pharm exam 2

One of the neurotransmitters can become decreased in the area of the corpus striatum. This results in the manifestations of Parkinson's disease. Which neurotransmitter will cause this? Gamma-aminobutyric acid (GABA) Acetylcholine Dopamine Serotonin

dopamine

A nurse administrates an opioid medication to a client. For what side effect should the nurse assess? Lower extremity paresthesia Drowsiness Occipital headache Polyuria

drowsiness

The nurse is caring for a client who is receiving cyclobenzaprine for relief of muscle spasms. What adverse effect should the nurse assess for? Muscle spasms Insomnia Drowsiness Urinary incontinence

drowsiness

A nurse is providing care for a client diagnosed with attention deficit hyperactivity disorder (ADHD) who has been taking methylphenidate for several months. When monitoring for potential adverse effects, the nurse should include what assessments? sleep patterns sexual function pupillary response orientation to person, place, and time

sleep patterns

A patient who has suffered a crushing injury to his thumb and two fingers in an accident at a factory is relieved to be administered a local anesthetic prior to treatment. The drugs that were administered decrease the permeability of the nerve cell membrane to: sodium. phosphorus. glucose. bicarbonate.

sodium

What type of seizure activity is characterized by generalized tonic-clonic convulsions lasting for several minutes during which the client does not regain consciousness? status epilepticus akinetic motor febrile

status epilepticus

A client has been diagnosed with partial seizures and has been prescribed carbamazepine. When providing health education about the safe and effective use of this medication, what should the nurse teach the client? "It's safest if you avoid drinking alcohol while you're taking this drug." "It's important to take a dose as soon as possible if you feel a seizure is coming." "I'll be showing you how to safely self-inject this drug." "I'll explain the foods that you should avoid while you're taking this drug."

"It's safest if you avoid drinking alcohol while you're taking this drug."

In addition to relieving agitation and anxiety, what is a rationale for using benzodiazepines in the treatment of a critically ill client? Increased diffusion and perfusion Decreased cardiac workload Increased level of consciousness Decreased blood pH

Decreased cardiac workload

Which conditions would occur due to the administration of an opioid antagonist in a client who is physically dependent on opioids? drowsiness hypotension withdrawal symptoms insomnia

withdrawal symptoms

A client admitted to a cardiac unit asks why a rest period is required each afternoon. The nurse's response should be based on what information regarding the PNS? "It is a time for all health care providers to complete documentation and review test results." "Families and visitors are encouraged to get lunch and rest during this time." "The nurses will be able to get some rest from the clients and other health care providers." "Clients are encouraged to rest and relax during this time, free of families and visitors."

"Clients are encouraged to rest and relax during this time, free of families and visitors."

The nurse is educating a client who has been prescribed atropine, an anticholinergic drug. Which instructions should the nurse provide to the client? "Do not drive or operate machinery." "If you experience eye pain, contact the health care provider about increasing the dosage." "Increase your fluid intake and activity level." "Take long, hot showers frequently to relieve uncomfortable side effects."

"Do not drive or operate machinery."

A client has told the nurse that she has been invited to a work colleague's house where she and some of her peers will be able to receive Botox injections. What is the nurse's best response? "It's safest to have these injections performed under medical supervision." "Have you ever received a Botox injection before?" "What effect are you hoping to achieve with the injections? "These injections have serious side effects so it's best to avoid them."

"It's safest to have these injections performed under medical supervision."

A 50-year-old woman has begun taking baclofen to treat her recently diagnosed multiple sclerosis (MS). What teaching point should the nurse provide to the patient about her new drug regimen? "It's best to avoid taking a dose of baclofen unless your spasticity becomes impossible to manage." "Make sure that you don't stop taking baclofen suddenly because it might cause your symptoms to rebound quite sharply." "Even though baclofen is a drug that's available over the counter, it still has the potential to cause serious adverse effects if taken incorrectly." "You'll likely have to stop taking your other medications for a week to ten days before starting to take baclofen."

"Make sure that you don't stop taking baclofen suddenly because it might cause your symptoms to rebound quite sharply."

A new mother asks her nurse about the safety of taking St. John's wort for postpartum depression. What would be the nurse's best response? "St. John's wort is a natural and safe alternative to prescription antidepressants." "There is insufficient evidence to support the use of St. John's wort, and drug interactions may be extensive." "Most experts agree that St. John's wort is effective in treating depression but that it can contribute to hypertension." "It's not clear that St. John's wort is effective in treating depression, but it won't cause any harm."

"There is insufficient evidence to support the use of St. John's wort, and drug interactions may be extensive."

A female client's seizure disorder has been successfully controlled by AEDs for years. She and her husband decide that it is time to start a family. She asks the nurse if it is safe for the fetus for her to continue her AEDs as prescribed. What is the nurse's best response? "They are safe during pregnancy." "They are considered teratogenic." "They may interfere with conception." "They are contraindicated during the third trimester."

"They are considered teratogenic."

A client is experiencing acute anxiety and the nurse has received an order for diazepam 4 mg PO STAT. What is the nurse's best action? Administer the medication as prescribed Contact the prescriber to confirm the dose Contact the prescriber to confirm the route Ensure flurazepam is available

Administer the medication as prescribed

A nurse is caring for a patient who has received carbidopa/levodopa. After administration of the first dose of the drug, the patient has developed gastrointestinal disturbances. Which nursing intervention should the nurse perform when caring for this patient? Administer the next drug dose with milk. Withhold the next dose of the drug. Observe alterations in blood pressure. Administer the next drug dose with meals.

Administer the next drug dose with meals.

A class of new nursing students is learning how to administer medications to clients. What should the instructor teach the students about giving opiates? Assess the client's vital signs hourly. Delay the ordered dose if respirations are below 15 bpm. Assess the respiratory rate before giving a dose of opiates. Give a dosage only if you think it is necessary.

Assess the respiratory rate before giving a dose of opiates.

The nurse is working in collaboration with a nurse anesthetist to assess a preoperative client. When addressing the client's risk for malignant hyperthermia as a result of neuromuscular junction blockers, what assessment should be prioritized? Assessing for a family history of malignant hyperthermia Assessing for a history of febrile seizures in childhood Assessing for any history of cytochrome P450 dysfunction Assessing the client's allergy status

Assessing for a family history of malignant hyperthermia

Which instruction should the nurse specifically stress when administering drugs used for muscle spasm and cramping? Take the drug with food. Stay upright for 30 minutes after taking the drugs. Avoid alcohol or other CNS depressants. Take the drug with 6 to 8 oz of water.

Avoid alcohol or other CNS depressants.

A nurse is reviewing the medication history of several clients. One of the clients is receiving a direct-acting cholinergic drug. The nurse would identify which drug? Bethanechol Pyridostigmine Guanidine Ambenonium

Bethanechol

A client has been admitted to the cardiac unit for heart failure and has been ordered carvedilol (Coreg). The client's blood pressure is 80/50. What should the nurse do? Give the medication so that the blood pressure will increase. Call the provider and advise them of the client's blood pressure prior to administering the medication. Continue to take the client's blood pressure using different BP machines until a better blood pressure is obtained. Call the provider after giving the medication, informing the provider of client's blood pressure when the medication was administered.

Call the provider and advise them of the client's blood pressure prior to administering the medication.

The nurse is caring for a client with glaucoma and is aware that which category of preanesthetic medication is contraindicated in this client? Opioid Antiemetic Cholinergic blocking Antianxiety

Cholinergic blocking

A client has been receiving bethanechol for 1 week. One hour after the dose is administered, the client develops sweating, flushing, abdominal cramps, and nausea. The nurse prepares to intervene for what condition? Myasthenic crisis Cholinergic overdose Anaphylactic reaction Pulmonary edema

Cholinergic overdose

Which statement accurately describes the pharmacodynamics of nondepolarizing neuromuscular junction (NMJ) blocking agents? Compete with acetylcholine for receptor sites Are excreted unchanged by the kidneys Are lipophilic and cross the blood-brain barrier Cause potassium to enter skeletal muscle cells

Compete with acetylcholine for receptor sites

A client with a history of malignant hyperthermia is scheduled for surgery. Which agent would the nurse most likely expect to administer? Botulinum toxin type B Dantrolene Baclofen Methocarbamol

Dantrolene

A client has been admitted to the unit for treatment of a multiple sclerosis exacerbation. The admission order indicates that the client is taking baclofen. Which outcome would the nurse expect to be associated with use of this medication? Reduction in the appearance of new lesions in magnetic resonance imaging (MRI) studies Decreased muscle spasms Increased muscle strength Decreased severity and duration of exacerbations

Decreased muscle spasms

A nurse has noted that a newly admitted client has been taking ramelteon for the past several weeks. The nurse is justified in suspecting that this client was experiencing what problem prior to starting this drug? Somnambulism Difficulty falling asleep at night Early morning waking Frequent nighttime awakenings

Difficulty falling asleep at night

A client who is scheduled for a diagnostic procedure has learned that the procedure will take place with a neuromuscular junction blocker rather than with a general anesthetic. The nurse should describe what benefit of this approach? Fewer effects of central nervous system depression Completion of procedures in a community setting Absence of pain during the procedure Enhanced long-term control of neuromuscular spasticity

Fewer effects of central nervous system depression

What action should the nurse take when administering meperidine 75 mg IM every 4 hours to a young adult? Give the medication as prescribed. Administer half the dose. Call the health care provider for a smaller dose. Give the dose by mouth.

