pharm mid-term study

In addition to facilitating sleep, what is another benefit of sedatives?

Decreased patient anxiety

The nurse is assessing an older patient with Parkinson's disease who was started on entacapone 1 week ago. The patient has a history of coronary artery disease and takes an antihypertensive and aspirin. Which information would support the need for a reduction in medication dosage by the health care provider?

Dizziness

The nurse is caring for a patient taking a cholinergic agent. When auscultating lung sounds, the nurse notes inspiratory and expiratory wheezing bilaterally. The best action for the nurse to take would be to

withhold the next dose and notify the physician

What can occur as a result of rapid withdrawal from long-term use of barbiturate therapy? (Select all that apply.)

-Grand mal seizures -Delirium -Weakness - Anxiety

Dopamine agonists have been linked with which adverse effects in patients with Parkinson's disease?

Sudden sleep events

Which adverse effects associated with levodopa therapy would support the nursing diagnosis risk for injury?

Orthostatic hypotension

When reviewing a patient's history and physical information, the nurse notes that the patient has physician's orders for chloral hydrate and warfarin. During assessment of this patient, the nurse observes areas of petechiae and ecchymosis on the upper and lower extremities. The most appropriate lab work for the nurse to assess next is

prothrombin time

A long-term care resident is taking an anticholinergic agent. The nurse observes the resident to be disoriented and hallucinating. The priority nursing action is to

provide for resident's safety

A patient's liquid cough medicine has been discontinued with one half of the bottle remaining. The home health nurse is aware that according to the U.S. Food and Drug Administration (FDA) guidelines on prescription medication disposal, the next step should be to

read the drug label for specific disposal instructions

The nurse is providing education to a patient recently placed on selegiline disintegrating tablets. Which statement by the patient indicates a need for further teaching?

"I will place the tablet on my tongue before breakfast."

Which action(s) would let the nurse know that the patient has mastered a psychomotor skill? (Select all that apply.)

- Ask questions about the process. - Give a reciprocal demonstration of the process

Which action(s) by the nurse can foster patient responsibility for adhering to the therapeutic regimen? (Select all that apply.)

- Determining the patient's level of understanding of content - Determining the patient's education level and learning style - Assessing the patient's readiness to learn

Which is an example of ethnocentrism?

A 36-year-old Asian prefers to take herbs instead of an oral medication

What is a critical care pathway?

A standardized care plan derived from best practice patterns

Which is an example of an interdependent nursing action?

Administer Demerol 50 mg intramuscularly (IM) every 4 hours PRN

Which example best demonstrates safe drug administration by the nurse?

Administering an oral medication with the patient sitting upright

The nurse is educating a 13-year-old boy newly diagnosed with diabetes and his parents about diet and glucose monitoring. Which domain of learning is represented when the patient expresses concern about feeling different from his peers?

Affective

Which is the most intangible portion of the learning process?

Affective

The autonomic nervous system can be subdivided into which types of adrenergic receptors?

Alpha and beta

A patient has been prescribed lorazepam (Ativan), a benzodiazepine used to treat insomnia. Which action will the nurse take?

Assess the patient's blood pressure in sitting and lying positions

Which vitamin will reduce the therapeutic effects of levodopa?

B6

Prior to the administration of metoprolol, a beta-adrenergic blocking agent, which is most important for the nurse to assess?

Blood pressure

What is the most reliable method to calculate a pediatric patient's medication dosage?

Body surface area (BSA)

Before the initiation of anticholinergic medications, it is important for the nurse to screen patients for which condition?

Closed-angle glaucoma

Which task is included in the assessment step of the nursing process?

Collecting and communicating data

What is medication reconciliation?

Comparing the patient's current medication orders to all of the medications actually being taken

The nurse determines that a prescribed medication has not been administered as ordered on the previous shift. What action will the nurse take?

Complete an incident report

Which action will the nurse take if a dosage is unclear on a health care provider's order?

Contact the health care provider to verify the correct dosage

What is the rationale for administering levodopa instead of dopamine for treatment of Parkinson's disease?

Dopamine does not cross the blood-brain barrier when administered orally

The nurse is providing information to a patient recently prescribed entacapone. Which statement is correct?

Dosage is adjusted according to the patient's response.

Which condition would alert the nurse of the need to use beta-adrenergic blockers cautiously?

Emphysema

The nurse has determined that the pain medication given to a patient an hour ago has been effective. The nurse is using which step of the nursing process?

Evaluation

The nurse has taught a patient's spouse to administer an injectable medication. After the spouse completed a return demonstration of the injection in the hospital, the nurse does not feel confident that this can be carried out independently at home and requests referral for a home health nurse. The nurse is using which phase of the nursing process?

Evaluation

What is the primary purpose of the nursing assessment?

Exploring patient responses to health problems

What is the basis of the NANDA-I taxonomy?

Human response patterns

What is the priority nursing diagnosis for an older adult with diabetes who is hospitalized for pneumonia?

Impaired gas exchange related to decreased pulmonary ventilation

The nurse is explaining the use of medications to a patient with insomnia. Which statement about sedatives is true?

