Nursing Pharmacology Exam 4

How is Levetiracetam unique in treating seizure disorders than other drugs?

It does not bind to GABA or any other neurotransmitter. It's actions are unknown.

What does the nurse identify as a possible adverse effect of long-term glucocorticoid therapy? (Select all that apply.) A. Adrenal insufficiency B. Osteoporosis C. Hypoglycemia D. Hyperkalemia E. Cataracts

A, B, & E

Feverfew is used primarily for prophylaxis of migraines and has few GI side effects. Although side effects are not commonly associated, which symptoms are associated with post-feverfew syndrome? A. Joint pain/ stiffness B. Tension H/A C. Insomnia D. Anorexia E. Fatigue F. Nervousness

A, B, C, E, & F

A nurse is teaching the family of a client who has Alzheimer's disease about donepezil. Which of the following information should the nurse include in the teaching? A. "Syncope episodes may occur when taking this medication." B. "This medication may cause tachycardia." C."You should administer the medication each morning." D. "You will need to monitor for constipation."

A. "Syncope episodes may occur when taking this medication." The nurse should inform the family to monitor for syncope, which places the client at risk for falling.

The nurse is teaching a patient with a new prescription for alprazolam [Xanax]. Which statement is the most appropriate to include in the teaching plan? A. "When it is time to discontinue this drug, you will need to taper it off slowly." B. "Protect your skin from the sun to prevent rash and exaggerated sunburn." C. "Increase your intake of fluid and high-fiber food to prevent constipation." D. "Take this medication on an empty stomach at least 2 hours after meals."

A. "When it is time to discontinue this drug, you will need to taper it off slowly." Alprazolam [Xanax] is a benzodiazepine for which abrupt discontinuation can precipitate withdrawal symptoms. Patients should withdraw the drug gradually over several weeks. The other statements are not related to alprazolam [Xanax].

A nurse is teaching a client who has a depressive disorder about fluoxetine. Which of the following information should the nurse include in the teaching? A. "You may experience a decreased sex drive while taking this medication." B."You will notice an improvement in your depressive symptoms in 2 to 3 days." C. "You may notice that you have less appetite while taking this medication." D. "You may experience drooling while taking this medication."

A. "You may experience a decreased sex drive while taking this medication." Fluoxetine can cause decreased libido and impotence in men.

The nurse is teaching a patient with a new prescription for ergotamine [Ergomar]. Which statement is most appropriate to include in the teaching plan? A. "You should not use this drug more than 1 or 2 days per week." B. "You should rise slowly from a sitting to a standing position." C. "Be sure to include bananas and melons in your diet to increase potassium." D. "You will need to return to the clinic for blood work monthly."

A. "You should not use this drug more than 1 or 2 days per week." Regular daily use of ergotamine is likely to cause physical dependence. Patients should limit its use to one or two times weekly. Withdrawal symptoms include headache, nausea, vomiting, and restlessness, which are similar to the migraine syndrome.

After administering acetylcysteine [Mucomyst] to a patient who overdosed on acetaminophen [Tylenol], a nurse should recognize which outcome as an indicator of the therapeutic effects of acetylcysteine? A. Absence of jaundice B. Clear breath sounds C. Increased bowel sounds D. Palpable pedal pulses

A. Absence of jaundice Acetylcysteine [Mucomyst] is a reversal agent of acetaminophen. Severe hepatic injury may occur with acetaminophen [Tylenol] poisoning, which is manifested by jaundiced sclera and skin.

Before administering celecoxib [Celebrex], it is most important for the nurse to assess the patient for a history of what? A. Allergy to sulfonamides B. History of hepatitis C C. Hypothyroidism D. Diabetes mellitus

A. Allergy to sulfonamides Celecoxib contains a sulfur molecule and therefore can precipitate an allergic reaction in patients allergic to sulfonamides. Accordingly, the drug should be avoided by patients with a sulfa allergy.

A patient asks the nurse for a supplement that can be used to prevent motion sickness during a vacation cruise. The nurse suggests which supplement? A. Ginger root (Zingiber officinale) B. Garlic (Allium sativum) C. Coenzyme Q-10 (CoQ-10) D. Feverfew (Tanacetum parthenium)

A. Ginger root (Zingiber officinale) Ginger root is used to suppress nausea and vomiting caused by motion sickness and morning sickness and also for postoperative nausea and vomiting. It may be involved in the blockade of serotonin receptors located in the chemoreceptor trigger zone of the brain.

