WEEK 12 [ADN 210] "Pharmacotherapy of Emotional and Mood Disorders"

When evaluating the effectiveness of muscle​ relaxants, which outcomes are ​expected? Select all that apply. A. Limited adverse effects B. Range of motion maintained C. Pain relief D. Improved ability to perform ADLs E. Client compliance with treatment

A. Limited adverse effects C. Pain relief D. Improved ability to perform ADLs E. Client compliance with treatment

The nurse is administering medications to older adult clients in a​ long-term care facility. Which does the nurse identify as a physiologic change affecting drug ​therapy? Select all that apply. A. Loss of muscle cells B. Increased amount of body fat C. Loss of skin tone and elasticity D. Decreased gastric mobility E. Less efficient blooddash-brain barrier

A. Loss of muscle cells B. Increased amount of body fat D. Decreased gastric mobility E. Less efficient blooddash-brain barrier

"You may experience suicidal thoughts while taking this medication." "Inform your health care provider immediately if you become pregnant while taking this medication."

An antidepressant has been prescribed for a young female adult client with depression. What would the nurse include when providing education to this client regarding her medication?

What factors help determine the health care provider​'s choice of anticonvulsant for a client with ​seizures? Select all that apply. A. Current diet B. Other diseases currently present C. Type of seizure D. Medical history E. Clinical manifestations of seizure activity

B. Other diseases currently present C. Type of seizure D. Medical history E. Clinical manifestations of seizure activity

SSRIs are considered effective in the management of depression (drug of choice). Therapy with an SSRI offers clients a quick response time to feel results. Most SSRIs have a good safety record. Fewer side effects occur with SSRIs than with TCAs.

The nurse is discussing a change to a selective serotonin reuptake inhibitor (SSRI) with an adult client who has been depressed. What are the advantages of using SSRI therapy for depression?

Amphetamines

The nurse is discussing medications that are often prescribed for children with newly diagnosed attention deficit/hyperactivity disorder (ADHD). What is the most common class of medication used to treat ADHD?

Acetylcholine

The nurse is discussing pharmacotherapy for Alzheimer disease with a group of student nurses. Low levels of which neurotransmitter are seen in individuals with Alzheimer disease?

Headache Dizziness Insomnia Muscle cramps

The nurse is discussing the drug donepezil hydrochloride (Aricept) with the family of an adult client who has Alzheimer disease. Which side effects will the nurse explain to the family?

Get regular exercise.

The nurse is educating a client with insomnia about good sleep habits. Which item would the nurse include in the teaching session?

Blocking acetylcholine effects Restoring dopamine levels

The nurse is investigating drugs used to treat Parkinson disease. Which are target actions of pharmacotherapy used to treat clients with Parkinson disease?

"He is hyperactive one minute and in a deep sleep the next minute."

The nurse is performing an admission assessment on a client with a diagnosis of schizophrenia. Which statement by a family member best correlates with the diagnosis?

History of frequent heartburn and dysphagia

The nurse is performing an assessment on a client who has been taking aripiprazole (Abilify). Which assessment finding warrants health care provider notification?

Clozapine (Clozaril)

The nurse is planning a post-conference seminar for a group of nursing students on atypical antipsychotic medication. Which medication would the nurse include in the teaching plan?

Symptoms of AD are progressive. Medications may decrease symptoms, but there is no cure for AD. Medications may be taken with food. Dry mouth is an expected symptom and will almost inevitably occur.

The nurse is planning teaching for the client and family. Which information will the nurse include for the client diagnosed with Alzheimer disease (AD)?

The goal of treatment is to allow maintenance of normal activity and self-care.

The nurse is preparing a teaching plan for clients with a diagnosis of schizophrenia and their family members. Which instruction would be included in the teaching plan?

Alcohol or substance abuse History of thyroid dysfunction Family history of depression Current prescription and nonprescription medications

The nurse is providing care for several clients in the clinic with mood disorders. When assessing these clients, the nurse should be aware of what underlying conditions that may contribute to a mood disorder?

Typical onset is between ages 40 and 70. Men are more prone to the disease than women. It can be idiopathic. Parkinson disease can be secondary to another disease, injury, or trauma.

The nurse is researching Parkinson disease before assessing the next client on the office schedule. What information correctly describes this neurological disease?

Natalizumab (Tysabri) Interferon beta-1b (Betaseron) Interferon beta-1a (Avonex) Glatiramer acetate (Copaxone)

The nurse is reviewing medications with an adult client diagnosed with MS. Which medications may be prescribed for young adult clients with MS?

Therapy with TCAs cannot be stopped abruptly.

The nurse is reviewing the tricyclic antidepressant (TCA) prescribed for an adult client with depression. What information is important to know regarding this class of medication?

Signs of seizure activity Reports of sexual dysfunction Bowel habits Vital signs

The nurse is working in a residential treatment center for adults with mood disorders. What should the nurse monitor in adult clients who are receiving antidepressants?

Social anxiety disorder

The nurse is working with a client who has a fear of speaking in front of an audience. The nurse anticipates a diagnosis of what type of anxiety disorder for this client?

1 week

The nurse observes that the newly admitted adult client is talkative and appears to be excessive in both her conversation and actions. How long must an adult client appear manic before a diagnosis and treatment plan are usually initiated?

Slowing the disease process Managing exacerbations Managing symptoms

The nurse recognizes symptoms of multiple sclerosis in a young adult client. What will pharmacologic treatment of this client focus on?

Dopamine

The nurse teaches a client that an insufficient amount of a particular neurotransmitter exists in the brains of people who have Parkinson disease. Which neurotransmitter is insufficient

Report any increase in symptoms. Medications may alter blood pressure, so change positions slowly. Do not take levodopa (Larodopa) with food. When taking anticholinergics, do not take an antihistamine.

The nurse is caring for a client who has Parkinson disease. The nurse is planning the teaching she will provide to the client and his family. Which information would be important to include in the teaching regarding pharmacotherapy for Parkinson disease?

Temazepam (Restoril)

The nurse is caring for a client who has been diagnosed with insomnia. Which medication does the nurse anticipate will be prescribed for this client?

Mania Depression Chronic pain

The nurse is caring for a client who has been diagnosed with long-term insomnia. Which factors found in the medical record support this diagnosis?

Antidepressant

The nurse is caring for a client who has been prescribed a selective serotonin reuptake inhibitor (SSRI) for the treatment of anxiety. The nurse teaches the client that this type of medication belongs to what class of drugs?

Generalized anxiety disorder (GAD)

The nurse is caring for a client who has been prescribed duloxetine hydrochloride (Cymbalta). Which anxiety disorder does the nurse anticipate that this client is most likely experiencing?

Chronic obstructive pulmonary disease (COPD) Acute pain Cirrhosis

The nurse is caring for a client who has been prescribed phenobarbital sodium (Luminal) for the treatment of insomnia. Which items in the medical history would make this medication contraindicated for this client?

Assess for signs of confusion

The nurse is caring for a client who is being treated for anxiety. Which strategy should the nurse use to assess the client's neurologic status?

Gastrointestinal

The nurse is caring for a client who is experiencing severe anxiety. The nurse educates the client that severe anxiety can likely adversely affect which body system?

Hallucination

The nurse is caring for a client with psychotic behaviors. The client states, "I see snakes crawling down from the ceiling." Which term best describes what the client is experiencing?

"Do you use any herbal products?" "What over-the-counter medications do you take on a regular basis?" "What prescriptions do you currently take?"

The nurse is collecting a health history from a client who is being treated for insomnia. The nurse is currently addressing medications that the client uses. Which questions are appropriate to include in a medication history?

The appropriate dose When to take the medication When to notify the health care provider regarding complications What adverse effects may occur from taking the medication

The nurse is constructing the plan of care for a client who is being treated for anxiety. What teaching points should the nurse include when educating the client about medication administration?

Puts his car keys in the freezer Consistently forgets to pay bills

The nurse is discussing Alzheimer disease with the wife of a newly admitted older adult male. The nurse explains that the symptoms of Alzheimer disease usually develop slowly, and gradually worsen over time. Which behaviors indicate common symptoms in the early stage of Alzheimer disease?

What condition is contraindicated for the use of​ nonphenothiazines? Seizure disorders Liver disease Renal disease Diabetes

Seizure disorders

A client has an order for heparin​ 3,000 units subcutaneous injection every 12 hours. The medication is available at​ 5,000 units/mL vials. What amount will the nurse​ administer? ______ mL

0.6

A health care provider has ordered a client to receive dexamethasone sodium phosphate​ (Decadron) 2 mg IV push stat for treatment of cerebral edema. The available vial label​ reads: 4​ mg/mL. Using the formula​ method, the nurse would prepare _____ mL

0.5

The client is to receive dexamethasone sodium phosphate​ (Decadron) 2 mg IV push stat for treatment of cerebral edema. The available vial label​ reads: 4​ mg/mL. What amount should the nurse should prepare to​ administer? _____ mL

0.5

The health care provider orders​ aluminum/magnesium antacid liquid 150 mg to be administered by mouth. The medication from the​ client's supply is 100 mg per 10 mL. The nurse would administer _____ ​ounce(s). Please limit your answer to a numeral.

0.5

Stages of Alzheimer Diseases: -Personality changes -Depression -Incontinence -Failure to pay bills -Inability to recall names of acquaintances -Forgetting location of common items -Sundowning syndrome -Weight loss -Difficulty providing​ self-care -Agitation -Inability to recognize self -Irritability -Inability to recall recent events -Inability to walk -Disorientation to​ time, persons, or places -Inability to recognize family members

-Middle -Early -Late -Early -Middle -Early -Late -Early -Middle -Early -Late -Early -Middle -Late -Middle -Late

Shallow or absent respirations Client may appear clumsy Found most often in children Brief loss of motor control Called grand mal Client may fall for no reason Characterized by staring Loss of consciousness Called petit mal

-Tonic-Clonic -Atonic -Absence -Atonic -Tonic-Clonic -Atonic -Absence -Tonic-Clonic -Absence

The nurse is providing education to a client who has been prescribed a muscle relaxant. Which substance should the client avoid while on this type of​ medication? A. Alcohol B. ​Over-the-counter (OTC) pain medication C. Sodium D. Tobacco

A. Alcohol

Which condition represents an increased risk for ​osteoarthritis? Select all that apply. A. Being postmenopausal B. Overproduction of PTH C. Rheumatic fever D. Low levels of vitamin D E. Overweight

12.1 remmebr

A nurse is preparing to administer a continuous intravenous​ (IV) infusion. Arrange the steps of the procedure in the correct sequence to ensure safe administration of medication.

1st Check the IV fluid label against the medication administration record (MAR). 2nd Verify the client's name and allergies. 3rd Check IV access for patency per policy. 4th Connect the primed IV line to the client's IV access. 5th Set the infusion pump per the IV infusion order. 6th Document administering the medication.

Which medications become less effective when taken with phenytoin ​(Dilantin)? Select all that apply. A. Corticosteroids B. Oral contraceptives C. Warfarin sodium​ (Coumadin Sodium) D. Aspirin​ (Bayer) E. Ibuprofen​ (Advil)

A. Corticosteroids B. Oral contraceptives C. Warfarin sodium​ (Coumadin Sodium)

A nurse is preparing to administer an oral medication to the client. Prioritize the​ nurse's actions for safe medication administration by placing the steps in order.