Give the medication as prescribed.

During recovery from general anesthesia, what would be a priority? Monitoring temperature and reflexes Providing comfort measures Have emergency equipment readily available Providing pain relief as ordered

Have emergency equipment readily available

The nurse is providing education to a client who has been prescribed dantrolene. What serious adverse effect should the nurse mention during teaching? Metabolic acidosis Hypercarbia Renal calculi Hepatitis

Hepatitis

Which assessment finding from a patient's history is significant for the nurse to report to the physician before surgery using a neuromuscular junction (NMJ) blocking agent? Hepatitis Inguinal hernia Gouty arthritis Schizophrenia

Hepatitis

An older adult client has been diagnosed with early-stage Alzheimer's disease and has begun treatment with donepezil. When providing health education to the client and the client's spouse, the nurse should identify what goal of treatment? Remission of Alzheimer's disease Cure of Alzheimer's disease Improvement of cognition and function Resolution of memory and cognitive deficits

Improvement of cognition and function

A client with symptomatic bradycardia has been receiving atropine for the past 4 days and the client reports constipation. What is the most important suggestion the nurse could give the client? Avoid driving at night. Increase bulk in the diet. Suck on hard candies. Promote oral care.

Increase bulk in the diet.

A client is administered atropine to increase the heart rate. What is the action of atropine? It blocks the parasympathetic vagal stimulation. It exacerbates the parasympathetic vagal stimulation. It provides long-acting antihistamine blockage. It blocks cell wall synthesis of gram-negative bacilli.

It blocks the parasympathetic vagal stimulation.

The nurse would contact the health care provider before administering an adrenergic drug to a client who is also taking which drug? Antibiotic MAO inhibitor Diuretic Analgesic

MAO inhibitor

The daughter of an older adult client asks the nurse if her father should be aware of any special precautions while taking lorazepam (Ativan). What is the nurse's best response? Monitor his urine output closely, due to the risk of kidney damage. Monitor for a yellowish color in the eyes and easy bruising, due to liver damage. Monitor for increased signs of confusion or forgetfulness. Monitor for muscle stiffness and rigid body posture.

Monitor for increased signs of confusion or forgetfulness.

Which action would be a priority for a client receiving apomorphine? Giving the drug with food Monitoring cardiac status Checking for skin lesions Palpating the bladder

Monitoring cardiac status

The nursing instructor is discussing cholinergic drugs with his clinical group. What system would the instructor tell the students is stimulated by cholinergic drugs? Sympathetic nervous system Parasympathetic nervous system Cardiac system Respiratory system

Parasympathetic nervous system

Which is an important function of serotonin? Coordination of impulses Prevention of over-excitability Prevention of depression Communication between nerves and muscles

Prevention of depression

A client who was previously taking paroxetine is being switched to phenelzine due to a lack of response. The nurse would expect that the phenelzine will be started at which time? Concurrently with the paroxetine as it is being tapered Several weeks after stopping the paroxetine Immediately upon stopping the paroxetine. Forty-eight hours after being weaned from the paroxetine

Several weeks after stopping the paroxetine

A nurse is monitoring a client closely for malignant hyperthermia because the client received which NMJ blocker? Pancuronium Vecuronium Atracurium Succinylcholine

Succinylcholine

Which neuromuscular blocking agent would a nurse expect to have the shortest duration of action? Succinylcholine Vecuronium Atracurium Rocuronium

Succinylcholine

For which assessment finding will the nurse intervene first when providing postoperative care to a patient who returned to the nursing unit 2 hours after receiving succinylcholine? Generalized muscle pain Pulse 90 beats per minute Temperature 40 degrees C (104 degrees F) Muscle weakness

Temperature 40 degrees C (104 degrees F)

How will the addition of nitrous oxide or IV anesthetics affect the minimum alveolar concentration (MAC) of isoflurane? The MAC will remain the same. The MAC will decrease. The MAC of isoflurane will not be relevant. The MAC will be more difficult to calculate.

The MAC will decrease.

The functions of the autonomic nervous system (ANS) can be broadly described as: the ability to produce an action potential and to convey electrical impulses. activities designed to maintain a constant internal environment, to respond to stress or emergencies, and to repair body tissues. the ability to regulate and produce acetylcholine. relaying motor impulses from the cortex to the thalamus.

activities designed to maintain a constant internal environment, to respond to stress or emergencies, and to repair body tissues.

When diagnostic testing reveals a bone fracture, what type of pain is the client experiencing? acute somatic pain chronic visceral pain visceral pain neuropathic pain

acute somatic pain

A 78-year-old man is admitted to the emergency department (ED) with bradycardia resulting from overdose of donepezil. The nurse knows that the ED is likely to order which medication? atropine pseudoephedrine propranolol bethanechol

atropine

What is a common risk for epileptic seizures during late infancy to early childhood? learning disability fever medication overdose malnutrition

fever

Which is the most primitive area of the brain and contains the brain stem? Midbrain Hindbrain Limbic system Forebrain

hindbrain

A patient with diabetes who uses insulin is also receiving labetalol. The nurse would monitor the patient closely for: hypotension. arrhythmias. hypoglycemia. bronchospasm.

hypoglycemia

What would be identified as the basic unit of the nervous system? Synapse Neurotransmitter Neuron Soma

neuron

Opioid antagonists may produce withdrawal symptoms in clients physically dependent on which substance? opioids alcohol NSAIDs benzodiazepines

opioids

A client is taking an OTC allergy product. The nurse would expect to find that this product most likely contains: ephedra. phenylephrine. epinephrine. albuterol.

phenylephrine

Most of the free norepinephrine molecules are taken up by the nerve terminal that releases them in which process? Diffusion Perfusion Osmosis Reuptake

reuptake

A client appears very drowsy at bedtime and is difficult to arouse. The client is receiving Halcion 0.25 mg PO at bedtime. Based on these findings, what would be the best nursing diagnosis for this client? Risk for altered elimination Ineffective individual coping Risk for injury Risk for skin breakdown

risk for injury

The nurse is caring for a client with asthma who has been administered albuterol in order to promote bronchodilation and relieve shortness of breath. When giving this medication, the nurse has affected the client's autonomic nervous system by: stimulating beta2-receptors. decreasing the reuptake of acetylcholine. converting a larger proportion of dopamine to norepinephrine. antagonizing alpha2-receptors.

stimulating B-2 receptors

Adrenergic drugs mimic the effects of stimulating what part of the nervous system? parasympathetic sympathetic autonomic central

sympathetic

The nurse is providing medication education to a client prescribed an adrenergic blocker. Which nervous system is the specific focus of this classification of medications? central peripheral sympathetic parasympathetic

sympathetic

A graduate of a nursing program is scheduled to take the NCLEX today. The test-taker's heart is racing and pupils are dilated. What can the test-taker attribute to this reaction? Autonomic nervous system Cardiovascular irregularity Sympathetic nervous system The release of dopamine

sympathetic nervous system

The adrenergic branch of the autonomic nervous system is also known by which name? Sympathetic nervous system Parasympathetic nervous system Central nervous system Somatic nervous system

sympathetic nervous system

A signal has reached the terminus of a client's nerve and is in the space where the nerve is closest to the effector cell in a muscle. At what location is this signal? Synapse Schwann cell Neuron Soma

synapse

What assessment would indicate a patient was experiencing a hypersensitivity reaction to a neuromuscular junction (NMJ) blocking agent? Hyperkalemia Metabolic acidosis Muscle paralysis Wheezing

wheezing

A client is using a scopolamine patch for treatment of motion sickness. The nurse would instruct the client to change the patch at which frequency? Every day Every 3 days Every 5 days Every 7 days

Every 3 days

The nurse instructs the parent of a young school-age child with a seizure disorder who takes an AED to be alert for what signs and symptoms? Poor study habits related to lack of concentration Hyperactivity and inability to concentrate Excessive sedation and interference with learning and social development Anger and agitation in the classroom setting

Excessive sedation and interference with learning and social development

An older adult client diagnosed with generalized anxiety disorder is prescribed a benzodiazepine. The nurse caring for the client knows to include what intervention in the client's care plan? Seizure precautions Falls risk assessment Frequent dysrhythmias monitoring Education regarding sexual dysfunction

Falls risk assessment

A male client diagnosed with bone cancer has an order for clonidine on his chart. The nurse is concerned that this may be a mistake and asks another nurse why clonidine would be ordered for this client. What would be an appropriate response from the second nurse? "Clonidine decreases cancer cells within the bone so the provider ordered it for that reason." "Clonidine is sometimes prescribed for severe pain in cancer clients like this client." "Clonidine will not hurt him, so follow the order." "Clonidine is given for hypotension, so this client must have a history of hypotension."

