Pharm exam 1

Which of the following statements is accurate regarding exogenous acetylcholine?

Acetylcholine has almost no therapeutic effects because it is rapidly destroyed once given.

Which of the following would be the most appropriate action while treating a patient who overdosed on risperidone (Risperdal) 20 minutes ago?

Administer activated charcoal.

A patient on a morphine patient-controlled analgesic (PCA) IV pump has a respiratory rate of 8, and is difficult to arouse. Which of the following would be the priority intervention?

Administering a medication that blocks mu and kappa receptors

A person who had her adrenergic receptors activated would experience:

Fight-or-flight effects

The client comes to the emergency department after an overdose of lorazepam (Ativan). The nurse will plan to administer which medication?

Flumazenil (Romazicon)

Which statement is correct in regard to the muscle relaxant botulinum toxin type B (Myobloc)?

In high doses, it is poisonous, causing the same symptoms food poisoning does.

Pharmacotherapy for Parkinson's disease is intended to:

Increase the amount of dopamine and reduce the amount of acetylcholine.

The physician prescribes cyclobenzaprine (Flexeril) for the client. When doing medication education, what will the best information of the nurse include?

Increase the intake of fiber while taking this medication.

The client comes to the emergency department with a head injury, broken ribs, and internal bleeding. Opioid analgesics are contraindicated. What does the nurse recognize as the primary rationale for this?

Opioids can mask changes in the client's level of consciousness.

CNS stimulants

Neurotransmitter levels are reduced, which produces a calming effect within the CNS.

Which receptor type is found at the ganglionic synapse of both the sympathetic and parasympathetic nervous systems?

Nicotinic

Identify the correct statement regarding opioid receptors:

Opioid agonists will activate mu and kappa receptors, producing analgesia.

Which area of the brain is primarily responsible for maintaining sleep and wakefulness?

Reticular activating system

The 2-year-old child comes to the emergency department with a laceration to the lower leg. The physician plans to use a local anesthetic, but the child screams at the sight of the needle. What is the best action by the nurse?

Rub a local anesthetic cream on the skin so the child will not feel the needle.

Depression that occurs during cold winter months would be classified as:

Seasonal affective disorder.

The client has been receiving escitalopram (Lexapro) for treatment of obsessive-compulsive disorder. Unknown to the nurse, the client has also been self-medicating with St. John's wort. The client comes to the office with symptoms of hyperthermia and diaphoresis. Which statement best describes the result of the nurse's assessment?

The client has combined two antidepressant medications and is experiencing serotonin syndrome.

The physician orders dantrolene (Dantrium) for the client. Which assessment data would result in the nurse contacting the physician prior to administration of this medication?

The client has glaucoma.

The client with schizophrenia is sitting quietly in a chair. The client does not respond much to what is happening, and has a lack of interest in the environment. What best describes the result of the nurse's assessment?

The client is experiencing negative symptoms.

The client is receiving clozapine (Clozaril). What is a priority outcome for this client?

The client reports any signs of a sore throat or an infection.

Which statement is accurate regarding attention-deficit hyperactivity disorder (ADHD)?

Which statement is accurate regarding attention-deficit hyperactivity disorder (ADHD)?

For any client receiving clozapine (Clozaril), which laboratory result should be reported to the physician?

White blood cell (WBC) of 3,800 cells/mcl.

The client receives morphine for pain. Which comment by the client does the nurse assess to be a side effect of morphine?

"I feel like I am going to throw up."

The client who is receiving antipsychotic medication complains of having a dry mouth. The client refused the morning dose of the medication. What is the best response by the nurse?

"A dry mouth is common, but drinking more water will help."

The client is scheduled for a surgical procedure. The nurse plans to teach the client about anesthesia. Which statement would be included in the best plan of the nurse?

"An intravenous (IV) agent will be used first to induce sleep; then, an inhaled agent will be used."

The client receives benztropine (Cogentin) and tells the nurse he is going on a Caribbean cruise. Which statement would be included in the best plan of the nurse?

"Be sure to take a hat and sunglasses."

The client has epilepsy and receives phenytoin (Dilantin). The client has been seizure-free, and asks the nurse why he still needs blood tests when he is not having seizures. What is the best response by the nurse?

"Because phenytoin (Dilantin) has a very narrow range between a therapeutic dose and a toxic dose."

What is an important instruction for the nurse to give to the client who is taking acetaminophen (Tylenol)?

"Do not drink alcohol with acetaminophen (Tylenol)."

The ten-year-old client is receiving methylphenidate (Ritalin). The client's mother tells the nurse he just won't sleep while on his medication. What is the best response by the nurse?

