Pharm Exam 4
The client is a 45-year-old man who is obese. He is seeking help losing weight. He wants to be prescribed dextroamphetamine. Based on the client's history, what would contraindicate the use of this medication?
Myocardial infarction 2 months previously
Which of the following medication is a narcotic antagonist?
Naloxone (Narcan)
A nurse is providing care for a client diagnosed with attention deficit hyperactivity disorder (ADHD) who has been taking methylphenidate for several months. When monitoring for potential adverse effects, the nurse should include what assessments?
sleep patterns
A 30-year-old female client is diagnosed with seizure disorder, and the provider is considering the use of carbamazepine. What assessment question best addresses the safety and effectiveness of the medication regimen?
"Is there any chance that you could be pregnant?"
A client has been taking fluoxetine (Prozac) for the last ten days. Today the client is reporting not feeling any better. What is the nurse's best response to this client?
"It may take another two to three weeks before the medication is completely effective."
The caregiver of a client who is started on antipsychotic drug therapy asks the nurse when the client's symptoms will improve. Which response by the nurse would be most appropriate?
"It might take about 6 weeks or so before the drug is most effective."
The nurse is teaching the parents of a child diagnosed with attention-deficit hyperactivity disorder how to administer extended release methylphenidate. What should the nurse teach the parents?
"It's best to give it at breakfast every day."
A client has been diagnosed with partial seizures and has been prescribed carbamazepine. When providing health education about the safe and effective use of this medication, what should the nurse teach the client?
"It's safest if you avoid drinking alcohol while you're taking this drug."
The client is scheduled for surgery. The nurse administers diazepam (Valium) preoperatively for what purpose?
Decreased anxiety
Which of the following effects can be noticed in a patient who has been administered amphetamines?
Decreased appetite
A black box warning alerts health care providers to risks in young adults 18 to 24 years of age when taking antidepressant medications. Which symptoms of concern should be included?
statements or resignation and futility and a desire to die
A male client is not only having difficulty falling asleep but wakes up frequently during the night. The health care provider prescribes zolpidem in the CR form. The client asks what makes this form of the drug different. What is the nurse's best response to this client?
"Ambien CR contains a rapid-releasing layer of medication, which aids a person in falling asleep, and a second layer, which is released more slowly to promote sleep all night."
A client has recently received a diagnosis of depression and has been prescribed citalopram. The nurse is providing health education and the client states, "I'm relieved to have some medication to help with my mood, because it's my daughter's wedding next weekend and I'll be feeling better." What is the nurse's best response?
"Antidepressants will help your mood but it usually takes a few weeks to experience the benefits."
A client is prescribed an anxiolytic agent. What would be most important for the nurse to include in the teaching?
"Be sure not to stop the drug abruptly."
A female client is prescribed a benzodiazepine for anxiety. She asks the nurse if she can stop the drug when she feels better. What is the nurse's best response?
"Benzodiazepines may cause physiologic dependence, and withdrawal symptoms will occur if the drug is stopped abruptly."
A nurse is instructing a client who's to receive disulfiram (Antabuse). Which statement by the client demonstrates that the teaching was effective?
"I can use any antacids."
The nurse is providing education to a client who has been prescribed an antipsychotic drug. Which statement suggests that the client understands the typical length of medication therapy?
"I may always have to take this medication."
A client is taking a benzodiazepine. The nurse evaluates teaching as effective when the client makes which statement?
"I should not stop this drug without talking to my health care provider first."
A client has been taking Prozac for the past 2 months for depression. She is seeing her gynecologist for premenopausal symptoms, and during the interview with the nurse she says, "I'm interested in trying fluoxetine because my friend is taking it and she says it works great." The nurse's best response is what?
"Sarafem and Prozac are different brand names for the same generic medication."
A client who is receiving a benzodiazepine asks the nurse about having a dry mouth. Which suggestion would the nurse include in the teaching plan for this client?
"Sucking on hard sugarless candy might help you."
A client who is experiencing lower back pain has been prescribed cyclobenzaprine. The nurse should provide what health education in order to ensure safe and effective treatment?
"This will likely make you drowsy, so don't take it before doing anything that would require alertness."
How long does a patient need to wait after stopping a phenelzine before starting paroxetine?
