Pharmacology

A patient has been diagnosed with cervical dystonia. The nurse would expect which medication to be ordered for this patient?

Botulinum toxin type B

Renin and erythropoietin are produced in which structure?

Juxtaglomerular apparatus

A patient comes to the clinic for a botox injection around her eyes. While making an assessment, the nurse finds that the patient is taking polymyxin for an infection. What would the nurse do first?

Notify the physician.

When describing the signs and symptoms associated with renal failure, what would be most important for a nurse to keep in mind?

Renal failure suggests that extensive kidney damage has already occurred.

A nurse is describing the renal system to a client with a kidney disorder. Which structure would the nurse identify as emptying into the ureters?

Renal pelvis

Which hormone is secreted by the juxtaglomerular apparatus?

Renin

Which is released in response to a decrease in blood flow to the nephron?

Renin

When describing the mechanism for blood pressure control by the kidneys, which occurs first when oxygenation to the nephron is decreased?

Renin release

The nurse is supporting a client who is undergoing a diagnostic procedure using neuromuscular junction blockers. What intervention should the nurse prioritize?

Reposition the client as possible to prevent skin breakdown

When reviewing a client's history, which condition would the nurse identify as contraindicating the use of a centrally acting skeletal muscle relaxant?

Rheumatic disorder

Which adverse effect of a neuromuscular junction (NMJ) blocking agent is the highest priority for the nurse to treat?

Hypotension

The nurse is caring for a patient who is receiving pancuronium to aid in their mechanical ventilation. The patient is also receiving a barbiturate. What does the nurse need to know about these drugs?

If they are given together, a precipitate may form.

Which nursing focus is the highest priority for the nurse caring for a patient receiving a neuromuscular junction (NMJ) blocking agent?

Impaired gas exchange

What indicates to the nurse that a patient has recovered from neuromuscular junction (NMJ) blocking anesthesia?

Deep tendon reflexes 2+

A nurse is caring for a patient with edema due to congestive heart failure (CHF). The physician has prescribed indapamide to the patient. The patient is also undergoing treatment with digitalis glycoside. Which intervention should the nurse perform when caring for this patient?

Frequently monitor the patient's pulse rate and rhythm.

Which assessment finding from a patient's history is significant for the nurse to report to the physician before surgery using a neuromuscular junction (NMJ) blocking agent?

Hepatitis

An older adult client has a complex medical history that includes heart failure, type 1 diabetes, and diabetic nephropathy. The nurse has questioned a health care provider's prescription for oral spironolactone because the client's health problems would contribute to a high risk of which adverse reaction?

Hyperkalemia

Which medication is classified as an antianxiety medication but is also used to treat muscle spasms?

Diazepam (Valium)

How soon after IV administration of the nondepolarizing neuromuscular junction (NMJ) agent pancuronium will the nurse expect the patient to exhibit flaccid paralysis and require respiratory support?

4 to 6 minutes

A patient that has a history of glaucoma is to receive a NMJ blocker. Which agent would the nurse identify as being most problematic for this patient?

Succinylcholine

A patient is receiving acetazolamide in a sustained release form. The nurse would anticipate the onset of drug action in approximately which time frame?

2 hours

A patient with a history of cystitis asks the nurse why this disorder is so common in women. Which response by the nurse would be most appropriate?

"A woman's urethra is shorter and exposed to an area of normal bacteria."

A patient with a longstanding diagnosis of chronic renal failure has experienced a significant decline in urine output in recent days, prompting him to seek care at a local clinic. A nurse at the clinic has suggested to a colleague that the administration of a diuretic such as hydrochlorothiazide may improve the patient's urine output. How should the colleague best respond to this suggestion?

"Actually, patients with renal failure usually can't take hydrochlorothiazide."

The nurse is caring for a 59 year-old female client who was diagnosed with multiple sclerosis two years ago. In recent weeks, the client has developed increasing muscle spasticity and the care team is considering the use of dantrolene. What assessment question should the nurse prioritize?

"Are you on hormone replacement therapy?"