1st Check the medication order against the medication administration record (MAR). 2nd Check the medication label against the medication administration record (MAR). 3rd Check the client's name and date of birth. 4th Check for client allergies to the medication. 5th Give the medication to the client with a glass of water. 6th Document administering the medication.

A client has been prescribed divalproex sodium​ (Depakote) 500 mg by mouth two times a day. The​ client's medication bin contains unit dose of Depakote​ delayed-release tablets labeled 250​ mg/tablet. How many tablets should the nurse administer for one​ dose? _________ tablets

2

A client has been prescribed ondansetron​ (Zofran) 8 mg PO 30 minutes prior to chemotherapy. The available vial label​ reads: 4​ mg/mL. Using the​ ratio/proportion method, the nurse would prepare ___ mL of the medication.

2

A client is to receive vancomycin 250 mg PO every 6 hours for treatment of C. difficile. Available from the pharmacy are 125 mg capsules. Using the fractional equation​ method, the nurse would prepare ____ capsule(s) per dose of the medication.

2

The nurse is to administer methylprednisolone sodium succinate​ (Solu-Medrol) for a client with acute spinal cord injury. The initial dosage is 30​ mg/kg IV over 15 min. The client weighs 165 pounds. The nurse should prepare how much of the drug for this initial​ dose? _____ mg

2, 250

The nurse is evaluating​ quality, safe care. Which nursing practice predisposes the client to the greatest chance of​ injury? A. Crushing of an​ extended-release medication B. Inadequate flushing of a nasogastric​ (NG) tube after medication administration C. Clients with dysphagia receiving medication sprinkled over food or put in liquid D. Administering drugs by the intranasal route

A. Crushing of an​ extended-release medication

The nurse is to administer Vancomycin 125 mg orally every 6 hours. Available is an oral solution of the drug at 250​ mg/5 mL. How much should the nurse prepare for each​ dose? ______ mL

2.5

Donald Frank is a​ 58-year-old White diabetic client who is prescribed gabapentin​ (Neurontin) 1,800 mg per day to take by mouth in 3 divided doses. The client has 200 mg tablets. The nurse will instruct the client to take _____ tablets with each meal.

3

Increased risk for suicide High suicidal tendency Poor adherence to medical therapy

The nurse is assessing an adult client who has newly diagnosed bipolar disorder. What aspects of bipolar disorder are significantly different from other depressive states?

A hospitalized client is taking phenytoin​ (Dilantin) 100 mg orally twice a day. Available is a suspension of the medication as​ 125mg/5mL. How much should the nurse administer per​ dose? ________ mL

4

Administer ordered benztropine mesylate (Cogentin).

A client is exhibiting symptoms of acute dystonia. Which initial nursing action is most appropriate

Hallucinations Disorganized speech patterns Delusional thoughts

A client is having positive symptoms of schizophrenia. Which clinical manifestations would the nurse expect the client to exhibit?

Symptoms of acute renal failure

A client who is taking antipsychotic drugs is experiencing all of the following clinical manifestations. Which one would require the nurse to notify the health care provider?

Cardiovascular impairment Pregnancy Diabetes mellitus Renal disease

A nurse who is working in the psychiatric clinic observes that lithium (Eskalith) has been prescribed for many of the clients. Clients with which conditions should be monitored closely when taking lithium?

The nurse is discussing the drug donepezil hydrochloride​ (Aricept) with the family of an adult client who has​ Alzheimer's disease. Which side effects will the nurse explain to the ​family? Select all that apply. A. Headache B. Muscle cramps C. Dizziness D. Insomnia E. Increased appetite

A. Headache B. Muscle cramps C. Dizziness D. Insomnia

The nurse is discussing pharmacotherapy for​ Alzheimer's disease with a group of student nurses. Low levels of which neurotransmitter are seen in individuals with​ Alzheimer's disease? A. Acetylcholine B. Glutamate C.Norepinephrine D. Dopamine

A. Acetylcholine

​Thirteen-year-old Ricky Coleman and his family came to your clinic after Ricky fell on the baseball field and twisted his ankle. The ankle is swollen and he cannot put weight on it. Ricky also has scratches and sunburn on his forearms. He complains that he​ didn't have time to eat much today and is very hungry. Ricky also says he feels a little​ light-headed. What is your nursing diagnosis of first​ priority? A. Activity intolerance related to twisted ankle and acute ankle pain B. Nutrition imbalance less than body​ requirements, related to overactivity C. Potential for skin​ breakdown, related to sunburn D. Electrolyte imbalance

A. Activity intolerance related to twisted ankle and acute ankle pain

When assessing your client​'s past drug​ history, what information should you ​record? Select all that apply. ​A. Adverse/side effects of any drugs B. Allergic reactions C. Tobacco and alcohol use D. OTC medications taken E. Client​'s medication questions

A. Adverse/side effects of any drugs B. Allergic reactions C. Tobacco and alcohol use D. OTC medications taken

The nurse is providing care to a​ 27-year-old client admitted with epilepsy. A student nurse is also working with this nurse and client. The student nurse is assessing the client prior to administering an antiseizure medication. Which nursing actions are appropriate for this ​client? Select all that apply. A. Assess for any drug allergies. B. Teach the client to ask for help with ambulation to prevent a fall or injury. C. Review the medication orders and clarify any orders that are not clear. D. Give all medications via intravenous access​ (IV). E. Correctly identify the client using at least two sources of identification.

A. Assess for any drug allergies. B. Teach the client to ask for help with ambulation to prevent a fall or injury. C. Review the medication orders and clarify any orders that are not clear. E. Correctly identify the client using at least two sources of identification.

Which categories of antiseizure medication have a mechanism of action that enhances the action of GABA in the ​brain? Select all that apply. A. Benzodiazepines ​B. Hydantoin-like medications C. Succinimides D. Hydantoins E. Barbiturates

A. Benzodiazepines E. Barbiturates

Which statements are accurate regarding the use of ​bisphosphonates? Select all that apply. A. Bisphosphonates are the drug of choice for osteoporosis. B. Following administration of​ bisphosphonates, the client must remain upright for 30 to 60 minutes. C. If GI upset​ occurs, bisphosphonates can be taken with calcium carbonate​ (Tums). D. When administered for bone​ metastasis, bisphosphonates can shrink the tumors. E. Before initiating treatment with​ bisphosphonates, the client should be assessed for hypocalcemia.

A. Bisphosphonates are the drug of choice for osteoporosis. B. Following administration of​ bisphosphonates, the client must remain upright for 30 to 60 minutes. E. Before initiating treatment with​ bisphosphonates, the client should be assessed for hypocalcemia.

Which substances help maintain calcium balance in the ​body? Select all that apply. A. Calcitonin B. Thyroxine C. Vitamin D D. Parathyroid hormone E. Cholesterol

A. Calcitonin C. Vitamin D D. Parathyroid hormone

A nurse is preparing to administer a medication for a client. Which of the following actions should the nurse take prior to administering the​ medication? A. Check the client​'s chart for any allergies. B. Administer a buccal medication on the chest area. C. Administer the medication provided by the family. D. Administer the medication with applesauce.

A. Check the client​'s chart for any allergies.

A nurse is preparing to administer an intravenous medication to a client. Which of the following assessments should the nurse conduct prior to administering the ​medication? Select all that apply. A. Check the client​'s most recent vital signs. B. Spike the bag of intravenous medication. C. Check the chart for the client​'s past medications. D. Assess the client​'s understanding of the medication. E. Inspect and palpate IV insertion site.

A. Check the client​'s most recent vital signs. C. Check the chart for the client​'s past medications. D. Assess the client​'s understanding of the medication. E. Inspect and palpate IV insertion site.

What class of drugs is most frequently prescribed for the treatment of​ Alzheimer's disease? A. Cholinesterase inhibitors B. Anticholinergics C. Atypical antipsychotics D. Dopaminergics

A. Cholinesterase inhibitors

Which clients would the nurse identify as being at risk for decreased calcium absorption and ​hypocalcemia? Select all that apply. A. Client with chronic diarrhea and irritable bowel syndrome​ (IBS) B. Client who follows a​ low-fat diet C. Client with vitamin D deficiency D. Client with chronic renal disease E. Client with decreased gastric acidity

A. Client with chronic diarrhea and irritable bowel syndrome​ (IBS) C. Client with vitamin D deficiency D. Client with chronic renal disease E. Client with decreased gastric acidity

Which statements about the effects of ibandronate​ (Boniva) are ​accurate? Select all that apply. A. Clients taking ibandronate​ (Boniva) should be instructed to immediately report muscle spasm and twitching. B. Ibandronate​ (Boniva) is approved for the prophylaxis of postmenopausal osteoporosis. C. Ibandronate​ (Boniva) can be administered to men to treat osteoporosis. D. Ibandronate​ (Boniva) can cause dyspepsia. E. Ibandronate​ (Boniva) is the bisphosphonate that is used to treat Paget disease.

A. Clients taking ibandronate​ (Boniva) should be instructed to immediately report muscle spasm and twitching. B. Ibandronate​ (Boniva) is approved for the prophylaxis of postmenopausal osteoporosis. D. Ibandronate​ (Boniva) can cause dyspepsia.

What are key aspects of the nurse​'s evaluation of pharmacotherapy for clients with​ Parkinson's disease,​ Alzheimer's disease, and multiple​ sclerosis? Select all that apply. A. Client​'s mood and affect B. Client​'s appetite and weight status C. Caregiver strain and resources D. Client​'s ability to perform ADLs E. Improvement or worsening of symptoms

A. Client​'s mood and affect C. Caregiver strain and resources D. Client​'s ability to perform ADLs E. Improvement or worsening of symptoms

The nurse has specific responsibilities when administering medications to the client with a degenerative disorder of the central nervous system. Before administering​ medications, what assessments does the nurse ​do? Select all that apply. A. Complete a thorough health history. B. Provide meals during an assessment. C. Assess baseline cognitive status. D. Assess the client​'s baseline muscle strength. E. Assess baseline vital signs.

A. Complete a thorough health history. C. Assess baseline cognitive status. D. Assess the client​'s baseline muscle strength. E. Assess baseline vital signs.

