PHARMACOLOGY TEST 4

The school nurse sees a child who has had an absence seizure. Which characteristics are typical of this type of seizure?

Alterations in consciousness that last seconds

The perioperative nurse is caring for a client who is undergoing abdominal surgery with the inclusion of succinylcholine in the client's anesthesia. The anesthesiologist tells the team that the client is exhibiting signs and symptoms suggestive of malignant hyperthermia. What is the nurse's best action? -Anticipate IV administration of dantrolene -Initiate resuscitation -Prepare to administer acetylcysteine IV -Administer naloxone IV as per facility protocol

Anticipate IV administration of dantrolene

A patient with a seizure disorder has had a recent change in medication ordered. In evaluating the new drug's control of the seizure disorder, what would the nurse do?

Assess for adverse effects

An older adult client diagnosed with Parkinson's disease will soon begin treatment with levodopa, carbidopa, and entacapone. Prior to starting this course of treatment, the nurse must ensure the implementation of which intervention?

Assess renal function

A client has been diagnosed with partial seizures and has been prescribed carbamazepine. When providing health education about the safe and effective use of this medication, what should the nurse teach the client?

"It's safest if you avoid drinking alcohol while you're taking this drug."

When reviewing a journal article about seizure disorders, the nurse would expect to find tonic-clonic seizures and myoclonic seizures being classified as which type of seizures?

Generalized seizures

A female client's seizure disorder has been successfully controlled by AEDs for years. She and her husband decide that it is time to start a family. She asks the nurse if it is safe for the fetus for her to continue her AEDs as prescribed. What is the nurse's best response?

"They are considered teratogenic."

A client with a history of chronic alcohol use is prescribed naltrexone. Which teaching will the nurse provide to the client about this medication? -"It can be taken before ingesting alcohol." -"It helps with the side effects of alcohol abuse." -"This medication decreases the desire to drink alcohol." -"This takes the place of pain medication."

"This medication decreases the desire to drink alcohol."

A surgical client's balanced anesthesia includes the use of vecuronium. What nursing action should the operating room nurses prioritize? -Protecting the client's skin integrity -Assessing and protecting the client's airway -Monitoring the client's deep tendon reflexes -Monitoring the client for signs of increased level of consciousness

Assessing and protecting the client's airway

The nurse is working in collaboration with a nurse anesthetist to assess a preoperative client. When addressing the client's risk for malignant hyperthermia as a result of neuromuscular junction blockers, what assessment should be prioritized? -Assessing for a history of febrile seizures in childhood -Assessing for a family history of malignant hyperthermia -Assessing the client's allergy status -Assessing for any history of cytochrome P450 dysfunction

Assessing for a family history of malignant hyperthermia

A 75-year-old client is brought to the emergency department by the family. The family relates that the client has confusion, seizures, and abnormal perception of movement. When the nurse looks at the medication that the family has brought to the ED, the nurse discovers that twice the number of tablets are missing from the vial as there should be if the prescription orders were being followed. What should the nurse suspect is wrong with this client?

Benzodiazepine toxicity

What would be considered a peripheral anticholinergic effect of anticholinergic drug therapy?

Blurred vision

A group of nursing students are preparing for a class presentation to discuss drugs used to treat Parkinson disease. Which drug would the group include when discussing dopaminergic agents?

Carbidopa

A patient is experiencing toxicity and prolonged paralysis after using a nondepolarizing neuromuscular junction (NMJ) blocking agent. Which type of medication will be used to reverse this condition? -Calcium-channel blocker -Loop diuretic -Cholinesterase inhibitor -Halogenated hydrocarbon anesthetic

Cholinesterase inhibitor

A client is to receive a narcotic cough syrup. The nurse would expect this preparation to contain: -codeine. -meperidine. -fentanyl. -hydromorphone.

Codeine

A client with a history of malignant hyperthermia is scheduled for surgery. Which agent would the nurse most likely expect to administer?

Dantrolene

A nurse administers carisoprodol to a client for the treatment of an acute musculoskeletal condition. The nurse would be alert for which adverse effect after administering the drug?

