Exam II-Pharm
The nurse is educating a client diagnosed with Parkinson's disease about the dietary implications of prescribed treatment with levodopa/carbidopa. Which statement by the nurse demonstrated an understanding of the proper administration of this medication? A) "It's important to take this medication on a full stomach so that it doesn't make you nauseous." B) "Most people find that it's best to take this medication at bedtime, provided you haven't snacked in the evening." C) "If possible, try to eat extra protein when you're taking this medication." D) "Dairy products will make this medication ineffective, so make sure you don't take them at the same time."
A) "It's important to take this medication on a full stomach so that it doesn't make you nauseous."
How should the nurse best explain the etiology of substance use disorder? A) "Substance abuse is multifactorial and involves genetics, personality, and culture." B) "Substance abuse is primarily a cultural concept, since definitions vary widely across time and place." C) "Many different factors contribute to substance abuse, but the primary ones are lack of willpower and impaired coping." D) "Substance abuse is a complex phenomenon, and science has not yet begun to truly understand the phenomenon."
A) "Substance abuse is multifactorial and involves genetics, personality, and culture."
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) 07:00 and 11:30 B) 07:30, 11:30, 16:30, and 20:00 C) 08:00 and 20:00 D) 09:00, 14:00, and 19:00
A) 07:00 and 11:30
The nurse is caring for a client that suddenly stopped taking a chronically prescribed beta-adrenergic blocking drug prescribed for hypertension. The client's blood pressure (BP) ranged from 110/70 to 130/70 mmHg and heart rate (HR) ranged 60 to 90 beats per minute while taking the drug. The nurse would predict which assessment findings to support the expected beta-adrenergic responsiveness? A) BP: 200/100 mm Hg; HR 110 B) BP: 88/50 mm Hg; HR 55 C) BP: 140/90 mm Hg; HR 60 to 90 D) BP: 110/70 mm Hg; HR 50 to 100
A) BP: 200/100 mm Hg; HR 110
A client is being treated for Parkinson's disease and has been prescribed both levodopa and carbidopa. Why is this course of combination treatment most effective? A) Levodopa restores dopamine, and carbidopa decreases peripheral breakdown of levodopa. B) Levodopa decreases the toxic effects of carbidopa to reduce the extrapyramidal reaction. C) Carbidopa increases the peripheral breakdown of levodopa to hasten its onset and peak. D) Levodopa and carbidopa, when combined, enhance voluntary movement to improve gait.
A) Levodopa restores dopamine, and carbidopa decreases peripheral breakdown of levodopa.
A client has been administered lidocaine in anticipation of a bronchoscopy and lung biopsy. What change in status would the nurse recognize as a potential hypersensitivity to lidocaine? A) audible wheeze B) pleural pain C) audible S3 D) hemoptysis
A) audible wheeze
What medication may be administered intravenously (IV) to assist in reducing status epilepticus seizure activity? A) diazepam B) hydromorphone C) insulin D) meperidine
A) diazepam
A client with schizophrenia has been taking haloperidol for several years. The care team and the client have collaborated and chosen to transition the client to an atypical antipsychotic in an effort to reduce adverse effects and maximize therapeutic effects. In order to reduce the client's risk of extrapyramidal effects during the transition from haloperidol to an atypical antipsycotic, the care team should implement which intervention? A) gradually taper the dose of haloperidol B) have a 2- to 3-week "drug holiday" between stopping the haloperidol and starting the atypical antipsychotic C) administer haloperidol and the atypical antipsychotic drug concurrently for 6 to 8 weeks D) arrange for weekly electroconvulsive therapy (ECT) during the time of transition
A) gradually taper the dose of haloperidol
A child is prescribed an amphetamine for attention deficit hyperactivity disorder (ADHD). Which effect provides evidence that the medications are working? A) improved grades B) increased sleep quality C) lethargy D) polyphagia
