N503 - GI and Neuro Practice Test Questions

The nurse determines the client needs further instruction on cimetidine if which statements were made? Select all that apply. A. "I will take the cimetidine with my meals." B. "I'll know the medication is working if my diarrhea stops." C. "My episodes of heartburn will decrease if the medication is effective." D. "Taking the cimetidine with an antacid will increase its effectiveness." E. "I will notify my health care provider if I become depressed or anxious."

A, C, D

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? A. "When it is time to discontinue this drug, you will need to taper it off slowly." B. "Protect your skin from the sun to prevent rash and exaggerated sunburn." C. "Increase your intake of fluid and high-fiber foods to prevent constipation." D. "Take this medication on an empty stomach at least 2 hours after meals."

A. "When it is time to discontinue this drug, you will need to taper it off slowly." Alprazolam [Xanax] is a benzodiazepine for which abrupt discontinuation can precipitate withdrawal symptoms. Patients should withdraw the drug gradually over several weeks. The other statements are not related to alprazolam [Xanax].

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? A. "Yes, there is a medication that works with your body's melatonin and is not a controlled substance." B. "No, all of the sleep medications are controlled substances." C. "There are some over-the-counter medications, and you can take those without discussing them with your healthcare provider." D. "Yes, but it is not for chronic insomnia."

A. "Yes, there is a medication that works with your body's melatonin and is not a controlled substance." Ramelteon [Rozerem] is a relatively new hypnotic with a unique mechanism of action: activation of receptors for melatonin. The drug is approved for treating chronic insomnia characterized by difficulty with sleep onset, but not with sleep maintenance. Long-term use is permitted. Of the major drugs for insomnia, ramelteon is the only one not regulated as a controlled substance.

A nurse is giving instructions to a client receiving lithium citrate. The nurse tells the client to do which of the following to prevent lithium toxicity: A. Avoid becoming dehydrated during exercise. B. Instruct the client to change positions slowly. C. Restrict salt intake in the diet. D. Limit fluid intake.

A. Avoid becoming dehydrated during exercise.

When comparing benzodiazepines to barbiturates, the nurse identifies which statements about benzodiazepines as true? (Select all that apply.) A. Benzodiazepines have a high safety profile. B. Benzodiazepines have a significant ability to depress central nervous system (CNS) function. C. Benzodiazepines are associated with a high suicide potential. D. Benzodiazepines have a low ability to cause tolerance. E. Benzodiazepines have a low abuse potential.

A. Benzodiazepines have a high safety profile. D. Benzodiazepines have a low ability to cause tolerance. E. Benzodiazepines have a low abuse potential.

A nurse administers metoclopramide [Reglan] to a patient who is having nausea and vomiting postoperatively. The nurse should expect which therapeutic action if the medication is having the desired result? A. Blocking of serotonin and dopamine receptors B. Inactivation of histaminergic (H1) receptors C. Activation of chloride channels in the intestine D. Reduced motility in the small intestine

A. Blocking of serotonin and dopamine receptors R: Metoclopramide works by blocking serotonin and dopamine receptors in the chemoreceptor trigger zone (CTZ) and by increasing motility in the small intestine.

A nurse provides instructions to a client taking fluoxetine (Prozac) a selective serotonin reuptake inhibitors (SSRI) antidepressant. The nurse tells the client to take the medication: A. Early in the morning. B. During lunch time. C. At snack time. D. At bedtime.

A. Early in the morning.

Before administering the anticholinergic drug dicyclomine (Bentyl), the nurse would be careful to assess the patient for a history of which condition? A. Glaucoma B. Hyperthyroidism C. Rheumatoid arthritis D. Gastroenteritis

A. Glaucoma R: Anticholinergic drugs are contraindicated in patients with glaucoma. These drugs can cause pupillary dilation, which can obstruct the flow of aqueous humor and increase intraocular pressure.

A client with a history of duodenal ulcer is taking calcium carbonate chewable tablets. The nurse determines that the client is experiencing optimal effects of the medication if: A. Heartburn is relieved B. Muscle twitching stops C. Serum calcium levels rise D. Serum phosphorous levels decrease

A. Heartburn is relieved

A healthcare provider diagnoses attention deficit hyperactivity disorder (ADHD) in a 7-year-old child and prescribes methylphenidate. The nurse discusses the child's treatment with the parents. What does the nurse emphasize as important for the parents to do? A. Monitor the effect of the medication on their child's behavior. B. Increase or decrease the dosage, depending on the child's behavior. C. Avoid imposing too many rules, because this will frustrate the child. D. Point out to their child that behavior can be controlled.

A. Monitor the effect of the medication on their child's behavior.

A client with schizophrenia has been started on medication therapy with clozapine (Clozaril). A nurse assesses the results of which laboratory study to monitor for adverse effect related to this medication? A. White blood cell. B. Platelet count. C. Liver function studies. D. Random blood sugar.

A. White blood cell. Clozapine can cause agranulocytosis.

An older adult living in a long-term care facility has been receiving 600 mg of lithium twice a day for 3 weeks to ease manic behavior. The client is experiencing nausea and vomiting, diarrhea, thirst, polyuria, slurred speech, and muscle weakness. What is the most appropriate nursing intervention? A. Withholding the next dose of lithium and drawing blood to test it for toxicity B. Obtaining a prescription for the antidote to lithium and administering it immediately C. Suggesting that the primary healthcare provider replace the lithium for an antiepileptic that will control the mania D. Assessing the client for coarse hand tremor and, if it is present, giving the daily dose of lithium with a bit of water

A. Withholding the next dose of lithium and drawing blood to test it for toxicity

Which of the following symptoms are seen when a client abruptly stops taking lorazepam (Ativan)? Select all that apply. 1. Insomnia. 2. Tremor. 3. Delirium. 4. Dry mouth. 5. Lethargy.

ANS: 1, 2, 3 Diazepam (Valium) is a benzodiazepine. Benzodiazepines are physiologically and psychologically addictive. If a benzodiazepine is stopped abruptly, a rebound stimulation of the central nervous system occurs, and the client may experience insomnia, increased anxiety, abdominal and muscle cramps, tremors, vomiting, sweating, convulsions, and delirium. 1. Insomnia is correct. 2. Tremor is correct. 3. Delirium is correct. 4. Dry mouth is a side effect of taking benzodiazepines and is not related to stopping the medication abruptly. 5. Lethargy is a side effect of taking benzodiazepines and is not related to stopping the medication abruptly.