Increased relaxation occurs with sedatives

Which medication route provides the most rapid onset of a medication but also poses the greatest risk of adverse effects?

Intravenous (IV)

The nursing assessment identifies that the client is nauseated and cannot take acetaminophen (Tylenol) orally. Which is true regarding the substitution of this medication to suppository form?

It is contraindicated without an order from the health care provider

Which medication order requires nursing judgment and means "administer if needed"?

Morphine 4 mg IV every 4 hours PRN

Parkinson's disease has which characteristic symptom(s)? (Select all that apply.)

Muscle tremors Posture alterations Slow body movement

Which disease is associated with insufficient sleep?

Myocardial infarction

A patient is experiencing adverse effects of a medication. Which information obtained by the nurse is subjective?

Nausea

Which statement regarding nursing diagnoses is accurate?

Nursing diagnoses describe patient problems that nurses treat.

For what conditions are benzodiazepines prescribed?

Preoperative sedation

What is the most important nursing consideration when teaching an older adult patient about a newly prescribed medication?

Present information slowly.

Which two phases make up normal sleep?

Rapid eye movement (REM) and non REM

What is the pharmacologic action of entacapone, a potent catechol O methyl transferase (COMT) inhibitor?

Reduces the destruction of dopamine in peripheral tissues

Which action will the nurse take when it is determined that the narcotic count is incorrect while obtaining a medication from the narcotic area?

Report the discrepancy to the charge nurse immediately

The nurse finds that a patient is extremely agitated, yells frequently, and is attempting to get out of bed without assistance. What is the nurse's initial action?

Spend uninterrupted time listening to the patient.

Which sleep pattern stage diminishes as an effect of aging?

Stage IV

What do the classification systems NIC and NOC provide?

Standardized language for reporting and analyzing nursing care delivery

The nurse is teaching a patient with Parkinson's disease about levodopa. Which statement by the nurse is accurate regarding drug administration?

Take this medication with food or antacids to reduce GI upset

When a nursing diagnosis statement is written, who or what directs the nurse to identify appropriate nursing interventions?

The etiologies of the problems identified in the nursing diagnoses

What is the nurse's primary source of information when obtaining a patient history?

The patient

A patient with Parkinson's disease asks the nurse why anticholinergics are used in the treatment. Which response by the nurse is most accurate?

These drugs inhibit the action of acetylcholine

Why are beta blockers used cautiously in patients with respiratory conditions?

They may produce severe bronchoconstriction.

A patient with a history of type 1 diabetes after myocardial infarction has been placed on a beta-adrenergic blocking agent. Which statement by the patient indicates a need for further teaching?

This medication lowers my blood pressure by helping me get rid of fluid

The nurse is assessing a patient who is being evaluated in an outpatient clinic for complaints of back pain. The patient reports taking diphenhydramine for insomnia related to job stress. Which statement by the nurse is accurate regarding this medication?

This medication should only be taken for 1 week

Which cholinergic symptoms of Parkinson's disease are reduced with anticholinergic drugs?

Tremors and drooling

What is the primary response to alpha-1 receptor stimulation?

Vasoconstriction

In preparing for health teaching with a patient who has an auditory learning style, which would be most appropriate?

Verbal description of the steps of a procedure

Which would positively affect readiness to learn?

Willingness to attain an optimal level of health

An older adult patient is to receive atenolol, a beta-adrenergic blocking agent. Prior to administration of the drug, the nurse assesses an apical pulse rate of 58 and notes ankle edema. Which action will the nurse take first?

Withhold the medication

Which outcome statement identified by the nurse is written correctly?

Within the next 8 hours, urine output will be greater than 30 mL/hr

Barbiturates have which common adverse effect(s)? (Select all that apply.)

a. Headache b. Residual daytime sedation c. Impaired coordination d. Blurred vision

Which nerve endings liberate norepinephrine?

adrenergic

A patient taking rasagiline is assessed by the nurse to have a lasting significant increase in blood pressure. When reviewing the patient's current list of medications, the nurse decides to hold the next dose of

ciprofloxacin

When a patient taking a monoamine oxidase B inhibitor receives his dietary tray, the nurse knows to remove the

cheese

What point(s) should be included when teaching a patient about the use of apomorphine for treatment of Parkinson's disease? (Select all that apply.)

-You may experience nausea and vomiting, which can be treated with trimethobenzamide (Tigan). -Apomorphine does not have any opioid activity. -You may experience sleep attacks or episodes of daytime sleepiness. - A multidose injector pen is commonly used to administer apomorphine.

The nurse is preparing to begin administration of apomorphine to a patient. Before administering, the nurse will perform a baseline assessment of the patient's (Select all that apply.)

-mobility. -orientation. -vital signs. -alertness.

Who defines the standards of care for the practice of nursing? (Select all that apply.)

- Federal laws regulating health care facilities - State boards of nursing - The Joint Commission - Professional nursing associations

Prior to the administration of a nephrotoxic drug, the nurse determines that the kidney lab data are within normal range. Which step of the nursing process is being used?