14 days
A nurse works in a sleep disorder clinic and is responsible for administering medications to the patients. Which of the following patients would be most likely to receive zaleplon (Sonata)?
A 35-year-old man who is having difficulty falling asleep, but once asleep can stay asleep
How should the nurse explain the major difference between normal and abnormal anxiety?
Abnormal anxiety is prolonged and impairs normal function.
A client informs the nurse that he plans on discontinuing the prescribed lorazepam (Ativan) he has been taking for the past four months. What is the nurse's best action in response to this client's statement?
Advise the client to contact his healthcare provider about tapering off the medication.
Ms. Mole, a 65-year-old woman with a history of chronic insomnia, is being seen for follow-up care. The nurse needs to develop a plan of care with Ms. Mole to improve her sleep. In addition to drug therapy, what would the nurse recommend as part of the client's plan of care?
Advise the client to practice relaxation techniques.
A 75-year-old client is brought to the emergency department by the family. The family relates that the client has confusion, seizures, and abnormal perception of movement. When the nurse looks at the medication that the family has brought to the ED, the nurse discovers that twice the number of tablets are missing from the vial as there should be if the prescription orders were being followed. What should the nurse suspect is wrong with this client?
Benzodiazepine toxicity
A client's seizure activity, which is isolated to facial and neck muscles, has been identified as being caused by one area of the client's brain. The nurse should anticipate the administration of what drug?
Carbamazepine
An older adult client is prescribed a sedative for the treatment of insomnia. The nurse would suspect that the client is experiencing an adverse reaction to the drug based on assessment of which of the following?
Confusion
A client with a history of malignant hyperthermia is scheduled for surgery. Which agent would the nurse most likely expect to administer?
Dantrolene
Nurses can help prevent drug abuse by all of the following EXCEPT:
Demanding drug testing for all clients.
Which of the following medications are used as an alcohol deterrent?
Disulfiram (Antabuse)
A client is started on aripiprazole and the nurse notices the client is experiencing dry mouth and nasal congestion. What intervention does the nurse teach the client to minimize the side effects of the medication?
Drinking frequent sips of water
The nurse administers an anxiolytic to the client. The nurse recognizes the family needs further teaching on the effects of the medication when the family initiates what action?
Encourages the client to walk to the bathroom independently
When describing the action of benzodiazepines as anxiolytics, what would the nurse need to keep in mind?
Enhanced action of gamma-aminobutyric acid
Which condition is most commonly found in a client who chronically abuses alcohol?
Enlarged liver
The pharmacology instructor is discussing the differences between monotherapy and therapy that includes AEDs. What would the instructor cite as an advantage of monotherapy?
Fewer drug-drug interactions
The patient states that he took LSD approximately 1 month ago and feels like he is "going crazy." What effects of the use of hallucinogens may be experienced days to years after taking LSD?
Flashbacks
A client has received a benzodiazepine for sedation before a diagnostic procedure. Which agent would the nurse expect the client to receive to reverse the sedative effects?
Flumazenil
A client is brought to the emergency department with suspected overdose of a benzodiazepine. Which drug should the nurse anticipate administering to counteract the effects of the overdose?
Flumazenil
Which agent would a nurse identify as a selective serotonin reuptake inhibitor?
Fluvoxamine
A patient who was on benzodiazepine antianxiety drug therapy intends to discontinue the treatment. What should the nurse suggest regarding continuation of the medication?
Gradually decrease dosage schedule.
The nurse is aware that CNS stimulants are prescribed for clients with ADHD because these medications have what effect on behavior and attention?
Improving
A patient with symptoms of anxiety is being assessed for antianxiety therapy. Which of the following physiological manifestations of anxiety should the nurse assess during the pre-administration assessment of the patient?
Increased blood pressure
The nurse is conducting an ongoing assessment on a client with schizophrenia who is receiving chlorpromazine. Assessment findings include excessive drowsiness and the need for assistance with ADLs and ambulation. Which nursing diagnosis should the nurse prioritize for this client?
Injury Risk
A primary health care provider has prescribed phenytoin parenterally for a client experiencing seizures. The nurse prepares to administer this drug via which route?
Intravenously
An client admitted to your emergency department (ED) is experiencing hallucinations. The friend who brought him to the ED indicates that the client has used recreational drugs in the past but has not done so for many weeks. Which of the following drugs can trigger recurrent hallucinations?
