Pharm2

Which statement by the patient indicates the need for additional teaching on phenothiazine (Thorazine) drug therapy?

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

The nurse is providing care for a neonate diagnosed with apnea of prematurity. The prescription by the health care provider is for caffeine citrate intravenously 5 mg/kg once daily. The infant's weight is 5.4 lb. What is the correct dosage to administer to the patient?

12. 3 mg

A patient receiving phenytoin (Dilantin) has a serum drug level drawn. Which level will the nurse note as therapeutic?

12mcg/mL

a pt is to receive flumazenil 0.2mg, IV push over 30 seconds as initial treatment for a possible banzodiazepine overdose. the medication is available in a 0.1mg/mL vial. how many milliliters of medication will the nurse draw up into the syringe for this dose?

2mL

amphetamine/dextroamphetamine sulfate

ADHD

The nurse will monitor the patient who is taking a muscle relaxant for which adverse effect?

CNS depression

While completing preoperative patient teaching, which information would the nurse include for a surgery with a general anesthetic?

It produces muscle relaxation and loss of consciousness

The physician has requested "lidocaine with epinephrine." The nurse recognizes that the most important reason for adding epinephrine is which of these factors?

It reduces bleeding in the surgical area.

phenytoin is prescribed for a pt. the nurse checks the pt's current list of medications and notes that interactions may occur with which drugs or drug classes?

PPIs warfarin sulfonamide antibiotics

a pt with back muscle spasms is being treated with a skeletal muscle relaxant. to ensure that these drugs are most effective, the nurse will make sure what other treatment is ordered?

PT

Which antiparkinson drug causes an increase in the levels of dopaminergic stimulation in the central nervous system (CNS) and therefore allows a decreased dose of other medications?

Selegiline (Eldepryl)

What is another approved and indicated use for the antidepressant bupropion (Zyban)?

Smoking cessation

Which considerations are important for the nurse to remember when administering a benzodiazepine as a sedative-hypnotic drug? (Select all that apply.)

The dose needs to be given approximately 1 hour before the patient's bedtime. The patient needs to be evaluated for the drowsiness that may occur the morning after a benzodiazepine is taken.

The nurse is giving medications to a patient. Which drug or drug class, when administered with lithium, increases the risk for lithium toxicity?

Thiazides

What is the goal of pharmacologic therapy in treating Parkinson's disease?

To balance cholinergic and dopaminergic activity in the brain

While obtaining a patient history, the nurse notes that the patient has been prescribed ethosuximide (Zarontin). The nurse suspects that the patient has which type of seizure?

absence

The nurse is reviewing the drugs currently taken by a patient who will be starting drug therapy with carbamazepine (Tegre-tol). Which drug may raise a concern for interactions?

acetaminophen (Tylenol)

pain that is sudden and usually subsides when treated

acute pain

an anticholinergic drug given preoperatively to dry secretions

atropine

the metabolic process that occurs when the metabolism of a drug increases over time, which leads to lower-than-expected drug concentrations

autoinduction

a stimulant that is either "snorted" through the nasal passages or injected IV

cocaine

a nurse is caring for a client who has a new prescription for pramipexole to treat Parkinson's disease. the nurse should recognize that which of the following lab tests requires monitoring?

creatinine clearance use cautiously for clients with renal disease

which drug represents the only drug that acts directly on skeletal muscle?

dantrolene

moderate to severe pain is best treated with which medication

fentanyl

a pt who is experiencing neuropathic pain tells the nurse that the physician is going to start him on a new medication that is generally used to treat seizures. the nurse anticipates that which drug will be ordered?

gabapentin

term for anesthetic drugs that alter the CNS , resulting in the LOC and deep muscle relaxation

general

medication used to treat mania

lithium (eskalith)

Mr. R is brought to the ED in severe pain, they recognize to bring the pain under some control. After assessing that it is not contraindicated, given is a strong pain reliever. this is a --- analgesic

opioid

While obtaining a medication history from a patient, the nurse notes that the patient is currently prescribed naltrexone. The nurse would question the patient about a previous history of which substance abuse?

opioid

A patient reports severe back pain and asks the nurse for medication "to take the pain away." Assessment findings on the physical examination include mydriasis, rhinorrhea, diaphoresis, lacrimation, blood pressure of 160/84 mm Hg, heart rate of 116 beats/min, and respiratory rate of 24 breaths/min. Which condition would the nurse suspect?

opioid withdrawal

carbidopa-levodopa is prescribed for a pt with PD. the nurse will inform the pt of which possible AE?

palpitations hypotension depression

a pt who has been taking a benzodiazepine for 5 weeks has been instructed to stop the med. which instruction will the nurse provide to the pt on how to discontinue the medication?

plan a gradual reduction in dosage

a nurse is teaching a client about interferon beta-1a. which of the following instructions should the nurse give to help the client avoid the adverse effects of this drug?

premedicate with acetaminophen can cause fever, chills, HA, muscle aches

a type of epilepsy with unknown cause

primary

immunomodulator

reduces symptoms of multiple sclerosis

Ergot alkaloids exert their therapeutic effect by which action?

vasoconstriction

pain that originates from the organs or smooth muscles

visceral pain

A patient has a new prescription for sumatriptan (Imitrex). The nurse providing patient teaching on self-administration will include which information?

Take the medication before the headache worsens.

a pt asks the nurse why a second drug is given with his drug for PD. the nurse notes that this drug, an anticholinergic, is given to control or minimize which symptom?

dry mouth (but I think its muscle rigidity)

which are expected side effects of the anticholinergic drugs used to treat PD?

dry mouth, decreased salivation urinary retention decreased GI motility and constipation smooth muscle relaxation

a pt with PD has difficulty performing voluntary movements. what is the correct term for this symptom

dyskinesia

baclofen

muscle spasms

a nurse is caring for a client who is taking donepezil to treat alzheimer's disease. for which of the following AE should the nurse monitor?

nausea v/d, take with food to minimize AE

The nurse is assessing a patient who has begun therapy with amantadine (Symmetrel) for Parkinson's disease. The nurse will look for which possible adverse effects? (Select all that apply.)

nausea dizziness insomnia

Ms. T. is taking a drug that binds to part of a receptor and causes effects that are not as strong as those of a pure agonist. She is taking a(n) --- agonist.

partial

the nurse is providing discharge instruction to the pt who will be taking phenytoin. with an understanding of the side effects of phenytoin, which instruction is the most important?

perform mouth care at least twice a day

a barbituate used primarily to control tonic-clonic and partial seizures

phenobarbital

the level of stimulus needed to produce a painful sensation is referred to as the pain

threshold

A patient who is taking disulfiram as part of an alcohol treat-ment program accidentally takes a dose of cough syrup that contains a small percentage of alcohol. The nurse expects to see which symptom as a result of acetaldehyde syndrome?

copious vomiting

which drug is considered first line treatment for partial and tonic-clonic seizures

diazepam

Which nursing diagnosis is appropriate for a patient who has just been administered a sedative-hypnotic drug?

risk for injury and falls

a rapid to intermediate acting nonpolarizing NMBD

rocuronium

"date rape" drug

roofies

a type of epilepsy with a distinct cause

secondary

A patient with renal cancer needs an opiate for pain control. Which opioid medication would be the safest choice for this patient?

methadone

a nurse is preparing to administer morphine 4mg IV bolus to a client who reports pain. available is morphine 10mg/mL. which of the following actions should the nurse take?

have another nurse witness the disposal of the extra medication

another term for primary seizures

idiopathic

a type of anesthetic drug that reduces pain sensations at the level of the peripheral nerves

local

to decrease the possibility of a headache after spinal anesthesia, the nurse will provide which instruction to the pt

maintain strict bed rest

Several patients have standard orders for acetaminophen as needed for pain. While reviewing their histories and assessments, the nurse discovers that one of the patients has a contraindication to acetaminophen therapy. Which patient should receive an alternate medication?

