Test 4 Pharm: Drugs Acting On Central, Peripheral, and Autonomic Nervous System

A nurse is teaching a client who has tobacco use disorder about nicotine replacement therapy. Which of the following statements by the client indicates an understanding of the teaching? A) "I should avoid eating right before I chew a piece of nicotine gum." B) " I will stop using the nicotine gum after 1 year. C) "I know that nicotine gum is a safe alternative to smoking if I become pregnant" D) "I must chew the nicotine gum quickly for about 15 minutes"

A) "I should avoid eating right before I chew a piece of nicotine gum." Feedback: The client should avoid eating or drinking 15 min prior to and while chewing the nicotine gum.

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? A) "It can take several weeks before you feel like the medication is helping" B) "Take the medication just before bedtime to promote sleep" C) "You should take the medication when needed for obsessive urges" D) "Monitor for weight gain while taking the medication"

A) "It can take several weeks before you feel like the medication is helping" Feedback: Paroxetine can take 1 to 4 weeks before the client reaches full therapeutic benefits.

A nurse is providing instructions to a client who has a new prescription for zolpidem. Which of the following instructions should the nurse include? A) "Notify the provider if you plan to become pregnant" B) " Take the medication 1 hr before you plan to go to sleep" C) "Allow at least 6 hr for sleep when taking zolpidem" D) "To increase the effectiveness of zolpidem take it with a bedtime snack"

A) "Notify the provider if you plan to become pregnant" Feedback: Zolpidem is a Preg. Risk Category C. The client should notify the provider if they plan to become pregnant.

A nurse is teaching a client about interferon beta-1a. Which of the following instructions should the nurse give to help the client avoid the adverse effects of this drug? A) "Premedicate with acetaminophen" B) "Take the drug with food" C) "Increase your fluid intake" D) "Take the drug in the morning"

A) "Premedicate with acetaminophen" Feedback: Interferon beta drugs can cause fever, chills, headaches, and muscle aches. Acetaminophen can help minimize these symptoms.

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? A) "Take a missed dose as soon as you remember" B) "Take the drug as needed at the first sign of anxious feelings" C) "Take the drug in the morning with a glass of grapefruit juice" D) "Drink a cup of chamomile tea at night with the drug"

A) "Take a missed dose as soon as you remember"

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

A) "You can have a decreased desire for intimacy while taking this medication. Feedback: Decreased libido is a potential adverse effect of fluoxetine and other SSRIs.

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? A) Anxiety B) Ringing in the ear C) Increased appetite D) Muscle spasms

A) Anxiety

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

A) Asthma Feedback: Timolol, a beta-adrenergic antagonist, can cause bronchospasm and difficulty breathing.

A nurse is teaching a client who has a prescription for baclofen. Which of the following instructions should the nurse include? A) Avoid driving until the drug's effects are evident B) Stop taking the drug immediately if headache occurs C) Take the drug as needed for spasticity D) Take the drug with antacids to reduce gastric effects.

A) Avoid driving until the drug's effects are evident. Feedback: Abrupt withdrawal of baclofen, a centrally-acting muscle relaxant, can cause seizures, fever, and hypotension. A better alternative is to treat headache, which can have many other causes, and see if it resolves as drug therapy with baclofen continues.

A nurse is teaching a client who has a prescription for carbamazepine. Which of the following instructions should the nurse include to help the client avoid adverse effects of this drug? A) Begin taking the drug at a low dosage B) Discontinue the drug immediately if diarrhea occurs. C) Have serum glucose levels checked regularly. D) Take the drug on an empty stomach

A) Begin taking the drug at a low dosage. Feedback: Visual disturbances, vertigo, and ataxia can result from taking carbamazepine, a drug that tx seizure disorders. Dosages should be low to minimize or prevent these adverse effects.

A nurse is teaching a client who is taking levadopa/carbidopa to treat Parkinson's disease. Which of the following instructions should the nurse include? A) Change position slowly to prevent orthostatic hypotension B) Eat high-protein snack to increase absorption C) Take the drug at bedtime to avoid daytime drowsiness D) Except eye twitching to develop with long-term therapy.

