Pharmacology, NUR 205 Practice Questions- Test 2

A patient with multiple sclerosis is prescribed baclofen (Lioresal). The nurse will observe the patient for which intended effect? A. Decreased strength B. Suppression of spasticity C. Improved muscle tone D. Increased muscle resistance

Answer: B Rationale: Baclofen suppresses hyperactive reflexes involved in regulation of muscle movement. The drug will suppress spasticity, which consists of heightened muscle tone, spasm, and loss of dexterity.

A patient is newly prescribed carbamazepine (Tegretol) for seizure control. Which food should the patient be taught to avoid? A. Tomatoes B. Grapefruit juice C. Spinach D. Kiwi fruit

Answer: B Rationale: Grapefruit juice can inhibit the metabolism of carbamazepine

The nurse teaches a patient about bethanechol (Urecholine). Which statement by the patient requires an intervention by the nurse? "The medication should be taken with meals." "Urgency may occur so I should be near a bathroom." "I should plan to take the drug 3 times each day." "This drug may cause a drop in my blood pressure."

Answer: A Rationale: Bethanechol should be taken 1 hour before or 2 hours after meals; nausea and vomiting and gastric upset may occur if bethanechol is taken with meals.

After an intramuscular injection of penicillin, the patient develops severe difficulty breathing and a swollen tongue. Which medication should the nurse prepare to administer? A. Dopamine (Inotropin) B. Epinephrine (Adrenalin) C. Norepinephrine (Levophed) D. Pseudoephedrine (Sudafed)

Answer: B

A patient taking levodopa/carbidopa (Sinemet) for Parkinson's disease experiences frequent "on-off" episodes (or abrupt loss of effect). Which action by the nurse is best? A. Administer the medication on an empty stomach. B. Instruct the patient to avoid high-protein foods. C. Have the patient increase intake of vitamin B6. D. Discontinue the drug for 10 days (for a "drug holiday").

Answer: B Rationale: Meals high in protein can reduce therapeutic responses to levodopa

A patient is concerned about developing Alzheimer's disease (AD). What should the nurse include in the teaching plan? A. Estrogen replacement therapy improves cognitive functioning. B. No solid evidence supports the use of drugs to prevent AD. C. Naproxen taken daily after age 50 years decreases the risk of AD. D. Daily doses of gingko biloba can prevent cognitive decline.

Answer: B Rationale: No solid evidence indicates that drugs, nutrients, supplements, exercise, cognitive training, or any other intervention can prevent Alzheimer's disease (AD) or can delay cognitive decline.

The nurse cares for a patient receiving pramipexole (Mirapex). The nurse is most concerned if the patient makes which statement? D. "I now use a patch instead of taking birth control pills." C. "Sometimes I just fall asleep without warning." B. "The pills make me sleepy, so I take a nap in the afternoon." A. "I have noticed that this medicine makes me constipated."

Answer: B Rationale: Pramipexole may cause sleep attacks; patients should inform the prescriber and should avoid potentially hazardous activities.

A patient who takes oxybutynin (Ditropan) for an overactive bladder takes an over-the-counter antihistamine for hay fever symptoms. What symptoms should the nurse watch for that would indicate toxicity? A. Cool, moist skin; confusion; and bradycardia B. Dry mouth, increased temperature, and blurred vision C. Hallucinations, increased salivation, and diaphoresis D. Hypothermia, increased respiratory rate, and pupil constriction

Answer: B Rationale: Symptoms of cholinergic antagonist toxicity include dry mouth; blurred vision; photophobia; hyperthermia; respiratory depression; and hot, dry, and flushed skin.

The nurse instructs a patient about taking dantrolene (Dantrium) for muscle spasm. The nurse determines that teaching is successful if the patient makes which statement? A. "It is common to experience insomnia when taking this drug." B. "Prescription muscle relaxants do not cause dependence." C. "I should avoid drinking alcohol while taking this medication." D. "This medication may cause increased saliva and diarrhea."

Answer: C Rationale: Adverse effects of centrally acting muscle relaxants such as orphenadrine include central nervous system (CNS) depression; patients should avoid alcohol and all other CNS depressants.

An elderly patient with skin cancer and hypertension is prescribed levodopa/carbidopa (Sinemet) to treat Parkinson's disease. Which action by the nurse is best? A. Give the medication if the blood pressure is normal. B. Administer the medication as prescribed. C. Ask the patient about the type of skin cancer. D. Hold the medication if the patient is older than 65 years.

Answer: C Rationale: Levodopa can activate malignant melanoma

A patient is prescribed phenytoin (Dilantin) for epileptic seizures. What is a priority nursing action? A. Warn the patient against using alcoholic beverages. B. Tell the patient to take the medication with meals. C. Inform the patient about prevention of gingival hyperplasia. D. Teach the patient to avoid abrupt cessation of treatment.

Answer: D Rationale: All of the interventions should be included in patient teaching; however, the most important is to avoid abrupt cessation of treatment. This could lead to a life-threatening seizure or to status epilepticus.

A patient is prescribed bethanechol (Urecholine) for urinary retention. If the patient exhibits signs of an overdose (e.g., increased salivation and sweating, bradycardia, hypotension), which medication should the nurse administer? A. Acetylcholine (Miochol-E) B. Cevimeline (Evoxac) C. Oxybutynin (Ditropan) D. Atropine (AtroPen)

Answer: D Rationale: Atropine is a selective muscarinic blocking agent that will reverse most signs of toxicity from an overdose of a muscarinic agonist (e.g., bethanechol).

A patient with mild symptoms of Alzheimer's disease is prescribed donepezil (Aricept). Which statement made by the patient indicates a need for further teaching? A. "The drug will improve transmission by neurons in my brain." B. "I may experience an upset stomach while taking this drug." C. "I will take the drug every night at bedtime with a snack." D. "The drug will stop damage to the neurons in my brain."

Answer: D Rationale: Donepezil is a cholinesterase inhibitor that increases the availability of acetylcholine at cholinergic synapses.

A patient is prescribed a dopamine agonist, pramipexole (Mirapex). Which statement made by the patient indicates a need for further teaching? A. "The drug should be taken with food to prevent nausea." B. "I may experience hallucinations while taking this drug." C. "I should rise slowly to prevent dizziness and fainting." D. "This drug will stop the progression of Parkinson's disease."

Answer: D Rationale: Dopamine agonists will improve patients' abilities to complete activities of daily living but are not a cure and will not delay progression of Parkinson's disease.

A patient is receiving dopamine (Inotropin) for treatment of shock. What would indicate to the nurse that the medication is effective? A. Decreased mean arterial pressure B. Gain of 2 kg in 24 hours C. Increased heart rate D. Increased urine output

Answer: D Rationale: Dopamine is used in the treatment of shock

The nurse prepares to administer dantrolene (Dantrium) to a patient. The nurse should assess which value before administration of the medication? A. Serum amylase B. Creatinine clearance C. Blood glucose D. Liver function tests

Answer: D Rationale: Dose-related liver damage is the most serious adverse effect of dantrolene. To reduce the risk of liver damage, liver function tests (LFTs) should be performed at baseline and periodically thereafter. LFTs include aspartate and alanine aminotransferases