A patient is asking advice about which over-the-counter antacid is considered the most safe to use for heartburn. The nurse explains that calcium antacids are not used as frequently as other antacids because a. their use may result in kidney stones. b. they cause decreased gastric acid production. c. they cause severe diarrhea. d. their use may result in fluid retention and edema.

ANS: A Calcium antacids are not used as frequently as other antacids because their use may lead to the development of kidney stones; they also cause increased gastric acid production. The other options are incorrect.

A client with depression has just been prescribed the antidepressant phenelizine (Nardil). She says to the nurse, " The doctor says I will need to watch my diet while I'm on this medication. What foods should I avoid?" Which of the following is the correct response by the nurse? A. Blue cheese, red wine, raisins B. Black beans, garlic, pears C. Pork, shellfish, egg yolks D Mild, peanuts, tomatoes

ANS: A Rationale: Phenelizine is a MAOI. MAOIs are known to have serious adverse effects with the possibility of developing hypertensive crisis with the consumption of foods that contain tyramine. Tyramine is found in blue cheese, red wine, and raisins.

A patient will be taking a 2-week course of combination therapy with omeprazole (Prilosec) and another drug for a peptic ulcer caused by Helicobacter pylori. The nurse expects a drug from which class to be ordered with the omeprazole? a. An antibiotic b. A nonsteroidal antiinflammatory drug c. An antacid d. An antiemetic

ANS: A The antibiotic clarithromycin is active against H. pylori and is used in combination with omeprazole to eradicate the bacteria. First-line therapy against H. pylori includes a 10- to 14-day course of a proton pump inhibitor such as omeprazole plus the antibiotics clarithromycin and either amoxicillin or metronidazole, or a combination of a proton pump inhibitor, bismuth subsalicylate, and the antibiotics tetracycline and metronidazole. Many different combinations are used.

After taking chlorpromazine (Thorazine) for 1 month, a client presents to an emergency department (ED) with severe muscle rigidity, tachycardia, and a temperature of 105F (40.5C). The nurse expects the physician to recognize which condition and implement which treatment? A. Neuroleptic malignant syndrome and treat by discontinuing Thorazine and administering dantrolene (Dantrium) B. Neuroleptic malignant syndrome and treat by increasing Thorazine dosage and administering an antianxiety medication C. Dystonia and treat by administering trihexyphenidyl (Artane) D. Dystonia and treat by administering bromocriptine (Parlodel)

ANS: A The nurse should expect that an ED physician would diagnose the client with neuroleptic malignant syndrome and treat the client by discontinuing chlorpromazine (Thorazine) and administering dantrolene (Dantrium). Neuroleptic malignant syndrome is a potentially fatal condition characterized by muscle rigidity, fever, altered consciousness, and autonomic instability. The use of typical antipsychotics is largely being replaced by atypical antipsychotics due to fewer side effects and lower risks.

A client diagnosed with schizophrenia is prescribed clozapine (Clozaril). Which client symptoms related to the side effects of this medication should prompt a nurse to intervene immediately? A. Sore throat, fever, and malaise B. Akathisia and hypersalivation C. Akinesia and insomnia D. Dry mouth and urinary retention

ANS: A The nurse should intervene immediately if the client experiences a sore throat, fever, and malaise when taking the atypical antipsychotic drug clozapine (Clozaril). Clozapine can have a serious side effect of agranulocytosis, in which a potentially fatal drop in white blood cells can occur. Symptoms of infectious processes would alert the nurse to this potential.

A client is prescribed phenelzine (Nardil). Which of the following client statements should indicate to a nurse that discharge teaching about this medication has been successful? (Select all that apply.) A. "I'll have to let my surgeon know about this medication before I have my cholecystectomy." B. "Guess I will have to give up my glass of red wine with dinner." C. "I'll have to be very careful about reading food and medication labels." D. "I'll be sure not to stop this medication abruptly."

ANS: A, B, C, D The nurse should evaluate that teaching has been successful when the client states that phenelzine (Nardil) should not be taken in conjunction with the use of alcohol or foods high in tyramine and should not be stopped abruptly. Phenelzine is a monoamine oxidase inhibitor (MAOI) that can have negative interactions with other medications. The client needs to tell other physicians about taking MAOIs due to the risk of drug interactions.

When reviewing the health history of a patient who will be receiving antacids, the nurse recalls that antacids containing magnesium need to be used cautiously in patients with which condition? a. Peptic ulcer disease b. Renal failure c. Hypertension d. Heart failure

ANS: B Both calcium- and magnesium-based antacids are more likely to accumulate to toxic levels in patients with renal disease and are commonly avoided in this patient group. The other options are incorrect.

Which antacid is likely to cause acid rebound? a. Aluminum hydroxide b. Calcium carbonate c. Magnesium hydroxide d. Magnesium trisilicate

ANS: B While calcium carbonate is most effective in neutralizing acid, a significant amount can be systemically absorbed and can cause acid rebound. The other antacids do not have significant systemic absorption.

The nurse is providing patient teaching about antacids. Which statements about antacids are accurate? (Select all that apply.) a. Antacids reduce the production of acid in the stomach. b. Antacids neutralize acid in the stomach. c. Rebound hyperacidity may occur with calcium-based antacids. d. Aluminum-based antacids cause diarrhea. e. Magnesium-based antacids cause diarrhea.

ANS: B, C, E Antacids neutralize acid in the stomach. Magnesium-based antacids cause diarrhea, and aluminum-based antacids cause constipation. Calcium-based antacids often cause rebound hyperacidity.

An aging client diagnosed with chronic schizophrenia takes an antipsychotic and a beta-adrenergic blocking agent (propranolol) for hypertension. Understanding the combined side effects of these drugs, which statement by a nurse is most appropriate? A. "Make sure you concentrate on taking slow, deep, cleansing breaths." B. "Watch your diet and try to engage in some regular physical activity." C. "Rise slowly when you change position from lying to sitting or sitting to standing." D. "Wear sunscreen and try to avoid midday sun exposure."

ANS: C The most appropriate statement by the nurse is to instruct the client to rise slowly when changing positions. Antipsychotic medications and beta blockers cause a decrease in blood pressure. When given in combination, this side effect places the client at risk for developing orthostatic hypotension.

A client with constipation has been directed to take oral bisacodyl. The nurse instructs the client on how to receive the most rapid effect from the medication. The client demonstrates understanding of use of this medication by stating that which method will produce the most rapid effect? A. "I should take it at bedtime." B. "I will take it with a large meal." C. "I will take it on an empty stomach." D. "I will drink 2 glasses of milk when I take it."

