Pharm Test 2
Parasympathomimetic:
Cholinergic drugs - mimic the PNS
Amphetamine prototype:
Methylphenidate
Benzodiazapine prototype:
Alprazolam, lorazepam, diazepam
Sympatholytic:
Adrenergic blocking drugs - block alpha and beta receptors
Sympathomimetic:
Adrenergic drugs - stimulate the nervous system
Parasympatholytic:
Anticholinergic drugs - block ACh receptors
Other antidepressant prototypes:
Duloxetine, trazadone, venlafaxine
Non-benzo, non-barbiturate Prototype:
Eszopiclone
Alpha-1 blockers are used to treat:
Hypertension (want to lower bp) and benign prostatic hypertrophy (to allow urine flow)
Drugs that stimulate alpha-2 receptors treat:
Hypertension by decreasing the effects of norepinephrine
Beta Blocks treat:
Hypertension, dysrhythmias, migraines, angina, CHF, and MI by decreasing contraction force, conduction velocity, and pulse rate
Drugs that stimulate alpha-1 receptors treat:
Nasal congestion, hypotension (increases bp), and dilates pupils
Hydantoin prototype:
Phenytoin
A 28-year-old patient is to receive a dose of lorazepam intravenously for sedation during a procedure. The nursing priority would be to assess for: A. respiratory disturbances and partial airway obstruction. B. leukopenia and diplopia. C. ataxia and confusion. D. seizures.
A
A client has been prescribed baclofen and will be taking the drug on an outpatient basis. The client asks the nurse if it still okay to drink wine with meals or end the day with a "nightcap." What is the nurse's best response? A. "The combination of baclofen and alcohol could depress your nervous system to a dangerous level." B. "It's best to keep your alcohol intake to a low level when you're taking muscle relaxants." C. "If you combine baclofen and alcohol you could suffer a severe allergic-type reaction." D. "You're not permitted to drink alcohol while you're taking baclofen."
A
A male client informs the nurse that he plans on discontinuing the prescribed lorazepam (Ativan) he has been taking for the past four months. What is the nurse's best action in response to this client's statement? A. Advise the client to contact his health care provider about tapering off the medication. B. Instruct the client to take the remaining medication in the prescription bottle, then discontinue the drug. C. Warn the client to watch for withdrawal symptoms six to eight weeks after discontinuing the drug. D. Document the client's plan to discontinue the drug in the client's medical record.
A
Common side effects of anticholinergics include: A. dry mouth, urinary retention, constipation, and increased pulse rate. B. blurred vision, decreased liver enzymes, increased blood pressure, and papillary constriction. C. decreased GI absorption, nausea, heartburn, and hypotension. D. skin rashes, decreased urinary output, constipation, and increased WBCs.
A
Dopaminergic agents can exacerbate cardiovascular disease due to dopamine receptor stimulation. A. True B. False
A
Indications for use of anticholinergic drugs in the treatment for Parkinsonism include to: A. decrease salivation, spasticity, and tremors. B. improve blurred vision. C. decrease motor movement. D. decrease headaches.
A
Levodopa is used as treatment for Parkinson's disease primarily acting as a replacement neurotransmitter. A. True B. False
A
Muscle spasms are thought to arise from the flood of sensory impulses coming to the spinal cord from an injured area. A. True B. False
A
The nurse is assessing a patient with glaucoma. What therapeutic effect will the health care provider expect from the cholinergic agonist administered? A. Decreased intraocular pressure B. Pinpoint pupils C. Clear vision D. Decreased use of eyeglasses
A
The nurse is caring for a client who has been prescribed oxazepam. What statement by the client should suggest an increased risk of CNS depression to the nurse? A. "I take an over-the-counter antihistamine each day for my allergies." B. "I'm almost finished my course of antibiotics for this sinus infection." C. "I'm also taking baby Aspirin each day for my heart." D. "If I get constipated, I sometimes take a stool softener for a couple of days."
A
The pharmacology instructor is discussing medications used to treat attention deficit hyperactivity disorder. According to the instructor, methylphenidate is A. a central CNS stimulant. B. an anoretic agent. C. a selective serotonin reuptake inhibitor (SSRI). D. a respiratory stimulant.
A
Tricyclic antidepressants reduce the reuptake of serotonin and norepinephrine. A. True B. False
A
Which agent would a nurse identify as a selective serotonin reuptake inhibitor? A. Fluvoxamine B. Mirtazapine C. Selegiline D. Nefazadone
A
Which medication is classified as an antianxiety medication but is also used to treat muscle spasms? A. Diazepam (Valium) B. Carisoprodol (Soma) C. Tizanidine (Zanaflex) D. Chlorzoxazone (Paraflex)
A
Atypical Antipsychotic prototypes:
Apriprazole, olanzapine
A client has been prescribed a beta blocker. The nurse knows that beta blockers can have which effect on the heart? A. Constrict the heart B. Decrease the heart rate C. Increase the heart rate D. Prevent normal sinus rhythm
B
A female client 70 years of age is receiving lithium. Which nursing intervention is appropriate for this client? A. Instruct the client to use barrier contraceptives. B. Monitor fluid and sodium intake every 12 hours. C. Check blood glucose levels every six hours. D. Encourage the client to check daily for weight loss.
