DRUGS FINAL

Anticholinergics have varied effects on the body. What is one of those effects?

Preventing vagal stimulation

A nurse is checking her understanding of the term psychosis. Which is a correct definition of psychosis?

Psychosis refers to a spectrum of disorders that affect mood and behavior.

Anticholinergic drugs are used in ophthalmology because they produce which effect?

Pupil dilation

A nurse should counsel patients receiving levodopa to avoid foods high in which vitamin as it reduces the effect of levodopa?

Pyridoxine (vitamin B6)

For which condition does the nurse understand the physician will order a combination therapy of rituximab and methotrexate?

RA

A patient has been administered an antipsychotic. Which reaction should be reported immediately?

Rigidity

A client is being treated with clozapine. What should the nurse monitor most closely?

White blood cell count

A bipolar client is being discharged home in 48 hours. What statement by the client indicates an understanding of treatment with lithium?

"I will increase my fluid intake."

A 15-year-old male client receiving phenytoin for treatment of epilepsy is being discharged from the hospital. What statement by Richard's mother leads you to believe she has understood your teaching related to his care and drug administration?

"I will make sure he has routine visits to the dentist." *Gingival hyperplasia, the overgrowth of gum tissue, is common in patients who take phenytoin

During an in-service, the charge nurse explains to the licensed vocational nurse (LVN) that there are six categories of anticonvulsants with different mechanisms of action. The LVN demonstrates understanding of the action of the miscellaneous drug, gabapentin, by stating which of the following?

"This drug is a gamma-aminobutyric acid (GABA) agonist."

One week ago, a client began taking ethosuximide (Zarontin) 500 mg/day PO for the treatment of absence seizures. The client reports gastrointestinal (GI) upset after taking with the drug. What health education should the nurse provide?

"Try taking your pills at the same time as you eat some food."

What instructions should a nurse include when teaching a client who has depression about the use of amitriptyline?

"Use sugarless hard candies and gum to deal with dry mouth."

Which medications are prescribed for mild dementia? (Select all that apply.)

-Aricept -Razadyne -Exelon

Which of the following are true in regards to the effect of caffeine on the body? Select all that apply:

-Respiratory stimulation -Central nervous system (CNS) stimulation -Diuresis

A nurse caring for a client taking amitriptyline (Elavil) for depression should monitor the client for which of the following adverse events? Select all that apply:

-Sedation -Dry mouth -Photosensitivity

Which of the following is true regarding tardive dyskinesia (TD) associated with the use of antipsychotic medication? Select all that apply:

-TD involves rhythmic, involuntary movements of the facial structures. -TD is less likely to occur with the use of atypical psychotics. -TD can occur after discontinuation of antipsychotic drug therapy.

The nurse is caring for a patient who is in hypovolemic shock. The patient's condition is increasing in severity. What features will present clinically? (Select all that apply.)

-Tachycardia -Cool exretmities -decreased urinary output

The nurse is teaching a male patient receiving epoetin alfa about the drug. The nurse informs the patient that he will receive the drug at which frequency?

3 times a week

In what patient is propranolol (Inderal) contraindicated?

35-year-old post-MI female with heart rate 42

When a patient is started on an antidepressant, it is important for the nurse to explain to the patient that it may take time to see a change in mood, but that adverse reaction may occur soon after initiation of therapy. How long can it take for the patient to see the beneficial effects of an antidepressant?

4 weeks

A male client comes into the emergency department and is agitated, swiping his arms at "the bugs" and screaming that Harry Potter sent the bugs to take him away. After two security officers help to restrain the client, the doctor orders 5 mg of Haldol STAT. How would the nurse administer this drug?

5 mg IM in the client's gluteus maximus

The nurse has just begun administering phenobarbital intravenously to a child within status epilepticus. The nurse would expect this drug to begin working within which time frame?

5 minutes

A nurse is talking to a group of families from the local nursing home about Alzheimer's disease (AD). Approximately how many people in the United States are diagnosed with AD?

5.4 million

What type of medication is given in conjunction with levodopa/carbidopa to lower the dosage of levodopa and provide more effective relief of symptoms?

A dopamine agonist

The health care provider would not prescribe duloxetine (Cymbalta) for a client with a mood disorder if the client took which other medication?

A medication for hypertension

Which of the following patients has the greatest potential to benefit from treatment with rituximab?

A woman who has chronic lymphocytic leukemia

A client is taking tolcapone for Parkinson's disease. What blood test will the nurse perform often on this client?

ALT

A school-aged child is brought to the clinic by her parents. The parents state that the child will be engaged in some activity at home and then will just stop suddenly for a few seconds and then pick up the activity again as if there had been no break in what she was doing. This child should be assessed for what neurological disorder?

Absence seizures

A client is newly diagnosed with parkinsonism and has been prescribed levodopa. After several weeks, no appreciable reduction in symptoms has been noted. The nurse should anticipate what change in the client's medication regimen?

Adding carbidopa to the client's medication regimen

Kate is experiencing status epilepticus. The physician orders IV diazepam. What special precautions need to be taken by a nurse to administer IV diazepam?

Administer the drug very slowly, no faster than 5 mg/min.

A nurse is caring for a patient who has received carbidopa/levodopa. After administration of the first dose of the drug, the patient has developed gastrointestinal disturbances. Which nursing intervention should the nurse perform when caring for this patient?

Administer the next drug dose with meals.

A nursing student is preparing a care plan and is choosing a nursing diagnosis for her client with Alzheimer's disease. The client is taking Exelon. Which would be an appropriate nursing diagnosis for this client?

Risk for Injury related to dizziness and fatigue

A client taking carbidopa-levodopa for the treatment of Parkinson's disease reports blurred vision and the nurse observes that the clients has worsening ataxia. Which nursing diagnosis should the nurse prioritize?

Risk for injury

A patient with rhabdomyosarcoma has been admitted for chemotherapy with Vincristine. While preparing a plan of care for this patient, what would be an appropriate nursing diagnosis to use?

Risk for injury

Which nursing diagnosis would be most important for a nurse to include in the plan of care for a client who is receiving an antiseizure agent and experiencing common adverse effects?

Risk for injury

Which is a cholinesterase inhibitor that is available in the form of a transdermal patch?

Rivastigmine (Exelon)

A patient with a seizure disorder has had a recent change in medication ordered. In evaluating the new drug's control of the seizure disorder, what would the nurse do?

Assess for adverse effects

The nurse is caring for a client who is prescribed haloperidol long term. What assessment should the nurse prioritize?

Assessment for involuntary movements

Understanding that beta-blockers are used mainly for cardiovascular disorders, which is not an indication for beta-blocker use?

Cardiac bradydysrhythmia

Mrs. Kelly Johnson, aged 46, was admitted to the hospital due to prior myocardial infarction, or heart attack. The diagnostic test revealed that her heart was unable to pump enough blood to adequately perfuse the vital organs. What type of shock does she seem to have suffered from?

Cardiogenic shock

Which of the following effects can be noticed in a patient who has been administered amphetamines?

Decreased appetite

A client has been prescribed benztropine as drug therapy for Parkinson's disease. What assessment finding would suggest a therapeutic effect to the nurse?

Decreased rigidity and tremors

A client's medication has been changed to clozapine (Clozaril). What assessment should the nurse perform to identify a life-threatening adverse effect early?

Vital signs monitoring

A client is experiencing absence seizures and has been prescribed a succinide. What prescription is most likely?

Zarontin *Ethosuximide (Zarontin) is drug of choice for absence seizures

A client reports gastrointestinal (GI) upset when taking phenytoin (Dilantin). The nurse should tell the client to:

take the medication with meals.

After teaching a client who is prescribed isocarboxazid, the nurse determines that additional teaching is needed when the client states a need to avoid what food?

whole milk

A client has chronic renal failure. As the disease progresses, the client is experiencing increasing shortness of breath, due to anemia. The nurse would anticipate which medication order?

Procrit

A nurse is caring for a patient who has been prescribed diphenhydramine for the treatment of allergies. The nurse observes that the patient has developed diplopia and the patient reports blurred vision. What nursing intervention should the nurse perform when caring for this patient?

Provide proper assistance with ambulation.

A male patient is taking an MAOI. The patient reports seasonal rhinitis and the physician has ordered a phenylephrine nasal spray. What should the nurse do before administering this drug?

Question the order with the prescriber. *Phenylephrine, combined with MAOIs, can cause severe hypertension, headache, and hyperpyrexia.

Beta-1 selective blockers have what as an effect?

Reduction in arrhythmia

A client has been prescribed phenytoin for the treatment of seizures. How should the nurse most accurately determine whether the client has therapeutic levels of the medication?

Review the client's laboratory blood work

Which class of antidepressants exerts its effects by inhibiting reuptake serotonin?

Selective serotonin reuptake inhibitors

Which herbal product should a nurse specifically question patients about due to the potential for adverse reactions when taken with antidepressants?

St. John't wort.

A patient is prescribed daily doses of phenytoin for seizures. The nurse knows that a single dose should not be missed during the course of treatment. Which condition could result if a dose is missed?

Status epilepticus

The nurse is planning patient education for a patient on antiseizure medications. The nurse should inform the patient that abrupt withdrawal from the medications can precipitate which problem?

Status epilepticus

Which adverse effects does the nurse attribute to methotrexate (Rheumatrex) therapy for rheumatoid arthritis (RA)? Select all that apply.

