeans d. history of bronchoconstriction

A client who is opioid tolerant has been receiving butorphanol. Which assessment findings should cause the nurse to suspect that the client is experiencing withdrawal? Select all that apply. a. anxiety b. tremors c. heart palpitations d. pulmonary edema e. excitability

a. anxiety b. tremors

A client recently started on fluoxetine for the treatment of depression asks the nurse if there are any adverse effects to be aware of. The nurse should inform the client to be alert for what effects? Select all that apply. a. tinnitus b. anxiety c. insomnia d. restless legs e. nervousness f. visual disturbances

a. anxiety c. insomnia e. nervousness

While studying pharmacology, the nursing student learns that a naturally occurring narcotic drug with analgesic and antitussive effects is: a. codeine. b. aspirin. c. ibuprofen. d. acetaminophen.

a. codeine.

A male client develops diarrhea secondary to antibiotic therapy. He is to receive two tablets of diphenoxylate HCl with atropine sulfate (Lomotil) orally as needed for each loose stool. The nurse should inform him that he may experience: a. dizziness. b. bradycardia. c. muscle aches. d. increase in appetite.

a. dizziness.

Common side effects of anticholinergics include: a. dry mouth, urinary retention, constipation, and increased pulse rate. b. blurred vision, decreased liver enzymes, increased B/P, and papillary constriction. c. decreased GI absorption, nausea, heartburn, and hypotension. d. skin rashes, decreased urinary output, constipation, and increased WBCs.

a. dry mouth, urinary retention, constipation, and increased pulse rate. Exp: Anticholinergic drugs may cause blurred vision, dry mouth, tachycardia, and urinary retention. They also decrease sweating and may cause fever or heatstroke. Fever may occur in any age group, but heatstroke is more likely to occur in older adults, especially with cardiovascular disease, strenuous activity, and high environmental temperatures. When centrally active anticholinergics are given for Parkinson's disease, agitation, mental confusion, hallucinations, and psychosis may occur.

The nurse is caring for a client who is receiving the cholinergic drug neostigmine for the treatment of myasthenia gravis. The nurse is aware that a potential complication of the treatment is cholinergic crisis, which is characterized by which event? a. excessive stimulation of the parasympathetic nervous system b. excessive stimulation of the sympathetic nervous system c. hypertension and respiratory failure d. stronger skeletal muscle contractions

a. excessive stimulation of the parasympathetic nervous system

Because of the systemic effects of anticholinergic drugs, patients using these drugs are more susceptible to: a. heat stroke related to decreased perspiration. b. diarrhea related to increased peristalsis. c. urinary frequency related to CNS effects. d. hypotension related to increased sympathetic response.

a. heat stroke related to decreased perspiration.

The nurse is caring for a client taking fluoxetine for depression. Which assessment findings indicate that the medication is effective? Select all that apply. a. improved sleep b. decreased anxiety c. reduced appetite d. weight loss e. interest in physical activity

a. improved sleep b. decreased anxiety e. interest in physical activity

Antipsychotic drugs are contraindicated in clients with: a. liver damage, coronary artery disease, severe hypertension, bone marrow depression, or cerebrovascular disease. b. kidney damage, chronic obstructive lung disease, mild hypotension, and chronic bone pain. c. nausea, severe hypotension, or intractable hiccups. d. peptic ulcer disease, mild hypertension, chronic joint pain, and kidney failure.

a. liver damage, coronary artery disease, severe hypertension, bone marrow depression, or cerebrovascular disease.

The nurse is caring for a client with asthma who has been administered albuterol in order to promote bronchodilation and relieve shortness of breath. When giving this medication, the nurse has affected the client's autonomic nervous system by: a. stimulating beta2-receptors. b. decreasing the reuptake of acetylcholine. c. converting a larger proportion of dopamine to norepinephrine. d. antagonizing alpha2-receptors.

a. stimulating beta2-receptors. Stimulation of beta2-receptors causes bronchial dilation. Manipulation of acetylcholine levels does not cause this effect, not increasing norepinephrine levels. Antagonizing the alpha2-receptors would not have this effect.