After teaching a patient about the action of spironolactone, the nurse determines that the teaching was successful when the patient states:

"I need to make sure I don't eat too many high potassium foods."

Which instruction would be most appropriate for a client who is taking a diuretic?

"It's okay to take it with food."

A client has told the nurse that she has been invited to a work colleague's house where she and some of her peers will be able to receive Botox injections. What is the nurse's best response?

"It's safest to have these injections performed under medical supervision."

A 50-year-old woman has begun taking baclofen to treat her recently diagnosed multiple sclerosis (MS). What teaching point should the nurse provide to the patient about her new drug regimen?

"Make sure that you don't stop taking baclofen suddenly because it might cause your symptoms to rebound quite sharply."

A 56-year-old woman with a diagnosis of multiple sclerosis has begun taking dantrolene. What client teaching should the nurse provide?

"Make sure to see your health care provider promptly if you develop yellowish skin or eyes."

A patient has been prescribed methocarbamol for fibromyalgia. The nurse has spent an hour educating the patient on the use of methocarbamol for muscle pain. Which statement by the patient indicates that the patient has an understanding of at least one of the significant side effects of methocarbamol?

"My urine could be discolored while I take this drug."

A daughter is talking with the urologist who is caring for the woman's 78-year-old mother. The mother has multiple sclerosis and has lost control of her bladder. The young woman asks the urologist what made her mother become incontinent. What would be the urologist's best answer?

"Once control of the bladder is learned, you must have a functioning nervous system to maintain it."

A client has been prescribed baclofen and will be taking the drug on an outpatient basis. The client asks the nurse if it is still okay to drink wine with meals or end the day with a "nightcap." What is the nurse's best response?

"The combination of baclofen and alcohol could depress your nervous system to a dangerous level."

A nurse is describing the reasons why more women than men are affected by cystitis. Which would the nurse identify as a major reason?

"The urethra exits into an area rich in gram-negative bacteria."

A client with a lower back injury was recently prescribed chlorzoxazone 250 mg PO t.i.d. The client has phoned the clinic, telling the nurse, "My pain's better, but I'm worried that my bladder is bleeding because there's been blood in my urine." What is the nurse's best response"

"This drug causes your urine to change color, so it's not likely blood that you're seeing."

A client who is experiencing lower back pain has been prescribed cyclobenzaprine. The nurse should provide what health education in order to ensure safe and effective treatment?

"This will likely make you drowsy, so don't take it before doing anything that would require alertness."

A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium). In light of this new addition to her drug regimen, what teaching point should the woman's nurse provide?

"You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity."

A client asks, "Why is my prescription being switched from furosemide to spironolactone?" What is the nurse's best response?

"You will lose less potassium with spironolactone than with furosemide."

A group of students are reviewing the function of the kidneys and demonstrate understanding when they identify that the kidneys receive what portion of the cardiac output?

1/4

The kidneys receive approximately what percentage of the cardiac output?

25%

A patient is to receive succinylcholine. The nurse would expect this drug to begin acting within which time frame?

30 to 60 seconds

A pre-op nurse is caring for a very anxious 33-year-old female patient who is having a tubal ligation. The patient tells the nurse that "the person from anesthesia said that they were going to use something called succinylcholine chloride to help me during surgery," and the patient wants to know how long it takes for this medicine to work. What would the nurse respond?

30-60 seconds

A nurse understands that succinylcholine lasts for approximately how long once it is administered?

4 to 6 minutes

A nurse is caring for a client with acute renal failure. The health care provider has prescribed a diuretic therapy for the client to promote dieresis. What intervention should the nurse perform to prevent the inconvenience caused by increased urination?

Administer the drug early in the day.

Aldosterone levels would be affected if which gland was dysfunctional?

Adrenal

Which is the strongest influence on potassium loss in the kidney?

Aldosterone

What would be a contraindication to the use of carbonic anhydrase inhibitors?

Allergy to sulfonamides

When a patient develops renal failure and the production of erythropoietin drops, the patient will develop:

Anemia

Which stimulates the release of aldosterone from the adrenal gland?