A) improved grades
Following the administration of naloxone to a client with moderate pain, the nurse should assess for what change in the client's vital sign? A) increased blood pressure B) decreased oxygen saturation C) increased temperature D) increased respiratory rate
A) increased blood pressure
A client who has a diagnosis of schizophrenia is likely to have which pathophysiologic effect? A) increased dopamine B) increased serum potassium C) decreased numbers of glutamate receptors D) decreased interaction with GABA
A) increased dopamine
What medication will be ordered for a client prescribed an opioid for pain who is unresponsive with respirations assessed at 6 breaths per minute? A) naloxone B) capsaicin C) butorphanol D) nalbuphine
A) naloxone
What effect will severe dehydration and a decreased albumin level have on a client's prescribed dose of phenytoin? A) potentially cause a toxic serum level B) result in a reduced serum level C) trigger increased seizure activity D) increase the risk for a thromboembolism
A) potentially cause a toxic serum level
Which side effect of fluoxetine is most commonly the cause for poor client adherence? A) sexual dysfunction B) hypotension C) pain and discomfort D) cardiac dysrhythmia
A) sexual dysfunction
In order to minimize the chances of withdrawal symptoms, the nurse knows that the client prescribed a benzodiazepine taken daily will likely be advised to take which precaution? A) tapering the dose of drug over a prolonged period of time B) replacing the drug with a herbal supplement in anticipation of stopping the medication C) substituting the immediate-acting form of the drug with a long-acting form D) exchanging the drug for an anticonvulsant
A) tapering the dose of drug over a prolonged period of time
What is the purpose of a "drug holiday" for a teenager prescribed an amphetamine for attention deficit hyperactivity disorder (ADHD)? A) to minimize weight loss B) to prevent hyperthyroidism C) to allow electrolyte imbalances to resolve D) to slow bone resorption
A) to minimize weight loss
The nurse administers intravenous (IV) norepinephrine to the client diagnosed with shock. The nurse would predict which receptor subtypes to be activated resulting in a stimulatory response? Select all that apply. A) alpha1 B) alpha2 C) beta1 D) beta2 E) nicotinicm
A,B,C
The nurse prepares to administer a selective alpha-adrenergic agonist medication to a client diagnosed with shock. Which of the following would the nurse consider to be therapeutic or desired effects based upon the characteristics of the prescribed medication? Select all that apply. A) increased blood pressure B) bronchodilation C) increased cardiac output D) tachycardia E) glycogenolysis
A,C
After the nurse administers a cholinergic medication to the client, the nurse would provide which interventions because of the drug's actions on the body? Select all that apply. A) Auscultate lung sounds and report bronchoconstriction. B) Monitor for hyperglycemia. C) Instruct client to report diarrhea. D) Check for improved mental activity. E) Compare muscle strength to baseline for improvement.
A,C,E
Which outcome should the nurse consider to be side effects of a selective cholinergic agonist based upon the characteristics of the prescribed medication? Select all that apply. A) increased drooling of oral secretions B) heart rate 110 C) abdominal cramping D) pupil dilation E) blood pressure 88/50 mm Hg
A,C,E
A client sustained a severe laceration to the right thumb and index finger that will require local anesthetic to facilitate suturing. Which statements should prompt the nurse to provide further client health education? A) "I have to admit I'm relieved that they'll be freezing my hand before they stitch it up." B) "I'm feeling pretty queasy about getting stitches, so I'm glad they'll be knocking me out." C) "They told me that it will take a few hours before I can feel my hand again." D) "If I understand correctly, I won't be able to move my hand normally for a while after getting the anesthesia."
B) "I'm feeling pretty queasy about getting stitches, so I'm glad they'll be knocking me out."