Stomatitis thinning hair cirrhosis of liver fatigue

Clients taking levodopa should avoid what due to their ability to increase dopa decarboxylase action?

Supplemental vitamins

The adrenergic branch of the autonomic nervous system is also known by which name?

Sympathetic nervous system

The nurse should be cautious and closely monitor clients receiving carbidopa/levodopa (Sinemet) with which medical conditions? (Select all that apply.)

-Renal disease -Asthma -Peptic ulcer disease

A client receiving clomipramine (Anafranil) is given a prescription for zolpidem (Ambien) QHS for sleep by a physician that was unaware the client was taking clomipramine. Which of the following reactions might the nurse observe in a client taking both clomipramine and zolpidem? Select all that apply:

-Respiratory depression -CNS depression

Ms. Rasz is being treated with phenelzine for her depression. You are developing a teaching plan to prevent adverse reactions to the medication. What would be important to include in the teaching plan? (Select all that apply.)

-The patient should limit the amount of time spent outdoors. -The patient should not use herbal preparations while taking phenelzine.

A nurse is performing a neuromuscular assessment on a client whose Parkinson's disease is being treated with medication. The nurse expects to see which symptom while performing the assessment? (Select all that apply.)

-Tremors -Drooling -Monotone speech pattern -Mask-like facial expression

What are common skin reactions that a nurse should warn a client about when they are initiated on antipsychotic therapy? (Select all that apply.)

-Urticaria -Photosensitivity

How long does a patient need to wait after stopping a phenelzine (Nardil) before starting paroxetine (Paxil)?

14 days

A nurse is instructing a mother about a new drug her son was prescribed for ADHD. The nurse should include which of the following instructions?

Always take the drug in the morning 30 to 45 minutes before breakfast and lunch.

For which client would the black box warning that is present on all antidepressants be most relevant?

A 12 year-old boy who has been diagnosed with depression by a pediatric psychiatrist *bringing attention to the increase in suicidality

A male client has been taking phenytoin (Dilantin) for the past 6 months for epileptic seizures. His Dilantin levels routinely fall within the therapeutic range. He contacts the physician's office reporting nausea, headache, and diarrhea. What would be the most appropriate intervention based on the assessment of the client's symptoms and laboratory results?

Advise the client to have his blood redrawn today to ensure that he is not at a toxic level.

When taking MAO inhibitors, clients should avoid which foods?

Aged cheeses and meats, concentrated yeast extracts, sauerkraut, and fave beans *MAO inhibitors are rarely used in clinical practice today, mainly because they may interact with some foods and drugs to produce severe hypertension and possible heart attack or stroke. Foods that interact contain tyramine, a monoamine precursor of norepinephrine

The school nurse sees a child who has had an absence seizure. Which characteristics are typical of this type of seizure?

Alterations in consciousness that last seconds

Cholinesterase inhibitors are utilized for the treatment of which of the following medical conditions? (Choose one)

Alzheimers disease

A client has developed drug induced Parkinson's disease following prolonged treatment with metoclopramide. The nurse should anticipate the use of what drug that is also classified as an antiviral?

Amantadine (Symmetrel)

A patient suffers from influenza A. Which of the following medications will be prescribed to treat influenza A?

Amantadine (Symmetrel)

A nurse observing a patient notices the patient has developed muscle rigidity, altered mental status, tachycardia, and sweating. Which of the following antidepressants drugs might cause these symptoms? (Choose one)

Amoxapine

The nurse is caring for a patient who is taking amitriptyline for depression. What nursing intervention would be most appropriate if this patient developed orthostatic hypotension?

Asking the patient to sit on the side of the bed for 1 minute before getting up

Because of the rapidly developing practice of using antibodies to target tumor cell receptor sites, the antibody prototype is the monoclonal antitumor antibody called rituximab (Rituxan). The pharmacokinetics of this drug can be described by which of the following? Choose all that apply.

Binds to the B-lymphocytes that are expressing CD20 surface marker Often used for patients with non-Hodgkin's lymphoma

Olanzapine (Zyprexa) has been prescribed for a new client. What should the nurse assess or confirm before administration of olanzapine?

Blood glucose

A nurse is caring for a patient receiving donepezil HCL for dementia of Alzheimer's disease. Which of the following factors should the nurse monitor when taking the initial assessments of the patient?

Body weight

A nurse is treating a patient who is receiving carbamazepine for a seizure disorder. The nurse knows that carbamazepine is contraindicated in patients with which diseases or disorders?

Bone marrow depression

While administering phenytoin, the nurse should observe the client for symptoms of which adverse reaction?

Bradycardia

A patient with bipolar disorder taking lithium carbonate for mood stabilization is also taking filgrastim. What laboratory tests should the patient be instructed to have more than twice a week?

CBC

Because of the rapidly developing practice of using antibodies to target tumor cell receptor sites, the antibody prototype is the monoclonal antitumor antibody called rituximab (Rituxan). The pharmacotherapeutics of this drug means it treats which of the following conditions? Choose all that apply.

CD20-positive B-cell malignancies Rheumatoid arthritis

A patient with cortical focal seizures has been prescribed phenobarbital. What adverse reaction should the nurse monitor for in the patient?

CNS depression

A client's seizure activity, which is isolated to facial and neck muscles, has been identified as being caused by one area of the client's brain. The nurse should anticipate the administration of what drug?

Carbamazepine (Tegretol)

A patient suffers from trigeminal neuralgia. What antiepileptic agent is used to treat trigeminal neuralgia?

Carbamazepine (Tegretol)

A client has been taking levodopa (L-dopa) for the treatment of Parkinson's disease. What additional medication may decrease the amount of levodopa needed to reach a therapeutic level in the brain, thereby reducing adverse effects of levodopa?

Carbidopa

Which drug is classified as a dopaminergic agent that treats Parkinsonism by supplementing the amount of dopamine in the brain?

Carbidopa (Lodosyn)

An 80-year-old client has been brought to the Emergency Department in shock. The client is receiving dopamine . The nurse should prioritize the assessment for what potentially serious adverse effect?

Cardiac arrhythmia

A client is brought in to the emergency department by ambulance in status epilepticus. What drug would best halt this client's seizure activity?

Fosphenytoin

A male client tells the nurse he is going to stop taking his medication because he is always having fine tremors and slurred speech. These reactions are preventing him from teaching art classes like he used to do. The nurse knows that what action could help him?

He could talk with his doctor and ask to have his medication dosage decreased, or change his medication to a second-generation antipsychotic.

A patient has been prescribed epoetin alfa. In reviewing this patient's history, what would the nurse know contraindicates the use of epoetin alfa?

Hypertension

The nurse has developed a plan of care for an older adult client newly diagnosed with Parkinson's disease. What outcome is most likely to be appropriate for this client?

Client will demonstrate the ability to ambulate the length of the hall within one week of starting medication

Which of the following is an effect of systemic administration of phenylephrine?

Reflex bradycardia

While taking the vital signs of a hospitalized client admitted for seizure control due to epilepsy, the nurse notices a bloody toothbrush on the client's bedside table and scattered bruising over the client's extremities. What is the nurse's best action?

Report the findings to the primary health care provider immediately.

A 52-year-old male client is being treated for Parkinson's disease. The nurse is aware that Parkinson's disease results in muscle rigidity, tremor at rest, and postural instability. What occurs in the neurons that causes these symptoms?

There is an imbalance between dopamine and acetylcholine.

A patient with benign prostatic hypertrophy (BPH) has been prescribed tamsulosin. How do alpha1-adrenergic blocking agents, such as tamsulosin, assist in treating the symptoms of BPH?

They inhibits contraction of the urinary bladder

The nurse is administering vincristine to a patient, and the container that the medication is in breaks open, resulting in the medication spraying over the patient and the nurse. The nurse follows the proper hospital procedures for cleaning up a chemotherapy spill. Afterward, what should the nurse be monitoring the patient for closely?

Severe eye irritation

A nurse is caring for a patient with suicidal tendencies and severe depression. The nurse is to prepare a report after monitoring the patient's condition. What should the nurse look for in the patient while preparing the report?

Signs of insomnia

After teaching a group of students about beta-1 selective blockers, the instructor determines that the teaching was successful when the students identify what as a contraindication to using this group of drugs?

Sinus bradycardia

The nurse is providing client education for a client newly prescribed a hydantoin antiseizure medication. The nurse has taught the client about the need to taper down the dose of the drug slowly when the provider decides it should be discontinued. What benefit of tapering should the nurse describe?

Reduced risk of status epilepticus

The nurse is caring for a client receiving ethotoin to control seizure activity. When reviewing the client's laboratory results, the nurse learns that the client's serum ethotoin level is 67 mcg/mL. What is the nurse's best action?

Report this to the provider and monitor for signs of toxicity

A patient has been taking a selective serotonin reuptake inhibitor. Which of the following represents the antidepressant affect of the medication?

Selective serotonin reuptake inhibitors downregulate 5-HT2

A client has been started on vincristine as part of treatment for cancer. What factor will the nurse need to assess with regard to interactions with this medication?

Sensory, motor, and perceptual functions

A patient suffers from depression and states feelings of gloom and inability to perform the activities of daily living. What neurotransmission is decreased?

Serotonin

Mrs. Keen is treated for leukemia. Her most recent laboratory results show a decrease in her platelet level. The physician has prescribed oprelvekin to increase her platelet count. What is the main adverse effect of oprelvekin?