"Clonidine is sometimes prescribed for severe pain in cancer clients like this client."

A nurse has been invited to speak to a support group for Parkinson's disease clients and families. Which statement addresses the chronic nature of the disease and the relevant drug therapies? "Drug therapy can consist of one or more drugs to eliminate the symptoms of these diseases." "Drugs do not cure these disorders; they instead enhance quality of life." "Persons of all cultures are treated similarly and respond in similar ways to treatment." "Drugs used to treat these disorders always pose a risk of severe liver and kidney dysfunction."

"Drugs do not cure these disorders; they instead enhance quality of life."

When the client prescribed entacapone asks the nurse to describe exactly how this medication works, what response is most appropriate? "Entacapone is best given parenterally to relieve symptoms." "Entacapone inhibits COMT so that dopamine is active for a longer time." "Entacapone increases the metabolism of levodopa in the bloodstream." "It is excreted almost entirely through the kidneys."

"Entacapone inhibits COMT so that dopamine is active for a longer time."

After teaching a client about a prescribed beta blocker therapy, the nurse determines that additional teaching is needed when the client relays which statement? "I can stop the drug anytime I feel any problems." "I need to get up slowly from the bed or a chair." "I should notify my doctor if I have trouble breathing." "I should learn how to check my blood pressure."

"I can stop the drug anytime I feel any problems."

Which patient statement indicates the need for additional teaching about propranolol? "I need to get up slowly after sitting or lying down." "I can stop the drug once my blood pressure is controlled." "I should space activities throughout the day." "I need to report if I have any chest pain or problems breathing."

"I can stop the drug once my blood pressure is controlled."

A 56-year-old woman with a diagnosis of multiple sclerosis has begun taking dantrolene. What client teaching should the nurse provide? "You'll find that your muscles will get progressively stronger over the next several weeks." "Make sure to see your health care provider promptly if you develop yellowish skin or eyes." "Take an over-the-counter laxative so that you don't get constipated." "You'll have to come to the hospital daily to be administered this drug."

"Make sure to see your health care provider promptly if you develop yellowish skin or eyes."

A 70-year-old male client asks why he is receiving a lower dose of zaleplon than his son. As part of the nurse's teaching plan, which explanation will the nurse give this client? "Older adults metabolize the drug more quickly, but due to renal dysfunction, the medication must be reduced." "Older adults metabolize the drug more slowly, and half-lives are longer than in younger adults." "Older adults metabolize the drug at the same speed as younger adults; I will check the dosage with your health care provider." "Older adults do not need as much of the medication for the desired effect as a younger adult does."

"Older adults metabolize the drug more slowly, and half-lives are longer than in younger adults."

The nurse is teaching a client about safe use of adrenergic drugs. Which statement should be included in the teaching? "Tell your health care provider if you are allergic to penicillin." "You shouldn't take cold remedies or appetite suppressants while on this drug, but you can take any other medication safely." "You can take cold medications while on this drug, but talk to your health care provider about other medications." "Talk to your health care provider before taking any other medications."

"Talk to your health care provider before taking any other medications."

A client has been prescribed baclofen and will be taking the drug on an outpatient basis. The client asks the nurse if it is still okay to drink wine with meals or end the day with a "nightcap." What is the nurse's best response? "The combination of baclofen and alcohol could depress your nervous system to a dangerous level." "If you combine baclofen and alcohol you could suffer a severe allergic-type reaction." "It's best to keep your alcohol intake to a low level when you're taking muscle relaxants." "You're not permitted to drink alcohol while you're taking baclofen."

"The combination of baclofen and alcohol could depress your nervous system to a dangerous level."

A female patient has expressed anxiety to the nurse surrounding the thought of being awake but unable to move or express pain during surgery. The patient states that she recently saw a movie that addressed this phenomenon and that she is consequently fearful about her impending surgery. How should the nurse reassure this patient? "Actually, the same drugs that make you unconscious are the ones that keep you from moving." "The whole surgical team will be monitoring you very closely throughout the procedure to make sure that things like this don't happen." "When you're unable to move because of the drugs that you're given, you're also unable to feel pain." "We will teach you signals to use in the unlikely event that you wake up during your surgery."

"The whole surgical team will be monitoring you very closely throughout the procedure to make sure that things like this don't happen."

One week ago, a client began taking ethosuximide 500 mg/day PO for the treatment of absence seizures. The client reports gastrointestinal (GI) upset after taking with the drug. What health education should the nurse provide? "Take the drug 1 hour before or 2 hours after a meal to minimize stomach upset." "Taking over-the-counter antacids before and after the dose helps for some clients." "Try taking your pills at the same time as you eat some food." "Contact your health care provider to see if there's an alternative drug that would work for you."

"Try taking your pills at the same time as you eat some food."

A patient is receiving sotalol. Which instruction would be most important for the nurse to provide to the patient to ensure maximum effectiveness of the drug? "Take an antacid at the same time you take the drug." "Be sure to take the drug on an empty stomach." "Eat a large meal and then take the drug." "Take the entire daily dose at one time."

"be sure to take the drug on an empty stomach"

A client is receiving propantheline as adjunctive therapy for peptic ulcers. The nurse instructs the client to take the medication at which time? 30 minutes before meals 1 hour after meals Only as needed for symptom relief During a meal

30 minutes before meals

A nurse caring for a client receiving bethanechol for urinary retention should advise the client that voiding usually occurs how long after oral administration? 30 to 90 minutes 5 to 15 minutes 2 to 4 hours 12 to 24 hours

30 to 90 minutes

After studying for a test on the brain and spinal cord, the students demonstrate understanding when they identify the spinal cord as being made up of how many pairs of nerves? 31 24 12 8

31

A client is receiving pancuronium. The nurse would expect to see the beginning effects of the drug in which approximate period of time? 30 to 60 seconds 1 to 2 minutes 4 to 6 minutes 8 to 10 minutes

4 to 6 minutes

Which patient would likely have the highest risk for hepatotoxicity from dantrolene? A 32-year-old male who is taking an antipsychotic drug A 45-year-old female who is taking an antihypertensive agent A 57-year-old female who is on hormone replacement therapy A 70-year-old male who is taking a cardiac glycoside

A 57-year-old female who is on hormone replacement therapy

A registered nurse who oversees the care in a large long-term care facility cares for several clients with Parkinson's disease. When reviewing the assessment findings from the practical nurses at the facility, what finding should the RN prioritize for follow-up? A client who began taking a dopaminergic three days ago and who is uncharacteristically disoriented. A client whose Parkinson's disease is newly diagnosed and who needs education. A client taking carbidopa-levodopa whose family states that the client's tremors have not improved. A client who was administered a scheduled dose of carbidopa-levodopa but who vomited one hour later.

A client who began taking a dopaminergic three days ago and who is uncharacteristically disoriented.