Lysergic acid diethylamide (LSD)
A patient comes to the clinic asking for help to quit drinking alcohol. She has a 21-year history of heavy drinking and is worried about developing cirrhosis of the liver. The patient agrees to take disulfiram (Antabuse). The nurse will teach the patient that the combination of alcohol and Antabuse will cause which of the following?
Nausea
A male client took zolpidem daily for 1 week with good response, then stopped the medication. Two days later, he returns to the office stating that his insomnia is worse than it ever was. The nurse is responsible for the development of a teaching plan for the client, including adverse reactions. After 1 week of regular use, which adverse reaction may occur with zolpidem?
Rebound insomnia
The nurse is teaching a client about the medication they are receiving as treatment for gout. The nurse determines the session is successful when the client correctly chooses which instruction as most important?
Reporting any skin rash
A school-aged child with ADHD has been prescribed methylphenidate for several months, with good effect. The possibility of a summertime drug holiday is being explored with the family now that the school year is ending. What aspect of the child's status would rule out the safe and effective introduction of a drug holiday?
The child is scheduled to attend summer camp for the next three weeks.
A client who is experiencing withdrawal from alcohol has developed psychosis and is being treated with haloperidol. Which assessment findings should prompt the care team to assess the client for neuroleptic malignant syndrome?
The client develops muscle rigidity and a sudden, high fever.
A nurse is giving an educational presentation on recreational drugs to a parents' group at the local middle school. What would the nurse indicate is a potential consequence of cocaine use?
life-threatening cardiac arrhythmias
While reviewing a client record, the nurse sees that the client has a history of chronic insomnia. What assumption can the nurse have regarding the client?
The client has been experiencing dysfunctional sleep for more than 1 month.
A family expresses concern when a family member withdrawing from alcohol is given lorazepam (Ativan). What information should be given to the family about the medication?
The medication is given for a short time to help the client complete the withdrawal process
Why are selective serotonin reuptake inhibitors considered the first line of drug therapy for patients with depression?
The medications have fewer anticholinergic effects than alternatives.
Which test should be scheduled every week for a patient taking clozapine?
WBC count
A client is being treated with clozapine. What should the nurse monitor most closely?
White blood cell count
The nurse is preparing to administer the next dose of methsuximide to a client experiencing partial seizures. The client remarks about hoping their stomach will do better this time. Which suggestion from the nurse will best assist this client when administering this next dose?
With some food or milk
What statement should a nurse use to plan a client assessment for the characterizations associated with major depression?
an impaired ability to function in activities and relationships
A client's thought disorder has been treated with haloperidol. For what adverse effect should the nurse most closely monitor the client?
extrapyramidal effects
Which drug is specifically marketed for the treatment of insomnia?
flurazepam
A client with schizophrenia is prescribed clozapine. For which information in the medical record will the nurse question giving this medication to the client?
history of seizure disorder
A nurse is working in the emergency department and is assigned to a client brought in by family members. The family thinks that the client is on methamphetamine. The nurse should assess for:
hypertension.
A client diagnosed with narcolepsy expresses reluctance to rely on medication therapy. What recommendation should the nurse provide?
maintaining regular sleeping and waking times to avoid periods of sleep deprivation
The nurse is assessing a client who takes benzodiazepines for the treatment of anxiety disorder. The client has presented nonresponsive and the client's partner reports he has recently taken oxycodone recreationally. The nurse should place the highest priority on what assessment?
respiratory function
A child was diagnosed with attention-deficit hyperactivity disorder and methylphenidate was prescribed for treatment to be taken once a day in a sustained release form. On future visits, what is a priority nursing assessment for this child?
weight and height
For which adverse reactions should the nurse monitor the patient who has been administered antipsychotic drugs?
Dry mouth
A child has been presented for care because he has episodes where he pauses what he is doing for a few seconds, is unresponsive, and then continues on with his activity. The nurse should anticipate the administration of what medication?
Ethosuximide
The nurse is assessing a client for depression. Which symptom would the nurse prioritize?
Extreme sadness
The community health nurse is conducting a class for parents of preschoolers. One of the parents asks if a child with ADHD will always have problems with hyperactivity. What is the nurse's best response?
"ADHD usually starts in childhood and may persist through adulthood."
The pediatric client has been prescribed methylphenidate. Which statement should be included in the teaching plan for a client receiving methylphenidate?