A hospital client's medication administration record specifies the parenteral administration of lidocaine before a tissue biopsy to be performed later in the day. What action should the nurse take in response to this order? A) Obtain an order for epinephrine in order to potentiate the action of lidocaine. B) Contact the prescriber because administration should be performed by a health care provider or nurse anesthetist. C) Administer a 500-mL bolus of normal saline to ensure adequate vascular volume. D) Assess the client's need for an antihistamine to be on hold during administration of the lidocaine.
B) Contact the prescriber because administration should be performed by a health care provider or nurse anesthetist.
A client diagnosed with myasthenia gravis is administered a cholinergic drug named neostigmine. How does this drug produce its therapeutic effect? A) It stimulates the sympathetic nervous system. B) It stimulates the parasympathetic nervous system. C) It stimulates the cardiac smooth muscle. D) It stimulates the respiratory system
B) It stimulates the parasympathetic nervous system.
A client has been taking a selective serotonin reuptake inhibitor (SSRI) for the treatment of depression. Which represents the action of the medication? A) SSRIs block GABA function. B) SSRIs prevent serotonin from being reabsorbed. C) SSRIs increase serotonin synthesis. D) SSRIs increase the number of serotonin binding sites.
B) SSRIs prevent serotonin from being reabsorbed.
A client being treated for a seizure disorder with phenytoin is admitted to the emergency room with sinus bradycardia. What action will occur regarding the phenytoin? A) Dosage will be reduced. B) The medication will be discontinued. C) The medication will be given every other day. D) Dosage will be increased.
B) The medication will be discontinued.
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 appetite C) a plan to enhance the child's self-esteem D) a strategy to regularly monitor the child's blood glucose levels
B) a plan to address the child's loss of appetite
Prior to elective hip replacement surgery, the nurse is explaining the basic characteristics of general anesthesia to the client. The nurse should perform this education in the understanding that general anesthesia is best understood as what result? A) a nonreversible, temporary state of unresponsiveness B) a state of reversible unconsciousness C) a stage N2 non-rapid eye movement sleep D) a stage N3 non-rapid eye movement sleep
B) a state of reversible unconsciousness
A client is prescribed midazolam in combination with an opioid in the preoperative phase of a laparoscopic cholecystectomy. What does the administration of midazolam assist in minimizing? A) oral secretions B) anxiety C) hypotension D) muscle tone
B) anxiety
A 33-year-old female with a recent history of visual disturbances and dysphagia has just been diagnosed with myasthenia gravis. The nurse should recognize that this client's health problem is ultimately attributable to what pathophysiological process? A) idiopathic overproduction of anticholinesterase B) autoimmune destruction of acetylcholine receptors C) demyelination of parasympathetic nerve pathways D) deficient synthesis of dopamine by the substantia nigra
B) autoimmune destruction of acetylcholine receptors
A client has atony (muscle weakness) of the smooth muscle of the gastrointestinal tract. Which type of medication may be administered to increase smooth muscle strength? A) anticholinergic drugs B) cholinergic drugs C) muscle relaxants D) selective serotonin reuptake inhibitors
B) cholinergic drugs
What is the primary goal for prescribing an anticholinergic agent for a preoperative client? A) prevent tachycardia B) decrease respiratory secretions C) decrease gastric motility D) relaxation of the detrusor muscle
B) decrease respiratory secretions
An older adult client is diagnosed with generalized anxiety disorder. The use of benzodiazepines in this client population creates a specific need for which intervention? A) seizure precautions B) falls risk assessment C) frequent dysrhythmias monitoring D) education regarding sexual dysfunction
B) falls risk assessment
What information identified by the client's history should the nurse consider to be a contraindication for the administration of a nonselective beta-adrenergic blocker? A) implanted pacemaker B) history of exercise-induced asthma C) history of gallbladder disease D) a current urinary tract infection
