drugs exam 4
A 60 year-old female client has multiple sclerosis accompanied by muscle spasticity. The client has responded well to dantrolene 200 mg PO daily in divided doses. What assessment finding should the nurse prioritize for communication to the client's provider? The client's most recent laboratory results show an upward trend in AST and ALT levels The client is reluctant to participate in physical therapy this morning, when she is normally highly motivated The client tells the nurse, "I'm struggling to come to grips with the fact that I'm never going to recover." The client has gained 1.5 lbs. over the past 48 hours
A
A nurse is caring for a male patient who has a spinal cord injury due to a motorcycle accident. He has been taking dantrolene (Dantrium) for 2 weeks. The nurse will monitor: prothrombin time and partial thromboplastin time. urine specific gravity. alanine aminotransferase and total bilirubin levels. follicle-stimulating hormone levels.
B
Dantrolene is being considered for the treatment of a client's spasticity. Which aspect of the client's current health status is most likely to contraindicate the use of this medication? The client's spasticity is due to rheumatoid arthritis The client takes opioid analgesics on a regular basis The client's adherence to drug therapy has been irregular The client has type 1 diabetes and takes insulin regularly
a
The nurse is caring for a client whose current medication regimen includes baclofen 60 mg PO daily. What assessment should the nurse nurse prioritize when assessing for therapeutic effects? Inspection for muscle spasticity and range of motion assessment Bilateral assessment of muscle strength Comparison of fine motor and gross motor skills Assessment for seizure activity
a
The nurse is caring for diverse group of clients. Which client is most likely to benefit from the administration of cyclosprorine? A client with chronic renal failure who is recovering from a kidney transplant A client who has multiple sclerosis and who has not responded to conservative treatment A client who has undergone treatment for malignant melanoma but who is now palliative A client being treated for active pulmonary tuberculosis
a
The post-anesthetic recovery unit nurse is caring for a client whose balanced anesthesia included midazolam. The nurse should prioritize assessments for what health problems? Respiratory depression and CNS suppression Myoclonic and tonic movements Nausea and vomiting Chills and hypotension
a
Which adverse effect of muscle relaxants is most pronounced when a client is prescribed tizanidine therapy? hypotension dark black urine excessive salivation eczema
a
A client with a history of malignant hyperthermia is scheduled for surgery. Which agent would the nurse most likely expect to administer? Botulinum toxin type B Dantrolene Baclofen Methocarbamol
b
A nurse is providing patient education to a 45-year-old man who is taking cyclosporine (Sandimmune). The nurse will provide the patient with education related to one of the most common and severe adverse effects of cyclosporine, which is: hyperthyroidism. nephrotoxicity. gastritis. cardiac effects.
b
A nurse administers carisoprodol to a client for the treatment of an acute musculoskeletal condition. The nurse would be alert for which adverse effect after administering the drug? Insomnia Anxiety Constipation Drowsiness
drowsiness
The nurse has reinforced the correct administration technique for alendronate in the knowledge that incorrect administration is associated with what increased risk? esophageal bleeding ischemic stroke decreased joint range of motion coronary artery disease (CAD)
esophageal bleeding
When prescribed dantrolene, what is the most serious adverse effect the client should be instructed about? metabolic acidosis hypercarbia renal calculi hepatitis
hepatitis
Centrally acting skeletal muscle relaxants lyse or destroy the spasm. True False
true
A client with a lower back injury was recently prescribed chlorzoxazone 250 mg PO t.i.d. The client has phoned the clinic, telling the nurse, "My pain's better, but I'm worried that my bladder is bleeding because there's been blood in my urine." What is the nurse's best response" "This drug causes your urine to change color, so it's not likely blood that you're seeing." "It's likely that your chlorzoxazone is reacting with one of your other medications." "There's a risk of that with this particular medication, so you should come be assessed promptly." "Please check in again if it doesn't clear up within the next 24 hours."
a
A client with spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered? Baclofen Carisoprodol Chlorzoxazone Cyclobenzaprine
a
A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which instruction? Eat a high-protein diet. Decrease the dosage if any adverse effect is experienced. Wear appropriate clothing and sunscreen whenever he is in direct sunlight. Have a complete blood cell count done weekly.
c
Dantrolene should be avoided in all patients who are 35 or older because of the increased risk of: congestive heart failure. cerebral hemorrhage. hepatocellular disease. diabetic ketoacidosis.
c
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? "This will likely relieve your muscle spasms but you'll probably develop a certain amount of dependence on the drug over time." "We'll need to closely monitor your blood sugar levels for the next week." "There's a small risk that you might experience some hallucinations in the first few days that you begin taking this drug." "You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity."
