Pharm Unit 1 - Intro to Pharm & Neurological System Pt 2

A nurse is caring for a client who recently began taking chlorpromazine to treat schizophrenia and who was admitted to the emergency room with spasms of their face and back. Which of the following adverse reactions should the nurse suspect? Cholinergic crisis Serotonin syndrome Stevens-Johnson syndrome Acute dystonia

Acute dystonia

A nurse is caring for a client who is schizoaffective disorder and who has been prescribed chlorpromazine. which of the following laboratory values should the nurse monitor during and immediately after IV administration of the medication? BUN level Blood pressure Urine specific gravity Pedal pulse strength

Blood pressure

A nurse is assessing a client who is experiencing post-traumatic stress disorder (PTSD) following a traumatic event. Which of the following medications should the nurse expect the provider to prescribe? A. Bupropion B. Phenelzine C. Mirtazapine D. Paroxetine

Correct Answer: D. Paroxetine The nurse should expect the provider to prescribe paroxetine, an SSRI that is considered the first-line treatment for PTSD.

A nurse is assessing a client who recently began taking haloperidol. Which of the following findings is the priority to report to the provider? Shuffling gait Neck spasms Drowsiness Sexual dysfunction

Neck spasms

A nurse is providing discharge instructions for a client who has a new prescription for an antihypertensive medication. Which of the following statements should the nurse give? "Be sure to limit your potassium intake while taking the medication" "You should check your blood pressure every 8 hours while taking this medication" "Your medication dosage will be increased if you develop tachycardia" "Change positions slowly when you move from sitting to standing."

"Change positions slowly when you move from sitting to standing."

A nurse is teaching a client about naproxen enteric-coated tablets. Which of the following statements should the nurse include in the teaching? "Drug absorption occurs in the stomach" "You should expect immediate absorption of the drug" "You should allow the tablet to dissolve in your mouth" "Do not crush or chew the tablet"

"Do not crush or chew the tablet"

A nurse is preparing a teaching plan for a female client who has bipolar disorder and a new prescription for carbamazepine. Which of the following instructions should the nurse include in the teaching? "This medication can safely be taken during pregnancy" "Eliminate grapefruit juice from your diet." "You will need to have a complete blood count and carbamazepine levels drawn periodically." "Notify your provider if you develop a rash." "Avoid driving for the first few days after starting this medication."

"Eliminate grapefruit juice from your diet." "You will need to have a complete blood count and carbamazepine levels drawn periodically." "Notify your provider if you develop a rash." "Avoid driving for the first few days after starting this medication."

A nurse is teaching a client who has a new prescription for escitalopram for treatment of generalized anxiety disorder. Which of the following statements by the client indicates understanding of the teaching? "I should take the medication on an empty stomach" "I will follow a low-sodium diet while taking this medication" "I need to discontinue this medication slowly" "I should not crush this medication before swallowing"

"I need to discontinue this medication slowly"

A nurse is completing discharge teaching for a patient who has a new prescription for transdermal patches. Which of the following statements should the nurse identify as an indication that the patient understands the instructions?

"I will apply the patch to an area of skin with no hair."

A nurse is teaching a client who has obsessive‐compulsive disorder and has a new prescription for paroxetine. Which of the following instructions should the nurse include? "It can take several weeks before you feel like the medication is helping." "Take the medication just before bedtime to promote sleep" "You should take the medication when needed for obsessive urges." "Monitor for weight gain while taking this medication."

"It can take several weeks before you feel like the medication is helping."

A nurse is providing teaching for a client who is to begin taking risperidone. Which of the following instructions should the nurse include? "Add extra snacks to your diet to prevent weight loss" "Notify the provider if you have trouble sleeping" "You may begin to have mild seizures while taking this medication" This medication is likely to increase your libido"

"Notify the provider if you have trouble sleeping"

A nurse is providing teaching to a client who has a new prescription for buspirone to treat anxiety. Which of the following information should the nurse include? "Take this medication on an empty stomach" "Expect optimal therapeutic effects within 24 hr." "Take this medication when needed for anxiety" "This medication has a low risk for dependency."

"This medication has a low risk for dependency."

A nurse is providing discharge teaching to a client who has anew prescription for fluoxetine for posttraumatic stress disorder. Which of the following statements should the nurse include in the teaching? "You may have a decreased desire for intimacy while taking this medication." "You should take this medication at bedtime to help promote sleep" "You will have fewer urinary adverse effects if you urinate just before taking this medication" "You'll need to wear sunglasses when outdoors due to the light sensitivity caused by this medication"

"You may have a decreased desire for intimacy while taking this medication."