Which product did the U.S. Food and Drug Administration (FDA) ban in the United States because of the serious adverse effects of myocardial infarction, stroke, and death? A. Ma huang (Ephedra) B. Valerian (Valeriana officinalis) C. St. John's wort (Hypericum perforatum) D. Saw palmetto (Serenoa repens)

A. Ma huang (Ephedra) Sales of ma huang have been banned in the United States since 2004, making it the first time that a dietary supplement has been ordered off the market. It has been associated with stroke, myocardial infarction, and death.

Which of these local anesthetic agents is most likely to cause an allergic response? A. Procaine [Novocain] B. Lidocaine [Xylocaine] C. Bupivacaine [Marcaine] D. Ropivacaine [Naropin]

A. Procaine [Novocain] Procaine is an ester-type anesthetic. Ester anesthetics pose a greater risk of allergic reactions than the amide-type anesthetics. All the other choices are amide anesthetics.

The nurse should question an order for glucocorticoids in the treatment of a patient with what? A. Systemic fungal infection B. Diabetes mellitus C. Myasthenia gravis D. Glaucoma

A. Systemic fungal infection Glucocorticoids are contraindicated in the treatment of a patient with a systemic fungal infection or in patients receiving live vaccines. (Glucocorticoids should be used with caution in patients with diabetes mellitus, myasthenia gravis, and glaucoma)

Butterbur is used for migraines, allergies and asthma due to its anti-inflammatory and vasodilating effects. Which of the following are adverse effects? Select all that apply. A. Diarrhea B. Eructation (belching) C. Headache D. Fatigue E. Prolonged bleeding

B, C, & D

The patient is prescribed warfarin [Coumadin] to treat deep vein thrombosis. The nurse is teaching the patient about dietary supplements that have the potential to interfere with coumadin therapy. What herbs should the nurse include in the teaching? (Select all that apply.) A. Echinacea B. Garlic C. Ginger root D. Gingko biloba E. Valerian

B, C, D

The nurse is working with the multidisciplinary healthcare team to optimize the care of a patient with schizophrenia. Which concepts will guide the nursing care of this patient? (Select all that apply.) A. The second-generation antipsychotics generally are more effective than the first-generation agents. B. Most antipsychotic agents increase the risk of mortality in elderly patients with dementia. C. Antipsychotic depot preparations carry a greater risk of neuroleptic malignant syndrome. D. The lipid levels of patients receiving second-generation antipsychotics should be monitored. Schizophrenia is characterized by disordered thinking and loss of touch with reality.

B, D, & E

A nurse is teaching a patient with chronic tophaceous gout who is scheduled to start taking allopurinol [Zyloprim]. Which of these statements should the nurse include in the teaching? A. "You'll see the joint swelling reduced in your toe in just a few days." B. "You may notice an increase in your pain attacks in the first month." C. "We need to collect periodic hair samples to measure uric acid levels." D. "It'll be important to minimize fluid intake so the kidneys can rest."

B. "You may notice an increase in your pain attacks in the first month." Allopurinol inhibits xanthine oxidase to reduce uric acid levels in chronic tophaceous gout. During the first months of treatment, it may increase the incidence of acute gouty arthritis.

The nurse is caring for a patient whose seizures are characterized by a 10- to 30-second loss of consciousness and mild, symmetric eye blinking. Which seizure type does this most closely illustrate? A. Tonic-clonic B. Absence C. Atonic D. Myoclonic

B. Absence This scenario accurately describes absence seizures. Tonic-clonic seizures present with convulsions and muscle rigidity followed by muscle jerks. Patients may experience urinary incontinence and loss of consciousness. Atonic seizures cause sudden loss of muscle tone. Myoclonic seizures present with sudden muscle contractions that last but a second.

A patient admitted to the hospital with a diagnosis of pneumonia asks the nurse, "Why am I receiving codeine? I don't have any pain." The nurse's response is based on the knowledge that codeine also has which effect? A. Immunostimulant B. Antitussive C. Expectorant D. Decongestant

B. Antitussive Codeine provides analgesic and antitussive therapeutic effects.

Saw Palmetto is used primarily for which of the following conditions? A. Hypertension B. BPH C. Immunocompromised D. Asthma

B. BPH Saw Palmetto is used for treating urinary symptoms associated with BPH and has no other uses.

Which statement should the nurse include in the teaching plan for a patient being started on levodopa/carbidopa [Sinemet] for newly diagnosed Parkinson's disease? A. Take the medication on a full stomach. B. Change positions slowly C. The drug may cause the urine to be very dilute. D. Carbidopa has many adverse effects.

