ATI questions over cognition unit

What administration considerations apply to carbamazepine?

-Administer with meals to reduce GI symptoms -The sustained release form should be swallowed whole, while chewable tablets should be chewed or crushed and taken with liquids. -Oral suspension shouldn't be mixed with other oral drug suspensions.

A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. The client has a mask like facial expression and is experiencing involuntary movement and tremors. Which of the following medication should the nurse anticipate administering? A.) Amantadine B.) Bupropion C.) Phenelzine D.) Hydroxyzine

A. Amantadine is an antiparkinsonian medication used to treat the extrapyramidal manifestations that can occur with chlorpromazine therapy.

A nurse is planning care for a client who has a seizure disorder and a new prescription for valproic acid. Which of the following lab values should the nurse plan to monitor? select all that apply (SATA) A) BUN B) PTT C) Aspartate aminotransferase (AST) D) urinalysis E) Alanine aminotransferase (ALT)

B, C, E

A home health nurse is visiting an older adult client who has Alzheimer's disease. His caregiver tells the nurse she has been administering prescribed lorazepam, 1 mg 3x per day, to the client for restlessness and anxiety over the past few days. For which of the following adverse effects should the nurse assess the client? A.) low grade fever B.) sedation C.) diuresis D.) tonic-clonic seizures

B.

A nurse is reviewing the medical record for a client who has a migraine and a prescription for sumatriptan. Which of the following factors in the client's medical history should the nurse ID as a contraindication to receiving sumatriptan? A.) renal impairment B.) ischemic heart disease C.) severe osteoporosis D.) cirrhosis

B.) Sumatriptan is a serotonin receptor agonist that can cause vasoconstriction and coronary vasospasm.

A nurse is assessing a client who has schizophrenia and takes haloperidol 3x daily. The client has developed involuntary writhing movements of the tongue and constant lip smacking. The nurse should ID that these manifestations indicate which of the following adverse effects of haloperidol? A.) akathisia B.) acute dystonia C.) tardive dyskinesia D.) pseudoparkinsonism

C.

A nurse is reviewing the medication administration record of a client who is receiving an opioid medication for pain. Which of the following prescriptions should the nurse clarify with the provider? A.) metoprolol B.) ondansetron C.) lorazepam D.) naloxone

C.

what administration considerations apply to pramipexole?

Give 2 to 3 hr before bedtime for restless leg syndrome. When increasing dosage, allow 5 to 7 days between each increase.

What administration considerations apply to donepezil?

Give at bedtime daily with or without food. also available as a syrup and in orally disintegrating tablets.

What administration considerations apply to selegiline?

Give with levodopa/carbidopa so that levodopa dosage may be reduced. give orally disintegrating form (Zelapar) by placing it on the top of the tongue. give before morning meal dont eat or drink for 5 min before or after administration.

What administration considerations apply to sumatriptan?

Use nasal spray by spraying once into a single nostril; may repeat after 2 hr. single dose: ranges from 5 to 20 mg. max dose: is 40 mg in 24 hr. Give one sc injection repeat once after 1 hr if no relief; no more than 2 doses in 24 hr. give one oral tablet; repeat once after 2hr if no relief. single dose: ranges from 25 mg to 100mg max dose: 200mg in 24hr.

What administration considerations apply to valproic acid?

-Available orally or IV - Give enteric-coated and administer with food to prevent GI symptoms -Dilute IV form in at least 50 ml of diluents and DONT mix with other drugs in solution -Depakote sprinkles may be opened and sprinkled on food. before consuming.

What administration considerations apply to levodopa/carbidopa?

-Begin administration with low doses to reduce adverse effects. -Advise client that it can take up to 6 months for full reponse to levodopa/carbidopa to occur -monitor for loss of drug effect and the on off phenomenon and report these to provider -immediate-release tablets begin working within 30 mins, then begin to wear off. -Extended-release tablets work over 4 to 6 hr but can take up to 2 hr to begin working in the morning.

A nurse is preparing to administer acetaminophen 1g PO 3 times per day PRN to a client who has a fever. The amount available is acetaminophen 325mg/ 1 tablet. How many tablets should the nurse administer per dose? (Fill in the blank with the numeric value only, round to the nearest whole number, and use a leading zero if applicable. Don't use a trailing zero.)