A nurse is providing discharge teaching to a client who has a new prescription for clozapine. Which of the following statements should the nurse include in the teaching? "You should have a high-carbohydrate snack between meals and at bedtime" "You are likely to develop hand tremors if you take this medication for a long period of time" "You may experience temporary numbness of your mouth after each dose" "You should have your white blood cell count monitored every week"

"You should have your white blood cell count monitored every week"

A nurse is providing teaching to a client who is about to begin amitriptyline therapy to treat major depressive disorder. which of the following instructions should the nurse include? Change positions slowly from sitting or lying to standing Do not stop taking the drug abruptly Avoid crushing the tablet Take the drug at bedtime to prevent daytime drowsiness Increase fiber and fluid intake is correct

- Change positions slowly from sitting or lying to standing - Do not stop taking the drug abruptly - Take the drug at bedtime to prevent daytime drowsiness - Increase fiber and fluid intake is correct

A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a contraindication to a medication for which of the following clients? (Select all that apply.) A client at 8 weeks of gestation who asks for an influenza immunization A client who takes prednisone and has a possible fungal infection A client who has chronic liver disease and is taking hydrocodone A client who has peptic ulcer disease, takes sucralfate, and has started taking OTC aluminum hydroxide A client who has a prosthetic heart valve, takes warfarin, and reports a suspected pregnancy

A client who takes prednisone and has a possible fungal infection A client who has chronic liver disease and is taking hydrocodone A client who has a prosthetic heart valve, takes warfarin, and reports a suspected pregnancy

A nurse is providing teaching to a client who has a prescription for buspirone. Which of the following instructions should the nurse include? Take the drug with grapefruit juice to increase absorption Use the drug as needed for anxiety Allow for 2-4 weeks for full therapeutic effects Take the drug on an empty stomach

Allow for 2-4 weeks for full therapeutic effects

A nurse is caring for a client who is taking oral oxycodone The client states he is also taking ibuprofen in three recommended doses daily. The nurse should identify that an interaction between these two medications will cause which of the following findings? A decrease in blood levels of ibuprofen, possibly leading to a need for increased doses of this medication A decrease in blood levels of oxycodone, possibly leading to a need for increased doses of this medication An increase in the expected therapeutic effect of both medications An increase in expected adverse effects for both medications

An increase in the expected therapeutic effect of both medications

A nurse is assessing a client who has been taking alprazolam for several days. Which of the following findings should the nurse identify as an adverse drug reaction caused by alprazolam? Anxiety Ringing of the ears Increased appetite Muscle spasms

Anxiety

A nurse is providing teaching to a client about instilling pilocarpine for managing open-angle glaucoma. Which of the following instructions should the nurse include in the teaching? Apply gentle pressure to the nasolacrimal duct for 1 min after instilling the drops Do not touch the tip of the dropper Wash hands after instilling the drops Rub eyes after instilling the drops Remove contact lenses prior to instilling the drop

Apply gentle pressure to the nasolacrimal duct for 1 min after instilling the drops Do not touch the tip of the dropper Remove contact lenses prior to instilling the drop

A nurse is preparing to administer eye drops to a patient. Which of the following actions should the nurse take (SATA)? Have the client lie on one side Ask the patient to look at the ceiling Tell the client to blink when the drops enter the eye Drop the medication into the center of the patient's conjunctival sac Instruct the patient to close her eye gently after instillation

Ask the patient to look at the ceiling Drop the medication into the center of the patient's conjunctival sac Instruct the patient to close her eye gently after instillation

A nurse should identify that timolol is contraindicated for a client who has which of the following disorders? Asthma Seizure disorder Diabetes mellitus Rheumatoid arthritis

Asthma

A nurse is providing teaching to a client who has a prescription for lithium carbonate about reducing the risk for lithium toxicity. Which of the following instruction should the nurse include? Consume low-sodium diet Reduce fluid intake Avoid taking NSAIDs Taking the drug with food

Avoid taking NSAIDs

A nurse is providing teaching for a client who has a new prescription for betaxolol eye drops. which of the following adverse effects should the nurse include in the teaching? Constricted pupils Discoloration of the iris Hypertension Bradycardia

Bradycardia

A nurse is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The nurse should recognize that the medication affected which of the following systems in the client? Cardiovascular Immune Central nervous Gastrointestinal

Central nervous

A nurse is teaching a client, who has schizophrenia, strategies to cope with anticholinergic effects of fluphenazine. Which of the following should the nurse suggest to the client to minimize anticholinergic effects? Take the medication int he morning to prevent insomnia Chew sugarless gum to moisten the mouth Use cooling measures to decrease fever Take an antacid to relieve nausea

Chew sugarless gum to moisten the mouth

A nurse is providing teaching to a client who has a new prescription for amitriptyline for treatment of depression. Which of the following should the nurse include in the teaching? (Select all that apply.) Expect therapeutic effects in 24 to 48 hr. Discontinue the medication after a week of improved mood. Change positions slowly to minimize dizziness Decrease dietary fiber intake to control diarrhea Chew sugarless gum to prevent dry mouth