Drowsiness

What is the most important nursing action when a client is admitted to the postanesthesia recovery unit (PACU)? -Position the client on his side to prevent aspiration of vomitus. -Check the client's pulse and blood pressure. -Administer pain medication. -Ensure the client has adequate respirations.

Ensure the client has adequate respirations

Which action would be a priority for a client receiving apomorphine?

Monitoring cardiac status

A client is receiving lamotrigine as treatment for partial seizures. Which assessment finding would lead the nurse to stop the drug immediately?

Rash

The nurse has taught a client who is receiving lamotrigine about possible adverse effects. The nurse determines that the client has understood the teaching when the client identifies a need to promptly report what adverse effect?

Rash

A 6-year-old child has been brought to the emergency department in apparent status asthmaticus. The care team recognizes the need to intubate the client, who is inconsolably agitated. The nurse should anticipate a STAT prescription for what medication? -Atracurium -Succinylcholine -Pancuronium -Rocuronium

Succinylcholine

A nurse is monitoring a client closely for malignant hyperthermia because the client received which NMJ blocker? -Succinylcholine -Pancuronium -Atracurium -Vecuronium

Succinylcholine

For which assessment finding will the nurse intervene first when providing postoperative care to a patient who returned to the nursing unit 2 hours after receiving succinylcholine?

Temperature 40 degrees C (104 degrees F)

A surgical client has developed malignant hyperthermia. Which medication can be used to treat this health emergency?

dantrolene

The home care nurse is caring for an 80-year-old patient who is receiving carbidopa-levodopa, a dopaminergic drug used to treat Parkinson's disease. The nurse knows that this drug may place the patient at increased risk for:

falls.

An otherwise healthy surgical client has developed sharply increased muscle tone and rapid increase in heart rate and core body temperature. The operating room team should proceed with assessments and interventions that address what health problem? -orthostatic hypotension -anaphylaxis -malignant hyperthermia -rhabdomyolysis

malignant hyperthermia

A nurse is caring for a 49-year-old client in the intensive care unit. The client was in a motor vehicle accident and is in severe pain. The client has been given morphine. After 2 days in the unit, the nurse can detect nasal congestion when the client speaks to her. The nurse will monitor for which? -hypersensitivity to the drug. -myocardial infarction. -renal impairment. -pneumonia.

pneumonia.

A 28-year-old patient is to receive a dose of lorazepam intravenously for sedation during a procedure. The nursing priority would be to assess for:

respiratory disturbances and partial airway obstruction

The nursing instructor is teaching the students about anesthesia and informs them that there are two types. What are those two types of anesthesia? (Select both that apply.) -Regional anesthesia -Local anesthesia -Spinal anesthesia -Topical anesthesia -General anesthesia

-Local anesthesia -General anesthesia

Prior to administering morphine sulfate to a client in the postanesthesia recover unit (PACU), what information must the nurse obtain? (Select all that apply.) -Urinary output -Pulse -IV fluid rate -Respirations -Blood pressure

-Pulse -Respiration -Blood pressure

A client who is experiencing lower back pain has been prescribed cyclobenzaprine. The nurse should provide what health education in order to ensure safe and effective treatment?

"This will likely make you drowsy, so don't take it before doing anything that would require alertness."

A client is receiving phenytoin. The nurse monitors the client's plasma drug level. Which level would alert the nurse to the possibility of toxicity?

27 µg/mL Phenytoin plasma levels between 10 and 20 µg/mL give optimal anticonvulsant effect.

A registered nurse who oversees the care in a large long-term care facility cares for several clients with Parkinson's disease. When reviewing the assessment findings from the practical nurses at the facility, what finding should the RN prioritize for follow-up?

A client who began taking a dopaminergic three days ago and who is uncharacteristically

A client who has been taking medication for a seizure disorder is asking the nurse about getting pregnant. Why is pregnancy discouraged in women who are being treated for seizure disorders?

Antiepilepsy drugs are teratogenic.

