QUIZ 8 MS2 Chapter 14-18 Drugs Used for Parkinsons and SEIzure Dis0rder

The pediatric nurse is caring for a patient diagnosed with refractory seizures. The physician orders a ketogenic diet. When the child receives his food tray, the nurse should remove any food containing high levels of: a. fat. b. salt. c. carbohydrates. d. vitamin K.

C Carbohydrate

Which medication is used to control seizures or prevent migraine headaches? a. Topiramate (Topamax) b. Zonisamide (Zonegran) c. Valproic acid (Depakene) d. Tiagabine (Gabitril)

A topiramate [Topamax]

When a patient taking a monoamine oxidase B inhibitor receives his dietary tray, the nurse knows to remove the: a .cheese. b. eggs. c. bread. d. coffee.

A cheese

Which premedication assessment by the nurse is most important prior to the initiation of carbamazepine (Tegretol) therapy? a. Determine patients ancestry. b. Monitor blood pressure (BP) lying, sitting, and standing. c. Auscultate lung sounds. d. Obtain smoking history.

A determine patient ancestry

Patients taking phenytoin (Dilantin) for control of seizures must be aware of the risk for which adverse effect(s)? (Select all that apply.) a. Blood dyscrasias b. Hyperglycemia c. Urinary retention d. Gingival hyperplasia e. Insomnia f. Sedation

ANS: A, B, D, F blood dysplasia hyperglycemia gingivitis hyperplasia sedation

Parkinsons disease has which characteristic symptom(s)? (Select all that apply.) a.Muscle tremors b.Posture alterations c.Muscle flaccidity d.Tachycardia e.Slow body movement

ANS: A, B, E muscle tremors posture alteration slow body movements

What point(s) should be included when teaching a patient about the use of apomorphine for treatment of Parkinsons disease? (Select all that apply.) a. The restoration of function resulting from stimulation of dopamine receptors is permanent. b. Apomorphine may be administered intravenously for rapid relief. c. Apomorphine does not have any opioid activity. d. A multidose injector pen is commonly used to administer apomorphine. e. You may experience nausea and vomiting, which can be treated with trimethobenzamide (Tigan). f. You may experience sleep attacks or episodes of daytime sleepiness.

ANS: C, D, E, F c. Apomorphine does not have any opioid activity. d. A multidose injector pen is commonly used to administer apomorphine. e. You may experience nausea and vomiting, which can be treated with trimethobenzamide (Tigan). f. You may experience sleep attacks or episodes of daytime sleepiness.

Which cholinergic symptoms of Parkinsons disease are reduced with anticholinergic drugs? a.Cognitive impairments b.Rigidity c.Tremors and drooling d.Postural abnormalities

C tremors and drooling

What is the drug of choice when treating a generalized tonic clonic seizure? a. Diazepam (Valium) b. Haloperidol (Haldol) c. Valproic acid (Depakene) d. Risperidone (Risperdal)

C. Valporic acid( depakene)

What information would be most important for the nurse to provide to a patient when teaching about the adverse effects of succinimide therapy? a. Nausea, vomiting, and indigestion are common during the initiation of therapy. b. Avoid taking the medication with food or milk to minimize adverse effects. c. Sedation, drowsiness, and dizziness tend to worsen with continued therapy. d. Reducing the dosage of medication will relieve symptoms of nausea.

A Nausea, vomiting, and indigestion are common during the initiation of therapy.

What is the rationale for administering levodopa instead of dopamine for treatment of Parkinsons disease? a.Dopamine does not cross the bloodbrain barrier when administered orally. b.Levodopa is much less expensive. c.The half life of dopamine is too short. d.Dopamine has too many reactions with other medications

A.Dopamine does not cross the bloodbrain barrier when administered orally.

The nurse is preparing to begin administration of apomorphine to a patient. Before administering, the nurse will perform a baseline assessment of the patients: (Select all that apply.) a.mobility. b.orientation. c.intellectual ability. d.alertness. e.vital signs.

ANS: A, B, D, E mobility orientation alertness vital sign

The health care provider orders diazepam (Valium) 10 mg IV stat for a patient who was admitted with status epilepticus. What important nursing interventions(s) associated with administration of this medication IV should the nurse perform? (Select all that apply.) a. Apply a cardiac monitor to the patient to assess for continuous heart rate, if not already done. b. Administer the prescribed dosage over 1 minute. c. Mix diazepam in a primary IV solution to avoid overdosing. d. Continuously assess the patients airway. e. Obtain the correct dose (10 mg) and administer over slow IV push. ANS: A, D, E

ANS: A, D, E A.Apply a cardiac monitor to the patient to assess for continuous heart rate, if not already done. d.Continuously assess the patients airway. e.Obtain the correct dose (10 mg) and administer over slow IV push.

0. What dose is within the acceptable range for administering IV phenytoin (Dilantin) to a patient with a seizure disorder? a. 5 mg/min b. 30 mg/min c. 60 mg/min d. 100 mg/min

B 30mg/min

Which vitamin will reduce the therapeutic effects of levodopa? a. A b.B6 c.C d.D

B B6

The nurse is providing education to a patient recently prescribed pregabalin (Lyrica). Which statement by the patient indicates a need for further instruction? a. I may feel tired at first, but this should improve with continued use. b. Once my pain improves, I will stop taking this medication. c. Taking sleeping aids will increase the sedative effect of this medication. d. This drug may affect my mental alertness, so I need to be careful around machinery.

B Once my pain improves, I will stop taking this medication.