B) history of exercise-induced asthma
A client has been administered an opioid. For which effect should the client be regularly assessed for? A) oliguria B) level of consciousness (LOC) C) edema D) tachycardia
B) level of consciousness (LOC)
A 13-year-old has been prescribed dextroamphetamine for the treatment of attention deficit hyperactivity disorder (ADHD) since age 10, achieving significant improvements in behavior and mood. When assessing the child during a scheduled follow-up appointment, the nurse should prioritize what physical assessment to monitor for a potential adverse reaction to the therapy? A) abdominal girth and assessment for peripheral edema B) measurement of height and body weight C) visual acuity and hearing ability D) assessment of deep tendon reflexes and peripheral pulses
B) measurement of height and body weight
A client is scheduled to undergo a bronchoscopy for the investigation of a bronchial mass. What benzodiazepine should the clinic nurse anticipate administering for conscious sedation? A) triazolam B) midazolam C) oxazepam D) chlordiazepoxide
B) midazolam
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
B) potential for abuse
Epinephrine performs what function when administered with lidocaine to affect local anesthesia? A) promoting vasodilation B) prolonging the effects of lidocaine C) preventing adverse effects of lidocaine D) blocking the afferent nerve pathways
B) prolonging the effects of lidocaine
A client experiencing cancer pain is receiving morphine every 2 hours. What assessment should the family be taught to make while caring for this client at home? A) diarrhea B) respiratory depression C) lung sounds D) urinary incontinence
B) respiratory depression
A client will undergo an endoscopy with conscious sedation using midazolam. The nurse who is participating in this procedure should monitor the client closely for which signs of adverse reaction? A) increased intracranial pressure (ICP) B) respiratory depression C) hemorrhage D) rhabdomyolysis
B) respiratory depression
A client, being treated for bipolar disorder with lithium carbonate, has a history of congestive heart failure and hypertension. The client has an increased fluid volume and has recently had difficulty breathing. What laboratory value should the nurse monitor to provide for affect the action of the client's lithium carbonate therapy? A) hematocrit B) serum sodium C) serum potassium D) white blood cell count
B) serum sodium
Following recent changes in memory and personality, a 72-year-old is undergoing neurological testing to rule out Alzheimer's disease. The nurse is aware that this disease is characterized by what pathophysiological phenomena? Select all that apply. A) meningiomas B) neuritic plaques C) neurofibrillary tangles D) arteriovenous malformations (AVMs) E) gliomas
B,C
A client with a history of migraine headaches self-medicates with an over-the-counter (OTC) medication at contains a commonly combined combination of drugs. The nurse recognizes the client is medicating with a combination of which drugs? Select all that apply. A) codeine B) acetaminophen C) aspirin D) caffeine E) naproxen
B,C,D
A client with depression has been prescribed a monoamine oxidase inhibitor (MAOI). What education should the nurse provide to this client? Select all that apply. A) Take the medication at bedtime with plenty of fluids. B) Monitor blood pressure closely. C) Do not take over-the-counter (OTC) drugs without talking to physician. D) Expect tarry stools near the beginning of treatment. E) Avoid foods containing tyramines.
B,C,E
After the nurse administers an anticholinergic medication to the client, the nurse would provide which interventions because of the drug's actions on the body? Select all that apply. A) Change bed linens for excessive perspiration. B) Provide frequent mouth care for dry mucous membranes. C) Instruct the client that the drug will make it easier to urinate. D) Auscultate bowel sounds and assess for constipation. E) Report heart rate less than 60 beats per minute
B,D
The nurse has been educating the client on the self-administration of phenytoin. Which statement made by the client demonstrates an understanding of the medication? A) "I'll only take the drug when I feel an impending seizure." B) "I'll reduce my dose if I remain seizure free." C) "I'll make sure to take the drug with food." D) "I'll stop taking the drug if I don't have a seizure for 8 weeks."
C) "I'll make sure to take the drug with food."
