PHARM TEST 2

The nurse is working with a patient who has recently been started on lorazepam (Ativan). The patient is also a new mother. What is the nurse's highest priority instruction to the patient?

"Do not breastfeed while taking the medication."

What is the primary information the nurse should teach a patient who has just started taking mephobarbital (Mebaral)?

"Do not drive until you determine how you react to the medication."

The nurse is teaching the patient being treated with an anticholinergic about dietary changes that might be necessary. What is the highest priority instruction for the patient?

"Increase your intake of fluids while on this medication."; to prevent constipation

Which statement made by a patient demonstrates a lack of understanding of patient teaching regarding phenothiazine drug therapy?

"It is okay to take this drug with a small glass of wine to help me relax."

A patient's family member informs the nurse that after taking buspirone hydrochloride (BuSpar) for almost a week, there has been no improvement in the patient's condition. What is the best advice provided by the nurse to the caregiver?

"Limit the intake of grapefruit juice."

The nurse is caring for a patient diagnosed with attention deficit/hyperactivity disorder (ADHD) who has been prescribed methylphenidate HCl (Ritalin). What instruction will the nurse provide for this patient? Select all that apply.

"Monitor your weight twice a week and report weight loss."; "Refrain from consuming over-the-counter (OTC) products with high caffeine content."

A child diagnosed with attention deficit/hyperactivity disorder (ADHD) has been prescribed a central nervous system (CNS) stimulant. Which symptoms described by the parent would be addressed with this medication? Select all that apply.

"My child is unable to complete tasks on time." "My child has trouble concentrating on anything." "My child performs excessive and purposeless activities."

A patient expresses fear of nausea and vomiting postoperatively from the anesthesia. Which is the nurse's best response?

"Nausea and vomiting occur much less frequently than in the past related to the use of a balanced approach to anesthesia."

The nurse is caring for a patient with Parkinson's disease. The patient has been taking entacapone (Comtan) for the past week to treat an on-off phenomenon. The patient expresses concern over brown-orange urine. What information will the nurse provide?

"This is a normal occurrence related to entacapone (Comtan)."

Which specific nursing instruction is relevant for a patient who is taking both anticonvulsants and oral contraceptives?

"Use an additional contraceptive method."

The nurse is assessing a patient with diabetes mellitus who has been prescribed insulin therapy. The patient asks the nurse, "How can I reduce my weight? Could you give me a suggestion?" What would be the best response given by the nurse?

"You need to follow a diet and exercise regimen for effective reduction in obesity."

The nurse is teaching a patient about therapy for a newly diagnosed seizure disorder. What statement should be included in the plan of care?

"Your medication is chosen based on your type of seizure."

The primary health care provider has prescribed diazepam (Valium) to an 8-month-old infant experiencing muscle spasms. Which medication dosage is safe to administer to the infant?

1-2.5 mg of medication orally twice a da

What is the correct therapeutic serum range for phenytoin (Dilantin)?

10-20 mcg/mL

A patient is detoxifying from alcohol abuse. Which type of medication is indicated to help the patient manage withdrawal symptoms?

A benzodiazepine is indicated in the management of the clinical manifestations of alcohol withdrawal because of their wide range of therapeutic effects.

A patient is prescribed calcipotriene (Dovonex) for treatment of psoriasis. What diagnostic finding requires immediate intervention by the nurse?

A serious adverse effect of calcipotriene (Dovonex) is hypercalcemia and hypercalcuria.

A patient receives an acetylcholine receptor (AChR) during surgery. This type of drug works by preventing the action potential in the motor neuron because it binds to the receptors in place of what?

Acetylcholine

A client is in status epilepticus. What is an appropriate nursing action?

Administer intravenous antiepileptic drug therapy;During status epilepticus, the client is unable to swallow medications, and the appropriate treatment is to administer intravenous drug therapy to stop the seizure.

A patient newly diagnosed with myasthenia gravis (MG) is started on neostigmine (Prostigmin). What is the correct nursing intervention for this patient?

Administer the drug on time. Neostigmine (Prostigmin) is an acetylcholinesterase inhibitor with a short half-life. It is administered every 2 to 4 hours and must be given on time to prevent muscle weakness.

