The Neurological System (Part 1)

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

Drowsiness, headache, rash Hirsutism is incorrect. Valproic acid is more likely to cause hair loss rather than hirsutism, or excessive hair growth. Drowsiness is correct. Clients taking valproic acid should report CNS depressant effects, such as sedation or drowsiness, because these adverse effects can indicate the need for a reduction in dose.Headache is correct. Valproic acid can cause headache, along with other CNS adverse effects, such as sleep disturbances.Ataxia is incorrect. Ataxia is an adverse effect of phenytoin and carbamazepine, which are drugs used to treat seizure disorders.Rash is correct. Skin rash is an adverse effect of valproic acid and other antiepileptic drugs.

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

Fatigue The nurse should identify that potential serious adverse effects of interferon beta-1b include unexplained bruising, bleeding, and fatigue. Clients should report these adverse effects to their provider immediately because they can indicate bone marrow suppression and decreased platelet count.

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

Tachycardia Amphetamine sulfate is an amphetamine stimulant. It can cause tachycardia and dysrhythmias. The client should notify the nurse if they develop palpitations or chest pain.

A nurse is caring for a client who has been taking amphetamine/dextroamphetamine sulfate for the treatment of attention deficit hyperactivity disorder (ADHD) for 2 weeks. The nurse should report which of the following findings to the provider? - Weight loss of 2.3 kg (5 lb) - BP 110/70 mm Hg - Apical pulse 80/min - Respiratory rate 16/min

Weight loss of 2.3 kg (5 lb) Amphetamine/dextroamphetamine sulfate can cause a decreased appetite and weight loss. The nurse should instruct the client to weigh themself twice weekly and report unintended weight loss.

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

Jaundice Valproic acid can cause hepatic toxicity, characterized by jaundice, abdominal pain, and nausea. Clients taking the drug should report these manifestations, and the nurse should monitor liver function studies prior to treatment and periodically during therapy.

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? - "Have kidney function tests done every month for a year." - "Take an extra dose if muscle aches occur." - "Store the drug at room temperature after mixing it." - "Administer the drug in your thigh or upper arm."

"Administer the drug in your thigh or upper arm." Interferon beta-1a is administered via the subcutaneous route. Therefore, the nurse should instruct the client how to perform subcutaneous injections for self-administration.

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? - "Premedicate with acetaminophen." - "Take the drug with food." - "Increase your fluid intake." - "Take the drug in the morning."

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

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? - Monitor for constipation. - The dosage will be increased weekly to provide optimum therapeutic effect. - Administering the drug first thing in the morning promotes effectiveness. - Avoid the use of NSAIDs for pain.

Avoid the use of NSAIDS for pain. Combining NSAIDs with donepezil can cause gastrointestinal bleeding. Therefore, the nurse should instruct the client's family to avoid the use of NSAIDs.

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

Avoid driving until the drug's effects are evident. Baclofen, a centrally-acting muscle relaxant, causes CNS depression. Clients taking the drug should avoid alcohol and other CNS depressants, and should not drive a vehicle until they know how the drug will affect them.

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? - Increase fluid intake to improve renal excretion. - Report memory loss or confusion. - Watch for signs of liver impairment, such as jaundice and abdominal pain. - Avoid taking over-the-counter antacids.

Avoid taking OTC antacids. Antacids that contain sodium bicarbonate increase urine alkalinity and can decrease drug excretion, ultimately leading to toxicity.

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? - Begin taking the drug at a low dosage. - Discontinue the drug immediately if diarrhea occurs. - Have serum glucose levels checked regularly. - Take the drug on an empty stomach.

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

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

Change position slowly to prevent orthostatic hypotension 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? - Chest pain - Polyuria - Joint pain - Insomnia

Chest pain Sumatriptan, a serotonin agonist, can cause coronary vasospasm and chest pain. Clients should report any pressure, pain, or tightness in the jaw, chest, or back. Sumatriptan is not an appropriate choice for clients who have a history of coronary artery disease.

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

Cirrhosis Memantine should be used cautiously in clients who have severe hepatic impairment. The nurse should contact the provider about the client's history of cirrhosis to see if laboratory testing is required before starting the drug or if the dosage needs to be adjusted.

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

Creatinine clearance Pramipexole, a direct-acting dopamine receptor agonist, should be used with caution for clients who have renal disease. Therefore, the nurse should monitor the client's renal function.

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 the following adverse effects? - Slow heart rate - Cough - Diarrhea - Hearing loss

Diarrhea Prolonged diarrhea can cause dehydration and other serious effects. Diarrhea, nausea, and vomiting are adverse effects of dantrolene. The client should report these effects so the nurse can monitor fluid balance and intervene accordingly.

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

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

A nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle spasms. The nurse should identify that which of the following laboratory tests requires monitoring? - Serum potassium - Liver function - Serum sodium - Thyroid function

Liver function Liver toxicity is a serious adverse effect of dantrolene. The nurse should monitor the client's liver function prior to treatment and at regular intervals and advise the client to report jaundice or abdominal pain.

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? - Frequent urination - Jaundice - Cellulitis - Muscle rigidity

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

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? - Neostigmine - Succinylcholine - Naloxone - Dantrolene

Naloxone (Narcan) Naloxone is an opioid antagonist that reverses the effects of opioids. Fentanyl, an opioid agonist, can cause severe respiratory depression. The nurse should also have resuscitation equipment available when administering fentanyl to a client.

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? - Confusion - Dry mouth - Nausea - Double vision

Nausea The most common adverse effects of donepezil, a cholinesterase inhibitor, are nausea, vomiting, and diarrhea. Taking donepezil with food can help minimize adverse effects.

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? - Hyperammonemia - Phenytoin toxicity - Hypertension - Peptic ulcer disease

Phenytoin toxicity Valproic acid can cause an 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? - Tonic-clonic seizures - Presence of a migraine headache - Exacerbation of multiple sclerosis - Alzheimer's disease

Presence of a migraine headache Sumatriptan is used in the treatment of migraine headaches.

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

Respiratory depression Methohexital, a short-acting barbiturate, causes respiratory depression. Mechanical ventilation and continuous monitoring are essential for clients receiving the drug.

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

Take the drug in the morning. Modafinil is a nonamphetamine stimulant. Taking it in the morning helps improve wakefulness for clients who have narcolepsy. Clients taking the drug for shift-work sleepiness should take it 1 hr before work.