NKTR Questions (CH. 3, 4, 6, 7)

What is the primary desired outcome of nonselective adrenergic agonist medication therapy? SATA 1. Improved coronary output 2. Decreased nasal congestion 3. Relaxation of bronchial tree 4. Vasoconstriction of blood vessels 5. Management of anaphylactic shock

1. Improved coronary output 4. Vasoconstriction of blood vessels

What should the nurse monitor to evaluate the effectiveness of carbamazepine in the management of a clients trigeminal neuralgia? 1. Pain intensity 2. Liver function 3. Cardiac output 4. Seizure activity

1. Pain intensity

When considering client safety, which statements should the nurse stress most when discussing medication instructions with a client who has been recently prescribed a hypnotic sedative? 1. "I need to share with you the signs and symptoms of drug tolerance." 2. "This medication will affect your rapid eye movement sleep." 3. "This medication has more effect on sleep then sedatives do." 4. "A barbiturate is a type of sedative-hypnotic."

1. "I need to share with you the signs and symptoms of drug tolerance."

A client is being considered for a prescription for pseudoephedrine. After assessing the client's current medication history, which medication poses a major drug interaction? 1. A serotonin/norepinephrine reuptake inhibitor 2. Tricyclic antidepressant 3. A beta-blocker 4. Digoxin

1. A serotonin/norepinephrine reuptake inhibitor

A client who is receiving phenytoin asks why folic acid was prescribed. What is the best explanation by the nurse? 1. Absorption from foods is inhibited. 2. The action of phenytoin is potentiated. 3. Absorption of iron from foods is improved. 4. Neuropathy caused by phenytoin is prevented.

1. Absorption from foods is inhibited

Damage or dysfunction of what organ increases the clients needs for adrenergic medication therapy? 1. Adrenal glands 2. Cerebral cortex 3. Lungs 4. Liver

1. Adrenal glands

Which client diagnoses would be a contraindication to the prescription of the receptor antagonist, phentolamine? 1. Angina 2. Pneumonia 3. Kidney disease 4. Cerebral arteriosclerosis

1. Angina

Which statements should the nurse rely upon when preparing information to discuss with a client who has been prescribed a CNS depressant/sedative? SATA 1. Causes a general anesthetic affect with very large doses 2. Produces no hypnotic affect with any dosage 3. Helps relieve anxiety with low doses 4. Reduces excitability 5. Causes insomnia

1. Causes a general anesthetic affect with large doses 3. Helps relieve anxiety with low doses 4. Reduces excitability

A nurse is assessing a client with a diagnosis of primary insomnia. Which finding from the client's history may be the cause of this disorder? SATA 1. Chronic stress 2. Severe anxiety 3. Generalized pain 4. Excessive caffeine 5. Chronic depression 6. Environment noise

1. Chronic stress 4. Excessive caffeine 6. Environmental noise

For which client diagnoses would epinephrine therapy be contraindicated? SATA 1. Closed angle glaucoma 2. Hyperthyroidism 3. Hypotension 4. Tachycardia 5. Lactation

1. Closed angle glaucoma 2. Hyperthyroidism

A client is prescribed a cholinergic medication affecting the parasympathetic nervous system. What physical processes are stimulated by the system? SATA 1. Digestion 2. Heart rate 3. Urination 4. Defecation 5. Fight or flight

1. Digestion 3. Urination 4. Defecation

The nurse should stress to a client prescribed a nonselective adrenergic agonist the importance of reporting which potential side effect of therapy? SATA 1. Dizziness 2. Anorexia 3. Insomnia 4. Constipation 5. Restlessness

1. Dizziness 2. Anorexia 3. Insomnia 5. Restlessness

The client has been prescribed oxcarbazepine. Which nursing assessments are of particular importance to a client prescribed iminostilbene therapy for a seizure disorder? 1. Eye 2. Skin 3. Hearing 4. Hematologic 5. Gastrointestinal

1. Eye 2. Skin 4. Hematologic

A client has been prescribed a cholinesterase inhibitor to serve as an irreversible inhibitor. Which disorder has a client most likely been diagnosed with? 1. Glaucoma 2. Dementia 3. Myasthenia gravis 4. COPD