Which client is most likely to benefit from the administration of an adrenergic agonist? A man who is in cardiogenic shock following a myocardial infarction A man who has a diagnosis of primary hypertension A woman who has been admitted with a suspected ischemic stroke A woman who is in labor and may require a cesarean section

A man who is in cardiogenic shock following a myocardial infarction

The psychiatric-mental health nurse is overseeing care of several clients who are being treated with selective serotonin reuptake inhibitors. Which client should the nurse monitor most closely for adverse effects? A severely depressed 14-year-old client who is receiving inpatient care A 79-year-old client who has a comorbidity of early stage dementia A 60-year-old female client who is also taking hormone replacement therapy A client whose treatment regimen also includes electroconvulsive therapy (ECT)

A severely depressed 14-year-old client who is receiving inpatient care

First-dose effect occurs when the client experiences marked hypotension and syncope with sudden loss of consciousness with the first few doses of the sympatholytic. Which intervention might be helpful for the nurse to do to decrease the risk for first-dose effect? Administer the dose at bedtime Administer half the prescribed dose Administer the drug with food Administer the drug at longer intervals than prescribed

Administer the dose at bedtime

A nurse is reviewing the structure and function of the blood--brain barrier . This anatomical feature would have the greatest effect on what aspect of nursing care? Administering antibiotics to treat brain infections Assessing a client's cranial nerve function Determining the site of damage after a traumatic brain injury Obtaining accurate electroencephalography readings

Administering antibiotics to treat brain infections

Some anticholinergic drugs have the same clinical indications in the pediatric population as in the adult population. Which statement accurately describes a difference between the populations related to the use of anticholinergics? Anticholinergic drugs create different adverse effects in children. Adverse effects tend to be more severe in children. Anticholinergic drugs are more effective in the pediatric population. Adverse effects tend to be less severe in children.

Adverse effects tend to be less severe in children.

The nurse is caring for a client who is receiving an indirect-acting cholinergic medication and knows it is indicated as a treatment for myasthenia gravis as well as which other condition? Muscular dystrophy Musculoskeletal cancer Alzheimer's disease Cerebrovascular dementia

Alzheimer's disease

A client has presented to the day surgery unit and will be having a diagnostic procedure that will involve the use of a neuromuscular junction blocker. The client says to the nurse, "Let me get this straight: I won't be able to talk or move my muscles but I'll be awake?" The nurse's response should address the possibility of what nursing diagnosis? Anxiety related to paralysis Deficient knowledge related to drug therapy Risk for trauma related to immobility Disturbed body image related to paralysis

Anxiety related to paralysis

Magnetic resonance imaging of a client's brain indicates a lesion in Wernicke's area. What assessment should the nurse perform when gauging the effects of this lesion? Assess the client's ability to comprehend spoken instructions. Ask the client to walk in a straight line with his or her eyes closed. Ask the client to draw the face of a clock identifying the current time. Assess the client's ability to discern cold from hot sensations.

Assess the client's ability to comprehend spoken instructions.

Nicotinic receptors are found in which area? GI tract Bladder Autonomic basal ganglia Sweat glands

Autonomic basal ganglia

The nurse is caring for a client who is receiving an intravenous barbiturate. What assessment should the nurse prioritize? Blood pressure Oxygen saturation Assessment for bleeding Anaphylaxis

BP

A client is experiencing urinary retention. The client has been prescribed terazosin (Hytrin). What condition contributes to the urinary retention? Bladder cancer Benign prostatic hypertrophy Urinary tract infection Kidney cancer

Benign prostatic hypertrophy

A 75-year-old client is brought to the emergency department by the family. The family relates that the client has confusion, seizures, and abnormal perception of movement. When the nurse looks at the medication that the family has brought to the ED, the nurse discovers that twice the number of tablets are missing from the vial as there should be if the prescription orders were being followed. What should the nurse suspect is wrong with this client? Benzodiazepine toxicity Antihypertensive toxicity Sedative toxicity Analgesic toxicity

Benzodiazepine toxicity

What would be considered a peripheral anticholinergic effect of anticholinergic drug therapy? Delirium Blurred vision Agitation Memory loss

Blurred vision

A client with a high-pressure job temporarily requires an anxiolytic that has no sedative properties. What medication is most likely to meet this client's needs? Buspirone Zaleplon Meprobamate Diphenhydramine

Buspirone

Which agent has no sedative, anticonvulsant, or muscle relaxant properties but does reduce the signs and symptoms of anxiety? Diphenhydramine Zaleplon Buspirone Meprobamate

Buspirone

A nursing instructor is describing Parkinsonism to a group of nursing students. When discussing the underlying cause of the symptoms, the instructor explains the depletion of dopamine in which of the following? Central nervous system Peripheral nervous system Smooth muscle Skeletal muscle

CNS

A group of nursing students are preparing for a class presentation to discuss drugs used to treat Parkinson disease. Which drug would the group include when discussing dopaminergic agents? Carbidopa Benztropine Biperiden Procyclidine

Carbidopa

A client has come to get lab results at the cardiology clinic. The nurse notes that the digoxin level is elevated. The nurse knows that what other medication may be responsible for the increase in digoxin level? Prozac Zantac Ampicillin Carvedilol

Carvedilol

Alpha/beta blockers block both alpha-adrenergic and beta-adrenergic receptors. Which antiadrenergic drug is an alpha/beta blocker? Carvedilol Sotalol Propranolol Phentolamine

Carvedilol

When assessing a patient who has received a nondepolarizing NMJ blocker, the nurse determines that the patient is experiencing excessive effects of the drug. What would the nurse expect to be used? Cholinesterase inhibitor Narcotic antagonist Direct acting skeletal muscle relaxant Peripheral nerve stimulator

Cholinesterase inhibitor

A client is prescribed lamotrigine for control of partial seizures. What is the most important medication teaching information the nurse should emphasize from the plan of care? Take this medication with food to prevent nausea and vomiting. A mild headache may occur while taking this medication. Contact the health care provider immediately if rash appears. Seek assistance when walking if dizziness occurs.

Contact the health care provider immediately if rash appears.

The client is taking cyclobenzaprine for muscle spasms secondary to an injury to the lumbar spine that occurred while lifting a motor at work. The client is being seen for a follow-up visit by the health care provider. The client reports dry mouth, blurred vision, and constipation. Why is the client having these side effects from cyclobenzaprine? Cyclobenzaprine produces an anticholinergic response Cyclobenzaprine acts in the peripheral nervous system Cyclobenzaprine has an effect at the neuromuscular junction Cyclobenzaprine is structurally similar to amitriptyline

Cyclobenzaprine produces an anticholinergic response

A client with amyotrophic lateral sclerosis is experiencing muscle spasticity. Which drug would the nurse expect the physician to order? Chlorzoxazone Metaxalone Dantrolene Methocarbamol

Dantrolene

A patient receiving succinylcholine experiences malignant hyperthermia. What drug is used to treat this condition? Phenobarbital Dantrolene Pyridostigmine Acetylsalicylic acid

Dantrolene

When describing the action of barbiturates and barbiturate-like agents in the control of seizures, what would the nurse include? Promotion of impulse conduction Stimulation of the cerebral cortex Depression of motor nerve output Maintenance of cerebellar function

Depression of motor nerve output

A female client is taking cholinergic medication to control bladder retention. She presents to the emergency department with confusion, shortness of breath, and an apical pulse of 42 beats per minute and irregular. What action would the nurse expect the health care provider to take? Increase the cholinergic medication to increase cardiac contractility. Increase the cholinergic medication to increase oxygenation to the heart through vasodilation. Decrease the cholinergic medication to alleviate the symptom of confusion. Discontinue the cholinergic medication secondary to the diagnosis of bradycardia.

Discontinue the cholinergic medication secondary to the diagnosis of bradycardia.

What is the most important teaching from the plan of care, to emphasize, when a client is prescribed a skeletal muscle relaxant? Do not drive or operate machinery until individual drug effects are known. Always take this medication with food to prevent nausea and vomiting. Report increased muscle spasm to the health care provider immediately. Drink eight to 10 glasses of water daily to prevent constipation.

Do not drive or operate machinery until individual drug effects are known.