The nurse is required to administer haloperidol decanoate (Haldol) to a patient for slow release of the drug every two weeks. What precaution should the nurse take during this procedure?

Administer the injection using the Z-track method.

The nurse is administering phenytoin (Dilantin) intravenously. What intervention is essential?

Administer the medication no faster than 50 mg/min.

The patient has been started on benzoyl-peroxide (Benzac, Persa-Gel) as part of the treatment regimen. The patient asks the nurse, "Why do my lips seem to swell whenever I use the medication?" What do the patient's symptoms indicate?

Allergic reaction to the medication.

The nurse is working with a patient who asks for medication for anxiety related to coping with a chronic illness. Which benzodiazepine does the nurse anticipate will be ordered for the patient?

Alprazolam (Xanax)

The patient has had natamycin (Natacyn Ophthalmic) added to the treatment regimen. The patient complains to the nurse of experiencing a stinging or burning sensation. What does the nurse suspect the patient is experiencing?

An expected side effect of the medication

While taking a patient's history prior to surgery for a cardiac problem, the patient informs the nurse he is addicted to cocaine. The nurse alerts the anesthesiologist of the finding because the nurse knows the use of cocaine can cause which effect when a patient is under anesthesia?

Anesthetic-induced complications

Which condition is a contraindication for administration of carbidopa-levodopa (Sinemet)?

Angle-closure glaucoma;Carbidopa-levodopa (Sinemet) is the drug combination contraindicated in patients with angle-closure glaucoma. The medication tends to cause an increase in intraocular pressure

The patient has been ordered to be treated with alprazolam (Xanax). The nurse recognizes that the patient is most likely experiencing which condition?

Anxiety with depression

A patient is scheduled for surgery and is prescribed propofol (Diprivan). What will the nurse ask the patient to prevent complications associated with propofol (Diprivan)?

Are you pregnant

Before applying povidone-iodine (Betadine) to a patient's skin, what is a primary nursing intervention?

Ask patient if he or she has any allergies.

A patient is prescribed carisoprodol (Soma) for relief of muscles spasms. What does the nurse instruct the patient to avoid while taking carisoprodol?

BEER

Which medication is used to treat spasticity?

Baclofen (Lioresal) is a skeletal-muscle relaxant that is used to treat spasticity in a patient who has suffered a stroke or other neurological disorders that produce spasticity. Spasticity is caused when the upper motor neurons fail to exert an inhibitory effect on the lower motor neurons.

Which medication is used to treat skeletal muscle spasticity?

Baclofen (Lioresal); Baclofen (Lioresal) is a centrally acting muscle relaxant used to treat skeletal muscle spasticity. It acts on the spinal cord and decreases pain.

The nurse is caring for a patient who has been diagnosed with seasonal affective disorder. Which medication should the nurse expect a primary health care provider to prescribe to the patient?

Bupropion HCl (Wellbutrin);

A patient with multiple sclerosis participates in a rehabilitation program. The patient takes baclofen (Lioresal) to help manage muscle spasticity. How will the baclofen (Lioresal) interfere with the patient's rehabilitation activities?

By producing drowsiness, lethargy, and blurred vision

A patient is complaining of excessive earwax that diminishes hearing ability. Which medication will the nurse use to assist the patient?

Carbamide peroxide (Debrox) Carbamide peroxide (Debrox) works to soften earwax for easy removal while providing a weak antibacterial action to prevent infection

The patient has been ordered diclofenac sodium (Voltaren Ophthalmic). The nurse recognizes that the patient has probably undergone which procedure?

Cataract surgery

The nurse notes that a patient who has been prescribed clorazepate dipotassium (Tranxene) is pregnant. What course of action should the nurse take to ensure the patient's well-being?

Consult with the primary health care provider to modify the prescription.

The patient is scheduled to begin treatment with carbidopa-levodopa (Sinemet). A family member tells the nurse that the patient has a history of undergoing treatment for narrow-angle glaucoma. What is the correct action for the nurse to take?