1. Glaucoma

A client with a history of coronary artery disease is admitted with pneumonia. The healthcare provider prescribes atenolol. What should the nurse monitor to determine the therapeutic effect of atenolol? 1. Heart rate 2. Respirations 3. Temperature 4. Pulse oximetry

1. Heart rate

A nurse is providing instructions for a client who is receiving phenytoin but has limited access to health care. What side effect is the basis for the nurse's emphasis on meticulous oral hygiene? 1. Hyperplasia of the gums 2. Alkalinity of the oral secretions 3. Irritation of the gingiva and destruction of tooth enamel 4. Promotion of plaque and bacterial growth at the gum lines

1. Hyperplasia of the gums

Considering client safety, which component of medication education has the most importance for a client prescribed a nonselective adrenergic agonists? 1. Recognizing and reporting adverse effects 2. Administering the medication as prescribed 3. Protocol for scheduling missed medication doses 4. The need to stop smoking any tobacco-based product

1. Recognizing and reporting adverse effects

An older adult client shares that, "I don't sleep as well as I did when I was younger." What fact about sleep disorders should the nurse use to base their response to this specific client's statement? 1. Sleep cycles are affected by age. 2. Sleep disorders are common among adults. 3. Sleep is very important to restoring the body. 4. Sleep disorders are usually reversible with appropriate treatment.

1. Sleep cycles are affected by age

Which clients have considerations that contraindicate the use of the melatonin agonist, Ramelteon? SATA 1. The woman who is breastfeeding 2. The toddler diagnosed with asthma 3. The man diagnosed with sleep apnea 4. The woman who is 30 weeks pregnant 5. The man diagnosed with cirrhosis of the liver

1. The woman who is breastfeeding 2. The toddler diagnosed with asthma 3. The man diagnosed with sleep apnea 5. The man diagnosed with cirrhosis of the liver

A client is receiving phenytoin for a seizure disorder and heparin for a deep vein thrombosis. Warfarin is added in preparation for discontinuing the heparin. Why must the nurse observe the client closely during the initial days of treatment with warfarin? 1. Warfarin affects the metabolism of phenytoin. 2. Phenytoin decreases warfarin's anticoagulant effect. 3. Warfarin's action is greater in clients with seizure disorders. 4. Seizures increase the metabolic degradation rate of warfarin.

1. Warfarin affects the metabolism of phenytoin

A client who is receiving phenytoin to control a seizure disorder questions to nurse regarding this medication after discharge. The nurse's best response is "This medication: 1. will probably be continued for life." 2. prevents the occurrence of seizures." 3. needs to be taken during periods of emotional stress." 4. can usually be stopped after a year's absence of seizures."

1. will probably be continued for life."

Which statement made by a client, who has developed a physical dependence on a hypnotic drug, demonstrates effective learning concerning the withdrawal process? SATA 1. "The symptoms of withdrawal will occur as soon as I stop the medication." 2. "I understand I might need to taper off from a cross-tolerant drug." 3. "There is a risk that I might become delirious during withdrawal." 4. "At least this drug doesn't make you emotionally dependent." 5. "I will have to gradually come off the medication."

2. "I understand I might need to taper off from a cross-tolerant drug." 3. "There is a risk that I might become delirious during withdrawal." 5. " I will have to gradually come off the medication."

A client who is in a four-bed room since admission becomes extremely anxious and is having difficulty sleeping. What is the nurse's best response? 1. "You seem unable to sleep at night." 2. "I'm going to move you to a private room." 3. "I'll get you the sedative that was prescribed." 4. "You'll be able to fall asleep when you're tired."

2. "I'm going to move you to a private room."

A client, recently diagnosed with status epilepticus, is prescribed anticonvulsant therapy. What response should the nurse provide when asked, "How long will I need to take this medicine?" 1. "That's a question best answered by your primary healthcare provider." 2. "It is not uncommon for the therapy to be necessary for a lifetime." 3. "It is a difficult situation but try your best not to worry." 4. "That decision varies from client to client."

2. "It is not uncommon for the therapy to be necessary for a lifetime."