Which adverse effects would a nurse most likely assess in a client who is receiving a centrally acting skeletal muscle relaxant? (Select all that apply.) Drowsiness Insomnia Dry mouth Constipation Urinary retention Hypertension

Drowsiness Insomnia Dry mouth Constipation

A client received fentanyl during a surgical procedure. The nurse will have what drug available to treat any possible respiratory depression associated with the use of fentanyl? -Naloxone -Vecuronium -Midazolam -Propofol

Naloxone

The post-anesthetic recovery unit nurse is caring for a client whose balanced anesthesia included midazolam. The nurse should prioritize assessments for what health problems? -Chills and hypotension -Respiratory depression and CNS suppression -Nausea and vomiting -Myoclonic and tonic movements

Respiratory depression and CNS suppression

A client with muscle spasticity has been prescribed baclofen. In order to promote the safe use of this medication, the nurse should encourage the client to:

avoid drinking alcohol for the duration of treatment.

A client diagnosed with Parkinson's disease is being treated with tolcapone. When reviewing the client's medication history, the nurse should confirm that the client is concurrently taking what other drug?

levodopa/carbidopa

A nurse has entered a client's room at the beginning of a shift to quickly assess the client's airway, breathing, circulation, and consciousness. The nurse observes that the client is wincing, stating, " Oh, I am in so much pain right now." What initial question should the nurse ask this client? -"In the past, what has helped your pain?" -"When did this pain begin?" -"Would you like me to get you something?" -"Where exactly are you hurting?"

"Where exactly are you hurting?"

Which medication is classified as an antianxiety medication but is also used to treat muscle spasms?

Diazepam (Valium)

Which factor should the clinician reassess when combination therapy is ineffective?

Drug-drug interactions

An older adult client diagnosed with generalized anxiety disorder is prescribed a benzodiazepine. The nurse caring for the client knows to include what intervention in the client's care plan?

Falls risk assessment

A 40-year-old male client with arthritis of the knee joint has been prescribed an analgesic to relieve the pain. Which medication is a narcotic analgesic? -Aspirin -Morphine -Celecoxib -Ibuprofen

Morphine

The nurse is preparing a patient for an endoscopic procedure that will use a nondepolarizing neuromuscular junction (NMJ) blocking agent. Which condition in the patient's history will require a change in anesthetic medication? -Myasthenia gravis -Peptic ulcer disease -Hypothyroidism -Osteoarthritis

Myasthenia gravis

The nurse notes a respiratory rate of 6 breaths/min in a client in the postanesthesia recovery unit. Which drug would the nurse anticipate being given immediately? -Epinephrine -Acetaminophen and diphenhydramine -Naloxone -Butorphanol

Naloxone

A patient comes to the clinic for a botox injection around her eyes. While making an assessment, the nurse finds that the patient is taking polymyxin for an infection. What would the nurse do first?

Notify the physician

A client who has been receiving long-term levodopa therapy tells the nurse, "I was making good progress and then it was like the drug stopped working." The nurse interprets this as which of the following?

On-off phenomenon

Gas anesthetics such as nitrous oxide must be combined with what element before they can be administered to the client? -Oxygen -Water -Nitrogen -Helium

Oxygen

Indications for use of anticholinergic drugs in the treatment for Parkinsonism include to:

decrease salivation, spasticity, and tremors

An older adult client experiencing recurrent tension headaches reports taking an over-the-counter (OTC) combination of acetaminophen, aspirin, and caffeine several times a week. The nurse should recognize that this combination medication may be contraindicated if the client has a history of what medical condition? -coronary artery disease -peripheral vascular disease -gastrointestinal (GI) bleeding -contact dermatitis

gastrointestinal (GI) bleeding

What assessment question would be most appropriate when providing care for a client newly prescribed chlordiazepoxide?

"When did you have your last drink of alcohol?"

Which patient is at the greatest risk for developing skin breakdown following a procedure that uses a neuromuscular junction (NMJ) blocking agent? -A 12-year-old boy with history of asthma -A 56-year-old woman with a history of breast cancer -A 28-year-old woman with a recent sports injury -A 73-year-old man with a history of hypertension

A 73-year-old man with a history of hypertension

The nurse observes that a new client's medication regimen includes sumatriptan. What assessment should the nurse prioritize? -Assessing the client for migraine pain -Assessing the client for respiratory depression -Assessing the client's lying, sitting and standing blood pressure -Assessing the client for narcotic withdrawal syndrome

Assessing the client for migraine pain

A client is receiving a barbiturate intravenously. The nurse would monitor the client for:

Brachycardia

The nurse has administered gabapentin to a client. Following administration, the nurse should assess the client for what possible adverse effect?