A client, with a creatinine level of 25 (1906.25 µmol/L), has been diagnosed with chronic obstructive pulmonary disease. Being prescribed tiotropium bromide, the client is at risk for developing which adverse condition? Drug toxicity Pneumonia Hepatotoxicity Central nervous system depression

Drug toxicity

The nurse is reviewing the results of a hospital client's serum phenytoin level, which has just become available. The results indicate that the client's phenytoin level is 17.5 mcg/mL. What is the nurse's best action? Document the fact that the nurse checked the client's phenytoin levels Contact the care provider to communicate this result Raise the client's bed rails and maintain the client on bed rest Perform a focused neurological assessment

Document the fact that the nurse checked the client's phenytoin levels

A 70-year-old female patient has just been diagnosed with Alzheimer's disease. What cholinergic drug is used for the treatment of Alzheimer's disease? Bethanechol (Duvoid) Neostigmine (Prostigmine) Donepezil (Aricept) Edrophonium (Tensilon)

Donepezil (Aricept)

A nurse administers carisoprodol to a client for the treatment of an acute musculoskeletal condition. The nurse would be alert for which adverse effect after administering the drug? Insomnia Anxiety Constipation Drowsiness

Drowsiness

When developing a teaching plan for a client who is to receive carisoprodol, which sign or symptom would the nurse include as a common adverse reaction? Drowsiness Dyspnea Hypertension Tachycardia

Drowsiness

Moderate CNS depression is characterized by: Wakefulness, mental alertness, and decreased fatigue. Drowsiness or sleep; decreased muscle tone; decreased ability to move; and decreased perception of sensations such as pain, heat, and cold. Increasing hyperactivity, excessive talking, nervousness, and insomnia. A lack of interest in surroundings and inability to focus on a topic.

Drowsiness or sleep; decreased muscle tone; decreased ability to move; and decreased perception of sensations such as pain, heat, and cold.

A client with schizophrenia has been taking haloperidol for several years. The care team and the client have collaborated and chosen to transition the client to an atypical antipsychotic in an effort to reduce adverse effects and maximize therapeutic effects. In order to reduce the client's risk of extrapyramidal effects during the transition from haloperidol to an atypical antipsychotic, the care team should implement which intervention? Gradually taper the dose of haloperidol. Have a 2- to 3-week "drug holiday" between stopping the haloperidol and starting the atypical antipsychotic. Administer haloperidol and the atypical antipsychotic drug concurrently for 6 to 8 weeks. Arrange for weekly electroconvulsive therapy (ECT) during the time of transition.

Gradually taper the dose of haloperidol.

A nurse is assessing a client's pain level. Which would be the most appropriate method? Ask the client to describe their pain in their own words. Have the client rate it on a scale of 0 to 10. Palpate the area where the client says the client has pain. Review the client's vital signs for changes.

Have the client rate it on a scale of 0 to 10.

Which action by the new nurse would alert the charge nurse that more education is needed for the new nurse, after administering an anxiolytic to a client? Having the client walk to the bathroom Raise the side rails Place the call light within reach Dim the lights

Having the client walk to the bathroom

Signs and symptoms of what would necessitate discontinuation of dantrolene therapy? Intermittent gastrointestinal upset Visual disturbances Urinary retention Hepatic dysfunction

Hepatic dysfunction

A student asks the physiology instructor what causes loss of muscle function, or paralysis. What would the instructor respond? If the anticholinergic muscle receptor cannot be activated paralysis, or loss of muscle function, occurs If ACh cannot react with the α-adrenergic receptors If ACh cannot react with the cholinergic muscle receptor to allow new stimulation muscle contraction, muscle paralysis, or loss of muscle function, occurs If the β-adrenergic muscle receptor cannot be activated paralysis, or loss of muscle function, occurs

If ACh cannot react with the cholinergic muscle receptor to allow new stimulation muscle contraction, muscle paralysis, or loss of muscle function, occurs

Which nursing focus is the highest priority for the nurse caring for a patient receiving a neuromuscular junction (NMJ) blocking agent? Altered comfort: pain Deficient knowledge Impaired gas exchange Impaired skin integrity

Impaired gas exchange

An older adult client has been prescribed an antiseizure medication and is experiencing central nervous system depression. What is the nurse's most appropriate action? Implement falls precautions Monitor vital signs hourly while the client is awake Maintain the client on bed rest Make a referral to occupational therapy

Implement falls precautions

The nurse is planning the care of a client who has been diagnosed with a cerebellar disorder. What should the nurse prioritize in this client's plan of care? Implement falls precautions. Reorient the client as needed. Monitor the client for seizure activity. Assess mood and affect once per shift.

Implement falls precautions.

The pharmacology instructor is discussing the drug therapy for Alzheimer's disease with a group of nursing students and states that indirect-acting cholinergic drugs do what to improve symptoms? Improve cholinergic neurotransmission to the brain Improve anticholinergic neurotransmission to the brain Improve medication absorption through the blood-brain barrier Cause vasodilation of the cerebral arteries

Improve cholinergic neurotransmission to the brain

The nurse administered donepezil (Aricept) to a patient. What is the therapeutic response the nurse expects to assess? Decreased urination Increased red blood cell count Decreased heart rate Improved memory

Improved memory

The client suffers from GERD and diverticulosis and has been admitted to a medical floor. The admitting physician orders cimetidine and a sedative to calm the client. What should the nurse be concerned about? Decreased sedative effect Increased sedative effect If the client's insurance will cover the two drugs Cost of the drugs

Increased sedative effect

A 70-year-old client is taking a cholinergic blocking drug. The family has noticed the client is a confused, excited, and not voiding normally. What would be the appropriate action by the nurse in this situation? Instruct the client's family to continue the medication and ignore the symptoms. Instruct the client's family to increase the dose of the medication to combat these symptoms. Instruct the client's family to withhold the next dose and the nurse will contact the prescribing provider. Instruct the client's family to take the client to the emergency department immediately.

Instruct the client's family to withhold the next dose and the nurse will contact the prescribing provider.

A client presents to the emergency department reporting rapid heart rate, severe headache, and pounding in the chest. While obtaining the clients history, the nurse learns the client stopped taking medications because the prescriptions ran out and had no funds to refill them. The nurse knows that which medications being abruptly stopped could be causing these symptoms? Labetalol An antidepressant Tylenol PM Reglan

Labetalol

Anticonvulsive medications are sometimes used in the treatment of bipolar disorder. What other drug is used to treat bipolar disorder? Valium Flexeril Lithium Restoril

Lithium

A client comes to the emergency department. The client is experiencing continuous seizure activity without any interruptions. Which anticonvulsant would the nurse anticipate that the primary health care provider would most likely prescribe initially? Lorazepam Phenytoin Fosphenytoin Valproic acid Clorazepate

Lorazepam

Prior to administering morphine, the nurse checks the client's medication history. The nurse will contact the health care provider and hold the morphine if the nurse notes the client is currently taking which medication? Antibiotic Antihypertensive Monoamine oxidase (MAO) inhibitor NSAID

Monoamine oxidase (MAO) inhibitor

A nurse is conducting a medication resolution of a new resident of a care facility and notes that the woman has been taking neostigmine. The nurse should recognize that the woman may have a history of what health problem? Alzheimer disease Parkinson disease Myasthenia gravis Multiple sclerosis

Myasthenia gravis

A nurse is reviewing a client's history for conditions that would contraindicate the use of anticholinergics for Parkinson's disease. Which would cause the nurse to be concerned? Hypertension Myasthenia gravis Hepatic dysfunction Cardiac arrhythmia

Myasthenia gravis

The nurse is preparing a patient for an endoscopic procedure that will use a nondepolarizing neuromuscular junction (NMJ) blocking agent. Which condition in the patient's history will require a change in anesthetic medication? Osteoarthritis Hypothyroidism Peptic ulcer disease Myasthenia gravis

Myasthenia gravis

After teaching a group of students about indirect acting cholinergic agonists used to treat myasthenia gravis, the instructor determines that the teaching was effective when the students identify which agent? Neostigmine Galantamine Rivastigmine Tacrine

Neostigmine

The student asks the physiology instructor where the motor neuron communicates with a skeletal muscle fiber. What would the instructor respond? Synapse Neuromuscular junction Synaptic cleft Afferent junction

Neuromuscular junction

A patient comes to the clinic for a botox injection around her eyes. While making an assessment, the nurse finds that the patient is taking polymyxin for an infection. What would the nurse do first? Prepare the patient for the injection. Wash her hands. Notify the physician. Document the polymyxin on the chart.

Notify the physician.

An elderly woman is given scopolamine while on a cruise. She becomes very agitated and confused and is taken to the sick-bay of the ship. The nurse knows that which is a likely reason for these symptoms? Most elderly clients have dementia, which would prevent them from having normal, visual adverse reactions to cholinergic blocking drugs. Urinary retention often causes agitation. Older clients have a greater chance of adverse reactions to cholinergic blocking drugs. Elderly clients have more difficulty sleeping than regular clients, so the drowsiness that is a common side effect does not occur.

Older clients have a greater chance of adverse reactions to cholinergic blocking drugs.

