Pharmacology Final 2

The nurse is caring for a client prescribed atomoxetine (Strattera) for ADHD. The client asks how this medication helps with the ADHD. Which is the nurse's best response? 1. The medication will decrease capability to complete assigned work. 2. The medication will increase ability to focus on tasks and reduce hyperactivity. 3. The medication will stimulate the heart rate and blood pressure. 4. The medication will dull the effects of stress.

2. The medication will increase ability to focus on tasks and reduce hyperactivity.

Which statement is priority teaching at the time of discharge for the client who receives imipramine (Tofranil)? 1."You will need to maintain a low-fat diet while on this medication." 2."You must maintain a normal intake of salt while on this medication." 3."Please notify your healthcare provider of any changes in urine quantity or quality." 4."You can stop the medication when you are no longer feeling depressed."

3."Please notify your healthcare provider of any changes in urine quantity or quality."

The mother of an 8-year-old client who is receiving methylphenidate (Ritalin) tells the nurse the child has not slept well since being started on this drug. Which assessment question is a priority for this client? 1."Is your child having problems at school?" 2."Do you give the medication with food?" 3."Does your child have sleep apnea?" 4."What time do you give your child the medication?"

4."What time do you give your child the medication?"

A client has been taking clonazepam (Klonopin) for chronic anxiety for three years. The client tells the nurse they want to stop the medication. What is the best response by the nurse? A. "You will need to gradually decrease your dose before stopping." B. "I don't think it is a good idea to stop your medication." C. "There are not any serious complications to stopping this drug." D. "Medications for anxiety must be taken for the rest of your life."

A. "You will need to gradually decrease your dose before stopping."

The client is prescribed phenelzine (Nardil). The client tells the nurse that they consumed two glasses of Chianti wine at lunchtime, What is the nurses's priority action? A. Assess the client's blood pressure B. Discuss the effects of wine on the action of antidepressants. C. Arrange for admittance to the psychiatric unit. D. Discuss how food can increase the symptoms of depression.

A. Assess the client's blood pressure

A client is discussing with the nurse ways to promote a sleeping environment. Which factors should be included in the plan of care? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. A. Avoid foods, caffeinated beverages, and alcohol prior to going to sleep. B. Ask the prescriber for a medication to assist in falling asleep. C. Eat a large meal with high protein and fat close to bedtime. D. Stressful conditions such as too much light or warm temperature should be avoided. E. Central nervous medications can aid to staying asleep.

A. Avoid foods, caffeinated beverages, and alcohol prior to going to sleep. D. Stressful conditions such as too much light or warm temperature should be avoided.

A client is being treated for an anxiety disorder. Which types of medications are used to treat anxiety disorders? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. A. Barbiturates B. Beta blockers C. Benzodiazepines D. Alpha blockers E. SSRIs

A. Barbiturates B. Beta blockers C. Benzodiazepines E. SSRIs

A client taking an MAOI should be instructed to avoid which item? A. Foods that contain tyramine and caffeine B. A diet that is high in fat C. Large amounts of water D. A diet that is high in salt

A. Foods that contain tyramine and caffeine

Which areas of the brain control anxiety and restlessness? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. A. Limbic system B. Hypothalamus C. Sympathetic nervous system D. Reticular activating system E. Cholinergic receptors

A. Limbic system B. Hypothalamus D. Reticular activating system

Which nursing statement regarding onset of action for zolpidem (Ambien) is the most appropriate? A. Rapidly, and should be taken just before bedtime B. Four hours after dosing C. Sixty minutes after dosing D. Two hours after dosing

A. Rapidly, and should be taken just before bedtime

Which instructions should the nurse provide to the client who is prescribed a benzodiazepine? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. A .Report significant mood changes B. Avoid OTC medications used to induce sleep C. Avoid alcoholic beverages D. If a dose is missed, the client should take a double dose as soon as possible E. Avoid caffeine

A.Report significant mood changes B.Avoid OTC medications used to induce sleep C.Avoid alcoholic beverages

A teenage client is taking duloxetine (Cymbalta) for a generalized anxiety disorder. The dose has been changed by the physician. What adverse effects will the nurse advise the client and family to watch? A.Warning signs of suicide B. Irritability C. Weight gain D. Fatigue

A.Warning signs of suicide

The physician has ordered a tricyclic antidepressant for a client with biological depression. The nurse expects to find which medications to be ordered for the client? a .Amitriptyline (Elavil) b Citalopram (Celexa) c. Duloxetine (Cymbalta) d. Fluoxetine (Prozac)

Amitriptyline (Elavil)

The client receives buspirone (BuSpar) for chronic anxiety. At time of discharge, what is a priority for the nurse to teach the client about the medication? A. "You can only take this for a few weeks, as dependence is very high with this drug." B. "It will take a few weeks before you feel a reduction in anxiety." C. "This drug must be taken on an empty stomach." D. "Therapeutic blood levels are required with this drug."