Contact the health care provider with this information

The primary health care provider writes a prescription for the nurse to administer phenytoin (Dilantin) by the intravenous route to a patient with seizures. What precaution should the nurse take while administering the phenytoin (Dilantin)?

Dilute the phenytoin with normal saline

The patient with myasthenia gravis was initially prescribed pyridostigmine (Mestinon). After reviewing the medical history of the patient, the nurse informs the primary health care provider (PHP) that the patient has asthma. What instruction would the nurse receive from the PHP?

Discontinue administering pyridostigmine (Mestinon). should not be administered to the patient with asthma because it will worsen the symptom

A 25-year-old female patient has begun taking phenobarbital therapy for seizure control. What information is essential for the nurse to include in discharge teaching?

Discuss alternate forms of birth control with the health care provide

A female patient who takes lorazepam (Ativan) for anxiety tells the nurse that she plans to become pregnant. What is the best instruction for the nurse to give the patient?

Discuss tapering the drug with the provider before conception

Which anticonvulsant medication is used as a mood stabilizer?

Divalproex (Depakote)

Which inhibitory neurotransmitter is involved in Parkinson's disease?

Dopamine is the inhibitory neurotransmitter involved in Parkinson's disease. The disease is characterized by low concentrations of dopamine. Acetylcholine is an excitatory neurot

Which patient may develop tachycardia as a drug side effect?

Epinephrine (Adrenalin) is an alpha-adrenergic blocker, which increases venous capacitance and increases heart rate, resulting in tachycardia.

A patient reports throbbing headaches. While investigating, the primary health care provider finds that the patient has consumed a six pack of beer the night before. Which medication does the nurse expect the primary health care provider to prescribe?

Ergot alkaloids

A patient is admitted to the emergency department with a severe overdose of a benzodiazepine. The nurse immediately prepares to administer which antidote from the emergency drug cart?

Flumazenil (Romazicon)

The nurse instructs a patient receiving phenytoin (Dilantin) to visit the dentist regularly and perform frequent oral hygiene. What common side effect is the nurse educating the patient about for this medication?

Gingival hyperplasia

The patient is being started on the first-line antiepileptic medication carbamazepine. The patient asks the nurse to assist in planning meals that will not conflict with dietary restrictions related to the medication. The nurse's response is based on the knowledge that the patient who is taking this medication should avoid which fluid?

Grapefruit juice

The client's serum phenytoin (Dilantin) level is 31 mcg/ml. What is the nurse's best action?

Hold the medication;A therapeutic drug level for phenytoin is 10 to 20 mcg/ml.

What is the proper use of an eye dropper

I will rinse the eye dropper with tap water after each use

The health care provider orders pyridostigmine bromide (Mestinon) for a patient. Which assessment will help confirm the therapeutic outcome for this medication?

Increased muscle strength

The nurse is caring for a patient with acne who has been prescribed benzoyl peroxide (Acne-Clear). The patient reports blistering and swelling of the skin. What nursing action is a priority?

Instruct the patient to immediately consult the primary health care provider

A patient suffering from chronic anxiety is prescribed tranylcypromine sulfate (Parnate). On assessment, the nurse finds that the patient often uses the herb St. John's wort. What course of action should the nurse take to prevent fatal complications?

Instruct the patient to stop using St. John's wort

A patient who is taking medication for severe cystic acne complains of conjunctivitis. Which drug may be responsible for this adverse reaction?

Isotretinoin

A primary health care provider has prescribed a monoamine oxidase inhibitor (MAOI) to a patient, along with carbidopa-levodopa (Sinemet). What does the nurse anticipate as the reason for suggesting this combination therapy with an MAOI?

It increases the efficacy of carbidopa-levodopa (Sinemet).

The nurse is assessing a patient who has recently been diagnosed with Parkinson's disease and who was prescribed tolcapone (Tasmar). What would the nurse assess for as a precaution with this particular medication?

It should be used with caution in patients with liver failure because it impairs hepatic functioning and worsens the symptoms

The nurse conducts preoperative teaching with a patient scheduled to undergo a laparotomy who will receive pancuronium during the procedure. What explanation does the nurse give for the administration of pancuronium?

