PME: The Neurological System Pt 1

A nurse is teaching a client who is about to begin sumatriptan therapy to treat migraine headaches. The nurse should instruct the client to monitor for which of the following adverse effects? -Chest pain -Polyuria -Joint pain -Insomnia

Chest pain. Rationale: Sumatriptan, a serotonin agonist, can cause coronary vasospasm and chest pain. Clients should report any pressure, pain, or tightness in the jaw, chest or back. Sumatriptan is not an appropriate choice for clients who have a history of coronary artery disease.

A nurse is teaching the family of a client who has a new diagnosis of Alzheimer's disease about donepezil. Which of the following information should the nurse include? Monitor for consitpation The dosage will be increased weekly to provide optimum therapeutic effect Administering the drug first thing in the morning promotes effectiveness Avoid the use of NSAIDs for pain

Avoid the use of NSAIDs for pain. Rationale: Combining NSAIDs with donepezil can cause GI bleeding. Therefore, the nurse should instruct the client's family to avoid the use of NSAIDs.

A nurse is teaching a client who has a prescription for baclofen. Which of the following instructions should the nurse include? -Avoid driving until the drug's effects are evident -Stop taking the drug immediately if headache occurs -Take the drug as needed for spasticity -Take the drug with antacids to reduce gastric effects

Avoid driving until the drug's effects are evident. Rationale: Baclofen, a centrally acting muscle relaxant, causes CNS depression. Clients 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.

A nurse is teaching a client who has a prescription for carbamazepine. Which of the following instructions should the nurse include to help the client avoid adverse effects of this drug? -Begin taking the drug at a low dosage -Discontinue the drug immediately if diarrhea occurs -Have serum glucose levels checked regularly -Take the drug on an empty stomach

Begin taking the drug at a lose dosage. Rationale: Visual disturbances, vertigo, and ataxia can result from taking carbamazepine, a drug that treats seizure disorders. Dosages should be low to minimize or prevent these adverse effects.

A nurse is preparing to administer memantine to a client who has Alzheimer's disease. Which of the following findings in the client's medical history indicates a need to withhold the drug and notify the provider? -Pancreatic cancer -Hypotension -Cirrhosis -Osteoporosis

Cirrhosis. Rationale: Memantine should be used cautiously in clients who have severe hepatic impairment. The nurse should contact the provider about the client's history of cirrhosis to see if laboratory testing is required before starting the drug or if the dosage needs to be adjusted.

A nurse is caring for a client who has new prescription for pramipexole to treat Parkinson's disease. The nurse should recognize that which of the following laboratory tests require monitoring? -C-reactive protein -Creatinine clearance -Thyroid function -CBC

Creatinine clearance. Rationale: Pramipexole, a direct-acting dopamine receptor agonist, should be used with caution for clients who have renal disease. Therefore, the nurse should monitor the client's renal function.

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? -Slow heart rate -Cough -Diarrhea -Hearing loss

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 imbalance and intervene accordingly.

A nurse is teaching a client who has a new prescription for vampiric acid to treat a seizure disorder. The nurse should instruct the client to monitor for which of the following adverse effects?

Drowsiness, headache, and rash. Rationale: Drowsiness is correct. Clients taking valproic acid should report CNS depressant effects, such as sedation or drowsiness, because these adverse effects can indicate the need for a reduction in dose. Headache is correct. Valproic acid can cause headache, along with other CNS adverse effects, such as sleep disturbances. Rash is correct. Skin rash is an adverse effect of valproic acid and other antiepileptic drugs.

A nurse is caring for a client who is taking interferon beta-1b. The nurse should identify that which of the following findings indicate a potential serious adverse effect of this drug? -Tinnitus -Twitching eyelids -Blue-green skin discoloration -Fatigue

Fatigue. Rationale: The nurse should identify that potential serious adverse effects of interferon beta-1b include unexplained bruising, bleeding, and fatigue. Clients should report these adverse effects to their provider immediately because they can indicate bone marrow suppression and decreased platelet count.

A nurse is providing teaching for a client who has a new prescription for vampiric acid to treat a seizure disorder. The nurse should instruct the client to monitor for which of the following adverse effects? -Hirsutism -Depression -Jaundice -Gum irritation

Jaundice. Rationale: Valporic acid can cause hepatic toxicity, 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 caring for a client who has been taking selegiline to treat Parkinson's disease. The provider is considering the use of analgesics for the client but should be aware that a drug interaction between selegiline and meperidine can result in which of the following? Frequent urination Jaundice Cellulitis Muscle rigidity

Muscle rigidity. Rationale: A drug interaction between selegiline and opioids, especially meperidine, can result in rigidity, stupor, agitation, hypertension, and fever.

A nurse is caring for a client who is taking donepezil to treat Alzheimer's disease. For which of the following adverse effects should the nurse monitor? -Confusion -Dry mouth -Nausea -Double vision

Nausea. Rationale: The most common adverse effects of donepezil, a cholinesterase inhibitor, are nausea, vomiting, and diarrhea. Taking donepezil with food can help minimize adverse effects. Most common AE: N/V, diarrhea

A nurse is preparing to administer sumatriptan for the first time. The nurse should instruct the client that sumatriptan is indicated for which of the following conditions? Tonic-clonic seizures Presence of a migraine headache Exacerbation of multiple sclerosis Alzheimer's Disease

Presence of a migraine headache. Rationale: Sumatriptan is used in the treatment of migraine headaches.