Chew sugarless gum to prevent dry mouth

A nurse is assessing a client who takes lithium carbonate for the treatment of bipolar disorder. The nurse should recognize which of the following findings as a possible indication of toxicity to this medication? Severe hypertension Coarse tremors Constipation Muscle spasms

Coarse tremors

A nurse is caring for a client who takes paroxetine to treat posttraumatic stress disorderand reports that he grinds his teeth during the night. The nurse should identify which of the following interventions to manage bruxism? (Select all that apply.) Concurrent administration of buspirone Administration of a different SSRI Use of a mouth guard Changing to a different class of antidepressant medication Increasing the dose of paroxetine

Concurrent administration of buspirone Use of a mouth guard Changing to a different class of antidepressant medication

A nurse is caring for a client with obsessive-compulsive disorder (OCD) who has been taking fluoxetine for 3 months. The client states, "This medication isn't working. I want to stop taking it." Which of the following responses should the nurse make? A. "It is best to discontinue the medication slowly over 1 or 2 months." B. "If the medication hasn't helped you in 3 months, it's not going to." C. "You will likely gain weight if you stop taking the medication." D. "This medication is the only treatment available for your condition."

Correct Answer: A. "It is best to discontinue the medication slowly over 1 or 2 months." The nurse should respond by telling the client that withdrawing from the medication should be done slowly to reduce any manifestations of withdrawal. This can be achieved by reducing the dosage by 25% every 1 to 2 months.

A nurse is caring for a client with premenstrual disorder (PMD) who has a prescription for fluoxetine. The client asks the nurse, "When should I notice the benefits of this medication?" Which of the following responses should the nurse make? A. "You should expect decreased manifestations within a few days." B. "Manifestations decrease after about 2 months." C. "You should expect decreased manifestations immediately." D. "Manifestations will decrease after several weeks."

Correct Answer: A. "You should expect decreased manifestations within a few days." The nurse should inform the client that fluoxetine is a selective serotonin reuptake inhibitor (SSRI) used to treat PMD. Unlike using fluoxetine to treat depression, using fluoxetine to treat PMD will improve manifestations more quickly.

A nurse is providing teaching to a client who has a new prescription for clozapine. Which of the following statements should the nurse include in the teaching? A. "You should have your white blood cell count checked once per week for 6 months." B. "You should check yourself every 3 days for weight loss." C. "You might experience frequent loose stools." D. "You might experience ringing in your ears."

Correct Answer: A. "You should have your white blood cell count checked once per week for 6 months." The nurse should instruct the client to have laboratory testing of WBCs and neutrophils every week for 6 months.

A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. The client has a mask-like facial expression and is experiencing involuntary movements and tremors. Which of the following medications should the nurse anticipate administering? A. Amantadine B. Bupropion C. Phenelzine D. Hydroxyzine

Correct Answer: A. Amantadine This client is experiencing Parkinsonism, which is an adverse effect of the antipsychotic medication chlorpromazine. Amantadine is an antiparkinsonian medication used to treat the extrapyramidal manifestations that can occur with chlorpromazine therapy.

A nurse is planning discharge teaching for a client who has major depressive disorder and a new prescription for phenelzine. Which of the following foods should the nurse include in the plan as safe for the client to consume while taking phenelzine? A. Broiled beef steak B. Macaroni and cheese C. Pepperoni pizza D. Smoked salmon

Correct Answer: A. Broiled beef steak Phenelzine, an MAOI, is an antidepressant. This medication interacts with a variety of foods to produce a hypertensive crisis. Beef steak and other meats that are fresh do not interact with phenelzine and are safe to consume.

A nurse is reviewing laboratory reports for a client who is taking risperidone. The nurse should identify that which of the following results indicates a potential adverse reaction to the medication? A. Elevated blood glucose B. Elevated WBC count C. Decreased platelet count D. Decreased aspartate transaminase (AST)

Correct Answer: A. Elevated blood glucose The nurse should identify that all second-generation antipsychotic medications such as risperidone can cause diabetes, weight gain, and dyslipidemia. To monitor for diabetes, a baseline glucose reading should be obtained and compared to a glucose reading taken 12 weeks later. If there is no change after 12 weeks, glucose should be monitored annually.

A nurse is caring for a client who has schizophrenia and a prescription for chlorpromazine. For which of the following adverse effects should the nurse monitor? A. Orthostatic hypotension B. Diarrhea C. Urinary frequency D. Bradycardia

Correct Answer: A. Orthostatic hypotension Orthostatic hypotension is an adverse effect of chlorpromazine. Other adverse effects include palpitations, tachycardia, constipation, sedation, and photosensitivity.

A nurse is conducting a risk assessment for clients who are prescribed medications that can cause orthostatic hypotension. Which of the following medications requires a follow-up by the nurse? A. Phenelzine B. Escitalopram oxalate C. Galantamine D. Naltrexone

Correct Answer: A. Phenelzine Phenelzine is a monoamine oxidase inhibitor that is prescribed for depression and other mental health disorders. An adverse effect of phenelzine is orthostatic hypotension. The nurse should inform the client who is taking phenelzine that dizziness and lightheadedness are indications of hypotension. The nurse should also instruct the client to rise slowly from a lying or sitting position to minimize a drop in blood pressure.

