prep u Chapter 18: CNS Stimulants

A nurse works at a weight management clinic. To which overweight client could the nurse safely administer dextroamphetamine? a) A 38-year-old Caucasian woman with glaucoma b) A 28-year-old African-American woman with hyperthyroidism c) A 60-year-old African-American man who experiences angina d) A 48-year-old Caucasian man who has adult-onset diabetes

A 48-year-old Caucasian man who has adult-onset diabetes

The nurse working with the family of a child prescribed methylphenidate should implement what strategy to address possible adverse effects? a) A strategy to ensure that the child maintains normal bladder function b) A plan to address the child's loss of self-esteem c) A strategy to regularly monitor the child's blood glucose levels d) A plan to address the child's loss of appetite

A plan to address the child's loss of appetite

A 12-year-old has been prescribed dextroamphetamine therapy, and the nurse is now reviewing the correct schedule for taking the drug. The child should most likely take the initial daily dose of dextroamphetamine at what times? a) 09:00, 14:00, and 19:00 b) 08:00 and 20:00 c) 07:30, 11:30, 16:30, and 20:00 d) 07:00 and 11:30

07:00 and 11:30

A client asks to have a year's worth of prescription refills for methylphenidate, explaining that it is very hard to leave work for clinic appointments. How should the nurse respond to that request to best assure client safety? a) "It would be very costly to purchase a years' worth of medication at one time." b) "The prescription dose is always started as low as possible, and the refills are monitored to prevent abuse." c) "I understand the inconvenience, but you have to come in at least every month to have blood work done." d) "I will speak with your health care provider about increasing the size of each refill."

"The prescription dose is always started as low as possible, and the refills are monitored to prevent abuse."

A nurse is caring for an obese client with no identified comorbidities. Which body mass index (BMI) would be required for the use of a prescribed anorexiant? a) 27 b) 31 c) 23 d) 25

31

While interviewing a pediatric client and his mother for the medical history. During the interview, the mother reveals that the client is taking methylphenidate (Concerta). What diagnosis would the nurse anticipate to be part of this client's medical history? a) Mood disorder b) Schizophrenia c) Attention deficit hyperactivity disorder (ADHD) d) Anxiety disorder

ADHD

A child has been receiving a CNS stimulant for long-term treatment of attention-deficit hyperactivity disorder (ADHD). The nurse would be especially alert for which finding? Select all that apply. a) Growth b) Hypotension c) Hyperglycemia d) Respiratory depression e) Weight loss

Growth Weight Loss

A client's medication history includes a long-term prescription for modafinil. Which assessment question should the nurse ask the client to confirm why the medication was prescribed? a) "have you ever been diagnosed with narcolepsy?" b) "Do you have trouble falling asleep?" c) "Do you have a history of depression?" d) Do you have a problem with sleepwalking?"

"Have you ever been diagnosed with narcolepsy?"

An adult client diagnosed with narcolepsy admits being embarrassed to recieve this diagnosis and is adamant that no one find out about it. The nurse should respond to the client by explaining what aspect of the etiology? a) "In a lot of cases, making improvements to your sleep habits can resolve narcolepsy." b) "This usually stems from suppressed emotions, so counseling usually helps greatly." c) "This is something that runs in certain families, and it's not your fault that this has happened." d) "This is the result of neurologic factors over which you have no direct control."

"This is the result of neurologic factors over which you have no direct control."

A high-school-age client, brought to the emergency department (ED) by friends after taking a "whole handful of dextroamphetamine," is now lapsing in and out of consciousness. The ED nurse should prioritize what assessment related to dextroamphetamine overdose? a) Cardiac monitoring b) Blood glucose monitoring c) Lung function testing d) Cognitive assessment

Cardiac monitoring

What is the central nervous system stimulant of choice to treat narcolepsy? a) Atomoxetine b) Caffeine c) Guarana d) Modafinil

Modafinil

The nurse anticipates the need for which substance to be administered to a client before, during, and after administration of a CNS stimulant to treat respiratory depression? a) Ipratropium b) Albuterol c) Salmeterol d) oxygen

Oxygen

The nursing student has learned that caffeine is a drug with many different effects on the body. The student realizes that caffeine can be found in many different foods including which? Select all that apply. a) Tea b) Chocolate c) Coffee d) Pasta e) Red meats

Tea Chocolate Coffee

A nurse is teaching the client about CNS medications and how they are addictive. What is the primary reason CNS medications are addictive? a) The medication stimulates the brain's visual centers, so the client sees everything more clearly. b) The medication decreases the amount of dopamine released into the body, causing feelings of euphoria. c) The medication stimulates the brain's sleep centers, so the client can sleep more soundly. d) The medication stimulates the brain's pleasure centers with enhanced neurotransmission of dopamine.