B. "It will take a few weeks before you feel a reduction in anxiety."

The client receives lorazepam (Ativan) for chronic anxiety. The nurse determines that medication education has been most effective when the client makes which statement? A. "I will probably always need this medication for my anxiety." B. "This medication will help me relax so I can focus on problem solving." C. "This medication is not addictive." D. "My anxiety will be eliminated when I take this medication."

B. "This medication will help me relax so I can focus on problem solving."

What would the nurse teach a client to avoid when taking barbiturates? A. Bananas B. Alcohol C. Caffeine D. Nicotine

B. Alcohol

The client will be receiving amitriptyline (Elavil), a tricyclic antidepressant, for chronic anxiety. Which nursing assessment is a priority for this client? A. History of alcoholism B. History of heart disease C. History of ulcers D. History of diabetes mellitus

B. History of heart disease

A nurse is caring for a client who reports frequent insomnia. Based on the client's assessment, what are the possible causes of insomnia? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. A. Darkened room B. Stress C. Caffeine D.Quiet sleeping area E.Early morning exercise

B. Stress C. Caffeine

An elderly client receives temazepam (Restoril) for sleep. Which assessment data is indicative of a potentially serious complication? A. The client reports a dry mouth. B. The client becomes agitated. C. The client sleeps for 1 hour longer than usual. D. The client reports a decrease in appetite.

B. The client becomes agitated.

. A client complains of restlessness, fatigue, nervousness, and sleep disturbances. The nurse knows these are symptoms of which clinical disorder? A.Obsessive-compulsive disorder B.Generalized anxiety disorder C.Panic disorder D.Post-traumatic stress disorder

B.Generalized anxiety disorder

The client asks the nurse why a tricyclic antidepressant has not been prescribed for depression. What is the best response by the nurse? A. "Tricyclic antidepressants have many side effects, including orthostatic hypotension, headache, and diarrhea." B. "Tricyclic antidepressants cause sexual dysfunction." C. "Tricyclic antidepressants are not recommended for a client with a history of heart attack." D. "Tricyclic antidepressants aid with digestion and elimination."

C. "Tricyclic antidepressants are not recommended for a client with a history of heart attack."

A client has abruptly stopped taking a CNS depressant, and is experiencing withdrawal symptoms. Which symptoms should the nurse expect to see? A. Hypothermia, psychosis, seizures, decreased heart rate, increased blood pressure, and panic anxiety B. Fever, euphoria, headache, increased heart rate, and fatigue C. Fever, psychosis, seizures, increased heart rate, decreased blood pressure, panic, and anxiety D. Euphoria, fever, tremor, relaxation, and coma

C. Fever, psychosis, seizures, increased heart rate, decreased blood pressure, panic, and anxiety

The physician ordered an MAOI for a client with depression. The nurse expects which medication to be ordered? A. Citalopram (Celexa) B. Fluoxetine (Prozac) C. Tranylcypromine (Parnate) D. Amitriptyline (Elavil)

C. Tranylcypromine (Parnate)

. A client has returned from combat, and is re-experiencing combat in dreams and feels helpless and anxious. What disorder does the nurse suspect this client is experiencing? A.Generalized anxiety disorder B.Obsessive-compulsive disorder C.Post-traumatic stress disorder D.Panic disorder

C.Post-traumatic stress disorder

The client receives zaleplon (Sonata) for sleep. What is the priority teaching by the nurse at the time of discharge? A. "This drug can be taken indefinitely." B. "Drinking a cup of tea with this drug will promote relaxation." C. "It will take about a week for this drug to be effective." D. "Avoid taking OTC sleep-inducing antihistamines."