B. Change positions slowly Postural hypotension is common early in treatment, so the patient should be instructed to change positions slowly.

The nurse is assessing a patient receiving dihydroergotamine [Migranal] for potential side effects. Which symptom, if found, would indicate a side effect of this drug? A. Nausea and vomiting B. Diarrhea C. Physical dependence D. Constipation

B. Diarrhea Diarrhea is a common problem with dihydroergotamine. The advantage of dihydroergotamine is that, unlike ergotamine, it does not cause nausea, vomiting, or physical dependence

A patient with Parkinson's disease is prescribed pramipexole [Mirapex] along with his levodopa/carbidopa [Sinemet]. Which symptom is most likely a manifestation of an adverse effect of these drugs when given together? A. Diarrhea B. Dyskinesia C. Wheezing D. Headache

B. Dyskinesia When pramipexole is combined with the levodopa component in Sinemet, patients are most likely to experience symptoms of dyskinesias, such as dyskinesia (head bobbing) and orthostatic hypotension. The other effects are not common responses to these drugs.

The nurse assesses a patient who takes ibuprofen [Advil] on a regular basis. Which finding does the nurse know is an adverse effect of ibuprofen [Advil] therapy? A. Hives B. Hematemesis C. Dysmenorrhea D. Jaundice

B. Hematemesis Ibuprofen is a member of the nonaspirin first-generation NSAIDs. Through inhibition of COX-1 and COX-2, ibuprofen poses a risk for gastric ulceration and bleeding, which may lead to hematemesis.

The nurse is completing an admission assessment for a patient who requires treatment of an anxiety disorder. The patient states "I take the dietary supplement kava every day to help my anxiety and stress." The nurse understands the patient is at risk for which serious adverse effect? A. Stroke B. Hepatoxicity C. Suicidal behavior D. Acute renal failure

B. Hepatoxicity In the United States, kava is promoted as a natural alternative to benodiazepines to treat anxiety and stress. However, kava has the risk for the serious adverse effect of hepatoxicity.

The nurse is planning care for a patient receiving morphine sulfate [Duramorph] by means of a patient-controlled analgesia (PCA) pump. Which intervention may be required because of a potential adverse effect of this drug? A. Administering a cough suppressant B. Inserting a Foley catheter C. Administering an antidiarrheal D. Monitoring liver function tests

B. Inserting a Foley catheter Morphine can cause urinary hesitancy and urinary retention. If bladder distention or inability to void is noted, the prescriber should be notified. Urinary catheterization may be required.

A patient is taking black cohosh (Cimicifuga racemosa) for relief of menopausal symptoms. The nurse should caution her about adverse interactive effects with which conventional medication? A. Docusate sodium [Colace] B. Insulin C. Furosemide [Lasix] D. Aspirin

B. Insulin Black cohosh may potentiate the hypoglycemic effect of insulin and oral hypoglycemics. In addition, adverse hypotensive effects have been associated with antihypertensive medications.

Donepezil is a cholinesterase inhibitor used to treat AD. Which of the following is false? A. It is used to treat mild, moderate, and severe AD B. It causes irreversible inhibition of AChE C. It is highly protein bound D. It has has a halflife of about 70 hrs

B. It causes irreversible inhibition of AChE Donepezil causes reversible inhibiting of AChE. It is more selective of AChE found in the brain than found in the periphery.

The nurse is caring for a female patient receiving sumatriptan [Imitrex]. Which concept guides the nursing care of this patient? A. Coronary vasospasm is a common problem with this drug. B. Many patients experience symptoms of chest pressure or heavy arms. C. Sumatriptan increases the risk of nausea and vomiting with migraines. D. Sumatriptan is considered safe to use during pregnancy.

B. Many patients experience symptoms of chest pressure or heavy arms. About 50% of patients taking sumatriptan experience these symptoms. Patients who are pregnant or have CAD should avoid sumatriptan. Sumatriptan will relieve other symptoms of migraines such as nausea, not increase.

