Evolve Q's Exam 3

The healthcare provider ordered lorazepam [Ativan] 0.5 mg IV every 6 hours for anxiety. The medication available is lorazepam [Ativan] 2 mg/mL. How many mL will the nurse administer?

0.25

The nurse is preparing to administer quetiapine extended-release 400 mg PO every day as ordered. The available medication is quetiapine 200-mg extended-release tablets. How many tablets should the nurse administer?

2

Which medication should the nurse anticipate administering to a patient in convulsive status epilepticus to halt seizure activity?

Lorazepam [Ativan] 0.1 mg/kg IV at a rate of 2 mg/min

The nurse understands that cholesterol is carried through the blood by lipoproteins. Which lipoprotein is most closely associated with coronary atherosclerosis?

Low-density lipoprotein (LDL)

Which statement made by a female patient newly diagnosed with complex partial seizures and starting treatment with valproic acid indicates a need for further teaching by the nurse?

"I should take the medication on an empty stomach"

The nurse is teaching a group of patients about dietary approaches to reduce cholesterol levels. Which statement is most important to include in the teaching?

"Read food labels and reduce your intake of saturated fats."

The healthcare provider prescribes lovastatin [Mevacor] for a patient discharged from the hospital post-myocardial infarction. Which instructions are most appropriate for the nurse to include in the patient's teaching plan? (Select all that apply.)

- "Do not start any new medications without first talking to your healthcare provider." Correct -"Before starting this medication a blood test will be done to check your total cholesterol level and to measure liver enzymes. -"Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains"

Which instruction would be inappropriate to include in the teaching plan for a patient being started on carbamazepine [Tegretol]?

- "Take the medication with a glass of grapefruit juice each morning."

The nurse is working with the multidisciplinary healthcare team to optimize the care of a patient with schizophrenia. Which concepts will guide the nursing care of this patient? (Select all that apply.)

- Most antipsychotic agents increase the risk of mortality in elderly patients with dementia. -The lipid levels of patients receiving second-generation antipsychotics should be monitored. -Schizophrenia is characterized by disordered thinking and loss of touch with reality.

The nurse is conducting discharge teaching related to a new prescription for phenytoin [Dilantin]. Which statements are appropriate to include in the teaching for this patient and family? (Select all that apply.)

-"Be sure to call the clinic if you or your family notice increased anxiety or agitation." -"You may have some mild sedation. Do not drive until you know how this drug will affect you." -""It is very important to have good oral hygiene and to visit your dentist regularly."

Which statements does the nurse include when teaching a patient about antipsychotic drug therapy? (Select all that apply.)

-"Dilute oral preparations in fruit juice to improve their palatability." -"Store oral preparations in a dark area." -"Do not make skin contact with these drugs; flush the affected area with water if a spill occurs.

When teaching the patient and family about clozapine therapy, which statements should the nurse include? (Select all that apply.)

-"It is important for you to obtain ordered blood tests when taking this medication." -"If you experience increased urination, increased thirst, or increased appetite, contact your healthcare provider." -"Inform your healthcare provider if you are taking any medications to control seizures." -"Contact your healthcare provider if you experience any unexplained tiredness, shortness of breath, increased respirations, chest pain, or heart palpitations."

A nurse is caring for several patients. In which patient is it appropriate to use the drug chlorpromazine [Thorazine]? (Select all that apply.)

-A 78-year-old man with intractable hiccups -A 48-year-old woman with schizoaffective disorder

When comparing benzodiazepines to barbiturates, the nurse identifies which statements about benzodiazepines as true? (Select all that apply.)

-Benzodiazepines have a high safety profile - Benzodiazepines have a low ability to cause tolerance. - Benzodiazepines have a low abuse potential.

The nurse is assessing a patient receiving valproic acid [Depakene] for potential adverse effects associated with this drug. What is the most common problem with this drug?

-NVD and indigestion

The nurse is caring for a patient receiving phenytoin [Dilantin] for treatment of tonic-clonic seizures. Which symptoms, if present, would indicate an adverse effect of this drug? (Select all that apply.)

-Swollen, tender gums - Measles-like rash -unusual hair growth

The nurse suspects that a female patient is experiencing phenytoin toxicity if which manifestation is noted? (Select all that apply.)

-The patient is walking with a staggering gait -The patient complains of double vision -The nurse observes rapid back and forth movement of the patient's eyes

Which statements about zaleplon [Sonata] does the nurse identify as true? (Select all that apply.)

-Zaleplon [Sonata] should not be administered with cimetidine -Zaleplon [Sonata] interacts with the neurotransmitter GABA.

Which are the main types of drugs used to prevent or relieve anginal pain? (Select all that apply.)

-beta blockers -nitrates -calcium channel blockers

The nurse understands patients receiving nitroglycerin are at risk for which adverse effects? (Select all that apply.)

-headache -dizziness -tachycardia

Which are beneficial effects that can be derived from simvaSTATIN [Zocor] and other drugs in this class? (all that apply)

-reduction of LDLs -elevation of HDLs -stabilization of plaque in coronary arteries -reduction of risk of cardiovascular events

The nurse is caring for a patient prescribed gemfibrozil [Lopid]. For which patient should the nurse question the use of this drug?

A patient with history of gallstones and elevated triglycerides

A patient with an elevated triglyceride level is prescribed a sustained-release form of nicotinic acid [Slo-Niacin]. Which laboratory value is most important for the nurse to monitor for in this patient?