Angiotensin III

Which would lead to a release of aldosterone?

Angiotensin III

The perioperative nurse is caring for a client who is undergoing abdominal surgery with the inclusion of succinylcholine in the client's anesthesia. The anesthesiologist tells the team that the client is exhibiting signs and symptoms suggestive of malignant hyperthermia. What is the nurse's best action?

Anticipate IV administration of dantrolene

A client has presented to the day surgery unit and will be having a diagnostic procedure that will involve the use of a neuromuscular junction blocker. The client says to the nurse, "Let me get this straight: I won't be able to talk or move my muscles but I'll be awake?" The nurse's response should address the possibility of what nursing diagnosis?

Anxiety related to paralysis

Which would be included when describing the site for most calcium reabsorption?

Ascending loop of Henle Proximal convoluted tubule

A client with spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered?

Baclofen

Which medication would the nurse expect to administer if prescribed to achieve skeletal muscle relaxation?

Baclofen

Which skeletal muscle relaxant is also available in intrathecal form?

Baclofen (Lioresal)

In a patient who is to be given vecuronium (Norcuron), anesthesia is induced before neuromuscular blockade is started. What is the reason for this?

Because it helps prevent the patient from undergoing the frightening experience of paralysis and the inability to breathe

When describing the action of chlorothiazide, what would a nurse include?

Blocking of the chloride pump

The nurse knows that a patient receiving the neuromuscular junction (NMJ) blocking agent succinylcholine will be unable to move or breathe independently for which reason?

Blocks acetylcholine from repolarizing muscle cells

The absorption of which electrolyte from the gastrointestinal (GI) tract is regulated by vitamin D ingested as part of the diet?

Calcium

A patient is experiencing toxicity and prolonged paralysis after using a nondepolarizing neuromuscular junction (NMJ) blocking agent. Which type of medication will be used to reverse this condition?

Cholinesterase inhibitor

Which statement accurately describes the pharmacodynamics of nondepolarizing neuromuscular junction (NMJ) blocking agents?

Compete with acetylcholine for receptor sites

When describing the functions of the kidney to a client, what would the nurse include?

Control of water balance

A client with amyotrophic lateral sclerosis is experiencing muscle spasticity. Which drug would the nurse expect the physician to order?

Dantrolene

A patient receiving succinylcholine experiences malignant hyperthermia. What drug is used to treat this condition?

Dantrolene

A client presents with ascites, secondary to cirrhosis. What mechanism is involved in this fluid shift?

Decreased plasma oncotic pressure

A nurse administers carisoprodol to a client for the treatment of an acute musculoskeletal condition. The nurse would be alert for which adverse effect after administering the drug?

Drowsiness

The nurse is caring for a client who is receiving cyclobenzaprine for relief of muscle spasms. What adverse effect should the nurse assess for?

Drowsiness

What type of diet should a patient taking diuretics have?

Eat potassium-rich or low-potassium diet as appropriate

What occurs as a result of a defect in the renal system's countercurrent mechanism process?

Electrolyte imbalance

In starting a new job as a nurse with a group of renal specialists, the nurse is taught that while the primary function of the urinary system is the transport of urine, the kidneys perform several functions. Which is NOT a function of the kidneys?

Excreting protein

When explaining the underlying mechanisms associated with renal failure, which would be most important for the nurse to keep in mind?

Extensive kidney damage has usually occurred by the time the patient is symptomatic.

An older adult resident of a long-term care facility is experiencing muscle spasticity and has just been prescribed a centrally acting skeletal muscle relaxant. The client has comorbidities of early stage Alzheimer's disease and chronic obstructive pulmonary disease (COPD). What nursing action should the nurse prioritize for adding to the client's care plan?

Falls prevention measures

The extrapyramidal tract is located primarily within the central nervous system.

False

A client who is scheduled for a diagnostic procedure has learned that the procedure will take place with a neuromuscular junction blocker rather than with a general anesthetic. The nurse should describe what benefit of this approach?