Which of the following are physiological changes in the older adult that affect medication ​administration? Select all that apply. A. Decreased number of​ protein-binding sites B. Decreased gastric motility and decreased gastric acid production C. Decreased adipose tissue proportionate to the body mass D. Administration of multiple medications E. Increased liver and kidney function

A. Decreased number of​ protein-binding sites B. Decreased gastric motility and decreased gastric acid production

JoAnn White and her​ husband, James, visit the health care provider because her urinary and fecal incontinence has increased since her last appointment. Mrs. White is also more agitated at night and does not sleep well. As the​ nurse, you explain to Mr. White that his wife​ is: A. Demonstrating symptoms associated with​ late-stage Alzheimer's disease with sundowning syndrome B. Demonstrating a tolerance to her​ medications, which will require a dose adjustment by the health care provider C. Experiencing an exacerbation of​ Alzheimer's disease and needs to be placed in a nursing home D. Suffering adverse effects of her donepezil​ (Aricept) prescription, which should be stopped immediately

A. Demonstrating symptoms associated with​ late-stage Alzheimer's disease with sundowning syndrome

The nurse teaches a client that an insufficient amount of a particular neurotransmitter exists in the brains of people who have​ Parkinson's disease. Which neurotransmitter is​ insufficient? A. Dopamine B. Epinephrine C. Magnesium D. Serotonin

A. Dopamine

Which nonpharmacologic treatment is commonly used to manage​ spasticity? A. Exercise B. Complete bed rest C. Traction D. Surgery

A. Exercise

Which bones are most often affected by Paget ​disease? Select all that apply. A. Femur and tibia B. Vertebrae C. Metacarpals D. Pelvic E. Humerus

A. Femur and tibia B. Vertebrae D. Pelvic

The nurse is reviewing the medical records for an older adult woman who has just been admitted to the​ long-term care facility. Which of the client​'s ​over-the-counter medications should be classified as herbal ​supplements? Select all that apply. A. Feverfew B. St. John​'s wort C. Valerian root D. Ginkgo biloba E. Glucosamine

A. Feverfew B. St. John​'s wort C. Valerian root D. Ginkgo biloba

What are possible contraindications for taking herbal ​supplements? Select all that apply. A. Food or drug allergies B. Prescribed medications C. Breastfeeding D. Acupuncture treatment E. Pregnancy

A. Food or drug allergies B. Prescribed medications C. Breastfeeding E. Pregnancy

The nurse is reviewing medications with an adult client diagnosed with MS. Which medications may be prescribed for young adult clients with ​MS? Select all that apply. A. Glatiramer acetate​ (Copaxone) B. Interferon​ beta-1a (Avonex) C. Interferon​ beta-1b (Betaseron) D. Natalizumab​ (Tysabri) E. Dopamine

A. Glatiramer acetate​ (Copaxone) B. Interferon​ beta-1a (Avonex) C. Interferon​ beta-1b (Betaseron) D. Natalizumab​ (Tysabri)

Your​ client, Mr. Dan​ Lee, is a retired older adult who takes multiple medications for multiple health​ issues, including onset of dementia. He lives with his son and​ daughter-in-law, who are very supportive. As his​ nurse, what do you recognize about Mr.​ Lee? A. He is a likely candidate for drug noncompliance. B. He should ask his family to monitor his drug compliance. C. He should be taught the various benefits of drug therapy. D. He needs to create a daily administration schedule.

A. He is a likely candidate for drug noncompliance.

Geneva​ Billings, age​ 45, is admitted to the hospital after reporting that her stools have changed to a​ "funny clay​ color" and her eyes look yellow. She has a history of multiple sclerosis and takes several medications for pain relief and muscle spasms. As the​ nurse, what condition do you​ suspect? A. Hepatotoxicity B. Medication overdose C. Normal anticholinergic effects D. Renal impairment

A. Hepatotoxicity

Which adverse effects are associated with raloxifene hydrochloride ​(Evista)? Select all that apply. A. Hot flashes B. Weight gain C. Hypocalcemia D. Leg cramps E. Increased serum cholesterol

A. Hot flashes B. Weight gain D. Leg cramps

The nurse is caring for a client who will receive botulinum toxin type A​ (Botox). The nurse educates the client that this medication can be administered by which ​routes? Select all that apply. A. IM B. ID C. PO D. SC E. IV

A. IM B. ID D. SC

What are reasons for changes in a pregnant client​'s pharmacokinetic response to ​drugs? Select all that apply. A. Increased estrogen levels affect the stomach​'s hydrochloric acid production. B. Decreased gastric emptying may occur. C. Blood flow through the kidneys decreases. D. Plasma proteins are diluted and less able to bind with a drug. E. The drug metabolism rate increases with physiological changes.

A. Increased estrogen levels affect the stomach​'s hydrochloric acid production. B. Decreased gastric emptying may occur. D. Plasma proteins are diluted and less able to bind with a drug. E. The drug metabolism rate increases with physiological changes.

A client at your​ clinic, Jamilla​ Johnson, has been taking phenobarbitol​ (Luminal) for her seizure disorder for many years. Which adverse​ effect(s) should you monitor Ms. Johnson for when she visits the​ clinic? A. Increased tolerance of drug over time B. Problems falling asleep and sleep apnea C. Gingival hyperplasia and plaque buildup D. Cerebrovascular accident and anemia

A. Increased tolerance of drug over time

The nurse is reviewing the lab values of a client who is taking a muscle relaxant. The lab values indicate possible hepatotoxicity. What assessment findings would support this lab ​result? Select all that apply. A. Itching B. ​Clay-colored stools C. Abdominal distention D. Decreased urine output E. Jaundice

A. Itching B. ​Clay-colored stools C. Abdominal distention E. Jaundice

For what condition does a client take the dietary supplements glucosamine and​ chondroitin? A. Joint pain from arthritis B. Hypertension C. Hyperglycemia D. Vision improvement

A. Joint pain from arthritis

The nurse is reviewing the principles of learning drugs with a new colleague who is providing care on the​ medical-surgical unit. Which strategy is the best to use for learning​ medications? A. Learn the prototypical drugs B. Learn each drug individually C. Learn only the generic names of each drug D. Learn only the brand names of each drug

A. Learn the prototypical drugs

The nurse at a clinic has been asked to review complementary and alternative medicine​ (CAM) therapies to incorporate into client care. Which is considered ​CAM? Select all that apply. A. Meditation practices B. Yoga C. Aromatherapy D. Massage E. Aerobic exercise

A. Meditation practices B. Yoga C. Aromatherapy D. Massage

The nurse on a​ medical-surgical unit is busy assessing newly admitted clients. Which client conditions or medical diagnoses indicate that a client may experience a​ seizure? Select all that apply. A. Meningitis in a​ 4-year-old child B. Fever of undetermined origin​ (FUO), 103.5degrees°F ​(rectal) ​(40degrees°​C), for past 2 hours in a toddler C. Abdominal​ pain, diarrhea, fever of 100degrees°F ​(38.1degrees°​C), ​nausea, vomiting, and reduced appetite in an otherwise healthy​ 24-year-old female D. Abnormally high glucose level and a​ 33-year history of type 1 diabetes E. Multiple trauma and a closed head injury as a result of a motor vehicle crash​ (MVC)

A. Meningitis in a​ 4-year-old child B. Fever of undetermined origin​ (FUO), 103.5degrees°F ​(rectal) ​(40degrees°​C), for past 2 hours in a toddler D. Abnormally high glucose level and a​ 33-year history of type 1 diabetes E. Multiple trauma and a closed head injury as a result of a motor vehicle crash​ (MVC)

A nurse is preparing to administer medications to a client. Which of the following medication orders would warrant a call from the nurse to the health care ​provider? Select all that apply. A. Morphine 4 mg IV for pain B. Furosemide 40 mg orally now C. Heparin​ 5,000 units subcut bid D. Guaifenesin syrup orally at bedtime E. Aspirin 81 mg once daily

A. Morphine 4 mg IV for pain D. Guaifenesin syrup orally at bedtime E. Aspirin 81 mg once daily

Medications prescribed for multiple sclerosis​ (MS) are often injected. What information would the nurse provide when administering medications to a client with​ MS? A. Pain and redness may occur at the injection site. B. There is no need to report signs of infection. C. Urine may have an orange tint. D. All medications may be stored at room temperature.

A. Pain and redness may occur at the injection site.

Inflated self-esteem Decreased need to sleep or eat Increased psychomotor activity Hallucinations or delusions

The nurse is assessing an adult client with a diagnosis of bipolar disorder. Which symptoms are characteristics of mania?

Which of the following statements are true regarding medication administration and genetic and cultural ​factors? Select all that apply. A. Pharmacogenetics can vary by race or ethnic group. B. Ethnopharmacology is the study of the genetic ability to produce enzymes that affect drug metabolism. C. Pharmacogenetics is the study of the genetic ability to produce enzymes that affect drug metabolism. D. Pharmacogenetics are always the same between all races and ethnic groups. E. Ethnopharmacology is the study of the effect of racial and ethnic differences and responses to prescribed medications.

A. Pharmacogenetics can vary by race or ethnic group. C. Pharmacogenetics is the study of the genetic ability to produce enzymes that affect drug metabolism. E. Ethnopharmacology is the study of the effect of racial and ethnic differences and responses to prescribed medications.

Pharmacotherapy for​ Parkinson's disease is centered on treating its symptoms. What are the symptoms of​ Parkinson's ​disease? Select all that apply. A. Postural instability B. Seizures C. Tremors D. Bradykinesia E. Muscle rigidity

A. Postural instability C. Tremors D. Bradykinesia E. Muscle rigidity

The nurse is performing an admission assessment on a client with several newly prescribed medications. Which information is most important to communicate to the health care​ provider? A. Presence of renal damage B. ​Client's occupation as a furniture mover C. Breast biopsy 3 weeks prior to admission D. Blood pressure reading of​ 128/70 mmHg

A. Presence of renal damage

What type of community health nurse would most likely teach about contraception and sexually transmitted​ diseases? Select all that apply. A. Public health nurse B. School nurse C. Assisted living facility nurse D. Home care nurse E. Hospice nurse

A. Public health nurse B. School nurse

The nurse is admitting a new​ 7-year-old male client with a diagnosis of epilepsy. Which actions by the nurse would be ​contraindicated? Select all that apply. A. Restrain the​ child's arms and legs. B. If the child has a​ seizure, slide a tongue blade or spoon into the child​'s mouth between the teeth. C. Protect the​ child's head during a seizure. D. Position the client on his side. E. Pad the side rails and remove clutter from the bedside.

A. Restrain the​ child's arms and legs. B. If the child has a​ seizure, slide a tongue blade or spoon into the child​'s mouth between the teeth.

Alzheimer disease

The nurse is assessing an older adult client with dementia. What is the most common cause of dementia in adults?

Immunomodulators are most commonly administered by what​ route? A. SC B. IM C. IV D. PO

A. SC

The nurse teaches the client and his wife the adverse effects of and most common problems associated with taking phenytoin​ (Dilantin) to treat epilepsy. These two common problems are gingival hyperplasia​ (swelling of the​ gums) and maintaining therapeutic levels rather than toxic levels of the drug. Which responses include actions that the client needs to take to counteract these ​problems? Select all that apply. A. Schedule and keep routine dental examinations and practice good oral hygiene and gum care. B. Monitor vital signs before and after each dose of phenytoin​ (Dilantin). C. Have serum phenytoin​ (Dilantin) levels monitored routinely. D. Do not take phenytoin​ (Dilantin) with grapefruit juice. E. Medication must be taken with food.

A. Schedule and keep routine dental examinations and practice good oral hygiene and gum care. C. Have serum phenytoin​ (Dilantin) levels monitored routinely.

What characteristics are associated with status ​epilepticus? Select all that apply. A. Serious condition that may occur during seizure activity B. Continued seizure activity for 30 minutes or more C. Repetitive seizure activity with no return to consciousness between seizures D. A class of seizures that can result in brain damage E. Repetitive seizure activity without loss of consciousness

A. Serious condition that may occur during seizure activity B. Continued seizure activity for 30 minutes or more C. Repetitive seizure activity with no return to consciousness between seizures

What symptoms are associated with​ Parkinson's ​disease? Select all that apply. A. Shuffling gait B. Stooped posture C. Intermittent motion or shaking at rest D. Uncontrollable arm movement while walking E. Difficulty with swallowing and chewing

A. Shuffling gait B. Stooped posture C. Intermittent motion or shaking at rest E. Difficulty with swallowing and chewing

What characteristics put infants and young children at a higher risk for drug​ toxicity? Select all that apply. A. Slower rate of gastric emptying B. A higher proportion of fat to water C. Immature liver function D. Strong gastric acids E. Immature kidney function

A. Slower rate of gastric emptying C. Immature liver function E. Immature kidney function

The nurse recognizes symptoms of multiple sclerosis in a young adult client. What will pharmacologic treatment of this client focus ​on? Select all that apply. A. Slowing the disease process B. Reversing demyelination C. Managing exacerbations D. Managing symptoms E. Curing the disorder

A. Slowing the disease process C. Managing exacerbations D. Managing symptoms

A nurse is preparing to administer medications to a client via a nasogastric tube. Which of the following nursing interventions are ​appropriate? Select all that apply. A. Stop the feeding for 30 to 60 min before administering medications that are not compatible with the enteral feeding. B. Maintain the client​'s position 60 min following medication administration. C. Crush a sustained release medication to a very fine powder and mix well with water. D. Flush the nasogastric tube with 30 mL of water following drug administration. E. Check for placement by aspirating content and verifying pH prior to administration.