A patient admitted with severe hepatitis

a nurse is reviewing the medical record of a client who reports drinking 3-4 glasses of wine each night and taking 3,000 mg of acetaminophen daily. which of the following lab values is the priority for the nurse to assess?

AST

A patient with a diagnosis of depression is being discharged with a prescription for an monoamine oxidase inhibitors (MAOI). Which instruction would the nurse include for this medication?

Avoid eating aged cheese

The nurse is reviewing the prescriptions for a patient who will be discharged to home after being hospitalized for a hysterectomy. The patient asked for a sleeping pill, and the surgeon wrote a prescription for Ambien, 10 mg at bedtime as needed for sleep. What is the nurse's priority action at this time?

Contact the prescriber to question the dose of the Ambien. (5mg max dose)

A patient prescribed lorazepam (Ativan) for the treatment of anxiety states, "I feel drowsy all the time, and it's interfering with every aspect of my life." The nurse knows that a better drug therapy option for this patient is which anxiolytic medication?

Buspirone (BuSpar)

acetaminophen (tylenol) is similar to NSAIDs with the exception that it lacks which effects (SATA)

antiinflammatory antiplatelet GI irritation

A patient diagnosed with narcolepsy is prescribed a central nervous system (CNS) stimulant. Which statement best describes the action of CNS stimulants?

CNS stimulants increase release of and block reuptake of neurotransmitters

A patient with narcolepsy will begin treatment with a CNS stimulant. The nurse expects to see which adverse effects? (Select all that apply.)

anxiety increased BP tremors

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

Maximally reducing seizure activity while minimizing the adverse effects of medication therapy.

A patient is taking entacapone (Comtan) as part of the therapy for Parkinson's disease. Which intervention by the nurse is appropriate at this time?

Notify the patient that this drug causes discoloration of the urine.

this class of drugs is one of the first-line drugs used to treat status epilepticus

benzodiazepines

a type of serious mental illness that can take several different forms and is associated with being truly out of touch with reality

psychosis

An atypical antipsychotic medication useful for treatment of schizophrenia

risperidone (risperdal)

An opioid analgesic is prescribed for a patient. The nurse checks the patient's medical history knowing this medication is contraindicated in which disorder? (Select all that apply.)

severe asthma sleep apnea severe head injury

a nurse is caring for a 2 year old child who has seizures and is receiving phenytoin in suspension form. which of the following actions should the nurse take before administering each dose?

shake the container vigorously

pain that originates from the skin or mucous membranes

superficial pain

a nurse is preparing to administer memantine to a client who has Alzheimer's disease. which of the following findings in the client's med history indicates a need to withhold the drug and notify the provider?

cirrhosis

When assessing a patient for adverse effects related to morphine sulfate (MS Contin), which clinical findings are the nurse most likely to find? (Select all that apply.)

constipation, inability to void

which of the following is an identified advantage for the use of nitrous oxide?

it has good analgesic properties

dantrolene

malignant hyperthermia

A patient will be receiving diazepam (Valium), 2 mg, IV push as part of preprocedure sedation. The medication is available in an injectable solution of 5 mg/mL. How many milliliters will the nurse give for this dose?

0.4 mg

a nurse is preparing to administer busipirone 7.5 mg PO every 12 hr to a client. the amount available is buspirone 15mg/tablet. how many tablets should the nurse administer per dose?

0.5

The medication order reads: "Atomoxetine (Strattera) 1.2 mg/ kg/day in 2 divided doses." The child weighs 66 lbs. How much will be given with each dose?

18

a nurse is preparing to administer hydromorphone 2.5mg. the amount available is 5mg/5mL elixir. How many mL should the nurse administer?

2.5

The nurse is preparing to administer phenobarbital. The order reads: "Give phenobarbital, IV, 2 mg/kg/day at 0900." The patient weighs 253 pounds. How many milligrams will the patient receive for each dose?

230

A patient with a feeding tube will be receiving risperidone (Risperdal) 8 mg in two divided doses via the feeding tube. The medication is available in a 1 mg/mL solution. How many milliliters will the nurse administer for each dose?

4

The order reads, "Bromocriptine (Parlodel) 10 mg per day PO." The medication is available in 2.5-mg tablets. How many tablets will the nurse give per dose?

4

A child is prescribed methylphenidate (Ritalin) to treat attention deficit hyperactivity disorder (ADHD). The parent expresses concern about using a controlled substance to treat ADHD and asks the nurse about using a noncontrolled substance. The nurse knows ADHD can be treated with which noncontrolled substance?

Atomoxetine (Strattera)

A patient is receiving an opioid via a PCA pump as part of his postoperative pain management program. During rounds, the nurse finds him unresponsive, with respirations of 8 breaths/min and blood pressure of 102/58 mm Hg. After stopping the opioid infusion, what should the nurse do next?

Administer an opiate antagonist per standing orders.

The nurse is preparing to give medications. Which is an appropriate nursing action for intravenous (IV) phenytoin (Dilantin)? (Select all that apply)

Administer in normal saline solutions. Use a filter for IV infusions.

A patient has been admitted to the emergency department because of an overdose of an oral benzodiazepine. He is very drowsy but still responsive. The nurse will prepare for which immediate intervention?

Administration of flumazenil

A patient is recovering from general anesthesia. What is the nurse's main concern during the immediate postoperative period?

Airway

The nurse is developing a plan of care for a patient receiving an anorexiant. Which human need statement is most appropriate?

Altered food and nutrient intake

Which human need statement is appropriate for a patient who is now recovering after having been under general anesthesia for 3 to 4 hours during surgery?

Altered oxygenation, decreased, due to the CNS depressant effect of general anesthesia

The nurse is admitting a patient in the emergency department for suspected overdose. The health care provider prescribes flumazenil for the patient. What type of overdose does the nurse suspect?

Benzodiazepines

A patient has been admitted to the emergency department after a suspected overdose of benzodiazepines mixed with alcohol. The patient is lethargic and cannot speak. The nurse expects which immediate measures to be implemented? (Select all that apply.)

Prepare to administer flumazenil. Monitor the patient for convulsions. Prepare for potential respiratory arrest.

When teaching a patient about carbidopa-levodopa (Sinemet), what information would the nurse include about this medication?

Carbidopa decreases levodopa's conversion in the periphery, increasing the levodopa available to cross the blood-brain barrier.

A nurse is education a patient on use of caffeine. If a patient has what condition, would alert the nurse to be concerned with use of this prescribed drug?

Cardiac dysrhythmias

The nurse is reviewing the history of a patient who will be starting the triptan sumatriptan (Imitrex) as part of treatment for migraine headaches. Which condition, if present, may be a contraindication to triptan therapy?

Cardiovascular disease

The nurse is providing care for a patient with a diagnosis of Parkinson's disease who has pre-existing liver failure. What class of medications, if prescribed, would the nurse question?