A) Change positions slowly to prevent orthostatic hypotension. Feedback: Levodopa/carbidopa can cause orthostatic hypotension

A nurse is teaching a client who is about to begin sumatriptan therapy to treat migraine headaches. The nurse should instruct the client to monitor for which of the following adverse effects? A) Chest pain B) Polyuria C) Joint pain D) Insomnia

A) Chest pain

A nurse is reviewing the drug hx 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? A) Furosemide for hypertension B) Acetaminophen for headaches C) Ciprofloxacin for a urinary tract infection D) Montelukast for asthma

A) Furosemide for hypertension

A nurse is caring for a client who has a prescription for fluoxetine and who reports self-administering St. John's wort daily for the past 2 weeks. Which of the following findings should the nurse report to the provider as an indication of serotonin syndrome? A) Hallucinations B) Decreased temp. C) Hypersexual behavior D) Constipation

A) Hallucinations

A nurse providing information to a client who has early Parkinson's disease and a new prescription for pramipexole. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? A) Hallucinations B) Increased salivation C) Diarrhea D) Discoloration of urine

A) Hallunications. Feedback: Pramipexole can cause hallucinations within 9 months of the initial dose and might require discontinuation.

A nurse in the post‑anesthesia recovery unit is caring for a client who received a nondepolarizing neuromuscular blocking agent and has muscle weakness. The nurse should anticipate a prescription for which of the following medications? A. Neostigmine B. Naloxone C. Dantrolene D. Vecuronium

A) Neostigmine Feedback: Neostigmine is a cholinsertase inhibitors used to reverse the effects of non-depolarizing neuromuscular blockers.

A nurse 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? A) Orthostatic hypotension B) Hearing loss C) GI bleeding D) Weight loss

A) Orthostatic hypotension Feedback: Orthostatic hypotension is an adverse effect of MAIOs, including phenelzine.

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

A) Perform immediate gastric lavage Feedback: Gastric lavage is appropriate for a client who has severe toxicity, as evidenced by a plasma lithium level of 2.1 mEq/L. This action will lower the clients lithium level.

A nurse is reviewing the medical hx of a client who has a new prescription for reduced dosage of alprazolam for anxiety. Which of the following findings should indicate to the nurse the reason for the prescription modifications? A) Renal function impairment B) Cataracts C) Recent weight loss D) Smoking

A) Renal function impairment

A nurse is teaching a client who has a prescription for modafinil to treat narcolepsy. Which of the following instructions should the nurse include? A) Take the drug in the morning B) Take the drug 30 min before bedtime. C) Anticipate daytime drowsiness D) Expect urinary frequency

A) Take the drug in the morning Feedback: Modafinil is a non-amphetamine stimulant. Taking it in the morning improve wakefulness for clients who has narcolepsy. Clients taking the drug for shift-work sleepiness should take it 1 hr before work.

A nurse is teaching an adolescent client who has a new prescription for clomipramine for OCD. Which of the following instructions should the nurse include to minimize the adverse effect of his medication? A) Wear sunglasses when outdoors B) Check your temperature daily C) Take this medication in the morning D) Add extra calories to your diet

A) Wear sunglasses when outdoors Feedback: Wearing sunglasses when outdoors will decrease photophobia, an anticholinergic effect associated with TCA use.

A nurse is caring for a client who has been taking amphetamine/dextroamphetamine sulfate for the tx of ADHD for 2 weeks. The nurse should report which of the following findings to the provider? A) Weight loss of 2.3 kg (5lbs) B) BP 110/70 mmHg C) Apical pulse 80/min D) Respirtaory rate 16/min

A) Weight loss of 2.3 kg (5lb) Feedback: Amphetamine/dextroamphetamine sulfate can cause a decreased appetite and weight loss.