A. Stop the feeding for 30 to 60 min before administering medications that are not compatible with the enteral feeding. B. Maintain the client​'s position 60 min following medication administration. D. Flush the nasogastric tube with 30 mL of water following drug administration. E. Check for placement by aspirating content and verifying pH prior to administration.

The nurse is planning teaching for the client and family. Which information will the nurse include for the client diagnosed with​ Alzheimer's disease ​(AD)? Select all that apply. A. Symptoms of AD are progressive. B. Medications may be taken with food. C. Medications may decrease​ symptoms, but there is no cure for AD. D. Stop taking medications abruptly if symptoms improve. E. Dry mouth is an expected symptom of many of the medications used to treat​ Parkinson's disease.

A. Symptoms of AD are progressive. B. Medications may be taken with food. C. Medications may decrease​ symptoms, but there is no cure for AD.

The nurse is assessing a newly admitted young adult client who offers vague symptoms. The nurse suspects that the client may have multiple sclerosis​ (MS). What symptoms would indicate that this client has ​MS? Select all that apply. A. Visual disturbances B. Dementia C. Mood swings D. Fatigue E. Difficulties with bladder control

A. Visual disturbances C. Mood swings D. Fatigue E. Difficulties with bladder control

Mr. Morimoto is newly diagnosed with​ Parkinson's disease. He is in the hospital due to a recent fall. Which of his statements indicates that he needs additional​ education? A. ​"I will be so glad when I recover from this​ Parkinson's disease because these tremors are​ annoying." B. ​"I hope the medication will help me to swallow better because I am afraid I will​ choke." C. ​"I guess the​ Parkinson's disease contributed to my​ fall." D. ​"I hope my daughter can stay with me since I am going to need extra​ help."

A. ​"I will be so glad when I recover from this​ Parkinson's disease because these tremors are​ annoying."

In cases of severe vitamin D​ malabsorption, how many units of vitamin D may be administered per​ day? A. ​50,000dash-​100,000 B. 400dash-600 C. ​10,000 D. ​2,000dash-​4,000

A. ​50,000dash-​100,000

The nurse is assessing an older adult client with dementia. What is the most common cause of dementia in​ adults? A. ​Alzheimer's disease B. Normal aging C. Chronic alcoholism D. ​Parkinson's disease

A. ​Alzheimer's disease

Nursing Process in the correct sequence:

Assessment Diagnosis Planning Implementation Evaluation

Liver function tests should be done before starting the drug. Children should be watched for suicidal ideation. Children can become irritable. Atomoxetine (Strattera) may raise blood pressure or cause heart palpitations.

Atomoxetine (Strattera) is a nonstimulant used in the treatment of attention deficit/hyperactivity disorder (ADHD). What nursing considerations should be included in parent education about this medication?

The nurse is preparing to administer methocarbamol​ (Robaxin) to a client who is experiencing muscle spasms and pain after a lumbar laminectomy. The nurse will administer the dose by IV push. How long should the nurse push a 6 mL dose for safe​ administration? A. 30 seconds B. 2 minutes C. 1 minute D. 90 seconds

B. 2 minutes

When providing education to a client regarding the use of muscle​ relaxants, which instructions should the nurse ​include? Select all that apply. A. It is safe to drive while taking muscle relaxants. B. Chew gum or suck on hard candy if dry mouth occurs. C. Do not mix alcohol with muscle relaxants. D. Report changes such as slurred speech or confusion. E. Take muscle relaxants on an empty stomach.

B. Chew gum or suck on hard candy if dry mouth occurs. C. Do not mix alcohol with muscle relaxants. D. Report changes such as slurred speech or confusion.

The nurse is performing the morning assessment on​ Frank, a​ 7-year-old client. Frank stares off into space for a few seconds and does not seem to hear the nurse as she says his name. A few seconds​ pass, then Frank continues as if nothing happened. Which type of seizure is this child​ experiencing? A. Myoclonic seizure B. Absence seizure C. Atonic seizure D. ​Tonic-clonic seizure

B. Absence seizure

As the nurse for a client with vitamin D​ deficiency, you carefully educate the client about the medications used to treat the disorder. What statement about vitamin D is the most​ accurate? A. Vitamin D medications must be given in the same form as that found in the diet. B. Clients who take too much vitamin D could have symptoms of hypercalcemia. C. Vitamin D cannot be administered to clients who are NPO. D. The daily requirement for vitamin D is universal.

B. Clients who take too much vitamin D could have symptoms of hypercalcemia.

The nurse is caring for a group of clients on a​ long-term care unit. Which client is most likely to experience​ spasticity? A. An​ 85-year old woman with​ Alzheimer's disease B. A​ 60-year-old woman with multiple sclerosis C. A​ 90-year-old man with benign prostatic hypertrophy​ (BPH) D. A​ 65-year-old man with dementia

B. A​ 60-year-old woman with multiple sclerosis

Which drug used for treating spasms or spasticity can be administered via the intrathecal​ route? A. Carisoprodol​ (Soma) B. Baclofen​ (Lioresal) C. Tizanidine hydrochloride​ (Zanaflex) D. Chlorzoxazone​ (Paraflex)

B. Baclofen​ (Lioresal)

A client tells the nurse that her neurologist said that phenytoin​ (Dilantin) is the drug of choice for treatment of seizures and asks how this medication works. The nurse explains that phenytoin inhibits seizure activity​ how? A. By slowing neuronal firing rates via increasing gamma aminobutyric acid​ (GABA) levels in the brain B. By desensitizing the sodium channels in the​ brain; this limits rapid firing of brain​ cells, thereby suppressing seizure activity C. By enhancing the action of gamma aminobutyric acid​ (GABA) in the​ brain, which decreases neuronal activity D. By suppressing the flow of sodium ions in the brain

B. By desensitizing the sodium channels in the​ brain; this limits rapid firing of brain​ cells, thereby suppressing seizure activity

The nurse is reviewing the medication order for a pregnant client. Which category of​ drugs, established by the U.S. Food and Drug Administration​ (FDA), is safest for the client to​ take? A. Category D B. Category A C. Category B D. Category C

B. Category A

10 minutes

The nurse is caring for a client who came to the emergency department because of an episode that was diagnosed as a panic attack. The nurse should tell the client that panic attacks will typically resolve within what period of time?

The nurse is discussing​ Alzheimer's disease with the wife of a newly admitted older adult male. The nurse explains that the symptoms of​ Alzheimer's disease usually develop​ slowly, and gradually worsen over time. Which behaviors indicate common symptoms in the early stage of​ Alzheimer's ​disease? Select all that apply. A. Unable to walk or feed himself independently B. Consistently forgets to pay bills C. Puts his car keys in the freezer D. Forgets how to take a bath E. Begins to use profane language​ often, not previously typical

B. Consistently forgets to pay bills C. Puts his car keys in the freezer

The nurse is caring for a pregnant client who has asthma. Which possible change would the nurse expect the health care provider to make to this client​'s treatment​ regimen? A. Increase in the inhalant dose. B. Decrease the inhalant dose. C. Discontinue the inhalant. D. Change the inhalant to a drug administered intravenously.

B. Decrease the inhalant dose.

Which instruction should the nurse give to a client who is prescribed carbamazepine​ (Tegretol) for​ seizures? A. Ginkgo will enhance the drug​'s effect. B. Do not take with grapefruit juice or St. John​'s wort. C. Alcohol consumption should be limited. D. The medication should be taken on an empty stomach.

B. Do not take with grapefruit juice or St. John​'s wort.

The emergency department​ (ED) nurse is busy assessing a newly admitted​ 27-year-old client who was involved in a motor vehicle accident. While in the​ ED, the client had seizure activity that lasted continuously for 47​ minutes, during which she did not regain consciousness. The nurse is aware that this client is in a medical emergency situation and needs​ what? Click the three Exhibit links below for additional information about the client. A. Information from any witness who was at the scene of the motor vehicle accident that offers clues to the cause of the seizure activity B. Emergency management of​ airway, breathing, and​ circulation; measurement of​ glucose, oxygen, and other blood gases C. Application of a cervical collar to prevent brain and spinal cord injuries and dysfunction D. Medication for possible head and neck injuries and severe pain

B. Emergency management of​ airway, breathing, and​ circulation; measurement of​ glucose, oxygen, and other blood gases

Which conditions may cause muscle ​spasms? Select all that apply. A. Edema B. Fractures C. Epilepsy D. Trauma E. Inflammation

B. Fractures C. Epilepsy D. Trauma

Prior to administering cyclobenzaprine​ (Flexeril), what other type of medication use is particularly critical for the nurse to​ assess? A. Antacids B. MAOIs C. Oral contraceptives D. NSAIDs

B. MAOIs

What is the body weight method of pediatric dose calculation based​ on? A. The child​'s body surface area​ (BSA) B. Milligrams per kilogram of​ weight, plus a unit of time C. A nomogram that plots height and weight ​D. Height, weight, and age of the child

B. Milligrams per kilogram of​ weight, plus a unit of time

The​ nurse, seeking the fastest and most consistent​ absorption, would administer drugs by which route to the infant ​client? Select all that apply. A. Intramuscular B. Oral C. Intravenous​ (IV) D. Subcutaneous E. Transdermal

B. Oral C. Intravenous​ (IV) E. Transdermal

The nurse is preparing to administer medications to a group of adult clients. What must the nurse consider when planning to administer the ​medications? Select all that apply. A. Expected client response to the taste of each drug B. Proper route of administration for each drug C. Compatibility of each drug with others to be administered D. Time of day each drug should be administered E. Need to hold other drugs or foods before or after administration

B. Proper route of administration for each drug C. Compatibility of each drug with others to be administered D. Time of day each drug should be administered E. Need to hold other drugs or foods before or after administration

Which medication is classified as a selective estrogen receptor​ modulator? A. Ergocalciferol​ (Drisdol) B. Raloxifene hydrochloride​ (Evista) C. Teriparatide​ (Forteo) D. Alendronate sodium​ (Fosamax)

B. Raloxifene hydrochloride​ (Evista)

The nurse is caring for a client who has​ Parkinson's disease. The nurse is planning the teaching she will provide to the client and his family. Which information would be important to include in the teaching regarding pharmacotherapy for​ Parkinson's ​disease? Select all that apply. A. Abruptly stop medications when symptoms disappear. B. Report any increase in symptoms. C. Medications may alter blood​ pressure, so change positions slowly. D. When taking​ anticholinergics, do not take an antihistamine. E. Do not take levodopa​ (Larodopa) with food.