Fewer effects of central nervous system depression

Which is the process in which there is the passage of fluid through the glomerulus into the nephron tubule?

Filtration

A client prescribed both an ACE inhibitor and a beta-blocker for the treatment of hypertension has been consistently obtaining blood pressure readings in the vicinity of 145/90 mm Hg. As a result, the client's primary health care provider has prescribed furosemide. What order would be most consistent with this client's health needs?

Furosemide 40 mg PO BID

Which structure acts as an ultra-fine filter for all the blood that flows through it?

Glomerulus

When preparing the teaching plan for a male client who is prescribed spironolactone, the nurse would alert the client to which potential adverse effect?

Gynecomastia

Signs and symptoms of what would necessitate discontinuation of dantrolene therapy?

Hepatic dysfunction

The nurse is providing education to a client who has been prescribed dantrolene. What serious adverse effect should the nurse mention during teaching?

Hepatitis

A client who is allergic to sulfonamide would use what diuretic cautiously?

Hydrochlorothiazide

A 91-year-old client, who is being prepared for discharge, has been prescribed the diuretic spironolactone. While teaching the client about the drug, what major adverse effect should the nurse be sure to mention?

Hyperkalemia

A male client is prescribed potassium-sparing diuretics to treat his disease process. During his annual visit to the health care provider, he reports experiencing muscle weakness and tingling in his fingers. What does the nurse suspect is wrong with this client?

Hyperkalemia

A client who has been taking hydrochlorothiazide arrives at the clinic for his 1-month follow-up appointment. The client tells the nurse that he feels weaker since he began taking the drug. What should the nurse consider as a possible cause of these symptoms?

Hypokalemia

A health care provider has prescribed a loop diuretic for a client with hypertension. The client also has diabetes mellitus. What condition should the nurse monitor for in this client after administering the prescribed drug?

Increased blood glucose levels

A nurse notes that a newly admitted client is currently prescribed both a loop diuretic as well as a thiazide diuretic. The nurse understands what primary rationale for the concurrent use of these two drugs?

Increased diuretic effect

A client comes to the health care provider's office. The client is to receive botulinum toxin. What, if assessed, would suggest to the nurse that the drug administration should be postponed?

Infection at the intended site of administration

A client is admitted to the emergency department with pulmonary edema. What diuretic does the nurse expect the health care provider to prescribe to achieve rapid therapeutic effect?

Loop diuretic

When describing where bumetanide acts, what would the nurse include?

Loop of Henle

A client is diagnosed with increased intracranial pressure. Which would the nurse expect to be ordered?

Mannitol

An older adult is prescribed a skeletal muscle relaxant for reports of neck pain. What is the top priority of care for the nurse to teach the family?

Monitor the client before ambulating.

A client with asthma has been scheduled for a bronchoscopy. The procedure will be facilitated by the administration of a nondepolarizing neuromuscular junction blocker. The client's current medication regimen includes theophylline and albuterol. What is the nurse's best action while monitoring the client during the bronchoscopy?

Monitor the client for indications of early return of muscle function.

A client with renal impairment is in need of a diuretic. Because of the renal problem, potassium-sparing diuretics are contraindicated but may be used if there is no other option. If they are used at all, what nursing intervention would be most important for this client?

Monitoring of serum electrolytes, creatinine, and BUN

A client is unconscious and experiencing increasing intracranial pressure. What type of diuretic will the client most likely be prescribed?

Osmotic diuretic

What is the term for the action of a diuretic in a patient with glaucoma?

Osmotic pull

The nurse would expect to administer tiludronate to a client with which condition?

Paget disease

A child experiencing edema as a result of a congenital heart defect is prescribed a thiazide diuretic. The nurse should closely monitor which of the client's clinical characteristics? (Select all that apply.)

Potassium level Daily weight Blood pressure Appetite

An ED nurse is caring for a patient who is receiving furosemide for treatment of pulmonary edema. What will the nurse monitor to observe for adverse effects of the drug?