The nurse is caring for a patient who is receiving lidocaine [Xylocaine] by epidural injection. Which nursing intervention is most important when caring for this patient? A. Keeping the patient in a supine position for about 12 hours B. Monitoring the patient's blood pressure throughout the epidural infusion C. Preparing a double tourniquet for use during the infusion D. Reducing the intravenous (IV) infusion rate to prevent hypertension

B. Monitoring the patient's blood pressure throughout the epidural infusion Hypotension is the most common complication with epidural anesthetics. Monitoring of the blood pressure is an essential nursing intervention.

An emergency department patient reports that she took frovatriptan 2.5 mg at home an hour ago but still has a migraine. Which action should the nurse take next? A. Give a second dose of frovatriptan. B. Notify the healthcare provider. C. Provide education about the use of frovatriptan. Incorrect D. Administer a different migraine medication.

B. Notify the healthcare provider. Notify the healthcare provider. Do not give a second dose. The initial dose is 2.5 mg. If headache recurs after initial relief, dosing can be repeated—but no sooner than 2 hours after the first dose.

A patient who has rheumatoid arthritis is scheduled to start taking celecoxib [Celebrex]. A nurse should recognize which factor from the patient's history as a contraindication to taking this medication? A. Hypothyroidism B. Recent heart bypass surgery C. Positive tuberculin skin test result D. Allergy to penicillin

B. Recent heart bypass surgery Celecoxib [Celebrex] should be avoided in patients who have undergone recent heart bypass surgery. Because it does not inhibit COX-1, platelet aggregation is not suppressed. It does inhibit COX-2 in blood vessels, which results in increased vasoconstriction.

The nurse knows that local anesthetics stop axonal conduction by blocking what? A. Potassium channels in the axonal membrane B. Sodium channels in the axonal membrane C. Calcium channels in the axonal membrane D. Protein channels in the axonal membrane

B. Sodium channels in the axonal membrane Local anesthetics stop axonal conduction by blocking sodium channels in the axonal membrane. Propagation of an action potential requires movement of sodium ions from outside the axon to the inside.

What is the first-line of drugs used for prevention of migraines?

Beta Blockers

Entacapone [Comtan] is a selective, reversible inhibitor of COMT indicated only for use with levodopa. What is the purpose of combining these two drugs together?

By inhibiting COMT, entacapone prolongs the plasma half-life of levodopa, and thereby prolongs the time that levodopa is available to the brain.

Which statements about the care of a patient with aspirin poisoning does the nurse identify as true? (Select all that apply.) A. Warming blankets are routinely used to raise the patient's temperature. B. Diuretics and fluid restrictions are needed to correct the fluid overload commonly seen with aspirin poisoning. C. Bicarbonate infusions are used to reverse acidosis and promote renal excretion of salicylates. D. Activated charcoal is contraindicated in the treatment of aspirin poisoning. E. Hemodialysis or peritoneal dialysis can accelerate salicylate removal.

C & E

A nurse is caring for an adolescent client who is receiving carbamazepine for partial seizure disorder. Which of the following statements by the client's parent is the nurse's priority? A."He takes a 2-hour nap every day after school." B. "He says he feels sick to his stomach after taking this medication." C. "He has so many new bruises on his body." D. "He says his mouth is always dry."

C. "He has so many new bruises on his body." Carbamazepine toxicity can cause bone marrow depression, including leukopenia, anemia, and thrombocytopenia. The parent should monitor the client for bruising, bleeding, and sore throat and have periodic blood work drawn to monitor for myelosuppression.

The nurse is caring for a patient taking buspirone [BuSpar]. Which statement by the patient indicates a need for further teaching about this drug? A. "This medication should not make me feel drowsy, but may make me feel dizzy." B. "This medication should help me feel less anxious." C. "I will drink grapefruit juice instead of coffee with breakfast." Grapefruit juice can greatly increase buspirone levels and should be avoided. The other statements are appropriate. D. "I will take my medication three times per day."

C. "I will drink grapefruit juice instead of coffee with breakfast." Grapefruit juice can greatly increase buspirone levels and should be avoided. The other statements are appropriate.

A patient with Parkinson's disease who has been positively responding to drug treatment with levodopa/carbidopa [Sinemet] suddenly develops a relapse of symptoms. Which explanation by the nurse is appropriate? A. "You have apparently developed resistance to your current medication and will have to change to another drug." B. "This is an atypical response. Unfortunately, there are no other options of drug therapy to treat your disease." C. "This is called the 'on-off' phenomenon. Your healthcare provider can change your medication regimen to help diminish this effect." D. "You should try to keep taking your medication at the current dose. These effects will go away with time."