B. Report any increase in symptoms. C. Medications may alter blood​ pressure, so change positions slowly. D. When taking​ anticholinergics, do not take an antihistamine. E. Do not take levodopa​ (Larodopa) with food.

The client tells the nurse that her neurologist recently weaned her off of her antiseizure​ medication, phenobarbital​ (Luminal), and prescribed phenytoin​ (Dilantin). The client indicated that she had been taking phenobarbital for almost 4​ years, and her neurologist said the side effects were the reason for this medication switch. The nurse explains that the major side effects of barbiturates include ​what? Select all that apply. A. Gingival hyperplasia​ (swelling of the​ gums) B. Slowed heart rate and​ respirations, and decreased blood pressure C. Dependence and increased tolerance of drug with continued​ use, requiring higher doses over time D. Blurred vision and rashes E. Drowsiness and sedation

B. Slowed heart rate and​ respirations, and decreased blood pressure C. Dependence and increased tolerance of drug with continued​ use, requiring higher doses over time E. Drowsiness and sedation

When educating clients about antiseizure​ medications, which activities will the nurse teach that will help decrease seizure ​activity? Select all that apply. A. Receiving a flu shot B. Taking medication consistently C. Following up with lab work D. Staying with the same drug brand E. Taking medication at specified times

B. Taking medication consistently C. Following up with lab work D. Staying with the same drug brand E. Taking medication at specified times

A nurse is teaching a client how to​ self-administer subcutaneous injections in preparation for discharge to home. Which of the following outcomes indicates to the nurse that the client has achieved the learning outcome for the teaching​ session? A. The client states he will be using a needle that is 1 in. long. B. The client pinches a skin fold on the abdomen. C. The client aspirates to check for blood return. D. The client pulls back on the skin to displace tissue.

B. The client pinches a skin fold on the abdomen.

All of the following are expected outcomes of medication administration​ except: A. The client will achieve therapeutic effects from the medication. B. The client will explain the medication regime to​ his/her family. C. The client will safely administer​ his/her own medications. D. The client will be without complications related to drug administration.

B. The client will explain the medication regime to​ his/her family.

What centrally acting skeletal muscle relaxant is the most effective for clients with spasticity or decreased muscle tone related to a brain or spinal cord​ injury? A. Dantrolene sodium​ (Dantrium) B. Tizanidine hydrochloride​ (Zanaflex) C. Cyclobenzaprine hydrochloride​ (Flexeril) D. Metaxalone​ (Skelaxin)

B. Tizanidine hydrochloride​ (Zanaflex)

Based on FDA​ guidelines, which category or categories of drugs should be avoided during pregnancy because evidence shows risk of fetal abnormalities and birth ​defects? Select all that apply. A X D B C

X D

The nurse is caring for a client who is receiving dantrolene​ (Dantrium). What should the nurse plan to assess ​closely? Select all that apply. A. Bronchospasm B. Urinary output C. Skin color D. Breath sounds E. Bowel function

B. Urinary output C. Skin color D. Breath sounds E. Bowel function

The nurse is reviewing the drugs taken by clients at an extended care facility for combination risks between herbal drugs and prescription medications. Clients taking which drug should have their histories reviewed​ first? A. Diphenhydramine​ (Benadryl) B. Warfarin​ (Coumadin) C. Ibuprofen​ (Advil) D. Cephalexin​ (Keflex)

B. Warfarin (Coumadin)

The nurse is caring for a client who has been prescribed physical therapy for the treatment of muscle spasticity. The client asks the nurse what he should expect from physical therapy. Which answers by the nurse are ​correct? Select all that apply. A. ​"The physical therapist will prescribe medication to help your​ spasticity." B. ​"The physical therapist will teach you passive range of motion exercises to help with​ spasticity." C. ​"The physical therapist will refer you for surgery to correct the cause of the​ spasticity." D. ​"The physical therapist will guide you in muscle group strengthening to help with the​ spasticity." E. ​"The physical therapist will provide muscle stretching to help relieve the​ spasticity."

B. ​"The physical therapist will teach you passive range of motion exercises to help with​ spasticity." D. ​"The physical therapist will guide you in muscle group strengthening to help with the​ spasticity." E. ​"The physical therapist will provide muscle stretching to help relieve the​ spasticity."

Extrapyramidal​ symptoms, such as​ akathisia, are serious adverse effects caused by antipsychotic medications. Which class of drugs is used to treat​ akathisia? Calcium channel blockers Diuretics Benzodiazepines Dopamine system stabilizers

Benzodiazepines

Erika Jackson is admitted to the psychiatric unit because of a suicide attempt. Her family reports that she frequently goes on spending​ sprees, goes long periods without​ eating, and sometimes does not sleep for days. As the​ nurse, what disorder do you suspect Ms. Jackson​ has, based on her​ behavior? Attention​ deficit/hyperactivity disorder Bipolar disorder Major depressive disorder Manic disorder

Bipolar disorder

Donald Frank is a​ 58-year-old White diabetic client who is considering using an insulin pump for better control of his blood sugar. In demonstrating the operation of the insulin pump to Mr.​ Frank, you explain this device administers insulin​ as: A. An intradermal bolus and continuous infusion B. An intramuscular bolus and continuous infusion C. A subcutaneous bolus and continuous infusion D. An intravenous bolus and continuous infusion

C. A subcutaneous bolus and continuous infusion

Which client contraindication applies to dantrolene sodium​ (Dantrium)? A. Renal impairment B. Cerebral vascular accident clients C. Active hepatic disease D. Women who are over age 35

C. Active hepatic disease

The nurse is providing education to a client regarding calcium. Which statements are accurate regarding the importance of calcium to the musculoskeletal ​system? Select all that apply. A. Adequate calcium plays a role in nerve conduction. B. Calcium is a necessary component in the formation of a clot. C. Adequate calcium is important for the growth of bones. D. Appropriate levels of calcium are important for muscle contraction. E. Adequate calcium is important for dental health.

C. Adequate calcium is important for the growth of bones. D. Appropriate levels of calcium are important for muscle contraction. E. Adequate calcium is important for dental health.

George Garrett is in the emergency room after a car accident. He is diagnosed with neck and back strain. His discharge instructions include a prescription for a muscle relaxant. Which nonpharmacologic instruction do you​ provide? A. Deep pressure massage B. Wine or beer for relaxation C. Application of cold packs D. Strict bed rest

C. Application of cold packs

The nurse is performing discharge teaching. The nurse notes the written prescription shown. Which action by the nurse is​ appropriate? A. Contact the health care provider to rewrite the prescription. B. Correct the client instructions section of the prescription. C. Continue with the discharge​ teaching; the prescription is properly written. D. Obtain clarification of the prescription order.

C. Continue with the discharge​ teaching; the prescription is properly written.

A nurse is preparing to administer medication to an​ 80-year-old male client with a diagnosis of congestive heart failure. Which lab test result raises concern about the potential for drug​ toxicity? A. White blood cells​ 6,000 mcL​ (normal: ​4,500dash-​10,000 ​mcL) B. Hemoglobin​ (Hgb) 13.6​ g/dL (normal: 13.5dash-18 ​g/dL) C. Creatinine clearance 75​ mL/min (normal: 97dash-137 ​mL/min) D. Brain natriuretic peptide​ (BNP) 120​ pg/mL (normal: less than 100​ pg/mL)

C. Creatinine clearance 75​ mL/min (normal: 97dash-137 ​mL/min)

Which antiseizure​ drugs, when administered by​ IV, can be very irritating to ​veins? Select all that apply. A. Carbamazepine​ (Tegretol) B. Ethosuximide​ (Zarontin) C. Diazepam​ (Valium) D. Methsuximide​ (Celontin) E. Lorazepam​ (Ativan)

C. Diazepam​ (Valium) E. Lorazepam​ (Ativan)

Drugs may pass from the mother to the fetus through various mechanisms. What is the term for a substance moving from an area of higher concentration to one of lower​ concentration? A. Solubility B. Binding C. Diffusion D. Active transport

C. Diffusion

The nurse is reviewing therapeutic options for a client with a seizure disorder who just learned she is pregnant. Teratogenic drugs pose the greatest risk to the fetus during which phase of​ pregnancy? A. Second and third trimesters B. Second trimester C. First trimester D. First and second trimesters

C. First Trimester

A nurse is preparing to administer an oral medication for a client. Which of the following is the most appropriate nursing action when a client refuses to take a medication due to​ nausea? A. Crush the medication and mix it with applesauce for administration. B. Give only half of the medication so that the client can better tolerate it. C. Hold the medication and report the information to the health care provider. D. Complete an incident report since the medication cannot be administered.

C. Hold the medication and report the information to the health care provider.

A nursing diagnosis applicable to a client​'s medication administration​ is: A. Severe psychosis resulting from drug abuse B. Inadequate qualifications of prescriber to use particular medications C. Knowledge deficit related to adverse effects of medication as indicated by client​'s verbalization D. Incorrect medication prescribed for client according to medical treatment protocol

C. Knowledge deficit related to adverse effects of medication as indicated by client​'s verbalization

Generalized seizures are different from partial seizures in that generalized seizures arise from multiple foci in both hemispheres of the brain and are often accompanied by​ what? A. Lip​ smacking, chewing, or pulling at clothing B. Disturbances in​ hearing, sight, or taste C. Loss of consciousness D. Seeing spots​ (aura) or experiencing automatisms

C. Loss of consciousness

The nurse reviews the prescribed orders on a client admitted to the​ medical-surgical unit. Which order should the nurse​ question? A. Tuberculin skin test 0.1 ml by intradermal injection B. Promethazine​ (Phenergan) 50 mg in 2 mL intramuscular​ (IM) every 6 hours as needed for nausea and vomiting C. Meperidine​ (Demerol) 100 mg in 2 ml subcutaneously every 4 hours D. D5LR intravenously​ (IV) 125​ ml/hour

C. Meperidine​ (Demerol) 100 mg in 2 ml subcutaneously every 4 hours

Which of the following is not an assessment that must be made during medication​ administration? A. Previous allergic reactions experienced by the client B. Vital signs of the client C. Nurse​'s opinion of client​'s pain level D. Client​'s understanding of the medication

C. Nurse​'s opinion of client​'s pain level

The nurse is preparing a teaching plan to increase a client​'s compliance with his prescribed drug regimen. Which should be included in the​ plan? A. Instruct the client that his role does little to influence the effectiveness of the medication. B Allow the client to change the regimen to meet his needs. C. Perform an assessment on foods or herbal products that interfere with the prescribed medication. D. Instruct the client to take two doses of the medication if symptoms worsen.