Catechol-O-methyltransferase (COMT) inhibitors

Which laboratory test would be monitored closely to assess for a potential life-threatening adverse effect to clozapine (Clozaril)?

Complete blood count

The nurse is completing discharge teaching for a patient prescribed an antiepileptic drug. The nurse instructs the patient of which potential complication if the medication is stopped abruptly?

Rebound seizure activity

The nurse is caring for a postoperative craniotomy patient. Which prescribed drug does the nurse have available to treat possible acute seizures?

Diazepam (Valium)

A patient experiencing ethanol withdrawal is beginning to show severe manifestations of delirium tremens. The nurse will plan to implement which interventions for this patient? (Select all that apply.)

Doses of an intravenous benzodiazepine Restraints if the patient becomes confused, agitated, or a threat to himself or others Thiamine supplementation Monitoring in the intensive care unit

.A patient at a weight management clinic who was given a prescription for orlistat (Xenical) calls the clinic hotline complaining of a "terrible side effect." The nurse suspects that the patient is refeanticonvuladdictirring to which problem?

Fecal incontinence

When administering intravenous (IV) phenytoin (Dilantin), which action would the nurse perform?

Flush the line with normal saline before and after administration to prevent precipitation.

a pt with a known history of chronic excessive ingestion of ethanol has developed memory problems and comes to the health clinic with hard-to believe stories of what has happened to him. the nurse recognizes that these symptoms are associated with

Korsakoffs psychosis

Which instructions would the nurse include in teaching a patient to reduce the gastrointestinal (GI) adverse effects of orlistat (Xenical)?

Limit dietary intake of fat.

The nurse is presenting a seminar on substance abuse. Which drug is the most commonly used illicit drug in the United States?

Marijuana

A patient will be taking selegiline (Eldepryl), 5 mg daily, in addition to dopamine replacement therapy for Parkinson's disease. The nurse will implement which precautions regarding selegiline?

Monitor for dizziness and orthostatic hypotension.

The nurse is administering an antiepileptic drug and will follow which guidelines? (Select all that apply)

Monitor the patient for drowsiness. Give the medication at the same time every day. Notify the prescriber if the patient is unable to take the medication.

A patient with Parkinson's disease will start taking entacapone (Comtan) along with the carbidopa-levodopa (Sinemet) he has been taking for a few years. The nurse recognizes that which of these is an advantage of taking entacapone?

The entacapone can reduce on-off effects.

A patient diagnosed with depression is being discharged with a prescription for tricyclic antidepressants (TCA) after no improvement of symptoms on a selective serotonin reuptake inhibitors (SSRI). Which instruction would the nurse include specific to TCAs?

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

A patient who has been taking antiparkinson medications for years begins to have increased symptoms on a constant basis. In documenting these symptoms, what term will the nurse use?

Wearing-off phenomenon

status epilepticus is considered a life threatening medical

emergency

dopamine receptor agonist

reduces the effects of Parkinson's disease

a group of psychotropic drugs prescribed to alleviate anxiety

benzodiazepines

a nonbenzodiazepine drug used to treat anxiety

buspirone (BuSpar)

a pt has asked for a cup of coffee. the nurse keeps in mind that pts with a history of which condition need to avoid caffeine?

cardiac dysrhythmias

a nurse is teaching a client who has a new prescription for fluoxetine to treat depression. which of the following statements by the client indicates an understanding of the teaching?

i'll take this medicine first thing in the morning

a nurse is providing teaching for a client who has schizophrenia and a new prescription for fluphenazine. which of the of the following information should the nurse provide?

sleepiness should subside within a week

intravenously administered antiepileptic drugs are given --- to avoid serious AE

slowly

the nurse is teaching a class to high school students regarding the negative effects of nicotine on the body. the nurse would include which effects?

stimulation followed by depression increased heart rate and blood pressure

the only depolarizing NMBD available, used for ETT intubation

succinylcholine

which is a new selective relaxant binding agent that is used for reversal of rocuronium or vecuronium

sugammadex

a nurse is caring for a client who has bipolar disorder and has been taking lithium for 1 year. before administering the medication, the nurse should check to see that which of the following tests have been completed?

thyroid hormone assay

which lab tests should you monitor for a client who is taking interferon beta-1b to treat multiple sclerosis?

thyroid hormones liver function CBC

the nurse is reviewing a pts medication administration record. which best describes a common use for doxapram?

to treat drug-induced respiratory depression

Mr. P is receiving an opioid around the clock for late stage cancer pain. lately, he has found that the pain med is not working as well as it did a week ago, this is an example of opioid ---

tolerance

While taking a patient's history before surgery for a cardiac problem, the patient tells the nurse, "I am addicted to cocaine." The nurse notifies the anesthesiologist of this finding because use of cocaine can cause which effect when a patient is under anesthesia?

Anesthetic-induced complications

For best results when treating severe pain associated with pathologic spinal fractures related to metastatic bone cancer, the nurse should remember that the best type of dosage schedule is to administer the pain medication is which of these?

Around the clock, with additional doses as needed for breakthrough pain

a nurse is teaching a client who has multiple sclerosis and a new prescription for dantrolene. which of the following statements by the client indicates an understanding of the teaching?

i need to apply a sunscreen when i go outside

a nurse is caring for a client who has just begun therapy with alprazolam to treat anxiety. the nurse should monitor the client for which of the following AE of this medication?

insomnia

a nurse is teaching a client who takes acetaminophen daily to manage mild knee pain. the nurse should instruct the client to monitor for which of the following AE to this med?

jaundice

a nurse is providing teaching for a client who has a new prescription for valproic acid to treat a seizure disorder. the nurse should instruct the client to monitor for which of the following adverse effects?

jaundice hepatic toxicity, abdominal pain, nausea

a nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle spasm. the nurse should identify that which of the following lab tests require monitoring?

liver function test (med can cause liver toxicity)

The health care provider prescribes dantrolene (Dantrium) to a patient immediately after surgery. The nurse is aware this medication is used to treat what condition?

malignant hyperthermia

A patient with narcolepsy is having problems with excessive daytime sleepiness. The nurse expects which drug to be prescribed to improve the patient's wakefulness?

modafinil (Provigil)

The patient asks the nurse to explain the difference between carbidopa-levodopa (Sinemet) and ropinirole (Requip). How will the nurse respond?

"Ropinirole is a dopamine agonist that has fewer adverse effects than carbidopa-levodopa."

a nurse is preparing to administer midazolam 0.2mg/kg via IV bolus now. the client weighs 220 lb. how many mg should the nurse administer?

20mg

A hospitalized patient is complaining of having difficulty sleeping. Which action will the nurse take first to address this problem?

Provide an environment that is restful, and reduce loud noises.

The nurse is preparing to administer suvorexant (Belsomra) for sleep. The nurse will need to include which teaching about this drug? (Select all that apply.)

