Pharm Ch 14-18-19
Which medication is contraindicated when a patient is taking warfarin (Coumadin)? a. Aspirin b. Acetaminophen (Tylenol) c. Propoxyphene (Darvon) d. Morphine (Roxanol)
a
How long after the administration of a parenteral pain medication will the nurse complete the next pain assessment to evaluate the effectiveness of the medication? a. 10 minutes b. 30 minutes c. 1 hour d. 2 hours
b
A patient is taking meperidine (Demerol) as needed for moderate to severe pain following an open appendectomy. The nurse assesses the following: current pain level 2, temperature 99°F, BP 130/76, respirations 10, lung sounds clear, abdomen soft and tender, bowel sounds present. Based on this assessment information, the priority nursing diagnosis is: a. altered breathing pattern. b. risk for altered body temperature. c. risk for constipation. d. pain.
a
Which condition(s) may be managed by salicylates? (Select all that apply.) a. Migraine headache b. Swollen joints c. Fever d. Muscle aches e. Myocardial infarction
b c d e
When performing a baseline neurologic assessment prior to the administration of an NSAID medication, the nurse will assess which patient characteristic(s)? (Select all that apply.) a. Vital signs b. Orientation to date, time, and place c. Mental alertness d. Bowel sounds e. Concurrent use of anticoagulant agents
b c
Patients taking phenytoin (Dilantin) for control of seizures must be aware of the risk for which adverse effect(s)? (Select all that apply.) a. Blood dyscrasias b. Hyperglycemia c. Urinary retention d. Gingival hyperplasia e. Insomnia f. Sedation
a b d f
Which common adverse effect(s) is/are associated with opiate agonists? (Select all that apply.) a. Dizziness b. Orthostatic hypotension c. Respiratory depression d. Confusion e. Diarrhea f. Urinary urgency
a b c d
The nurse is preparing to begin administration of apomorphine to a patient. Before administering, the nurse will perform a baseline assessment of the patient's: (Select all that apply.) a. mobility. b. orientation. c. intellectual ability. d. alertness. e. vital signs.
a b d e
When teaching a patient who is starting therapy with NSAIDs, the nurse must be sure to mention drug interactions with which drug(s)? (Select all that apply.) a. Warfarin (Coumadin) b. Lithium (Eskalith) c. Hydroxyzine (Vistaril) d. Insulin e. Diuretics f. Digitalis (Digoxin)
a b e
Which cholinergic symptoms of Parkinson's disease are reduced with anticholinergic drugs? a. Cognitive impairments b. Rigidity c. Tremors and drooling d. Postural abnormalities
c
Which patient assessment would indicate to the nurse that salicylate toxicity is occurring? a. Gastrointestinal (GI) bleeding b. Increased bleeding times c. Tinnitus d. Occasional nausea
c
What point(s) should be included when teaching a patient about the use of apomorphine for treatment of Parkinson's disease? (Select all that apply.) a. The restoration of function resulting from stimulation of dopamine receptors is permanent. b. Apomorphine may be administered intravenously for rapid relief. c. Apomorphine does not have any opioid activity. d. A multidose injector pen is commonly used to administer apomorphine. e. You may experience nausea and vomiting, which can be treated with trimethobenzamide (Tigan). f. You may experience sleep attacks or episodes of daytime sleepiness.
c d e f
When a patient taking a monoamine oxidase B inhibitor receives his dietary tray, the nurse knows to remove the: a. cheese. b. eggs. c. bread. d. coffee.