A nurse is teaching a client who received a prescription for interferon beta-1a for treatment of multiple sclerosis. Which of the following information should the nurse include? -Have kidney function tests done every month for a year -Take an extra dose if muscle aches occur -Store the drug at room temperature after mixing it -Administer the drug in your thigh or upper arm

"Administer the drug in your thigh or upper arm." Rationale: Interferon beta-1a is administered via the subcutaneous route. Therefore, the nurse should instruct the client how to perform subcutaneous injections for self-administration.

A nurse is teaching a client about interferon beta-1a. Which of the following instructions should the nurse give to help the client avoid the adverse effects of this drug? -Premedicate with acetaminophen -Take the drug with food -Increase your fluid intake -Take the drug in the morning

"Premedicate with acetaminophen." Rationale: Interferon beta drugs can cause fever, chills, headaches, and muscle aches. Acetaminophen can help minimize these symptoms.

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? -Change position slowly to prevent orthostatic hypotension -Eat a high-protein snack to increase absorption -Take the drug at bedtime to avoid daytime drowsiness -Expect eye twitching to develop with long-term therapy

Change positions slowly to prevent orthostatic hypotension. Rationale: Levodopa/carbidopa can cause orthostatic hypotension.

A nurse is teaching a client who has a new diagnosis of Parkinson's disease about how levodopa/carbidopa can help control symptoms. The nurse should identify that the drug has which of the following pharmacologic effects? -Increases available acetylcholine in the brain -Inhibits norepinephtine metabolism in the brain -Inhibits serotonin metabolism in the brain -Increases available dopamine in the brain

Increases available dopamine in the brain. Rationale: Levodopa/carbidopa, a dopaminergic agent, can increase dopamine in the extrapyramidal center of the brain, reducing involuntary motion, or tremors, associated with Parkinson's disease.

A nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle spasms. The nurse should identify that which of the following laboratory tests requires monitoring? -Serum potassium -Liver function -Serum sodium -Thyroid function

Liver function. Rationale: Liver toxicity is a serious adverse effect of dantrolene. The nurse should monitor the client's liver function prior to treatment and at regular intervals and advise the client to report jaundice or abdominal pain.

A nurse is administering fentanyl to a client to reduce pain. Which of the following drugs should the nurse have available to reverse the effects of fentanyl? -Neostigmine -Succinylcholine -Naloxone -Dantrolene

Naloxone. Rationale: Naloxone is an opioid antagonist that reverses the effects of opioids. Fentanyl, an opioid agonist, can cause severe respiratory depression. The nurse should also have resuscitation equipment available when administering fentanyl to a client.

A nurse is reviewing the medical record of a client who has a newly diagnoses seizure disorder and a new prescription for vampiric acid and phenytoin. The nurse should identify that which of the following can occur as a result of an interaction between these drugs? -Hyperammonemia -Phenytoin toxicity -Hypertension -Peptic ulcer disease

Phenytoin toxicity. Rationale: Vampiric acid can cause an increase in phenytoin blood levels, resulting in phenytoin toxicity. The nurse should monitor serum phenytoin levels and notify the provider if levels begin to exceed the therapeutic range.

A nurse is caring for a client who is receiving methohexital sodium. The nurse should monitor the client for which of the following adverse effects? -Cardiac excitability -Respiratory depression -Hyperthermia -Hypertension

Respiratory depression. Rationale: Methohexital, a short acting barbiturate, causes respiratory depression. Mechanical ventilation and continuous monitoring are essential for clients receiving this drug. depressant drug.

A nurse is caring for a client who has a new prescription for amphetamine sulfate. The nurse should monitor the client for which of the following adverse effects? Hypotension Tinnitus Tachycardia Bronchospasm

Tachycardia. Rationale: Amphetamine sulfate is an amphetamine stimulant. It can cause tachycardia and dysrhythmias. The client should notify the nurse if they develop palpitations or chest pain.

A nurse is teaching a client who has a prescription for modafinil to treat narcolepsy. Which of the following instructions should the nurse include? -Take the drug in the morning -Take the drug 30 minutes before bedtime -Anticipate daytime drowsiness -Expect urinary frequency

Take the drug in the morning. Rationale: Modafinil is a non amphetamine stimulant. Taking it in the morning helps improve wakefulness for clients who have narcolepsy. Clients taking the drug for shift-work sleepiness should take it 1 hr before work.

A nurse is caring for a client who has been taking amphetamine/dextroamphetamine sulfate for the treatment of ADHD for 2 weeks. The nurse should report which of the following findings to the provider? -Weight loss of 2.3 kg (5#) -BP 110.70 mm Hg -Apical pulse 80/min -Respiratory rate 16/min

Weight loss of 2.3 kg (5lb). Rationale: Amphetamine/dextroamphetamine sulfate can cause a decreased appetite and weight loss. The nurse should instruct the client to weigh themselves twice weekly and report unintended weight loss.