Weight gain/fluid retention, which can worsen heart failure

A patient, newly diagnosed with a seizure disorder, asks the nurse why they are receiving a specific drug. What would be the best answer by the nurse?

When prescribing an AED, the physician takes into account the type of seizure the patient is having.

A patient taking chemotherapy is receiving epoetin alfa because anemia has resulted. When should the oncology nurse be concerned about the length of use of epoetin alfa?

When the physician continues to order the epoetin 8 weeks after the chemotherapy is complete

The nurse provides client teaching about use of levodopa for treatment of Parkinson's disease. What statement by the client would indicate a good understanding of levodopa?

"I should take this drug with food to avoid an upset stomach."

A patient is being treated for anemia with epoetin alfa (Epogen). Which of the following laboratory values should be assessed before and during treatment?

CBC

The nurse is teaching a nursing student about anemia and knows that it is important to start by explaining the causes of anemia. Which statement is true about the cause of anemia?

"Anemia is a condition caused by reduced amounts of hemoglobin, causing less oxygen to be delivered to the tissues."

The nurse is educating a patient who has been prescribed atropine, an anticholinergic drug. Which instructions should the nurse provide to the patient?

"Do not drive or operate machinery."

Rituximab has been prescribed for a patient who has longstanding history of severe rheumatoid arthritis that has been minimally responsive to standard therapies. When assessing the patient prior to the start of the course of treatment, what assessment question is the nurse's priority?

"Do you have any history of heart disease or irregular heart rhythms?"

A client comes to the clinic with a possible mood disorder diagnosis of unipolar depression. What question by the nurse will best help in assessing this client's mental status?

"Have you felt hopeless anytime lately?"`

A female client 25 years of age has begun taking lithium for treatment of bipolar disorder. Which statement indicates that the client needs further instruction?

"I will need to stop taking my birth control pills while I take lithium." *Women of childbearing age are often prescribed contraceptives during lithium therapy because lithium is a pregnancy category D

A patient newly diagnosed with CML has been prescribed treatment with imatinib. The patient asks the nurse how imatinib works. What would be the nurse's best response?

"Imatinib inhibits the enzyme created by the Philadelphia chromosome abnormality in CML."

A nurse is educating a patient newly diagnosed with Parkinson's disease. Which description would the nurse offer to describe the disease?

"It is characterized abnormalities in posture."

A patient is receiving lithium carbonate for treatment of bipolar disorder. Which of the following statements should be included in discharge education for this patient?

"Keep your scheduled appointments for measurement of lithium levels."

The nurse is teaching a patient about safe use of adrenergic drugs. Which statement should be included in the teaching?

"Talk to your doctor before taking any other medications."

The nurse is mentoring a first-year nursing student while caring for a client with a disease that affects the hematopoietic system. The student looks confused and says "I've never heard of that system. What is it?" How would the nurse repond?

"The hematopoietic system is composed of fluid, red blood cells, white blood cells, and platelets."

Which patient receiving 5-FU therapy has the potential for severe neurotoxicity?

A 29-year-old female with familial pyrimidinemia

The nurse is preparing discharge teaching for four clients. Which client should be advised by the nurse that over-the-counter cold and allergy preparations contain phenylephrine and should be avoided?

A 47-year-old female with hypertension

The nurse is working with a male client diagnosed with chronic renal disease. To increase compliance with the drug regimen, what should the nurse provide the patient who has been prescribed epoetin alfa?

A calendar to mark the days of the week the drug is to be administered

A nurse provides care on a psychiatric unit, and many of the clients on the unit take antidepressants. What client factor would the nurse have to consider when administering these medications?

A client has dysphagia

What psychiatric client is most likely to have the lowest risk of extrapyramidal effects?

A client taking clozapine (Clozaril) 25 mg PO t.i.d. *Advantages of clozapine include improvement of negative symptoms without causing the extrapyramidal effects associated with older antipsychotic drugs

For which client would Procrit NOT be indicated?

A client with a hemoglobin of 12, with shortness of breath.

What client is being treated with a typical antipsychotic?

An agitated client who was given haloperidol during acute psychosis *Haloperidol is a typical antipsychotic. Ziprasidone, clozapine, and paliperidone are atypical antipsychotics.

A patient has a left temporal brain tumor. He smells an odor of ammonia prior to experiencing rapid rhythmic jerking movements. What is the odor of ammonia?

An aura prior to the seizure activity

Venlafaxine (Effexor) is an antidepressant that has become more popular with adults in treating their depression. Why has it become more popular?

An extended release form is available.

Major depression is associated with:

An impaired ability to function in usual activities and relationships.

A patient with chronic renal failure receiving epoetin alfa will be having a total left hip arthroplasty. What supplementation should the patient receive prior to surgery?

An iron supplement

The antibody prototype is the monoclonal antitumor antibody called rituximab (Rituxan). The contraindications and precautions of this drug are described by which of the following? Choose all that apply.

Anaphylaxis

A patient with dementia of Alzheimer's disease is prescribed rivastigmine. Which adverse effects associated with the administration of cholinesterase inhibitors should the nurse assess for when caring for the patient?

Anorexia and nausea

A client is receiving carbamazepine therapy and the client's latest serum level of the drug is 13 mcg/mL. What action is most appropriate?

Anticipate a reduction in dosage

A client with dementia has been very agitated lately. What type of medication might the provider prescribe to help with the agitation?

Antipsychotic

A nurse is caring for a hospital client who has just been prescribed phenytoin (Dilantin) for a seizure disorder. What assessment should the nurse prioritize when assessing for adverse effects?

Assessment of respiratory rate and oxygen saturation

A client, newly diagnosed with Parkinson's disease, has been prescribed an anticholinergic drug. What assessment should the nurse perform when monitoring for adverse effects of anticholinergic agents used for the treatment of Parkinson's disease?

Assessment of the client's bowel pattern

Gabapentin is frequently used to treat neuropathies. Under which of the following conditions should the first dose of the drug be given?

At bedtime

A patient is receiving irinotecan (CPT-11) for colorectal cancer and begins having diarrhea, sweating, flushing, and abdominal cramping. What can the oncology nurse give to relieve these symptoms?

Atropine 0.5 mg intravenous (IV)

A student nurse is caring for a client who is receiving a hematopoietic agent. To test the student's understanding, the nursing instructor states that the drug could be administered by what route?

B and C Subcutaneous and intravenous

Which adrenergic receptor is responsible for increased heart rate and increased force of myocardial contraction?

Beta-1 receptors

Which adrenergic receptor is responsible for vasodilation of peripheral vessels and bronchodilation?

Beta2 receptors

A patient is brought to the Emergency Department after a motor vehicle accident. The patient is diagnosed with multiple injuries including a bladder injury. The patient is taken to surgery and develops a nonobstructive postoperative urinary retention. What drug would the nurse expect to be ordered for this patient?

Bethanechol

Lithium is not a true antipsychotic medication but is used to treat which antipsychotic disorder?

Bipolar mania

Psychosis is a severe mental illness characterized by what?

Bizarre behavior

A patient taking tamoxifen to reduce the risk of contralateral breast cancer asks the nurse about adverse effects of the drug. What is an adverse effect of tamoxifen?

Cerebrovascular accidents

A patient has been prescribed phenelzine sulfate (Nardil), which is an MAO inhibitor. Which food should the patient avoid eating?

Cheddar cheese and bratwurst

A student asks the pharmacology instructor to describe the function of a cholinergic agonist. What would the instructor reply?

Cholinergic agonists increase the activity of acetylcholine receptor sites throughout the body.

The nurse is caring for a client with glaucoma and is aware that which category of preanesthetic medication is contraindicated in this client?

Cholinergic blocking

Administration of which classes of medications can decrease secretions of the upper respiratory tract?

Cholinergic blocking drugs

A nurse is caring for a 49-year-old patient who has been taking bethanechol, a cholinergic agonist, for treatment of neurogenic bladder. After one week, the patient develops sweating, heavy salivation, and bronchospasm. What would the nurse suspect is happening with this patient?

Cholinergic crisis

A patient has been receiving bethanechol (Urecholine) for 1 week. One hour after the dose is administered, the patient develops sweating, flushing, abdominal cramps, and nausea. What is the rationale for the development of these symptoms?

Cholinergic overdose.

A 32-year-old breast-feeding mother has been diagnosed with closed-angle glaucoma and is receiving cholinergic therapy. She does not have a history of asthma, cardiovascular disease, or biliary disorder. What is the most important factor that the nurse would consider during ongoing assessment of the therapy?

Cholinergic stimulation in her infant.

The client is a woman 65 years of age being treated for anemia secondary to chronic kidney disease. The nurse explains to the client that she will be getting a prescription for Epogen. Which of the following additional information would the nurse provide?

Chronic kidney disease slows the production of red blood cells causing anemia. Epogen stimulates the production of red blood cells to treat anemia.

The physician has prescribed lithium to Mr. Johnson, a 34-year-old male with a history of obesity, cirrhosis of the liver secondary to alcohol abuse, diabetes, and hypertension. Which condition places him at highest risk of lithium toxicity?

Cirrhosis of the liver

Unwanted anticholinergic effects include:

Constipation and dry mouth.

The nurse is teaching a patient who is to receive epoetin alfa about possible adverse effects. Which would the nurse include? (Select all that apply.)

Diarrhea Asthenia Vomiting

Which adverse effects might a nurse assess in a patient receiving bethanechol? (Select all that apply.)