The medication stimulates the brain's pleasure centers with enhanced neurotransmission of dopamine.

The nurse is providing education to an adolescent client who has been prescribed an amphetamine for attention deficit hyperactivity disorder. How does the nurse explain the purpose of a "drug holiday?" a) To prevent hyperthyroidism b) To allow electrolyte imbalances to resolve c) To minimize weight loss d) To slow bone resorption

To minimize weight loss

A child was diagnosed with attention-deficit hyperactivity disorder and methylphenidate was prescribed for treatment to be taken once a day in a sustained release form. On future visits, what is a priority nursing assessment for this child?

Weight and height

A 10 year old boy is taking dextroamphetamine (Dexedrine) daily for ADHD. At each clinic visit, the nurse must assess the child. The priority assessment since he is on this medication would be which? a) height and weight b) body temperature c) vision d) blood pressure

height and weight

A child with attention-deficit hyperactivity disorder is prescribed atomoxetine. The nurse would assess the child closely for which adverse reaction? a) suicidal ideation b) hypertension c) hyperglycemia d) dyspnea

suicidal ideation

When counseling a client about attention deficit hyperactivity disorder (ADHD), the nurse would include the etiology of the disease. Select the statement that is not true about the etiology of ADHD. a) Research demonstrates that ADHD is highly heritable. b) ADHD is linked to dysfunction of the parietal and occipital lobes. c) ADHD is associated with dysfunction in the transport of dopamine. d) ADHD is associated with dysfunction in the transport of norepinephrine.

ADHD is linked to dysfunction of the parietal and occipital lobes.

The classification of central nervous system (CNS) stimulants frequently prescribed for exogenous obesity is: a) Anorexiants b) Amphetamines c) Analeptics d) Atropines

Amphetamines

A client with a history of drug and alcohol abuse has recently been diagnosed with attention deficit hyperactivity disorder (ADHD). The client requires treatment with medication. Which medication would the nurse anticipate to be prescribed for this client? a) Atomoxetine (Strattera) b) Dextroamphetamine (Dexedrine) c) Methylphenidate (Ritalin) d) Modafinil (Provigil)

Atomoxetine (Strattera)

A nursing instructor is conducting a class about drugs that affect the central nervous system (CNS). The instructor determines that the teaching was successful when the students identify which as a component of the CNS? Select all that apply. a) Afferent nerves b) Efferent nerves c) Spinal cord d) Autonomic nerves e) Brain

Brain Spinal Cord

An infant born at 31 weeks' gestation is admitted to the neonatal intensive care unit (NICU). The infant's heart rate is 70 bpm; oxygen saturation is between 80% to 85%. The infant is also having periodic apnea lasting longer than 20 seconds. Of the following, which would be part of the treatment plan for this infant? a) Dextroamphetamine (Dexedrine) b) Anorectics c) Atomoxetine (Strattera) d) Caffeine

Caffeine

A nurse is reviewing information about anorexiants. The nurse would expect to find that most of these drugs are classified as which pregnancy category? a) Category B b) Category X c) Category A d) Category C

Category X

A presurgical client has reported a history of illicit amphetamine use. The nurse is concerned because of the effect this type of abuse has on what physiological functions? Select all that apply a) sympathetic nervous system (SNS) b) respiratory system c) Central nervous system (CNS) d) gastrointestinal (GI) system e) parasympathetic nervous system (PSNS)

