PHARM 2: TEST 1

The nurse is caring for a patient who is receiving Pramipexole. The nurse is most concerned if the patient makes which statement?

"Sometimes I just fall asleep without warning"

A patient with mild symptoms of Alzheimer's disease is prescribed Donepezil (Aricept). Which statement made by the patient indicates the need for further teaching?

"The drug will stop damage to the neurons in my brain" -it will NOT! (but it WILL slow the progression of it) fun fact: take this drug at bedtime

A patient is prescribed the dopamine agonist Pramipexole. Which statement made by the patient indicates a need for further teaching?

"This drug will stop the progression of PD" -NOOOOO! just slow it

Which patient would be at highest risk for systemic toxicity from the topical administration of a local anesthetic?

A 58-year-old patient who receives a local anesthetic to a 10x20-cm ABRASION

The nurse prepares to administer Dantrolene to a patient. Before the administration of the drug, it is most important for the nurse to assess which laboratory value?

Aminotransferases (LFTs)

The nurse prepares to administer a cholinesterase inhibitor to a patient with AD. Which medication, if ordered by the health care provider, should the nurse question?

Amitriptyline (Elavil) -TCA that blocks the cholinergic receptors (just like Benadryl and other 1st generation antihistamines, TCAs, and antipsychotics), therefore, decreasing the therapeutic effects

The nurse prepares to administer Memantine (Namenda) to a patient with severe AD. The nurse should assess what before administering the medication?

Blood urea nitrogen (BUN) and serum creatinine -assess renal function (dose may need to be decreased in the patient with impaired renal function)

The nurse is caring for a patient who is taking Phenytoin (Dilantin). Which medication, if ordered by the physician, should the nurse question?

Cimetidine (Tagamet) -H2 blocker (metabolism inhibitor; therefore, it increases Phenytoin levels, which could lead to possible toxicity due to the narrow therapeutic index)

The patient has received Isoflurane (Forane) as a general anesthetic. What should the nurse closely observe the patient for during the immediate post-op period?

Decreased respiratory rate

The nurse is caring for a patient who is receiving IV Propofol (Diprivan). Which action by the nurse is MOST appropriate?

Discard any unused solution within 6 hours (to keep from growing bacteria and getting too many triglycerides in the formula --> would put the patient at a great risk for pancreatitis)

A patient is newly prescribed Carbamazepine (Tegretol) for seizure control. It is most important for the nurse to teach the patient to avoid which food?

Grapefruit juice (inhibits metabolism of other drugs, therefore, it will increase their levels in the body)

An adult patient receives lidocaine by injection before a procedure. Which finding indicates that the patient is experiencing a systemic reaction and toxicity?

Heart rate of 42 beats/minute

A patient taking Levodopa/Carbidopa for PD experiences frequent "on-off" episodes (i.e., the abrupt loss of effect). What action by the nurse is best?

Instruct the patient to avoid high-protein foods

A patient has an allergy to PROCAINE (Novocain). What local anesthetic would be SAFE to administer to this patient?

Lidocaine (Xylocaine) --> Amide

A patient receives SUCCINYLCHOLINE (Anectine) before endotracheal intubation. What would the nurse expect?

Muscle paralysis for 5-10 minutes

A patient receives vercuronium (Norcuron) to facilitate mechanical ventilation. Which medication would the nurse administer to reverse muscle paralysis?

Neostigmine (Prostigmin)

A patient is concerned about developing AD. What should the nurse include in the teaching plan?

No solid evidence supports the use of drugs to prevent AD

A patient with MS is prescribed Baclofen. Which assessment by the nurse indicates that the medication is exerting its desired effects?

Suppression of spasticity

A patient is prescribed Phenytoin (Dilantin) for epileptic seizures. Which of the following is the priority for patient teaching?

Teach the patient to avoid the abrupt cessation of treatment (could lead to status epilepticus)

A patient in labor requests a spinal anesthetic. The patient has many questions to ask the nurse. How should the nurse respond to the following question from the patient? "I want to be awake during the birth. Will I fall asleep after I have the spinal?"

You will not lose consciousness

The physician orders an IV infusion of CISATACURIUM (Nimbex) for a patient receiving mechanical ventilation. It is most important for the nurse to take which action before starting the infusion?

administer lorazepam (Ativan) IV