D. "Avoid taking OTC sleep-inducing antihistamines."

The client receives temazepam (Restoril) at bedtime for sleep. The client tells the nurse that he also has a glass of wine before bed to help him sleep. What is the nurse's best response? A. "One glass of wine is okay, but be sure not to have more than that." B. "Combining wine with your medication will decrease the effectiveness of your medication." C. "This is okay as long as you have a high-fat meal with your wine." D. "Combining wine with your medication can sedate you and cause breathing problems."

D. "Combining wine with your medication can sedate you and cause breathing problems."

The risk for physical and psychological dependence is high from which class of medications, which is rarely used to treat insomnia or anxiety? A .SSRIs B.MAOIs C. Benzodiazepines D. Barbiturates

D. Barbiturates

The nurse instructs the client that buspirone (BuSpar) has which common side effects? A.Nausea and vomiting B. Cognitive impairment C. Decreased heart rate and blood pressure D. Dizziness, headache, and drowsiness

D. Dizziness, headache, and drowsiness

Which area of the brain is responsible for sleeping and wakefulness? A. Cerebral cortex B. Diencephalon C. Hypothalamus D. Reticular activating system

D. Reticular activating system

A benzodiazepine has been prescribed for a client with short-term insomnia. Which benzodiazepine is appropriate to treat insomnia? A. Diazepam (Valium) B. Chlordiazepoxide (Librium) C. Clonazepam (Klonopin) D. Temazepam (Restoril)

D. Temazepam (Restoril)

A client has been prescribed a medication to help him fall asleep but wake early. Which drug would the nurse expect to find ordered for this client? A. Diphenhydramine (Nytol) B. Eszopiclone (Lunesta) C. Ramelteon (Rozerem) D. Zaleplon (Sonata)

D. Zaleplon (Sonata)

According to an evidence-based approach, what is the most productive way to treat anxiety disorders? A.Provide the client with a powerful medication B.Allow the client to self-medicate with OTC medications C.Immediately start multiple-drug therapy D.Uncover and address the cause of anxiety

D.Uncover and address the cause of anxiety

The client receives amitriptyline (Elavil). What is a priority teaching point at discharge? a . Do not rapidly stand up or change positions. b. Begin a low-carbohydrate diet. c . Avoid green, leafy vegetables. d. Do not take aspirin with this drug.

a . Do not rapidly stand up or change positions.

The nurse is caring for a client with depression. The nurse recognizes which assessment findings to be symptoms of depression? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. a .Lack of energy b .Sleep disturbances c. Feelings of despair d. Increased energy e. Euphoria

a .Lack of energy b .Sleep disturbances c. Feelings of despair

The client receives phenelzine (Nardil). Which dietary components would indicate the best planning by the nurse and client? (Select all that apply.) a .Tomato soup b. Avocado salad c. .Grilled chicken breast d .Bologna sandwich e. Wine and beer, in moderation

a .Tomato soup c. .Grilled chicken breast

The client asks the nurse what causes depression. What is the best answer by the nurse? a. " There are many causes, including genetics, hormone changes, grief, substance abuse, and prescription drugs" b. " Most people are not really depressed. They are just looking for attention" c. " The main cause of depression is substance abuse" d. " Most people who are depressed suffer from seasonal affective disorder."

a. " There are many causes, including genetics, hormone changes, grief, substance abuse, and prescription drugs"

Which teaching points should the nurse include for a client who has been prescribed an SSRI? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. a. Add dietary fiber b. Drink adequate amounts of fluid c . Avoid laxatives d .Restrict fluid intake e. Avoid stool softeners

a. Add dietary fiber b. Drink adequate amounts of fluid

The nurse instructs the client receiving MAOIs to avoid which item? a. Avocado b. Baked chicken c.. Cottage cheese d. Apple

a. Avocado

Which are treatment interventions used in severe depression? (Select all that apply.) a. Cognitive-behavioral therapies b. Electroconvulsive therapies c. Long-term hospitalization d. Transcranial magnetic stimulation e. Medications

a. Cognitive-behavioral therapies b. Electroconvulsive therapies d. Transcranial magnetic stimulation e. Medications