"Do not give the medication after 4:00 p.m."

eight-year-old client is receiving methylphenidate (Ritalin). The client's mother tells the nurse that he won't eat while on his medication. What is the best response by the nurse?

"Give the medication after meals and encourage him to have supplements between meals."

The client has been depressed and the physician plans to begin treatment with an antidepressant medication. In performing the initial assessment, what is the most important question for the nurse to ask?

"Have you had any thoughts about killing yourself?"

The physician prescribes haloperidol (Haldol) for the client. The client says to the nurse "My doctor said this medication is high potency, what does that mean?" What is the best response of the nurse?

"High potency means you might have some muscle spasms while taking this medication."

The client is receiving clozaril (Clozapine) for the treatment of schizophrenia. The nurse evaluates the effectiveness of this medication when the client makes which statement?

"I am not hearing the voices anymore."

The client receives methyldopa (Aldomet), an adrenergic drug. The nurse determines that the client is having side effects when the client makes which statement?

"I am so anxious; I really need to walk around the room."

The nurse has completed medication education for the anxious client who is receiving buspirone (BuSpar). The nurse determines that the client needs additional instruction when the client makes which statement?

"I can take this medication when I feel anxious and it will relax me."

The nurse has completed medication education with the client who is receiving clozapine (Clozaril). The nurse evaluates that the education has been effective when the client makes which statement?

"I must have my blood work done while taking this medication."

The client receives levodopa (Larodopa). The nurse has completed medication education and determines that learning has occurred when the client makes which statement?

"I must increase the fiber in my diet."

The client receives baclofen (Lioresal) and the nurse has completed medication education. The nurse determines that learning has occurred when the client makes which statement?

"I must take the medication with milk or meals."

The nurse has been doing medication education for the client receiving atenolol (Tenormin), a beta-blocker. The nurse determines that learning has occurred when the client makes which statement?

"I need to take my pulse every day."

The physician has prescribed sertraline (Zoloft) for the client who is anxious and depressed. The client calls the nurse to report that he has experienced delayed ejaculation since being on this medication. What is the best response by the nurse?

"I will let your doctor know, and he will most likely change your medication."

The client receives dantrolene (Dantrium). The nurse has completed medication education and determines that that learning has occurred when the client makes which statement?

"If I experience side effects, I will call my doctor before stopping the medicine."

The client tells the nurse that she awakens frequently during the night because of leg and foot cramps. What is the best response by the nurse?

"Increase your intake of calcium."

The client has been receiving amitriptyline (Elavil) for two weeks. He tells the nurse he doesn't think this medicine is working, as he is still depressed. What is the best response by the nurse?

"It is working, but it can take several weeks to have an effect."

The client receives morphine for pain. He asks the nurse how it works to relieve pain. What is the best response by the nurse?

"It stimulates a receptor in your brain that induces pleasure."

The client has generalized anxiety disorder. He asks the nurse "Will I need medication for this? My neighbor is very nervous and he takes medication." What is the best response by the nurse?

"Medication is necessary when anxiety interferes with your quality of life."

The client, addicted to heroin, is being treated for opioid dependence. He has been prescribed methadone (Dolophine). The client asks how this will help because methadone (Dolophine) is another opioid. What is the best response by the nurse?

"Methadone (Dolophine) does not cause euphoria like heroin does."

The student nurse asks the nursing instructor "Do the medications we are studying actually make more neurotransmitters?" What is the best response by the nursing instructor

"No, medications can only increase or decrease the action of neurotransmitters."

The client is receiving phenobarbital (Luminal) for seizure control. The client asks the nurse how this little pill can stop his seizures. What is the best response by the nurse?

"Phenobarbital (Luminal) stops your seizures by increasing a chemical called GABA that calms down the excitability in your brain."

The client tells the nurse that she has been taking phenytoin (Dilantin) for two years now and is still having too many side effects. She wants to stop taking it. What is the best response by the nurse?

"Please do not stop the medication abruptly, as you will have withdrawal seizures."

The client is receiving Phenobarbital (Luminal) for control of seizures. The client tells the nurse she plans to become pregnant. What is the best response of the nurse?

"Please talk to your doctor; this drug is contraindicated in pregnancy."

The client receives quetiapine (Seroquel) and asks the nurse how the medication works. What is the best response by the nurse?

"Quetiapine (Seroquel) decreases dopamine in your brain and that decreases your symptoms."

The student nurse does an operating room rotation and notes that many clients receive succinylcholine (Anectine). The student nurse asks the nursing instructor how the drug works. What is the best response by the nursing instructor?