A charge nurse is planning a staff education session to discuss medications used during the care of a client experiencing alcohol withdrawal. Which of the following meds should the charge nurse include in the discussion? (Select all that apply) A) Lorazepam B) Diazepam C) Disulfiram D) Naltrexone E) Acamprosate

A, B

A nurse is caring for a client who has depression and a new prescription for venlafaxine. The nurse should monitor the client for which of the following manifestations as an adverse effect of this medication? A) Mydriasis B) Dizziness C) Decreased libido D) Alopecia E) Hypotension

A, B, C

A nurse is caring for a client who has a prescription for alprazolam. For which of the following adverse effects should the nurse monitor? (Select all that apply) A) Tolerance B) Anxiety C) Sedation D) Respiratory depression E) Constipation

A, B, C, D

A nurse in the post-anesthesia care unit is caring for a client who is experiencing malignant hyperthermia. Which of the following actions should the nurse take? (Select all that apply) A) Place a cooling blanket on the client B) Administer oxygen at 100% C) Administer iced 0.9% NaCl D) Administer KCl IV E) Monitor core body temp

A, B, C, E

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

A, B, D

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? (Select all that apply) A) Tremors B) Confusion C) Bronchospasm D) Nausea E) Muscle weakness

A, B, D, E

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? (Select all that apply) A) Change positions slowly from sitting or lying to standing B) Do not stop taking the drug abruptly C) Wear sunscreen and protective clothing D) Take the drug at bedtime to prevent daytime drowsiness E) Increase fiber and fluid intake.

A, B, D, E

A nurse is reviewing a new prescription for oxcarbazepine with a client who has partial seizures. Which of the following instructions should the nurse include? (Select all that apply) A) "Use caution if given a prescription for a diuretic med" B) "Consider using an alternate form of contraception if you are using oral contraceptives" C) "Chew gum to increase saliva production" D) "Avoid driving until you see how the medication affects you" E) "Notify your provider if you develop a skin rash"

A, B, D, E

A nurse is caring for a client who has a prescription for valproic acid. The nurse should instruct the client to have which of the following blood laboratory tests completed periodically? (Select all that apply) A) Thrombocyte count B) Glucose C) Amylase D) Liver function tests E) Potassium

A, C, D

A nurse is caring for a client who takes paroxetine to treat post-traumatic stress disorder and reports that they grind their teeth during the night. The nurse should identify which of the following interventions to manage bruxism? (Select all that apply) A) Concurrent admin. of buspirone. B) Admin. of a different SSRI C) Use of mouthguard. D) Changing to a different class of antidepressant medication. E) Increasing the dose of paroxetine.

A, C, D

A nurse is teaching the guardians and their school-age child about a new prescription for lisdexamfetamine. Which of the following information should the nurse include in the teaching? (Select all that apply) A) An adverse effect of this medication is CNS stimulation. B) Administer the medication before bedtime C) Monitor blood pressure while taking this medication. D) The therapeutic effects of this medication will take 1 to 3 weeks to fully develop. E) This medication raises the levels of dopamine in the brain

A, C, E

A nurse is providing instructions to a client who has been experiencing insomnia and has a new prescription for temazepam. The nurse should inform the client that which of the following manifestations are adverse effects of temazepam? (Select all that apply) A) Incoordination B) Hypertension C) Pruritus D) Sleep driving E) Amnesia

A, D, E

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

B) "If you have persistent headache, let the provider know" Feedback: The client should report persistent headaches, anxiety, or insomnia to the provider as an adverse drug reaction.

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

B) "Notify the provider if you have trouble sleeping" Feedback: The client should report difficulty sleeping, agitation or irritability to the provider so this can be managed.

A nurse is caring for a client who has schizoaffective disorder and who has been prescribed chlorpromazine. Which of the following lab values should the nurse monitor during and immediately after IV admin. of the drug? A) Cardiac output B) BP C) Urine specific gravity D) O2 Sat

B) BP

A client presents at the clinic with symptoms of hyperexcitability and agitation. Which medication would the nurse expect the physician to prescribe? A) Hypnotic B) Benzo C) Barbiturate D) Other anxiolytic and hypnotic drug

B) Benzo Feedback: Hyperexcitability and agitation are indications for the use of benzos.

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

B) Chew sugarless gum to moisten the mouth. Feedback: Chewing sugarless gum can help the client cope with dry mouth, a potential anticholinergic effect of fluphenazine.

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

B) Coarse tremors Feedback: Coarse tremors are an indication of toxicity.