3

A nurse is providing teaching to a client with a seizure disorder who has a new prescription for carbamazepine. Which of the following statements should the nurse including in the teaching? A.) this medication will decrease the effectiveness of oral contraceptives B.) Once you are seizure free for a month you will be able to stop taking the medication. C.) You can cut the dose in half if GI upset occurs D.) This med might initially increase the frequency of your seizures.

A.

A nurse is teaching a client who has a new prescription for phenytoin. The nurse should inform the client that which of the following adverse effects can occur with the abrupt withdrawal of phenytoin? A.) status epilepticus B.) bleeding gums C.) disorientation D.) severe nausea

A.

A nurse is teaching about levodopa with a family member of a client who has Parkinson's disease. Which of the following pieces of information should the nurse include. A.) a full therapeutic response may take several months to happen. B.) the medication should be taken with high protein foods C.) A full therapeutic response might cause vivid dreams. D.) The medication is given at the onset of mild symptoms.

A.

A nurse is teaching the family of a client who has Alzheimer's disease about donepezil. Which of the following information should the nurse include in the teaching? A) Syncope episodes may occur when taking this medication. B)This medication may cause tachycardia. C) You should administer the medication each morning.

A.

A nurse is teaching the family of a client who has Alzheimer's disease about donepezil. Which of the following statements should the nurse include in the teaching? A.) Donepezil can improve cognitive functioning during the earlier stages of the disease. B.) Donepezil cures the disease process if started at the first recognition of dementia. C.) Donepezil provides long term reversal of memory loss in the last phase of the disease. D.) Donepezil accelerates the breakdown of acetylcholine within the client's brain.

A.

A nurse is caring for a child who has epilepsy and is scheduled to receive a dose of phenytoin. The nurse notes the child's serum phenytoin level is 14 mcg/mL. which of the following actions should the nurse take? A.) Administer the dose B.) administer half the dose C.) Don't administer the dose D.) Clarify the dose with the provider

A. A serum phenytoin level expected reference range is 10 to 20mcg/mL. The nurse should administer the medication as prescribed.

A nurse is caring for a group of older adult clients. which of the following manifestations indicates one of the clients is experiencing delirium? A.) a client wants to know the current time while there is a clock on the wall. B.) a client attempts to climb out of bed and repeatedly states she must get home. C.) a client requests extra blankets when the thermostat in the room indicates 25.6 C (78F) D.) A client refuses to get out of bed and has no motivation to attend to daily hygiene.

B.

A nurse is monitoring a client who is receiving phenytoin IV for the treatment of status epilepticus. Which of the following findings should the nurse ID as an adverse effect of the medication? A.) HTN B.) Cardiac dysrhythmias C.) Gastric discomfort D.) tachycardia

B.

A nurse is providing teaching to a client who has a new prescription for sertraline. The client asks the nurse if he should continue to take St. John's wort for depression. Which of the following instructions should the nurse give the client? A.) take the medication and herbal supplement together. B.) stop taking the herbal supplement while taking the medication. C.) take the herbal supplement and medication at least 2Hrs apart D.) take an antacid with both the herbal supplement and the medication.

B.

A nurse is reviewing the medical record of a client who has a new prescription for tranylcypromine. the client still has a current prescription for sertraline. The nurse should notify the provider because taking these medications concurrently increases the risk of which of the following adverse effects? A.) Increase IOP B.) serotonin syndrome C.) acute kidney injury D.) hypertensive crisis

B.

A nurse is teaching about taking donepezil with a client who was recently dx with early Alzheimer's disease. Which of the following instructions should the nurse include in the teaching? A.) you should chew the medication thoroughly prior to swallowing. B.) you should take this medication late in the evening C.) you should take this medication with food. D.) if you miss taking a dose for a day, take 2 doses the following day.

B.

A nurse is caring for a client who is taking selegiline. The nurse should monitor the client for which of the following adverse effects of selegiline and notify the provider if it occurs? A.) bruising B.) drowsiness C.) coughing D.) constipation

B. Drowsiness can be an adverse effect of selegiline and a manifestation of serotonin syndrome. the nurse should notify the provider about this finding immediately.