C. Perform an assessment on foods or herbal products that interfere with the prescribed medication.

You are assessing your​ client, Stuart​ Silkowski, before administering an antiseizure medication. Mr. Silkowski does not take any other drugs or​ herbals; however, he does have chronic gingivitis. Which medication should Mr. Silkowski​ avoid, if​ possible? A. Diazepam​ (Valium) B. Phenobarbital​ (Luminal) C. Phenytoin​ (Dilantin) D. Carbamazepine​ (Tegretol)

C. Phenytoin​ (Dilantin)

Which statement best describes the focus of treatment for multiple​ sclerosis? A. No​ focus, because no treatment is available B. Cure the disease by regenerating the myelin sheaths C. Slow the disease process and manage exacerbations and symptoms D. Regenerate the electrical impulses in the neuromuscular system

C. Slow the disease process and manage exacerbations and symptoms

What is the primary cause of spasticity associated with cerebral​ palsy? A. Cerebrovascular accident B. Destruction of myelin sheath C. Trauma to the brain at birth D. Progressive degeneration of motor neurons

C. Trauma to the brain at birth

The pediatric nurse is studying pharmacokinetics of drugs in children. Which factors are recognized as increasing drug toxicity in ​children? Select all that apply. A. Highly developed blooddash-brain barrier in the newborn B. Low water relative to body weight in the newborn C. Weak acids in the gastrointestinal​ (GI) tract D. Immature kidney function in the child E. Prolonged​ half-life

C. Weak acids in the gastrointestinal​ (GI) tract D. Immature kidney function in the child E. Prolonged​ half-life

The nurse is investigating drugs used to treat​ Parkinson's disease. Which are target actions of pharmacotherapy used to treat clients with​ Parkinson's ​disease? Select all that apply. A. Reducing blood pressure B. Providing brain stimulation C. Sedating the client D. Blocking acetylcholine effects E. Restoring dopamine levels

D. Blocking acetylcholine effects E. Restoring dopamine levels

The client who is experiencing chronic muscle spasms tells the nurse about reading that the application of heat can be useful in the treatment of spasms. The client asks the nurse why heat is effective. Which answer by the nurse is the most​ correct? A. ​"Applying heat generates heat in the muscle from​ low-frequency sound​ waves, which decreases pain and​ inflammation." B. ​"Applying heat slows the transmission of​ pain." C. ​"Applying heat reduces cramping and relieves​ pain." ​D. "Applying heat helps maintain flexibility and improves muscle strength and​ stability."

C. ​"Applying heat reduces cramping and relieves​ pain."

When evaluating client education on hydroxychloroquine​ (Plaquenil Sulfate), what statement indicates that the client understood​ his/her instructions? A. ​"If I don​'t have any improvement in symptoms within 2​ weeks, my medication will be​ stopped." B. ​"Blurred vision may occur temporarily after I take my​ medicine." C. ​"I will wear sunscreen or protective clothing when​ outside." D. ​"If I experience nausea after taking my​ medication, I can take an​ antacid."

C. ​"I will wear sunscreen or protective clothing when​ outside."

The nurse is caring for a client who is being evaluated for chronic back pain. The client reports that he has been experiencing spasms with increasing frequency. Which client statement would cause the nurse to suspect he is experiencing clonic​ spasms? ​A. "The spasm runs down my​ legs." B. ​"My back will spasm for hours at a​ time." C. ​"My back has a spasm several times in a row and then​ relaxes." D. ​"My back has a single spasm and then​ relaxes."

C. ​"My back has a spasm several times in a row and then​ relaxes."

The nurse is performing discharge teaching for an older adult client with arteriosclerotic heart disease​ (ASD), hyperlipidemia, and type 2 diabetes mellitus. The client asks the​ nurse, "Why do I have to take fish​ oil?" Which is the nurse​'s most appropriate​ response? ​A. "Fish oil has been shown to prevent the common​ cold." B. ​"The fish oil is prescribed for​ arthritis." C. ​"The fish oil can be used to decrease your cholesterol​ level." D. ​"The use of fish oil can control your blood​ sugar."

C. ​"The fish oil can be used to decrease your cholesterol​ level."

Modulate immune response

Common medications prescribed for multiple sclerosis include glatiramer acetate (Copaxone), interferon beta-1a (Avonex), interferon beta-1b (Betaseron), and natalizumab (Tysabri). What are these types of medications designed to do in relation to multiple sclerosis?

Before medications are​ started, what is a common point of education for clients with​ Parkinson's disease,​ Alzheimer's disease, or multiple​ sclerosis? Select all that apply. A. Avoid foods high in protein and vitamin B B. Make position changes slowly C. Take medications with food D. Report any increase in symptoms

D. Report any increase in symptoms

As the​ nurse, what advice should you give to older adult clients who have been approved to take herbal or dietary​ supplements? A. Start with the recommended dose on the label. B. Ask the health food store manager about dosage. C. Increase the dose​ slowly, every other week. D. Start with the smallest possible dose.

D. Start with the smallest possible dose.

After what age does​ Alzheimer's disease usually manifest​ itself? A. 85 years B. 50 years C. 70 years D. 60 years

D. 60 years

The nurse is caring for a client receiving treatment for spasticity associated with multiple​ sclerosis; the client was admitted to the hospital today because of high fever and hallucinations. The nurse attributes these symptoms to the abrupt discontinuation of which intrathecal​ medication? A. Carisoprodol​ (Soma) B. Metaxalone​ (Skelaxin) C. Tizanidine hydrochloride​ (Zanaflex) D. Baclofen​ (Lioresal)

D. Baclofen​ (Lioresal)

The nurse is caring for a client who has multiple sclerosis​ (MS) and diabetes mellitus​ (DM). The client is experiencing severe spasticity from the MS and neuropathic pain from the DM. Which skeletal muscle relaxant would be the best choice for this​ client? A. Carisoprodol​ (Soma) B. Metaxalone​ (Skelaxin) C. Methocarbamol​ (Robaxin) D. Baclofen​ (Lioresal)

D. Baclofen​ (Lioresal)

The nurse is preparing to administer phenytoin​ (Dilantin), an antiseizure​ medication, to the client. Which nursing action is most important in relation to this​ medication? A. Remind the client not to take the medication with grapefruit juice. B. Keep the phenytoin​ (Dilantin) in a safe place out of the reach of children. C. Make sure phenytoin​ (Dilantin) is taken on an empty stomach. D. Before administering the​ medication, review lab data for the current blood level.

D. Before administering the​ medication, review lab data for the current blood level.

You are the school nurse working with Eva​ Lim, a teen who has suffered a​ mild, one-time seizure during a​ two-hour metalworking class.​ Eva's temperature is​ 98.8°F (37.1°C). Four other students in her class report nausea and headaches. What is the most likely cause of​ Eva's seizure? A. Fever or infection B. Family history of cardiac disease C. Past head injury D. Chemical or toxin exposure

D. Chemical or toxin exposure

The neurologist diagnosed a​ 23-year-old male client with epilepsy several days ago. At age​ 20, this client was diagnosed with viral​ meningitis, which precipitated his seizures. The client tells the nurse that his older sister had one single seizure that lasted for one​ minute, several years​ ago, when she was in treatment for alcohol withdrawal. She was given one dose of diazepam​ (Valium), which stopped the seizure. She has not had any subsequent seizures. The client asks the nurse why his neurologist ordered phenytoin​ (Dilantin) for his epilepsy instead of diazepam. Which response by the nurse is least complex and still answers the client​'s ​question? A. Phenytoin​ (Dilantin) acts by desensitizing neurologic channels that are responsible for the seizure activity and disrupting or suppressing that seizure activity. Phenytoin does not have the addictive potential associated with diazepam. B. Diazepam​ (Valium) is a benzodiazepine that enhances or improves the effects of gamma aminobutyric acid​ (GABA) in the​ brain, thereby inhibiting further seizures. C. Diazepam​ (Valium) is a benzodiazepine. Benzodiazepines are used to gain short term control of seizure activity rather than​ long-term treatment of seizures. D. Diazepam​ (Valium) is often ordered to control a​ one-time seizure​ event, whereas phenytoin​ (Dilantin) is one of the most commonly prescribed antiseizure medications for epilepsy.

D. Diazepam​ (Valium) is often ordered to control a​ one-time seizure​ event, whereas phenytoin​ (Dilantin) is one of the most commonly prescribed antiseizure medications for epilepsy.

The nurse is reviewing the​ client's chart for information obtained during an initial nursing interview. Which is the most important information for the nurse to report to the health care provider prescribing​ medications? A. Health history ​B. Nurses' notes C. Vital signs D. Drug history

D. Drug History

The nurse identifies several problems in a client admitted with a diagnosis of pneumonia. Which problem should have top​ priority? A. Nutritional deficiencies B. Insomnia C. Dysuria D. Dyspnea

D. Dyspnea

During which phase of the nursing process is the client​'s current health status compared with the desired​ outcome? A. Diagnosis B. Implementation C. Planning D. Evaluation

D. Evaluation

Mrs.​ Wellston, a​ 75-year-old widow, was admitted to the medical unit after being found wandering along the side of the road. While in the emergency​ department, she had a black tarry stool. Mrs. Wellston tells you that she cannot remember the way​ home, but she does not act anxious or depressed. From her​ purse, she hands you a prescription bottle that reads​ "donepezil hydrochloride​ (Aricept)." You recognize this drug as a cholinesterase inhibitor. You suspect that Mrs. Wellston has​ Alzheimer's disease. What​ complication, associated with the use of her​ medication, do you think she may be​ experiencing? A. Acute psychosis B. Hepatotoxicity C. Fecal impaction D. GI bleeding

D. GI bleeding

The nurse is caring for a client who is taking a skeletal muscle relaxant for muscle spasms. The nurse anticipates which lab test to be ordered for this​ client? A. Arterial blood gas B. Electrolyte panel C. Blood glucose level D. Hepatic studies

D. Hepatic studies

The client tells the nurse that his medication bottle indicates that he is to avoid drinking grapefruit juice with his antiseizure​ medication, but he does not really understand why. He asks the nurse to explain. Which response by the nurse will best help the client understand why grapefruit juice must be avoided with his antiseizure​ medication? A. Taking carbamazepine​ (Tegretol) with grapefruit juice is contraindicated. B. When some medications are taken with grapefruit​ juice, this combination can cause excessive​ sedation, low blood​ pressure, and EKG changes. C. The grapefruit juicedash-drug interaction can lead to unpredictable and hazardous levels of certain important drugs. D. If carbamazepine​ (Tegretol) is taken with grapefruit​ juice, this combination leads to a significant increase in the concentration of the medication in the​ bloodstream, which can be toxic and​ life-threatening.

D. If carbamazepine​ (Tegretol) is taken with grapefruit​ juice, this combination leads to a significant increase in the concentration of the medication in the​ bloodstream, which can be toxic and​ life-threatening.