A nurse is caring for a client who has a new prescription for pramipexole to treay Parkinson's disease. The nurse should recognize that which of the following lab tests require monitoring? A) C-reactive protein B) Creatinine clearance C) Thyroid function D) CBC

B) Creatinine clearance Feedback: Pramipexole, a direct-acting dopamine receptor agonist, should be used with caution for clients who has renal disease.

A nurse is teaching a client who has a new prescription for clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects?. A) Diarrhea B) Dry mouth C) Insomnia D) Hypertension

B) Dry mouth Feedback: Dry mouth can be an adverse effect associated with clonidine use.

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 developing serotonin syndrome? A) Brusing B) Fever C) Tinnitus D) Rash

B) Fever Feedback: Fever is a manifestation of serotonin syndrome, which can result from taking an SSRI such as sertraline.

A nurse is teaching a client who has a new prescription for ramelteon. The nurse should instruct the client to avoid which of the following foods at the time of medication admin.? A) Baked potato B) Fried chicken C) Whole-grain bread D) Citrus fruit

B) Fried chicken Feedback: High-fat foods prolong the absorption of ramelteon. The client should not eat high-fat foods with or just before taking ramelteon.

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

B) Hypertensive crisis

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

B) Identify the client's level of orientation Feedback: The first action to take when using the nursing process is to assess the client. Identifying the client's level of orientation is the priority action.

A nurse is teaching the caregiver of a school-age child about transdermal methylphenidate. Which of the following instruction should the nurse include? A) Apply one patch twice per day. B) Leave the patch on for 9 hrs. C) Apply the patch to the child's waist. D) Use opened tray within 6 months.

B) Leave the patch on for 9 hrs Feedback: Transdermal methylphenidate is admin. for 9 hr/day.

A nurse is caring for a school-age child who has a new prescription for atomoxetine. The nurse should monitor the client for which of the following manifestations as an adverse effect of these medications? A) Kidney toxicity B) Liver damage C) Seizure activity D) Adrenal insufficiency

B) Liver damage Feedback: Liver damage is an adverse effect of atomoxetine. Monitor for manifestations.

A nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle spasm. The nurse should identify that which of the following lab tests requires monitoring? A) Serum potassium B) Liver function C) Serum sodium D) Thyroid function

B) Liver function Feedback: Liver toxicity is a serious adverse effect of dantrolene.

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

B) Neck spasms Feedback: Neck spasms are an indication of acute dystonia. The greatest risk to this client is respiratory insufficiency if the laryngeal muscles are also affected.

A nurse is reviewing the medical record of a client who has a newly diagnosed seizure disorder and a new prescription for valproic acid and phenytoin. The nurse should identify that which of the following can occur as a result of an interaction between these drugs? A) Hyperammonemia B) Phenytoin toxicity C) Hypertension D) Peptic ulcer disease

B) Phenytoin toxicity Feedback: Valproic acid can cause increase in phenytoin blood levels, resulting in phenytoin toxicity. The nurse should monitor serum phenytoin levels and notify the provider if levels begin to exceed the therapeutic range.

A nurse is preparing to administer sumatriptan to a client for the first time. The nurse should instruct the client that sumatriptan is indicated for which of the following conditions? A) Tonic-clonic seizures B) Presence of a migraine headache C) Exacerbation of multiple sclerosis D) Alzheimer's disease

B) Presence of a migraine headache. Feedback: Sumatriptan is used in the tx of migraine headaches.

A nurse is caring for client who is receiving methohexital sodium. The nurse should monitor the client for which of the following adverse effects? A) Cardiac excitability B) Respiratory depression C) Hyperthermia D) Hypertension

B) Respiratory depression Feedback: Methohexital, a short acting barbiturate, cause respiratory depression. Mechanical ventilation and continuous monitoring are essential for clients receiving the drug.

A nurse is teaching the guardians of a child who has a new prescription for desipramine. The nurse should include that which of the following adverse effects is the priority to report to the provider? A) Constipation B) Suicidal thoughts C) Photophobia D) Dry mouth

B) Suicidal thoughts

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

B) Wear sunscreen when exposed to sunlight

You are admitting a new patient to the clinic. A review of home medications indicates the patient is taking a barbiturate to help him sleep. The patient tells you that he is having problems with both his visual and auditory senses. The patient wants to know what's wrong. What would be the best response? A) We will have to wait and see what the doctor says. B) What you are describing could be adverse effects from the sleep medicine you are taking C) There is nothing wrong. You are just getting older. D) Sometimes these things happen with our patients. We need to do a complete assessment before we know for sure.