A nurse is caring for a client with Alzheimer's disease who has an new prescription for memantine. Which of the following lab results should the nurse ID as increasing the client's risk for decreased clearance of the medication? A.) Alanine aminotransferase (ALT) 30 units/L B.) Creatinine clearance 35 mL/ min C.) HbA1C 5% D.) BMI 31

B. The kidneys excrete memantine, and decreased clearance occurs with moderate renal impairment.

A nurse is caring for an adolescent client who is receiving carbamazepine for partial seizure disorder. which of the following statements by the client's parent is the nurse's priority? A.) he takes a 2 hr nap every day after school B.) he says he feels sick to his stomach after taking this medication C.) he has so many new bruises on his body D.) he says his mouth is always dry

C.

A nurse is teaching the family of a client who has a new Dx of epilepsy about the actions to take if the client experiences a seizure. which of the following instructions should the nurse include in the teaching? A.) insert a padded tongue blade into the client's mouth B.) restrain the client C.) place the client on his back D.) move objects away from the client.

D

A nurse in a providers office is collecting information from an older adult client who reports taking acetaminophen 500 mg/day for severe joint pain. The nurse should instruct the client that large doses of acetaminophen could cause which of the following adverse effects? A) constipation B) gastric ulcers C) respiratory depression D) liver damage

D.

A nurse in an acute mental health facility is reviewing the medication records of a group of clients. The nurse should expect a prescription for memantine for a client who has which of the following diagnoses? A.) PP depression B.) Schizophrenia C.) obesity D.) severe Alzheimer's disease.

D.

A nurse is assessing a client with psychotic disorder who has a new prescription for haloperidol. The client is pacing in the hallway and states, "I can't seem to sit still". Which of the following extrapyramidal side effects is this client likely experiencing? A.) dystonia B.) parkinsonism C.) tardive dyskinesia D.) Akathisia.

D.

A nurse is caring for a 5 yr old child who has a fever and begins to have a seizure. Which of the following actions should the nurse take? A.) Give acetaminophen 240 mg PO immediately following the seizure B.) sponge the child's skin with a mixture of cold water and rubbing alcohol C.) administer rectal diazepam if the seizure lasts longer than 2 minutes D.) Place the child in a side lying position

D.

A nurse is caring for a client who is receiving sumatriptan for cluster headaches. Which of the following findings should the nurse expect as an adverse effect? A.) hypotension B.) tinnitus C.) urinary retention D.) chest pressure

D.

A nurse is planning to administer diphenhydramine 50 mg via IV bolus to an client who is having an allergic reaction. The client has an IV infusion containing a medication that is incompatible with diphenhydramine in solution. Which of the following actions should the nurse take? A.) Choose an IV port for IV bolus injection of diphenhydramine as near as possible to the client's hanging IV bag. B.) Flush the IV tubing with 2ml of 0.9% sodium chloride before and after administering diphenhydramine C.) Allow the IV infusion to keep running while administering the diphenhydramine via IV bolus. D.) Aspirate to check for IV patency before administering the diphenhydramine.

D.

A nurse is caring for a client who is taking diphenhydramine for allergies. The client reports, " I feel sleepy during the day." Which of the following responses should the nurse make? A.) You will find that all antihistamines cause sedation. B.) You should avoid taking the antihistamine with food. C.) the effects of sedation will occur with each dose. D.) You should try antihistamines with non-sedative effects.

D. Diphenhydramine is a first generation antihistamine and has a common adverse effect of sedation.

A nurse in the ER is caring for a child who accidentally ingested an overdose amount of acetaminophen. Which of the following medications should the nurse expect to administer? A.) Naloxone B.) Diphenhydramine C.) Glucagon D.) Acetylcysteine

D. Acetylcysteine is the antidote for acetaminophen overdose or poisoning.

A nurse is caring for a client who has Alzheimer's disease and a new prescription for donepezil. which of the following actions should the nurse take? A.) monitor the client's liver function while taking this medication B.) increase the dosage of this medication every 72 h C.) offer the client a PRN NSAID while taking this medication D.) administer the medication at bedtime

D. Donepezil is used to treat the manifestations of mild to moderate Alzheimer's disease. the nurse should administer this medication at bedtime to reduce the risk of injury due to bradycardia and syncope.