Diarrhea Dehydration Diaphoresis

The client has been prescribed a cholinergic medication. Which nursing diagnosis is common for clients taking a cholinergic medication?

Diarrhea related to medication side effect

William is prescribed olanzapine to treat the symptoms of schizophrenia. He suddenly begins to exhibit signs of orthostatic hypotension. During the assessment, he reveals that he uses an anxiety-relieving drug obtained through a friend. What drug is William most likely self-administering?

Diazepam

A client is brought to the emergency department in the midst of acute alcohol withdrawal accompanied by seizure activity. What drug is most likely to meet this client's needs?

Diazepam (Valium)

Katie, a 45-year-old patient with breast cancer, is currently undergoing chemotherapy. She is started on epoetin alfa secondary to decreased hemoglobin and hematocrit levels. What rule is important when administering epoetin alfa, after reconstituting it?

Do not shake the drug vigorously.

When teaching a patient on an MAO inhibitor, what would be important to include in the teaching?

Do not take OTC drugs.

The nurse evaluates the client's latest serum phenytoin (Dilantin) level which is revealed to be 16 mcg/mL. What is the nurse's best action?

Document the fact that the client's phenytoin level is therapeutic *The therapeutic serum level range for phenytoin is between 10 and 20 mcg/mL.

Mrs. Dermon has called to report that her husband, who is on SSRI therapy, appears to be overly stimulated, especially after breakfast and dinner. What is likely to have caused this effect?

Drug interaction with a caffeinated beverage

When combination therapy is ineffective, what needs to be reassessed?

Drug-drug interactions

Extrapyramidal symptoms include all of the following except:

Dystocia. *Dystocia is an abnormal or difficult childbirth or labor. NOT associated w/ drug therapy.

A client's current medication regimen includes clomipramine and the client denies any history of depression. For what other health problem should the nurse assess the client?

Early-onset Alzheimer disease

The nursing instructor is talking with a student about erythropoietin drug therapy. What is an adverse effect of erythropoietin drug therapy that the instructor would tell the student about?

Edema

A client has been prescribed carbamazepine for the prevention of seizures. What action should the nurse perform?

Educate the client about the need to ake the pills as scheduled

Anticholinergic drugs are used in the pediatric population for basically the same reasons as in the adult population. Anticholinergic drugs can have the same adverse effects in the pediatric population as in the adult population. What is a difference between the pediatric population and the adult population and anticholinergic drugs?

Effects are more severe in children.

Which drug is classified as a catechol-O-methyltransferase (COMT) inhibitor?

Entacapone (Comtan)

A patient suffers from bronchial asthma. Which medication will be administered?

Epinephrine

An instructor is preparing a teaching plan for a group of students about adrenergic agonists. Which would the nurse include as an alpha- and beta-adrenergic agonist?

Epinephrine

______________ is the prototype of the adrenergic drugs.

Epinephrine (Adrenalin)

A nurse is caring for a patient with depression. Which symptom should the nurse closely monitor for in the patient?

Extreme sadness

A client with schizophrenia will exhibit fluctuations in mood swings from depression to mania.

FALSE

The mature red blood cell contains a nucleus.

FALSE

Anticholinergics do not block the effects of acetylcholine in the central nervous system.

FALSE IT DOES

Adrenergic blockers are often called sympathomimetic agents.

FALSE; Adrenergic blockers are often called sympatholytic agents because they lyse or block the effects of the sympathetic nervous system.

Alpha- and beta-specific adrenergic agonists are primarily used to treat obstructive pulmonary conditions.

False

With Parkinson's disease, nerve cell bodies in the medulla begin to degenerate.

False

The development of diabetes mellitus is associated with the use of typical antipsychotics.

False *ATYPICAL ANTIPSYCHOTICS has a risk for developing diabetes.

Mr. Hall is prescribed haloperidol for acute psychosis. As the nurse caring for him, you note the following changes in his afternoon assessment: increased temperature, tachycardia, urinary incontinence, and lethargy. Based on the assessment, what is happening to Mr. Hall?

He has developed neuroleptic malignant syndrome. *This syndrome is characterized by fever, sweating, tachycardia, muscle rigidity, tremor, incontinence, stupor, leukocytosis, elevated creatinine phosphokinase levels, and renal failure.

A male client is being seen in the emergency department because he has a high fever and cannot move his arm. During the history-taking process, he says he is being treated with an antipsychotic medication for schizophrenia. The nurse knows that what may be happening with this client?

He may be having a neuroleptic malignant syndrome reaction to his antipsychotic medication and needs treatment immediately.

What would be a contraindication to the use of a non-selective adrenergic blocker?

Heart block

The nurse should observe patients receiving a cholinergic blocking drug during the hot summer months because these patients are at increased risk for what negative effect?

Heat prostration

A patient taking antihypertensive medication is beginning rituximab therapy. What should the nurse instruct the patient to do prior to starting the rituximab?

Hold the antihypertensive medication for 12 hours before rituximab administration and 12-24 hours after.

A client is newly diagnosed with Parkinson's disease and levodopa (Dopar) has been prescribed. What health education should the nurse provide?

Identifying foods and supplements high in vitamin B6

A client receiving a dopaminergic agent has recently experienced nausea, vomiting, and dysphagia. Which nursing diagnosis would be most appropriate for this client?

Imbalanced nutrition: less than body requirements

What would be the priority nursing diagnosis for a patient who is prescribed epoetin alfa?

Impaired tissue oxygenation related to anemia

A 11-year-old client has been hospitalized on the adolescent psychiatry unit with severe depression. For the past several weeks, the client has been prescribed a selective serotonin reuptake inhibitor (SSRI). What is the priority nursing action?

Implement suicide precautions *Recent studies have linked the incidence of suicide attempts to the use of SSRIs in pediatric clients.

A nurse is writing a plan of care for a patient who is taking bethanechol (Urecholine). What would be an appropriate outcome for this patient?

Improved bladder function

The nurse is assessing a client who was prescribed levodopa one week earlier. What change in the client's status would suggest the effectiveness of drug therapy?

Improvement in handwriting

A client with symptomatic bradycardia has been receiving atropine for the past 4 days. The client reports constipation, a common adverse effect of the drug. What is the most important suggestion the nurse could give the client?

Increase bulk in diet

Adrenergic drugs produce which effect?

Increased heart rate

Which is an effect of epinephrine?

Increased heart rate

Concomitant administration of fluconazole (Diflucan) and phenytoin (Dilantin) can result in which of the following? (Choose one)

Increased levels of phenytoin (Dilantin)

A patient is being treated for bipolar disorder with lithium carbonate (Eskalith). He also suffers from congestive heart failure and hypertension. The patient has an increased fluid volume and difficulty breathing. What laboratory value will be increased and effect the action of the patient's lithium carbonate?

Increased sodium level

A patient is administered epinephrine in conjunction with a local anesthetic. What effect will epinephrine produce?

Increased vasoconstrictive effects

A client with a recent history of seizures has been prescribed carbamazepine. The nurse should recognize that this medication will achieve a therapeutic effect by what means?

Increasing gamma-aminobutyric acid (GABA) activity and blocking sodium and calcium channels

Which intervention would be an appropriate part of a plan of care for a patient with a seizure disorder?

Informing the patient and family that seizure control is not gained immediately

An older adult was diagnosed with depression several decades and has been taking tricyclic antidepressants (TCAs) ever since, with good effect. The nurse should recognize what therapeutic action of this client's medication?

Inhibiting reuptake of norepinephrine and serotonin

Typical antipsychotic medications are thought to exert their effects in which way?

Inhibiting the release of dopamine in the brain

What best reflects the action of barbiturates when used to control seizures?

Inhibition of impulse conduction

A physician recently ordered a change in medication for a patient with a seizure disorder. Which action would the nurse take in evaluating the new drug's control of the seizure disorder?

Interview and observe for adverse effects

A patient who suffers from asthma is given theophylline. What effect will theophylline have on the patient?

It will cause insomnia.

Jack Thomas is a 45-year-old automobile mechanic with a history of throat cancer. Jack has just undergone radical neck resection. As a result of the surgery, Jack suffers from xerostomia, a dry mouth condition. He is prescribed pilocarpine therapy. What advice should you give Jack regarding the drug therapy?

Jack should be cautioned about blurred vision and its hazards.

Cholinesterase inhibitors should not be administered to patients in which stage of Alzheimer's disease? (Choose one)

LAte

A nurse is caring for a 28-year-old female who is to begin epoetin alfa therapy for iron replacement. What is it important for the nurse to know before initiating therapy?

Last menstrual period -to make sure they are NOT pregnant.

For a client diagnosed with Parkinson's and narrow angle glaucoma, what medication would be contraindicated?

Levodopa *Because levodopa can dilate pupils and raise intraocular pressure, it is contraindicated in narrow-angle glaucoma

What should the nurse include as a possible adverse effect when teaching a client about phenytoin?

Liver toxicity

What should the nurse monitor for when an elderly patient is receiving cholinergic blocking drugs? Select all that apply.

Mental confusion Drowsiness Urinary retention

Ms. Ellis is treated for thrombocytopenia secondary to chemotherapy. As the nurse caring for Ms. Ellis, you are aware that during therapy for this condition, what ongoing assessment will be important?

Monitor the platelet count.

Which would be important to perform for a patient who has received an anticholinergic agent? (Select all that apply.)