A client's medication regimen for treatment of anxiety has been changed from a benzodiazepine. The client asks the nurse what likely prompted the health care provider to change the medication. What is the nurse's best response? A) "Your doctor may have been concerned about causing depression." B) "Your doctor may have been worried about the possibility of convulsions." C) "Long-term use of benzodiazepines can result in dependency." D) "Long-term use of benzodiazepines can cause insomnia."
C) "Long-term use of benzodiazepines can result in dependency."
A client has been treated for migraines on an ongoing basis, and the care provider has just prescribed sumatriptan. What statement made by the nurse reflects the priority education intervention for a client prescribed sumatriptan? A) "You might get dizzy and light-headed after you take sumatriptan, but this is normal." B) "It's important that you never take acetaminophen within 12 hours of sumatriptan." C) "Make sure that you stop taking ergotamine before you get this prescription filled." D) "You will likely experience a brief worsening of your migraine before this drug relieves the pain."
C) "Make sure that you stop taking ergotamine before you get this prescription filled."
How should the nurse best assess the client for physical dependence on alcohol? A) Assess the client's perceptions of coping strategies. B) Assess whether the client ever feels guilty about drinking. C) Assess the client for signs and symptoms of alcohol withdrawal. D) Assess the client's typical alcohol intake.
C) Assess the client for signs and symptoms of alcohol withdrawal.
34. In order to maximize therapeutic benefit while reducing the risk of adverse effects of sumatriptan, the nurse should encourage the client to implement which intervention? A) Take the medication before breakfast each day. B) Take the medication on days when migraines may be anticipated. C) Take the medication as soon as the earliest symptoms of migraine are sensed. D) Take the medication when the pain of a migraine becomes too much to bear.
C) Take the medication as soon as the earliest symptoms of migraine are sensed.
What is the most effective way for the nurse to evaluate the client's pain response after administering an opioid analgesic? A) Observe the client when he/she is not aware you are assessing him/her. B) Ask another nurse to assess the client's response to the medication. C) Using a pain scale, ask the client to describe the pain. D) Ask the family to determine the client's response to the pain.
C) Using a pain scale, ask the client to describe the pain.
A 40-year-old, diagnosed with myasthenia gravis (MG), is scheduled to begin treatment with oral neostigmine. When providing relevant health education, the nurse should emphasize that successful control of MG symptoms will primarily depend on what personal behavior? A) matching each dose of neostigmine to the severity of symptoms at that time B) making lifestyle modifications to prioritize a healthy diet and regular activity C) adhering strictly to the prescribed administration schedule D) developing acceptance of the functional deficits that result from MG
C) adhering strictly to the prescribed administration schedule
Which medication will be administered to treat urinary retention? A) neostigmine B) donepezil C) bethanechol D) ambenonium
C) bethanechol
A client is admitted to an alcohol rehabilitation program. What medication will the client most likely be prescribed to treat alcohol withdrawal syndromes? A) clonidine B) methyldopa C) chlordiazepoxide D) atenolol
C) chlordiazepoxide
A client prescribed a selective serotonin reuptake inhibitor (SSRI) has begun taking St. John's wort daily. The nurse should teach that client that this combination may result in what adverse reaction? A) worsened symptoms of depression B) development of blood dyscrasias C) dangerous drug interactions D) hemostatic instability
C) dangerous drug interactions
59. The nurse should recognize what as the primary goal of treatment for haloperidol therapy? A) increased insight into delusional thinking B) increased sophistication of thinking C) decreased agitation and combativeness D) decreased central nervous system (CNS) stimulation
C) decreased agitation and combativeness
A client is diagnosed with Alzheimer's disease. The nurse should anticipate administering which medication? A) bethanechol B) neostigmine C) donepezil D) physostigmine salicylate
C) donepezil