Central nervous system sympathetic nervous system

The Chold is diagnosed with attention deficit hyperactivity disorder (ADHD). Which medication will most likely be administered in conjunction with treatment? a) Selective serotonin reuptake inhibitors (SSRIs) b) monaomine oxidase inhibitors (MAOIs) c) ACE Inhibitors d) Central nervous system (CNS) stimulants

Central nervous system (CNS) stimulants

Prior to administering a CNS stimulant to reverse respiratory depression, which would the nurse need to ensure about the client? a) Normal blood pressure b) Respiration greater than 24 breaths per minute c) Patent airway d) Pulse less than 100 beats per minute

Patent airway

The nurse practitioner knows not to prescribe an anorexiant for weight loss to a client with: a) diabetes who takes insulin. b) a history of kidney stones. c) depression who takes an antidepressant. d) diverticulosis who takes a fiber supplement.

a patient with depression who takes an antidepressant

A 22-year-old client comes into the emergency department. He is highly active, and says his heart is pounding. On further questioning, he says he took several pills at a party. What type of medication does the nurse suspect he took at the party? a) amphetamine b) antidepressant c) anorexiant d) analeptic

amphetamine

A mother brings her child to the clinic and informs the health care provider that the child is having a difficult time paying attention in school, seems to be getting in trouble several times a day, and is acting very impulsively. The nurse can expect the provider to order which drugs for this child? a) armodafinil b) modafinil c) diethylpropion d) methylphenidate

methylphenidate

The client is admitted to the medical floor with a diagnosis of narcolepsy. The nurse can anticipate the health care provider to order which medication to treat this disorder? a) diethylpropion b) doxapram c) modafinil d) benzphetamine

modafinil

A client has recently been placed on modafinil 200 mg PO once daily. modafinil (Provigil) is first-line pharmacologic therapy for: a) attention deficit hyperactivity disorder (ADHD) b) schizophrenia c) anxiety d) narcolepsy

narcolepsy

A client is being prescribed dextroamphetamine for the treatment of attention deficit hyperactivity disorder (ADHD). During health education, the nurse should make the client aware of the black box warning relating to what potential risk issue? a) kidney failure b) Potential for abuse c) stroke with excessive doses d) unstable blood glucose levels

potential for abuse

A nurse is assessing a client who is suspected of having attention deficit hyperactivity disorder (ADHD). Which is a characteristic of ADHD? a) drowsiness b) spasticity c) impulsiveness d) hallucinations

impulsiveness

A client who has already started behavioral therapy for attention deficit hyperactivity disorder (ADHD) will also need pharmacologic therapy. The nurse anticipates that this client will be placed on which type of medication? a) Anorectic b) Barbiturate c) Opioid d) Analeptic

Analeptic

The nursing student learned in pharmacology class that drugs that affect the CNS do which of the following? (Check all that apply.) a) Alter sensation b) Decrease K+ c) Alter the interpretation of information in the brain d) Alter mood e) Lower glucose levels

Alter mood Alter sensation Alter the interpretation of information in the brain

A client has been treated with amphetamines for ADHD. At the age of 16 years, the client is diagnosed with hyperthyroidism. What intervention should be implemented with this client? a) Discontinue the high-calorie diet b) Discontinue the amphetamines c) Assess the client for pulmonary edema d) Administer a proton pump inhibitor

Discontinue the amphetamines

Atomoxetine has been selected as the primary pharmacologic treatment for a young adult client diagnosed with attention deficit hyperactivity disorder (ADHD). What characteristics make this a good drug of choice for this population of clients? Select all that apply. a) known to be safe to take during pregnancy b) a lower potential for abuse c) is administered orally d) presents with few significant adverse effects e) a low risk for dependency

Lower potential for abuse Low risk for dependency Administered orally

A client is prescribed an anorexiant at an outpatient visit. The nurse would caution the client about which condition? a) Impaired hearing related to tinnitus b) Masking of extreme fatigue c) Problems associated with frequent urination d) Possibility of extreme sweating

Masking of extreme fatigue

A nurse is providing care for a client who is receiving an analeptic drug for respiratory depression. Which interventions would be most appropriate? Select all that apply. a) Monitoring the pulse rate every half hour b) Monitoring the level of consciousness c) Obtaining specimens for arterial blood gas analysis at ordered intervals d) Recording a summary of the behavior pattern e) Observing the client for adverse drug reactions

