Pharm Ch 22

A nurse is reviewing a patient's serum lithium level. Which result would indicate that the patient is experiencing lithium toxicity? a) 0.6 mEq/L b) 1.2 mEq/L c) 1.8 mEq/L d) 0.8 mEq/L

1.8mEq/L

The nursing student learned in anatomy and physiology class that the nervous system has how many divisions? a) 3 b) 4 c) 1 d) 2

2

A male client comes into the emergency department and is agitated, swiping his arms at "the bugs" and screaming that Harry Potter sent the bugs to take him away. After two security officers help to restrain the client, the doctor orders 5 mg of Haldol STAT. How would the nurse administer this drug? a) 5 mg IM in the client's gluteus maximus b) 5 mg IV after calming the client down and placing an IV c) two 2.5 mg tablets rectally d) 5 mg IM in the client's left hand

5mg IM in the client's gluteus maximus

Which statement should be included in the teaching plan for a patient receiving methylphenidate (Ritalin)? a) "There is no risk of dependence." b) "The drug may cause weight gain." c) "The medication is usually taken just before bedtime." d) "Adverse effects include hypertension and nervousness."

Adverse effects include hypertension and nervousness

A 75-year-old male client is given an order for a CNS stimulant secondary to a new diagnosis of narcolepsy. He begins to experience signs and symptoms of excessive CNS stimulation. The nurse knows that the client is likely to also experience an exacerbation of which preexisting condition? a) Cardiac dysrhythmias b) Diabetes c) Gout d) Hyperparathyroidism

Cardiac dysrhythmias

The nurse expects to monitor a client's white blood count weekly when the client is prescribed: a) Quetiapine b) Olanzapine c) Aripiprazole d) Clozapine

Clozapine

Which of the following effects can be noticed in a patient who has been administered amphetamines? a) Low blood pressure b) Depression c) Decreased appetite d) Drowsiness

Decreased appetite

A patient is prescribed olanzapine (Zyprexa) for the treatment of acute bipolar disorder. The patient tells the nurse he is voiding three times at night and is always thirsty. Based on the adverse effects of this medication, what should the nurse suspect the patient has developed? a) A urinary tract infection b) Hyperthyroidism c) Diabetes mellitus d) Renal calculi

Diabetes mellitus

A patient has been treated with amphetamines for ADHD. At the age of 16 years, she is diagnosed with hyperthyroidism. What intervention should be implemented with this patient? a) Discontinue the amphetamines b) Discontinue the high-calorie diet c) Administer a proton pump inhibitor d) Assess the patient for pulmonary edema

Discontinue the amphetamines

A client asks the nurse dopamine is. What is a correct response by the nurse? a) "Dopamine is a medication that is given to fight infections and help with pain." b) "Dopamine is a part of the brain that controls your impulses and thoughts." c) "Dopamine is an enzyme that regulates your temperature." d) "Dopamine is a neurotransmitter that deals with pleasure and reward in the brain."

Dopamine is a neurotransmitter that deals withpleasure and reward in the brain

A client is receiving haloperidol. The nurse would be most especially alert for the development of which of the following adverse effects? a) Hypotension b) Sedation c) Anticholinergic d) Extrapyramidal

Extrapyramidal

Kate, age 34, comes to your office for preconception counseling. She is currently drinking 10 to 12 cans of diet cola each day. She verbalizes her concern about her excessive caffeine intake and the adverse effects that caffeine will have on the baby. She asks what she can do to limit her caffeine intake. What is the best recommendation for you to make? a) Increase the intake of grapefruit juice to reduce the adverse effects of caffeine. b) Gradually decrease her daily intake of caffeine. c) Stop the intake of all beverages containing caffeine immediately. d) Limit her caffeine intake to no more than three or four caffeine-containing beverages per day.

Gradually decrease her daily intake of caffeine

A male client is being seen in the emergency department because he has a high fever and cannot move his arm. During the history-taking process, he says he is being treated with an antipsychotic medication for schizophrenia. The nurse knows that what may be happening with this client? a) He may have broken his arm and not remember what happened because of his schizophrenia. b) He may be having a neuroleptic malignant syndrome reaction to his antipsychotic medication and needs treatment immediately. c) He may have neuroleptic malignant syndrome, which will self-resolve in a few hours after rest and Tylenol. d) He may have influenza A and will need to be put into isolation.

He may be having a neuroleptic malignant syndrome reaction to his antipsychotic medication and needs treatment immediately.

A patient expresses that being diagnosed with narcolepsy has been devastating for him. Which statement by the patient should the nurse focus on initially during the assessment? a) "I don't like the way the stimulant medication makes me feel." b) "I have had to change my job. I now work from home." c) "I hate being so dependent. I have to have somebody drive me everytwhere I go." d) "I sometimes wonder if it is worth living a life that has so many restrictions."