A client who has been receiving long-term levodopa therapy tells the nurse, "I was making good progress and then it was like the drug stopped working." The nurse interprets this as which of the following? On-off phenomenon Drug holiday Bradykinesia Choreiform movements

On-off phenomenon

The nursing instructor is discussing cholinergic drugs. The nursing students understand what system is acted upon by this family of drugs? Sympathetic nervous system Parasympathetic nervous system Cardiovascular system Genitourinary system

Parasympathetic nervous system

The nurse is aware that which medication taken by a client for treatment of mood disorder requires a diet that restricts the amount of tyramine eaten? Diazepam Phenelzine Triazolam Paroxetine

Phenelzine

A nurse is preparing to administer an anticonvulsant that produces its effects by stabilizing the hyperexcitability postsynaptically in the motor cortex of the brain. Which medication would the nurse administer? Phenytoin Valproic acid Ethosuximide Lorazepam

Phenytoin

The nurse is preparing a client who will receive intravenous anesthetic during a short surgical procedure. The nurse understands that this client is most likely to receive which medication? Diazepam Nitrous oxide Isoflurane Propofol

Propofol

The nurse is preparing a teaching plan for a patient who is to receive a nonselective beta blocker. The nurse would make sure to address safety measures as a priority for the patient receiving: Carteolol Nadolol Sotalol Propranolol

Propranolol

A patient undergoing treatment with barbiturates is showing symptoms of barbiturate toxicity. Which intervention should the nurse perform? Provide assistance with movement Provide supportive care Provide respiratory assistance Provide a safe environment

Provide respiratory assistance

A client is prescribed glycopyrrolate preoperatively. The nurse integrates understanding of the drug's action, explaining that this drug will help achieve which effect? Reduction of oral secretions Increase muscle rigidity Relaxation Prolongation of anesthesia

Reduction of oral secretions

While taking the vital signs of a hospitalized client admitted for seizure control due to epilepsy, the nurse notices a bloody toothbrush on the client's bedside table and scattered bruising over the client's extremities. What is the nurse's best action? Document the findings and offer the client a soft-bristled toothbrush. Notify the charge nurse about reporting suspected physical abuse. Tell the client to ask for assistance when ambulating so as to prevent bruising. Report the findings to the primary health care provider immediately.

Report the findings to the primary health care provider immediately.

A military nurse is part of a team reviewing the appropriate response to chemical weapons attacks, including sarin, tabun, and soman. When reviewing the physiology of a response to such drugs, the nurse should identify what goal of treatment? Restore anticholinesterase function Restore GABA function Restore dopamine function Restore appropriate serotonin reuptake

Restore anticholinesterase function

A patient is receiving tamsulosin. The nurse understands that this drug is most likely being given for which reason? To relax prostatic smooth muscles To decrease vascular tone To promote vasodilation To induce a reflex tachycardia

To relax prostatic smooth muscles

A 27-year-old client has been in the intensive care unit for two weeks following a car accident. The primary nurse is concerned that the client is not getting the rest needed for recovery. Which nursing diagnosis would be appropriate for this problem? Risk for Narcolepsy related to nighttime wakefulness Risk for Body Image Disturbance related to injuries Risk for Disturbed Sleep Pattern related to hospitalization Risk for Psychosis related to head injury

Risk for Disturbed Sleep Pattern related to hospitalization

Which nursing diagnosis would be most important for a nurse to include in the plan of care for a client who is receiving an antiseizure agent and experiencing common adverse effects? Risk for injury Risk for imbalanced fluid volume Impaired skin integrity Ineffective coping

Risk for injury

A female client is going on a cruise to Nova Scotia with her husband to celebrate their 15th wedding anniversary. She is concerned because she has experienced severe, debilitating seasickness in the past. What would the nurse expect the health care provider to order? Scopolamine Dexamethasone Palonosetron Ondansetron

Scopolamine

Which anticholinergic agent is sometimes used to manage motion sickness when delivered by transdermal patch? Scopolamine Hyoscyamine Atropine Tolterodine

Scopolamine

A client is to receive diazepam as part of the treatment for status epilepticus. The client has ana peripheral intravenous infusion in the left arm that is being used to administer phenytoin. Which action would be most appropriate for the nurse to do? Start another IV line in the client's right arm. Contact the prescriber to question the order. Add the diazepam to the current IV infusion. Wait until the infusion is completed to give the diazepam.

Start another IV line in the client's right arm.

A patient is prescribed daily doses of phenytoin for seizures. The nurse knows that a single dose should not be missed during the course of treatment. Which condition could result if a dose is missed? CNS depression Hypotension Status epilepticus Nystagmus

Status epilepticus

The nurse is caring for a client with asthma who has been experiencing shortness of breath and who has been administered a medication to cause bronchodilation. What aspect of autonomic nervous function has the nurse most likely influenced? Stimulation of beta-adrenergic receptors Reuptake of acetylcholine Synthesis of acetylcholinesterase Inhibition of alpha-adrenergic receptors

Stimulation of beta-adrenergic receptors

A surgical client is receiving a neuromuscular junction (NMJ) blocker. The nurse knows that the client cannot move because the client's acetylcholine receptor sites have been stimulated and the drug is remaining in the receptor sites, preventing repolarization. What medication is this client receiving? Succinylcholine Pancuronium Atracurium Vecuronium

Succinylcholine

A 27-year-old male is taking an anticholinergic drug as adjunctive therapy to treat his peptic ulcer disease. The client comes to the clinic and tells the nurse that he "feels his heart beating." What adverse effect is the client experiencing from the anticholinergic medication? Tachypnea Tachycardia Hypotension Urinary frequency

Tachycardia

The nurse is providing education to a client who has been prescribed sumatriptan. In order to maximize therapeutic benefit while reducing the risk of adverse effects, the nurse should encourage the client to implement which intervention? Take the medication before breakfast each day. Take the medication on days when migraines may be anticipated. Take the medication as soon as the earliest symptoms of migraine are sensed. Take the medication when the pain of a migraine becomes too much to bear.

Take the medication as soon as the earliest symptoms of migraine are sensed.

The nurse is caring for a patient who is taking an oral neuroleptic medication. What would be important to include in the patient teaching? Urge incontinence Orthostatic hypotension Bradycardia Tardive dyskinesias

Tardive dyskinesias

A client diagnosed with migraines expresses interest in taking an over-the-counter acetaminophen, aspirin, and caffeine combination drug. Which information presented in the client's history should prompt the nurse to discourage the client from taking the drug? The client has not adhered to previous treatment regimens. The client has a chronic venous ulcer on the lower leg. The client has a diagnosis of liver cirrhosis. The client is a smoker.

The client has a diagnosis of liver cirrhosis.

A female client is diagnosed with Parkinson's disease and is having difficulty performing her activities of daily living. Her health care provider orders pramipexole. Pramipexole may be used alone for which purpose? To maintain ability to perform activities of daily living To delay physical impairment related to Parkinson's disease To delay mental impairment related to Parkinson's disease To improve motor performance and improve ability to participate in usual activities of daily living

To improve motor performance and improve ability to participate in usual activities of daily living

The nurse is assessing a client. What assessment finding is the clearest indicator of autonomic function? The client's respiratory rate is 22 breaths per minute The client's hearing is intact The client's muscle strength is equal bilaterally The client can discern hot sensation from cold

The client's respiratory rate is 22 breaths per minute

A client admitted for a severe migraine reports taking ergotamine tartrate at home. What is most essential information for the nurse to obtain? What other medications the client takes The client's ability to swallow The number of ergotamine tablets the client took at home How long the client has had the headache

The number of ergotamine tablets the client took at home

A nurse is caring for a patient who requires antiparkinsonism drugs. What should the nurse confirm to ensure that the use of COMT inhibitors is not contraindicated in this patient? The patient is not lactating. The patient does not have achalasia. The patient does not have peptic ulcers. The patient does not have glaucoma.

The patient is not lactating.

A client has been prescribed the nonselective beta-adrenergic blocker, timolol for the treatment of open angle glaucoma. What instructions should the nurse provide to assure the effectiveness of the medication? Keep the medication refrigerated between administration The proper method for instilling eye drops Be aware that diastolic blood pressure may temporarily rise Medication should be taken with a full glass of fluids

The proper method for instilling eye drops

Morphine, an opioid agonist, is administered for both acute and chronic pain. Along with the administered dosage, what determines the patient's response to morphine? The patient's insistence on receiving the drug The patient's gender The route of administration The patient's disease process

The route of administration

A 52-year-old male client is being treated for Parkinson's disease. The nurse is aware that Parkinson's disease results in several physical manifestations. What occurs in the neurons that causes these symptoms? There is an increase in dopamine in the terminal nerve endings. There is an imbalance between dopamine and acetylcholine. There is an increased level of GABA at the striatum. There is a decrease in stimulation of the nigrostriatal neural tracts.