Potassium levels

The pharmacology instructor is discussing the differences among the various diuretic agents. Which would the instructor cite as a difference between spironolactone and hydrochlorothiazide?

Potassium losses are greater with hydrochlorothiazide than with spironolactone.

Which structure in the male reproductive system is responsible for maintaining sperm and lubricating the urinary tract?

Prostate gland

The majority of the reabsorption process takes place in what anatomical location?

Proximal tubule

When does a client with spinal cord injury-associated spasticity require treatment for this condition?

Safety, mobility, and activities of daily living are impaired.

Which electrolyte filters through the glomerulus and enters the renal tubule?

Sodium

A male client has cirrhosis and is receiving diuretic therapy. The nurse knows that what drug will help prevent metabolic alkalosis or hypokalemia in this client?

Spironolactone

A nurse is preparing to administer a diuretic that antagonizes the action of aldosterone. Which drug would the nurse likely administer?

Spironolactone

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?

Succinylcholine

The nurse is preparing a male client for surgery. The nurse is reviewing the family history, which includes familial plasma pseudocholinesterase. The patient has a history of malignant hyperthermia and narrow-angle glaucoma. Which anesthetic is highly contraindicated for such a patient?

Succinylcholine

Which agent would be associated with increased intraocular pressure?

Succinylcholine

Which neuromuscular blocking agent would a nurse expect to have the shortest duration of action?

Succinylcholine

When reviewing the medical record of a client who is to receive dantrolene, which condition would alert the nurse to the need for close monitoring?

The client has respiratory depression from opioid analgesia

An adult client with a diagnosis of hypertension has been prescribed oral furosemide. What goal should the nurse identify when planning this client's medication teaching session?

The client will identify strategies for limiting sodium intake.

What is the expected outcome when the glomerular membrane is damaged?

The filtration of fluid from the blood into the kidney's nephron tubule is impaired

Which substance acts to increase blood pressure by inducing vasoconstriction?

angiotensin II

What is the focus of the renal system's renin-angiotensin-aldosterone system?

The regulation of blood pressure

What best describes the structure of the kidneys?

The renal pelvises drain urine into the ureters.

The health care provider indicates that a client experiencing renal failure is not a candidate for therapy with potassium-sparing diuretics. How will the nurse respond when the client's family member asks why this is the case?

They may cause hyperkalemia.

Centrally acting skeletal muscle relaxants lyse or destroy the spasm.

True

Nondepolarizing NMJ blockers are metabolized in the serum.

True

Spinal reflexes are the simplest nerve pathways that monitor movement and posture.

True

The countercurrent mechanism occurs in the loop of Henle.

True

The nurse is providing care for a client with an enlarged prostate gland. What assessment finding should the nurse attribute to this problem?

Urinary hesitancy and frequency

Which substances are moved from the glomerulus into the tubule due to hydrostatic pressure?

Water

A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which instruction?

Wear appropriate clothing and sunscreen whenever he is in direct sunlight.

A hospital client demonstrating peripheral edema has been prescribed furosemide. How should the nurse best determine the extent of the client's desired fluid loss?

Weigh the client daily.

When a nondepolarizing NMJ blocker is used as an adjunct to surgery, what classification of medications could reverse the neuromuscular blockage leading to early arousal and return of muscle function?

Xanthines

A nurse is caring for a male patient who has a spinal cord injury due to a motorcycle accident. He has been taking dantrolene (Dantrium) for 2 weeks. The nurse will monitor:

alanine aminotransferase and total bilirubin levels.

A client with muscle spasticity has been prescribed baclofen. In order to promote the safe use of this medication, the nurse should encourage the client to:

avoid drinking alcohol for the duration of treatment.

Which of these ions plays an important role in pH homeostasis?

bicarbonate

A nurse understands that loop diuretics are considered high ceiling diuretics because they:

cause a greater diuresis.