I sometimes wonder if it is worth living a life that has so many restrictions

A nurse is caring for a patient who is taking haloperidol. The patient has orders for a new drug, and the nurse notes that it is highly protein bound. The nurse will plan care based on a(n): a) decreased risk for toxic effects of haloperidol therapy. b) decreased risk for muscular contractions and spasms. c) increased risk for toxic effects of haloperidol therapy. d) high drug efficacy of haloperidol.

Increased risk for toxic effects of haloperidol therapy

A child with attention deficit hyperactivity disorder has been receiving methylphenidate for several years. The plan is to stop the drug. What best reflects the rationale for this plan? a) The drug needs to be switched to another agent that is less toxic. b) The risk for adverse effects is greater if the child doesn't have a break. c) The child doesn't need the medication because he is older. d) It needs to be determined whether the child still has symptoms that require treatment.

It needs to be determined whether the child still has symptoms that require treatments

Antipsychotic drugs are contraindicated in clients with: a) peptic ulcer disease, mild hypertension, chronic joint pain, and kidney failure. b) nausea, severe hypotension, or intractable hiccups. c) liver damage, coronary artery disease, severe hypertension, bone marrow depression, or cerebrovascular disease. d) kidney damage, chronic obstructive lung disease, mild hypotension, and chronic bone pain.

Liver damage, coronary artery disease, severe hypertension, bone marrow depression, or cerebrovascular disease

A patient with narcolepsy is placed on a central nervous system stimulant for treatment of his narcolepsy. What is the central nervous system stimulant of choice to treat narcolepsy? a) Guarana b) Atomoxetine (Straterra) c) Caffeine d) Modafinil (Provigil)

Modafinil (Provigil)

For which of the following patients are CNS stimulants contraindicated? a) Patients with renal dysfunction b) Patients with Parkinson's disease c) Patients younger than 20 d) Patients with severe hypertension

Patients with severe hypertension

Which CNS stimulant is used in the treatment of obesity? a) Phentermine (Adipex-P) b) Methylphenidate (Concerta) c) Dexmethylphenidate (Focalin) d) Modafinil (Provigil)

Phentermine (Adipex-P)

A female client relates that she is taking Valium for a muscle relaxant and Provigil for treatment of narcolepsy. Additionally, she informs you that she takes a contraceptive. As part of client education, the nurse would include: a) Provigil will not interfere with any of the medications she is taking. b) Provigil may decrease the effects of her contraceptive, and she may need to use other protection. c) Provigil may decrease the effects of Valium. d) Provigil should not be taken if the client is on a contraceptive.

Provigil may decrease the effects of her contraceptive, and she may need to use other protection

Anorexiants are primarily used for which of the purposes? (Choose one) a) Treat attention deficit hyperactivity disorder b) Suppress the cardiovascular system c) Stimulate the respiratory system d) Suppress the appetite

Suppress the apetite

For which patient is clozapine, an antipsychotic, contraindicated? a) The 45-year-old with bone marrow depression b) The 16-year-old with an upper respiratory infection c) The 32-year-old with osteoarthritis d) The 23-year-old with diabetes insipidus

The 45 year old with bone marrow depression

Typical antipsychotics block dopamine receptors. a) False b) True

True

After teaching the parents of a child diagnosed with ADHD about the disorder and its treatment, the nurse determines that the teaching has been effective when the parents state: a) "We should set up regular routines for him but not worry if he violates the limits once in a while." b) "We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention." c) "We need to be careful so he doesn't develop a substance abuse problem as he grows older." d) "We should stop the medication after 2 months to see how effective it is in really controlling his symptoms."

We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention

A 30-year-old man with a BMI of 59 has recently been diagnosed with type 2 diabetes mellitus. In light of the man's lack of success with weight loss programs in the past, his care provider has prescribed sibutramine (Meridia). What instructions should the nurse consequently provide to this patient? a) "This drug will help you to lose weight without having to exercise or change your normal diet." b) "It's best to take a dose of sibutramine after each meal." c) "Take a dose when you feel like you are tempted to binge on food." d) "Take this drug once each day on an empty stomach."

Take this drug once a day on an empty stomach

While caring for a client who is receiving antipsychotic therapy, the nurse observes lip smacking, a darting tongue, and slow and aimless arm movements. The nurse interprets this as: a) tardive dyskinesia. b) dystonia. c) pseudoparkinsonism. d) akathisia.

Tardive dyskinesia

What should the nurse's pre-administration assessment of a client receiving a CNS stimulant for respiratory depression include? (Select all that apply.) a) Review recent lab work b) Respiratory rate c) Blood pressure d) Pulse e) Respiratory pattern

a) Review recent lab work b) Respiratory rate c) Blood pressure d) Pulse e) Respiratory pattern