Neurology Part 2

Which of the following instructions should a health care professional include when advising a patient about instilling pilocarpine (Isopto Carpine) for managing open-angle glaucoma? A. apply gentle pressure to the nasolacrimal duct for 1 min after instilling the drops do not touch the tip of the dropper B. do not touch the tip of the dropper C. wash hands after instilling the drops D. Rub eyes gently after instilling the drops E. Remove contact lenses prior to instilling the drops

Answers: Reasonings: A. keeps the drug from entering the systemic circultion B. remain sterility C. wash before, washing after is not necessary unless spilling of the drug occured D. avoid rubbing/touching eyes-can cause eye damage E. leaving contacts in can cuase further irritation if left in place

A health care professional should monitor and older adult patient who is taking alprazolam (Xanax) for which of the following adverse effects? A. tolerance B. anxiety C. sedation D. respiratory depression E. constipation

Answers: A, B, C, D Reasonings: A. tolerance tolerance and dependence develop with benzos. Use only as needed for short periods of time B. anxiety paradoxical rxn can develop, especially in elderly patients-report findings C. sedation CNS depression D. respiratory depression benzos cause CNS depression. Monitor for respiratory depression and use lowest effective dose E. Constipation unlikely. However, can cause n/v/d

A health care professional is caring for a patient who is about to begin amitriptyline therapy to treat major depression. The health care professional should include which of the following instructions when talking with the patient about taking the drug? A. change position slowly B. do not quit taking abruptly C. Wear sunscreen and protective clothing D. take at bedtime to prevent daytime drowsiness E. Increase fiber and fluid intake

Answers: A, B, D, E A. change position slowly -orthostatic hypotension B. do not quit taking abruptly -relapse and withdrawal s/s can occur. Reduce dose over a 2 week period C. Wear sunscreen and protective clothing -sun exposure is unlikely to cause photo-sensitivity D. take at bedtime to prevent daytime drowsiness -can cause drowsiness: avoid activities requiring mental alertness E. Increase fiber and fluid intake -Amitriptyline, a tricyclic antidepressant, causes anticholinergic effects, such as dry mouth, constipation, and urinary retention. Patients should increase fiber and fluid intake during drug therapy and urinate before taking the drug.

A health care professional is caring for a patient who is about to begin taking lithium carbonate (Lithobid) to treat bipolar disorder. The health care professional should caution the patient to watch for which of the following indications of litium toxicity? A. tremors B. confusion C. Bronchospasm D. nausea E. muscle weakness

Answers: A, B, D, E Reasoning: A. advances toxicity resulting in seizures B. confusion, slurred speach, and ataxia are indications of lithium toxicity due to the drug's narrow therapeutic range C. lithium does not normally affect the respiratory system D. n/v/d are early indications of toxicity. pts should report any of these adverse effects E. muscle weakness is an early indication of toxicity due to the drug's narrow therapeutic range *HCP should monitor lithium levels periodically

When reviewing the indications for various antidepressants, a health care professional should understand that bupropion hydrochloride (Wellbutrin) is an appropriate choice for patients who have which of the following? A. motion sickness B. seasonal affective d/o C. depression D. seasonal effective disorder E. nicotine addiction

Answers: B, D, E Reasoning a. can cause n/v and constipation-does not tx motion sickness b. atypical antidepressant, helps prevent and treat seasonal affective disorder, a type of depresssion associated with the reduction of natural light during winter months c. can cause insomnia and agitation d. appropriate for patients trying to quit smoking e. antidepressants help tx depression

A health care professional is talking to a patient who is taking lithium carbonate (Lithobid). Which of the following instructions should be included to reduce the risk of lithium toxicity?

Avoid taking NSAIDS Reasoning: NSAIDS increase renal absorption of lithium and Na.

When talking to a patient about buspirone, the health care professional should include which of the following instructions? A. Take the drug with grapefruit juice to increase absorption B. Use the drug only as needed for anxiety C. allow 2-4wks before expecting to feel better D. Take the drug on an empty stomach

C. allow 2 to 4 weeks to notice effects Reasoning: A. avoid- increases drug levels B. take on a regular basis to avoid recurrance or worsening of s/s C. 2-4wk before in full therapeutic effect D. can cause nausea so take with food

A health care professional is collecting data from a patient who is taking bupropion hydroooride (Wellbutrin) to treat depression. The health care professional notes that the patient has a recent history of a head injury. She should recognize that the drug is inappropriate for the patient because of the increase risk for which of the following? A. ischemic stroke B. Drowsiness C. Respiratory depression D. Seizure activity

D. Seizure activity Reasoning: Bupropion, an atypical anti-depressant, can cause seizure activity when patients take high doses or have a seizure d/o, a CNS tumor, or a hx of head trauma

A health care professional is obtaining a patient drug history when he finds that the patient is taking lithium carbonate (Lithobid) for bipolar disorder. Which of the following findings in the patients drug history should alert the health care professional to monitor him for lithium toxicity?

Furosemide (Lasix) for hypertension Reasoning: Lasix is a high-ceiling diuretic, increases Na loss and can cause lithium re-absorption. HCP should eval for lithium toxicity

When reviewing the adverse effects of drug therapy with a patient, a health care professional should explain orthostatic hypotension is a common adverse reaction of which of the following drugs?