ANS: C The most rapid results from bisacodyl occur when it is taken on an empty stomach. If it is taken at bedtime, the client will have a bowel movement in the morning. It will not have a rapid effect if taken with a large meal or with 2 glasses of milk.

A client diagnosed with schizophrenia is slow to respond and appears to be listening to unseen others. Which medication should a nurse expect a physician to order to address this type of symptom? A. Haloperidol (Haldol) to address the negative symptom B. Clonazepam (Klonopin) to address the positive symptom C. Risperidone (Risperdal) to address the positive symptom D. Clozapine (Clozaril) to address the negative symptom

ANS: C The nurse should expect the physician to order risperidone (Risperdal) to address the positive symptoms of schizophrenia. Risperidone (Risperdal) is an atypical antipsychotic used to reduce positive symptoms, including disturbances in content of thought (delusions), form of thought (neologisms), or sensory perception (hallucinations).

A client is diagnosed with schizophrenia. A physician orders haloperidol (Haldol) 50 mg bid, benztropine (Cogentin) 1 mg prn, and zolpidem (Ambien) 10 mg HS. Which client behavior would warrant the nurse to administer benztropine? A. Tactile hallucinations B. Tardive dyskinesia C. Restlessness and muscle rigidity D. Reports of hearing disturbing voices

ANS: C The symptom of tactile hallucinations and reports of hearing disturbing voices would be addressed by an antipsychotic medication such as haloperidol. Tardive dyskinesia, a potentially irreversible condition, would warrant the discontinuation of an antipsychotic medication such as haloperidol. An anticholinergic medication such as benztropine would be used to treat the extrapyramidal symptoms of restlessness and muscle rigidity.

A client diagnosed with schizophrenia takes an antipsychotic agent daily. Which assessment finding should a nurse immediately report to the client's attending psychiatrist? A. Respirations of 22 beats/minute B. Weight gain of 8 pounds in 2 months C. Temperature of 104F (40C) D. Excessive salivation

ANS: C When assessing a client diagnosed with schizophrenia who takes an antipsychotic agent daily, the nurse should immediately address a temperature of 104F (40C). A temperature this high can be a symptom of the rare but life-threatening neuroleptic malignant syndrome.

A patient has been taking famotidine (Pepcid) 20 mg bid to treat an ulcer but continues to have pain. The provider has ordered lansoprazole (Prevacid) 15 mg per day. The patient asks why the new drug is necessary, since it is more expensive. The nurse will explain that lansoprazole a. can be used for long-term therapy. b. does not interact with other drugs. c. has fewer medication side effects. d. is more potent than famotidine.

ANS: D Famotidine is a histamine2 (H2) blocker. When patients fail therapy with these agents, proton pump inhibitors, which can inhibit gastric acid secretion up to 90% greater than the H2 blockers, are used. Lansoprazole is not for long-term treatment and has drug interactions and drug side effects as do all other medications.

The nurse is teaching a patient who will be taking a proton pump inhibitor as long-term therapy about potential adverse effects. Which statement is correct? a. Proton pump inhibitors can cause diarrhea. b. These drugs can cause nausea and anorexia. c. Proton pump inhibitors cause drowsiness. d. Long-term use of these drugs may contribute to osteoporosis.

ANS: D New concerns have arisen over the potential for long-term users of proton pump inhibitors (PPIs) to develop osteoporosis. This is thought to be due to the inhibition of stomach acid, and it is speculated that PPIs speed up bone mineral loss. The other options are incorrect.

Education for the client who is taking MAOI's should include which of the following? A. Fluid and sodium replacement when appropriate, frequent drug blood levels, signs and symptoms of toxicity. B. Lifetime of continuous use, possible tardive dyskinesia, advantages of an injection every 2 to 4 weeks. C. Short-term use, possible tolerance to beneficial effects, careful tapering of the drug at the end of treatment. D. Tyramine-restricted diet, prohibitive concurrent use of over-the-counter medications without physician notification.

ANS: D Rationale: Tyramine can cause episodes of hypertensive crisis. Foods that contain tyramine include:aged cheeses, raisins, fava beans, red wines, smoked and processed meats, chicken of beef liver, soy sauce, meat tenderizer, chocolate.There is a lot of medication interactions that occur with MAOI's so it is important to consult your physician before taking any OTC meds.

A client diagnosed with chronic schizophrenia presents in an emergency department (ED) with uncontrollable tongue movements, stiff neck, and difficulty swallowing. The nurse would expect the physician to recognize which condition and implement which treatment? A. Neuroleptic malignant syndrome and treat by discontinuing antipsychotic medications B. Agranulocytosis and treat by administration of clozapine (Clozaril) C. Extrapyramidal symptoms and treat by administration of benztropine (Cogentin) D. Tardive dyskinesia and treat by discontinuing antipsychotic medications

ANS: D The nurse should expect that an ED physician would diagnose the client with tardive dyskinesia and discontinue antipsychotic medications. Tardive dyskinesia is a condition of abnormal involuntary movements of the mouth, tongue, trunk, and extremities that can be an irreversible side effect of typical antipsychotic medications.

A newly admitted client has started taking bupropion (Wellbutrin). The nurse monitors which of the following side effects that would indicate an overdose of the medication? A. Headache. B. Dizziness. C. Constipation. D. Seizure

ANS: D Wellbutrin (bupropion) is an antidepressant medication used to treat major depressive disorder and seasonal affective disorder. Overdose symptoms may include seizure. muscle stiffness. hallucinations. fast or uneven heartbeat. shallow breathing. or fainting.Options A. B. and C are the common side effects of the medication.

The nurse is caring for a client with gastroesophageal reflux disease (GERD) and would question an order for which of the following? 1) Amoxicillin (Amoxil) 2) Ranitidine (Zantac) 3) Pantoprazole (Protonix) 4) Calcium carbonate ( Tums)

ANSWER: 1 Antibiotics such as amoxicillin (Amoxil) are used in the treatment of peptic ulcers (PUD) caused by H. pylori. They are not indicated for the treatment of GERD. Options 2, 3, and 4 are incorrect. Antacids, H2 blockers, and PPIs are used in the treatment of GERD. Calcium carbonate, rantidine, and pantoprazole would be appropriate drugs to use.