The nurse prepares to administer a preoperative anticholinergic to a client. Which of the following should the nurse consider to be a desired effect based upon the characteristics of the prescribed medication? A) wheezing B) heart rate 50 C) dry mucous membranes D) bilateral pupils constricted
C) dry mucous membranes
Which diet will require the dose of lithium carbonate to be reduced? A) low calorie B) low carbohydrate C) low sodium D) low residue
C) low sodium
When considering migraine headaches, what is the primary goal of abortive therapy? A) permanently correcting the client's brain physiology B) ensuring that the client experiences fewer migraine headaches C) relief of the symptoms associated with migraines D) fostering coping skills that will allow the client to live with the migraines
C) relief of the symptoms associated with migraines
The nurse is scheduled to administer pancuronium, a neuromuscular-blocking medication, to a client receiving mechanical ventilation. The nurse would predict which receptor subtype(s) to be activated resulting in a stimulatory response? A) all muscarinic receptors B) specifically nicotinicn receptors C) specifically nicotinicm receptors D) both muscarinic and nicotinic receptors
C) specifically nicotinicm receptors
The nurse is teaching a client taking a monoamine oxidase inhibitor (MAOI) about dietary changes required to minimize adverse effects of the drug. The nurse determines that the client understands a low-tyramine diet when what meal is chosen? A) A chop salad with blue cheese, sardines, and pepperoni B) A sandwich with turkey, avocado, and Swiss cheese C) Corned beef hash, eggs, and hash browns D) A hamburger, French fries, and a strawberry milkshake
D) A hamburger, French fries, and a strawberry milkshake
What explanation should the nurse provide for why pregnancy is discouraged in women who are being treated for seizure disorders? A) Seizure disorders are genetic. B) Seizure disorders are familial. C) Antiepilepsy drugs decrease fertility. D) Antiepilepsy drugs are teratogenic.
D) Antiepilepsy drugs are teratogenic.
An adult client who is currently undergoing rhinoplasty has developed the characteristic signs and symptoms of malignant hyperthermia. The operating room nurse should anticipate what intervention? A) hemodialysis B) tracheal intubation C) IV administration of naloxone D) IV administration of dantrolene sodium
D) IV administration of dantrolene sodium
An older adult was diagnosed with depression several decades and has been taking tricyclic antidepressants (TCAs) ever since, with good effect. The nurse should recognize what therapeutic action of this client's medication? A) Inhibiting monoamine oxidase inhibitors that break down norepinephrine B) Inhibiting generalized neuron activity, preventing overexcitability or stimulation C) Blocking the reuptake of serotonin, which increases the levels of norepinephrine D) Inhibiting reuptake of norepinephrine and serotonin
D) Inhibiting reuptake of norepinephrine and serotonin
A young client has been prescribed an antipsychotic agent to relieve psychotic symptoms. Which goal of care is the priority? A) The client will demonstrate independent health maintenance. B) The client will interact therapeutically with peers. C) The client will participate in activities of daily living (ADL). D) The client will remain safe.
D) The client will remain safe.
A client receiving morphine sulfate 5 mg IV every 4 hours for the past several days now states that the pain is not being relieved as well as it was in the past. What is the reason for this development? A) a dependency on the morphine B) natural response to metastatic cancer and dying C) greater pain associated with inactivity D) a tolerance to morphine
D) a tolerance to morphine
A client who diagnosed with Parkinson's disease is being treated with levodopa/carbidopa. Which disorder will result in the discontinuation of this drug based on a disease-related contraindication? A) human immune deficiency virus B) human papillomavirus C) transient ischemic attacks (TIA) D) narrow-angle glaucoma
D) narrow-angle glaucoma
The normal function of which neurotransmitter is most likely impaired when a client expresses feelings of gloom and the inability to perform activities of daily living? A) acetylcholine B) epinephrine C) insulin D) serotonin
D) serotonin
The nurse should prioritize which assessment when caring for a teenager who has recently been prescribed a selective serotonin reuptake inhibitor (SSRI)? A) venous thromboembolism (VTE) B) cardiac rate and rhythm C) hypomanic state D) suicidal ideation
D) suicidal ideation