a
Which condition would indicate to the nurse that a patient has phenytoin (Dilantin) toxicity? a. Oculogyric crisis b. Nystagmus c. Strabismus d. Amblyopia
b
Which vitamin will reduce the therapeutic effects of levodopa? a. A b. B6 c. C d. D
b
The nurse is assessing a patient's pain. When the patient describes his pain as cramping and burning, which component of the pain history is being addressed? a. Depth b. Location c. Quality d. Severity
c
What term is used to define an awareness of pain? a. Tolerance b. Threshold c. Perception d. Sensation
c
The nurse is assessing an older patient with Parkinson's disease who was started on entacapone 1 week ago. The patient has a history of coronary artery disease and takes an antihypertensive and aspirin. Which information would support the need for a reduction in medication dosage by the healthcare provider? a. Constipation b. Brownish orange urine c. Drowsiness d. Dizziness
d
The nurse is providing information to a patient recently prescribed entacapone. Which statement is correct? a. This medication is not to be taken with carbidopa levodopa. b. Dosage is adjusted according to the patient's response. c. There will be fewer incidences of dopaminergic effects, such as confusion. d. This medication increases the production of dopamine in the brain.
b
Which statement is true about neuropathic pain? a. This pain is the result of a stimulus to pain receptors. b. Patients describe it as dull and aching. c. It commonly originates in the abdominal region. d. The pain is a result of nerve injury.
d
For which condition may carbamazepine (Tegretol) be used? a. Tardive dyskinesia b. Psychotic episodes c. Trigeminal neuralgia pain d. Sedation
c
A patient experiencing chronic pain as a result of metastatic cancer has a new order for fentanyl (Duragesic) transdermal patch. The initial patch is applied at 8 AM on Monday. At 8 PM on Monday, the patient reports a pain level of 8. The nurse's best response is to: a. immediately contact the physician. b. reassess pain level in 30 to 45 minutes. c. remove current patch and reapply a new patch. d. provide a PRN analgesic medication as ordered.
d
In which case would the nurse be correct in withholding an opiate agonist? a. Evidence of postural hypotension b. Presence of constipation c. Pain rating of 7 on a 0 to 10 scale d. Respiratory rate of 10 breaths/min
d
The nurse is teaching a patient with Parkinson's disease about levodopa. Which statement by the nurse is accurate regarding drug administration? a. "Take this medication in between meals." b. "Take this medication at bedtime to prevent dizziness." c. "Take this medication when your tremors get worse." d. "Take this medication with food or antacids to reduce GI upset."
d
What is a guideline for the nurse when administering phenytoin (Dilantin) intravenously? a. Deliver rapidly. b. Monitor for signs of tachycardia. c. Assess for hypertensive crisis. d. Administer without mixing with other medications.
d
What is the best way for the nurse to evaluate the effectiveness of the patient's opiate agonist? a. Ability of the patient to tolerate more activity b. Increased sleep time throughout the night c. Reduction of respiratory rate from 24 to 18 breaths/min d. Verbal report of 2 on a 1 to 10 scale
d
Which action will the nurse take when a patient receiving morphine sulfate via percutaneous coronary angioplasty (PCA) has a shallow, irregular respiratory rate of 6 breaths/min? a. Elevate the patient's head of bed to facilitate lung expansion. b. Increase the patient's primary intravenous (IV) flow rate. c. Complete the FLACC scale. d. Notify the healthcare provider and prepare to administer naloxone (Narcan).
d
Which condition is associated with hydantoin therapy? a. Postictal state b. Atonia c. Seizure threshold reduction d. Gingival hyperplasia
d
Dopamine agonists have been linked with which adverse effects in patients with Parkinson's disease? a. Oculogyric crisis b. Tardive dyskinesia c. Sudden sleep events d. Akathisia
c
The nurse is completing an assessment on a nonverbal adult patient. Which type of pain scale assessment tool is the most accurate to use? a. TPPPS b. FLACC c. POCIS d. MOPS
b
The nurse is preparing discharge instructions for a patient with a history of diabetes who has just been diagnosed with seizure disorder. The patient has been prescribed hydantoin therapy. What will the patient most likely experiencing? a. Hunger b. Hyperglycemia c. Diarrhea d. Pupil dilation
b
The nurse is providing education to a patient recently placed on selegiline disintegrating tablets. Which statement by the patient indicates a need for further teaching? a. "This medication will help slow the development of symptoms." b. "I will place the tablet on my tongue before breakfast." c. "I may need to use a stool softener for constipation." d. "I should not push the tablet through the foil."