The nurse is preparing to administer chemotherapy to the oncology client who also has an order for ondansetron (Zofran). When should the nurse administer the odansetron? 1) Every time the client complains of nausea 2) 30 to 60 min before starting chemotherapy 3) Only when the client complains of nausea 4) When the client begins to experience vomiting during the chemotherapy

ANSWER: 2 Rationale: To be most effective, ondansetron (Zofran) or other antiemetics should be administered 30 to 60 min before initiating the chemotherapy drugs. Options 1, 3, and 4 are incorrect. Almost all chemotherapy drugs have emetic potential and the nurse should not wait until the client complains of nausea or experiences vomiting before giving the drug. The client may complain of nausea more frequently than is possible to give the drug. Other nondrug relief strategies such as diversion techniques or ginger should also be tried.

A client with severe diarrhea has an order for diphenoxylate with atropine (Lomotil). When assessing for therapeutic effects, which of the following will the nurse expect to find? 1) Increased bowel sounds 2) Decreased belching and flatus 3) Decrease in loose, watery stools 4) Decreased abdominal cramping

ANSWER: 3 Rationale: A decrease in the consistency of stools is a therapeutic effect of diphenoxylate with atropine (lomotil). Options, 1, 2, 4 are incorrect. A decrease in bowel sounds rather than an increase would not be noted if the drug is having a therapeutic effect. The drug has no direct effect on the causes of belching or flatus. Although reduction in abdominal cramping may occur due to the decreased peristalsis, it is not the therapeutic indication for this drug.

A female client reports using OTC aluminum hydroxide (AlternaGel) for relief of gastric upset. She is on renal dialysis 3x a week. What should the nurse teach this client? 1) Continue using the antacids but if she needs to continue beyond a few months, she should consult the health care provider about different therapies. 2) Take the antacid no longer than 2 weeks; if it has not worked by then it will not be effective 3) Consult with the health care provider about the appropriate amount and type of antacid 4) Continue to take the antacid; it is OTC and safe

ANSWER: 3 Rationale: Antacids are generally combinations of aluminum hydroxide, calcium, and/or magnesium hydroxide. Hypermagnesemia, hypercalcemia, or hypophosphatemia can develop with the use of OTC antacids. Because this client is on renal dialysis, her kidneys are unable to adequately control the excretion of electrolytes. The nephrologist should be contacted about whether an antacid is appropriate for this client. Options 1, 2, 4 are incorrect. Because of concerns about electrolyte imbalance, taking the antacid for limited periods may not be advisable. Because a drug is OTC does not guarantee its safety and it may produce adverse effects in clients

In taking a new client's history, the nurse notices he has been taking omeprazole (Prilosec) consistently over the past 6 months for epigastric pain. Which recommendation would be the best for the nurse to give this client? 1) Try switching to a different form of the drug 2) Try a drug like cimetidine (Tagament) or famotidine (Pepcid) 3) Try taking the drug after meals instead of before meals 4) Check with his health care provider about his continued discomfort

ANSWER: 4 Rationale: PPIs, omeprazole (Prilosec) are recommended for short-term therapy, approximately 4 to 8 weeks in length. If symptoms of epigastric pain and discomfort continue, other therapies and screenings for H. pylori may be indicated. Options, 1,2, and 3 are incorrect. Switching to another PPI still exceeds the recommended time of use for this category of drugs. h2 receptor blockers such as cimetidine (Tagamet) and famotidine (Pepcid) may be indicated but their use should be evaluated by a health care provider because a more definitive treatment may be required. PPI should be taken 30 min before meals.

A 35 year old male client has been prescribed omeprazole (Prilosec) for treatment of GERD. Which of the following assessment findings would assist the nurse to determine whether drug therapy has been effective? Select all the apply 1) Decreased "gnawing" upper abdominal pain on an empty stomach 2) Decrease belching 3) Decreased appetite 4) Decreased nausea 5) Decreased dysphagia

ANSWERS: 2, 3, 5 Rationale: Symptoms of GERD include dysphagia, dyspepsia, nausea, belching, and chest pain. Therapeutic effects of omeprazole (Prilosec) would include relief of these symptoms. Options, 1 and 3 are incorrect. Gnawing or burning supper abdominal pain is symptomatic of PUD, not GERD. A decreased appetite should not occur with omeprazole

The nurse in the emergency department is caring for a patient with a suspected overdose of lorazepam (Ativan). Which agent is most likely to be administered to reverse the effects of diazepam? A. Naloxone [Narcan] B. Flumazenil [Romazicon] C. Acetylcysteine [Mucomyst] D. Vitamin K

B. Flumazenil [Romazicon] Flumazenil [Romazicon], a benzodiazepine receptor antagonist, is the treatment of choice for overdose of the benzodiazepine lorazepam (Ativan). Naloxone [Narcan] is used to reverse opioid overdose. Acetylcysteine [Mucomyst] is used to reverse acetaminophen [Tylenol]overdose. Vitamin K is used to reverse warfarin toxicity.

There is a risk of experiencing serotonin syndrome when SSRI's are given with monoamine oxidase inhibitors such as phenelzine (Nardil). Serotonin syndrome is best characterized in which of the following? A. Hypotension and urinary retention. B. Muscle rigidity and high fever. C. A productive cough and vomiting. D. Tea-colored urine and constipation.

B. Muscle rigidity and high fever.

A client has been taking 3 mg of risperidone twice a day for the past 8 days. At the follow-up appointment, the client reports tremors, shortness of breath, a fever, and sweating. What will the nurse do? A. Call 911 and have the client transported to the nearest psychiatric unit. B. Take the client's vital signs and arrange for immediate transfer to a hospital. C. Check the number of risperidone tablets left in the prescription bottle to see whether there was an overdose. D. Request a prescription for 2 mg of intramuscular benztropine stat and assess the client in 10 to 15 minutes for symptom relief.

B. Take the client's vital signs and arrange for immediate transfer to a hospital.

A client taking lithium carbonate (Lithobid) started complaining of nausea, vomiting, diarrhea, drowsiness, muscle weakness, tremor, blurred vision and ringing in the ears. The lithium level is 2 mEq/L. The nurse interprets this value as: A. Normal level. B. Toxic level. C. Below normal level. D. Above normal level.