"Adverse effects include hypertension and nervousness."
While the school nurse is providing health education to a group of children on the dangers of illicit drug use, a child asks the nurse what sniffing gasoline or glue does to the body. What response is most effective in addressing this question?
"Doing that damages the brain and other body organs."
A client is taking antipsychotic medication and asks the nurse what dopamine is. What is a correct response by the nurse?
"Dopamine is a neurotransmitter that deals with pleasure and reward in the brain."
A client receiving outpatient therapy with antipsychotic therapy experiences dizziness from time to time. Which suggestion by the nurse would be appropriate?
"Get up slowly from the bed or chair."
A client's medication history includes a long-term prescription for modafinil. Which assessment question should the nurse ask the client to confirm why the medication was prescribed?
"Have you ever been diagnosed with narcolepsy?"
The nurse is caring for a client who has been prescribed oxazepam. What statement by the client would suggest an increased risk of CNS depression to the nurse?
"I take an over-the-counter antihistamine each day for my allergies."
The nurse provides teaching for a client diagnosed with rheumatoid arthritis (RA) about the prescribed methotrexate. Which client statement determines the need for further teaching?
"I will have labs to monitor for possible bad effects of methotrexate drawn every 6 months."
A client has been prescribed alprazolam 0.5 mg PO t.i.d. for the treatment of anxiety. What statement by the client demonstrates an accurate understanding of the drug regimen?
"I will make sure not to stop the drug abruptly."
A client with myoclonic seizures has been prescribed clonazepam as an adjunctive treatment by the neurologist. What teaching should the nurse prioritize when explaining this new drug regimen to the client?
"Make sure you don't stop taking this abruptly because that might bring on a seizure."
The nurse is talking with a patient who is in the hospital from complications related to alcoholism. The patient states, "My father and grandfather were alcoholics. Do you think this is why I am?" What is the best response by the nurse?
"Many studies say that certain genes can cause alcoholism."
A client who is prescribed chlorpromazine is experiencing symptom relief and tells the nurse, "I'm going to stop my meds for a while and see how I feel." What should the nurse teach the client?
"Stopping suddenly isn't safe and can cause some very unpleasant symptoms."
A client with depression has been taking citalopram for several months and has presented for a follow-up assessment. The client tells the nurse, "I've been reading a lot online about the benefits of St. John's wort for depression, so I've started taking it once per day." In addition to referring the client to the provider, what is the nurse's best response?
"There can be an unsafe reaction between your antidepressant and St. John's wort, which is why taking them both is discouraged."
One week ago, a client began taking ethosuximide 500 mg/day PO for the treatment of absence seizures. The client reports gastrointestinal (GI) upset after taking with the drug. What health education should the nurse provide?
"Try taking your pills at the same time as you eat some food."
The parents of a child receiving a central nervous system stimulant for treatment of attention deficit disorder asks the nurse why they are stopping the drug for a time. Which statement by the nurse would be most appropriate?
"We need to check and see if he still has symptoms that require drug therapy."
A client with a substance use disorder has been prescribed haloperidol 3.5 mg IM. The nurse obtains a vial of haloperidol 5 mg/mL. The nurse should draw up what quantity of the medication?
0.7
A child who is in first grade has been diagnosed with ADHD and has been initially prescribed atomoxetine 0.5 mg/kg PO. The child weighs 44 lb, so the nurse should prepare what dose?
10
A client who is receiving phenytoin has a serum drug level drawn. Which result would the nurse interpret as within the therapeutic range?
12 mcg/mL
The nurse at a community clinic administers methadone to clients in recovery from opioid addictions. A client is prescribed methadone 40 mg PO daily and the medication is available in an oral solution at 10 mg/5 mL. What quantity of methadone should the nurse administer?
20
A nurse is required to administer an antipsychotic agent parenterally. After administering the drug, the nurse would ensure that the client remains lying down for which time frame?
30 minutes
A client is receiving an SSRI. The nurse would inform the client that the full benefits of the drug may not occur for which time period?
4 weeks
When a client is started on an antidepressant, it is important for the nurse to explain to the client that it may take time to see a change in mood. How long can it take for the client to see the beneficial effects of an antidepressant?