B) What you are describing could be adverse effects from the sleep medicine you are taking Feedback: Nursing diagnosis related to drug therapy might include: Disturbed thought processes and disturbed sensory perception, related to CNS effects.

A nurse is teaching a client who has a new prescription for baclofen to treat muscle spasms. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply) A) "I will stop taking this medication right away if I develop dizziness" B) "I know the doctor will gradually increase my dose of this medication for a while." C) "I should increase fiber to prevent constipation from the medication." D) "I wont be able to drink alcohol while i'm taking this medication" E) "I should take this medication on an empty stomach each morning"

B, C, D

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

B, C, D, E

A nurse is teaching a client who has a new prescription for valproic acid to treat seizure disorder. The nurse should instruct the client to monitor for which of the following adverse effects? Select all that apply. A) Hirsutism B) Drowsiness C) Headache D) Ataxia E) Rash

B, C, E

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? (Select all that apply) A) Motion sickness B) Seasonal affective disorder C) Insomnia D) Nicotine addiction E) Depression

B, D, E

A nurse is preparing to administer a medication to a client who has absence seizures. The nurse should expect to administer which of the following medications to the client? (Select all that apply) A) Pheytoin B) Ethosuximide C) Gabapentin D) Carbamazepine E) Valproic acid F) Lamotrigine

B, E, F

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

C) "I need to discontinue the medication slowly" Feedback: When discontinuing escitalopram, the client should taper the medication slowly according to prescribed tapered dosing schedule to reduce the risk of withdrawal symptoms.

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

C) Allow 2 to 4 weeks for full therapeutic effects

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 instructions should the nurse include? A) Consume a low sodium diet. B) Reduce fluid intake. C) Avoid taking NSAIDs D) Take the drug with food.

C) Avoid taking NSAIDs

A nurse is preparing to administer memantine to a client who has Alzheimer's disease. Which of the following findings in the clients medical hx indicates a need to withhold the drug and notify the provider? A) Pancreatic cancer B) Hypotension C) Cirrhosis D) Osteoporosis

C) Cirrhosis Feedback: Memantine should be used cautiously in clients who have severe hepatic impairment.

A nurse in the operating room is caring for a client who received a dose of succinylcholine. During the operation, the client suddenly develops rigidity and a rise in body temperature. The nurse should expect a prescription for which of the following medications? A) Neostigmine B) Naloxone C) Dantrolene D) Vecuronium

C) Dantrolene Feedback: Muscle rigidity and a sudden rise in temperature is a manifestation of malignant hyperthermia. Dantrolene acts on skeletal muscles to reduce metabolic.

A nurse is providing teaching for a client who is withdrawing from alcohol who has a new prescription for propranolol. Which of the following information should the nurse include in the teaching? A) Increases the risk of seizure activity B) Provides a form of aversion therapy C) Decreases cravings D) Can increase blood pressure

C) Decreases cravings Feedback: Propranolol is an adjunct med used during withdrawal to decrease the clients craving for alcohol.

A nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle spasms. The nurse should instruct the client to report which of following adverse effects? A) Slow heart rate B) Cough C) Diarrhea D) Hearing loss

C) Diarrhea Feedback: Prolonged diarrhea can cause dehydration and other serious effects. Diarrhea, nausea, and vomiting are adverse effects of dantrolene.

A nurse is assessing a client who has a prescription for bethanechol to treat urinary retention. The nurse should identify which of the following findings is a manifestation of muscarinic stimulation? A) Dry mouth B) Hypertension C) Excessive perspiration D) Fecal impaction

C) Excessive perspiration Feedback: Bethanechol is a muscarinic agonist. Muscarinic stimulation can result in sweating.