It will relax the abdominal muscles for the surgery; a neuromuscular blocking agent that is used during surgery to relax muscles for exposure of the surgical site and for intubation and mechanical ventilation. Pancuronium acts by blocking the action of acetylcholine.

Which statement is true regarding pyridostigmine (Mestinon)?

Its overdose causes cholinergic crisis;Pyridostigmine (Mestinon) is an acetylcholinesterase inhibitor that is used to treat myasthenia gravis. Overdose of this drug increases acetylcholine in the neuromuscular junction and causes cholinergic crises.

What is the mechanism of action of benzoyl peroxide (Benzac)?

Loosens the outer horny layer of epidermis

The nurse is caring for a patient who is experiencing a myasthenic crisis. What is the primary nursing intervention?

Maintain the patient's airway.

While teaching a patient newly diagnosed with a seizure disorder, what does the nurse state as the goal of pharmacologic therapy of this medication?

Maximally reducing seizure activity while minimizing side effects of medication therapy

A child has been taking methylphenidate (Ritalin) for two months. The child's parent tells the nurse, "Each time I go to get my child's medication, the pharmacist asks me to get a new prescription. Why is this so?" What will the nurse explain to the parent?

Methylphenidate (Ritalin) is an amphetamine drug that is a central nervous system (CNS) stimulant. This drug has a high risk of abuse, so a new prescription is required for getting the medication.

Which medication is used for the treatment of baldness in men and women?

Minoxidil (Rogaine)

The nurse is caring for a patient who describes symptoms indicative of narcolepsy. The nurse recognizes that the physician is most likely to order which medication for the patient?

Modafinil (Provigil)

The patient is being treated with the drug fingolimod (Gilenya). What disease or disorder would the nurse expect the patient to have?

Multiple sclerosis;

The nurse is caring for a patient who has been diagnosed with multiple sclerosis. The health care provider opts to include baclofen (Lioresal) as part of this patient's treatment regimen. The nurse recognizes that this is an appropriate medication for this patient because the drug will treat which symptom?

Muscle spasticity

Which disorder is treated by the drug modafinil (Provigil)?

Narcolepsy

At the time of birth, infants are often treated with erythromycin eye ointment as prophylactic treatment against what possible organism?

Neisseria gonorrhoeae Erythromycin eye ointment is indicated for the treatment of neonatal conjunctivitis caused by Chlamydia trachomatis and for the prevention of eye infections in newborns that may be caused by Neisseria gonorrhoeae or other susceptible organisms.

Which inhalable gas can be used as a general anesthetic?

Nitrous oxide

The patient has been started on donepezil (Aricept). The patient's family member notifies the nurse that the patient fainted at home. What is the highest priority action on the part of the nurse?

Notify the health care provider; the patient may need to be taken off the drug.

Which neurodegenerative disorder is caused by a decrease in dopamine levels and an increase in acetylcholine levels in the brain?

Parkinson's disease

A patient has been taking benztropine (Cogentin). Which outcome assessment helps the nurse verify therapeutic effects of this medication?

Patient has had a decrease in tremors

A patient with Alzheimer's disease is prescribed memantine (Namenda) 10 mg twice daily. Based on the laboratory reports, the nurse tells the primary health care provider to reduce the dose to 5 mg twice daily. Which laboratory finding warranted the dose reduction in the patient?

Pt has renal impairment

Which medication is used as an antidote for the nerve gas soman?

Pyridostigmine bromide (Mestinon);

While completing discharge teaching for a patient prescribed an antiepileptic drug, the nurse instructs the patient that what potential complication could occur if he or she abruptly stopped taking the antiepileptic drug?

Rebound seizure activity

Which nursing diagnosis is appropriate for a patient who has received a sedative-hypnotic drug?

Risk for injury;central nervous system (CNS) depression, putting the patient at risk for injury

A patient currently prescribed duloxetine (Cymbalta) comes to the health clinic complaining of restlessness, agitation, diaphoresis, and tremors. The nurse suspects serotonin syndrome and questions the patient regarding concurrent use of which substance?

Serotonin syndrome may occur with SSRIs when they are combined with herbal products such as ginseng and St. John's wort.