"The client will need assistance with breathing; it paralyzes respiratory muscles."

The client tells the nurse that she is interested in the human brain, and questions which parts of the brain control anxiety and insomnia. What is the best reply by the nurse?

"The limbic system and reticular activating system."

The client has been diagnosed with Alzheimer's disease. What is the best medication education the nurse gives to the client's husband?

"The medication may help her symptoms for a little while."

The client is diagnosed with Parkinson's disease. The client's wife asks the nurse how taking medicine will help her husband. What is the best response by the nurse?

"The medications will help your husband to eat and walk."

The client is receiving escitalopram (Lexapro) for treatment of generalized anxiety disorder. The client asks the nurse "I am just nervous, not depressed. Why am I taking an antidepressant medicine?" What is the best response by the nurse?

"The same brain chemicals are involved with anxiety as well as depression, and these medications are very safe."

The nurse is teaching a class for caregivers of clients with Alzheimer's disease. The nurse determines that learning has occurred when the caregivers make which statement?

"There are drugs that will help decrease symptoms for a little while."

The client receives aspirin. The nurse assesses an adverse effect to this drug when the client makes which response?

"There is a constant ringing in my ears."

The mother of a seven-year-old child says to the nurse "My child is distractible in school, cannot complete assignments on time, and interrupts other children while they are speaking. What do you think?" What is the best response by the nurse?

"This could be Attention Deficit Hyperactivity Disorder (ADHD); you might want to have your child tested."

The client has Parkinson's disease, and develops depression. What is the best education the nurse can give the client's family?

"This is a common problem with Parkinson's disease."

What is a priority assessment question to ask a post-surgical client prior to administration of an opioid analgesic?

"Would you please rate your pain on a scale of 1-to-10?"

The client says to the nurse "My doctor said I have epilepsy and need to take medicine for those seizures I had. Do I really need medicine?" What is the best response by the nurse?

"Yes, you need to take medication on a continuous basis to control the seizures."

The client asks the nurse why she needs to continue using table salt because her prescribed lithium (Eskalith) is a salt. What is the best response by the nurse?

"You must use table salt or your kidneys will retain lithium (Eskalith); and you will become toxic."

The client receives aspirin, a multivitamin, and an antihistamine every day. What is the best instruction by the nurse prior to administering levodopa (Larodopa)?

"You should not take the multivitamin with your levodopa (Larodopa)."

A pregnant woman has a malignant melanoma on her leg, and will need surgery. She is concerned about anesthesia. What is the best response by the nurse?

"You will most likely have local anesthesia; this will not affect your baby."

A parent says to the nurse "The doctor prescribed ethosuximide (Zarontin) for my child, who has absence seizures. What does this mean?" What is the best response by the nurse?

"Your daughter's seizures manifest as a staring into space for a few seconds. Ethosuximide (Zarontin) is a good medication for this type of seizure."

The traditionally prescribed drug types used to treat attention-deficit hyperactivity disorder (ADHD) include:

. CNS stimulants.

The nurse is conducting a group education session for clients who have been diagnosed with depression. The nurse evaluates the education as effective when a client makes which comment(s) about the cause of depression? Select all that apply.

."Depression has many causes; they could include environmental as well as brain based disorders." 2."Depression includes impaired relationships, and is also an inherited illness.

The physician has ordered intravenous phenytoin (Dilantin). The client is also receiving 5% dextrose in water (D5W) intravenously (IV). What will the nurse plan to do before administering this medication? Select all that apply.

.Flush the intravenous (IV) line with saline. 2.Use an intravenous (IV) line with a filter. 3.Use a large vein for the infusion.

Which of the following symptoms experienced over 1 month would be most helpful to diagnose bipolar disorder?

1. Abnormal eating patterns, feelings of despair, flight of ideas

The nurse has completed group education for clients with anxiety disorders. The education is evaluated as successful when the clients make which statements? Select all that apply.

1."Antianxiety medicine should not be used indefinitely." 2."Relaxation techniques will often decrease anxiety." 3."We need therapy to learn where this anxiety comes from."

The nurse is teaching a class for clients who have been recently diagnosed with epilepsy. The nurse determines that learning has occurred when the clients make which statements? Select all that apply.

1."Epilepsy may be caused by a head injury." 2. "With some cases of epilepsy, the cause is never determined." 3. "A stroke, or brain attack, could increase the risk for developing epilepsy."

The nurse teaches the client about the correct use of a topical anesthetic for a skin condition. The nurse determines that learning has occurred when the client makes which statement(s)? Select all that apply.