C. "This is called the 'on-off' phenomenon. Your healthcare provider can change your medication regimen to help diminish this effect." Patients who have been taking levodopa/carbidopa for a period of time may experience episodes of symptom return. Adding other medications to the drug regimen can help minimize this phenomenon.

The nurse is teaching a patient with cancer about a new prescription for a fentanyl [Sublimaze] patch, 25 mcg/hr, for chronic back pain. Which statement is the most appropriate to include in the teaching plan? A. "You will need to change this patch every day, regardless of your pain level." B. "This type of pain medication is not as likely to cause breathing problems." C. "With the first patch, it will take about 24 hours before you feel the full effects." D. "Use your heating pad for the back pain. It will also improve the patch's effectiveness."

C. "With the first patch, it will take about 24 hours before you feel the full effects." Full analgesic effects can take up to 24 hours to develop with fentanyl patches. Most patches are changed every 72 hours. Fentanyl has the same adverse effects as other opioids, including respiratory depression. Patients should avoid exposing the patch to external heat sources, because this may increase the risk of toxicity.

Which patient would be at highest risk for systemic toxicity from topical administration of a local anesthetic? A. A 42-year-old patient who receives epinephrine with a local anesthetic B. A 72-year-old patient who receives a local anesthetic topically to intact skin C. A 58-year-old patient who receives a local anesthetic to a 10 x 20-cm abrasion D. A 34-year-old patient given an injection of bupivacaine as a nerve block

C. A 58-year-old patient who receives a local anesthetic to a 10 x 20-cm abrasion The risk of toxicity increases with a large surface area or an abraded area

A nurse is caring for a client who has been hospitalized for treatment of bipolar disorder and will be discharged with a prescription for lithium. Which of the following is NOT a sign of lithium toxicity A. Diarrhea B. Vomiting C. Anorexia and loss of appetite D. The client who runs 4 miles outdoors every afternoon

C. Anorexia and loss of appetite Although anorexia is a common side effect of Lithium, it is not a sign of toxicity. Diarrhea, vomiting and strenuous outdoor activity are signs or may lead to toxicity.

Which of the following measurements would prompt the nurse to hold the sumatriptan dose and contact the provider? A. Respiratory rate 20 B. Heart rate 59 C. Blood pressure 190/100 Correct Triptans are contraindicated in hypertension. The patient may be hypertensive because he or she is in pain, but the nurse should consult the provider before administering the dose. D. SpO2 90%

C. Blood pressure 190/100 Triptans are contraindicated in hypertension. The nurse should consult the provider before administering the dose.

Valerian is primarily used as a sedative to promote sleep through increasing availability of GABA. Which drugs should patients be using with caution while taking Valerian? A. Beta Blockers B. Loop Diuretics C. CNS Depressants D. Local Anesthetics

C. CNS Depressants CNS depressants such as alcohol, opioids, barbiturates, antihistamines and benzos should be used with caution since Valerian may potentiate the effects.

The nurse should be concerned about which finding in a patient on long-term, low-dose colchicine therapy to prevent gout? A. White blood cell (WBC) count of 6500/mcL B. Platelet count of 200,000/mcL C. Complaints of muscle pain and weakness D. Complaints of headache

C. Complaints of muscle pain and weakness Long-term, low-dose therapy with colchicine can cause rhabdomyolysis, which is manifested by complaints of muscle tenderness, pain, and weakness. Because the drug causes myelosuppression, patients should be monitored for leukopenia and thrombocytopenia.

When administering prednisone to a patient, the nurse will do what? A. Administer the prednisone in the evening to coincide with the natural secretion pattern of the adrenal cortex. B. Instruct the patient to stop taking the prednisone immediately if diarrhea develops. C. Ensure that meals are at bedside so that administration with food reduces gastric irritation. D. Avoid intravenous delivery to prevent adverse effects.

C. Ensure that meals are at bedside so that administration with food reduces gastric irritation. Glucocorticoids may produce gastric irritation and ulcers. They should be given with food. Doses should also be administered before 9:00 AM to maximize endocrine function.