A client is being treated for depression. Which question is directed at assessing the client's ability to metabolize catecholamines? 1. "What chronic physical conditions are you being treated for?" 2. "What antidepressant medication are you prescribed?" 3. "Are you adhering to any specific diet restrictions?" 4. "Do you exercise regularly?"

2. "What antidepressant medication are you prescribed?"

And adrenergic agonist targets which receptors to improve circulation in the eyes, prostate, and blood vessels? 1. Dopaminergic 2. Alpha 1 3. Beta 1 4. Beta 2

2. Alpha 1

A client who is obtund has a blood pressure of 85/35 mm Hg after a blood transfusion. In an effort to support renal perfusion, the nurse administers dopamine at 2 mcg/kg/min as prescribed. What is the most relevant outcome indicating effectiveness of the medication for this client? 1. A decrease in blood pressure 2. An increase in urinary output 3. A decrease in core temperature 4. An increase in level of consciousness

2. An increase in urinary output

Which medication classification is likely to produce a drug interaction with the acetylcholinesterase inhibitor, donepezil? 1. NSAIDs 2. Beta blockers 3. Corticosteroids 4. Tricyclic antidepressants

2. Beta blockers

A client with myasthenia gravis has been receiving neostigmine and asks about its action. What information about its action should the nurse consider when formulating a response? 1. Stimulates the cerebral cortex 2. Blocks the action of cholinesterase 3. Replaces deficient neurotransmitters 4. Accelerates transmission along neural sheaths

2. Blocks the action of cholinesterase

Propranolol is prescribed for a client with hypertension. For which side effect should the nurse monitor the client? 1. Hirsutism 2. Bradycardia 3. Restlessness 4. Hypertension

2. Bradycardia

What is an example of a direct adrenergic agonistic drug? 1. Ephedrine 2. Epinephrine 3. Amphetamine 4. Pseudoephedrine

2. Epinephrine

What medication should the nurse expect to administer to actively reverse the overdose sedative effects of benzodiazepines? 1. Lithium 2. Flumazenil 3. Methadone 4. Chlorpromazine

2. Flumazenil

When entering a room on a medical unit, the nurse identifies that a client is having a seizure. What should the nurse do in addition to protecting the client from self-injury? 1. Insert an oral airway. 2. Monitor the seizure activity. 3. Turn the client on the left side. 4. Begin oxygen by mask at 8 L/min

2. Monitor the seizure activity

A client with a history of seizures is admitted with a partial occlusion of the left common carotid artery. The client has been taking phenytoin for 10 years. When planning care for this client, what should the nurse do first? 1. Place in airway and restraints at the bedside. 2. Obtain a history of seizure type and incidence. 3. Ask the client to remove any dentures and eyeglasses. 4. Observed the client for increased restlessness and agitation.

2. Obtain a history of seizure type and incidence

A nurse is caring for a client who abruptly withdrew from barbiturate use. What should the nurse anticipate that the client may experience? 1. Ataxia 2. Seizures 3. Diarrhea 4. Urticaria

2. Seizures

A client newly prescribed a sedative-hypnotic medication asks the nurse, "How long will I be expected to take this medication?" Considering client safety, what fact about this classification of medications should the nurse base the response to the client's question? 1. Duration of treatment depends on the nature of the sleep disorder. 2. This type of medication is generally prescribed for short-term or occasional use. 3. Hypnotic medications alter the character or duration of rapid eye movement sleep. 4. This classification's tendency to cause the development of tolerance limits its long-term usefulness.

2. This type of medication is generally prescribed for short-term or occasional use.

A client is prescribed endrophonium, an acetylcholinesterase inhibitor, for a newly diagnosed myasthenia gravis. Which assessment data poses a contraindication for this medication? 1. Photosensitivity 2. Urinary retention 3. Dysrhythmia 4. Asthma

2. Urinary retention

A child is to receive 60 mg of phenytoin. The medication is available as an oral suspension that contains 125 mg/5 mL. How many milliliters should the nurse administer?

2.4 mL

A child with a seizure disorder is to be discharged with a prescription for phenytoin 140 mg a day to be divided into two doses. The hospital pharmacy prepares an oral suspension at a concentration of 125 mg/5 mL. What amount of solution should the nurse teach the parents to give for each dose?