A nurse is caring for a client who is receiving moderate sedation with diazepam IV. The client is over-sedated. Which of the following medications should the nurse expect to administer to this client? A) Ketamine B) Naltrexone C) Flumazenil D) Fluvoxamine

C) Flumazenil Feedback: Flumazenil is a competitive benzo antagonist used to reverse sedation and other effects of benzo.

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? A) Venlafaxine B) Bupropion C) Imipramine D) Valproic acid

C) Imipramine

A nurse is providing teaching for a client who has a new prescription for valproic acid to treat seizure disorder. The nurse should instruct the client to monitor for which of the following adverse effects? A) Hirsutism B) Depresion C) Jaundice D) Gum irritation

C) Jaundice Feedback: Valproic acid can cause hepatic toxicity, characterized by jaundice, abd. pain, and nausea.

A nurse is administering fentanyl to a client to reduce pain. Which of the following drugs should the nurse have available to reverse the effects of fentanyl? A) Neostigmine B) Succinylcholine C) Naloxene D) Dantrolene

C) Naloxene

A nurse is caring for a client who is taking donepezil to treat Alzheimer's disease. For which of the following adverse effects should the nurse monitor? A) Confusion B) Dry mouth C) Nausea D) Double vision

C) Nausea Feedback: The most common adverse effects of donepezil, a cholinesterase inhibitor, are nausea, vomiting, and diarrhea. Take with food to minimize adverse effects.

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

C) Phenelzine Feedback: Clients should not take venlafaxine, within 14 days of taking phenelzine, other MAOIs, or serotonergic drugs.

A nurse is caring for a client who has a new prescription for amphetamine sulfate. The nurse should monitor the client for which of the following adverse effects? A) Hypotension B) Tinnitus C) Tachycardia D) Bronchospasm

C) Tachycardia Feedback: Amphetamine sulfate is an amphetamine stimulant. It can cause tachycardia and dysrhythmias.

A nurse is teaching a client who has a new prescription for levodopa /carbidopa for Parkinson's disease. Which of the following instructions should the nurse include? A) Increase the intake of protein-rich foods. B) Expect muscle twitching to occur C) Take this medication with food D) Anticipate relief of manifestations in 24 hr.

C) Take this medication with food. Feedback: The client should take this medication with food to reduce GI effects.

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? A) Chest x-ray B) Tonometry C) Thyroid function tests D) ERCP

C) Thyroid function tests Feedback: Hypothyroidism is an adverse effect of lithium carbonate.

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

C, E

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? A) "Take this medication on an empty stomach" B) "Expect optimal therapeutic effects within 24 hours" C) "Take this medication when needed for anxiety" D) "This medication has a low risk for dependency"

D) "This medication has a low risk for dependency" Feedback: Buspirone has a low risk for physcial or psychological dependence or tolerance.

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? A) "You should have a high-carbohydrate snack between meals and at bedtime" B) "You are likely to develop hand tremors if you take this medication for a long period of time" C) "You may experience temporary numbness of your mouth after each dose" D) "You should have your white blood cell count monitored every week"

D) "You should have your white blood cell count monitored every week" Feedback: Due to the risk for fatal agranulocytosis, weekly monitoring while taking clozapine.

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

D) Acute dystonia

A nurse is teaching a client who received a prescription for interferon beta-1a for the treatment of multiple sclerosis. Which of the following information should the nurse include? A) "Have kidney function tests done every month for a year" B) "Take an extra dose if muscle aches occur" C) "Store the drug at room temperature after mixing it." D) "Administer the drug in your thigh or upper arm"

D) Administer the drug in your thigh or upper arm. Feedback: Interferon beta-1a is administered via the subQ route.

A nurse is teaching a client who has Alzheimer's disease and their caregiver about memantine. Which of the following instructions should the nurse include? A) Increase fluid intake to improve renal excretion. B) Report memory loss or confusion C) Watch for signs of liver impairment, such as jaundice and abdominal pain. D) Avoid taking over-the-counter antacids.

D) Avoid taking over-the-counter antacids. Feedback: Antacids that contain sodium bicarbonate increase urinary alkalinity and can decrease drug excretion, ultimately leading to toxicity.