The glomerulus is a:

cluster of capillaries at the entrance of the nephron

The glomerulus is a:

cluster of capillaries that filters blood

A surgical client has developed malignant hyperthermia. Which medication can be used to treat this health emergency?

dantrolene

The nurse is caring for an older adult client who receives furosemide on a regular basis. The nurse should prioritize assessments related to what health problem?

dehydration

A 49-year-old client reports frequent muscle cramps while on hydrochlorothiazide therapy. The nurse would advise the client to do which?

eat potassium-rich foods.

When the kidneys notice that they're not getting enough oxygen, what substance do they produce to stimulate red blood cell production?

erythropoietin

Which diuretic will most likely be the initial drug of choice when a client demonstrates dyspnea related to pulmonary edema?

furosemide

Within the kidney, the process of filtration takes place in the:

glomerulus

A physician has prescribed triamterene to a client with renal disease. The client informs the nurse that they are taking potassium supplements to address some heart problems. The nurse would be alert for which of the following?

increased risk of hyperkalemia.

A patient has been stung by a bee. The patient's blood pressure drops. Which part of the nephron will release a substance to increase the patient's blood pressure?

juxtaglomerular apparatus

A patient will be undergoing surgery, during which the anesthesiologist plans to administer vecuronium. The nurse will recognize that the administration of this drug creates a need for:

mechanical ventilation.

A client is receiving hydrochlorothiazide. The nurse would expect to administer this drug by which route?

oral

A nurse is caring for a 78-year-old patient with renal insufficiency and chronic heart failure who is receiving rapid infusions of high-dose furosemide. It will be a priority for the nurse to monitor for:

ototoxicity

An adult client with multiple chronic health problems has been prescribed furosemide in the management of hypertension. When reviewing this client's current medication administration record, what drug should signal the nurse to a potentially increased risk of hypokalemia?

prednisone

The students are studying the male reproductive system. The instructor tells the students that in the male, the urethra leaves the urinary bladder and passes through the:

prostate gland

The part of the nephron that drains into the nephron loop is the

proximal tubule

The renal pelvis drains directly into the

ureter

A nurse is providing patient teaching for a 62-year-old woman who is taking triamterene. The nurse will teach the patient to avoid what in her diet?

Avocados

A nurse is teaching a client about musculoskeletal medication that has been prescribed. The client needs further teaching about the medication when making which statements?

"I take my medicine with three to four beers each evening."

The nurse is teaching a 62-year-old client about hydrochlorothiazide, which the health care provider has prescribed for treatment of hypertension. What statement, made by the client, suggests that the client understands the teaching?

"I will need to stand slowly."

A client receives a dose of furosemide intravenously at 8:00 AM. The nurse would expect this drug to exert is peak effects at which time?

8:30 AM

A patient receives furosemide intravenously at 9 AM. The nurse would expect to assess peak effects of the drug at which time?

9:30 AM

What client is using his or her pyramidal tract to the largest extent?

A client who is filling out the dietary preferences card for the next day

Which patient is at greatest risk for toxicity if given a neuromuscular junction (NMJ) blocking agent?

A patient with chronic azotemia

A client has edema of the lower extremities and abdomen. What is the reason to administer a stronger diuretic than a thiazide diuretic to this client?

A thiazide diuretic will be ineffective when immediate diuresis is needed.

Which instruction should the nurse specifically stress when administering drugs used for muscle spasm and cramping?

Avoid alcohol or other CNS depressants.

A 75-year-old client is diagnosed with atrial fibrillation and chronic congestive heart failure. The health care provider orders a combination of digoxin and diuretics to treat the client's diseases. Recent laboratory results indicate that the client's potassium level is 2 mEq/L. This client is at risk for which problem?

Digoxin toxicity

A client has been prescribed both digoxin and furosemide. The nurse should monitor the client for development of what adverse effect?

Digoxin toxicity

Diuretics increase the production and output of urine. Which statement helps explain how diuretics achieve these effects?

Diuretics reduce the reabsorption of water in the kidneys.

An operating room nurse is assisting the anesthesiologist in the preparation of an intravenous dose of dantrolene. What emergent issue most likely prompted the need to give the patient dantrolene?