Alanine aminotransferase (ALT)

Which statement about aripiprazole would the nurse identify as true?

It is the first representative of a unique class of antipsychotic drugs called dopamine system stabilizers

A patient is receiving isosorbide dinitrate [Isordil] 20 mg 3 times/day for management of newly diagnosed stable angina. Which assessment finding would require an immediate nursing intervention?

An increase in the resting heart rate to 110 beats/min from baseline rates of 68 to 72 beats/min

Which drug is the most effective for lowering LDL cholesterol?

Atorvastatin

Which drug should be used with caution in a patient with first-degree atrioventricular (AV) heart block?

Lacosamide [Vimpat]

The nurse is caring for a patient prescribed a cholesterol-lowering drug. Which drug is least likely to cause systemic side effects?

Colesevelam

Which medication combination is useful in the treatment of variant angina?

Diltiazem [Cardizem] and isosorbide dinitrate

Alprazolam [Xanax] is prescribed for an adult with panic attacks. The nurse recognizes that this drug exerts its therapeutic effect by interacting with which neurotransmitter?

GABA

The nurse is providing discharge teaching for a patient with a new prescription for a nitroglycerin transdermal patch. Which statement by the patient indicates a need for further teaching?

I will limit my alcohol intake to one drink a day

The nurse is monitoring a patient receiving ranolazine [Ranexa] for angina. Which assessment finding indicates an adverse effect of this drug?

QT prolongation on the ECG

Which medication can cause this acid-base disturbance: pH 7.32, paCO2 33, HCO3 20?

Topiramate [Topamax

The nurse is caring for a patient receiving clozapine [Clozaril]. Which assessment finding is most indicative of an adverse effect of this drug?

White blood cell (WBC) count of 2000/mm3

Which agent is most likely to be prescribed today for short-term management of insomnia?

Zolpidem (ambien)

The nurse is caring for a patient whose seizures are characterized by a 10- to 30-second loss of consciousness and mild, symmetric eye blinking. Which seizure type does this most closely illustrate?

absence

The nurse is preparing to give ethosuximide [Zarontin]. The nurse understands that this drug is only indicated for which seizure type?

absence

A nurse assesses a patient receiving haloperidol [Haldol]. The nurse notices that the patient is shifting in the chair, rocking back and forth, and tapping both feet constantly. What is the most accurate term to document these findings?

akathisia

The home health nurse observes the patient for proper use of topical nitroglycerin ointment. Which action by the patient indicates the need for further teaching?

applies the prescribed ribbon of ointment to the applicator paper and places it on the chest

The nurse is caring for a patient who is receiving enteral feedings because of dysphagia. The healthcare provider prescribes isosorbide mononitrate [Imdur] 60 mg SR daily via the enteral tube. What is the most appropriate action by the nurse?

call the healthcare provider about an alternate form of nitrate for administration

The nurse receives a laboratory report indicating that the phenytoin [Dilantin] level for the patient seen in the clinic yesterday is 16 mcg/mL. Which intervention is most appropriate?

continue as planned b/c the level is w/in normal limits

A female patient who is originally from Thailand is seen in the clinic for seizure control. She receives a new prescription for carbamazepine [Tegretol]. Before the patient takes the drug, which is the most appropriate initial nursing intervention?

ensure that genetic testing for HLA-B1502 is performed

The nurse in the emergency department is caring for a patient with a suspected overdose of diazepam [Valium]. Which agent is most likely to be administered to reverse the effects of diazepam?

flumazenil

Which discharge instructions should the nurse include for a patient prescribed cholestyramine [Questran]?

mix with water or juice

The nurse is preparing to administer the aripiprazole extended-release 400-mg injection. The nurse is aware that this medication is scheduled to be given how often?

monthly

The nurse is caring for a patient with a seizure disorder who takes phenobarbital at bedtime each night to control seizures. Which symptom, if present, would most likely indicate an adverse effect of this drug?

morning sedation

A patient with cardiovascular disease is taking rosuvaSTATIN [Crestor]. The nurse is monitoring for potential adverse effects. Which finding indicates a potential adverse effect of this drug?

muscle pain and tenderness

The nurse is teaching a patient newly diagnosed with a seizure disorder about her disorder. Which statement made by the nurse best describes the goals of therapy with antiepilepsy medication?

our goal is to reduce your seizures to an extent that helps you live normal life

The nurse is caring for a group of patients who have been prescribed sedative-hypnotic agents. Which agent has the greatest abuse potential?

phenobarbital

A patient with angina is being discharged with a prescription for nitroglycerin sublingual tablets. Which instruction should the nurse include?

store the tablets in the original container and tightly close it after use

The nurse has just administered the first dose of haloperidol [Haldol] to a patient with schizophrenia. Which finding, if present, is the most important for the nurse to report to the healthcare provider before administering the next dose of medication?

temperature of 101

The nurse is caring for a patient receiving nitrates for relief of angina. What pharmacodynamic action is responsible for the relief of anginal pain with nitrates?

vasodilation leads to decreased preload, which decreases oxygen demand

The nurse is teaching a patient with a new prescription for alprazolam [Xanax]. Which statement is the most appropriate to include in the teaching plan?

when it is time to discontinue this drug you will need to taper it off slowly

The nurse is caring for a patient with insomnia. The patient asks if there are medications for sleep that are not controlled substances. Which statement by the nurse is correct?

yes, there is a medication that works with your body's melatonin and is not a controlled substance (ramelteon)