The nurse should monitor for which central nervous system (CNS) adverse effect that can result when sufficient amounts of local anesthetics are absorbed systemically? A. Hallucinations and nightmares B. Tremors of the lower extremities C. Excitation followed by depression D. Vertigo and nausea/vomiting

C. Excitation followed by depression Local anesthetics can cause CNS excitation followed by depression when large enough amounts are absorbed in the system. This can lead to drowsiness, loss of consciousness, and death.

A nurse administers naloxone [Narcan] to a postoperative patient experiencing respiratory sedation. What undesirable effect would the nurse anticipate after giving this medication? A. Drowsiness B. Tics and tremors C. Increased pain D. Nausea and vomiting

C. Increased pain Naloxone reverses the effects of narcotics. Although the patient's respiratory status will improve after administration of naloxone, the pain will be more acute.

A nurse is caring for a client who has bipolar disorder and a new prescription for valproate. Which of the following instructions should the nurse give the client about the use of this medication? A. Thyroid function tests should be performed every 6 months. B. A pretreatment electroencephalogram (EEG) will be done. C. Liver function tests must be monitored. D. High serum sodium levels can cause toxic levels of valproate.

C. Liver function tests must be monitored. Pancreatitis, hepatic dysfunction, and thrombocytopenia are serious adverse effects occasionally associated with valproate. Liver function tests should be monitored periodically to check for hepatic failure.

Which medication should the nurse anticipate administering to a patient in convulsive status epilepticus to halt seizure activity? A. Phenytoin [Dilantin] 200 mg IV over 4 minutes B. Phenobarbital 30 mg IM C. Lorazepam [Ativan] 0.1 mg/kg IV at a rate of 2 mg/min D. Valproic acid [Depacon] 250 mg in 100 mL of normal saline infused IV over 60 minutes

C. Lorazepam [Ativan] 0.1 mg/kg IV at a rate of 2 mg/min Intravenous benzodiazepines, such as lorazepam or diazepam, are used for abrupt termination of convulsive seizure activity. Lorazepam is preferred over diazepam because of its longer effects.

Which statement about memantine [Namenda] is false? A. Memantine is indicated for moderate or severe AD. B. Memantine modulates the effects of glutamate. C. Memantine does not slow the decline in function. D. The most common side effects are dizziness, headache, confusion, and constipation.

C. Memantine does not slow the decline in function. For many patients, the drug can slow the decline in function, and, in some cases, it may actually cause symptoms to improve. The other statements are true.

A patient with a history of Parkinson's disease treated with selegiline [Eldepryl] has returned from the operating room after an open reduction of the femur. Which physician order should the nurse question? A. Decaffeinated tea, gelatin cubes, and ginger ale when alert B. Docusate 100 mg orally daily C. Meperidine 50 mg IM every 4 hours as needed for pain D. Acetaminophen 650 mg every 6 hours as needed for temperature

C. Meperidine 50 mg IM every 4 hours as needed for pain Selegiline can have a dangerous interaction with meperidine, leading to stupor, rigidity, agitation, and hyperthermia; therefore, this order should be questioned. Foods that contain tyramine should be restricted.

A nurse should recognize that a patient who takes an angiotensin-converting enzyme (ACE) inhibitor while also taking high-dose aspirin is at risk of developing what complication? A. Congestive heart failure B. Liver toxicity C. Renal failure D. Hemorrhage

C. Renal failure High-dose aspirin therapy should be avoided in patients taking ACE inhibitors. In susceptible patients, these medications can impair renal function when they are combined with aspirin.

A nurse is teaching a client who has a new prescription for phenytoin. The nurse should instruct the client to monitor for and report which of the following adverse effects of this medication? A. Metallic taste B. Diarrhea C. Skin rash D. Anxiety

C. Skin rash Phenytoin is an antiepileptic medication used to treat partial seizures and tonic-clonic seizures. Phenytoin can cause a rash that can progress to Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). If a rash develops, the client should notify the provider immediately and stop the use of phenytoin.

Which herbal supplement is primarily used for oral therapy of mild to moderate depression? A. Gingko Biloba B. Green Tea C. St. John's Wort D. Valerian

C. St. John's Wort

The nurse is reviewing the medication orders for a patient on sumatriptan and sertraline [Zoloft]. The nurse notes which of the following possible interactions between these medications? A. Both medications can cause hypotension. B. The combined medications can cause severe sedation. C. The combined medications can cause serotonin syndrome. D. Both medications treat migraines and can be used together.