The client receives sertraline (Zoloft) and lithium. Which assessment data are most indicative of a potentially serious complication? a. Fever and lack of muscular coordination b. Dry mouth and constipation c. Anxiety and insomnia d. Nausea and headache

a. Fever and lack of muscular coordination

The nurse is providing care to a client who is diagnosed with depression. The client asks the nurse which medication she is likely to be prescribed. What has become the drug of choice in treating depression? a. SSRI's b. MAOI's c. SNRI's d. TCA's

a. SSRI's

The nurse evaluates a client taking a high daily dose of duloxetine (Cymbalta) for which signs and symptoms? (Select all that apply.) a. Suicidal ideation b . Increased libido c. Liver failure d. Seizures e. Hypotension

a. Suicidal ideation c. Liver failure d. Seizures

Which teaching instruction is most appropriate for a client who has just been prescribed an SSRI? a. The full therapeutic effect takes one month. b. Take the medication at bedtime. c. The depression should improve immediately. d. There are few side effects of SSRIs.

a. The full therapeutic effect takes one month.

The nurse has been doing medication education for the client receiving lithium (Eskalith). Which statement by the client indicates that teaching has been effective? a.. "I need to call my physician if I excessively sweat during exercise." b. "I need to restrict my intake of salt while I am taking lithium." c. "I don't need to have my blood checked anymore after I leave the hospital." d. "I can stop taking my lithium when my moods are stable."

a.. "I need to call my physician if I excessively sweat during exercise."

A client is taking St. John's wort and an SSRI. The nurse observes the client for which symptoms? (Select all that apply.) a.. Mania b. Confusion c. Renal failure d. Tachycardia e. Hypotension

a.. Mania b. Confusion c. Renal failure

A child diagnosed with ADHD would likely exhibit which symptoms? (Select all that apply.) a. Able to focus on a task for an extended period of time b . Impulsiveness c . Excessive talking d .Easily distracted e . Violent behavior

b . Impulsiveness c . Excessive talking d .Easily distracted

The client receives paroxetine (Paxil), and tells the nurse that sexual dysfunction has become a problem. What is the best response by the nurse? a ."This side effect usually subsides in a few months." b ."This is common. Please discuss it with your physician." c ."Your depression is of primary concern right now." d. "You should stop the medication right away."

b ."This is common. Please discuss it with your physician."

A client has just begun therapy with lithium (Eskalith). The nurse notices the serum level of lithium for this client is 1.3 mEq/L. What is the normal range of lithium? a. 1.5-3.0 mEq/L. b. 0.6-1.5 mEq/L. c. 3.0-4.5 mEq/L. d. 0.1-0.6 mEq/L.

b. 0.6-1.5 mEq/L.

A female client has been prescribed a tricyclic antidepressant. The nurse will educate this client that most of these medications belong to which pregnancy categories? a. B and C b. C and D c. A and D d. A and B

b. C and D

The nurse is caring for a client diagnosed with bipolar disorder who is exhibiting the following symptoms: insomnia, exaggerated confidence, attention seeking, and easily agitated. Based on these symptoms, what does the nurse believe these symptoms are caused by? a. Overdose of barbiturates b. Mania c. Side effects of lithium (Eskalith) d depression

b. Mania

A client is being treated for reoccurring severe depressive illness. The nurse expects the client to receive which type of treatment? a. Grief counseling b. Medication and psychotherapy c. Medication only d. Psychotherapy only

b. Medication and psychotherapy

A client receiving lithium (Eskalith) for bipolar disorder would be at risk for increased lithium toxicity if it were prescribed with which other medication? a. Potassium citrate b. There are no drug interactions with lithium (Eskalith) c. Diuretics d. Sodium bicarbonate

c. Diuretics

A child has been ordered the most commonly prescribed medication for ADHD. What medication does the nurse expect? a. Clonidine (Kapvay) b. .Methamphetamine (Desoxyn) c. Methylphenidate (Ritalin) d. Sertraline (Zoloft)

c. Methylphenidate (Ritalin)

The client is in a manic phase of bipolar disorder, and is receiving lithium. What will the nurse expect to assess when the client's lithium level is 0.3 mEq/L? a. .Sleepiness b. Calm behavior c. .Relaxed appearance d. Hyperactivity

d. Hyperactivity

The nurse is caring for a client who has not responded to several antidepressant drugs. The nurse expects the physician to order which classification of medication for this client? a. SNRI b. TCA c. SSRI d. MAOI

d. MAOI

The nurse is performing an assessment on a client who has been taking a tricyclic antidepressant for several weeks. Which common adverse effect of tricyclic antidepressants is most likely to occur? a. Dry mouth b. Bradycardia c . Sedation d. Orthostatic hypotension

d. Orthostatic hypotension