B. Toxic level.

The nurse is reviewing medication therapy with the parents of an adolescent with ADHD. Which statement is correct? (Select all that apply.) a) "Be sure to have your child blow his nose before administering the nasal spray." b) "This medication is used only when symptoms of ADHD are severe." c) "The last dose should be taken 4 to 6 hours before bedtime to avoid interference with sleep." d) "Be sure to contact the physician right away if you notice expression of suicidal thoughts." e) "We will need to check your child's height and weight periodically to monitor physical growth." f) "If adverse effects become severe, stop the medication for 3 to 4 days."

C, D, E

A client is relying on OTC laxatives for regular elimination. Which of the following pieces of information is most important for the nurse to provide to the client? A. daily bowel movements are not necessary for good intestinal health B. Excessive laxative use may cause decreased sodium levels C. Chronic use of laxatives can lead to dependency of elimination D. The client should increase intake of high-fiber diet

C. Chronic use of laxatives can lead to dependency of elimination

A patient receiving an anticholinergic drug to treat nausea and vomiting should be taught to expect which side effect? A. Diarrhea B. Lacrimation C. Dry mouth D. Bradycardia

C. Dry mouth R: Anticholinergic drugs block the parasympathetic nervous system, which causes the body to "rest and digest." Blocking of these effects leads to constipation, urinary retention, and decreased secretions (dry mouth).

A client has a PRN order for loperamide (Imodium). The nurse should plan to administer this medication if the client has: A. Constipation B. Abdominal pain C. Episode of diarrhea D. Hematest-positive nasogastric tube drainage

C. Episode of diarrhea

A client with a history of methamphetamine use is admitted to the medical unit. What clinical manifestation does the nurse expect when assessing the client? A. Constricted pupils B. Intractable diarrhea C. Increased heart rate D. Decreased respirations

C. Increased heart rate

Which of the following conditions can you safely administer Metoclopramide (Reglan)? A. Patient with bowel obstruction. B. Patient with gastrointestinal hemorrhage. C. Patient undergoing radiation. D. Patients with pheochromocytoma.

C. Patient undergoing radiation. Metoclopramide can be safely administered to patients having vomiting episodes following radiation, chemotherapy, and surgery. Options A and B: It is contraindicated in patients with conditions where stimulation of gastrointestinal motility might be harmful, such as mechanical bowel obstruction, bowel perforation, or gastrointestinal hemorrhage. Option D: Hypertensive crises may occur in patients with pheochromocytoma due to induction of catecholamine release from the tumor.

A nurse notes that a client with schizophrenia and receiving an antipsychotic medication is having uncontrolled movement of the lips and tongue. The nurse determines that the client is experiencing? A. Hypertensive crisis. B. Parkinsonism. C. Tardive dyskinesia. D. Neuroleptic malignant syndrome.

C. Tardive dyskinesia.

A client has been receiving lithium for the past 2 weeks for the treatment of bipolar disorder, manic phase. What will the nurse include in the teaching plan for this client? A. A diuretic is necessary for anyone taking lithium. B. Lithium must be taken for the rest of the client's life. C. The blood level of lithium must be checked every month. D. A low-sodium diet must be followed while lithium is being taken.

C. The blood level of lithium must be checked every month.

A nurse teaches a client taking metoclopramide (Reglan) to discontinue the medication immediately and call the physician if which side effect occurs with long- term use? A. Excessive excitability B. Anxiety or irritability C. Uncontrolled rhythmic movements of the face or limbs D. Dry mouth not helped by the use of sugar-free hard candy

C. Uncontrolled rhythmic movements of the face or limbs

Which agent is most likely to be prescribed today for short-term management of insomnia? A. Secobarbital [Seconal Sodium] B. Meprobamate [Miltown] C. Zolpidem [Ambien] D. Flumazenil [Romazicon]

C. Zolpidem [Ambien] Zolpidem is a benzodiazepine-like drug that is widely used in the treatment of insomnia. It is safer than the barbiturates (secobarbital) or miscellaneous sedative-hypnotics (meprobamate). Flumazenil is a reversal agent for the benzodiazepines.

When planning administration of antiemetic medications to a patient, the nurse is aware that combination therapy is preferred because A. the risk of constipation is decreased. B. lower doses of medication are cost-effective. C. different vomiting pathways are blocked. D. increased sedation is achieved by higher doses of medication.

C. different vomiting pathways are blocked. R: Combining antiemetic drugs from various categories allows the blocking of the vomiting center and chemoreceptor trigger zone through different pathways, thus enhancing the antiemetic effect.

A physician orders a colonoscopy b/c of the client's persistent diarrhea. The nurse instructs the client to drink 250 mL of an electrolyte solution called GOLYTELY every 15 minutes over a 2 hour period. Which observation by the nurse provides the best evidence that the solution has achieved its primary purpose? A. the client's serum electrolyte levels are normal B. the client's intake approximates the output C. the client's stools become clear liquid D. the client's bladder fills with urine

C. the client's stools become clear liquid

The nurse recognizes that metoclopramide (Reglan) is useful in treating postoperative nausea and vomiting because it A. decreases motility in the gastrointestinal tract. B. decreases chemoreceptor stimulation. C. improves the body's response to analgesia. D. promotes motility in the small intestine.

D. promotes motility in the small intestine. R: Metoclopramide works by increasing gastrointestinal motility in the small intestine, thus minimizing gastric distention and accompanying stimulation of the vomiting center.

Select all that apply that is appropriate when there is a benzodiazepine overdose: 1. Administration of syrup of ipecac 2. Gastric lavage 3. Activated charcoal and a saline cathartic 4. Hemodialysis 5. Administration of Flumazenil

2, 3, 5

Methylphenidate (Ritalin) is prescribed to an 8-year-old child for the treatment of attention deficit hyperactivity disorder (ADHD). The nurse will most likely monitor which of the following during the medication therapy? A. Deep tendon reflex. B. Intake and output. C. Temperature and breath sound. D. Height and weight.

D. Height and weight.

A client is receiving haloperidol for agitation, and the nurse is monitoring the client for side effects. Which response identified by the nurse is unrelated to an extrapyramidal tract effect? A. Akathisia B. Opisthotonos C. Oculogyric crisis D. Hypertensive crisis

D. Hypertensive crisis

A health care provider has written a prescription for ranitidine (Zantac) 300 mg once daily on the client's discharge medication list. The nurse plans to instruct the client to take the medication at which time? 1. At bedtime 2. After lunch 3. With supper 4. Before breakfast

1. At bedtime Rationale: A single daily dose of ranitidine should be taken at bedtime. This allows for prolonged effect and the greatest protection of gastric mucosa. Therefore, the other options are incorrect.