b
The nurse is providing education to a patient recently prescribed pregabalin (Lyrica). Which statement by the patient indicates a need for further instruction? a. "I may feel tired at first, but this should improve with continued use." b. "Once my pain improves, I will stop taking this medication." c. "Taking sleeping aids will increase the sedative effect of this medication." d. "This drug may affect my mental alertness, so I need to be careful around machinery."
b
What dose is within the acceptable range for administering IV phenytoin (Dilantin) to a patient with a seizure disorder? a. 5 mg/min b. 30 mg/min c. 60 mg/min d. 100 mg/min
b
What information is most accurate regarding the nurse's understanding of pain management? a. Older patients have difficulty describing their pain level. b. Encourage patients to report pain before the pain becomes too severe. c. Use the smallest dose of medication possible to control pain. d. Pain medication administration ordered PRN will maintain a constant blood level.
b
What is the advantage of taking a nonsteroidal antiinflammatory drug (NSAID) that is a COX-2 inhibitor? a. The medication is cheaper than aspirin. b. There are fewer GI adverse effects. c. They are more effective than COX-1 inhibitors. d. They have no known adverse effects.
b
Which medication would the nurse administer to a patient who is rating the pain at 8 on a 0 to 10 scale? a. Acetaminophen (Tylenol) b. Morphine (Roxanol) c. Oxycodone (OxyContin) d. Oxycodone and aspirin (Percodan)
b
Which sign or symptom displayed by a patient would be indicative of opiate withdrawal? a. Bradycardia b. Diarrhea c. Lethargy d. Hypothermia
b
What is included in the nursing management of the patient with generalized tonic-clonic seizure activity? (Select all that apply.) a. Restraining the patient's arms to avoid further injury b. Placing padding around or under the patient's head c. Attempting to insert a tongue depressor into the patient's mouth d. Positioning the patient on the side once the relaxation stage is entered to allow oral secretions to drain e. Requesting additional assistance and/or necessary equipment in case the patient does not begin breathing spontaneously when the seizure is over
b d e
A patient taking rasagiline is assessed by the nurse to have a lasting significant increase in blood pressure. When reviewing the patient's current list of medications, the nurse decides to hold the next dose of: a. dextromethorphan. b. levodopa. c. ciprofloxacin. d. Valium.
c
Which additional nursing intervention(s) would be effective with pain management in the pediatric population? (Select all that apply.) a. Provide diversional activities such as coloring, puzzles, and games. b. Allow uninterrupted sleep and rest. c. Perform hygiene measures. d. Encourage parental participation with caregiving to diminish the child's anxiety. e. With the healthcare provider's approval, encourage the child to drink eight to ten 8- ounce glasses of fluid daily.
a b c d
Parkinson's disease has which characteristic symptom(s)? (Select all that apply.) a. Muscle tremors b. Posture alterations c. Muscle flaccidity d. Tachycardia e. Slow body movement
a b e
A patient on anticonvulsant therapy confides to the nurse at an outpatient clinic that she suspects she may be pregnant. The nurse should encourage the patient to take which action(s)? (Select all that apply.) a. Consult an obstetrician. b. Discontinue medications. c. Carry an identification card. d. Provide a list of seizure medications. e. Consider oral contraception.
a c d
The healthcare provider orders diazepam (Valium) 10 mg IV stat for a patient who was admitted with status epilepticus. What important nursing interventions(s) associated with administration of this medication IV should the nurse perform? (Select all that apply.) a. Apply a cardiac monitor to the patient to assess for continuous heart rate, if not already done. b. Administer the prescribed dosage over 1 minute. c. Mix diazepam in a primary IV solution to avoid overdosing. d. Continuously assess the patient's airway. e. Obtain the correct dose (10 mg) and administer over slow IV push.