Which intervention is most appropriate for the patient with second-degree burns?

Silver sulfadiazine (Silvadene) cream

The primary health care provider prescribes pentobarbital (Nembutal) for a patient who has seizures. On assessment, the nurse finds that the patient is using oral contraceptive medication on a regular basis. What intervention by the nurse is most suitable in this situation?

Suggest an alternate contraceptive method to the patient

An Asian patient reports unusual sleep patterns and lack of sleep.The nurse asks the patient to drink warm milk before going to sleep. However, the patient develops diarrhea. What is the best non-pharmacological nursing intervention to promote patient comfort?

Suggest drinking lactose-free milk at bedtime.

The health care provider is considering placing the patient on memantine (Namenda). The patient's family member tells the nurse that the patient has a history of kidney disease. Based on this information, the nurse anticipates which action on the part of the health care provider? Select all that apply.

The dosage of the drug may be reduced;The reduction in kidney function may lead the health care provider to choose to reduce the dosage of the medication to prevent toxicity from developing

A patient is admitted to the hospital in an unconscious state due to an overdose of benzodiazepines. The nurse administers flumazenil (Romazicon), and the patient regained consciousness, but became unconscious again after some time. What is the reason for the patient becoming unconscious again?

The half-life of flumazenil (Romazicon) is short

In a pregnant patient, medications to depress the central nervous system are administered to reduce the risk of injury from a seizure to mother and baby. Which patient teaching is mandatory to reduce the risk of complications?

The nurse should instruct the patient to avoid consuming alcohol in order to prevent an increase in central nervous system depression.

When examining a prescription, the nurse finds that the primary health care provider has prescribed methylphenidate HCl (Ritalin) to the patient. What diagnosis of the patient led to this prescription, according to the nurse? Select all that apply.

The patient has a short attention span. The patient's impulsiveness has interfered with peer relationships.

The primary health care provider prescribes lithium to an Asian client who has a psychotic illness. What will the nurse expect to find in the patient's prescription?

The patient has been prescribed a lower than usual dose of the drug.;. These patients have a slower elimination rate of drugs, and therefore require lower doses.

The primary health care provider prescribes theophylline to an adult patient. What does the nurse anticipate is the reason behind the administration of this medication to the patient?

The patient has been suffering from irritation of the bronchioles.

The nurse administered donepezil (Aricept) to a patient. Which finding indicates that the medication is therapeutic?

The patient has increased cognition.

A student nurse is giving examples of different types of depression. Which scenario is an example of reactive depression?

The patient is sad after the death of a parent

A patient involved in a factory fire presents with extensive burns. The patient's skin is pearly white in color, and he or she feels no pain. What is the tissue depth of the burns?

The patient is suffering from third-degree burns with full thickness.

The nurse is caring for a patient who is undergoing treatment for bipolar disorder. The patient's caregiver informs the nurse that the patient has become extremely forgetful and is confused much of the time. Which reason does the nurse suspect for this behavior in the patient?

The patient is taking lithium citrate (Eskalith).

The primary health care provider reviews the medical history of a patient who is taking phentermine (Ionamin) and instructs the nurse to discontinue administering the medication for 2 weeks. What is a possible reason for this instruction?

The patient is taking monoamine oxidase inhibitors (MAOIs).

A teenage female patient is going to be prescribed isotretinoin (Amnesteem) for acne. Which information is most important for the nurse to include in the education of the patient?

The patient must use at least two forms of contraception while taking this medication.

The nurse is caring for a patient with acute mania who has been prescribed lithium carbonate (Lithobid). The blood tests of the patient indicate the serum lithium level to be 1.2 mEq/L. What does the nurse interpret from this?

The patient should have effective relief from the manic symptoms; .5-1.5 therapeutic range

The patient has recently been prescribed a benzodiazepine and reports experiencing vivid dreams. What does this symptom indicate?

Therapeutic effect of the medication

A patient diagnosed with depression is started on a tricyclic antidepressant (TCA) after failure to improve symptoms on a selective serotonin reuptake inhibitor (SSRI). The nurse should include which teaching point when educating the patient about the new medication?