d
When developing a teaching plan for a client who is to receive carisoprodol, which sign or symptom would the nurse include as the most common adverse reaction? Hypertension Dyspnea Tachycardia Drowsiness
d
Patients receiving chlorzoxazone should be cautioned that what will occur with administration? Discoloration of urine Liver toxicity Hypotension Hypertension
A
A client with a complex health history has been experiencing muscle spasticity following a musculoskeletal injury. The client's current medication regimen includes carbamazepine, tamsulosin, fluoxetine and famotidine. What should the nurse prioritize in this client's plan of care? Close monitoring for seizure activity Bladder scanning once per shift Daily assessment for suicidal ideation Daily assessment for signs and symptoms of GI bleeding
a
A nurse is preparing an ordered dose of sodium iodide 131I. The nurse should proceed knowing that this drug will help to resolve hyperthyroidism by what means? destroying thyroid tissue antagonizing T3 and T4 receptors in cells inducing a reduction in cellular metabolism suppressing pituitary release of thyroid-stimulating hormone (TSH)
a
A client with multiple sclerosis asks the nurse to explain why deep tissue massages do not relieve spasticity. The nurse should explain that spasticity is caused by: skeletal muscle trauma and will improve in time. nerve damage in the brain and spinal cord, and it is a permanent condition. inflammation of the muscles; therefore, NSAIDs may be effective. stimulation of "association areas" in the brain; therefore, only nerve blocks will be effective.
a
A client's migraines are not being adequately controlled by triptans and so the client is preparing to begin treatment with onabotulinumtoxin A. What should the nurse teach the client about this treatment? Treatment will involve a series of injections every three months The client will receive in intramuscular depot injection once per week The client will likely require inpatient monitoring for the first 24 hours after starting treatment The client will need to carry a supply of the botulism antitoxin for the duration of treatment
a
Which information about medication administration and meals should the nurse include in teaching a client prescribed calcium orally? Take with or after meals. Take 2 hours before a meal. Take early in the morning. Take as recommended by the pharmacist.
a
A client with amyotrophic lateral sclerosis is experiencing muscle spasticity. Which drug would the nurse expect the physician to order? Chlorzoxazone Metaxalone Dantrolene Methocarbamol
c
A nurse is caring for a patient who is receiving azathioprine following kidney transplant. For what serious adverse effect should the nurse monitor the patient? Respiratory distress Mental depression Infection Severe diarrhea
c
A surgical client has developed malignant hyperthermia. Which medication can be used to treat this health emergency? metaxalone methocarbamol dantrolene carisoprodol
dantrolene
A 32-year-old female client is taking tizanidine (Zanaflex) for spasticity related to her multiple sclerosis. The nurse will inform the client and her husband that the adverse effect that poses the greatest safety risk to the client is: constipation. dry mouth. fatigue. hypotension.
hypotension
A female client has been admitted to the emergency department in distress and the nurse's review of the client's medication administration record reveals that the client takes cyclosporine and mycophenolate. What is the nurse's most appropriate assessment question for the client's family members? "Has she ever been the recipient of a tissue transplant?" "Do you happen to know her HIV status?" "Is there any chance at all that she may be pregnant?" "Has she ever been treated for cancer?"
a
A nurse is teaching a client about musculoskeletal medication that has been prescribed. The client needs further teaching about the medication when making which statements? "I take my medicine with three to four beers each evening." "I made an appointment in two to three weeks to be reevaluated." "I take my medication right after dinner." "I usually lie down for a few minutes after taking my medication."
a
A patient has been prescribed methocarbamol for fibromyalgia. The nurse has spent an hour educating the patient on the use of methocarbamol for muscle pain. Which statement by the patient indicates that the patient has an understanding of at least one of the significant side effects of methocarbamol? "My urine could be discolored while I take this drug." "I should have lots of energy while taking this drug." "I will probably have diarrhea while taking this drug." "This drug will help my tension headaches."
a
What is the most important teaching from the plan of care, to emphasize, when a client is prescribed a skeletal muscle relaxant? Do not drive or operate machinery until individual drug effects are known. Always take this medication with food to prevent nausea and vomiting. Report increased muscle spasm to the health care provider immediately. Drink eight to 10 glasses of water daily to prevent constipation.
a
The nurse is caring for a client with severe hypothyroidism and knows to contact the health care provider if which symptoms of myxedema coma occur? (Select all that apply.) Decreased level of consciousness Fever Decreased respirations High blood glucose level Decreased blood pressure
a,c,d
An operating room nurse is assisting the anesthesiologist in the preparation of an intravenous dose of dantrolene. What emergent issue most likely prompted the need to give the patient dantrolene? Cerebrovascular accident Malignant hyperthermia Myocardial ischemia Uncontrolled hypertension
b
A patient is having surgery to repair a ruptured Achilles tendon. The patient develops severe muscle contractions and hyperthermia. Which medications will be administered? Dantrolene sodium Baclofen Carisoprodol Cyclobenzaprine
dantrolene