A nurse is assessing a client who began taking clozapine 3 weeks ago. Which of the following findings should the nurse report to the provider immediately? A. Tachypnea and tachycardia B. Abdominal pain and constipation C. Enuresis and polyuria D. Dry mouth and blurred vision

Correct Answer: A. Tachypnea and tachycardia The greatest risk to the client is the development of myocarditis, a potentially fatal adverse effect of clozapine. Myocarditis is an inflammation of the heart muscle that typically occurs within 30 days of starting the medication. Manifestations of myocarditis include chest pain, palpitations, tachycardia, cardiac arrhythmias, dyspnea, tachypnea, a fever, peripheral edema, and unexplained fatigue. Clozapine should be discontinued if a client develops myocarditis, and its use should be avoided in the future.

A nurse is caring for a client with schizophrenia who has been taking chlorpromazine for the past 2 months. Which of the following findings demonstrates that the chlorpromazine has been effective? A. The client reports that hallucinations occur less frequently. B. The client sleeps uninterrupted for 6 hr each night. C. The client reports that she is the "most important person on the unit." D. The client demonstrates stereotyped behaviors.

Correct Answer: A. The client reports that hallucinations occur less frequently. The nurse should identify that chlorpromazine, when used to treat schizophrenia, reduces hallucinations. Chlorpromazine is a first-generation conventional antipsychotic medication and is effective in decreasing delusions, hallucinations, and agitation. It can also treat manic behavior in clients who have bipolar disorder.

A nurse is teaching a client who has anxiety and a new prescription for buspirone. Which of the following pieces of information should the nurse include in the teaching? A. "Buspirone carries a high potential for abuse." B. "Avoid consuming grapefruit juice when taking this medication." C. "Take the medication 4 times daily." D. "The peak effects of buspirone occur within 1 week."

Correct Answer: B. "Avoid consuming grapefruit juice when taking this medication." The nurse should instruct the client to avoid drinking grapefruit juice when taking buspirone because it can cause levels of the medication to increase. Elevated levels can cause drowsiness and subjective effects such as dysphoria

A nurse is teaching a client who has a new prescription for amitriptyline to treat depression. Which of the following client statements indicates an understanding of the teaching? A. "I should take this medication when I experience active symptoms." B. "I should take this medication before bedtime." C. "This medication may cause excess salivation." D. "I might experience weight loss while taking this medication."

Correct Answer: B. "I should take this medication before bedtime." The nurse should instruct the client that an adverse effect of amitriptyline is sedation. The nurse should instruct the client to take the medication at bedtime to minimize sedation during waking hours while promoting sleep.

A nurse is providing discharge teaching to a client who has been hospitalized for major depressive disorder and has a prescription for amitriptyline. Which of the following statements by the client indicates an understanding of the teaching? A. "I will take amitriptyline in the morning because I'll likely have trouble falling asleep if I take it in the evening." B. "I will move slowly when I stand up because amitriptyline can cause my blood pressure to decrease." C. "I can drink a glass of beer or wine with my evening meal because amitriptyline doesn't interact with alcohol." D. "I will avoid foods that are high in fiber because amitriptyline can cause diarrhea."

Correct Answer: B. "I will move slowly when I stand up because amitriptyline can cause my blood pressure to decrease." Amitriptyline can cause orthostatic hypotension. The nurse should instruct the client to take precautions to prevent an injury due to a fall while taking amitriptyline.

A nurse is caring for a client who is receiving chlorpromazine to treat schizophrenia. Which of the following statements by the client should prompt the nurse to notify the provider immediately? A. "My last bowel movement was 2 days ago." B. "My tongue keeps moving like a worm." C. "I feel dizzy when I stand up too quickly." D. "I can't stop blinking when I'm in the sun."

Correct Answer: B. "My tongue keeps moving like a worm." Involuntary tongue movement indicates that this client is at greatest risk for tardive dyskinesia, which is a rare neurological syndrome that has no cure. Therefore, this is the priority statement.

A nurse is providing teaching to a client who has social anxiety disorder and a new prescription for paroxetine. Which of the following statements should the nurse include in the teaching? A. "You can take this medication when needed." B. "The medication takes a few weeks to build up in your system." C. "You should plan to take this medication for 6 months." D. "Relapsing after withdrawing from this medication is rare."

Correct Answer: B. "The medication takes a few weeks to build up in your system." The nurse should inform the client that initial effects of paroxetine take about 4 weeks to develop. Optimal effects of the medication can be seen in 8 to 12 weeks.