This drug needs to be taken approximately 30 minutes before bedtime. The patient needs to be cautioned about the high incidence of daytime somnolence and unconscious nighttime behaviors that may occur.

drugs used in combination with anesthetics for anesthesia initiation (induction), sedation, reduction of anxiety, and amnesia

adjunctive

when a second drug is given with a primary analgesic to enhance the analgesic effect, the second drug is being used as an --- drug

adjuvant

a nurse is preparing to administer phenytoin IV to a client that has a seizure disorder. which of the following actions should the nurse plan to take?

administer a saline solution after injection

a nurse is preparing to administer phenytoin 50mg by intermittent IV bolus to a client who has a seizure disorder. which of the following actions should the nurse take?

administer medication over 1 min

a nurse is teaching a client who received a prescription for interferon beta-1a for the treatment of multiple sclerosis. which of the following information should the nurse include?

administer the drug in your thigh or upper arm subq

a nurse is caring for a client who has Wernicke-Korsakoff psychosis as a result of chronic alcohol use disorder? which intervention should the nurse anticipate?

administration of thiamine (d/t hepatic dysfunction)

emotional disorders characterized by changes in mood

affective disorders

the nurse is administering the antipsychotic drug clozapine (Clozaril) and should montior the pt for what long-term problems associated with this drug

agranulocytosis weight gain increased appetite

a nurse is providing teaching to a client who has seizures and a new prescription for phenytoin. which of the following information should the nurse provide?

alcohol increases the chance of phenytoin toxicity

you are instructing a client who has multiple sclerosis about how dantrolene will help control spasticity. with which mechanism is the drug effective in treating this manifestation?

alters intracellular calcium exchange at the muscles

which drug may be used early in the treatment of PD but eventually loses effectiveness and must be replaced by another drug

amantadine

the most widely used tricyclic antidepressant

amitriptyline (elavil)

An intravenous dose of midazolam (Versed) has been prescribed for a patient before a colonoscopy. What does the nurse teach the patient is the most common adverse effect of this medication?

amnesia

fentanyl

anesthesia or cancer pain management

the term for drugs that depress the CNS used for surgical procedures

anesthetics

Which condition will alert the nurse to a potential caution or contraindication regarding the use of a dopaminergic drug for treatment of mild Parkinson's disease

angle-closure glaucoma

Mr. D's drug binds to a receptor, but the drug prevents a response. he is taking a drug with --- properties?

antagonist

The unpleasant state of mind in which real or imagined dangers are anticipated and or exaggerated

anxiety

a nurse is planning to apply a transdermal analgesic cream prior to inserting an IV for a preschool age child. which of the following actions should the nurse take?

apply to intact skin apply the med an hour before the procedure begins cleanse the skin prior to the procedure use a visual pain rating scale to evaluate effectiveness of treatment

a nurse is teaching a client who has a new prescription for cyclobenzaprine. which of the following information should the nurse include in the teaching?

avoid driving until effects are known

a nurse is teaching a client who has a prescription for baclofen. which of the following instructions should the nurse include?

avoid driving until the drug's effects are evident

a nurse is teaching a client who has alzheimer's disease and their caregiver about memantine. which of the following instructions should the nurse include?

avoid taking OTC antacids increases urine alkalinity and decrease drug excretion

the practice of using combinations of drugs to produce general anesthesia rather than using a single drug

balanced

a nurse is teaching a client who has a prescription for carbamazepine. which of the following instructions should the nurse include to help the client avoid AE of this drug?

begin taking the drug at a low dosage

a pt will be receiving the barbituate phenobarbital as part of treatment for seizures. the nurse assesses the pts current list of medication

benzodiazepines oral contraceptives anticoagulants MAOIs

a major psychological disorder characterized by episodes of mania or hypomania cycling with depression

bipolar affective disorder

When doing an admission drug history, the nurse notes that the patient has a prescription for lithium. The nurse suspects that this patient has been diagnosed with which condition?

bipolar disorder

a nurse is teaching a client who reports taking ginko biloba to improve his memory. which of the following AE should the nurse include?

bleeding gums

a nurse is providing dietary teaching for a client who has a new prescription for a MAOI . when the client develops a sample lunch menu, which of the following items requires intervention by the nurse?

bologna sandwhich

a nicotine free treatment for nicotine dependence

bupropion

Intravenous morphine is prescribed for a patient who has had surgery. The nurse informs the patient that which common adverse effects can occur with this medication? (Select all that apply.)

constipation pruritus nausea

hydantoin

controls seizures

A patient with a diagnosis of pneumonia asks the nurse, "Why am I receiving codeine when I have no pain?" The nurse's response is based on knowledge that codeine also has what effect?

cough suppressant

a nurse is caring for a client who has a prescription for olanzapine. the nurse should monitor the client for which of the following manifestations as an expected response to this medication?

decreased auditory hallucinations

the nurse is administering a stimulant drug and expects which response from stimulation of the CNS

decreased drowsiness increased respiration euphoria

A patient who has been taking lithium for 6 months has had severe vomiting and diarrhea from a gastrointestinal flu. The nurse will assess for which potential problem at this time?

dehydration

An abnormal emotional state characterized by exaggerated feelings of sadness, melancholy, and worthlessness out of proportion to reality

depression

a pt who has been taking disulfiram therapy for 3 months has been off the therapy for 2 days. he decides to go out with friend to have a beer. what effects may he experience (SATA)

diaphoresis vomiting facial flushing

a nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle spasms. the nurse should instruct the client to report which of the following AE?

diarrhea n/v, dehydration

a nurse is caring for a client who is exhibiting signs of alcohol withdrawal. which of the following medications should the nurse plan to administer?

diazepam

The nurse is assessing a newly admitted patient who has a history of seizures. During the assessment, the patient has a generalized seizure that does not stop for several minutes. The nurse expects that which drug will be ordered for this condition?

diazepam (Valium)

a pt has been admitted to the ED with status epilepticus. the nurse knows that which of these drugs is considered the drug of choice for this condition?

diazepam (benzo)

Long acting benzodiazepines

diazepam (valium)

a nurse is teaching a client who has a new prescription for diazepam. which of the following information should the nurse include in the teaching?

diazepam can cause drowsiness

used to deter the use of alcohol during alcohol abuse treatment

disulfram

a nurse is teaching a client who has a new prescription for disulfiram. which of the following information should the nurse include in the teaching?

do not drink alcohol while taking this medication

a pt will be taking sumatriptan (Imitrex) as part of treatment for migraine headaches. before beginning therapy, the nurse reviews the pts current list of meds. which med may have an interaction with sumatriptan?

ergot alkaloids SSRIs MAOIs

during an information session about drug abuse, the nurse relates that the most common drug effect that leads to abuse of opioids is

euphoria

The nurse teaches a patient prescribed the fentanyl (Duragesic) transdermal delivery system to change the patch at what interval?

every 72h

Term for the symptoms/adverse effects that often occur with antipsychotic medications.

extrapyramidal effects

a nurse on a medical unit is planning care for an OA client who takes several medications. which of the following prescribed medications places the client at risk for orthostatic hypotension?

furosemide telmisartan duloxetine

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

gingival hyperplasia

you are caring for a client who is preop and is NPO. the client takes carbamazepine, 200mg PO BID for seizure disorder. which action should the nurse take?

give the oral dose of carbamazepine with a sip of water

while obtaining a client's medical history, you find that the client is taking levodopa/carbidopa for Parkinson's disease. which information in the client's health history alerts you to take further action?

glaucoma

a nurse is preparing to administer the monthly injection of haloperidol decanonate to a client who has schizophrenia. Which of the following actions should the nurse plan to take?

have the client lie down for 30 min after the medication is injected

A patient is prescribed selegiline (Eldepryl), an MAO-B inhibitor, as adjunctive therapy in treatment of Parkinson's disease. What potential adverse effects would the nurse include in education for this patient? (Select all that apply.)