2.8 mL

An adult client is prescribed zalephlon 15 mg at bedtime for a sleep disorder. The nurse provides medication education that the medication may be dispensed in a variety of mg doses. The nurse asked the client to calculate the appropriate dosage when given 5 mg tablets. The nurse determines that the client can accurately administer the medication when selecting how many tablets? Record your answer using whole numbers.

3 tablets

Which assessment question should the nurse ask to determine the effect a client's insomnia is having on their function? 1. "How many hours do you usually sleep each night?" 2. "When did you first notice you weren't sleeping well?" 3. "Do you ever get sleepy and fall asleep during the day?" 4. "Do you experience nightmares when you are able to sleep?"

3. "Do you ever get sleepy and fall asleep during the day?"

Which statement made by a nurse preparing to care for an unconscious client just admitted with a diagnosis of acute barbiturate poisoning demonstrates a need for further instructions on the appropriate treatment? 1. "We'll need to support brain function." 2. "I'll prepare for the client's intubation." 3. "Naloxone needs to be placed at the bedside." 4. "Flushing the system of the barbiturate is a priority."

3. "Naloxone needs to be placed at the bedside."

A client is scheduled to receive phenytoin 100 mg orally at 6 PM but is having difficulty swallowing capsules. What method should the nurse use to help a client take the medication? 1. Sprinkle the powder from the capsule into a cup of water. 2. Insert a rectal suppository containing 100 mg of phenytoin. 3. Administer 4 mL of phenytoin suspension containing 125 mg/5 mL. 4. Obtain a change in the administration route to allow an IM injection.

3. Administer 4 mL of phenytoin suspension containing 125 mg/5 mL

A client who is receiving atenolol for hypertension frequently reports feeling dizzy. What effect of atenolol should the nurse consider may be responsible for this response? 1. Depleting acetylcholine 2. Stimulating histamine release 3. Blocking the adrenergic response 4. Decreasing adrenal release of epinephrine

3. Blocking the adrenergic response

What classification of medications can act as an antidote for toxicity caused by cholinesterase inhibitor therapy? 1. Cholinesterases 2. Cholinergic agonists 3. Cholinergic antagonists 4. Acetylcholinesterase inhibitors

3. Cholinergic antagonists

A client is diagnosed with tonic-clonic seizures is being considered for iminostilbene therapy. Which situation would likely prevent the client from safely being prescribed either carbamazepine or oxcarbazepine? 1. Currently prescribed warfarin 2. Has a history of bundle branch block 3. Currently on MAOI antidepressant therapy 4. Admits to having frequent suicidal ideations

3. Currently on MAOI antidepressant therapy

What effect should the nurse expect to see in a client who has administered a cholinergic agonist? 1. Dilated pupils 2. Urinary retention 3. Decrease in heart rate 4. Hypoactive bowel sounds

3. Decrease in heart rate

A client is treated with lorazepam for status epilepticus. What effect of lorazepam does the nurse consider therapeutic? 1. Slows cardiac contractions 2. Dilates tracheobronchial structures 3. Depresses the central nervous system 4. Provides amnesia for the convulsive episode

3. Depresses the central nervous system

A client has been prescribed a cholinergic antagonist medication. What side effect of this medication class should the nurse discuss with the client? 1. Anxiety 2. Insomnia 3. Dry mouth 4. A faster pulse rate

3. Dry mouth

What is the mode of action for the cholinergic agonist classification of medications? 1. Increases acetylcholine in the brain 2. Increases acetylcholine in the synapses 3. Increases acetylcholine at muscarinic receptors 4. Blocks activity of the muscarinic acetylcholine receptor

3. Increases acetylcholine at muscarinic receptors

A client tells a nurse, "I have been having trouble sleeping and feel wide awake as soon as I get into bed." Which strategies should the nurse teach the client that will promote sleep? SATA 1. Eat a heavy snack near bedtime. 2. Read in bed before shutting out the light. 3. Leave the bedroom if you are unable to sleep. 4. Drink a cup of warm tea with milk at bedtime. 5. Exercise in the afternoon rather that in the evening 6. Count backward from 100 to 0 when your mind is racing.