The nurse is speaking to a group at the senior citizen's center about Parkinson disease. What should the nurse explain is importance to avoiding when taking an anticholinergic medication? a. strenuous exercise in high environmental temperatures b. salt substitutes and foods high in potassium c. foods high in vitamin K such as dark green, leafy vegetables d. over-the-counter medications containing acetaminophen

a. strenuous exercise in high environmental temperatures

The nurse provides client teaching about use of levodopa for treatment of Parkinson disease. What statement by the client would indicate a good understanding of levodopa? (select all that apply) a. "I'll know within about a year whether this drug has cured my Parkinson disease." b. " I will not stop this medication suddenly" c. "I should avoid exercising while taking this drug so that I don't get injured." d. "I should take this drug with food to avoid an upset stomach." e. "I will avoid foods high in Pyridoxine (vitamin B6)" f. "I will notify the provider if I have involuntary movements or if the drug stops working"

b. " I will not stop this medication suddenly" d. "I should take this drug with food to avoid an upset stomach." e. "I will avoid foods high in Pyridoxine (vitamin B6)" f. "I will notify the provider if I have involuntary movements or if the drug stops working"

A client who has been prescribed bethanechol asks a nurse to explain how the drug works. What would be a correct response? a. "Bethanechol is an indirect-acting cholinergic drug that causes the bladder to constrict." b. "Bethanechol is a direct-acting cholinergic drug that causes contraction of the smooth muscles of the bladder and passage of urine." c. "Bethanechol is a diuretic that works in the loop of Henle, blocking the reuptake of sodium, which causes one to void." d. "Bethanechol is a medication that increases the amount of water that is produced by the kidneys, causing one to void."

b. "Bethanechol is a direct-acting cholinergic drug that causes contraction of the smooth muscles of the bladder and passage of urine."

An older client is taking an anticholinergic agent. After teaching the client about the drug, which client statement indicates the need for additional teaching? a. "I should make sure that I drink plenty of fluids." b. "I need to exercise frequently outside in the warm weather." c. "I should avoid driving if I feel light-headed or dizzy." d. "I should eat plenty of fiber to prevent constipation."

b. "I need to exercise frequently outside in the warm weather."

A client with type 1 diabetes mellitus has been dealing with feelings of depression for the last month, and the health care provider has elected to start this client on fluoxetine. What client teaching is most important for the nurse to share with this client? a. "You will probably need to increase your usual insulin dosage." b. "Increase your monitoring of your blood sugar because there is an increased chance of hypoglycemia." c. "Double the carbohydrates you eat daily to prevent hypoglycemia from occurring." d. "Decrease your calorie intake by one half by skipping all in-between meals."

b. "Increase your monitoring of your blood sugar because there is an increased chance of hypoglycemia."

A 70-year-old male client asks why he is receiving a lower dose of zolpidem than his son. As part of the nurse's teaching plan, which explanation will the nurse give this client? a. "Older adults metabolize the drug more quickly, but due to renal dysfunction, the medication must be reduced." b. "Older adults metabolize the drug more slowly, and half-lives are longer than in younger adults." c. "Older adults metabolize the drug at the same speed as younger adults; I will check the dosage with your health care provider." d. "Older adults do not need as much of the medication for the desired effect as a younger adult does."

b. "Older adults metabolize the drug more slowly, and half-lives are longer than in younger adults."

A 50-year-old woman has been prescribed sumatriptan for the treatment of migraines. What instructions should then the nurse provide to the patient about the safe and effective use of this drug? Select all that apply a. "Take a dose of sumatriptan each morning when you suspect there's a chance of having a migraine." b. "Take this drug as soon as you feel the first signs of a migraine." c. "Lie down when you feel a migraine coming on and take some sumatriptan around 30 minutes later." d. "Take a dose of sumatriptan after you feel that you're unable to endure the pain of your migraine." e. "You can take another dose 2 hours the first one"

b. "Take this drug as soon as you feel the first signs of a migraine." e. "You can take another dose 2 hours the first one"

A client who is receiving phenytoin has a serum drug level drawn. Which result would the nurse interpret as within the therapeutic range? a. 4 mcg/mL b. 12 mcg/mL c. 22 mcg/mL d. 30 mcg/mL

b. 12 mcg/mL Exp: The therapeutic serum phenytoin levels range from 10 to 20 mcg/mL. Thus, a level of 12 mcg/mL would fall within this range.

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? a. After surgery, a client may feel nauseated as a side effect of the anesthesia. b. Abrupt reversal of opioid-induced respiratory depression may cause vomiting. c. This is a precaution in case the client begins to choke when resuming a general diet. d. Suction equipment should be placed in all client rooms as a standard of care postoperatively.

b. Abrupt reversal of opioid-induced respiratory depression may cause vomiting.