A nurse is teaching an assistive personnel (AP) about dietary restrictions for a client who is taking phenelzine to treat depression. The AP's selection of which of the following foods for the client's lunch indicates an understanding of the teaching? A. Bologna on wheat bread B. Chicken salad C. Cheddar cheese and crackers D. Pizza with pepperoni

Correct Answer: B. Chicken salad Phenelzine is an MAOI. Clients taking MAOIs must avoid foods that contain tyramine due to the potential for a dangerous food-drug interaction. Foods high in tyramine include those that are processed and aged, such as luncheon meats and cheeses. This menu selection does not contain food high in tyramine and indicates an understanding of the teaching.

A nurse is reviewing the medical record of a client who has a new prescription for tranylcypromine. The client still has a current prescription for sertraline. The nurse should notify the provider because taking these medications concurrently increases the risk of which of the following adverse effects? A. Increased intracranial pressure B. Serotonin syndrome C. Acute kidney injury D. Hypertensive crisis

Correct Answer: B. Serotonin syndrome Serotonin syndrome is a toxic effect that can occur from taking an MAOI such as tranylcypromine and an SSRI such as sertraline simultaneously. Manifestations include delirium, abdominal pain, muscle spasms, and irritability, and the condition can worsen to cause cardiovascular shock and death. The nurse should notify the provider immediately of this potential interaction.

A nurse is providing teaching to a client who has a new prescription for sertraline. The client asks the nurse if he should continue to take St. John's wort for depression. Which of the following instructions should the nurse give the client? A. Take the medication and herbal supplement together. B. Stop taking the herbal supplement while taking the medication. C. Take the herbal supplement and the medication at least 2 hr apart. D. Take an antacid with both the herbal supplement and the medication.

Correct Answer: B. Stop taking the herbal supplement while taking the medication. Taking the antidepressant sertraline and the herbal supplement St. John's wort increases the client's risk of serotonin syndrome.

A nurse is providing teaching to a client who has a new prescription for chlorpromazine. Which of the following statements should the nurse make? A. "This medication is a tricyclic antidepressant and will improve your mood." B. "This medication is an opioid antagonist that blocks the pleasurable effects of alcohol." C. "This medication is an antipsychotic that controls manifestations of schizophrenia." D. "This medication is a cholinesterase inhibitor that slows the progression of dementia."

Correct Answer: C. "This medication is an antipsychotic that controls manifestations of schizophrenia." Antipsychotic medications like chlorpromazine are thought to act directly on dopamine receptors in the brain to prevent the reuptake of dopamine, thereby controlling psychotic manifestations.

A nurse is caring for a client who has depression and started taking paroxetine 1 week ago. The client states to the nurse, "My family would be better off without me." Which of the following responses should the nurse make? A. "Why do you feel your family would be better off without you?" B. "Many people feel this way when they are depressed." C. "You sound upset. Are you thinking of hurting yourself?" D. "Your medication hasn't started working yet. Soon, you'll be feeling differently."

Correct Answer: C. "You sound upset. Are you thinking of hurting yourself?" This response exemplifies the therapeutic communication technique of showing empathy. The nurse is focusing on the client's feelings, which is a demonstration of therapeutic communication. In addition, the nurse addresses the possibility of suicidal ideation by asking the client directly about any intent to self-harm.

A nurse is providing teaching to a client who has generalized anxiety disorder and a new prescription for buspirone. Which of the following manifestations is a common adverse effect of this medication? A. Confusion B. Bradycardia C. Dizziness D. Insomnia

Correct Answer: C. Dizziness The nurse should inform the client that dizziness is a common adverse effect of buspirone. The nurse should instruct the client to avoid driving and operating heavy machinery until the presence of adverse effects has been determined.

A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this medication? A. Hearing examination B. Glucose tolerance test C. Electrocardiogram D. Pulmonary function tests

Correct Answer: C. Electrocardiogram Amitriptyline can cause tachycardia and ECG changes. An older adult client is at risk for cardiovascular effects while using amitriptyline; therefore, an ECG should be performed prior to the start of therapy to obtain a baseline of the client's cardiovascular status.

A nurse is assessing a client who is taking buspirone to treat generalized anxiety disorder. Which of the following findings should the nurse identify as an adverse effect of this medication? A. Arthralgia B. Photophobia C. Xerostomia D. Bradycardia

Correct Answer: C. Xerostomia Buspirone can cause xerostomia or dry mouth. Other adverse effects include headache, nausea, and insomnia.

A nurse is providing teaching to a client who has a new prescription for buspirone to treat anxiety. Which of the following statements should the nurse include in the teaching? A. "Use buspirone with caution because it raises the risk of experiencing suicidal thoughts." B. "You can minimize adverse effects by taking buspirone with grapefruit juice." C. "Buspirone enhances the depressant effects of alcohol." D. "Buspirone causes nausea in some people."

Correct Answer: D. "Buspirone causes nausea in some people." Adverse effects of buspirone include nausea, dizziness, headaches, nervousness, sedation, lightheadedness, and excitement.