headache, insomnia, depression, blood pressure changes

a nurse is providing teaching to a client who has schizophrenia and is receiving chlorpormazine. which of the following client statements indicates an understanding of the teaching?

i will contact my provider if i have difficulty swallowing

a nurse is performing discharge teaching for a client who has seizures and a new prescription for phenytoin. which of the following statements by the client indicates a need for further teaching?

i'll be glad when i can stop taking this medicine

In developing a plan of care for a patient receiving morphine sulfate (MS Contin), which nursing diagnosis has the highest priority?

impaired gas exchange related to respiratory depression

A patient is prescribed an opioid analgesic for chronic pain. Which information would the nurse discuss with the patient to minimize the GI adverse effects?

increase fluid intake and fiber in diet

a nurse is teaching a client who has a new diagnosis of Parkinson's disease about how levodopa/carbidopa can help control symptoms. the nurse should identify that the drug has which of the following pharmacologic effects?

increases available dopamine in the brain

How would a patient receiving narcotic analgesics for chronic pain can minimize the GI side effects?

increasing fluid and fiber in the diet

while assisting with a procedure in the ED, the nurse prepares lidocaine for the use with which type of anesthesia

infiltration

the HCP is about to administer a loading dose of phenytoin IV. which of the following is essential for the HCP to do before administering phenytoin IV?

infuse phenytoin slowly (no faster than 50mg per min, rapid infusion causes hypotension, bradycardia, cv collapse)

the nurse is giving an IV dose of phenytoin. which guidelines will the nurse follow for administration (SATA)

inject slowly injection followed by injection of sterile saline do not infuse phenytoin continuously

A patient with narcolepsy is prescribed methylphenidate (Ritalin). Which adverse effects would the nurse include when teaching about this drug? (Select all that apply.)

insomnia, headache, weight loss

the wife of a pt who has started taking antidepressant therapy asks, "how long will it take for him to feel better". what is the best response?

it may take 4-6 weeks before you see an improvement

a nurse is providing teaching to a client who takes opioid pain medication and has a new prescription for docusate sodium. which of the following statements by the client indicate an understanding of the teaching?

it might take up to 3 days for the med to work

a nurse is providing teaching to a client who has a new diagnosis of PD. on which of the following meds should the nurse instruct the client?

levodopa/carbidopa

a pt who has just returned from surgery has suddenly developed a severe elevation in body temp. the nurse recognizes that this change may indicate?

malignant hyperthermia

a state characterized by an expansive emotional state (including symptoms of extreme excitement and elation) and hyperactivity

mania

A patient prescribed massage therapy for musculoskeletal pain asks the nurse, "How is rubbing my muscles going to make the pain go away?" What is the nurse's best response?

massaging muscles activates large sensory nerve fibers that send signals to the spinal cord to close the gate, thus blocking painful stimuli from reaching the brain

in which pt population would the nurse expect to see the use of analeptics in the treatment of respiratory depression

neonates

The nurse plans pharmacologic management for a patient with pain. The nurse would administer the pain medication based on what dosage schedule?

pain relief is best obtained by administering analgesics around the clock

pain that relates to a body part that has been removed

phantom pain

when reviewing actions of drugs, the nurse recognizes that a hypnotic is a drug that performs which action?

produces sleep

a client receives spinal anesthesia with ldiocaine and epinephrine. you explain that epinephrine is used with lidocaine for which of the following reasons?

prolongs the anesthetic effects

a nurse is caring for a client who is receiving methohexital socdium. the nurse should monitor the client for which of the following AE?

respiratory depression cardiac depression, hypothermia, hypotension

a nurse is assessing a client prior to the administration of morphine. the nurse recognizes which of the following assessments is priority?

respiratory rate

A nurse working with patients who are diagnosed with ADHD is aware that such patients often take CNS stimulant drugs. These medications are potent with a high potential for abuse and dependence. Based on this potential, how are these medications classified?

schedule II

which drug classes are used as adjunctive drugs with anesthesia (SATA)

sedative-hypnotics anticholinergics opioid analgesics

a brief episode of abnormal electrical activity in the nerve cells of the brain

seizure

a nurse is teaching a client who has a new prescription for phenytoin. the nurse should instruct the client to monitor for and report

skin rash

a pt receiving a NMBD, put in order the areas becoming paralyzed from first to last

small, rapidly moving muscles (fingers and eyes) limbs, neck, trunk muscles intercostal muscles and diaphragm

a nurse is teaching a client who has a new prescription for lithium to treat bipolar disorder. the nurse should instruct the client to ensure adequate intake of which of the following dietary elements?

sodium

Mr. J twisted his ankle in a friendly basketball game with his peers after work. His wife brings him to the urgent care center several hours later because of the pain. Mr. J is probably experiencing --- pain

somatic

during a marathon, a runner had to drop out after 16 miles because of severe muscle spasms. which type of pain is the runner experiencing?

somatic pain

a pt is experiencing a seizure that has lasted for several minutes, and he has not regained consciousness. the nurse recognizes that this is a life-threatening emergency known as

status epilepticus

After a patient has been treated for depression for 4 weeks, the nurse calls the patient to schedule a follow-up visit. What concern will the nurse assess for during the conversation with the patient?

sucidal ideation

during therapy for depression with a SSRI, it is most important for the nurse to instruct the family to monitor for which AE?

suicidal thoughts

a pt has been taking antiepileptic drugs for 1 year. the nurse reviewing the pts recent history will monitor for which condition that may develop during this time?

suicidal thoughts or behavior

Mrs. G is experiencing pain and itching as a result of a severe case of poison ivy on the skin of her arms and legs, she is experiencing --- pain

superficial

the nurse is reviewing a policy for local anesthesia. local anesthesia is indicated for which procedures? (SATA)

suturing a skin laceration diagnostic procedures dental procedures

Patient teaching for a patient receiving an MAOI would include instructions to avoid which food products? (Select all that apply.)

swiss cheese milk

a nurse is caring for a client who has a new prescription for amphetamine sulfate. the nurse should monitor the client for which of the following AE?

tachycardia dysrhythmias hypertension irritability and insomnia diarrhea and nausea

During a patient's recovery from a lengthy surgery, the nurse monitors for signs of malignant hyperthermia. In addition to a rapid rise in body temperature, which assessment findings would indicate the possible presence of this condition? (Select all that apply.)

tachypnea tachycardia muscle rigidity

a PCP prescribes sumatriptan to treat a client's migraine headaches. which instructions should the nurse include when telling the client how to take sumatriptan?

take the drug after onset of the migraine repeat the dose once if the headache returns

a nurse is teaching a client who has a prescription for modafinil to treat narcolepsy. which of the following instructions should the nurse include?

take the drug in the morning

a hospice nurse is caring for a client who has terminal cancer and takes PO morphine for pain relief. the client reports that he had to increase the dose of morphine this week to obtain pain relief. which of the following scenarios should the nurse document as the explanation for this situation?

the client developed a tolerance to the medication

a nurse is assessing a client who has been taking sertraline for 2 weeks. the nurse should identify which of the following findings as an indication that the medication is effective?

the client reports increase in mood

which statement describes the rationale for combining carbidopa with levodopa in the treatment of PD?