1."I must wash my hands before touching my eyes." 2."This lotion should only be used on small areas of skin."

The nurse has completed medication education for a client prior to the client receiving phenelzine (Nardil). The nurse evaluates the education as effective when the client makes which statement(s)? Select all that apply.

1."I'll have to give up my beer at the football games." 2."I am not supposed to have processed meats or cheese."

The nurse teaches clients about nonpharmacological techniques for pain management. The nurse determines learning has occurred when the clients make which statement(s)? Select all that apply.

1."Nonpharmacological techniques may be used in place of drugs." 2."Nonpharmacological techniques are a good adjunct to pharmacotherapy."

The client has been admitted to the hospital for the treatment of schizophrenia. The client's mother says to the nurse "This is all so confusing. How did he get this? Did I do something?" What is (are) the best response(s) of the nurse? Select all that apply.

1."Research indicates that schizophrenia is a genetic disorder." 2."Schizophrenia is a biological brain disorder." 3."Schizophrenia is due to too much dopamine in certain parts of the brain."

The nursing instructor teaches the student nurses about the nervous system. The instructor determines that learning has occurred when the students make which statement(s)? Select all that apply.

1."The central nervous system includes the brain and spinal cord." has mainly sensory functions." 3."The somatic nervous system gives us voluntary control over moving." 5."The nervous system helps us react to environmental changes."

The nursing instructor teaches the student nurses about the autonomic nervous system. The instructor determines that learning has occurred when the students make which statement(s)? Select all that apply.

1."The parasympathetic nervous system causes bronchial constriction." 2."The sympathetic and parasympathetic systems are not always opposite in their effects." 3."The sympathetic nervous system is activated under stress."

The client tells the nurse "I am really confused after talking to my doctor. He said I would be taking different kinds of medications for my anxiety and insomnia. Will you please explain it?" What is the best response by the nurse? Select all that apply.

1."You will be taking medications known as sedative-hypnotics." 2."You will be taking medications known as benzodiazepines." 5."You will be taking medications known as antidepressants."

Several senior citizens have asked the nurse to do a presentation on degenerative diseases. What does the nurse plan to teach as the most common degenerative diseases? Select all that apply.

1.Alzheimer's disease 2.Parkinson's disease

The nursing instructor teaches the nursing students about the advantages of the newer local anesthetics, such as lidocaine (Xylocaine). What will the best plan of the nursing instructor include? Select all that apply.

1.Amides have fewer side effects than esters. 2.Amides tend to last longer than esters.

The nurse teaches the client with a neuromuscular disorder about nonpharmacological treatment of muscle spasms. What will the best information include? Select all that apply.

1.Application of heat or cold 2.Ultrasound 3.Massage

The client is using a patient-controlled analgesia (PCA) pump with morphine to control pain. Prioritize the nursing interventions.

1.Assess the client's pain level and vital signs frequently. 2.Instruct the client to use the patient-controlled analgesia (PCA) before the pain becomes severe. 3.Check the intravenous (IV) line for patency every 2 hours 4. Ask the physician if the client can switch to an oral analgesic.

The nurse teaches a class about muscle movement to a group of clients who have neuromuscular disorders. What will the best plan of the nurse include? Select all that apply.

1.Body movement depends on intact nerves. 2.Body movement depends on proper functioning of muscles.

The nurse plans to teach a class about Alzheimer's disease to a caregiver's support group. What will the best plan of the nurse include? Select all that apply.

1.Memory difficulties are an early symptom of the disease. 2.Chronic inflammation of the brain may be a cause of the disease. 3.Depression and aggressive behavior are common with the disease

The client has been receiving phenelzine (Nardil) for two months. She comes to the clinic and tells the nurse she had red wine and pepperoni pizza for lunch. What is the priority action of the nurse at this time?

1.Notify the client's physician 2.Assess the client's blood pressure 3.Drive the client to the nearest emergency department 4.Ask the client if she has dizziness or a headache

The client is to start on sumatriptan (Imitrex) for migraine headaches. What will the best plan of the nurse include as it relates to this medication? Select all that apply.

1.Plan to teach the client not to drive until the effects of the medication are known. 2.Plan to teach the client to avoid pseudoephedrine (Sudafed) with this medication.

Which patient would be at greatest risk for developing opioid dependence?

24-year-old with sickle-cell anemia

For which of the following patients suffering a migraine headache would sumatriptan (Imitrex) be indicated?

27-year-old asthmatic male

Which of the following patients suffering from muscle spasms should not receive the direct-acting antispasmodic medication dantrolene sodium (Dantrium)?