Imipramine (Tofranil) Reasoning: imipramine (tricyclic antidepressant, can result in orthostatic (postural) hypotension. Patients taking this drug should change positions slowly from sitting or lying to standing

A health care professional is caring for a patient who is about to begin using betaxolol (Betoptic) eye drops to treat open-angle glaucoma. The health care professional should advise the patient to expect which of the following reactions?

Ocular Stinging Betaxolol, a beta-adrenergic blocker, can cause short-term, mild stinging and burning of the eye. Patients should expect transient eye discomfort, but should not rub their eyes. Continuous irritation should be reported

A health care professional is caring for a patient who is taking venlafaxine to treat major depression. The health care professional should recognize that which of the following drugs can cause serotonin syndrome when patient take it concurrently with venlafaxine

Phenelzine (Nardil) Reasoning: patients hsould not take venlafaxine, a serotonin norepinephrine reuptake inhibitor, within 14 days of taking phenelzine, other MAOIs, or serotonergic drugs. Serotonin syndrome is a life-threatening complication characterized by anxiety, confusion, hallucinations, and fever

Soon after beginning fluxetine (Prozac), a patient is admitted to the emergency department with agitation and confusion. The health care professional should suspect which of the following?

Serotonin Syndrome Reasoning: can begin 2-72 hr after begining fluoxetine, and SSRI. Manifestations: confusion, difficulty concentration, and agitation

A health care professional is caring for a young adult patient who is taking fluuxetine (Prozac) to treat depression. The health care professional should tell the patient and the patients family to report which of the following?

Suicidal Thoughts Reasoning: fluuxetine (SSRI) have increased risk for suicide, eps in early tx. pts who are severly depressed can have, with drug therapy, the energy for self harm. Monitor for worsening depression

A healthcare professional is caring for a patient who is taking lithium carbonate (Lithobid) to treat bipolar disorder. Which of the following diagnostic test should the health care professional recommend periodically for the patient?

Thyroid function test Reasoning: hypothyroidism is an adverse effect of lithium carbonate. pts should report neck enlargement, weight gain, lethargy, and constipation. They should also have their thyroid function checked before they begin and annually thereafter

A patient is admitted to the emergency department with spasms of his face and back. He has recently begun taking chlorpromazine to treat schizophrenia. Which of the following adverse reactions should the health care professional suspect?

acute dystonia Reasoning: manifestations include muscle spasms of the back, neck, face, and tongue. Tx includes IMMEDIATE administration of an anticholinergic drug, such as diphenhydramine.

A health care professional should question the use of timolol (Timoptic) for a patient who has which of the following disorders?

asthma Reasoning: Timolol, a beta-adrenergic antagonist, can cause bronchospasm and dyspnea. Pts who have compromised respiratory function should not use this drug.

During and immediately following IV administration of chlorpromazine to a patient who has schizoaffective disorder, the health care professional should monitor which of the following?

blood pressure Reasoning: pts recieving are at risk for hypotension during and immediatley after IV administration. Remain supine for 30 minutes post IV adm. HCP should monitor BP It's ESSENTIAL to infuse slowly and not to mix it with other drugs

A health care professional should expect which of the following adverse effects for a patient who is taking betaxolol (Betoptic) eye drops to treat glaucoma?

bradycardia Reasoning: blockade of cardiac beta1 receptors Nsg Interventions: check pulse regularly and report any sustained decreases

A health care professional is caring for a patient who is about to begin taking echothiophate (Phospholine Iodid) to treat glaucoma. The health care professional should monitor the patient for the development of which of the following adverse effects?

cataracts Reasoning: echothiophate , a cholinesterase inhibitor, can cause cataracts or opacity of the lens of the eye. Patients should report any changes in vision, such as cloudiness or halos around lights

A HCP should question the use of alprazolam (Xanax) for a patient who

drinks two 8-oz glasses of wine each evening Reasoning: prevent severe dehydration and respiratory depression. avoid alcohol and CNS depressants when taking benzos

A health care professional should advise a patient who is taking phenelzine (Nardil) to avoid tyamine-enriched foods because of an increased risk for which of the following adverse reactions?

hypertensive crisis Reasoning: Tyramine-enriched foods, such aged cheese and processed meat, can trigger severe hypertension in patients who are taking phenelzine. Manifestations include hypertension, headache, and nausea.

When caring for a patient who is taking risperidone (Risperdal) for schizophrenia, the health care professional should monitor for which of the following adverse effects of the drug?

polyuria Reasoning: atypical antipsychotic, can cause new-onset diabetes mellitus. It's essential to monitor pts taking the drug, for signs of hyperglycemia, and check their glucose levels regularly

While taking with a patient about taking chlorpromazine, which of the following instructions should the health care professional include?

wear sunscreen when exposed to light Reasoning: can cause photosensitivity or increased susceptibility to sunburn when exposed to sunlight. Limit exposure and wear protective clothing when outdoors

A health care professional is caring for a patient who has been taking alprazolam (Xanax) for an extended period of time to treat anxiety. The health care professional should recognize that stopping alprazolam therapy suddenly can resulting which of the following?

withdrawal symptoms Reasoning: alprazolam (benzo) users can develop dependence with long-term use