Assessment

A patient is being discharged on an adrenergic bronchodilator. Which common adverse effect(s) will the nurse include in discharge teaching? (Select all that apply.)

Dizziness Orthostatic hypotension Tremors Palpitations

Where would the procedures and treatments directed by the health care provider be found?

Physician's order form

Which represents the psychomotor domain of learning?

The patient draws up insulin in a syringe

Which statement best describes the planning phase of the nursing process?

The patient will state the expected adverse effects of medication by the end of the teaching session

A patient with chronic obstructive pulmonary disease (COPD) reports having insomnia and a racing heart after starting terbutaline therapy. Which explanation by the nurse is most accurate?

The symptoms will tend to resolve with continued therapy.

Which is true regarding the unit dose drug distribution system?

The use of single dose packages of drugs dispensed to fill each dose requirement as it is ordered

The nurse is administering Somnote to a patient. When providing medication education to the patient, the nurse will include that Somnote should be

taken with a full glass of water

The nurse caring for a Spanish-speaking patient uses the assistance of an interpreter to help with preoperative teaching. While implementing the education, the nurse should

look directly at the patient.

A teaching plan has been developed by the nurse to educate the mother of a preterm infant on prescribed medications. Before initiating this teaching plan, the nurse should

recognize the individual's health beliefs

The nurse is preparing a patient's prescribed medications. In order to ensure patient safety, the nurse will perform which intervention(s)? (Select all that apply.)

- Document in chart all aspects of medication administration. - Select the correct supplies. - Administer the medication by the correct route. - Educate patient regarding medications prescribed

Which statement(s) regarding critical pathways is/are true? (Select all that apply.)

- Enhanced communication for a variety of health care providers - Efficient for specific diseases or case types - Standardized and enhanced quality care

What must the nurse have before administering any medication? (Select all that apply.)

- Knowledge of the client's diagnosis - A medication order signed by a practitioner licensed with prescription privileges - Knowledge of the medication - Consultation with a pharmacist - A current license to practice

The nurse is caring for an older patient recently admitted to an assisted living center who is experiencing insomnia associated with the recent relocation. At bedtime, which nursing action will assist the patient to sleep?

Performing back massage

An obese patient did not meet the goal of "by the end of the second week, is able to follow a 1500 calorie diet." What will the nurse and the patient reassess?

Patient's understanding of the 1500 calorie diet

The nurse is assessing a patient prior to discharge from same day surgery following an incisional breast biopsy. When assessing the patient's central nervous system (CNS) function following sedative-hypnotic therapy, what will the nurse include? (Select all that apply.)

- Level of alertness - Orientation - Ability to perform motor functions

Which statement(s) is/are true regarding the types of medication orders? (Select all that apply.)

- Renewal orders facilitate physician review before continuance of high-risk medications. - Standing orders indicate the number of specified doses of a medication to be given.

The nurse is preparing to instruct a patient and his wife on technique and importance of assessing pulse prior to taking heart medication. Which principle(s) of learning would be appropriate in this situation? (Select all that apply.)

- The patient's and wife's learning styles - The objectives/goal statements listed on the patient's care plan - The learning environment - The patient's understanding of the seriousness of his illness

Which statement(s) is/are true about efferent nerves? (Select all that apply.)

- They transmit signals that control contractions of some glandular secretions. - They are part of the peripheral nervous system. - They transmit signals that control contractions of smooth and skeletal muscle. - They leave the CNS to carry impulses to other body parts.

Which instruction(s) given by the nurse will assist a patient to cope with the common adverse effects of anticholinergic medications? (Select all that apply.)

-Increase fluids daily. -Suck on candy or ice chips

What should the nurse include during discharge in addition to verbal instructions? (Select all that apply.)

- Written instructions for the patient's reference - A phone number of the provider or hospital unit for follow-up questions - Documentation in the nurse's discharge notes of the nursing and collaborative problems that require continued monitoring and intervention - Written instructions for monitoring of parameters used to evaluate therapy

Which body function(s) is/are controlled by the autonomic nervous system? (Select all that apply.)

-Body temperature -Urination -GI secretion -Blood pressure

The nurse and patient are participating in cooperative goal setting regarding drug therapy. The nurse is aware that it is imperative to encourage the patient to perform which task(s)? (Select all that apply.)

-Monitor parameters used to evaluate therapy. - Keep records of essential data needed to evaluate prescribed therapy. - See the health care provider regularly

Which category of medications is used for peripheral vascular diseases characterized by excessive vasoconstriction, such as Raynaud's disease?

Alpha-adrenergic blocking agents

The nurse is prioritizing care of a pediatric patient diagnosed with cystic fibrosis. Which nursing diagnosis would the nurse consider the highest priority?

Altered breathing pattern related to thickened mucus secretions

Which is known as the "fifth vital sign"?

Pain

An older adult patient received a hypnotic agent at 9:00 PM. At 2:00 AM, the nurse discovers that the patient has removed her gown and is attempting to get out of bed without assistance. What type of medication effect is the patient exhibiting?

Paradoxical