57-year-old suffering from congestive heart failure

The relapse rate for psychotic patients who are not compliant and discontinue their medications is:

60-80%.

The nurse provides care for several clients. For which client would the nurse assess acetaminophen (Tylenol) to be contraindicated?

A 55-year old who socially drinks alcohol

Which client is most likely to experience an adverse reaction to inhalation anesthesia?

A 79-year-old with arteriosclerosis

The nurse identifies a patient with a repeating pattern of muscle contraction of the leg for 5 seconds followed by 2 seconds of relaxation as experiencing:

A clonic spasm.

Which of the following drug actions would be most likely to produce a bronchospasm in a patient suffering from asthma?

A drug that blocked beta1 and beta2 receptors

The client has intractable pain, and the physician has proposed a nerve block. The nurse plans to teach the client about nerve blocks. Which statement would be included in the best plan of the nurse?

A nerve block stops pain transmission along the nerve to stop the pain.

A person who stops talking mid-sentence and has a blank stare for 5 seconds would most likely be experiencing:

A petit mal seizure.

The nurse prepares to administer benztropine (Cogentin) to the client. The nurse holds the dose and notifies the physician based on which assessment finding?

A pulse of 102.

Which of the following correctly identifies a signs of general anesthesia?

A total loss of body movements

A patient experiencing an extrapyramidal adverse effect is not able to relax. This is known as:

Akathisia.

Identify the correct statement regarding the neural mechanism of pain:

Alpha fibers are wrapped in myelin; C fibers are not.

Which statement regarding the use of zolpidem (Ambien) for insomnia is accurate?

Ambien will take longer to produce an effect when taken with food.

The nurse works with a physician who frequently prescribes benzodiazepines. The use of benzodiazepines in which client would cause the nurse the most concern?

An 87-year-old client who uses a cane for ambulation.

An elderly female psychotic patient has been taking haloperidol (Haldol) for 1 week. The patient has been making wormlike movements with her tongue. The nurse identifies this to most likely be:

An adverse effect likely caused by the medication, known as tardive dyskinesia

Which of the following lists of treatment options would be considered optimal for treating a muscle spasm with an unknown cause?

Analgesics, muscle relaxants, and massage

Vitamin D deficiency would most likely be seen in a patient with seizures who is being treated with which drug type?

Barbiturates

Which intervention would be the most appropriate for a patient who was overdosed on thiopental (Pentothal) during a surgical procedure?

Assess breathing, and support if necessary.

The client has been treated by the same physician for two years and has had insomnia the entire time. Many different medications have been tried with limited success. What should be the nurse's primary assessment at this time?

Assess for a primary sleep disorder such as sleep apnea.

A low-income patient without insurance has been prescribed several different medications over several months for seizure control without any improvement. The patient indicates she has not experienced any adverse effects. At this point the nurse should:

Assess for medication compliance.

The client has had spinal anesthesia. Prioritize the nursing interventions post-operatively.

Assess the client's vital signs. Palpate the client's bladder for fullness. Assess the client for leg movement and sensation. Ambulate the client.

The physician has ordered intravenous (IV) diazepam (Valium) for the client in status epilepticus. During administration, which assessment by the nurse is most important?

Assessing respirations every 5 to 15 minutes

The client receives dantrolene (Dantrium) intravenously (IV). What will a priority assessment of the nurse include?

Assessing the client's intravenous (IV) site

Benzodiazepines are often the drug of choice for managing anxiety and insomnia. Which statement best explains why?

Benzodiazepines have the lowest risk of dependency and tolerance.

The nurse has completed diet education for a group of clients who are receiving antipsychotic medications. If the medication education has been effective, clients will eliminate what choice from their menu selection?

Beverages with caffeine

The client tells the nurse "I thought I was just depressed, but my doctor says I have bipolar disorder. What is that?" What is the best response by the nurse?

Bipolar disorder means you have cycles of depression as well as hyperactivity, or mania.

Which of the following adverse effects would most likely be associated with the use of phenytoin (Dilantin)?

Bleeding

The client is receiving valproic acid (Depakene) for treatment of seizures. The client has also been taking a daily 81 mg aspirin tablet prophylactically for a cardiac condition. What would the nurse be most likely to observe?

Bleeding from the gums and bruising of the skin.

Local anesthetics work by:

Blocking sodium channels

The nurse knows that atropine (Atropair) increases heart rate by:

Blocking the effects of acetylcholine by occupying muscarinic receptors.

The client receives nadolol (Corgard), a nonselective beta-adrenergic blocker. What will be the priority assessment of the nurse?

