The Neurological System (Part 1)

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

"Administer the drug in your thigh or upper arm." Rationale: Interferon beta-1a is administered via the subcutaneous route. Therefore, the nurse should instruct the client how to perform subcutaneous injections for self-administration.

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." Rationale: Interferon beta drugs can cause fever, chills, headaches, and muscle aches. Acetaminophen can help minimize these symptoms.

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. Rationale: Baclofen, a centrally acting muscle relaxant, causes CNS depression. Clients taking the drug should avoid alcohol and other CNS depressants, and should not drive a vehicle until they know how the drug will affect them.

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 over-the-counter antacids. Rationale: Antacids that contain sodium bicarbonate increase urine alkalinity and can decrease excretion, ultimately leading to toxicity.

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 the use of NSAIDs for pain. Rationale: Combining NSAIDs with donepezil can cause GI bleeding. Therefore, the nurse should instruct the client's family to avoid the use of NSAIDs.

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 adverse effects of this drug?

Begin taking the drug at a lose dosage. Rationale: Visual disturbances, vertigo, and ataxia can result from taking carbamazepine, a drug that treats seizure disorders. Dosages should be low to minimize or prevent these adverse effects.

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 positions slowly to prevent orthostatic hypotension. Rationale: Levodopa/carbidopa can cause orthostatic hypotension.

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 adverse effects?

Chest pain. Rationale: Sumatriptan, a serotonin agonist, can cause coronary vasospasm and chest pain. Clients should report any pressure, pain, or tightness in the jaw, chest or back. Sumatriptan is not an appropriate choice for clients who have a history of coronary artery disease.

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

Cirrhosis. Rationale: Memantine should be used cautiously in clients who have severe hepatic impairment. The nurse should contact the provider about the client's history of cirrhosis to see if laboratory testing is required before starting the drug or if the dosage needs to be adjusted.

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

Creatinine clearance. Rationale: Pramipexole, a direct-acting dopamine receptor agonist, should be used with caution for clients who have renal disease. Therefore, the nurse should monitor the client's renal function.

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 adverse effects?

Diarrhea. Rationale: Prolonged diarrhea can cause dehydration and other serious effects. Diarrhea, nausea, and vomiting are adverse effects of dantrolene. The client should report these effects so the nurse can monitor fluid imbalance and intervene accordingly.

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

Drowsiness, headache, and rash.

A nurse is caring for a client who is taking interferon beta-1b. The nurse should identify that which of the following findings indicate a potential serious adverse effect of this drug?

Fatigue. Rationale: The nurse should identify that potential serious adverse effects of interferon beta-1b include unexplained bruising, bleeding, and fatigue. Clients should report these adverse effects to their provider immediately because they can indicate bone marrow suppression and decreased platelet count.

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. Rationale: Levodopa/carbidopa, a dopaminergic agent, can increase dopamine in the extrapyramidal center of the brain, reducing involuntary motion, or tremors, associated with Parkinson's disease.

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

Jaundice. Rationale: Valporic acid can cause hepatic toxicity, characterized by jaundice, abdominal pain, and nausea. Clients taking the drug should report these manifestations, and the nurse should monitor liver function studies prior to treatment and periodically during therapy.

A nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle spasms. The nurse should identify that which of the following laboratory tests requires monitoring?

Liver function. Rationale: Liver toxicity is a serious adverse effect of dantrolene. The nurse should monitor the client's liver function prior to treatment and at regular intervals and advise the client to report jaundice or abdominal pain.

A nurse is caring for a client who has been taking selegiline 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 in which of the following?

Muscle rigidity. Rationale: A drug interaction between selegiline and opioids, especially meperidine, can result in rigidity, stupor, agitation, hypertension, and fever.

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. Rationale: Naloxone is an opioid antagonist that reverses the effects of opioids. Fentanyl, an opioid agonist, can cause severe respiratory depression. The nurse should also have resuscitation equipment available when administering fentanyl to a client.

A nurse is caring for a client who is taking donepezil to treat Alzheimer's disease. For which of the following adverse effects should the nurse monitor?

Nausea. Rationale: The most common adverse effects of donepezil, a cholinesterase inhibitor, are nausea, vomiting, and diarrhea. Taking donepezil with food can help minimize adverse effects.

A nurse is reviewing the medical record of a client who has a newly diagnoses seizure disorder and a new prescription for vampiric 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. Rationale: Vampiric acid can cause an increase in phenytoin blood levels, resulting in phenytoin toxicity. The nurse should monitor serum phenytoin levels and notify the provider if levels begin to exceed the therapeutic range.

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

Presence of a migraine headache. Rationale: Sumatriptan is used in the treatment of migraine headaches.

A nurse is caring for a client who is receiving methohexital sodium. The nurse should monitor the client for which of the following adverse effects?

Respiratory depression. Rationale: Methohexital, a short acting barbiturate, causes respiratory depression. Mechanical ventilation and continuous monitoring are essential for clients receiving this drug.

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 adverse effects?

Tachycardia. Rationale: Amphetamine sulfate is an amphetamine stimulant. It can cause tachycardia and dysrhythmias. The client should notify the nurse if they develop palpitations or chest pain.

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. Rationale: Modafinil is a non amphetamine stimulant. Taking it in the morning helps improve wakefulness for clients who have narcolepsy. Clients taking the drug for shift-work sleepiness should take it 1 hr before work.

A nurse is caring for a client who has been takingamphetamine/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 2.3 kg (5lb). Rationale: Amphetamine/dextroamphetamine sulfate can cause a decreased appetite and weight loss. The nurse should instruct the client to weigh themselves twice weekly and report unintended weight loss.