A client rates anxiety at 8 out of 10 on a scale of 1 to 10, is restless, and has narrowed perceptions. Which of the following medications would appropriately be prescribed to address these symptoms? Select all that apply. 1. Clonazepam (Klonopin). 2. Lithium carbonate (lithium). 3. Clozapine (Clozaril). 4. Oxazepam (Serax).

1. Clonazepam (Klonopin) is a benzodiazepine. Benzodiazepines are classified as antianxiety medications and would be appropriately prescribed toaddress signs and symptoms of anxiety. 4. Oxazepam (Serax) is a benzodiazepine. Benzodiazepines are classified as antianxiety medications and would be appropriately prescribed to address signs and symptoms of anxiety.

Select all that apply to the use of barbiturates in treating insomnia: 1. Barbiturates deprive people of NREM sleep 2. Barbiturates deprive people of REM sleep 3. When the barbiturates are discontinued, the NREM sleep increases. 4. When the barbiturates are discontinued, the REM sleep increases. 5. Nightmares are often an adverse effect when discontinuing barbiturates.

2, 4, 5

A patient is admitted to the emergency department with an overdose of a barbiturate. The nurse immediately prepares to administer which of the following from the emergency drug cart? 1. Naloxone HCl (Narcan) 2. Activated charcoal 3. Flumazenil (Romazicon) 4. Ipecac syrup

2. Activated charcoal

Older adults who take long-acting sedatives or hypnotics are likely to experience: 1. Hallucinations 2. Ataxia 3. Alertness 4. Dyspnea

2. Ataxia

In which situation would benzodiazepines be prescribed appropriately? 1. Long-term treatment of posttraumatic stress disorder, convulsive disorder, andalcohol withdrawal. 2. Short-term treatment of generalized anxiety disorder, alcohol withdrawal, and preoperativesedation. 3. Short-term treatment of obsessive-compulsive disorder, skeletal muscle spasms, andessential hypertension. 4. Long-term treatment of panic disorder, alcohol dependence, and bipolar affectivedisorder: manic episode.

2. Benzodiazepines are prescribed for short term treatment of generalized anxiety disorder and alcohol withdrawal, and can be prescribed during preoperative sedation.

When teaching a client who is being started on imipramine hydrochloride (Tofranil), when should the nurse tell the client that the medication should have the desired effects? 1. Desired effects start during the first week of administration. 2. Desired effects do not occur for 3 to 5 weeks of administration. 3. Desired effects start immediately following initial administration. 4. Desired effects do not occur until after 2 months of administration.

2. Desired effects do not occur for 3 to 5 weeks of administration.

The client has been taking omeprazole (Prilosec) for 4 weeks. The nurse evaluates that the client is receiving an optimal intended effect of the medication if the client reports the absence of which symptom? 1. Diarrhea 2. Heartburn 3. Flatulence 4. Constipation

2. Heartburn Rationale: Omeprazole is a proton pump inhibitor classified as an antiulcer agent. The intended effect of the medication is relief of pain from gastric irritation, often called "heartburn" by clients. Omeprazole is not used to treat the conditions identified in options 1, 3, and 4.

A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is reinforcing teaching for the client about the medications prescribed, including clarithromycin (Biaxin), esomeprazole (Nexium), and amoxicillin (Amoxil). Which statement by the client indicates the best understanding of the medication regimen? 1. "My ulcer will heal because these medications will kill the bacteria." 2. "These medications are only taken when I have pain from my ulcer." 3. "The medications will kill the bacteria and stop the acid production." 4. "These medications will coat the ulcer and decrease the acid production in my stomach."

3. "The medications will kill the bacteria and stop the acid production." Rationale: Triple therapy for Helicobacter pylori infection usually includes two antibacterial drugs and a proton pump inhibitor. Clarithromycin and amoxicillin are antibacterials. Esomeprazole is a proton pump inhibitor. These medications will kill the bacteria and decrease acid production.

A long-term care nurse is caring for an older client taking cimetidine (Tagamet). The nurse observes this client frequently for which most common central nervous system (CNS) side effect of this medication? 1. Tremors 2. Dizziness 3. Confusion 4. Hallucinations

3. Confusion Rationale: Older clients are especially susceptible to CNS side effects of cimetidine, of which confusion is most common. Less common ones are headache, dizziness, drowsiness, and hallucinations.

A client has begun taking lansoprazole (Prevacid). The nurse monitors for which intended effect of this medication? 1. Relief of abdominal pain 2. Decrease in intestinal gas 3. Relief of nighttime heartburn 4. Absence of nausea and vomiting

3. Relief of nighttime heartburn Rationale: Lansoprazole is a proton pump inhibitor that suppresses gastric acid secretion. It is not used as an antiemetic (option 4). It is not used to directly treat abdominal pain or intestinal gas.

A hospitalized client asks the nurse for sodium bicarbonate to relieve heartburn following a meal. The nurse reviews the client's medical record, knowing that the medication is contraindicated in which of the following conditions? 1. urinary calculi 2. chronic bronchitis 3. metabolic alkalosis 4. respiratory acidosis

3. metabolic alkalosis

The client has a new prescription for metoclopramide (Reglan). On review of the chart, the nurse identifies that this medication can be safely administered with which condition? 1. Intestinal obstruction 2. Peptic ulcer with melena 3. Diverticulitis with perforation 4. Vomiting following cancer chemotherapy

4. Vomiting following cancer chemotherapy Rationale: Metoclopramide is a gastrointestinal (GI) stimulant and antiemetic. Because it is a GI stimulant, it is contraindicated with GI obstruction, hemorrhage, or perforation. It is used in the treatment of emesis after surgery, chemotherapy, and radiation.

A client who is on lithium carbonate (Lithobid) will be discharged at the end of the week. In reinforcing a discharge teaching plan, the nurse should include which instructions? 1. Avoid soy sauce, wine, and aged cheese. 2. Have the lithium level checked every week. 3. Take medication only as prescribed because it can become addicting. 4. Consume adequate amounts of sodium and water.

4. Consume adequate amounts of sodium and water.

The nurse is preparing to reinforce instructions to the client who has been given a prescription for diphenoxylate with atropine (Lomotil). Which instructions should the nurse include? 1. Anticipate excitability as a side effect. 2. Take the medication with a bulk-forming laxative. 3. Expect increased saliva production while taking the medication. 4. Do not exceed the recommended dose because it can be habit forming.