Central nervous system (CNS) depression

The nurse is assisting in the care of a client during surgery. The nurse will be prepared to administer which drug if the client develops malignant hyperthermia? -Acetaminophen -Diazepam -Dantrolene sodium -Toradol

Dantrolene sodium

The nurse works in a long-term care facility. When administering narcotics to clients, the nurse must monitor for which side effect? -Bleeding -Constipation -Diarrhea -Sleep deprivation

Constipation

A client is prescribed lamotrigine for control of partial seizures. What is the most important medication teaching information the nurse should emphasize from the plan of care?

Contact the health care provider immediately if rash appears.

A patient receiving succinylcholine experiences malignant hyperthermia. What drug is used to treat this condition? -Acetylsalicylic acid -Dantrolene -Pyridostigmine -Phenobarbital

Dantrolene

What is the most important teaching from the plan of care, to emphasize, when a client is prescribed a skeletal muscle relaxant?

Do not drive or operate machinery until individual drug effects are known.

When developing a teaching plan for a client who is to receive carisoprodol, which sign or symptom would the nurse include as a common adverse reaction?

Drowsiness

The nurse is preparing to administer a dose of ergotamine to a client. After administration, what assessments should the nurse prioritize to assure safe care? Select all that apply. -respiratory rate -temperature -heart rate -oxygen saturation level -blood pressure

Heart rate Blood pressure

The nurse is caring for a client whose current medication regimen includes baclofen 60 mg PO daily. What assessment should the nurse prioritize when assessing for therapeutic effects?

Inspection for muscle spasticity and range of motion assessment

A client has been administered an opioid. For what effect should the nurse regularly assess? -Oliguria -Tachycardia -Level of consciousness (LOC) -Edema

Level of consciousness (LOC)

What would lead the nurse to suspect that a client is experiencing withdrawal symptoms associated with benzodiazepine use?

Nightmares

A 60-year-old client has developed a tremor of the right hand with a pill-rolling motion. Upon interviewing, the client states having sustained several head injuries. This information supports which possible diagnosis?

Parkinson's disease

A client is receiving levodopa as treatment for Parkinson disease. The nurse would instruct the client to avoid foods high in which vitamin to prevent a reduction in the effect of levodopa?

Pyridoxine (vitamin B6)

A client is prescribed topiramate. The nurse cautions the client to avoid the intake of alcohol for which reason?

The client is at risk for increased CNS depression

A female client is diagnosed with Parkinson's disease and is having difficulty performing her activities of daily living. Her health care provider orders pramipexole. Pramipexole may be used alone for which purpose?

To improve motor performance and improve ability to participate in usual activities of daily living

The operating room nurse is taking a male patient into the OR when the patient informs the operating nurse that his grandmother spiked a 104°F temperature in the operating room and nearly died 15 years ago. The nurse knows that the anesthetist is planning to use a volatile liquid as part of the anesthetic. What relevance is this information regarding the patient? -The patient may be nervous. -The patient may be at risk for hypothermia. -The grandmother's surgery has no relevance to the patient's surgery. -The patient may be at risk for developing malignant hyperthermia.

The patient may be at risk for developing malignant hyperthermia.

A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which instruction?

Wear appropriate clothing and sunscreen whenever he is in direct sunlight.

A client has a diagnosis of Parkinson disease, and the health care provider will prescribe carbidopa-levodopa. Before drug therapy, the client should be carefully assessed for the presence of:

closed-angle glaucoma.

The nurse is caring for a client who has been diagnosed with both Parkinson's disease and narrow-angle glaucoma. What medication should cause the nurse concern?

levodopa

The nurse is caring for a 26-year-old client with partial seizures and has been prescribed oxcarbazepine as monotherapy. It will be critical for the nurse to inform the client of which needed action?

since she is taking oral contraceptives, she will need to use an additional form of birth control