3. Leave the bedroom if you are unable to sleep. 5. Exercise in the afternoon rather than in the evening. 6. Count backward from 100 to 0 when mind is racing

A client diagnosed with depression is likely to be prescribed which medication to inhibit catecholamine metabolism? 1. A beta blocker 2. An alpha blocker 3. Monoamine oxidase inhibitors 4. A selective adrenergic agonist

3. Monoamine oxidase inhibitors

A healthcare provider in the emergency department identifies that a client is in mild hypovolemic shock. Which type of drug should the nurse anticipate will be prescribed? 1. Loop diuretic 2. Cardiac glycoside 3. Sympathomimetic 4. Alpha-adrenergic blocker

3. Sympathomimetic

Which assessment question should the nurse ask a client being evaluated for a diagnoses of secondary sleep disorder? 1. "Do you have any rituals that help you fall asleep?" 2. "Have you ever been told that you walk in your sleep?" 3. "Do you ever fall asleep while engaging in some activities?" 4. "What medications both prescribed and over-the-counter do you take regularly?"

4. "What medications both over-the-counter do you take regularly?"

The client has been prescribed oxcarbazepine. Which adverse reaction requires the nurse's priority attention to best assure client safety? 1. Ataxia 2. Depression 3. Blurred vision 4. Agranulocytosis

4. Agranulocytosis

A client who has a history of seizures is scheduled for an arteriogram at 10 AM and has to have nothing by mouth before the test. The client is scheduled to receive an anticonvulsant medication at 9 AM. What should the nurse do? 1. Omit the 9 AM dose of the drug. 2. Give the same dosage of the drug rectally. 3. Administer the drug with 30 mL of water at 9 AM. 4. Ask the healthcare provider if the drug can be given IV.

4. Ask the healthcare provider if the drug can be given IV

What is the primary responsibility of a nurse during a client's generalized motor seizure? 1. Inserting a plastic airway between the teeth 2. Determining whether an aura was experienced 3. Administering the prescribed PRN anticonvulsant 4. Clearing the immediate environment for client safety

4. Clearing the immediate environment for client safety

A client is scheduled for a 6-week electroconvulsive therapy (ECT) treatment program. What intervention is important during the 6-week course of treatment? 1. Provision of tyramine-free meals 2. Avoidance of exposure to the sun 3. Maintenance of a steady sodium intake 4. Elimination of benzodiazepines for nighttime sedation

4. Elimination of benzodiazepines for nighttime sedation

By what process do alpha blockers decrease blood pressure? 1. Decreasing heart rate 2. Blocking beta 1 receptors 3. Blocking beta 2 receptors 4. Fostering vasodilation

4. Fostering vasodilation

Which intervention is required for a client prescribed an acetylcholinesterase inhibitor? 1. Instructing to take medication without food 2. Providing laxative for anticipated constipation 3. Educating client that wheezing as an expected side effect 4. Having atropine sulfate available for treatment overdose.

4. Having atropine sulfate available for treatment overdose

A nurse identifies which clinical indicator of parasympathetic dominance in a client under stress? 1. Constipation 2. Goosebumps 3. Excess epinephrine secretion 4. Increased gastrointestinal secretions

4. Increased gastrointestinal secretions

What principle should the nurse rely upon when responding to a client whose inquires about "feeling hung-over" after taking their prescribed sedative? 1. Long term use of such medications can result in depression 2. The body is demonstrating a need for additional medication 3. Abruptly stopping the medication after taking it for an extended period of time 4. The liver causes the medication to persist in the body causing a hangover effect

4. The liver causes the medication to persist in the body causing a hangover effect

A nurse is evaluating the medication regimens of a group of clients to determine whether the therapeutic level has been achieved. For which medication should the nurse review the client's serum blood level? 1. Sertraline 2. Lorazepam 3. Olanzapine 4. Valproic acid

4. Vaproic acid

Phenytoin suspension 200 mg is prescribed for a client with epilepsy. The suspension contains 125 mg/5 mL. How much solution should the nurse administer?

8 mL