A nurse is providing teaching to a client who has a new prescription for buspirone. Which of the following statements by the client indicates an understanding of the teaching? A. "I need to watch for signs of dehydration." B. "I need to have my kidney function monitored while taking this medication." C. "I should take this medication on an empty stomach." D. "I might not notice the effects of this medication for several weeks."

Correct Answer: D. "I might not notice the effects of this medication for several weeks." The effects of buspirone develop slowly. The initial response takes at least a week, and a peak response takes several weeks. Because of the delayed action, buspirone should not be taken as a PRN medication for the relief of anxiety.

A nurse is providing teaching to a client who has generalized anxiety disorder and a new prescription for venlafaxine. Which of the following statements should the nurse make? A. "This medication is only for short-term use." B. "This medication can be taken on an as-needed basis." C. "This medication will effectively reduce your physical manifestations of anxiety." D. "This medication should not be stopped abruptly."

Correct Answer: D. "This medication should not be stopped abruptly." The nurse should instruct the client that stopping venlafaxine abruptly will lead to manifestations of withdrawal.

A nurse is reviewing the laboratory data for a client who is receiving clozapine for schizophrenia. The nurse should identify which of the following findings as a potential adverse effect of the medication? A. Fasting blood glucose 95 mg/dL B. Triglycerides 135 mg/dL C. Total cholesterol 175 mg/dL D. Absolute neutrophil count 1,200 mm^3

Correct Answer: D. Absolute neutrophil count 1,200 mm^3 The nurse should identify that an absolute neutrophil count of 1,200/mm^3 is less than the expected reference range of 2,500 to 8,000/mm^3. An adverse effect of clozapine can include agranulocytosis, which is a life-threatening conditioning in which WBCs (including neutrophils) are severely decreased

A nurse is assessing a client who is receiving clozapine to treat schizophrenia. The nurse should identify an increase in which of the following parameters as an early indication of an adverse effect of this medication? A. Urine specific gravity B. Urine output C. Blood pressure D. Temperature

Correct Answer: D. Temperature Antipsychotic medications such as clozapine can cause agranulocytosis, which is the depletion of WBCs. This increases the client's risk of infection. A fever is an early indication to check the client's WBC count to detect agranulocytosis.

A nurse is assessing a client who has panic disorder and has been taking paroxetine. Which of the following assessments should the nurse identify as an adverse effect of the medication? A. Peripheral edema B. Chest congestion C. Shuffling gait D. Weight gain

Correct Answer: D. Weight gain Weight gain is an expected adverse effect of paroxetine and other SSRIs. Other adverse effects include nausea, headaches, insomnia, and sexual dysfunction.

A nurse is following up with a client who takes chlorpromazine for the treatment of schizophrenia. The nurse should expect to find the greatest improvement in which of the following manifestations? (Select all that apply.) Disorganized speech Bizarre behavior Impaired social interactions Hallucinations Decreased motivation

Disorganized speech Bizarre behavior Hallucinations

A nurse is caring for a client who is having difficulty remembering to take their prescribed drug three times each day. The nurse should identify that which of the following alternate forms of the drug can help to promote adherence to the prescribed dosage? Liquid Suspension Immediate-release capsule Extended-release tablet Powder form

Extended-release tablet

A nurse is providing teaching to a pregnant client who is taking captopril, an ACE inhibitor, to treat hypertension. The nurse informs the client that captopril is a teratogenic drug. The nurse should explain that teratogenic drugs can cause which of the following? Maternal bleeding Maternal blood clots Gestational diabetes mellitus Fetal malformation

Fetal malformation

A nurse is reviewing the drug history of a client who is taking lithium carbonate for bipolar disorder. Which of the following findings should indicate to the nurse to monitor for lithium toxicity? Furosemide for hypertension Acetaminophen for headaches Ciprofloxacin for a urinary tract infection Montelukast for asthma

Furosemide for hypertension

A nurse is caring for a client who has a prescription for fluoxetine and who reports self-administering St. Johns wart daily for the past 2 weeks. Which of the following findings should the nurse report to the provider as an indication of serotonin syndrome? Hallucinations Decreased temperature Hypersexual behavior Constipation

Hallucinations

A nurse is providing teaching for a client who has a prescription for phenelzine. The nurse should instruct the client to avoid tyramine-enriched food because of an increased risk for which of the following reactions? Respiratory depression Hypertensive crisis Neuroleptic malignant syndrome Serotonin syndrome

Hypertensive crisis

A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity due to an overdose. Which of the following actions is the nurse's priority? Administer flumazenil. Identify the client's level of orientation. Infuse IV fluids. Prepare the client for gastric lavage.

Identify the client's level of orientation.