An older adult client diagnosed with Parkinson's disease will soon begin treatment with levodopa, carbidopa, and entacapone. Prior to starting this course of treatment, the nurse must ensure the implementation of which intervention? a. Monitor cardiac-related vital signs b. Assess renal function c. Review results of a pulmonary functions test d. Assess for lactose intolerance

b. Assess renal function

A surgical client's balanced anesthesia includes the use of vecuronium. What nursing action should the operating room nurses prioritize? a. Monitoring the client for signs of increased level of consciousness b. Assessing and protecting the client's airway c. Protecting the client's skin integrity d. Monitoring the client's deep tendon reflexes

b. Assessing and protecting the client's airway

When should the nurse instruct a client's parents to administer dexmethylphenidate (Focalin) to the client? Select all that apply: a. After breakfast b. Before breakfast c. After lunch d. Before lunch e. At bedtime

b. Before breakfast d. Before lunch Exp: The nurse should instruct the client's parents to administer dexmethylphenidate 30 to 45 minutes before breakfast and before lunch.

A female client received a 4% solution of lidocaine by nebulizer in preparation for a bronchoscopy. The nurse assesses this client for what adverse effect related to this medication's route of administration? a. Rash b. Bronchospasm c. Heart block d. Sepsis

b. Bronchospasm

A nurse is caring for a 49-year-old client who has been taking bethanechol for treatment of neurogenic bladder. After one week, the client develops sweating, heavy salivation, and bronchospasm. What would the nurse suspect is happening with this client? a. Myasthenic crisis b. Cholinergic crisis c. Anaphylactic reaction d. Pulmonary edema

b. Cholinergic crisis

When the client prescribed entacapone asks the nurse to describe exactly how this medication works, what response is most appropriate? a. "Entacapone is best given parenterally to relieve symptoms." b. "Entacapone inhibits COMT so that dopamine is active for a longer time." c. "Entacapone increases the metabolism of levodopa in the bloodstream." d. "It is excreted almost entirely through the kidneys."

b. Entacapone inhibits COMT so that dopamine is active for a longer time."

A client is admitted to the emergency department for an opioid overdose. What would the nurse expect to administer to this client? a. Oxycodone b. Naloxone c. Normeperidine d. Corticosteroids

b. Naloxone

A client who was previously taking paroxetine (SSRI) is being switched to phenelzine (MAO) due to a lack of response. The nurse would expect that the phenelzine will be started at which time? a. Concurrently with the paroxetine as it is being tapered b. Several weeks after stopping the paroxetine c. Immediately upon stopping the paroxetine. d. Forty-eight hours after being weaned from the paroxetine

b. Several weeks after stopping the paroxetine

The nurse assessed a client at 0800 and obtained a blood pressure of 111/70 mmHg. Two hours later, the client's blood pressure has increased to 130/81 mmHg. The nurse should attribute this change to what action within the autonomic nervous system? a. Stimulation of beta-receptors b. Antagonism of alpha-receptors c. Decreasing levels of acetylcholinesterase d. Stimulation of nicotinic receptors

b. Stimulation of beta-receptors

A 29-year-old female client in labor has just received epidural anesthesia. Before the procedure her blood pressure was 120/78 and her pulse was 60 bpm. Now her blood pressure is 100/60 and her pulse is 80 bpm. She reports a metallic taste in her mouth, hears a ringing in her ears, and appears confused. What is this client most likely experiencing? a. Anxiety related to administration of an epidural b. Systemic toxicity from local anesthesia c. Signs of preeclampsia d. A normal adverse effect of local anesthesia

b. Systemic toxicity from local anesthesia

A client who was diagnosed with schizophrenia in 1962 was prescribed chlorpromazine. The client has been taking the medication for more than 40 years and demonstrates lip smacking and appears to be chewing continually. What adverse effect is the client most likely experience? a. Hypertension b. Tardive dyskinesia c. Akathisia d. Urinary frequency

b. Tardive dyskinesia

A client has been taking levodopa (L-dopa) for the treatment of Parkinson's disease. What additional medication may decrease the amount of levodopa needed to reach a therapeutic level in the brain, thereby reducing adverse effects of levodopa? a. bromocriptine b. carbidopa c. amantadine d. trihexyphenidyl

b. carbidopa

A client has a diagnosis of Parkinson disease, and the health care provider will prescribe carbidopa-levodopa. Before drug therapy, the client should be carefully assessed for the presence of: a. macular degeneration. b. closed-angle glaucoma. c. peptic ulcer disease. d. diabetes mellitus.

b. closed-angle glaucoma. Exp: Carbidopa-levodopa is contraindicated in a person with closed-angle glaucoma. However, it can be used in a person with open-angle glaucoma if intraocular pressure is closely monitored and controlled. Carbidopa-levodopa can be used by persons with peptic ulcer disease and diabetes mellitus, but it may exacerbate the symptoms of these disorders.