Monitoring heart rate Monitoring urine output Auscultating bowel sounds

A client, newly diagnosed with a seizure disorder, has been prescribed valproic acid. When assessing for adverse effects, what assessment should the nurse prioritize?

Monitoring the client's liver enzyme levels

The physician has ordered carbidopa-levodopa for a male client to treat his symptoms of Parkinson disease. What chronic illness would be a contraindication to the use of this medication in Mr. Adams?

Mr. Adams has undiagnosed skin lesions on his face and arms.

A patient has been diagnosed with narrow-angle glaucoma. What ocular effect will be produced if the patient is prescribed an adrenergic agent?

Mydriasis

A patient with advanced-stage Alzheimer's disease is seen by a physician who prescribes a newer drug that is not a cholinesterase inhibitor. This drug is a N-methyl-D-asparate (NMDA) receptor antagonist. This drug is better known as:

Namenda

Which of the following is an adverse reaction of antipsychotics that is potentially fatal? (Choose one)

Neuroleptic malignant syndrome

The patient with which of the following symptoms is experiencing a complication of tamoxifen (Nolvadex) therapy?

New onset of pulmonary emboli

A nurse is caring for a patient prescribed phenobarbital for status epilepticus. What intervention should the nurse perform when the patient has been administered the drug?

Observe respirations frequently.

A client is prescribed methsuximide. The nurse should expect to administer this drug by which route?

Oral

A patient with dementia of Alzheimer's disease is prescribed rivastigmine by the primary health care provider. Which is the correct method of administering rivastigmine to the patient?

Orally

A nurse is monitoring the vital signs of a patient who has been administered epinephrine. Which of the readings should nurse report immediately to the primary health care provider?

Systolic blood pressure below 100 mm Hg; *Epinephrine should raise the blood pressure, so a continued low systolic pressure indicates the medication has not been effective.

The adverse effects of selective serotonin reuptake inhibitors are less than other antidepressants.

TRUE

Typical antipsychotics block dopamine receptors.

TRUE

The nurse is teaching a client newly-diagnosed with Parkinson's disease about the appropriate use of levodopa-carbidopa (Sinemet). What should the nurse teach the client?

Take the drug three times each day, at the times that are specified

A patient with partial seizures has been prescribed succinimides at a health care facility. The patient experiences GI upset after succinimides administration. What should the nurse instruct the patient to do?

Take the drug with food or milk.

A postmenopausal woman with breast cancer will most likely be treated with which anti-estrogen drug?

Tamoxifen

A nurse is charting a client who has repetitive tongue thrusting, jaw movements, and a facial tick. What term could the nurse use in charting to describe these findings?

Tardive dyskinesia

A nurse observes rhythmic, involuntary facial movements in a patient who has been administered antipsychotic drugs. The patient also makes chewing movements and, at times, his tongue protrudes. What is the most likely reason for the patient's behavior?

Tardive dyskinesia

Which of the following is an irreversible adverse reaction associated with the use of antipsychotics? (Choose one)

Tardive dyskinesia

The nurse is caring for a patient who is taking an oral neuroleptic medication. What would be important to include in the patient teaching?

Tardive dyskinesias

A nurse recommends a client avoid other CNS stimulants while taking dexmethylphenidate (Focalin) which include which of the following? Select all that apply:

Tea Chocolate Coffee Cola drinks

A client with a history of partial seizures has been taking lamotrigine (Lamictal) for the past several days. The client calls the clinic and reports the development of a facial and torso rash to the nurse. What is the nurse's best action?

Tell the client to take no further doses and come be assessed at the clinic immediately.

The use of levodopa may interfere with which of the following test? (Choose one)

Tests for ketones in the urine

A client is receiving a selective serotonin reuptake inhibitor (SSRI) and is being switched to a monoamine oxidase inhibitor (MAOI) due to lack of response. When would the nurse teach the client to begin the MAOI?

The MAOI would be started 2 to 4 weeks after stopping the SSRI.

A client's medication regimen includes lithium. What assessment finding would suggest a therapeutic effect?

The client denies severe depressive or manic episodes

A female client has been diagnosed with depression. She also has a history of alcoholism. She has been sober now for 4 months, but at her last physical examination, the physician noted right-upper-quadrant tenderness and elevated liver enzyme levels. The physician has prescribed sertraline to treat Ms. Tooka's depression. Which factor would need to be considered prior to administering this medication to her?

The medication should be started at a lower dose due to liver dysfunction, and the patient should be monitored for side effects.

Why are selective serotonin reuptake inhibitors considered the first line of drug therapy for patients with depression?

The medications have fewer anticholinergic effects than alternatives.

The nurse is caring for a client with bipolar disorder whose medication regimen includes lithium and who will soon be discharged. What health education should the nurse prioritize?

The need to have follow-up blood samples drawn on schedule

The nurse is administering rituximab to a patient who states "My heart feels like it is beating out of my chest." When the nurse connects the patient to the monitor, ventricular tachycardia is observed. What does the nurse understand is happening with this patient?

The patient is most likely having an infusion reaction syndrome.

Which of the following patients is at greatest risk for experiencing status epilepticus?

The patient who suddenly stops drinking after consuming large amounts of alcohol for the past 5 years

Ms. Keller has been prescribed sertraline for depression and anxiety. She has been taking the medication for 3 months now. After completing her health history, you note that she is having difficulty sleeping since starting this medication. What would be the best common goal for Ms. Keller, based on your assessment of her sleep dysfunction?

The patient will sleep 8 hours each night.

The nurse is caring for a patient who is receiving drug therapy for a psychotic disorder. Which goals should the nurse include in a care plan for the patient following discharge from the hospital?

The patient will take medications as prescribed.

A patient is started on chemotherapy. The chemotherapy regimen includes three agents. What is the rationale for using three different antineoplastic agents?

The use of three agents decreases the development of cell resistance.

A xanthine used in the treatment of respiratory disorders, such as asthma and bronchitis is:

Theophylline.

What does the nurse anticipate is an outcome for the patient in a chronic hypoxic state?

There will be a stimulation of erythropoietin production.

A male client is taking Procrit. He requests changing his medication from the IM to the PO route. The nurse's best response is:

This medication is destroyed in the stomach and can only be given IM.

A nurse is caring for a patient being treated with antineoplastic drugs. The patient reports recently experiencing bloody urine. What complication might this patient be experiencing?

Thrombocytopenia

A child suffers from tics and verbal outbursts while awake. The patient is prescribed haloperidol (Haldol). What disease process is haloperidol (Haldol) used to treat?

Tourette's syndrome

A patient suffers from insomnia and temporomandibular joint pain. Which of the following selective serotonin reuptake inhibitors is most effective for treating insomnia?

Trazodone (Desyrel)

Anticholinergic effects such as dry mouth, sedation, and urinary retention are common adverse events occurring with the use of which classes of antidepressants?

Tricyclic antidepressants

Which class of antidepressants exerts their effects by inhibiting reuptake of norepinephrine and serotonin?

Tricyclic antidepressants

The nursing student correctly identifies that the transmitter in the cholinergic neuropathways that appears insufficient in patients with Alzheimer's disease is:

acetylcholine.

The symptoms of parkinsonism are caused by the depletion of dopamine in the:

central nervous system.

A nurse is preparing an antineoplastic agent for a 9-year-old cancer patient. Before administering an antineoplastic agent, the nurse's most important action should be to:

check indexes of bone marrow functioning.

The prototype drug used to create red blood cells (RBCs) is epoetin alfa (Epogen, Procrit). The pharmacokinetics include which of the following? Choose all that apply.

intravenous subcutaneous

The pathophysiology instructor is discussing neoplasms with the pre-nursing students. The instructor explains that the effects of neoplasms are caused by:

invading healthy tissue.

A patient with acute lymphoblastic leukemia (ALL) is receiving imatinib on an inpatient basis. When planning the care of this patient, what assessment should be specified in the patient's plan of nursing care?

daily weights

You are the nurse in a respiratory clinic. You should be aware that the effects of anticholinergic agents include

decreased respiratory secretions

Stem cells located in the red bone marrow, found in the long bones and vertebral skeleton, produce the three types of functional hematopoietic cells. Choose the three types from the list below.

erythrocytes leukocytes platelets

The home care nurse is caring for an 80-year-old patient who is receiving carbidopa-levodopa, a dopaminergic drug used to treat Parkinson's disease. The nurse knows that this drug may place the patient at increased risk for:

falls. *Adverse effects of dopaminergic drugs such as carbidopa-levodopa include orthostatic hypotension.

A client, who has been diagnosed with schizophrenia and is taking an antipsychotic medication, reports constant thirst, frequent urination, and feeling nauseous. The nurse knows that the client may:

have undiagnosed diabetes.

Red blood cells (RBCs) are mainly composed of _________________, which enables the cells to carry oxygen to the cells in the body.

hemoglobin

A patient has been prescribed a monoamine oxidase inhibitor (MAOI) by the physician. Before administration of the drug, the patient wants to know the adverse reactions of the drug. What is an adverse reaction to the drug?

hypertensive crisis

The main goal of therapy when using CNS stimulants is to:

relieve the symptoms for which they were prescribed.

The FDA has issued a BLACK BOX WARNING for clients taking lamotrigine (Lamictal), instructing them to discontinue the medication immediately if they develop:

skin rashes.