A nurse is teaching the family of a client who has a new diagnosis of Alzheimer's disease about donepezil. Which of the following information should the nurse include? A) Monitor for constipation. B) The dosage will increased weekly to provide optimum therapeutic effect. C) Administering the drug first thing in the morning promotes effectiveness. D) Avoid the use of NSAIDSs for pain

D) Avoid the use of NSAIDs for pain. Feedback: Combining NSAIDs with donepezil can cause GI bleeding.

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? A) Constricted pupils B) Discoloration of the iris C) Hypertension D) Bradycardia

D) Bradycardia Feedback: Betaxolol and timolol can cause bradycardia because of the blockade of cardiac beta 1 receptors. Clients should check their pulse rate regularly and report any sustained decreases.

A nurse is caring for a client who is taking interferon beta-1b. The nurse should identify that which of the following findings indicates a potential serious adverse effect of this drug? A) Tinnitus B) Twitching eyelids C) Blue-green skin discoloration D) Fatigue

D) Fatigue Feedback: The nurse should identify that potential serious adverse effects of interferon beta-1b include unexplained bruising, bleeding, and fatigue.

A nurse is teaching a client who has a new diagnosis of Parkinson's disease about how levadopa/carbidopa can help control symptoms. The nurse should identify that the drug has which of the following pharmacologic effects? A) Increases available acetylcholine in the brain. B) Inhibits norepinephrine metabolism in the brain C) Inhibits serotonin metabolism in the brain D) Increases available dopamine in the brain.

D) Increases available dopamine in the brain. Feedback: Levodopa/carbidopa, a dopaminergic agent, can increase dopamine in the extrapyramidal center of the brain, reducing involuntary motion, or tremors, assoicated with Parkinson's disease.

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

D) Limit aerobic activity in hot weather Feedback: The client should avoid activities that have the potential to cause sodium/water depletion, which can increase the risk for toxicity.

A nurse is caring for a client who has been taking selegiline to treat Parkinson's disease. The provider is considering the use of analgesics for the client but should be aware that a drug interaction between selegiline and meperidine can result in which of the following? A) Frequent urination B) Jaundice C) Cellulitis D) Muscle rigidity

D) Muscle rigidity Feedback: A drug interaction between selegiline and opioids, especially meperidine, can result in rigidity, stupor, agitation, hypertension, and fever.

A nurse in an acute mental health facility is caring for a client who is experiencing withdrawal from opioid use and has a new prescription for clonidine. Which of the following actions should the nurse identify as the priority? A) Administer the clonidine on the prescribed schedule. B) Provide ice chips at the client's bedside C) Educate the client on the effects of clonidine. D) Obtain baseline vital signs

D) Obtain baseline vital signs Feedback: Assessment is the initial step of the nursing process. Obtaining the client's baseline vital signs is the priority nursing action.

A nurse is caring for a client who is to undergo a surgical procedure. Which of the following preexisting conditions can be a contraindication for the use of ketamine as an intravenous anesthetic? A) Peptic ulcer disease B) Breast cancer C) Diabetes mellitus D) Schizophrenia

D) Schizophrenia Feedback: Ketamine can produce psychological effects. Therefore, schizophrenia can be a contraindication for the use of ketamines.

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? A) Ischemic stroke B) Drowsiness C) Respiratory depression D) Seizure activity

D) Seizure activity Feedback: Bupropion, can cause seizure activity when clients take high doses or have a seizure disorder, a CNS tumor, or a hx of head trauma.

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? A) Anterograde amnesia B) Respiratory depression C) Paradoxical reaction D) Withdrawal symptoms

D) Withdrawal symptoms

A nurse is reviewing the medical record of a client who reports urinary incontinence and asks about a prescription for oxybutynin. The nurse should recognize that oxybutynin is contraindicated in the presence of which of the following conditions? A) Bursitis B) Sinusitis C) Depression D) Glaucoma

D. Glaucoma Feedback: Oxybutynin is an anticholinergic and can increase intraocular pressure. It is contraindicated for clients who have glaucoma.

T/F: Peak levels of barbiturates occur in 60 to 90 minutes.

False Feedback: The barbiturates are absorbed well, reaching peak levels in 20 to 60 minutes.