Bronchoconstriction

Which statement describes the primary difference between centrally acting muscle relaxants and direct-acting antispasmodics?

Centrally acting agents inhibit neurons of the central nervous system, while direct-acting agents work at the level of the neuromuscular junction and skeletal muscles.

Spasticity is most commonly caused by damage to what area of the body?

Cerebral cortex

Which of the following food items should the nurse advise a patient taking a monoamine oxidase inhibitor (MAOI) to avoid?

Chocolate, wine, and fava beans

Which of the following best explains why structural changes occur within the brains of people with Alzheimer's disease?

Chronic inflammation and oxidate cellular damage

The client receives dantrolene (Dantrium) for treatment of muscle spasms following a spinal cord injury. What is the best outcome for this client?

Client will sleep without pain

Which of the following drugs would be indicated for a schizophrenic who needs management of both positive and negative symptoms?

Clozapine (Clozaril)

The client has a serious laceration to the arm. The client receives a local anesthetic mixed with epinephrine prior to suturing. What does the nurse recognize as the rationale for the epinephrine?

Constricted blood vessels will extend the duration of action of the drug.

The client is receiving antipsychotic medications and tells the nurse he has not had a bowel movement for two days. What is the best initial action of the nurse?

Contact the physician for an order for a Fleet Enema.

The client is receiving risperidone (Risperdal). During morning assessment, the nurse notes that the client has a temperature of 102 degrees F. What is the priority nursing intervention?

Contact the physician, as this could be a symptom of neuroleptic malignant syndrome.

A patient with a psychiatric history is communicating using made-up words, and indicates he doesn't care about anything. This patient would most likely be:

Demonstrating positive symptoms of schizophrenia.

The most productive way of managing stress would be to

Determine the cause and address it accordingly

The client receives baclofen (Lioresal). What will the best plan of the nurse include as relates to medication education?

Do not stop the medication abruptly.

Which of the following would most likely be an initial treatment for a patient with Alzheimer's disease?

Donepezil hydrochloride (Aricept)

Symptoms of schizophrenia are thought to be associated with which receptor sites?

Dopamine type 2

Which of the following is a common adverse effect of cyclobenzaprine (Flexeril)?

Drowsiness

Which of the following would inhibit the function of the autonomic nervous system?

Drugs that prevent the storage of neurotransmitter in vesicles

A drug that is used to treat petit mal seizures but not tonic-clonic seizures and works by decreasing neuronal activity in the motor cortex is:

Ethosuximide (Zarontin).

Which statement is accurate regarding the use of antipsychotic agents?

Elderly clients need a more gradual dosage increase.

Which statement is accurate concerning the use of aspirin (ASA) to treat pain?

Enteric-coated capsules are available to reduce GI side effects.

Which clinical technique for administering anesthesia is common for pregnant women during labor and delivery?

Epidural

Which statement correctly identifies why epinephrine is used with local anesthetic agents?

Epinephrine use prolongs surgical time.

The client has received spinal anesthesia. What common reaction will the nurse assess in the client?

Headache

The physician has ordered bethanechol (Urecholine), a cholinergic drug, for the client with urinary retention. The client also has an enlarged prostate gland. What is the priority action by the nurse?

Hold the drug and contact the physician.

The client has bipolar disorder and is in a manic phase. The physician prescribes lithium (Eskalith). The client's current lithium level is 0.4. What will the nurse expect to assess in this client?

Hyperactivity and pressured speech

The young child has absence seizures. The physician has prescribed valproic acid (Depakene) syrup. The nurse has completed medication education with the child's mother and determines that learning has occurred when the mother makes which statement?

I should not mix this with carbonated beverages."

The client has been taking lorazepam (Ativan) for two years. The client stopped this medication after a neighbor said the drug manufacturer's plant was contaminated with rat droppings. What best describes the nurse's assessment of the client when seen three days after stopping his medication?

Increased heart rate, fever, and muscle cramps

The physician ordered prazosin (Minipress), an alpha-adrenergic blocker, for the client. The nurse plans to do medication education. What will the best plan of the nurse include?

Instruct the client to not take hot tub baths or hot showers.

The client is quadriplegic and receives oxybutynin (Ditropan), an anticholinergic drug, to increase his bladder capacity. What is an important assessment of this client by the nurse?

Is he constipated?

The physician orders dicyclomine (Bentyl), an anticholinergic drug, for a client. What is the nurse's priority assessment prior to administering this drug?

Is the client able to urinate?

The physician has ordered dantrolene (Dantrium) for a client. What is a priority assessment by the nurse prior to administering this medication?

Is the client pregnant or lactating?