C. The combined medications can cause serotonin syndrome. Sertraline [Zoloft] is a SSRI. Triptans should not be combined with SSRIs or SNRIs because serotonin syndrome could occur.

What is the goal of pharmacologic therapy in the treatment of Parkinson's disease? A. To increase the amount of acetylcholine at the presynaptic neurons B. To reduce the amount of dopamine available in the substantia nigra C. To balance cholinergic and dopaminergic activity in the brain D. To block dopamine receptors in presynaptic and postsynaptic neurons

C. To balance cholinergic and dopaminergic activity in the brain

Garlic is known for its effects on which system?

Cardiovascular The herb is taken to reduce levels of triglycerides and LDL levels and to raise HDL levels.

A nurse is performing discharge teaching for a client who has seizures and a new prescription for phenytoin. Which of the following statements by the client indicates a need for further teaching? A. "I will notify my doctor before taking any other medications." B. "I have made an appointment to see my dentist next week." C. "I know that I cannot switch brands of this medication." D "I'll be glad when I can stop taking this medicine."

D "I'll be glad when I can stop taking this medicine." Phenytoin is an anticonvulsant used to treat various types of seizures. Clients on anticonvulsant medications commonly require them for lifetime administration, and phenytoin should not be stopped without the advice of the client's provider.

A nurse instructs the parent of a child with influenza that which medication or medications may be used safely to reduce fever? A. Ibuprofen [Advil] B. Naproxen [Aleve] C. Aspirin [Bayer] D. Acetaminophen [Tylenol] CorrectThe use of NSAIDs, which include ibuprofen [Advil], naproxen [Aleve], indomethacin [Indocin], and especially aspirin [Bayer], by children with influenza or chickenpox may precipitate Reye's syndrome. This is a potentially fatal multisystem organ disease. Acetaminophen [Tylenol] may be used safely to reduce fever in children with influenza. Indomethacin [Indocin]

D. Acetaminophen [Tylenol] The use of NSAIDs, especially aspirin, by children with influenza or chickenpox may precipitate Reye's syndrome. This is a potentially fatal multisystem organ disease characterized by swelling in the brain and liver damage

The nurse should recognize which of the following findings as an indication that the medication is effective? A. Increased weight gain B.Increased urinary output C. Decreased sexual function D. Decreased urge to smoke

D. Decreased urge to smoke Bupropion is an antidepressant, also used for smoking cessation

A nurse knows that which of the following about Lamotrigine is false? A. Common side effects include dizziness, diplopia, and blurred vision B. Benefits derive from blocking sodium channels and partly blocking calcium channels C. Estrogen can lower lamotrigine levels while lamotrigine may lower progesterone levels D. It has a narrow spectrum of antiseizure activity.

D. It has a narrow spectrum of antiseizure activity. Lamotrigine has a broad spectrum of antiseizure activity. It treats 1. adjunctive therapy of partial seizures 2. adjunctive therapy of generalized seizures associated with Lennox-Gastaut syndrome, 3. adjunctive therapy or generalized tonic-clonic seizures in adults and children above 2.

The nurse is preparing to give ergotamine [Ergomar]. This agent is effective against headaches of which origin? A. Hypertension B. Hyperthyroidism C. Sinus Pressure D. No identifiable cause

D. No identifiable cause Ergotamine is effective against headaches that have no other identifiable cause and are assumed to be migraine or cluster headache. Headaches caused by hypertension, hyperthyroidism, and etc. should be treated based on their underlying cause

The nurse is caring for a group of patients who have been prescribed sedative-hypnotic agents. Which agent has the greatest abuse potential? A. Diazepam [Valium] B. Triazolam [Halcion] C. Zolpidem [Ambien] D. Phenobarbital [Luminal Sodium]

D. Phenobarbital [Luminal Sodium] Phenobarbital is a barbiturate drug that carries a higher abuse potential than the benzodiazepine or benzodiazepine-like drugs

The nurse recognizes that the supplement echinacea (Echinacea angustifolia) should not be taken as prolonged therapy for patients with which condition? A. Peptic ulcer disease B. Diabetes C. Glaucoma D. Tuberculosis

D. Tuberculosis Echinacea has few adverse effects, however, if taken as long-term therapy, it can suppress immune function. It should be avoided in patients with chronic infections, such as tuberculosis