A nurse is providing teaching to a client who has a new prescription for diazepam for anxiety disorders. Which of the following client statements indicates an understanding of the teaching? It's not a big deal if I forget my pills for a couple of days I should limit alcohol intake to one drink daily while taking this medication I will avoid salt because this medication can increase my blood pressure If I become pregnant, it is important to let my health care provider know.

If I become pregnant, it is important to let my health care provider know.

A nurse is providing teaching to a client who has a new prescription for fluoxetine. Which of the following instructions should the nurse include? Weigh yourself twice a month. If you have persistent headaches, let the provider know. Reduce your daily sodium intake. If your symptoms don't improve in 10 days, you will need a higher dosage.

If you have persistent headaches, let the provider know.

A nurse is providing teaching to a client about the adverse effects of drug therapy. The nurse should include that orthostatic hypotension is a common adverse reaction of which of the following drugs? Venlafaxine Bupropion Imipramine Valproic acid

Imipramine

A nurse is preparing to teach a client how to take care of a newly created colostomy. The nurse should identify that which of the following factors can decrease the client's ability to learn? (Select all that apply.) Impaired cognitive level Language barrier Discomfort Repetition of teaching Unreadiness to learn

Impaired cognitive level Language barrier Discomfort Unreadiness to learn

A nurse in a provider's of office is reviewing the medical record of a client who is pregnant and is at her first prenatal visit. Which of the following immunizations may the nurse administer safely to this client? Varicella vaccine Rubella vaccine Inactivated influenza vaccine Measles vaccine

Inactivated influenza vaccine

A nurse is preparing to administer a drug to a client. In which of the following sections of a drug handbook should the nurse look to determine if the drug has more than one use? Adverse effects Indications Pharmacokinetics Nursing implications

Indications

A nurse is preparing to administer medications to a 4‐month‐old infant. Which of the following pharmacokinetic principles should the nurse consider when administering medications to this client? (Select all that apply.) Infants have a more rapid gastric emptying time. Infants have immature liver function Infants blood-brain barrier is poorly developed Infants have an increased ability to absorb topical medications Infants have an increased number of protein-binding sites.

Infants have immature liver function Infants blood-brain barrier is poorly developed Infants have an increased ability to absorb topical medications

When reviewing a list of drugs in a handbook, a nurse can identify the generic name for a drug in which of the following ways? It begins with a lower-case letter It is listed in parenthesis along with the trade name There are both letters and numbers in the name The chemical name is listed in parenthesis before the generic name

It begins with a lower-case letter

A nurse is caring for a client who has a new prescription for lithium carbonate. When teaching the client about ways to prevent lithium toxicity, the nurse should advise the client to do which of the following? Avoid the use of acetaminophen for headaches. Restrict the intake of foods rich in sodium. Decrease fluid intake to less than 1,500 mL daily. Limit aerobic activity in hot weather.

Limit aerobic activity in hot weather.

A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages (SATA)? Increased renal excretion Increased medication-metabolizing enzymes Liver failure Peripheral vascular disease Concurrent use of medication the same pathway metabolizes

Liver failure Concurrent use of medication the same pathway metabolizes

A nurse is caring for a client who has depression and a new prescription for venlafaxine. For which of the following adverse effects should the nurse monitor this client? (Select all that apply) Mydriasis Dizziness Decreased libido Alopecia Hypotension

Mydriasis Dizziness Decreased libido

A nurse reviewing a patient's medical record notes a new prescription for verifying the trough level of the patient's medication. Which of the following actions should the nurse take? Obtain a blood specimen immediately prior to administering the next dose of medication Verify that the client has been taking medication for 24 hr before obtaining a blood specimen Ask the client to provide a urine specimen after the next dose of medication Administer the medication, and obtain a blood specimen 30 min later

Obtain a blood specimen immediately prior to administering the next dose of medication

A provider prescribes phenobarbital for a patient who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication? One Two Three Four

One

A nurse is caring for a client who has a new prescription for phenelzine for the treatment of depression. Which of the following indicates that the client has developed an adverse effect of this medication? Orthostatic hypotension Hearing loss Gastrointestinal bleeding Weight loss

Orthostatic hypotension

A nurse is reviewing laboratory findings and notes that a client's plasma lithium level is 2.1 mEq/L. Which of the following is an appropriate actions by the nurse? Perform immediate gastric lavage. Prepare the client for hemodialysis. Administer an additional oral dose of lithium. Request a stat repeat of the laboratory test.

Perform immediate gastric lavage.

A nurse is caring for a client who has prescribed an antidepressant based on its ability to prevent the reuptake of neurotransmitters. The nurse should identify that which of the following terms describes why this drug was prescribed for the client? Pharmacological Action Chemical stability Route Adverse effects

Pharmacological Action

A nurse is caring for a client who is taking venlafaxine to treat major depressive disorder. The nurse should identify that which of the following drugs can cause serotonin syndrome when taken concurrently with venlafaxine? Alprazolam Phenytoin Phenelzine Pilocarpine

Phenelzine (MAOI)

A nurse is reviewing a drug handbook prior to administering a drug to a client who has kidney disease. The handbook states that the drug can be administered but identifies certain risks. Which of the following terms describes these risks? Contraindications Precautions Paradoxical effects Adverse effects

Precautions

A nurse on a medical‐surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness? Reduced cardiac function. First-pass effect. Reduced hepatic function. Increased gastric motility.