The nurse is caring for a client receiving intramuscular butorphanol for pain management. Which assessment finding indicates that the client is experiencing an adverse effect of this medication? a. rhinorrhea b. hallucinations c. muscle cramps d. hyperactive bowel sounds

b. hallucinations

The nurse administers a medication that stimulates the muscarinic receptors. What manifestations should the nurse expect to assess in this client? a. pupil dilation b. increased activity of bowel sounds c. increased heart rate d. muscle contractions

b. increased activity of bowel sounds Feedback: Stimulation of muscarinic receptors increases gastrointestinal (GI) motility which would cause increased activity of bowel sounds. Other effects include pupil constriction, increased urinary bladder contraction, and a slowing of the heart rate. Stimulation of nicotinic receptors cause muscle contractions.

A client prescribed fluoxetine 1 week ago presents for a scheduled follow-up appointment. What should be the focus of the client's nursing assessment to best assure client safety? a. cardiac rate and rhythm b. presence of suicidal ideation c. improvement in the ability to concentrate d. indications of a type IV hypersensitivity reaction

b. presence of suicidal ideation

The nurse is scheduled to administer pancuronium, a neuromuscular-blocking medication, to a client receiving mechanical ventilation. The nurse would predict which receptor subtype(s) to be activated resulting in a stimulatory response? a. All muscarinic receptors b. specifically nicotinicn receptors c. specifically nicotinicm receptors Both muscarinic and nicotinic receptors

b. specifically nicotinicn receptors

The nurse is explaining to a client about the analgesic and its possible adverse effects. The client is receiving an opioid analgesic. What would be important to teach this client is a possible adverse effect of this drug? a. Ataxia b. Blurred vision c. Hypotension d. arrhythmias

c. Hypotension

A client has been prescribed an anticholinergic medication. What instructions should the nurse provide related to safety when outside in hot weather? a. Wear a hat to protect the head b. Wear sunglasses to protect the eyes c. Keep well hydrated d. Keep arms and legs covered

c. Keep well hydrated

A client is experiencing significant respiratory depression and sedation related to morphine administration. The nurse would anticipate administering: a. Butorphanol. b. Buprenorphine. c. Naloxone. d. Ergotamine.

c. Naloxone Exp: Naloxone is a narcotic antagonist that is used to reverse the effects of narcotics such as morphine. Butorphanol and buprenorphine are narcotic agonists-antagonists that are used for moderate to severe pain relief. Ergotamine would be used to prevent and treat migraine attacks.

A male client took zolpidem daily for 1 week with good response, then stopped the medication. Two days later, he returns to the office stating that his insomnia is worse than it ever was. The nurse is responsible for the development of a teaching plan for the client, including adverse reactions. After 1 week of regular use, which adverse reaction may occur with zolpidem? a. Chronic insomnia b. Short-term insomnia c. Rebound insomnia d. Long-term insomnia

c. Rebound insomnia

An opioid naive patient experiences acute pain after surgery and is put on opioid therapy. Which severe adverse reactions of opioid treatment should the nurse monitor for in the patient? a. Pruritus b. Severe headache c. Respiratory depression d. Urticaria

c. Respiratory depression

A client prescribed phenytoin for a seizure disorder has recently run out of medication and has not obtained a refill. What is the client at risk for developing? a. Hypotension b. Migraine headaches c. Status epilepticus d. Depression

c. Status epilepticus Exp: In a person taking medications for a diagnosed seizure disorder, the most common cause of status epilepticus is abruptly stopping AEDs. Abruptly stopping phenytoin will not cause hypotension, migraine headaches, or depression.

A graduate of a nursing program is scheduled to take the NCLEX today. The test-taker's heart is racing and pupils are dilated. What can the test-taker attribute to this reaction? a. Autonomic nervous system b. Cardiovascular irregularity c. Sympathetic nervous system d. The release of dopamine

c. Sympathetic nervous system

What statement best explains the central and peripheral nervous system? a. Structures of the central nervous system include the brain, neurons, and ganglia. b. The central nervous system (CNS) can be broken down into the somatic and autonomic pathways. c. The two main divisions that control the nervous system are the central and peripheral nervous system. d. Structures of the peripheral nervous system include the hypothalamus, brain stem, and spinal column.

c. The two main divisions that control the nervous system are the central and peripheral nervous system. Explanation: The nervous system has two main divisions: the central nervous system and the peripheral nervous system. The CNS includes the brain and spinal cord, while the PNS includes the neurons and ganglia outside the CNS. The efferent portion of the PNS has two subdivisions: the somatic and autonomic nervous system.

