Neurological System (Pt. 2)

Season Affective Disorder Depression Nicotine Addiction

When reviewing the indications for various antidepressants, a health care professional should understand that bupropion hydrochloride (Wellbutrin) is an appropriate choice for patients who have which of the following? (Select all that apply.) -Insomnia -Season affective disorder -Motion sickness -Depression -Nicotine Addiction

A. Allow 2 to 4 weeks before expecting to feel better.

When talking to a patient about taking buspirone, the health care professional should include which of the following instructions? A. Allow 2 to 4 weeks before expecting to feel better. B. Take the drug with grapefruit juice to increase absorption. C. Use the drug only as needed for anxiety. D. Take the drug on an empty stomach.

-Increase fiber and fluid intake -Change position slowly from sitting or lying to standing. -Do not stop taking the drug abruptly. -Take the drug at bedtime to prevent daytime drowsiness.

A health care professional is caring for a patient who is about to begin amitripyline therapy to treat major depression. The health care professional should include which of the following instructions with the patient about taking the drug? (Select all that apply.) -Increase fiber and fluid intake -Change position slowly from sitting or lying to standing. -Wear sunscreen and protective clothing. -Do not stop taking the drug abruptly. -Take the drug at bedtime to prevent daytime drowsiness.

D. Cataracts (Echothiophate, a cholinesterase inhibitor, can cause cataracts, or opacity of the lens of the eye. Patients should report any changes in vision, such as cloudiness or halos around lights.)

A health care professional is caring for a patient who is about to begin taking echothiophate )Phospholine Iodide) to treat glaucoma. The health care professional should monitor the patient for the development of which of the following adverse effects? A. Tachycardia B. Urinary retention C. Farsightedness D. Cataracts

-Nausea -Tremors -Confusion -Muscle weakness

A health care professional is caring for a patient who is about to begin taking lithium carbonate (Lithobid) to treat bipolar disorder. The health care professional should caution the patient to watch for which of the following indications of lithium toxicity? (Select all that apply.) -Nausea -Tremors -Confusion -Muscle weakness -Bronchospasm

Ocular Stinging

A health care professional is caring for a patient who is about to begin using betaxolol (Betoptic) eye drops to treat open-angle glaucoma. The health care professional should advise the patient to expect which of the following reactions? A. Nasal discharge B. Eyelid twitching C. Diaphoresis D. Ocular Stinging

A. Thyroid function tests. (Hypothyroidism is an adverse effect of lithium carbonate.

A health care professional is caring for a patient who is taking lithium carbonate (lithobid) to treat bipolar disorder. Which of the following diagnostic tests should the health care professional recommend periodically for the patient? A. Thyroid function tests. B. Tonometry C. Chest x-ray D. Endoscopic retrograde cholangiopancreatography (ERCP)

B. Phenelzine (Nardil) Patients should not take venlafaxine, a serotonin norepinephrine reuptake inhibitor, within 14 days of taking phenlzine, other MAOIs, or serotongergic drugs. Serotonin syndrome is a life-threatening complication characterized by anxiety, confusion, hallucinations, and fever.

A health care professional is caring for a patient who is taking venlafaxine to treat major depression. The health care professional should recognize that which of the following drugs can cause serotonin syndrome when patients take it concurrently with venlafaxine? A. Pilocarpine (Isopto Carpine) B. Phenelzine (Nardil) C. Alprazolam (Xanax) D. Phenytoin (Dilantin)

A. Suicidal thoughts (Young adults taking fluoxetine, a selective serotonin reuptake inhibitor, have an increased risk for suicide, especially in the early stages of treatment. )

A health care professional is caring for a young adult patient who is taking fluoxetine (Prozac) to treat depression. The health care professional should tell the patient and the ptient's family to report which of the following? A. Suicidal thoughts B. Double vision C. Fever D. Excessive salivation

Seizure Activity

A health care professional is collecting data from a patient who is taking bupropion hyrdrochloride (Wellbutrin) to treat depression. The health care professional notes that the patient has a recent history of a head injury. She should recognize that the drug is inappropriate for the patient because of the increased risk for which of the following? A. Seizure Activity B. Drowsiness C. Ischemic Stroke D. Respiratory Depression

Furosemide (Lasix) for hypertension

A health care professional is obtaining a patient's drug history when he finds that the patient is taking lithium carbonate (Lithobid) for bipolar disorder. Which of the following findings in the patient's drug history should alert the health care professional to monitor for lithium toxicity? A. Ciprofloxacin (Cipro) for a urinary tract infection B. Furosemide (Lasix) for hypertension C. Acetaminophen (Tylenol) for headaches D. Montelukast (Singulair) for asthma

Avoid taking NSAIDs. (NSAIDs increase renal reabsorption of lithium and sodium. Patients taking lithium should not take NSAIDs.

A health care professional is talking to a patient who is taking lithium carbonate (Lithobid). Which of the following instructions should be included to reduce the risk of lithium toxicity? A. Avoid taking NSAIDs. B. Reduce fluid intake. C. Take the drug with food. D. Consume a low-sodium diet.

C. Hypertensive crisis (Tyramine-enriched foods, such as aged cheese and processed meat, can trigger severe hypertension in patients who are taking phenelzine. Manifestations include hypertension, headache, and nausea.)