Which statement is accurate regarding the use of levodopa (Larodopa)?

It can take up to 6 months to achieve therapeutic effects.

From a pharmacology standpoint, which of the following best explains why levodopa is superior to dopamine?

It crosses the blood-brain barrier.

The nurse has completed medication education about pyridostigmine (Mestinon), an indirect cholinergic drug, for the client with myasthenia gravis. The nurse determines that learning has occurred when the client makes which statement?

It is really important to take my medication on time."

Which of the following treatments has the highest potential to provide total pain relief?

Neuronal injection of alcohol

The client is in Stage 2 of general anesthesia. What are the priority nursing interventions at this time?

Keep the environment quiet and calm.

Which of the following local anesthetic agents would be considered first due to its lower rate of adverse effects?

Lidocaine

A 40-year-old patient experiencing periods of mania and periods of depression would most likely benefit from which of the following?

Lithium (Eskalith)

The client receives tacrine (Cognex) as treatment for Alzheimer's disease. Which laboratory test(s) will the nurse primarily assess?

Liver function tests

The physician has ordered intravenous (IV) phenytoin (Dilantin). The nurse does not read the drug label and administers the medication intramuscularly (IM). What is the most likely response in the client?

Local tissue damage following extravasation will most likely occur

A patient taking which of the following medications should avoid foods high in tyramine?

MAOIs

What does the nurse recognize as the most dangerous adverse effect of inhalation anesthesia?

Malignant hyperthermia

The nurse plans care for a client with Parkinson's disease. What will the best plan of the nurse include?

Monitor the client for the ability to chew and swallow.

Which of the following drug types used to treat depression works by preventing enzymatic destruction of the neurotransmitter norepinephrine?

Monoamine oxidase inhibitors (MAOIs)

The elderly client receives levodopa (Larodopa). The nurse is primarily concerned about which problem with this client?

Muscle twitching

Which sleep stage accounts for about one-half of total sleep?

NREM sleep stage 2

The client has a patient-controlled analgesia (PCA) pump following surgery. The nurse keeps naloxone (Narcan) in the client's room as per protocol. What does the nurse recognize as the rationale for this protocol?

Naloxone (Narcan) will reverse the effects of the narcotic in the patient-controlled analgesia (PCA) pump if an overdose occurs.

A patient who has been treated with antipsychotic agents for schizophrenia has an elevated blood pressure, dyspnea, and an extremely high temperature. This condition is known as:

Neurolept malignant syndrome.

Which of the following degenerative diseases of the central nervous system is the most common?

Parkinson's

Muscle stiffness, pill-rolling activity, and bradykinesia are symptoms most likely associated with which disorder?

Parkinson's disease

Which of the following seizure drugs is most likely to be administered IV and result in soft tissue damage following extravasation?

Phenytoin (Dilantin)

The post-surgical client has an order for morphine 2 mg IV push every two hours and propoxyphene 100 (Darvon 100) every three hours. He received the morphine two hours ago, and is complaining of pain again. What will the best plan of the nurse include?

Plan to assess the client's level of pain.

The physician has prescribed phenytoin (Dilantin) for a client with diabetes mellitus, type 1. What does the nurse include in the plan of care for this client?

Plan to discuss with the physician the need to increase the client's insulin based on serum glucose levels.

The client receives succinylcholine (Anectine). What will be a priority assessment by the nurse?

Respiratory paralysis

Which of the following responses are regulated by the sympathetic nervous system?

Relaxation of bladder, pupil dilation

The client has entered Stage 3 of general anesthesia, known as surgical anesthesia. What will the best assessment of the nurse reveal?

Relaxation, stable respiration, and slow eye movements

The client receives dantrolene (Dantrium). A consulting physician orders hydroxyzine (Vistaril) for the client and he begins taking it. What will the best assessment of the nurse reveal?

Respiratory depression

Which of the following is an adverse affect associated with morphine, and would be the priority if present?

Respiratory depression

he elderly client is taking phenobarbital (Luminal) for seizure control. What is most important for the nurse to assess in the client?

Respiratory function

Which drug category can be used for treating anxiety?

Seizure drugs

Identify the correct statement regarding seizures?

Seizures can be caused by bacterial infections of the nervous system.

Which of the following drug types are often used as a first-line treatment for depression due to their side effect profile?

Selective serotonin reuptake inhibitors (SSRIs)

An individual who has difficulty sleeping due to two final examinations scheduled for the same day later in the week most likely would be suffering from:

Situational anxiety.

The client is receiving zolpidem (Ambien) for treatment of short-term insomnia. What is the primary safety concern of the nurse when the client takes this medication?