A client being evaluated for an infection informs the nurse that she is concerned about taking any medications because she is in the 18th week of pregnancy. Which physiologic changes must be considered when prescribing medications to this​ client? A. Decreased blood flow to the kidneys B. Accelerated gastric emptying C. Decreased total body water D. Increased levels of hydrochloric acid in the stomach

D. Increased levels of hydrochloric acid in the stomach

What is the drug of choice for​ Parkinson's disease? A. Bromocriptine​ (Parlodel) B. ​Carbidopa-levodopa (Sinemet) C. Amantadine​ (Symmetrel) D. Levodopa​ (Larodopa)

D. Levodopa​ (Larodopa)

Common medications prescribed for multiple sclerosis include glatiramer acetate​ (Copaxone), interferon​ beta-1a (Avonex), interferon​ beta-1b (Betaseron), and natalizumab​ (Tysabri). What are these types of medications designed to do in relation to multiple​ sclerosis? A. Decrease dopamine levels B. Increase serotonin levels C. Control epinephrine levels D. Modulate immune response

D. Modulate immune response

Your​ client, Ms. Joelle​ Brewster, is a new mother with a diagnosis of rheumatoid arthritis​ (RA), who is beginning to breastfeed her son. Her health care provider took her off methotrexate sodium​ (MTX) during pregnancy and lactation because that drug is in pregnancy category X. For joint swelling and​ pain, she is currently prescribed small doses of prednisone​ (Orasone), in pregnancy category​ C, and acetaminophen​ (Tylenol), in pregnancy category B. What is the most important thing for you to teach Ms. Brewster to​ do? A. Weigh herself daily at the same time B. Use nipple cream to decrease possible side effects to her son C. Increase her prednisone​ (Orasone) incrementally, as needed D. Observe her son for adverse affects such as diarrhea or constipation

D. Observe her son for adverse affects such as diarrhea or constipation

The nurse is preparing to perform discharge teaching to a client being discharged after an appendectomy. Which factor should be considered for the timing of the teaching​ session? A. Language barriers B. Cognitive level C. Client age D. Pain level

D. Pain Level

Mr. Baker has been admitted to the hospital for an acute exacerbation of multiple sclerosis. Mr. Baker recently completed a​ 2½-week course of prednisone​ (Deltasone). He takes routine medication for pain but has been noncompliant with outpatient physical therapy. As the​ nurse, what do you anticipate the health care​ provider's orders will​ include? A. ​Low-dose steroid, clear liquid​ diet, and physical therapy B. Prednisone​ (Deltasone), diabetic​ diet, finger-stick blood sugar test before​ meals, and physical therapy C. Interferon​ beta-1a (Avonex) PO​ daily, regular​ diet, and occupational therapy D. Prednisone​ (Deltasone), regular​ diet, finger-stick blood sugar test before​ meals, and physical therapy

D. Prednisone​ (Deltasone), regular​ diet, finger-stick blood sugar test before​ meals, and physical therapy

All of the following are physiological and timing factors affecting medication administration​ except: A. Stomach contents B. Circulatory dysfunction C. Kidney dysfunction D. Time of day

D. Time of day

The nurse in a primary care clinic reviews a​ client's chart. Which statement by the nurse about the​ client's disorder is the most​ accurate? A. ​"We will need to draw some blood to test for​ anemia." ​B. "Your pain is caused by too much​ activity." C. ​"The relief of pain with rest indicates that you have rheumatoid​ arthritis." D. ​"For your​ pain, acetaminophen​ (Tylenol) is the recommended initial​ treatment."

D. ​"For your​ pain, acetaminophen​ (Tylenol) is the recommended initial​ treatment."

Johnny Cooper is a​ 45-year-old obese client. He has a medical diagnoses of hypertension and osteoarthritis. He has three different antihypertensive medications​ prescribed, as well as two different arthritis medications. Which statement made by Mr. Cooper indicates a knowledge deficit discovered during the assessment phase of medication​ administration? A. ​"I asked my pharmacy to give me nonchildproof pill bottles so that I can open​ them." B. ​"I keep a written log of my daily blood pressure​ readings." C. ​"I have no environmental allergies or allergies to​ medications." D. ​"I take about 10 pills each​ day, but​ I'm not sure what​ they're for."

D. ​"I take about 10 pills each​ day, but​ I'm not sure what​ they're for."

Your​ client, Dionne​ Washington, has type 1 diabetes. She is taking insulin and eats a restricted diet. While completing a health​ history, you learn that Ms. Washington has successfully used meditation to lower her​ stress/anxiety levels. Now she is interested in trying some herbal supplements. She​ asks, "They are​ natural, so they must be​ okay, right?" How should you best respond to Ms.​ Washington? A. ​"I agree that natural supplements are safer than chemical​ ones." B. ​"Type 2 diabetics are at greater risk for negative effects from herbals than type​ 1." ​C. "You can try herbal products if you have no food or drug​ allergies." D. ​"Natural does not automatically mean​ safe, especially when combined with​ insulin."

D. ​"Natural does not automatically mean​ safe, especially when combined with​ insulin."

Jayden Simms was born with cerebral palsy. His mother brought him to the neurologic clinic because the spasticity in his arms and legs is getting worse despite medication therapy. The health care provider suggests intrathecal baclofen​ (Lioresal) administration with pump placement. How should you describe to​ Jayden's mother the benefit of a baclofen​ pump? ​A. "The pump can deliver larger​ doses, which will decrease muscle spasms and​ spasticity." B. ​"The pump placement could eliminate​ Jayden's cerebral palsy​ symptoms." ​C. "The pump is placed under the skin in the upper abdomen so that more medication is administered to the lower​ extremities." D. ​"The continuous infusion results in a smaller dose​ requirement, fewer side​ effects, and improvement in muscle​ spasms."

D. ​"The continuous infusion results in a smaller dose​ requirement, fewer side​ effects, and improvement in muscle​ spasms."

What symptoms are associated with ​schizophrenia? Select all that apply. Active social life Decline in job or academic performance Constant state of hyperactivity Decline in personal hygiene Disorganized speech and thoughts

Decline in job or academic performance Decline in personal hygiene Disorganized speech and thoughts

When evaluating antidepressant​ therapy, how is effectiveness primarily​ manifested? a.)Emotional and mental status are no worse b.)Increased periods of productivity c.)Decrease in symptoms d.)Client compliance with medication regimen

Decrease in symptoms emotionThe effectiveness of antidepressant therapy is primarily seen as a decrease in symptoms. Although medication compliance is important and no worsening of symptoms is​ good, they do not reflect the effectiveness of therapy as much as a decrease in symptoms. Increased periods of productivity could indicate a worsening of symptoms in clients with bipolar disorder.

When evaluating antidepressant​ therapy, how is effectiveness primarily​ manifested? a.)Emotional and mental status are no worse b.)Increased periods of productivity c.)Decrease in symptoms d.)Client compliance with medication regimen

Decrease in symptoms The effectiveness of antidepressant therapy is primarily seen as a decrease in symptoms. Although medication compliance is important and no worsening of symptoms is​ good, they do not reflect the effectiveness of therapy as much as a decrease in symptoms. Increased periods of productivity could indicate a worsening of symptoms in clients with bipolar disorder.

What characteristic of psychotic behavior is defined as ideas or beliefs that are false and not grounded in​ reality? Inappropriate mood and affect Hallucinations Delusions Cognitive function

Delusions

Mr. Jenson is a​ 27-year-old male with a personal and family history of schizophrenia. He arrives at the clinic today with his​ mother, who is concerned about his behavior. Mr. Jenson has a disheveled​ appearance, paces​ constantly, and​ chain-smokes. When you ask him to enter the exam​ room, he accuses you of being a spy who wants to mistreat him. What best describes the behavior Mr. Jenson is​ displaying? Social isolation and withdrawal Apathetic behavior Delusions​ and/or paranoia Chronic psychosis

Delusions​ and/or paranoia

Ms. Salma White is in the hospital for pneumonia. As you complete her medical​ history, she tells you that she is taking chlorpromazine hydrochloride​ (Thorazine). She says it has not helped her​ "supposed" schizophrenia or made the voice in her head go away as the doctor said. You notice that her hands are shaking and she has an unsteady gait when walking to the bathroom. You also notice that she blinks her eyes rapidly during the interview. What do you suspect Ms. White may be experiencing because of her​ medication? Tardive dyskinesia Akathisia Extrapyramidal symptoms ​ Parkinson's disease

Extrapyramidal symptoms

The nurse is caring for a client receiving lithium​ (Lithobid) who is due for a dose in 15 minutes. The laboratory report shows the​ client's lithium level to be 1.6. What should the nurse do​ first? a.)Administer half of the lithium​ (Lithobid) tablet. b.)Hold the dose of lithium​ (Lithobid). c.)Administer the dose of lithium​ (Lithobid). d.)Obtain another blood sample and repeat the test. (Lithobid).

Hold the dose of lithium The therapeutic range for lithium​ (Lithobid) ranges from 0.4​ - 1.0​ mEq/L. Since the​ client's blood level is​ 1.6, the nurse should hold the dose. Administering the prescribed dose or even half of the dose would be dangerous since the lithium​ (Lithobid) level is increased. Having another blood sample drawn is not practical.​

What important aspect should the nurse include in the patient education for a client who is prescribed paroxetine​ (Paxil) for the treatment of​ depression? a.)You need to take this medication daily on an empty stomach. b.)You need to return in 3 weeks to obtain a blood level of this medication. c.)It may take up to 5 weeks to see the full effects of this medication. d.)You can discontinue the use of birth control pills while on this medication.

It may take up to 5 weeks to see the full effects of this medication. Selective Seratonin Reuptake Inhibitors​ (SSRIs) such as paroxetine​ (Paxil) can take up to 5 weeks to achieve a therapeutic effect. The medication should be taken with food to prevent gastrointestinal upset. The client needs to continue to take their birth control pills while taking an SSRI to prevent pregnancy as this medication as this medication is in the Pregnancy Category C. Blood levels are obtained with lithium​ (Lithobid) not the SSRIs.

Ms. Ellis is a​ 19-year-old college freshman. This is her first time away from home. She came to the​ school's health center because she does not like the way her new medication is making her feel. She says it has not helped her depression and lack of motivation. Ms. Ellis complains of​ insomnia, dizziness, and headache. She started taking aripiprazole​ (Abilify) less than 10 days​ ago, but she wants to stop the medication. As the​ nurse, what instruction should you offer Ms. Ellis at this​ time? You probably need inpatient therapy and should go to the nearest ER. Stop the medication for​ now, but go see your regular health care provider as soon as possible. Many medications do not take effect​ immediately, so you should continue to take the medication as prescribed. It appears that you are on the wrong​ medication, so you should go see the health care provider who prescribed it.

Many medications do not take effect​ immediately, so you should continue to take the medication as prescribed.

Pain and redness may occur at the injection site.

Medications prescribed for multiple sclerosis (MS) are often injected. What information would the nurse provide when administering medications to a client with MS?

Tremors Muscle rigidity Bradykinesia Postural instability

Pharmacotherapy for Parkinson disease is centered on treating its symptoms. What are the symptoms of Parkinson disease?

Catherine Collins is an​ 82-year-old woman who comes to your clinic for her annual physical. She admits that she has felt overwhelming sadness since her husband died a few months ago. To make matters​ worse, her husband failed to maintain his life insurance policy before he​ died, causing subsequent financial strain on Mrs. Collins. What disorder do you suspect she is most likely​ experiencing? Dysthymic disorder Major depressive disorder Seasonal affective disorder Situational depression

Situational depression

Catherine Collins is an​ 82-year-old woman who comes to your clinic for her annual physical. She admits that she has felt overwhelming sadness since her husband died a few months ago. To make matters​ worse, her husband failed to maintain his life insurance policy before he​ died, causing subsequent financial strain on Mrs. Collins. What disorder do you suspect she is most likely​ experiencing? Dysthymic disorder Major depressive disorder Situational depression Seasonal affective disorder

Situational depression

What adverse effects are associated with phenothiazines? Select all that apply. Tardive dyskinesia Excessive secretions Bradycardia ​Parkinson-like symptoms Sexual dysfunction

Tardive dyskinesia Parkinson-like symptoms Sexual dysfunction

​Ten-year-old Tyrone has just been diagnosed with attention​ deficit/hyperactivity disorder​ (ADHD). His custodial grandmother tells you she is concerned about starting Tyrone on medication for ADHD. What should you tell​ her? Medication should increase his school grades to As. The goal of pharmacotherapy is to decrease​ Tyrone's inattention, and increase his ability to focus. No adverse effects are associated with the medications used for ADHD treatment. Once Tyrone has settled​ down, the medication can be stopped.