A health care professional should advise a patient who is taking phenelzine (Nardil) to avoid tyramine-enriched foods because of an increased risk for which of the following adverse reactions? A. Serotonin syndrome B. Respiratory depression C. Hypertensive crisis D. Neuroleptic malignant syndrome.

-Respiratory depression -Anxiety -Tolerance -Sedation

A health care professional should monitor an older adult patient who is taking alprazolam (Xanax) for which of the following adverse effects? (Select all that apply.) -Respiratory depression -Anxiety -Tolerance -Constipation -Sedation

A. Drinks two 8-oz glasses of wine each evening. (To prevent severe sedation and respiratory depression, patients should avoid alcohol and other CNS depressants when taking benzodiazepines.)

A health care professional should question the use of alprazolam (Xanax) for a patient who A. Drinks two 8-oz glasses of wine each evening. B. Takes valproic acid (Depakote) for a seizure disorder. C. Has a history of thromboembolism. D. Takes prenisolone (Prelone) for rheumatoid arthritis.

Bradycardia

A healthcare professional should expect which of the following adverse effects for a patient who is taking betaxolol (Betoptic) eye drops to treat glaucoma? A.Discoloration of the Iris B. Hypertension C. Bradycardia D. Constricted Pupils

A. Withdrawal symptoms

A health care professional is caring for a patient who has been taking alprazolam (Xanax) for an extended period of time to treat anxiety. The health care professional should recognize that stopping alprazolam therapy suddenly can result in which of the following? A. Withdrawal symptoms B. Paradoxical reaction C. Anterograde amnesia D. Respiratory depression

C. Asthma (Timolol, a beta-adrenergic antagonist, can cause bronchospasm and difficulty breathing. Patients who have asthma or any disorder that compromises respiratory function should not use the drug.)

A health care professional should question the use of timolol (Timoptic) for a patient who has which of the following disorders? A. Seizure disorder B. Rheumatoid arthritis C. Asthma D. Diabetes mellitus

D. Acute Dystonia (Acute dystonia can develop during the first few days of treatment with chlorpromazine. Manifestations include muscle spasms of the back, neck, face, and tongue. Treathment includes immediate administration of an anticholingergic drug, such as diphenhydramine.)

A patient is admitted to the emergency department with spasms of his face and back. He has recently begun taking chlorpromazine to treat schizophrenia. Which of the following adverse reactions should the health care professional suspect? A. Cholinergic crisis B. Serotonin syndrome C. Stevens-Johnson syndrome D. Acute Dystonia

Blood Pressure

During and immediately following IV administration of chlorpromazine to a patient who has schizoaffective disorder, the health care professional should monitor which of the following? A. Oxygen Saturation B. Cardiac Output C. Urine Specific Gravity D. Blood Pressure

C. Serotonin syndrome (Serotonin syndrome can begin 2 to 72 hr after beginning to take fluoxetine, a selective serotonin reuptake inhibitor. Manifestations include mental confusion, difficulty concentration, and agitation.

Soon after beginning fluoxetine (Prozac), a patient is admitted to the emergency department with agitation and confusion. The health care professional should suspect which of the following? A. Stevens-Johnsnon syndrome B. Neuroleptic malignant syndrome C. Serotonin syndrome D. Extrapyramidal symptoms

D. Polyuria (Risperidone, an atypical antipsychotic, can cause new-onset diabetes mellitus. It is essential to monitor patients taking the drug for the signs of hyperglycemia, and check their glucose levels regularly.

When caring for a patient who is taking risperidone (Risperdal) for schizophrenia, the health care professional should monitor for which of the following adverse effects of the drug? A. Chest pain B. Seizures C. Paresthesias D. Polyuria

Imipramine (Tofranil) (Imipramine, a tricyclic antidepressant, can result in orthostatic (Postural) hypotension. Patients taking this drug should change positions slowly from sitting or lying to standing.)

When reviewing the adverse effects of the drug therapy with a patient, a health care professional should explain that orthostatic hypotension is a common adverse reaction of which of the following drugs? A. Venlafaxine B. Imipramine (Tofranil) C. Bupropion (Wellbutrin) D. Valproic acid (Depakote)

-Remove contact lenses prior to instilling the drops -Do not touch the tip of the dropper -Apply gentle pressure to the nasolacrimal duct for 1 min after instilling the drops

Which of the following instructions should a health care professional include when advising a patient about instilling pilocarpine (Isopto Carpine) for managing open-angle glaucoma? (Select all that apply.) -Remove contact lenses prior to instilling the drops. -Do not touch the tip of the dropper. -Apply gentle pressure tot he nasolacrimal duct for 1 min after instilling the drops. -Rub eyes gently after instilling the drops. -Wash hands after instilling the drops.

A. Wear sunscreen when exposed to sunlight. (Chlorpromazine, a conventional antipsychotic, can cause photosensitivity, or increased susceptibility to sunburn, when exposed to sunlight.)

While talking with a patient about taking chlorpromazine, which of the following instructions should the health care professional include? A. Wear sunscreen when exposed to sunlight. B. Take the drug in the morning to prevent nocturia. C. Take the drug with food to reduce GI distress. D. Stop taking the drug immediately with the first sign of a sore throat.