There is an imbalance between dopamine and acetylcholine.

A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which instruction? Eat a high-protein diet. Decrease the dosage if any adverse effect is experienced. Wear appropriate clothing and sunscreen whenever he is in direct sunlight. Have a complete blood cell count done weekly.

Wear appropriate clothing and sunscreen whenever he is in direct sunlight.

A male client is admitted to the emergency department via ambulance. He is attempting to pull out his IV line, exhibiting symptoms of agitation, and thrashing about. The physician orders a benzodiazepine-type sedative. What information is needed prior to administration of the drug? Whether the client has a history of agitation Whether the client is currently taking antibiotics Whether the client is experiencing drug intoxication or withdrawal Whether the client is currently taking a diuretic

Whether the client is experiencing drug intoxication or withdrawal

A male client is diagnosed with chronic renal failure. He routinely takes amantadine for his Parkinson's disease with success. Why would his health care provider consider discontinuing the amantadine? With amantadine, 50% of the drug is excreted via the kidneys. With amantadine, metabolism occurs in the kidneys. With amantadine, catabolism occurs in the kidneys. With amantadine, excretion is primarily via the kidneys.

With amantadine, excretion is primarily via the kidneys.

The nurse has just administered an opioid antagonist to a client who had been experiencing respiratory depression. How soon can the nurse expect to see improvement in the client's respiratory function? Improvement will occur within 30 minutes from the time of administration. Slow improvement can be noted throughout the shift. Within one to five minutes, an effect may be seen. Response is highly individualized based upon client weight.

Within one to five minutes, an effect may be seen.

A client diagnosed with Parkinson's disease and hepatic disease is to begin tolcapone therapy. What intervention should be included in the client's plan of care? regular cardiograms daily glucose finger sticks annual eye examinations a baseline liver function test

a baseline liver function test

When administering an opioid antagonist drug to a client, the primary goal of the therapy is to provide: a return to normal respiratory rate, rhythm, and depth. management of alcohol withdrawal symptoms. a reduction in the client's rating of their pain. alertness and improve memory function.

a return to normal respiratory rate, rhythm, and depth.

In a person being treated for a diagnosed seizure disorder, what is the most common cause of status epilepticus? abusing drugs and/or alcohol abruptly stopping the antiseizure medications hypoxia-inducing experience experiencing a brain injury

abruptly stopping the antiseizure medications

Which assessment finding indicates that a neuromuscular junction (NMJ) blocking agent is effective? Absent reflexes Patient reports no pain Hypocalcemia Hyperkalemia

absent reflexes

A client is experiencing sympathetic stimulation in response to a stressful event. Which substance will most affect the client's sodium and water retention? Aldosterone Thyroid hormone Cortisol Glucose

aldosterone

The client has been ordered a nonselective beta-blocking agent called propranolol, PO. Propranolol is used in the treatment of which disorders? Hypertension Angina Arrhythmias All the above

all the above

A client has recently been prescribed a drug that treats hypertension by blocking the sympathetic receptors in the sympathetic nervous system. This action is characteristic of which? an adrenergic antagonist. an adrenergic agonist. a cardiotonic. a neurotransmitter.

an adrenergic antagonist

A nurse is caring for a patient who is having a sympathetic response. A sympathetic response involves: a decrease in sweating, decrease in respirations, and pupil constriction. a decrease in heart rate, decrease in blood flow to skeletal muscles, and increase in inflammatory reactions. an increase in blood pressure, bronchi dilation, and decreased bowel sounds increased motility, secretions in the GI tract, and constriction of bronchi and pupils

an increase in blood pressure, bronchi dilation, and decreased bowel sounds

The nurse is caring for a school-aged child who recently underwent dental surgery that involved the administration of procaine. The child has just been given permission to resume oral fluid intake. When monitoring the child's intake, the nurse should prioritize assessment for what potential complication? aspiration oral hemorrhage rebound pain irritation of oral mucous membranes

aspiration

The client is taking digitalis and has not been monitoring pulse rate. The client presents to the emergency department via ambulance experiencing digitalis toxicity and symptomatic bradycardia. The nurse knows that which medication may be administered to treat bradycardia? Atropine Milrinone Norvasc Lasix

atropine

Which agent would be used to counteract a severe reaction occurring with the use of neostigmine? Atropine Naloxone Edrophonium Phentolamine

atropine

The nurse is providing education to a client who has been recently diagnosed with myasthenia gravis. During teaching, the nurse would describe it as what type of disorder? connective tissue autoimmune genetic chronic inflammatory

autoimmune

A patient is admitted to the emergency room after a car accident. Based on the experience of the emergency room nurse, what system will affect a response to the emergency? Central nervous system Autonomic nervous system Endocrine system Cardiovascular system

autonomic nervous system

A patient has sustained an injury to the cerebellum. Which area would be the primary area for assessment? Vital signs Neurologic system Cardiac function Coordination

coordination

A client with asthma is prescribed albuterol to dilate the bronchioles. The nurse understands that this drug is likely acting on which receptors? Beta-2 Alpha-1 Alpha-2 Beta-1

beta-2

A client is being treated for asthma. What would the nurse expect to administer? Alpha- and beta-adrenergic agonist Alpha-specific adrenergic agonist Beta-1-specific adrenergic agonist Beta-2-specific adrenergic agonist

beta-2 adrenergic agonist

The nurse knows that which class of drugs prevents epinephrine and norepinephrine from occupying receptor sites on the cell membranes? Beta-blocking agonist Beta-adrenergic drugs Beta-helping drugs Beta-adrenergic blocking drugs

beta-adrenegric blocking drugs

A client with chronic obstructive pulmonary disease (COPD) is experiencing bronchoconstriction. When choosing interventions to address this problem, the nurse should aim to influence the client's autonomic nervous system by stimulating: the parasympathetic response. alpha-adrenergic receptors. beta-adrenergic receptors. acetylcholine release.

beta-adrenergic receptors.

A trauma client has been receiving frequent doses of morphine in the 6 days since his accident. This pattern of analgesic administration should prompt the nurse to carefully monitor the client's what? urine specific gravity. skin integrity. bowel patterns. core body temperature.

bowel patterns

A client is receiving a barbiturate intravenously. The nurse would monitor the client for: hypertension. bradycardia. tachypnea. bleeding.

bradycardia.

Which would a nurse identify as a component of the hindbrain? Thalamus Limbic system Brain stem Cerebrum

brain stem

A client receives a beta-specific agonist. What would lead the nurse to determine that the drug is effective? Bronchodilation Decreased heart rate Tremor Slowed cardiac conductivity

bronchodilation

A patient has been administered dobutamine HCL. Which adverse reactions should the nurse monitor for in the patient? Cardiac arrhythmias Urinary retention Elevated temperature Sleeplessness

cardiac arrythmias

A 21-year-old man experienced massive trauma and blood loss during a motorcycle accident and has been started on a dopamine infusion upon his arrival at the hospital. In light of this drug treatment, what assessment should the care team prioritize? Respiratory assessment Arterial blood gases Monitoring of intracranial pressure Cardiac monitoring

cardiac monitoring

A patient exhibiting an uncoordinated gait has presented at the clinic. The nurse knows that what brain structure has the function of balance and coordination? Cerebellum Pons Medulla Midbrain

cerebellum

The CNS structure involved in all higher order functions, including conscious processes containing both motor and sensory areas, is the: thalamus. hypothalamus. cerebral cortex. corpus callosum.

cerebral cortex.

The home health nurse is caring for a 77-year-old male patient who has just been discharged from the hospital. The patient is taking dobutamine for congestive heart failure. What would be most important to monitor in this patient? Availability of caregivers Effectiveness of comfort measures Dietary intake Compliance with drug regimen

compliance with drug regimen

An older adult client is prescribed a sedative for the treatment of insomnia. The nurse would suspect that the client is experiencing an adverse reaction to the drug based on assessment of which of the following? Headache Stress Confusion Anxiety

confusion

The nurse works in a long-term care facility. When administering narcotics to clients, the nurse must monitor for which side effect? Diarrhea Bleeding Sleep deprivation Constipation

constipation

A client has been prescribed a beta blocker. The nurse knows that beta blockers can have which effect on the heart? Decrease the heart rate Increase the heart rate Prevent normal sinus rhythm Constrict the heart

decrease HR

Indications for use of anticholinergic drugs in the treatment for Parkinsonism include to: decrease headaches. improve blurred vision. decrease salivation, spasticity, and tremors. decrease motor movement.

decrease salivation, spasticity, and tremors.