4. Do not exceed the recommended dose because it can be habit forming. Rationale: Diphenoxylate with atropine is an antidiarrheal, and the client should not exceed the recommended dose because it may be habit forming. Because it is an antidiarrheal, it should not be taken with a laxative. Side effects of the medication include dry mouth and drowsiness.

Which of the following is an appropriate nursing intervention for patients who are receiving CNS depressants? 1. Prevent any activity within the hospital setting while on oral muscle relaxants 2. Make sure that the patient knows that sedation should be minimal with these agents. 3. Cardiovascular stimulation, a common side effect, would lead to hypertension 4. Make sure the patient's call light is close by in case of the need for assistance with activities.

4. Make sure the patient's call light is close by in case of the need for assistance with activities.

The client has a PRN prescription for ondansetron (Zofran). For which condition should this medication be administered to the postoperative client? 1. Paralytic ileus 2. Incisional pain 3. Urinary retention 4. Nausea and vomiting

4. Nausea and vomiting Rationale: Ondansetron is an antiemetic used to treat postoperative nausea and vomiting, as well as nausea and vomiting associated with chemotherapy. The other options are incorrect.

A client is taking docusate sodium (Colace). The nurse monitors which result to determine whether the client is having a therapeutic effect from this medication? 1. Abdominal pain 2. Reduction in steatorrhea 3. Hematest-negative stools 4. Regular bowel movements

4. Regular bowel movements Rationale: Docusate sodium is a stool softener that promotes the absorption of water into the stool, producing a softer consistency of stool. The intended effect is relief or prevention of constipation. The medication does not relieve abdominal pain, stop gastrointestinal (GI) bleeding, or decrease the amount of fat in the stools.

A nurse is planning to administer ondansetron to a client. For which of the following adverse effects of ondansetron should the nurse monitor? (Select all that apply.) A. Headache B. Diarrhea C. Shortened PR interval D. Hyperglycemia E. Prolonged QT interval

A, B, E

A client with depression who has been taking amitriptyline for three months returns to the clinic for a follow-up. The nurse observes the client for which of the following symptoms? A. Suicidal thoughts. B. Lack of energy. C. Loss of interest in personal appearance. D. Neglect of responsibilities.

ANS: A Clients may have thoughts about suicide when taking an antidepressant such as amitriptyline. especially clients younger than 24 years old. Options B. C. and D are signs of depressions but are most likely improved as the treatment goes on.

The nurse had administered prochlorperazine (Compazine) to a client for a postoperative nausea. Before administering this medication, it is essential that the nurse check which of the following? 1) Pain level 2) Blood pressure 3) Breath sounds 4) Temperature

ANSWER: 2 Rationale: Prochlorperzine (Compazine) may cause decreased blood pressure or hypotension as an adverse effect. The blood pressure should be taken before administering and the drug help if the BP is below 90/60 or is below HCP orders. Options, 1, 3, and 4 are incorrect. Although it is important to assess pain level, breath sounds, and temperature in a postoperative client, prochlorperzine does not directly affect these parameters

A client tells the nurse that he takes laxatives every day but is still constipated. The nurse's response is based on: A. Habitual laxative use is the most common cause of chronic constipation. B. If laxatives are not effective, the client should begin to use enemas. C. A laxative that works by a different method should be used. D. Chronic constipation is nothing to be concerned about.

Ans: A Feedback: Occasional use of laxatives is not harmful for most people, but they should not become dependent on them. Although many people do take laxatives because they believe they are constipated, most are unaware that habitual use of laxatives is the most common cause of chronic constipation.

The home care nurse visits a client and is reviewing the medications that the client uses. Which medication would the nurse identify as acting directly on the intestine to slow bowel motility, or to absorb excess fluid in the bowel? a) Laxative b) Antidiarrheal agent c) Suppository d) Antiflatulence agent

Ans: B Antidiarrheal agents act directly on the intestine to slow bowel motility or to absorb excess fluid in the bowel. Antiflatulence agents are used to relieve gas. Laxatives promote evacuation of hardened stool from the bowel. Suppositories, when inserted into the rectum, melt and can be absorbed for systemic or local effects.

A client with schizophrenia is started on a regimen of chlorpromazine. After 10 days a shuffling gait, tremors, and some rigidity are apparent. Benztropine mesylate 2 mg by mouth daily is prescribed. What does the nurse remember when administering these medications together? A. Both medications are cholinesterase inhibitors. B. Both medications have a cholinergic-blocking action. C. The antipsychotic effects of chlorpromazine will be decreased. D. The synergistic effect of these medications will cause drooling.

B. Both medications have a cholinergic-blocking action.

A nurse is caring for a client who has diabetes and is experiencing nausea due to gastroparesis. The nurse should expect a prescription for which of the following medications? A. Lubiprostone B. Metoclopramide C. Bisacodyl D. Loperamide

B. Metoclopramide

A client has been taking aluminum hydroxide 30 mL six times per day at home to treat his peptic ulcer. He tells the nurse that he has been unable to have a bowel movement for 3 days. Based on this information, the nurse would determine that which of the following is the most likely cause of the client's constipation? A. The client needs to increase his daily exercise B. The client has not been including enough fiber in his diet C. The client is experiencing a side effect of the aluminum hydroxide D. The client has developed a gastrointestinal obstruction

C. The client is experiencing a side effect of the aluminum hydroxide

A nurse is administering medications to clients on a psychiatric unit. What does the nurse identify as the reason that so many psychiatric clients are given the drug benztropine or trihexyphenidyl in conjunction with the phenothiazine-derivative neuroleptic medications? A. They reduce postural hypotension. B. They potentiate the effects of the neuroleptic drug. C. They combat the extrapyramidal side effects of the neuroleptic drug. D. They ameliorate the depression that may accompany schizophrenia.

C. They combat the extrapyramidal side effects of the neuroleptic drug.

Which statement about psychotherapeutic drugs in elderly clients requires correction? A. Tricyclic antidepressants may increase anxiety in elderly clients. B. Normal dosage of lithium may result in lithium toxicity in elderly clients. C. Elderly clients on antipsychotic drugs are susceptible to orthostatic hypotension. D. Low serum levels of the drug are reported in elderly clients on psychotherapeutic drugs.