Which adrenergic receptor is responsible for the vasoconstriction of peripheral blood vessels?

alpha-1 receptors

Which of the following is a symptom of psychosis that is defined as finding no pleasure in activities that are normally pleasurable? (Choose one)

anhedonia

A priority nursing assessment for a patient who is to receive an alpha- or beta- adrenergic blocking agent would be to:

assess heart rate.

A patient is brought to the Emergency Department (ED) and is found to have cholinergic toxicity. What is the drug of choice to treat this condition?

atropine ITS AN ANTICHOLINERGIC

In providing care to a client with wheezing, the nurse knows that a medication targets which receptors?

beta 2 -produce bronchodilation

A patient has been diagnosed with a mood disorder that is characterized by alternating periods of mania and depression. This disorder is

bipolar disorder.

The nurse should exercise caution when administering antimetabolites to a patient with:

bone marrow suppression.

Which of the following anticonvulsants exert their effect by elevating the seizure threshold by decreasing postsynaptic excitation? Select all that apply:

-Clonazepam (Klonopin) -Phenobarbital (Luminal) -Lorazepam (Ativan)

Dilantin has several side effects. When teaching the patient about these side effects, which symptom would indicate a life-threatening condition and should be reported to the health care provider immediately?

Rash with itching

A patient has been prescribed an amphetamine as part of obesity treatment. Which of the following interventions should the nurse perform before the dosage regimen starts?

Record the patient's weight.

The nurse has provided teaching for a patient who has a new order for nadolol (Corgard) to treat their hypertension. What statement by the patient concerning nadolol (Corgard) would indicate that the teaching has been effective?

"I should never stop taking this drug abruptly, but will taper the doses gradually."

The nurse has been educating the patient on the self-administration of phenytoin (Dilantin). Which of the following statements by the patient demonstrates an understanding of the medication?

"I should not change brands without checking with my physician first."

A patient has been diagnosed with depression. The physician has ordered sertraline. The patient asks, "How soon will it be until I feel better?" What would be the best response?

"The medication will start to work in as soon as 10 days, but it may take up to 4 weeks to be fully effective."

A patient is diagnosed with a brain tumor. The patient is told that the cancer cells proliferate. The patient asks the nurse what this means. What is the nurse's best response?

"The proliferation is the growth of cancer cells and the rate of growth."

A client is brought into the emergency department in status epilepticus and the nurse is administering phenobarbital 300 mg IV as prescribed. Family members ask the nurse how long it will take to stop the seizures. What is the nurse's best response?

"The seizures will probably stop in around 5 minutes."

A new mother asks her nurse about the safety of taking St. John's wort for postpartum depression. What would be the nurse's best response?

"There is insufficient evidence to support the use of St. John's wort, and drug interactions may be extensive."

A physician has prescribed an antidepressant medication for a 15-year-old female patient. Which statement would be appropriate for inclusion in patient teaching?

"There may be an increased risk of suicide while taking this drug."

An oncology nurse is performing patient teaching for a woman who is scheduled to begin treatment with a targeted therapy. The woman is unfamiliar with this class of drugs. How should the nurse best describe targeted therapies to this patient?

"These drugs are capable of controlling the signals that tell cancer cells to grow and divide."

A male patient with cancer tells the nurse that a friend is receiving a medication, epoetin alfa for anemia. The patient wants to know why they are not able to receive the drug to help make them feel better from the anemia they have. What is the best response by the nurse?

"This drug can cause serious risks for you as well as shorten survival and increase the risk of recurrence of your tumor."

A patient is prescribed amantadine (Symmetrel). Which of the following statements indicates the patient has understood the patient teaching?

"This drug will improve my tremors in 1-5 days."

The antibody prototype is the monoclonal antitumor antibody called rituximab (Rituxan). The adverse effects of this drug are described by which of the following? Choose all that apply.

*fever, flushing, chills, and rigors *respiratory distress, more common if tumor is larger

Unlike other interleukins, oprelvekin (Neumega) primarily alters hematopoietic activity and stimulates the production of platelets. Interleukin-11, the sole drug in this class, is by necessity also the prototype. The pharmacodynamics of this drug include which of the following? Choose all that apply.

--Platelet counts begin to rise 5 to 9 days after starting. --It is produced in E. coli by recombinant DNA technology. --It stimulates the production of megakaryocyte progenitor cells and thrombopoietin.

A client in the clinic with a history of epilepsy has just tested positive for pregnancy. What is the nurse's next action?

Consult with the primary health care provider.

What discharge instructions should the nurse provide to the patient going home after rituximab therapy?

Consume large amounts of water and report decreased urine output.

A client is prescribed lamotrigine (Lamictal) for control of partial seizures. What is the most important medication teaching information the nurse should emphasize from the plan of care?

Contact the health care provider immediately if rash appears.

A nurse is caring for a male client who is being given an adrenergic drug for shock. Which action should the nurse do?

Continually assess the client for physiological changes and notify the primary care provider with relevant changes.

A patient is seen in the ambulatory care clinic with a report of insomnia. What should the nurse assess in regard to the insomnia?

Daily intake of caffeine-containing products

When carbidopa is given with levodopa (L-dopa), the dosage of L-dopa may be reduced. What does the reduction in the dosage of L-dopa cause?

Decreased adverse effects

A patient with postpartum thyroiditis could potentially experience all the following adverse cardiovascular effects from caffeine, EXCEPT:

Decreased cardiac output

A nurse is assessing a client with Parkinson's disease. The nurse determines that the client's drug therapy is effective when the client exhibits what?

Decreased tremors

Moderate CNS depression is characterized by:

Drowsiness or sleep; decreased muscle tone; decreased ability to move; and decreased perception of sensations such as pain, heat, and cold.

Which of the following is the adrenergic drug of choice for treatment of anaphylactic shock?

Epinephrine

The patient with chronic renal failure requires an agent to increase red blood cell production. What drug does the nurse anticipate administering?

Epoetin alfa

The nurse is teaching a client about erythrocytes. Which information would the nurse include in the teaching plan?

Erythrocytes are also called red blood cells.

A child has been presented for care because he has episodes where he pauses what he is doing for a few seconds, is unresponsive, and then continues on with his activity. The nurse should anticipate the administration of what medication?

Ethosuximide

Katherine, a patient with mixed-type epilepsy, is given ethosuximide for tonic-clonic seizures. She is noted to be receiving a therapeutic dose of the medication but is having an increase in the frequency of tonic-clonic seizures. What could be the most likely reason for the increase in the frequency of seizures?

Ethosuximide might have been used as monotherapy, leading to the increase in the seizures.

A nurse is caring for a patient who has been prescribed an antiparkinsonism drug. Which of the following interventions should the nurse perform as part of the patient's preadministration assessment?

Evaluate the patient's current mental condition

A client's thought disorder has been treated with haloperidol (Haldol). For what adverse effect should the nurse most closely monitor the client?

Extrapyramidal effects

A client is seen in the emergency department for third-degree burns over 50% of his body. The nurse knows that this client is experiencing what type of shock due to fluid loss?

Hypovolemic shock

A patient with dementia of Alzheimer's disease is administered donepezil HCL. What are the actions associated with cholinesterase inhibitors?

Increase in the level of acetylcholine in CNS

A patient is to be administered duloxetine (Cymbalta) to treat depression. Which laboratory values would prevent the patient from being treated with this medication?

Increased ALT

The pharmacology class learns that epoetin alfa is an immunosuppressant drug that is designed to have what expected outcome?

Increased RBC count

A patient suffering from schizophrenia is likely to have which pathophysiologic effects?

Increased dopamine

A client who was diagnosed with iron deficiency anemia is worried because she does not know why she was prescribed iron supplements. The nurse teaches the client about which action of oral iron administration?

Iron acts by elevating the serum iron concentration to replenish hemoglobin to treat anemia

The nurse is caring for a client who is receiving epoetin alfa. What adjunct treatment will the nurse expect the physician to order for this client?

Iron supplement

The nurse is educating a patient who is taking levodopa for treatment of Parkinson's disease. Which of the following items should the nurse instruct the patient to avoid using concurrently with levodopa?

Iron supplements

The client has been depressed since her father died 6 months ago and the health care provider has prescribed amitriptyline.What aspect of this client's health history should prompt the nurse to contact the prescriber?

Ischemic heart disease

The nurse knows that which of the following is true about tardive dyskinesia?

It is IRREVERSIBLE.

Terry, age 46, has a history of bipolar disorder and has been taking lithium for the past 15 years. He recently began showing signs of low thyroid function and changes in his urinary output. Which adverse effect could be affecting Terry's kidneys?

Lithium impairs the ability of the kidneys to concentrate urine.

A nurse is caring for an older adult who is taking lithium for treatment of bipolar disorder. Which of the following statements helps explain why it is important to monitor lithium levels in this patient?

Lithium is entirely excreted by the kidneys and clearance decreases in older adults.

A patient experiences an acute convulsive seizure in the emergency department. Which of the following antiseizure drugs can be administered intravenously first to terminate this type of seizure?

Lorazepam

A patient is admitted to the emergency room with uncontrolled tonic-clonic seizures. What medication is administered intravenously to assist in reducing seizure activity?

Lorazepam (Ativan)

Which is the drug of choice in the treatment of status epilepticus, an emergency characterized continual seizure activity with no interruptions?

Lorazepam (Ativan)

A 10-year-old child with spina bifida is receiving bethanechol (Urecholine) for treatment of neurogenic bladder. What adverse effect will the nurse be sure to assess for?