the combo allows lower levels of dopamine to be used with the same effect on alleviation of symptoms

the nurse is preparing to administer an opioid analgesic. which factors should be assessed before the dose is given? (SATA)

the level of pain rated on a scale prior analgesic use (time, type, amount, effectiveness) allergies

a nurse is caring for a client who has a fractured ulna and a new prescription for cyclobenzaprine. before administering, which of the following explanations should the nurse provide to explain the purpose of the medication?

the medication will relieve muscle spasms that might occur with a fracture

a type of anesthetic that is applied directly to the skin and mucous membranes

topical

when administering certain antipsychotic drugs, the nurse monitors for which EPS effects

tremors painful muscle spasms motor restlessness

The nurse is caring for a patient with a history of chronic alcohol abuse. The nurse understands the need to assess for what symptoms of withdrawal? (Select all that apply.)

tremors, agitation, hypertension

A patient receiving valproic acid (Depakote) would be monitored for which adverse effects? (Select all that apply.)

tremors, weight gain, hepatotoxicity

an older class of antidepressant drugs

tricyclics

pts taking MAOIs need to be taught to avoid foods containing this substance

tyramine

a pt will be undergoing a brief surgical procedure to obtain a biopsy from a superficial mass on his arm. the nurse expects that which type of barbituate will be used at this time?

ultrashort

The nurse would monitor an older adult patient prescribed a benzodiazepine for treatment of insomnia for which potential adverse effect?

unsteady gait

the nurse is providing teaching on COMT inhibitors to a pt with a new prescription. the nurse will be sure to educate the pt on the possibility of which of the following AE?

urine discoloration

pain thought to account for most migraine headaches

vascular pain

Mr. E paces the floor all night, holding his side. the pain is so severe that he is nauseated. his wife brings him to the emergency department, where it is quickly discovered that Mr. E has a kidney stone. the type of pain he has been experiencing is?

visceral

a nurse is admitting a client who states he takes ginko biloba every day to improve his memory. the nurse should identify a potential interaction with which of the following medications the client is taking?

warfarin

primary side effects of the SSRIs include which symptoms

weight gain and sexual dysfunction

The nurse is providing education for a patient who will be taking an antiepileptic drug for the first time. Which statement by the patient indicates that further teaching is indicated?

"I can drive to work again once my drug levels are normal."

The nurse is monitoring a patient taking an antipsychotic medication for extrapyramidal symptoms. Which clinical finding indicates the patient is having an adverse effect from this drug?

Muscle cramps of the head and neck

A patient who has been taking carbidopa-levodopa for Parkin-son's disease for over 1 year wants to start a low-carbohydrate/ high-protein weight-loss diet. The nurse tells the patient that this type of diet may have what effect on his drug therapy?

The high-protein diet can slow or prevent absorption of this medication.

A mechanically ventilated patient receiving a neuromuscular-blocking drug has tearing in the eyes and increased heart rate and blood pressure. How does the nurse interpret this clinical finding?

The patient's level of sedation is inadequate.

a nurse is teaching the family of a client who has a new diagnosis of Alzheimer's disease about donepezil. which of the following information should the nurse include?

avoid NSAIDs for pain (combining the two will induce GI bleeding) take before bed (causes drowsiness/dizziness) dose increases after 1-3 months after initial causes diarrhea

a nurse is instructing the parents of a client who has a new prescription for methylphenidate. which of the following instructions should the nurse include?

avoid activities that require alertness (like driving)

a nurse is teaching a client who has multiple sclerosis about a new prescription for baclofen. which of the following instructions should the nurse include in the teaching?

do not take antihistamines with this med

the nurse is administering phenobarbital and will monitor the pt for which possible adverse effect

drowsiness

a nurse is teaching a client who has a new prescription for valproic acid to treat a seizure disorder. the nurse should instruct the client to monitor for which of the following adverse effects?

drowsiness, headache, rash

a stimulant that is popular at raves with college students

ecstasy

A patient is experiencing withdrawal from opioids. The nurse expects to see which assessment findings most commonly associated with acute opioid withdrawal? (Select all that apply.)

elevated BP diaphoresis vomiting

The nurse is educating a group of college students about substance abuse. When discussing the potential use and abuse of stimulants, the nurse is aware these drugs are commonly abused and cause what signs and symptoms? (Select all that apply.)

elevated mood increased alertness

recurrent episodes of convulsive seizures

epilepsy

cholinesterase inhibitor

helps minimize symptoms of Alzheimer's disease

a potential AE of valproic acid

hepatotoxicity

an opioid that is injected by mainlining or skin popping

heroin

a pt with migraine headaches is being treated with serotonin antagonist. which condition would cause the nurse to question the use of this class of meds to tx the pts migraines?

hypertension

the nurse instructs a pt who is undergoing therapy with MAOIs to avoid tyramine containing foods. what medical emergency may occur if the pt eats these foods while taking MAOIs?

hypertensive crisis

during a procedure, the nurse is monitoring a pt who has received dexmedetominide for moderate sedation. the nurse will observe for which potential AE?

hypotension

The nurse is administering an NMBD to a patient during a surgical procedure. Number the following phases of muscle paralysis in the order in which the patient will experience them. (Number 1 is the first step.)

muscle weakness paralysis of small rapidly moving muscles (fingers/eyes) paralysis of muscles of the limbs, neck, trunk paralysis of intercostals and diaphragm muscles

a nurse is caring for a newborn who has respiratory depression. which of the following medications should the nurse anticipate administering?

naloxone

a nurse is preparing to administer morphine IV to a client. which of the following medications should the nurse plan to have available

naloxone

a young man has been taken to the ED because of suspected overdose of morphine tablets. the nurse prepares to administer?

naloxone

a nurse is administering fentanyl to a client to reduce pain. which of the following drugs should the nurse have available to reverse the effects of fentanyl?

naloxone neostigmine reverses pancuronium dantrolene reverses malignant hyperthermia/spasticity

Which medication is used to treat a patient with severe adverse effects of a narcotic analgesic and reverse the adverse effects?

naloxone (Narcan)

an opioid antagonist used for opioid abuse or dependence

naltrexone

pain that results from injury or damage to the peripheral nerve fibers

neuropathic pain

the addictive chemical in tobacco products

nicotine

the HCP is now assessing the client. which of the following findings can be an early indication of phenytoin toxicity?

nystagmus (serum phenytoin levels >20mcg/mL causing nystagmus, ataxia, sedation, and blurred/double vision)

the physician has ordered orlistat. the nurse recognizes that this drug is used to treat which condition?

obesity

a nurse is providing discharge teaching to a client who has a new prescription for lithium. which of the following information should the nurse include in the teaching?

obtain a daily weight

at a visit to the provider's office, an older adult client's partner reports that the client has n, diarrhea, and loss of appetite. he has a history of alzheimer's disease and is taking donepezil. which info should be provided by the nurse?

take the drug with food (cholinesterase inhibitors cause GI symptoms)

The nurse is assessing a patient for possible substance abuse. Which assessment finding indicates possible use of amphetamines?

talkativeness and euphoria

a nurse is assessing a client who has schizophrenia and has been on long term treatment with chlorpromazine. he notes that the client is experiencing some involuntary movements of the tongue and face. the nurse should suspect a development of ?

tardive dyskinesia

a pt has been taking antipsychotic med for years, and his wife has noticed that he has had some new physical symptoms. she describes him as having odd facial movements, sticking out his tongue, and having movements of his arm that he cannot seem to control. the nurse suspects that the pt is exhibiting signs of which condition?

tardive dyskinesia

In monitoring a patient for adverse effects related to morphine sulfate (MS Contin), the nurse assesses for stimulation of which area in the central nervous system (CNS)?

the chemoreceptor trigger zone

any drug that binds to a receptor and causes a response has --- properties

agonist

What assessment is highest priority when monitoring a patient on an opioid analgesic?