B
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? A. Whether the client is currently taking a diuretic B. Whether the client is experiencing drug intoxication or withdrawal C. Whether the client has a history of agitation D. Whether the client is currently taking antibiotics
B
A nurse in the intensive care unit is caring for a patient in shock and has started IV administration of dopamine (Intropin). For a patient in shock, dopamine helps to: A. decrease heart rate. B. increase blood pressure. C. increase body temperature. D. decrease blood pressure.
B
A nurse is caring for a 49-year-old patient who has been taking bethanechol, a cholinergic agonist, for treatment of neurogenic bladder. After one week, the patient develops sweating, heavy salivation, and bronchospasm. What would the nurse suspect is happening with this patient? A. Pulmonary edema B. Cholinergic crisis C. Anaphylactic reaction D. Myasthenic crisis
B
A nurse observes rhythmic, involuntary facial movements in a patient who has been administered antipsychotic drugs. The patient also makes chewing movements and, at times, his tongue protrudes. What is the most likely reason for the patient's behavior? A. Stevens-Johnson syndrome B. Tardive dyskinesia C. Extrapyramidal syndrome D. Neuroleptic malignant syndrome
B
A patient is administered atropine to increase the heart rate. What is the action of atropine? A. It provides long-acting antihistamine blockage. B. It blocks the parasympathetic vagal stimulation. C. It blocks cell wall synthesis of gram-negative bacilli. D. It exacerbates the parasympathetic vagal stimulation.
B
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? A. Nystagmus B. Status epilepticus C. CNS depression D. Hypotension
B
After teaching the parents of a child diagnosed with ADHD about the disorder and its treatment, the nurse determines that the teaching has been effective when the parents state: A. "We need to be careful so he doesn't develop a substance abuse problem as he grows older." B. "We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention." C. "We should set up regular routines for him but not worry if he violates the limits once in a while." D. "We should stop the medication after 2 months to see how effective it is in really controlling his symptoms."
B
An adolescent taking oral contraceptives has been prescribed an anticonvulsant medication. The nurse should tell the client to: A. watch for signs of hyperglycemia, such as increased thirst, hunger, and urination. B. use another form of birth control, such as condoms. C. stop driving due to the increased depressant effects and excessive drowsiness. D. be aware that these two drugs will interact and increase seizure activity initially.
B
What assessment finding should lead the nurse to suspect that a client receiving antipsychotic therapy is developing tardive dyskinesia? A. Abnormal eye movements B. Lip smacking C. Urinary incontinence D. Disorientation
B
What is the substance responsible for transmission of nerve impulses across the parasympathetic nervous system? A. Dopamine B. Acetylcholine C. Serotonin D. Norepinephrine
B
Which patient is most likely to benefit from the administration of an adrenergic agonist? A. A woman who has been admitted with a suspected ischemic stroke B. A man who is in cardiogenic shock following a myocardial infarction C. A woman who is in labor and may require a caesarean section D. A man who has a diagnosis of primary hypertension
B
A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium). In light of this new addition to her drug regimen, what teaching point should the woman's nurse provide? A. "We'll need to closely monitor your blood sugar levels for the next week." B. "This will likely relieve your muscle spasms but you'll probably develop a certain amount of dependence on the drug over time." C. "You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity." D. "There's a small risk that you might experience some hallucinations in the first few days that you begin taking this drug."
C
A client with a history of seizures takes phenytoin on a regular basis. What should the nurse teach the client in order to ensure the client's safety? A. Do not take garlic or ginger supplements B. Do not take OTC antacids C. Avoid ginkgo supplements D. Avoid brewer's yeast
C
A male client is being seen in the emergency department because he has a high fever and cannot move his arm. During the history-taking process, he says he is being treated with an antipsychotic medication for schizophrenia. The nurse knows that what may be happening with this client? A. He may have broken his arm and not remember what happened because of his schizophrenia. B. He may have neuroleptic malignant syndrome, which will self-resolve in a few hours after rest and Tylenol. C. He may be having a neuroleptic malignant syndrome reaction to his antipsychotic medication and needs treatment immediately. D. He may have influenza A and will need to be put into isolation.
C
A nurse is caring for a patient who has just been diagnosed with Parkinson's disease. The patient does not understand how the medication ordered, carbidopa-levodopa, is going to help the condition. What is the correct response by the nurse? A. "This drug will change the immune processes in your body to help decrease the tissue damage." B. "Your drug therapy will reduce excessive reflex activity causing your muscle spasms and will allow for muscle relaxation." C. "Carbidopa-levodopa increases the activity of dopamine in your body, which will decrease your symptoms." D. "Carbidopa-levodopa will delay the loss of muscle strength and limb function for several months."