Loss of bowel and bladder control

A patient has been taking lithium carbonate (Eskalith) for many years to treat bipolar disorder. Which of the following diets will require the dose of lithium carbonate (Eskalith) be reduced?

Low sodium

During which phase of the cell cycle would a nurse expect a mitotic inhibitor to act?

M

A patient diagnosed with schizophrenia is being seen by the home care nurse. What is the most important aspect of patient teaching with this patient?

Maintain medication regime

A nurse is caring for a patient with seizure disorders. The patient has been prescribed phenytoin. Which of the following ongoing assessment activities should a nurse perform during the treatment?

Measure regular serum plasma levels of the drug.

Which agent would the nurse expect to find when reviewing over-the-counter allergy products?

Phenylephrine

Laura, 25 years old, is treated for eclampsia with magnesium sulfate. Which antiepileptic drug would work as an alternative to magnesium sulfate?

Phenytoin

Which anticonvulsant elicits its effects by stabilizing the hyperexcitability postsynaptically in the motor cortex of the brain?

Phenytoin (Dilantin)

A patient is being treated for a seizure disorder with phenytoin (Dilantin). He is admitted to the emergency room with sinus bradycardia. What action will occur regarding his antiepileptic agent?

Phenytoin (Dilantin) will be discontinued

A patient has developed symptoms of rigidity and bradykinesia. Which of the following medications has been linked to secondary parkinsonism?

Metoclopramide (Reglan)

A female client 70 years of age is receiving lithium. Which nursing intervention is appropriate for this client?

Monitor fluid and sodium intake every 12 hours.

An elderly patient is admitted to the medical division after a fall. At home he is taking amitriptyline (Elavil) 25 mg three times per day. What adverse effect could be related to the patient's fall?

Orthostatic hypotension

A client is receiving a cholinergic medication for urinary retention. What assessment should the nurse perform prior to administering the medication?

Palpate the pelvic region to assess fullness of bladder.

A patient with Alzheimer's disease is being treated with Exelon. The nurse knows that this drug is also used to treat which disorder?

Parkinson's disease

Which term refers to a group of symptoms involving motor movement characterized by tremors, rigidity, and bradykinesia?

Parkinsonism

Simple seizures, motor seizures, and somatosensory seizures are classified as what type of seizure?

Partial seizures

For which patient are CNS stimulants contraindicated?

Patients with severe hypertension

Which of the following cholinergic drugs is available in an ophthalmic drop for the treatment of glaucoma? (Choose one)

Pilocarpine (Pilopine)

A patient is scheduled to begin a course of rituximab for the treatment of multiple myeloma. The dose and rate of the initial infusion of the drug have been determined by the care team. The dose and rate will be increased in subsequent infusions of the drug based on what factor?

The absence of adverse reactions.

During change of shift report, a hospital nurse reminds the colleague who is coming on shift that a client's transdermal patch for treating Parkinson's disease must be changed at 0900. The colleague should recognize what aspect of this client's status?

The client has been prescribed rotigotine (Neupro)

When reviewing the medical record of a client receiving levodopa, what client factors should alert the nurse to the need for closer monitoring after administering the drug?

The client has peptic ulcer disease and takes bronchodilators for the treatment of asthma

A client is prescribed topiramate. The nurse cautions the client to avoid the intake of alcohol for which reason?

The client is at risk for increased CNS depression.

A client in the locked psychiatric unit continually tells the nurse he is the king of England, even though the staff has corrected him that he is not the king of England. How could the nurse best describe this in the client's chart?

The client is delusional. *Delusions are false beliefs that cannot be changed with reason, such as the client thinking he is the king, for example. Hallucinations are false sensations.

A 21 year-old male client is distraught about the implications of his recent diagnosis of seizure activity. When addressing this client's most likely psychosocial needs, what topic should the nurse address?

The client's loss of his driver's license

A client has a new diagnosis of a seizure disorder. What aspect of this client's health status would contraindicate the use of carbamazepine (Tegretol)?

The client's most recent blood work reveal pancytopenia

Ms. Taylor, a 25-year-old woman, is being treated for multiple sclerosis with glatiramer. She is pregnant. Based on the pregnancy risk of this medication, how would you advise Ms. Taylor about continuing therapy during pregnancy?

The medication is safe to use during pregnancy.

For clients taking clozapine (Clozaril), it is necessary to monitor what lab test for the first 6 months?

White blood cells

The teaching priority for a diabetic patient being treated with a non-specific beta-blocker would be to:

understand signs and symptoms of hypo- or hyperglycemic reaction.

An adolescent taking oral contraceptives has been prescribed an anticonvulsant medication. The nurse should tell the client to:

use another form of birth control, such as condoms. *Anticonvulsants and oral contraceptives interact, leading to decreased effectiveness of birth control.

`A nurse should be cautious when administering amitriptyline (Elavil) to which clients? (Select all that apply.)

-Clients with cardiac disease -Elderly clients

A postmenopausal patient is receiving epoetin alfa for chronic kidney disease. She informs the nurse that she has begun menstruating again after many years. What is the best response by the nurse?

"This happens in some women receiving this medication; you should be sure to use alternative methods of pregnancy protection."

A physician informs a patient who is a Jehovah's Witness that the patient needs epoetin alfa injections. The patient asks the nurse if any blood products are in this medication. What is the best response by the nurse?

"This medication is not considered a blood component by religious affiliations that object to transfusions."

The nurse is caring for a client who has been prescribed lithium and will perform which nursing interventions related to this medication? (Select all that apply.)

-Administer lithium with food. -Monitor client for drowsiness. -Increase fluid intake to approximately 3000 mL/day.

A client wants to know which symptoms of schizophrenia would be considered positive symptoms of schizophrenia. What symptoms would the nurse include? Select all that apply.

-Agitation -Delusions -Hallucinations

The nursing student learned in pharmacology class that drugs that affect the CNS do which of the following? (Check all that apply.)

-Alter mood -Alter sensation -Alter the interpretation of information in the brain

The prototype drug used to create red blood cells (RBCs) is epoetin alfa (Epogen, Procrit). It has many indications for use. Which are selected indications? Select all that apply.

-Anemia from chronic renal disease (CRD) -Anemia related to zidovudine therapy in HIV-associated illness -Anemia related to chemotherapy in patients with cancer

The antibody prototype is the monoclonal antitumor antibody called rituximab (Rituxan). The pharmacodynamics of this drug can be described by which of the following? Choose all that apply.

-Binds specifically to the CD20 antigen -Causes cell lysis -Decreases IgG and IgM serum levels

The nurse is caring for a group of clients who all take lithium and monitors which clients for an increased chance of lithium toxicity? Select all that apply.

-Client with dehydration -Client with a temperature of 102ºF -Client who takes furosemide (Lasix) for edema

The nursing instructor is discussing psychosis with the nursing students. What behavior would the instructor explain people with psychosis exhibit?

Disorganized and often bizarre thinking

The nurse is reviewing the results of a hospital client's serum phenytoin level, which has just become available. The results indicate that the client's phenytoin level is 17.5 mcg/mL. What is the nurse's best action?

Document the fact that the nurse checked the client's phenytoin levels *Therapeutic range is 10-20 mpg/mL

One of the neurotransmitters can become decreased in the area of the corpus striatum. This results in the manifestations of Parkinson's disease. Which neurotransmitter will cause this?

Dopamine

Clients with Parkinson's disease experience a deterioration in intellectual functioning along with incoordination of unconscious muscle movement.

False *Parkinson's disease does not affect a person's intellectual functioning.

After completing a head-to-toe assessment, an oncology nurse has just initiated the infusion of a patient's first dose of rituximab. When monitoring the patient for potential adverse effects, the nurse should closely observe the patient for which of the following signs and symptoms?

Fever and chills

The pharmacology instructor is discussing the differences between monotherapy and therapy that includes AEDs. What would the instructor cite as an advantage of monotherapy?

Fewer drug-drug interactions

An 80-year-old male patient has severe pain after a case of shingles. The pain is noted along the shoulder and back. He states the pain is so severe he cannot sleep. What is the primary medication that will relieve this pain?

Gabapentin (Neurontin)

In which organ are the majority of beta-adrenergic receptors found? (Choose one)

HEART

The nurse is preparing a teaching plan for a patient who is taking rivastigmine. What precaution should the nurse teach the patient and family to minimize the risk of GI adverse effects?

Having small, frequent meals

The nurse is aware that which medication taken by a client for treatment of mood disorder requires a diet that restricts the amount of tyramine eaten?

Phenelzine (Nardil)`

A client is admitted to the emergency department with severe recurrent convulsive seizures. What drug should the nurse expect to be ordered for use in emergency control of status epilepticus?

Phenobarbital

Why does phenytoin increase the risk for neonatal hemorrhage in the first 24 hours after birth?

Phenytoin is a competitive inhibitor of vitamin K.

A 15-year-old is observed having a tonic-clonic seizure at school. Which behavior would allow the school nurse to recognize the clonic phase of the seizure?

Rapid rhythmic and symmetric jerking movements

The nurse has taught a client who is receiving lamotrigine about possible adverse effects. The nurse determines that the client has understood the teaching when the client identifies a need to promptly report what adverse effect?

Rash

A 79-year-old male client is brought to the emergency department by his family because he is "talking to people who aren't there." During the initial admission assessment, his daughter mentions that her mother died 4 months ago and "Dad just hasn't been the same. The doctor has even put him on antidepressant medication. I go by the house every day to make sure he takes his medication." What would the nurse suspect is happening to this client?