The nurse is caring for a client who is known to have deficient levels of dopamine because of a dietary lack of tyrosine. The nurse should expect to assess for evidence of: decreased adrenergic response. increased adrenergic response. overstimulation of nicotinic receptors. hyperfunction of the sympathetic nervous system.

decreased adrenergic response.

A client has been prescribed an adrenergic blocking drug for glaucoma. Which nursing interventions should the nurse include when teaching the client? Demonstrate the technique of eye drop instillation Demonstrate the method of cleaning eyes Suggest the client protect his eyes from exposure to sunlight Inform the client about eye drop preservation

demonstrate the technique of eye drop instillation

A client who is going on a cruise is concerned about motion sickness and sees the health care provider, who prescribes scopolamine. The nurse informs the client that using scopolamine may cause the client to experience: pupil constriction. drowsiness. diarrhea. urinary incontinence.

drowsiness.

When combination therapy is ineffective, what needs to be reassessed? Whether the patient is truly having seizures Drug-drug interactions Understanding of drug therapy regimen Age and gender of patient

drug-drug intx

Common side effects of anticholinergics include: dry mouth, urinary retention, constipation, and increased pulse rate. blurred vision, decreased liver enzymes, increased B/P, and papillary constriction. decreased GI absorption, nausea, heartburn, and hypotension. skin rashes, decreased urinary output, constipation, and increased WBCs.

dry mouth, urinary retention, constipation, and increased pulse rate.

The nurse prepares to administer a preoperative anticholinergic to a client. What is a desired effect based upon the characteristics of the prescribed medication? wheezing heart rate 50 dry mucous membranes bilateral constricted

dry mucous membranes

A client is experiencing anaphylaxis. What drug will the nurse most likely administer? Epinephrine Norepinephrine Acetylcysteine Dantrolene sodium

epinephrine

Which would the nurse expect to be prescribed to a client experiencing acute bronchospasm? Epinephrine Dopamine Metaraminol Norepinephrine

epinephrine

The nurse is aware that cholinergic blocking agents will be used preoperatively for what type of anesthesia? Topical Local Regional General

general

Which substance is required for brain cell metabolism? Glucose Serotonin Bile Oxytocin

glucose

A nurse is caring for a patient who is being administered alprazolam. What initial adverse reaction of alprazolam should the nurse assess for? Heartburn Anorexia Headache Allergy

headache

A nurse in the intensive care unit is caring for a client in shock and has started IV administration of dopamine (Intropin). For a client in shock, dopamine helps to: decrease heart rate. decrease blood pressure. increase blood pressure. increase body temperature.

increase BP

What is the resulting physiologic effect when the parasympathetic nervous system is stimulated? Decreased GI secretions Increased GI motility Increased heart rate Pupil dilation

increased GI motility

The nurse is assessing a client who received epinephrine, an adrenergic drug, for the treatment of cardiac arrest. The nurse would expect to observe what effect of the drug? Increased heart rate Decreased respiratory rate Urinary retention Decreased kidney perfusion

increased HR

A client is administered epinephrine in conjunction with a local anesthetic. What effect will epinephrine produce? Decreased cerebral circulation Decreased coronary circulation Increased vasoconstrictive effects Increased bronchoconstriction

increased vasoconstrictive effects

A 60-year-old client tearfully explains to the nurse how her husband downplays her frequent migraines and tells her that she needs to "just push through a headache." She describes how her migraines have limited her ability to provide childcare for her young grandchildren and explains that she is unable to keep up her garden. The nurse should identify what nursing diagnosis when planning this client's care? ineffective health maintenance related to migraine headaches ineffective role performance related to migraine headaches situational low self-esteem related to migraine headaches spiritual distress related to migraine headaches

ineffective role performance related to migraine headaches

A nurse is educating a client who has Parkinson's disease and family regarding possible adverse effects of carbidopa-levodopa. The nurse emphasizes which should be a closely monitored effect? involuntary movements. perspiration. appetite or thirst. mobility.

involuntary movements.

A 10-year-old child has been playing soccer and sustains a closed head injury in a collision with another player. The parent states that the child was unconscious for 5 minutes. Upon admission to the emergency department, the child has difficulty breathing. What area of the brain will have developed cerebral edema? Thalamus Cerebellum Pituitary Medulla oblongata

medulla oblongata.

The CNS structure containing groups of neurons responsible for vital cardiac, respiratory, and vasomotor functions is the: reticular activating system. limbic system. medulla oblongata. hypothalamus.

medulla oblongata.

A client is prescribed methsuximide. The nurse should expect to administer this drug by which route? Oral Rectal Intramuscular Intravenous

oral

A client is prescribed propantheline. The nurse would administer this drug by which route? Oral Subcutaneous Intramuscular Intravenous

oral

A patient with dementia of Alzheimer's disease is prescribed rivastigmine by the primary health care provider. Which is the correct method of administering rivastigmine to the patient? Intravenously Intramuscularly Orally Subcutaneously

orally

What adverse effect could be related to a fall experienced by an older client prescribed amitriptyline? urinary frequency urinary retention visual disturbances orthostatic hypotension

orthostatic hypotension

A patient is experiencing a heart rate of 42 beats per minute. Which system contributes to bradycardia? Parasympathetic nervous system Pulmonary system Autonomic nervous system Peripheral vascular system

parasympathetic nervous system

Which medication prescribed for insomnia is thought to play a role in maintenance of the circadian rhythm? ramelteon zaleplon zolpidem alprazolam

ramelteon

A 71-year-old patient with a history of depression will be receiving vecuronium to prevent trauma during electroconvulsive therapy. Prior to the procedure, the care team must assess the patient's: understanding of the pharmacodynamics of vecuronium. goals for recovery. renal and hepatic status. blood glucose levels

renal and hepatic status.

A nurse is caring for a client with trigeminal neuralgia at a health care facility. The health care provider has prescribed carbamazepine. In which case is the use of carbamazepine contraindicated in clients with: nervous breakdown. renal impairment. hearing impairment. respiratory depression.

renal impairment.

The client has had a myocardial infarction. The nurse is administering morphine sulfate for the pain. What vital sign would the nurse monitor that directly relates to the use of this narcotic? Heart rate Respiratory rate Temperature Pulse

resp rate

A client is diagnosed with a sleep disorder. Which neurotransmitter is most likely to be dysfunctional for this client? Serotonin Glutamate GABA Acetylcholine

serotonin

When levels of serotonin are high in the RAS, the system shuts off and what occurs? Arousal Sleep Memory loss Pain

sleep

An 87-year-old female has had extensive surgery for an acoustic neuroma (inner ear benign tumor). Six hours after surgery she hemorrhages and goes into a coma. After awakening and undergoing 2 months of therapy, she is transferred to a long-term care facility. Due to damage in the midbrain, the nurse caring for the patient will expect the patient to exhibit difficulty in: sleeping. swallowing. distinguishing hot and cold. speaking.

sleeping

A client is acutely ill with a brain abscess and the family has questioned why the client is not receiving intravenous antibiotics. When providing education to the family, the nurse should explain: the structure and function of the blood-brain barrier. the lack of blood perfusion in many areas of the brain. the effect that macrophages in the CNS have on medications. the role of cerebral spinal fluid (CSF) in pharmacokinetics.

the structure and function of the blood-brain barrier.

Muscle spasms are thought to arise from the flood of sensory impulses coming to the spinal cord from an injured area. True False

true

Spinal reflexes are the simplest nerve pathways that monitor movement and posture. True False

true

The circle of Willis distributes blood to the brain as needed. True False

true

True or false: Patients who are receiving alpha-specific adrenergic agents should not stop taking the drug abruptly.

true

true or false: Phentolamine is the agent used to treat extravasation of dobutamine.

true

Norepinephrine is made by nerve cells using which substance? Choline Tyrosine Decarboxylase Glycogen

tyrosine

An adolescent taking oral contraceptives has been prescribed an anticonvulsant medication. The nurse should tell the client to do which? use another form of birth control, such as condoms. watch for signs of hyperglycemia, such as increased thirst, hunger, and urination. be aware that these two drugs will interact and increase seizure activity initially. stop driving due to the increased depressant effects and excessive drowsiness.

use another form of birth control, such as condoms.