Sleepwalking

A dull, aching pain is defined as:

Somatic.

The nursing instructor teaches the nursing students about neural mechanisms of pain. What does the nursing instructor teach about substance P?

Substance P controls which pain signals reach the brain.

The client receives levodopa and carbidopa (Sinemet). What will the best teaching of the nurse include as relates to this medication?

Take the medication on an empty stomach.

The physician has prescribed haloperidol (Haldol) for the client with schizophrenia. What is the priority client outcome?

The client will be compliant with taking the medication as prescribed.

The nurse has completed medication education with the client who is receiving lithium (Eskalith). What is the best client outcome?

The client will identify signs of lithium (Eskalith) toxicity and verbalize measures to avoid it.

The nurse has been conducting medication education for a client with epilepsy. What is the best outcome for this client?

The client will recognize that the antiseizure medication must be continued indefinitely.

What is the priority outcome for a six-year-old client who had been started on methylphenidate (Ritalin)?

The client will use age-appropriate play with peers

The client is receiving clonazepam (Klonopin) for the treatment of panic attacks. What is an important medication outcome for this client as it relates to safety?

The client will verbalize the consequences of stopping the drug abruptly.

The nurse is preparing to administer medications to a group of clients. One of the medications is atropine, an anticholinergic drug. This drug is contraindicated in which client?

The client with glaucoma

The nurse is preparing to administer medications to a group of clients. One of the medications is benztropine (Cogentin), an anticholinergic drug. This drug is contraindicated in which client?

The client with tachycardia

The client receives imipramine (Tofranil) as treatment for depression. He is admitted to the Emergency Department following an intentional overdose of this medication. What will the best assessment of the nurse include?

The client's cardiac status

The client receives metaproterenol (Alupent), an adrenergic drug. A consulting physician orders carteolol (Cartrol), a beta-blocker. What best describes the nurse's assessment?

The effects of metaproterenol (Alupent) will be decreased

Which of the following correctly identifies a state of general anesthesia desirable for surgery?

The patient is unconscious with slow eye movements.

The ability of a person to use his arm muscles to lift a weight is primarily regulated by:

The somatic nervous system

Which statement is accurate concerning drugs classified as adrenergic antagonists?

Their actions are the opposite of those of sympathomimetics.

Which statement about skeletal muscle relaxants is correct?

They inhibit upper motor neuron activity within the central nervous system.

Which statement is the most accurate regarding acetylcholinesterase inhibitors when used for Alzheimer's disease?

They intensify the effect of acetylcholine at the receptor.

Which explanation best indicates why barbiturates are rarely used to treat anxiety and insomnia?

They produce many serious adverse effects

The client is scheduled to have an EEG to confirm the presence of a sleep disorder. The client asks the nurse to describe Stage IV NREM sleep. What is the best response by the nurse?

This is the deepest stage of sleep; without it you will be tired and depressed."

Which of the following correctly identifies the initial use for an IV in a patient undergoing a lengthy abdominal surgery that requires general anesthesia?

To administer agents that will produce rapid unconsciousness

The client is started on a medication to treat a neuromuscular disorder. What does the nurse teach as the primary therapeutic goal of the medication?

To allow the client increased independence

A patient undergoing surgery is receiving general anesthesia as well as a neuromuscular blocking agent. Which statement best indicates the primary reason for the neuromuscular blocking agent?

To cause total skeletal muscle relaxation

The client has been receiving chlorpromazine (Thorazine) for the treatment of schizophrenia. The nurse assesses that the client has tardive dyskinesia. What describes the result of the nurse's assessment?

Unusual facial movements and lip smacking

The client receives trihexyphenidyl (Artane) for Parkinson's disease. Which assessment data will the nurse report to the physician?

Urinary retention

The nurse is managing the care of a group of clients with schizophrenia. The clients are receiving conventional antipsychotic medications. When assessing for anticholinergic side effects, which would the nurse immediately report to the physician?

Urinary retention.

Which statement is accurate concerning the management of migraine headaches?

Vasoconstriction of cranial arteries helps reduce acute headache pain.

The client receives dantrolene (Dantrium). Which medication would the nurse evaluate as being contraindicated with dantrolene (Dantrium)?

Verapamil (Calan)

Which of the following common adverse effects of selective serotonin reuptake inhibitors (SSRIs) would be stressed by the nurse during patient discharge?

Weight gain and sexual dysfunction

The client tells the nurse he worries about everything all day, feels confused, restless, and just can't stop worrying. What is the best response by the nurse?

You have generalized anxiety; I will teach you some relaxation techniques."