The nurse is providing discharge teaching to a patient prescribed phenytoin (Dilantin) for management of a seizure disorder. Which patient statement indicates a need for further teaching? a. I need to avoid or limit caffeine intake. b. I will check with the pharmacist before taking over the counter medication. c. If I develop enlarged gums, I will stop taking the medication. d. It is important for me to take my medicine at the same time daily.

C If I develop enlarged gums, I will stop taking the medication.

For which condition may carbamazepine (Tegretol) be used? a. Tardive dyskinesia b. Psychotic episodes c. Trigeminal neuralgia pain d. Sedation

C Trigeminal neuralgia pain

What is a guideline for the nurse when administering phenytoin (Dilantin) intravenously? a. Deliver rapidly. b. Monitor for signs of tachycardia. c. Assess for hypertensive crisis. d. Administer without mixing with other medications.

D Administer without mixing with other medications.

Which condition is associated with hydantoin therapy? a.Postictal state b.Atonia c.Seizure threshold reduction d.Gingival hyperplasia

D Gintival hyperplasia

The nurse is assessing an older patient with Parkinsons disease who was started on entacapone 1 week ago. The patient has a history of coronary artery disease and takes an antihypertensive and aspirin. Which information would support the need for a reduction in medication dosage by the health care provider? a.Constipation b.Brownish orange urine c.Drowsiness d.Dizziness

D dizziness

Which response by the nurse is accurate when a patient who has been on lamotrigine (Lamictal) for seizure control reports a skin rash and urticaria? a.Reassure the patient that this is a common adverse effect of the medication and not to worry. b.Instruct the patient to discontinue use of the drug immediately. c.Instruct the patient to decrease the dosage of the medication until the rash disappears. d.Advise the patient that this adverse effect usually resolves but should be reported to the health care provider.

D.Advise the patient that this adverse effect usually resolves but should be reported to the health care provider.

A patient taking rasagiline is assessed by the nurse to have a lasting significant increase in blood pressure. When reviewing the patients current list of medications, the nurse decides to hold the next dose of: a.dextromethorphan. b.levodopa. c.ciprofloxacin. d.Valium.

c. ciprofloxacin

Which adverse effects associated with levodopa therapy would support the nursing diagnosis Risk for injury? a.Nausea and vomiting b.Orthostatic hypotension c.Anorexia and depression d.Tachycardia and palpitations

B orthodontic hypertension

Which condition would indicate to the nurse that a patient has phenytoin (Dilantin) toxicity? a. Oculogyric crisis b. Nystagmus c. Strabismus d. Amblyopia

B nystagmus

The nurse is preparing discharge instructions for a patient with a history of diabetes who has just been diagnosed with seizure disorder. The patient has been prescribed hydantoin therapy. What will the patient most likely experience? a. Hunger b. Hyperglycemia c. Diarrhea d. Pupil dilation

B hyperglycemia

The nurse is teaching a patient with Parkinsons disease about levodopa. Which statement by the nurse is accurate regarding drug administration? a.Take this medication in between meals. b.Take this medication at bedtime to prevent dizziness. c.Take this medication when your tremors get worse. d.Take this medication with food or antacids to reduce GI upset.

D.Take this medication with food or antacids to reduce GI upset.

The nurse is preparing to administer zonisamide (Zonegran) to a newly admitted patient with the diagnosis of adult partial seizures. The nurse should hold this medication if the patient has which sign(s) or symptom(s)? (Select all that apply.) a. Skin rash b. Urinary frequency c. Drowsiness d. Allergy to Bactrim e. Pruritus

ANS: A, D, E skin allergy to Bactrim Pruritus

What is included in the nursing management of the patient with generalized tonic clonic seizure activity? (Select all that apply.) a. Restraining the patients arms to avoid further injury b. Placing padding around or under the patients head c. Attempting to insert a tongue depressor into the patients mouth d. Positioning the patient on the side once the relaxation stage is entered to allow oral secretions to drain e. Requesting additional assistance and/or necessary equipment in case the patient does not begin breathing spontaneously when the seizure is over

ANS: B, D, E Placing padding around or under the patients head Positioning the patient on the side once the relaxation stage is entered to allow oral secretions to drain Requesting additional assistance and/or necessary equipment in case the patient does not begin breathing spontaneously when the seizure is over

The nurse is providing information to a patient recently prescribed entacapone. Which statement is correct a.This medication is not to be taken with carbidopa levodopa. b.Dosage is adjusted according to the patients response. c.There will be fewer incidences of dopaminergic effects, such as confusion. d.This medication increases the production of dopamine in the brain.

B dosage adjusted according to the patient response

The nurse is providing education to a patient recently placed on selegiline disintegrating tablets. Which statement by the patient indicates a need for further teaching? a.This medication will help slow the development of symptoms. b.I will place the tablet on my tongue before breakfast. c.I may need to use a stool softener for constipation. d.I should not push the tablet through the foil.

B i will place the tablet on my tongue before breakfast.

What is the pharmacologic action of entacapone, a potent catechol O methyl transferase (COMT) inhibitor? a.Slows the deterioration of dopaminergic nerve cells b.Inhibits the relative excess of dopaminergic activity c.Reduces the destruction of dopamine in peripheral tissues d.Enhances the cholinergic symptoms of Parkinsons disease

C reduce distraction of dopamine in peripheral tissues

Dopamine agonists have been linked with which adverse effects in patients with Parkinsons disease? a.Oculogyric crisis b.Tardive dyskinesia c.Sudden sleep events d.Akathisia

C sudden sleep events