a d e
The nurse is preparing to administer zonisamide (Zonegran) to a newly admitted patient with the diagnosis of adult partial seizures. The nurse should hold this medication if the patient has which sign(s) or symptom(s)? (Select all that apply.) a. Skin rash b. Urinary frequency c. Drowsiness d. Allergy to Bactrim e. Pruritus
a d e
Which adverse effects associated with levodopa therapy would support the nursing diagnosis risk for injury? a. Nausea and vomiting b. Orthostatic hypotension c. Anorexia and depression d. Tachycardia and palpitations
b
An 86-year-old patient who was admitted with GI bleeding as a result of salicylate therapy is being discharged. As the nurse reviews the discharge medication list, the patient states that she doesn't understand why Tylenol doesn't work as well as the aspirin she had been taking. What would be the nurse's best response? a. "Tylenol and aspirin are chemically the same drug." b. "Tylenol is appropriate for only minor pain." c. "Tylenol does not help with inflammatory discomfort." d. "A therapeutic blood level must be established with Tylenol."
c
What information would be most important for the nurse to provide to a patient when teaching about the adverse effects of succinimide therapy? a. Nausea, vomiting, and indigestion are common during the initiation of therapy. b. Avoid taking the medication with food or milk to minimize adverse effects. c. Sedation, drowsiness, and dizziness tend to worsen with continued therapy. d. Reducing the dosage of medication will relieve symptoms of nausea.
a
What is the rationale for administering levodopa instead of dopamine for treatment of Parkinson's disease? a. Dopamine does not cross the blood-brain barrier when administered orally. b. Levodopa is much less expensive. c. The half-life of dopamine is too short. d. Dopamine has too many reactions with other medications.
a
Which medication is used to control seizures or prevent migraine headaches? a. Topiramate (Topamax) b. Zonisamide (Zonegran) c. Valproic acid (Depakene) d. Tiagabine (Gabitril)
a
Which premedication assessment by the nurse is most important prior to the initiation of carbamazepine (Tegretol) therapy? a. Determine patient's ancestry. b. Monitor blood pressure (BP) lying, sitting, and standing. c. Auscultate lung sounds. d. Obtain smoking history.
a
The nurse is providing discharge teaching to a patient prescribed phenytoin (Dilantin) for management of a seizure disorder. Which patient statement indicates a need for further teaching? a. "I need to avoid or limit caffeine intake." b. "I will check with the pharmacist before taking over-the-counter medication." c. "If I develop enlarged gums, I will stop taking the medication." d. "It is important for me to take my medicine at the same time daily."
c
The pediatric nurse is caring for a patient diagnosed with refractory seizures. The physician orders a ketogenic diet. When the child receives his food tray, the nurse should remove any food containing high levels of: a. fat. b. salt. c. carbohydrates. d. vitamin K.
c
What is the drug of choice when treating a generalized tonic-clonic seizure? a. Diazepam (Valium) b. Haloperidol (Haldol) c. Valproic acid (Depakene) d. Risperidone (Risperdal)
c
What is the pharmacologic action of entacapone, a potent catechol O methyl transferase (COMT) inhibitor? a. Slows the deterioration of dopaminergic nerve cells. b. Inhibits the relative excess of dopaminergic activity. c. Reduces the destruction of dopamine in peripheral tissues. d. Enhances the cholinergic symptoms of Parkinson's disease.
c
Which response by the nurse is accurate when a patient who has been on lamotrigine (Lamictal) for seizure control reports a skin rash and urticaria? a. Reassure the patient that this is a common adverse effect of the medication and not to worry. b. Instruct the patient to discontinue use of the drug immediately. c. Instruct the patient to decrease the dosage of the medication until the rash disappears. d. Advise the patient that this adverse effect usually resolves but should be reported to the healthcare provider.
d