Obtaining specimens for arterial blood gas analysis is ordered at intervals Observing the client for adverse drug reactions Monitoring the level of consciousness

A group of nursing students are reviewing information about CNS stimulants. The students demonstrate understanding of the information when they identify which drug as being used to treat obesity? a) Methylphenidate b) Modafinil c) Dexmethylphenidate d) Phentermine

Phentermine

A client with attention deficit hyperactivity disorder (ADHD) has not had an adequate response to behavioral therapy. All these medications would be acceptable except: a) Atomoxetine (Strattera) b) Methylphenidate (Ritalin). c) Phentermine (Ionamin). d) Amphetamine (Adderall).

Phentermine (lonamin)

A pediatric client has been admitted to the floor and started on Ritalin therapy for ADHD. The nurse knows that an important daily intervention for this client would be which? a) Suction the client daily. b) Weigh the client daily. c) Perform ROM exercises daily. d) Record a daily summary of client's behavior.

Record a daily summary of the client's behavior.

A nurse is providing care for a client diagnosed with attention deficit hyperactivity disorder (ADHD) who has been taking methylphenidate for several months. When monitoring for potential adverse effects, the nurse should include what assessments?

Sleep Patterns

The nurse has learned that there is a high incidence of suicidal ideation in children and adolescents when using which of the following drugs? a) Provigil b) Dopram c) Nuvigil d) Strattera

Strattera

The client is prescribed dextroamphetamine. The nurse is counseling the client prior to beginning this medication. Which information should the nurse include in the teaching? Select all that apply. a) Take this medication in the morning with breakfast. b) You may see an improvement within 24 to 48 hours. c) Take this medication first thing in the morning on an empty stomach. d) Take this medication with food at night. e) You may see an improvement in symptoms within 5 to 7 days.

Take this medication first thing in the morning with breakfast

The nurse is assessing an adolescent client diagnosed with attention deficit hyperactivity disorder (ADHD) for therapeutic effects of methylphenidate. The nurse should focus on improvement associated with what client functions? Select all that apply. a) behavior b) motor task performance c) cognitive task performance d) stamina e) endurance

behavior Motor task performance Cognitive task performance

a 49-year-old woman experienced postsurgical respiratory depression and was given caffeine to stimulate the respiratory system. The client is now irritable, excited, unable to sleep, has headache, and muscle twitching. The appropriate nursing diagnoses for the client would include which? Select all that apply. a) anxiety b) Nonadherence to therapeutic regimen c) imbalanced nutrition d) deficient fluid volume e) disturbed sleep pattern

disturbed sleep pattern anxiety

The nursing instructor is describing the effects of CNS stimulants and their potential for addiction due to their euphoric sensations. The instructor determines that the discussion was successful when the students identify which substances as being involved with this pleasurable feeling? a) dopamine b) serotonin c) norepinephrine d) epinephrine

dopamine

The nurse is working in post-op and the client has just come out of surgery. The nurse notes that the clients respiratory rate is 4 breaths per minute. The nurse has a standing order to give doxapram 0.5 mg/kg IV for respiratory depression. What should the nurse do next? a) draw up medication, have it checked by a second provider, have suction close by, and give the medication b) Give Narcan instead of doxapram because the client received a large dose of fentanyl while in surgery, causing his respiratory depression. c) continually shake the client and talk loudly to him to wake him up d) Draw up the medication and give it to the client without getting it double checked (since its an emergency)

draw up medication, have it checked by second provider, have suction close by, and give the medication

A nurse is providing care for a client diagnosed with attention deficit hyperactivity disorder (ADHD) who has been taking methylphenidate for several months. When monitoring for potential adverse effects, the nurse should include what assessments? a) sexual function b) pupillary response c) sleep patterns d) orientation to person, place, and time

sleep patterns

The nurse instructs a client with a history of heart palpitations not to take oral caffeine. The client asks the nurse why, and the nurse explains that nonprescription caffeine should be avoided in clients with what history? (Check all that apply.) a) diabetes b) stomach ulcers c) gout d) high blood pressure e) heart disease

stomach ulcers Heart disease High Blood pressure