There is a risk of toxicity when this medication is taken with alcohol.

Which antiparkinsonian medication may cause severe liver damage?

Tolcapone (Tasmar)

When experiencing a seizure, a patient's skeletal muscles contract in a spasm that lasts for 5 seconds. The contraction is followed by jerking of the legs and arms for 2 minutes. What type of seizure is the patient experiencing?

Tonic-clonic seizure;A tonic-clonic seizure occurs in two phases. In the tonic phase, sustained muscle contraction takes place. The patient experiences spasms for 3 to 5 seconds. In the clonic phase, dysrhythmic muscle contraction takes place.

Which factors may trigger myasthenic crisis? Select all that apply.

Trauma, pregnancy, and emotional stress

glaucoma

accumulation of aqueous humor

Isotretinoin (Amnesteem) and tretinoin (Retin-A) are common dermatologic drugs used to treat

acne

A patient taking pyridostigmine (Mestinon) develops symptoms of a cholinergic crisis. What action does the nurse anticipate performing next?

administer atropine;the antidote for treating a cholinergic crisis.

The patient is receiving triazolam (Halcion) as part of treatment for insomnia. The patient complains of experiencing memory problems. What does this symptom indicate may be occurring?

adverse reaction

The nurse is caring for a patient whose medication regimen includes the benzodiazepine chlordiazepoxide (Librium). The nurse recognizes that the patient is most likely experiencing which condition?

alcohol withdrawal

The nurse is caring for a patient who is taking a barbiturate. Which assessment finding requires immediate action by the nurse?

bp 90/60

Which symptoms are associated with Parkinson's disease? Select all that apply.

bradykinesia, tremors, rigidity

Which laboratory test should be monitored frequently to assess for a potential life-threatening adverse reaction to clozapine (Clozaril)?

complete blood count; This is an atypical antipsychotic drug

A patient has been prescribed methylphenidate HCl (Ritalin). What are the expected outcomes for the patient? Select all that apply.

hyperactivity will decrease, patients attention span will increase

The nurse is working with a patient who has recently been started on temazepam (Restoril). The nurse recognizes that the patient is most likely experiencing which condition?

insomnia

Which class of drugs is prescribed for a patient who is obese to promote weight reduction?

lipase inhibitors

The nurse is caring for a patient who has Parkinson's disease who has been prescribed amantadine (Symadine). After assessing the patient's vital signs, the nurse notes that the patient has developed adverse effects of the medication. The nurse instructs the patient to slowly change position when getting up from sitting or lying down. Which adverse effect did the nurse find?

orthostatic hypotension

Which disorder can most likely cause damage to the eustachian canal?

otitis media:

While completing preoperative patient teaching, the nurse explains that general anesthesia:

produces deep muscle relaxation and loss of consciousness.

A patient has a shuffling gait, pill-rolling motion of the hand, and bradykinesia. From what does the nurse suspect the patient to be suffering?

pseudoparkinsonism; Shuffling gait, pill-rolling motion of the hand, and bradykinesia are symptoms of pseudoparkinsonism

The patient has been ordered doxapram HCl (Dopram). The nurse recognizes that this medication is intended as what?

respiratory stimulant

What are the physiological functions of the skin? Select all that apply.

sensation, absorption, protection

A patient asks the nurse how long it will take for escitalopram (Lexapro) to be completely effective. Which time frame should the nurse include in patient teaching?

several weeks

peudoparkinsonism

shuffling gait, tremors at rest, pit rolling of the hand

When planning care for a burn patient, the nurse would anticipate applying which topical medication?

silver sulfadiazine (Sulfadine) - treats 2nd / 3rd degree burns

Which layer of the skin is abundant in adipose tissue?

subcutaneous

The nurse is caring for a patient who is a new mother. The patient tells the nurse, "I saw the nurses put some kind of drops in my baby's eyes after she was born. Could those drops damage her eyes?" The nurse frames a response based on the knowledge that:

the medication was likely given to prevent infection of the newborn's eyes.

Which medication is used to treat age-related macular degeneration (ARMD)?

types of medications used to help treat ARMD: ranibizumab, bevacizumab, pegaptanib, aflibercept