RR

this substance is commonly manufactured from the OTC decongestant pseudoephedrine

methamphetamine

A patient verbalizes concern to the nurse regarding postoperative nausea and vomiting from the anesthesia. Which is the nurse's best response?

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

The nurse is reviewing medication therapy with the parents of an adolescent with ADHD. Which statement is correct? (Select all that apply.)

"The last dose should be taken 4 to 6 hours before bedtime to avoid interference with sleep." "Be sure to contact the physician right away if you notice an expression of suicidal thoughts." "We will need to check your child's height and weight periodically to monitor physical growth."

A patient with Parkinson's disease who has been positively responding to carbidopa-levodopa (Sinemet) asks the nurse, "Why have I suddenly developed a relapse of my symptoms." Which explanation by the nurse is appropriate?

"This is called the "on-off phenomenon." Discuss this with your health care provider and a possible change in the medication regimen to help manage this effect."

A patient questions the use of epinephrine for repair of a laceration, stating, "I thought that was the drug used in the emergency department for someone who is coding." Which is the nurse's best response?

"Vasoconstriction caused by epinephrine enhances the duration of action for lidocaine and minimizes bleeding at the laceration site."

a nurse is caring for a client who has schizo and is experiencing hallucinations. the provider prescribes chlorpromazine 50mg IM every 4hr as needed. available is chlorpromazine injections 25mg/mL. how many mL should the nurse administer per dose?

2

a nurse is preparing to administer fluoxetine 30mg PO daily to a client. the amount available is fluoxetine 10mg/tablet. how many tablets should the nurse administer per dose?

3

The surgical nurse is reviewing operative cases scheduled for the day. Which of these patients is more prone to complications from general anesthesia? (Select all that apply.)

A 79-year-old woman who is about to have hip replacement surgery A 19-year-old male who has a history of substance and alcohol abuse

In caring for a patient experiencing ethanol withdrawal, the nurse expects to administer which medication or medication class as treatment for this condition?

Benzodiazepines

A nurse working in behavioral medicine is aware of long-term consequences from alcohol abuse. What potential vitamin deficiency can occur and potentially lead to Wernicke's encephalopathy?

Vitamin B1

A patient with bone pain caused by metastatic cancer will be receiving transdermal fentanyl patches. The patient asks the nurse what benefits these patches have. The nurse's best response includes which of these features?

More constant drug levels for analgesia

Immediate postoperative assessment of a patient reveals a body temperature of 102° F. What is the appropriate nursing intervention?

Notify the health care provider.

An older adult has been given a benzodiazepine for sleep induction, but the night nurse noted that the patient was awake most of the night, watching television and reading in bed. The nurse documents that the patient has had which type of reaction to the medication?

Paradoxical

Which response would the nurse expect to find in a patient with a phenytoin (Dilantin) level of 25 mcg/mL?

Postherpetic neuralgia

An intubated, mechanically ventilated patient in the intensive care unit (ICU) is becoming increasingly restless and anxious. The nurse expects to administer which intravenous (IV) anesthetic drug?

Propofol (Diprivan)

What atypical antipsychotic medication would the nurse anticipate the health care provider prescribing for treatment of refractory schizophrenia?

Risperidone (Risperdal)

A patient who is prescribed duloxetine (Cymbalta) comes to the medical clinic complaining of restlessness, sweating, and tremors. The nurse suspects serotonin syndrome and questions the patient regarding concurrent use of which herbal product or dietary supplement?

St. John's wort

The nurse is providing care for a patient in the emergency department who reports a headache and weakness and is noted to have cardiac dysrhythmias on the electrocardiogram. The patient is talkative, restless, anxious, and asking to leave the emergency department. The nurse suspects that the patient might be taking which abuse substance?

Stimulants

Which postoperative nursing action will help the patient avoid serious complications from general anesthesia?

Teach to turn, cough, and deep breathe.

The nurse is teaching a patient about treatment with an SSRI antidepressant. Which teaching considerations are appropriate? (Select all that apply.)

The patient should be instructed to use caution when standing up from a sitting position. The patient should not take any products that contain the herbal product St. John's wort. This medication should not be stopped abruptly. The patient should be told to check with the prescriber before taking any over-the-counter medications.

A patient is about to undergo cardioversion, and the nurse is reviewing the procedure and explaining moder-ate sedation with propofol. The patient asks, "I am afraid of feeling it when they shock me." What is the nurse's best response?

These medications will help ease any pain during the procedure, and many patients often report having no recollection of the procedure

The nurse is caring for a patient who has been taking clozapine (Clozaril) for 2 months. Which laboratory test(s) should be performed regularly while the patient is taking this medication?

WBC count

The nurse is teaching a class about the effects of alcohol. Long-term excessive use of alcohol is associated with which of these problems? (Select all that apply.)

Wernicke's encephalopathy Polyneuritis Cirrhosis of the liver Korsakoff's psychosis

While admitting a patient for treatment of an acetaminophen (Tylenol) overdose, the nurse prepares to administer which medication to prevent toxicity?

acetylcysteine

a nurse is teaching a client who is taking levodopa/carbidopa to treat Parkinson's disease. which of the following instructions should the nurse include?

change position slowly causes orthostatic hypotension eat after taking drug (avoid high protein) divide doses throughout the day muscle twitching --> toxicity

A patient is admitted to the emergency department after taking an overdose of a barbiturate 15 minutes before arrival. The nurse can anticipate that which drug will be prescribed?

charcoal (activated charcoal)

a nurse is teaching a client who is about to begin sumatriptan therapy to treat migraine headaches. the nurse should instruct the client to monitor for which of the following AE?

chest pain

Mrs. H has experienced back pain for years, she says it is worse in the late afternoon and at night...it is there at all times in some form

chronic

A patient needs to switch analgesic drugs secondary to an adverse reaction to the current treatment regimen. The patient is concerned that the new prescription will not provide optimal pain control. The nurse's response is based on knowledge that doses of analgesics are determined using an equianalgesic table with which drug prototype?

morphine

Which statement is accurate for the nurse to use when teaching a patient the difference between a sedative and hypnotic effect of a drug?

most drugs produce sedation at low doses and sleep, the hypnotic effect, at higher doses

when the effects of local anesthetics begin to wear off, which physiologic response is the first to occur

motor activity returns

a nurse is reviewing discharge instructions with a client who has bipolar disorder and is taking lithium. which of the following manifestations should the nurse include as an indication of mild toxicity?

muscle weakness

This word is often used interchangeably with the term opioid

opiate

generic name of a first-line antiepileptic drug that can cause gingival hyperplasia with long-term use

phenytoin

the HCP is talking with the client, who is soon to be discharged to home, about the adverse effects of phenytoin. which of the following instructions may help minimize the AE of phenytoin?

use of good oral hygiene (risk for gingival hyperplasia, reduced with flossing and gum massage)

a nurse is teaching a client who has bipolar disorder and a prescription for lithium to recognize the manifestations of toxicity. which of the following statements by the client indicates an understanding of the teaching?