C
A patient is prescribed olanzapine (Zyprexa) for the treatment of acute bipolar disorder. The patient tells the nurse he is voiding three times at night and is always thirsty. Based on the adverse effects of this medication, what should the nurse suspect the patient has developed? A. Renal calculi B. Hyperthyroidism C. Diabetes mellitus D. A urinary tract infection
C
A patient who suffers from Parkinson's disease is being treated with levodopa (L-dopa). Which disorder will result in the discontinuation of levodopa (L-dopa) based on a disease-related contraindication? A. Human immune deficiency virus B. Normal-tension glaucoma C. Narrow-angle glaucoma D. Human papillomavirus
C
The nurse is interviewing the client who is to receive a tricyclic antidepressant. Which client statement should alert the nurse to a likely contraindication? A. "My kidneys aren't functioning like they should." B. "I've had glaucoma for several years." C. "I had a myelogram yesterday." D. "My doctor says that I have an enlarged prostate."
C
Which instruction should the nurse specifically stress when administering drugs used for muscle spasm and cramping? A. Take the drug with 6 to 8 oz of water. B. Take the drug with food. C. Avoid alcohol or other CNS depressants. D. Stay upright for 30 minutes after taking the drugs.
C
Which would the nurse expect to be given to a patient experiencing acute bronchospasm? A. Norepinephrine B. Dopamine C. Epinephrine D. Metaraminol
C
The nurse should monitor a client receiving a dopaminergic agent for which adverse effects. Select all that apply. A. Hypertension B. Urinary frequency C. Flushing D. Dysphagia E. Nervousness
C, D, E
Iminostilbenes prototype:
Carbamazepine
A 52-year-old male client is being treated for Parkinson's disease. The nurse is aware that Parkinson's disease results in muscle rigidity, tremor at rest, and postural instability. What occurs in the neurons that causes these symptoms? A. There is a decrease in stimulation of the nigrostriatal neural tracts. B. There is an increased level of GABA at the striatum. C. There is an increase in dopamine in the terminal nerve endings. D. There is an imbalance between dopamine and acetylcholine.
D
A 78-year-old female patient who is about to begin home care has been prescribed anticholinergic drugs. What should the home care nurse explain to the patient and her family? A. The patient may need assistance with ambulation. B. The patient may be at increased risk of heat stroke. C. The patient may benefit from additional fiber and fluids in her diet. D. All the above
D
A group of nursing students answers correctly if they identify which medication as the prototype benzodiazepine? A. Alprazolam (Xanax) B. Lorazepam (Ativan) C. Clonazepam (Klonopin) D. Diazepam (Valium)
D
A male client is prescribed an anticholinergic drug by his physician. He likes to hike with his grandchildren. The home care nurse instructs the client that anticholinergic medications have which effect? A. Increased sweating and the risk for heat stroke and dehydration B. Bradycardia in older adults, which increases the risk for falls and from exposure to the elements C. Postural hypotension and increased risk for falls and from exposure to the elements D. Prevents sweating and heat loss and increasing the risk of heat stroke
D
A patient is receiving an antidepressant that helps to decrease addictive behavior. Which drug most likely would be prescribed? A. Buproprion B. Selegiline C. Mirtazapine D. Venlafaxine
D
Epinephrine causes relaxation of: A. superficial blood vessels. B. sphincter muscles. C. smooth muscles in the intestinal wall. D. bronchioles.
D
Following a thorough health history and assessment, a client's health care provider has diagnosed the client with depression. The nurse should anticipate that the client will likely be prescribed what classification of antidepressant? A. Monoamine oxidase inhibitor B. Tricyclic C. Benzodiazepine D. Selective serotonin reuptake inhibitor
D
The adrenergic branch of the autonomic nervous system is also known by which name? A. Somatic nervous system B. Parasympathetic nervous system C. Central nervous system D. Sympathetic nervous system
D
The nurse is reviewing the medical record of a client who is taking an alpha- and beta adrenergic agonist. What would be of least concern to the nurse? A. Caffeine B. Over-the-counter (OTC) cold preparations C. Ma huang D. St. John's wort
D
The prototype for benzodiazepines is: A. clonazepam. B. alprazolam. C. lorazepam. D. diazepam.
D
Direct Acting Muscle Relaxant prototype:
Dantrolene
Antidote for benzos:
Flumazenil
SSRI prototype:
Fluoxetine
Drugs that stimulate beta-2 receptors are used:
For bronchodilation. Use albuterol
Drugs that stimulate beta-1 receptors:
Increase heart rate and force, increase automaticity, and increase renin that causes an increase in bp
CNS stimulant prototype:
Lisdexamfetamine
Bipolar drug prototype:
Lithium