Reduced hepatic function.

A nurse is reviewing the medical history of a client who has a new prescription for a reduced dosage of alprazolam for anxiety. which of the following findings should indicate to the nurse the reason for the prescription modification? Renal function impairment Cataracts Recent weight loss Smoking

Renal function impairment

When reviewing the indications for various antidepressants, a nurse should identify that bupropion hydrochloride is an appropriate choice for clients who have which of the following? Motion sickness Seasonal affective disorder Insomnia Nicotine addictionDepression

Seasonal affective disorder Nicotine addiction Depression

A nurse is caring for a client who was admitted to the emergency department with a head injury. The nurse notes that the client has an existing prescription for bupropion hydrochloride to treat depression. For which of the following adverse effects is the client at increased risk? Ischemic stroke Drowsiness Respiratory depression Seizure activity

Seizure activity

A nurse is providing teaching to a client who has a prescription for buspirone to treat anxiety. Which of the following instructions should the nurse include? Take a missed dose as soon as you remember Take the drug as needed at the first sign of anxious feelings Take the drug in the morning with a glass of grapefruit juice Drink a cup of chamomile yea at night with the drug

Take a missed dose as soon as you remember

A nurse is preparing a patient's medications. Which of the following actions should the nurse take in following legal practice guidelines (SATA)? Teaching the client about the medication Determine the dosage Monitor for adverse effects Lock compartments for controlled substances Determine the client's insurance status

Teaching the client about the medication Monitor for adverse effects Lock compartments for controlled substances

A nurse is reviewing drugs in a drug reference. The nurse should identify that drugs in the same class share which of the following similarities. They have similar mechanisms of actions. They have the same half-life. They are administered by the same route. They have similar availability.

They have similar mechanisms of actions.

A nurse is teaching a client who has a prescription for a drug that has a receptor agonists effect. Which of the following information should the nurse include in the teaching? This will increase the effects of normal cellular functions This prevents cells in your body from performing certain actions This prevents hormones in your body from attaching to cell receptor sites This minimizes the risk that medications you take will become toxic

This will increase the effects of normal cellular functions

A nurse is caring for a client who has a new prescription for valproic acid. The nurse should instruct the client that while taking this medication he will need to have which of the following laboratory tests completed periodically? Thrombocyte count. Glucose. Amylase. Liver function tests. Potassium.

Thrombocyte count. Amylase. Liver function tests.

A nurse is caring for a client who is taking lithium carbonate to treat bipolar disorder. Which of the following diagnostic tests should the nurse recommend that the client undergo periodically? Chest x-ray Tonometry Thyroid function tests Endoscopic retrograde cholangiopancreatography (ERCP)

Thyroid function tests

A nurse is caring for a client who has been taking sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing serotonin syndrome? Bruising Fever Tinnitus Rash

Tinnitus

A nurse is caring for a client who has a prescription for alprazolam. for which of the following adverse effects should the nurse monitor? (SATA) Tolerance Anxiety Sedation Respiratory depression Constipation

Tolerance Anxiety Sedation Respiratory depression

A nurse is caring for a client who is about to begin taking lithium carbonate to treat bipolar disorder. the nurse should instruct the client to monitor for which of the following findings as indications of lithium toxicity. Tremors Confusion Bronchospasm Nausea Muscle weakness

Tremors Confusion Nausea Muscle weakness

A nurse is admitting a patient and completing a preassessment before administering medications. Which of the following data should the nurse include in the preassessment (SATA)? Use of herbal products Daily fluid intake Ability to swallow Previous surgical history Allergies

Use of herbal products Ability to swallow Allergies

A nurse is providing teaching to a client who has prescription for chlorpromazine. Which of the following instructions should the nurse include? Stop taking the drug immediately with the first sign of a sore throat Wear sunscreen when exposed to sunlight Take the drug with food to reduce gastrointestinal distress Take the drug in the morning to prevent nocturia

Wear sunscreen when exposed to sunlight

A nurse is caring for a client who has been taking alprazolam for an extended period of time to treat anxiety. The nurse should identify that abruptly stopping alprazolam therapy can result in which of the following adverse effects? Anterograde amnesia Respiratory depression Paradoxical reaction Withdrawal symptoms

Withdrawal symptoms

A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states she took penicillin 3 years ago and developed a rash. Which of the following actions should the nurse take? Administer the prescribed dose. Withhold the medication. Ask the provider to change the prescription to an oral form. Administer an oral antihistamine at the same time.

Withhold the medication.