Malignant hyperthermia

The nurse is caring for a client who is experiencing elevated intracranial pressure following neurosurgery. The health care provider orders an osmotic diuretic to reduce pressure. Which medication would the nurse expect to be ordered?

Mannitol

Because of the action of methazolamide, the nurse would assess a patient closely for signs and symptoms of which acid-base imbalance?

Metabolic acidosis

A nurse is caring for a patient who is receiving cyclobenzaprine. Which of is the action of the drug on the patient?

Reduction of muscle spasm

What are key roles of the kidneys? (Select all that apply.)

Regulating body fluid volume Maintaining blood pressure Balancing acids/bases

Countercurrent focuses on what mechanism to regulate fluid and electrolyte balance

Regulating sodium absorption

How does the renal system influence the production of red blood cells?

Regulating the production and secretion of erythropoietin

The client asks the nurse about the functions of the kidney. Which should the nurse include when responding to the client? (Select all that apply.)

Regulation of blood pressure Vitamin D synthesis

Dantrolene should be avoided in all patients who are 35 or older because of the increased risk of:

hepatocellular disease.

The nurse is providing education to a client who has been prescribed tizanidine. What adverse effect should the nurse mention during teaching?

Hypotension

A female patient has expressed anxiety to the nurse surrounding the thought of being awake but unable to move or express pain during surgery. The patient states that she recently saw a movie that addressed this phenomenon and that she is consequently fearful about her impending surgery. How should the nurse reassure this patient?

"The whole surgical team will be monitoring you very closely throughout the procedure to make sure that things like this don't happen."

The amount of fluid excreted as urine each day averages approximately less than how many liters?

2 L

A client is receiving hydrochlorothiazide. The nurse would expect this drug to begin acting within which time frame?

2 hours

After teaching a group of nursing students about diuretics, the instructor determines that the teaching was successful when the group identifies which as a loop diuretic?

Furosemide

After teaching a group of students about loop diuretics, the instructor determines that the teaching has been successful when the students identify which agent as the safest for use in the home?

Furosemide

A student asks the physiology instructor what causes loss of muscle function, or paralysis. What would the instructor respond?

If ACh cannot react with the cholinergic muscle receptor to allow new stimulation muscle contraction, muscle paralysis, or loss of muscle function, occurs

Ms. Crampton is prescribed furosemide for chronic heart failure. The nurse knows that furosemide can cause electrolyte imbalances and what other serious side effect?

Metabolic alkalosis

A male client routinely takes baclofen as a skeletal muscle relaxant for a neuromuscular disorder. His last lab results indicate that he is experiencing renal insufficiency. Based on these data, what would the nurse expect the health care provider to do?

Reduce the dose

A health care provider prescribes spironolactone, a potassium-sparing diuretic, for a client with cirrhosis. For which category of clients is the use of potassium-sparing diuretics contraindicated?

hyperkalemia

The outer portion of the kidney is called the

renal cortex

What would contraindicate the use of indapamide?

renal disease

The nurse assesses a client receiving furosemide for:

Hypotension

A nurse is monitoring a client closely for malignant hyperthermia because the client received which NMJ blocker?

Succinylcholine

A student asks the pharmacology instructor how succinylcholine differs from acetylcholine (ACh). What should the instructor respond?

"Succinylcholine is not broken down instantly."

After teaching a group of students about the formation of urine by the kidneys, the instructor determines that the teaching was successful when the students state which amount is usually filtered out by the kidneys each day?

180 liters

The nurse is caring for a young adult client in the emergency department (ED) requiring rapid sequence induction and placement on mechanical ventilation. The client has no known allergies; takes no medications, over-the-counter (OTC) drugs, herbals, or alcohol; and has no history of chronic conditions. The nurse administered the prescribed intravenous (IV) succinylcholine. Which best action would the nurse take when the client remains paralyzed 30 minutes after the intubation?

Notify the emergency department health care provider.