D. Low serum levels of the drug are reported in elderly clients on psychotherapeutic drugs.

A client is taking docusate sodium (Colace). The nurse monitors which of the following to determine whether the client is having a therapeutic effect from this medication? A. Abdominal pain B. Reduction in steatorrhea C. Hematest-negative stools D. Regular bowel movements

D. Regular bowel movements

The nurse is caring for a group of patients who have been prescribed sedative-hypnotic agents. Which agent has the greatest abuse potential? A. Diazepam [Valium] B. Triazolam [Halcion] C. Zolpidem [Ambien] D. Secobarbital [Seconal]

D. Secobarbital [Seconal] Secobarbital is a barbiturate drug that carries a higher abuse potential than the benzodiazepine or benzodiazepine-like drugs.

Which drug works by blocking serotonin in the gastrointestinal tract, vomiting center, and chemoreceptor trigger zone (CTZ)? A. metoclopramide (Reglan) B. meclizine (Antivert) C. droperidol (Inapsine) D. ondansetron (Zofran)

D. ondansetron (Zofran) R: Ondansetron is a serotonin blocker. Metoclopramide is a prokinetic drug, meclizine is an antihistamine, and droperidol is an antidopaminergic drug.

The patient asks how stool softeners relieve constipation. Which of the following would be the best response by the nurse? Stool softeners relieve constipation by: a. stimulating the walls of the intestine b. promoting the retention of sodium in the fecal mass c. promoting the retention of water in the fecal mass d. lubricating the intestinal walls

c. promoting the retention of water in the fecal mass

A patient is receiving an aluminum-containing antacid. The nurse will inform the patient to watch for which possible adverse effect? a. Diarrhea b. Constipation c. Nausea d. Abdominal cramping

ANS: B Aluminum-based antacids have a constipating effect as well as an acid-neutralizing capacity. The other options are incorrect.

In teaching a client about his antidepressant medication, fluoxetine, which of the following would the nurse include? (Select ALL that apply) A. Don't eat chocolate while taking this medication. B. Keep taking this medication, even if you don't feel it is helping. It sometimes take a while to take effect. C. Don't take this medication with the migraine drugs "triptans". D. Go to the lab each week to have your blood drawn for therapeutic levels of this drug. E. This drug causes a high degree of sedation, so take it just before bedtime.

B, C

The nurse is teaching a patient about treatment w/an SSRI antidepressant. Which teaching considerations are appropriate? (Select all that apply.) a) The patient should be told which foods contain tyramine and instructed to avoid these foods. b) The patient should be instructed to use caution when standing up from a sitting position. c) The patient should not take any products that contain the herbal product St. John's wort. d) This medication should not be stopped abruptly. e) Drug levels may become toxic if dehydration occurs. f) The patient should be told to check with the prescriber before taking and OTC medications.

B, C, D, F

A client who has been taking the prescribed dose of zolpidem for 5 days returns to the clinic for a follow-up visit. When interviewing the client, the nurse identifies that the medication has been effective when the client makes which statement? A. "I have less pain." B. "I have been sleeping better." C. "My blood glucose is under control." D. "My blood pressure is coming down."

B. "I have been sleeping better."

Dicyclomine hydrochloride has been prescribed for a client with irritable bowel syndrome, and the nurse provides instructions to the client about how to take this medication. Which statement, if made by the client, indicates an understanding of how to take this medication? A. "I should take the pill with food and at mealtimes." B. "I should take the pill 30 minutes before each meal." C. "I should take the pill after I have finished eating my meal." D. "I should take the pill when I first wake up in the morning and right before I go to bed."

B. "I should take the pill 30 minutes before each meal." Dicyclomine hydrochloride is an anticholinergic, antispasmodic agent often used to treat irritable bowel syndrome that is unresponsive to diet therapy. To be effective in decreasing bowel motility, antispasmodic medication should be administered 30 minutes before meals. The other options are incorrect.

A client is taking an antacid for treatment of a peptic ulcer. Which of the following statements best indicates that the client understands how to correctly take the antacid? A. "I should take my antacid before I take my other medications." B. "It is best for me to take my antacid 1 to 3 hours after meals." C. "I need to decrease my intake of fluids so that I don't dilute the effects of my antacid." D. "My antacid will be most effective if I take it whenever I experience stomach pains."

B. "It is best for me to take my antacid 1 to 3 hours after meals."

A client asks the nurse how psychotropic medications work. How does the nurse reply? A. "These medications decrease the metabolic needs of your brain." B. "These medications increase the production of healthy nervous tissue." C. "These medications affect the chemicals used in communication between nerve cells." D. "These medications regulate the sensory input received from the external environment."

C. "These medications affect the chemicals used in communication between nerve cells."

The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the client, indicates the best understanding of the medication therapy? A. "Omeprazole (Prilosec) will coat the ulcer and help it heal." B. "Antacids will coat my stomach." C. "Sucralfate (Carafate) will change the fluid in my stomach." D. "The cimetidine (Tagamet) will cause me to produce less stomach acid."

D. "The cimetidine (Tagamet) will cause me to produce less stomach acid."

Which toxic effect would the nurse find in a client who has overdosed on isocarboxazid? A. Mydriasis B. Bradycardia C. Hypothermia D. Circulatory collapse

D. Circulatory collapse

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? A.Norepinephrine B. Acetylcholine C. Serotonin (5-HT) D. Gamma-aminobutyric acid (GABA)

D. Gamma-aminobutyric acid (GABA) Alprazolam is a benzodiazepine; this class of drugs reduces anxiety by potentiating the action of GABA.

An antianxiety medication is prescribed for an extremely anxious client. The client says, "I'm afraid to take this medication because I heard they're addictive." The nurse teaches the client that antianxiety medications have what properties? A. Rarely cause dependence when the dosage is controlled B. May require increases in dosage but rarely cause dependence C. Usually result in psychological but not physiologic dependence D. Have the potential for physiologic and psychological dependence

D. Have the potential for physiologic and psychological dependence

Imipramine, 75 mg three times per day, is prescribed for a client. What nursing action is appropriate when this medication is being administered? A. Telling the client that barbiturates and steroids will not be prescribed B. Warning the client not to eat cheese, fermented products, and chicken liver C. Monitoring the client for increased tolerance and reporting when the dosage is no longer effective D. Having the client checked for increased intraocular pressure and teaching about glaucoma symptoms

D. Having the client checked for increased intraocular pressure and teaching about glaucoma symptoms

A patient w/narcolepsy will begin treatment w/a CNS stimulant. The nurse expects to see which adverse effect? a) Bradycardia b) Nervousness c) Mental clouding d) Drowsiness at night

b) Nervousness