A 40-year-old, diagnosed with myasthenia gravis (MG), is scheduled to begin treatment with oral neostigmine. When providing relevant health education, the nurse should emphasize that successful control of MG symptoms will primarily depend on what personal behavior? a. Matching each dose of neostigmine to the severity of symptoms at that time b. Making lifestyle modifications to prioritize a healthy diet and regular activity c. Adhering strictly to the prescribed administration schedule d. Developing acceptance of the functional deficits that result from MG

c. adhering strictly to the prescribed administration schedule. Exp: Strict adherence to timely medication administration promotes optimal blood levels of neostigmine and optimal symptom control. Doses are not typically matched to short-term symptom severity, except in emergencies. Lifestyle modifications and acceptance may be of benefit, but pharmacologic therapy is of paramount importance in the treatment of MG.

Indications for use of anticholinergic drugs in the treatment for Parkinsonism include to: a. decrease headaches. b. improve blurred vision. c. decrease salivation, spasticity, and tremors. d. decrease motor movement.

c. decrease salivation, spasticity, and tremors.

The nurse has been educating the client on the self-administration of phenytoin. Which statement made by the client demonstrates an understanding of the medication? Select all that apply a. "I'll only take the drug when I feel an impending seizure." b. "I'll make sure to take the drug with food." c. "I'll stop taking the drug if I don't have a seizure for 8 weeks." d. "I should not change brands without checking with my health care provider."

d. "I should not change brands without checking with my health care provider." b. "I'll make sure to take the drug with food."

An adult client who is currently undergoing rhinoplasty has developed the characteristic signs and symptoms of malignant hyperthermia. The operating room nurse should anticipate what intervention? a. Hemodialysis b. Tracheal intubation c. IV administration of naloxone d. IV administration of dantrolene sodium

d. IV administration of dantrolene sodium

The nurse administers an anticholinergic medication to a client. The nurse would predict which receptor subtypes to be blocked? Select all that apply. a. Alpha b. Beta c. Dopaminergic d. Muscarinic e. Nicotinic

d. Muscarinic e. Nicotinic

A 34-year-old executive for an insurance company has been taking lorazepam for the last 6 months for anxiety. The client abruptly stopped the medication. The client then calls the health care provider and reports feeling irritable, and increased heart rate, and restlessness. What would explain the client's current symptoms? a. anxiety has increased in severity b. difficulty at work c. psychological addiction to lorazepam d. withdrawal from stopping the medication

d. Withdrawal from stopping the medication. Exp: Rationale: Prolonged administration of lorazepam or any other benzodiazepine produces physical dependence, and withdrawal symptoms occur if the drug is stopped suddenly. The symptoms of withdrawal include restlessness, irritability, tachycardia, insomnia, and sweating. Dependence is not synonymous with addiction.

Oral lidocaine viscous has been prescribed for a client who has developed stomatitis. To minimize the client's chance of aspiration, the nurse should encourage what intervention? a. Taking small bites of food and small sips of fluid after administration b. Adopting a minced and pureed diet for the duration of treatment c. Remaining in a high Fowler's position for 90 minutes following the use of lidocaine viscous d. Avoiding eating or drinking for 1 hour following the use of lidocaine viscous

d. avoid eating or drinking for 1 hour following the use of lidocaine viscous. Patients should not drink fluids or eat after gargling with viscous lidocaine for at least 60 minutes due to risk of aspiration. Upright positioning will not mitigate this risk. A textured diet is unnecessary.

The client is 65-years-old and has a diagnosis of cancer. Morphine has been ordered for pain management. Before the administration of morphine, the initial action of the nurse would be to check which? a. apical pulse and compare it with the radial pulse. b. blood pressure. c. temperature. d. respiratory rate, depth, and rhythm.

d. respiratory rate, depth, and rhythm.

A client has been newly diagnosed with myasthenia gravis. What education should the nurse provide the client and family? a. the importance of taking anticholinergic medications as prescribed b. the signs and symptoms of a medication overdose c. strategies for encouraging activity when the client is tired d. the importance of monitoring level of consciousness

d. the importance of monitoring level of consciousness