vomiting is an indication of toxicity

a nurse is caring for a client who has been taking amphetamine/dextroamphetamine sulfate for the treatment of ADHD for 2 weeks. the nurse should report which of the following findings to the provider?

weight loss of 2.3kg (5lb) weigh self 2x a week

you are instructing a school-age child and his parent about the use of amphetamine-dextroamphetamine to manage the child's ADHD. which clinical manifestations should the nurse instruct the parent to report?

weight loss, insomnia, hallucinations

The nurse is preparing to administer an intravenous injection of morphine to a patient. The nurse assesses a respiratory rate of 10 breaths/min. What is the appropriate action of the nurse?

withhold med and notify the health care provider

a nurse is teaching a client who has a new prescription for codeine. which of the following instructions should the nurse include in the teaching?

you should change positions slowly

Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) both function by which mechanism?

block the reuptake of neurotransmitters at nerve endings

which outcome represents the most serious AE of lithium?

cardiac dysrhythmia

pain that occurs with tumors, trauma, inflammation of the brain

central pain

persistent or recurring pain that is often difficult to treat

chronic pain

the nurse is assisting a pt who is experiencing opioid withdrawal and anticipates the possible use of which medications to lessen the symptoms of withdrawal (SATA)

clonidine methadone naloxone

During treatment for withdrawal from opioids, the nurse expects which medication to be ordered?

clonidine (Catapres)

an involuntary spasmodic contraction of voluntary muscles thorughout the body

convulsion

a charge nurse is supervising a newly licensed nurse provide care for a client who has a PCA pump. which of the following statements made by the nurse requires further action by the charge nurse?

"i discarded the remaining 2 mg of morphine from the PCA pump. please document that you witnessed it"

The nurse is administering an intravenous dose of morphine sulfate to a 48-year-old postoperative patient. The dose ordered is 3 mg every 3 hours as needed for pain. The medication is supplied in vials of 4 mg/mL. How much will be drawn into the syringe for this dose?

0.75mL

A patient is to receive diazepam 4 mg IV push as a "now" order for sedation. The medication is available for injection with a concentration of 5 mg/mL. How many milliliters will the nurse give for this dosage?

0.8

in which time frame should the nurse expect the greatest risk for hypotension after administration of muscle relaxants?

60 mins after administration

a nurse is caring for a client who is taking interferon beta-1b. the nurse should identify that which of the following findings indicates a potential serious AE of this drug?

fatigue unexplained bruising, bleeding , bone marrow suppression, decreased platelet count

The nurse is caring for a patient with Parkinson's disease who 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 to the patient?

This is a normal adverse effect of entacapone (Comtan) and is not harmful.

The nurse is reading a patient's substance abuse history on admission to inpatient rehabilitation. The patient states to the nurse, "I have been increasing my drug dosage to get the same effect." What is the patient experiencing?

Tolerance

A patient with Parkinson's disease discusses with the nurse experiencing insomnia recently. The patient asks the nurse, "Can I take my old prescription of benzodiazepine that is prescribed to treat my insomnia?" What does the nurse know about the use of benzodiazepines in patients taking levodopa (Larodopa)?

Use of benzodiazepines decreases the therapeutic effect of the levodopa and may result in an increase in the symptoms of Parkinson's disease.

when evaluating the pts drug history, the nurse notes the pt is taking an opioid twice a day for pain. which additional drug, taken concurrently, would concern the nurse the most?

a MAOI

Mrs. M had breast reduction surgery yesterday and is complaining of pain around her incision. Mrs. M. is experiencing --- pain

acute

the client is taking oral contraceptives for BC. which of the following instructions should the HCP include?

additional birth control methods (teratogenic)

An unresponsive young adult is taken to the emergency department by friends. The friends tell the nurse, "we were too scared to call 911 because we were at a party popping roofies." Which medication would the nurse expect to administer to this patient?

flumazenil

a charge nurse is teaching a group of nurses about the antagonist action of medications. the nurse should include in the teaching that which of the following antagonist medications is used for benzodiazepines?

flumazenil

the nurse is providing care for a pt who has accidentally taken an overdose of benzodiazepines. which drug would be used to treat this pt?

flumazenil

used to antagonize the action of benzodiazepines and reverse sedation

flumazenil

A patient is admitted to the hospital with a diagnosis of benzodiazepine overdose. The nurse anticipates the health care provider will prescribe which antidote for benzodiazepine overdose?

flumazenil (Rmazicon)

a nurse is assessing a client who reports acute pain. the nurse should anticipate which of the following findings?

increased heart rate

The nurse is reviewing the medication orders for a patient who has been taking selegiline (Eldepryl). Which of these medications or medication classes, if ordered, would cause a problem due to an interaction? (Select all that apply.)

meperidine (Demerol) A cough syrup that contains dextromethorphan Serotonergic antidepressants

The nurse is caring for a patient with opioid addiction. The nurse anticipates that the patient will be prescribed which medication?

methadone

generic name for the drug that is most often used for moderate-sedation procedures

midazolam

a nurse is preparing to administer nalbuphine to postop client who is experiencing pain. the nurse should monitor the client for which of the following potential AE of this medication?

miosis

a nurse is caring for a client who has been taking slegiline to treat Parkinson's disease. the provider is considering the use of analgesics for the client but should be aware that a drug interaction between selegiline and meperidine can result int?

muscle rigidity stupor, agitation, hypertension, fever

a nurse is reviewing the medical record of a client who has a newly diagnosed seizure disorder and a new prescription for valproic acid and phenytoin. the nurse should identify that which of the following can occur as a result of an interaction between these drugs?

phenytoin toxicity

when a child is taking drugs for ADHD, what will the nurse instruct the caregivers to closely monitor in the child?

physical growth, especially weight

a nurse is preparing to administer sumatriptan to client for the first time. the nurse should instruct the client that sumatriptan is indicated for which of the following conditions?

presence of migraine headaches

a nurse in a mental health clinic is caring for a client who has BPD and a prescription for an antipsychotic mediation. the provider and nursing staff suspect that the client is not adhering to this medication therapy. which of the following interventions would help encourage the client's adherence?

provide for once-daily dosing use sustained-release forms engage the client in conversation following med admin

an anticonvulsant drug has been ordered as part of a pts pain management program. the nurse explains to the pt that the purpose of the anticonvulsant is to?

relieve neuropathic pain

the nurse monitoring a pt after surgery keeps in mind that the primary concern with the use of a NMBD is which adverse effect

respiratory arrest

when teaching a pt about drug interactions, the nurse is aware that combining benzodiazepines with ethanol or barbituates may lead to death from

respiratory arrest

while monitoring a pt who took an overdose of barbituates, the nurse keeps in mind that a potential cause of death would be which of these?

respiratory arrest

a nurse is caring for a client who is postop following abdominal surgery and reports incisional pain. the surgeon has prescribed morphine 4mg IV bolus every 6 hr as needed. before administering this medication, the nurse should complete which priority assessment?

respiratory rate

which of the following assessments of this client is most important immediately following the administration of IV diazepam?

respiratory rate

which drug may be used as monotherapy or in conjunction with levodopa to treat PD

selegiline

pain that originates from the skeletal muscles, ligaments, or joints

somatic pain

a pt who is newly diagnosed with PD and beginning med therapy with entacapone (COMT inhibitor) asks the nurse, "how soon will improvement occur"? what is the best response

you should notice a difference in a few days