The goal of pharmacotherapy is to decrease​ Tyrone's inattention, and increase his ability to focus

​Ten-year-old Tyrone has just been diagnosed with attention​ deficit/hyperactivity disorder​ (ADHD). His custodial grandmother tells you she is concerned about starting Tyrone on medication for ADHD. What should you tell​ her? No adverse effects are associated with the medications used for ADHD treatment. Once Tyrone has settled​ down, the medication can be stopped. Medication should increase his school grades to As. The goal of pharmacotherapy is to decrease​ Tyrone's inattention, and increase his ability to focus.

The goal of pharmacotherapy is to decrease​ Tyrone's inattention, and increase his ability to focus.

"Concerta is not recommended for children under 6 years of age. Let's talk about some other alternatives."

The mother of a 5-year-old child with ADHD tells the nurse she is planning to ask the health care provider to prescribe methylphenidate (Concerta) for her son because this medication has helped his cousin's performance in school. What is the nurse's best response to this parent?

Major Depression, Situational Depression

The nurse at the university health clinic is completing a health assessment for a female client who reports feelings of "sadness" that have persisted for three months. The client reports that she broke up with her boyfriend two months ago; she has no children. She lives in an apartment near campus with two roommates. She denies hallucinations, delusions, and changes in her speech patterns. Based on this limited information, thus far, which mood disorders does the nurse suspect?

"I should notice an improvement in symptoms immediately."

The nurse has performed discharge teaching for a client receiving antipsychotic medications. Which statement indicates that further instructions are necessary?

Assess the client's baseline muscle strength. Complete a thorough health history. Assess baseline vital signs. Assess baseline cognitive status.

The nurse has specific responsibilities when administering medications to the client with a degenerative disorder of the central nervous system. Before administering medications, what assessments does the nurse do?

Poor listening skills Poor focus Excessive fidgeting or squirming Excessive careless mistakes

The nurse is assessing a 6-year-old child with newly diagnosed attention deficit/hyperactivity disorder (ADHD). What symptoms would the nurse expect to discuss with the parent of this child?

Home medications

The nurse is assessing a client, transferred from another hospital, who has a diagnosis of schizophrenia. Assessment reveals sustained muscle contraction of the neck. Which part of the record should be reported to the health care provider?

Fatigue Visual disturbances Mood swings Difficulties with bladder control

The nurse is assessing a newly admitted young adult client who offers vague symptoms. The nurse suspects that the client may have multiple sclerosis (MS). What symptoms would indicate that this client has MS?

Early signs of Alzheimer disease History of thyroid disease Use of birth control pills Use of corticosteroids

The nurse is assessing an adult client who appears depressed. When taking the client's medical history, the nurse should be alert for what factors that might be contributing to depression?

Teenager Beverly Lopez has just been diagnosed with major depressive disorder. She is given a prescription for sertraline​ (Zoloft). What is the most important instruction to include when educating Beverly and her family about the administration of her​ medications? Stop taking the drugs if no benefits are experienced Monitor vital​ signs, especially pulse and blood pressure Watch for and immediately report any suicidal thoughts Monitor for urinary retention or constipation A teenager waiting for medication instructions

Watch for and immediately report any suicidal thoughts

Teenager Beverly Lopez has just been diagnosed with major depressive disorder. She is given a prescription for sertraline​ (Zoloft). What is the most important instruction to include when educating Beverly and her family about the administration of her​ medications? Watch for and immediately report any suicidal thoughts Monitor vital​ signs, especially pulse and blood pressure Stop taking the drugs if no benefits are experienced Monitor for urinary retention or constipation

Watch for and immediately report any suicidal thoughts

Norepinephrine Serotonin Dopamine

While discussing antidepressant pharmacotherapy with the client, the nurse explains that antidepressant medications target three major neurotransmitters. Which neurotransmitters does the nurse discuss?

Which nursing considerations are associated with valproic acid ​(Depakene)? Select all that apply. a.)Considered the drug of choice for clients with bipolar disorder b.)Has teratogenic effects c.)Approved for mood stabilization and mania suppression d.)Therapeutically classified as an atypical antipsychotic e.)Classified as pregnancy category C

a.)Considered the drug of choice for clients with bipolar disorder b.)Has teratogenic effects c.)Approved for mood stabilization and mania suppression Valproic acid​ (Depakene) is considered the drug of choice for clients with bipolar disorder. It is approved for mood stabilization and mania suppression. Because it has teratogenic​ effects, valproic acid is classified as pregnancy category​ D, not C. Valproic acid is classified as an anticonvulsant​ (antiseizure medication), not an atypical antipsychotic.

Which drugs are examples of atypical ​antidepressants? Select all that apply. a.)Trazodone​ (Oleptro) b.)Bupropion​ (Wellbutrin) c.)Duloxetine​ (Cymbalta) d.)Clomipramine​ (Anafranil) e.)Paroxetine​ (Paxil)

a.)Trazodone​ (Oleptro) b.)Bupropion​ (Wellbutrin) c.)Duloxetine​ (Cymbalta) Bupropion​ (Wellbutrin), duloxetine​ (Cymbalta), and trazodone​ (Oleptro) are all examples of atypical antidepressants. Clomipramine​ (Anafranil) is an example of a tricyclic​ antidepressant, and paroxetine​ (Paxil) is an example of a selective serotonin reuptake inhibitor.

Which characteristics are associated with bipolar ​disorder? Select all that apply. a.)At least three days of manic behavior b.)Drug noncompliance c.)High risk for suicide d.)Extreme changes in mood e.)Grandiose feelings during manic state

b.)Drug noncompliance c.)High risk for suicide d.)Extreme changes in mood e.)Grandiose feelings during manic state Bipolar disorder is characterized by extreme mood swings ranging from euphoria to depression. During the manic​ state, clients have feelings of​ grandiosity, have a decreased need to sleep and​ eat, and are easily distracted. Bipolar clients are at high risk of suicide. Up to​ 50% attempt suicide and​ 50% stop taking their medication within the first year of treatment. Manic symptoms must be present for at least 7 days for a client to be diagnosed with bipolar disorder.

Adolescents and children who take antidepressants have​ what? a.)No risk of suicide due to lack of emotional development b.)Increased risk of suicide and suicide attempts c.)Decreased risk of suicide d.)Increased risk of suicide if treatment becomes​ long-term

b.)Increased risk of suicide and suicide attempts Adolescents and children who take antidepressants have increased risk for suicide and suicide attempts. This increased risk may be directly associated with their lack of emotional development. As a​ result, children and adolescents should be closely assessed before and during the first few weeks of antidepressant treatment. The risk decreases after full therapeutic levels are reached.

Which drugs are examples of atypical ​antipsychotics? Select all that apply. a.)Lamotrigine​ (Lamictal) b.)Quetiapine​ (Seroquel) c.)Aripiprazole​ (Abilify) d.)Risperidone​ (Risperdal) e.)Olanzapine​ (Zyprexa)

b.)Quetiapine​ (Seroquel) c.)Aripiprazole​ (Abilify) d.)Risperidone​ (Risperdal) e.)Olanzapine​ (Zyprexa) Aripiprazole​ (Abilify), olanzapine​ (Zyprexa), quetiapine​ (Seroquel), and risperidone​ (Risperdal) are all atypical antipsychotics. Lamotrigine​ (Lamictal) is an antiseizure medication.

When assessing clients for​ depression, which other medical conditions could contribute to a depressed ​state? Select all that apply. a.)​End-stage Alzheimer disease b.)Thyroid gland dysfunction c.)Use of oral contraceptives in women d.)Vitamin B deficiencies e.)Use of beta blockers for treatment of hypertension

b.)Thyroid gland dysfunction c.)Use of oral contraceptives in women d.)Vitamin B deficiencies e.)Use of beta blockers for treatment of hypertension Thyroid gland​ dysfunction, vitamin B​ deficiencies, beta​ blockers, and oral contraceptives can all contribute to a client​'s depressed mood. The same is true in early stages of Alzheimer​ disease, but not the end stage.

Which statement about selective serotonin reuptake inhibitors​(SSRIs) is​ true? a.)SSRIs take more time to produce a therapeutic​ response, compared to other classes of antidepressants. b.)SSRIs prevent the reabsorption of​ serotonin, norepinephrine, and dopamine. c.)SSRIs are the drugs of choice for the pharmacologic management of depression. d.)SSRIs are safer​ than, but not as effective​ as, other classes of antidepressants.

c.)SSRIs are the drugs of choice for the pharmacologic management of depression. Selective serotonin reuptake inhibitors​ (SSRIs) are the drugs of choice for the pharmacologic management of depression. They are safer​ than, and just as effective​ as, other classes of antidepressants. They typically produce a therapeutic response​ faster, not​ slower, than tricyclic antidepressants. SSRIs prevent the reuptake of one​ neurotransmitter, serotonin.

Numbness and inability to move right arm

client taking the drug olanzapine (Zyprexa) is exhibiting the following adverse effects. Which causes the nurse the most concern?

Which statement accurately describes the administration of lithium​(Eskalith) in the pharmacotherapy of bipolar​ disorder? a.)Administration is only at night due to resulting drowsiness b.)Lithium can be administered once a day c.)Lithium is safe to administer with SSRIs d.)Therapeutic dose is based on serum drug levels

d.)Therapeutic dose is based on serum drug levels The therapeutic dose of lithium​ (Eskalith) is​ individualized, based on the client​'s serum drug levels.​ Therefore, regular lab tests are needed for dose adjustments. Although drowsiness is an adverse effect of​ lithium, it must be administered several times a​ day, not just at​ night, in order to reach and maintain a therapeutic serum level. Lithium has many potentially harmful drug interactions. Administering it with a selective serotonin reuptake inhibitor​ (SSRI) places the client at risk for serotonin syndrome.

The nurse who is caring for a​ 66-year-old female client with osteoarthritis provides the client with education about the risk​ factors, pathophysiology, and clinical manifestations of her disorder. Which statements indicate that the client understood the ​teaching? Select all that apply. ​A. "Any of my joints that appear​ hard, cool, and larger than usual may be affected by​ osteoarthritis." B. ​"My joint pain will decrease with​ rest." C. ​"Losing weight can decrease my risk for developing further​ osteoarthritis." D. ​"My osteoarthritis is different from rheumatoid​ arthritis; it is because of overuse of my joints over​ time." E. ​"My elbows and shoulders are most likely to be affected by​ osteoarthritis."

​A. "Any of my joints that appear​ hard, cool, and larger than usual may be affected by​ osteoarthritis." B. ​"My joint pain will decrease with​ rest." C. ​"Losing weight can decrease my risk for developing further​ osteoarthritis." D. ​"My osteoarthritis is different from rheumatoid​ arthritis; it is because of overuse of my joints over​ time."

The nurse is researching​ Parkinson's disease before assessing the next client on the office schedule. What information correctly describes this neurological ​disease? Select all that apply. A. ​Parkinson's disease is the fifth most common neurologic disorder in older adults. ​B. Parkinson's disease can be secondary to another​ disease, injury, or trauma. C. Men are more prone to the disease than women. D. Typical onset is between ages 40 and 70. E. It can be idiopathic.

​B. Parkinson's disease can be secondary to another​ disease, injury, or trauma. C. Men are more prone to the disease than women. D. Typical onset is between ages 40 and 70. E. It can be idiopathic.

What tool is commonly used to assess cognitive status in 5dash-10 ​minutes? A. Brief Mental State Exam B. Montreal Cognitive Assessment ​C. Mini-Mental State Exam D. Neurobehavorial Cognitive Exam

​C. Mini-Mental State Exam