The client is having hallucinations as an adverse effect of antidepressant therapy

Which test should be scheduled every week for a patient taking clozapine?

WBC count

A nurse is caring for a patient with depression. The patient has been prescribed amitriptyline, a tricyclic antidepressant. What should the nurse identify as the effect of this antidepressant on the patient's body?

Decreased reuptake of norepinephrine

A client comes to the clinic for a follow-up visit. The client is prescribed lamotrigine for seizure control. The nurse suspects that the client may be experiencing Stevens-Johnson syndrome based on which of the following? Select all that apply.

-Complaints of muscle pain -Lesions on the mucous membranes -Blisters on the face and neck

A mother is concerned about recent behaviors by her young-adult son, and asks the nurse about what behaviors characterize schizophrenia. The nurse knows that the characteristics of schizophrenia include what actions? (Select all that apply.)

-Disordered thinking -impaired socialization -abnormal behavior

Which are classified as catechol-O-methyltransferase (COMT) inhibitor drugs? (Select all that apply.)

-Entacapone (Comtan) -Tolcapone (Tasmar)

Which of the following should be reported to the physician once identified by the nurse observing a client taking an antidepressant? Select all that apply:

-Expressions of guilt -Indirect threats of suicide -Insomnia

A client treated with an antipsychotic medication might demonstrate which of the following behaviors if the antipsychotic medication was stopped? Select all that apply:

-Hallucinations -anhedonia -delusions -flatten affect

A nurse may be asked to administer adrenergic drugs to clients with which conditions? (Select all that apply.)

-Hypovolemic shock -Respiratory distress -Allergic reactions -Cardiac arrest

A nurse is making a care plan for a client with Parkinson's disease and has started on an antiparkinson medication. Which nursing diagnosis would be appropriate for this client's care plan? (Select all that apply.)

-Imbalanced Nutrition: Less than Body Requirements -Altered Bowel Movements: Constipation -Risk for Injury

Antidepressants often can cause GI side effects that lead to imbalanced nutrition. Which of the following recommendations should the nurse make to the client to help alleviate GI side effects? Select all that apply:

-Increase fiber intake. -Increase fluid intake. -Chew sugarless gum.v

Which medications should not be administered to clients receiving monoamine oxidase inhibitors (MAOIs) because of the increased risk of hypertensive episodes? (Select all that apply.)

-Meperidine (Demerol) -Sertraline (Zoloft) -Amitriptyline (Elavil)

The nurse should monitor a client closely for which of the following symptoms after an abrupt reduction in levodopa dose as neuroleptic malignant-like syndrome may occur? Select all that apply:

-Muscular rigidity -Fever -Mental status changes

In which clients should the nurse review medical conditions prior to administering a carbidopa/levodopa (Sinemet), as its use is contraindicated in these clients? (Select all that apply.)

-Narrow angle glaucoma -Renal disease -Hepatic disease -Use of MAOI antidepressants

The essential components of the immune system are hematopoietic cells, barrier defenses, the nonspecific immune response, the specific immune response, and immunity. Which of the following describe the nonspecific immune response? Choose all that apply.

-Neutrophils are the most common granulocyte. -Granulocyte, monocyte, and macrophage activities destroy the invader. -Phagocytosis occurs.

The nurse interviews the family of a patient hospitalized with severe depression and suicidal ideations. What assessment data is important in planning this family's plan of care? (Mark all that apply.)

-Recent suicide attempts -GI obstruction -Affect

The essential components of the immune system are hematopoietic cells, barrier defenses, the nonspecific immune response, the specific immune response, and immunity. Which of the following describes hematopoietic cells? Choose all that apply.

-Red blood cells (RBCs) are mainly composed of hemoglobin. -Erythropoietin stimulates production of RBCs. -Platelets are the formed element involved in blood coagulation.

The essential components of the immune system are hematopoietic cells, barrier defenses, the nonspecific immune response, the specific immune response, and immunity. Which of the following describes barrier defenses? Choose all that apply.

-The gastrointestinal tract provides an acid protector. -Skin is the first line of defense. -Mucus is a barrier defense.

The nurse is administering an adrenergic agonist to a patient and realizes that this medication will cause stimulation of the sympathetic nervous system. Which effects will it produce? (Select all that apply.)

-bronchodilation -decreased bladder tone *Adrenergic agents produce a sympathetic response that produces the following effects: pupil dilation, increased salivation, bronchodilation, increased heart rate, contractility, conduction and vasoconstriction, decreased gastric acid secretion, gastric motility, and decreased tone of the bladder and uterus muscles.

Which of the following are reasons a nurse may need to contact the client's physician to administer an antipsychotic drug intramuscularly instead of orally? Select all that apply:

-client is combative -client won't allow the nurse to inspect the oral cavity -client refuses the medication -Client has difficulty swallowing

A nurse is listing adverse reactions to a client who is taking an anticholinergic medication. Which would be correct for the nurse to list? (Select all that apply.)

-dry mouth -Blurred vision

During maturation in the bone marrow, white blood cells (WBCs) differentiate into three main cell types. Which of the following are the cell types?

-granulocytes -monocytes -lymphocytes

Unlike other interleukins, oprelvekin (Neumega) primarily alters hematopoietic activity and stimulates the production of platelets. Interleukin-11, the sole drug in this class, is by necessity also the prototype. The pharmacotherapeutics of this drug include which of the following? Choose all that apply.

-prevent severe thrombocytopenia -reduce the need for platelet transfusions

A patient treated for bipolar disorder with lithium carbonate (Eskalith) is scheduled for a lithium blood level. What is the therapeutic serum lithium level?

0.5-1.2 milliequivalents per liter

A nurse is reviewing a client's serum lithium level. Which finding would indicate that the client is experiencing lithium toxicity?

1.8 mEq/L *Therapeutic serum lithium levels range from 0.6 mEq/L to 1.2 mEq/L

The nurse is caring for a patient receiving epoetin alfa (Procrit). The nurse would know that an appropriate order for epoetin alfa (Procrit) is:

150 units/kg Sub-Q 3 times per week

The nurse at an outpatient mental health unit is reviewing the black box warning that applies to clients who are taking antidepressants. To which of the nurse's clients would the black box warning apply?

A 14 year-old client who has been diagnosed with major depression

The nuring instructor is teaching students about Alzheimer's disease. The instructor informs the students that patients with this illness experience problems with memory and thinking. The reason that this happens is:

Degeneration of cholinergic pathways.

A client with advanced Parkinson's disease has undergone diagnostic testing and diagnostic imaging. What are the results most likely to reveal?

Degeneration of dopamine-producing nerve cells

A client 19 years of age who is a drug addict comes to the emergency department reporting extreme fatigue and shortness of breath. The nurse assesses the client and, after taking a complete history, determines that the client has malnutrition. The nurse knows that malnutrition can cause which type of anemia?

Folic acid deficiency anemia occurs because of a dietary lack of folic acid, a component necessary in the formation of red blood cells.

Kate, age 34, comes to your office for preconception counseling. She is currently drinking 10 to 12 cans of diet cola each day. She verbalizes her concern about her excessive caffeine intake and the adverse effects that caffeine will have on the baby. She asks what she can do to limit her caffeine intake. What is the best recommendation for you to make?

Gradually decrease her daily intake of caffeine.

The nurse is caring for a patient with chronic kidney disease who is receiving epoetin alfa. Which assessment finding would be of greatest concern for the nurse?

Reports of calf pain on dorsiflexion of the foot

A client's dose of Sinemet has recently been increased due to an exacerbation of the client's parkinsonian symptoms. What assessment finding would suggest that the client is experiencing adverse effects?

The client is retaining urine and has required a urinary catheter

Activation of beta3-adrenergic receptors produces lipolysis and increased release of free fatty acids into the blood. True or false?

True

Anticholinergics block acetylcholine at the muscarinic receptors.

True

Dopaminergic agents can exacerbate cardiovascular disease due to dopamine receptor stimulation.

True

Levodopa is used as treatment for Parkinson's disease primarily acting as a replacement neurotransmitter.

True

Most nonselective adrenergic blockers are used to treat hypertension.

True

The patient is being prescribed epoetin alfa for the treatment of anemia related to the renal failure. The patient also has a history of diabetes mellitus, uncontrolled hypertension, osteoarthritis, and hypothyroidism. Which of these conditions should the nurse bring to the physician's attention prior to administering the medication?

Uncontrolled hypertension

A home health nurse is visiting an older adult client with Parkinson's disease. What should the nurse assess this man for related to common adverse effects?

Urinary retention

What condition is the cholinergic drug bethanechol (Duvoid) used to treat?

Urinary retention

A patient has come to the short-stay unit to receive their IV chemotherapy. What action by the nurse would be the least beneficial to the patient?

Using an infusion pump to administer the medication

Which of the following is an example of an antineoplastic drug that interferes with amino acid production in the S phase and the formation of microtubules in the M phase?

Vinblastine (Velban)

A nurse is caring for a 70-year-old patient undergoing antiparkinsonism drug therapy. The patient is prescribed pramipexole by the physician. The nurse should monitor the patient's condition for the development of which of the following adverse reactions associated with the use of this drug?

Visual hallucinations

The physiology instructor is talking with the students about the development of blood cells. What would the instructor tell the students causes a hemocytoblast to change into an immature RBC?

Vitamin B12

A client is taking levodopa. What should the nurse caution the client to avoid?

Vitamin B6