A client with a history of allergy to sulfonamides is identified as a candidate for diuretic therapy. What diuretics would be contraindicated by the allergy? Select all that apply.

hydrochlorothiazide furosemide chlorothiazide

A 32-year-old female client is taking tizanidine (Zanaflex) for spasticity related to her multiple sclerosis. The nurse will inform the client and her husband that the adverse effect that poses the greatest safety risk to the client is:

hypotension.

The health care provider orders furosemide for a pediatric client. The nurse knows that the established dose of the drug should not exceed how many milligrams per kilogram of body weight per day?

6

Which assessment finding indicates that a neuromuscular junction (NMJ) blocking agent is effective?

Absent reflexes

A nurse demonstrates understanding of diuretics when identifying which medication as exerting its effect by inhibiting the enzyme carbonic anhydrase?

Acetazolamide

The nurse is working in collaboration with a nurse anesthetist to assess a preoperative client. When addressing the client's risk for malignant hyperthermia as a result of neuromuscular junction blockers, what assessment should be prioritized?

Assessing for a family history of malignant hyperthermia

The client is taking cyclobenzaprine for muscle spasms secondary to an injury to the lumbar spine that occurred while lifting a motor at work. The client is being seen for a follow-up visit by the health care provider. The client reports dry mouth, blurred vision, and constipation. Why is the client having these side effects from cyclobenzaprine?

Cyclobenzaprine produces an anticholinergic response

A client has been admitted to the unit for treatment of a multiple sclerosis exacerbation. The admission order indicates that the client is taking baclofen. Which outcome would the nurse expect to be associated with use of this medication?

Decreased muscle spasms

A client who has multiple sclerosis has experienced a fall and requires open reduction and internal fixation of a femoral fracture. The anesthesiologist has informed the perioperative nurse that the client will be given a neuromuscular junction (NMJ) blocker to facilitate anesthesia. What is the nurse's best action?

Monitor the client's status before, during, and after surgery as per usual protocol.

The nurse is preparing a patient for an endoscopic procedure that will use a nondepolarizing neuromuscular junction (NMJ) blocking agent. Which condition in the patient's history will require a change in anesthetic medication?

Myasthenia gravis

A group of students are reviewing the structure and function of the renal system. The students demonstrate understanding when they identify what as the functional unit?

Nephron

The student asks the physiology instructor where the motor neuron communicates with a skeletal muscle fiber. What would the instructor respond?

Neuromuscular junction

After teaching students about neuromuscular junction (NMJ) blockers, the instructor determines that the teaching was successful when the students identify which as an example of a nondepolarizing NMJ blocker? (Select all that apply.)

Pancuronium Vecuronium Cisatracurium

A 6-year-old child has been brought to the emergency department in apparent status asthmaticus. The care team recognizes the need to intubate the client, who is inconsolably agitated. The nurse should anticipate a STAT prescription for what medication?

Succinylcholine

For which assessment finding will the nurse intervene first when providing postoperative care to a patient who returned to the nursing unit 2 hours after receiving succinylcholine?

Temperature 40 degrees C (104 degrees F)

Diuretics can either block the reabsorption of components of the urine or block the reabsorption of water back into the body. What does the increase in urine flow from the body depend on with a patient on loop diuretics?

The amount of sodium and chloride reabsorption that it blocks

The operating room nurse has performed an assessment of a preoperative client and the client reports a family history of malignant hyperthermia. The nurse has confirmed with the anesthesiologist that this has been identified. The nurse should anticipate what consequence of this for the client's intraoperative care?

The anesthesiologist will exercise caution when giving the client neuromuscular junction blockers

A 60 year-old female client has multiple sclerosis accompanied by muscle spasticity. The client has responded well to dantrolene 200 mg PO daily in divided doses. What assessment finding should the nurse prioritize for communication to the client's provider?

The client's most recent laboratory results show an upward trend in AST and ALT levels

In order, tubular fluid passes through the

proximal tubule, nephron loop, distal tubule, collecting duct

A 71-year-old patient with a history of depression will be receiving vecuronium to prevent trauma during electroconvulsive therapy. Prior to the procedure, the care team must assess the patient's:

renal and hepatic status.