4 weeks
A pediatric client has been prescribed dextroamphetamine (Adderall) 2.5 mg PO BID. How many mg would this client take each day?
5
The nurse who is a case manager is overseeing the care of several clients, both inpatient and community-dwelling. Which client is most likely to benefit from the administration of baclofen?
A client who is undergoing rehabilitation following a spinal cord injury at C7
A client in status epilepticus has been brought to the emergency department. The nurse should anticipate which treatment measures?
Administration of intravenous lorazepam
The client has been prescribed an MAO inhibitor. As the nurse teaches the client about this medication, what foods will the client be instructed to avoid?
Aged cheeses and meats, concentrated yeast extracts, sauerkraut, and fava beans
A nurse is instructing a mother about a new drug her son was prescribed for ADHD. The nurse should include which instructions?
Always take the drug in the morning 30 to 45 minutes before breakfast and lunch.
A client experiencing depression is reluctant to start on antidepressant medication. What information should be the basis for the nurse's best response?
Antidepressant therapy may be indicated if depressive symptoms impair social relationships or work performance and occur independently of life events.
A male client's anxiety is interfering with his ability to perform basic activities of daily living and return to work. The nurse expects that which diagnosis will probably be made by his health care provider?
Anxiety disorder
A group of nursing students are reviewing information about antianxiety drugs. The students demonstrate understanding of the information when they identify which as another name for this group of drugs?
Anxiolytics
Which instruction should the nurse specifically stress when administering drugs used for muscle spasm and cramping?
Avoid alcohol or other CNS depressants.
A truck driver has been diagnosed with a generalized anxiety disorder (GAD) and lorazepam has been prescribed. The client asked the nurse how this medication will affect his job. The nurse would advise him how?
Avoid driving until he is aware of the adverse effects.
Which of the following instructions should a nurse provide a client with alcohol dependence who is prescribed disulfiram?
Avoid mixing disulfiram and alcohol
Which medication would the nurse expect to administer if prescribed to achieve skeletal muscle relaxation?
Baclofen
A woman in her twenties has been accompanied to her primary care provider by her mother, who states that her daughter has been experiencing increasingly severe episodes of irritable grandiose behavior. The care provider has consequently begun a treatment regimen that includes pharmacological therapies. This patient is most likely experiencing which of the following mood disorders?
Bipolar disorder
After teaching a group of nursing students about the various drugs used to treat musculoskeletal conditions, the instructor determines that the teaching was successful when the students correctly choose which drug as being used to treat osteoporosis?
Bone resorption inhibitors
A 75-year-old male client is given an order for a CNS stimulant secondary to a new diagnosis of narcolepsy. He begins to experience signs and symptoms of excessive CNS stimulation. The nurse knows that the client is likely to also experience an exacerbation of which preexisting condition?
Cardiac arrhythmias
A toddler brought into the clinic by the parents is flaccid and cyanotic. The parents relate that just prior to arrival, the toddler was running a fever of 104.3°F (40.2°C) and began twitching uncontrollably. What is the nurse's first priority?
Check the airway.
The nurse works on a busy floor giving multiple sedatives and hypnotics. What priority concern should the nurse carefully assess for when administering a sedative or hypnotic?
Depressed respiratory function
Dexmethylphenidate has been prescribed to Scott, a 7-year-old boy who was diagnosed with ADHD. The mother asks how this medication will help her son. Which would be the most accurate description of the purpose of this medication?
Dexmethylphenidate will improve Scott's attention span so that he will be able to complete a task.
A group of nursing students answers correctly if they identify which medication as the prototype benzodiazepine?
Diazepam
The instructor is discussing psychosis with the nursing students. The instructor knows that teaching was effective when the students identify what behaviors are exhibited by people with psychosis?
Disorganized and often bizarre thinking
The nursing instructor is discussing psychosis with the nursing students. What behavior would the instructor explain people with psychosis exhibit?
Disorganized and often bizarre thinking
When combination therapy is ineffective, what needs to be reassessed?
Drug-drug interactions
Which neurotransmitter is most likely responsible for the rewarding and reinforcing effect of cocaine?
Dopamine
A nurse administers carisoprodol to a client for the treatment of an acute musculoskeletal condition. The nurse would be alert for which adverse effect after administering the drug?
Drowsiness
When developing a teaching plan for a client who is to receive carisoprodol, which sign or symptom would the nurse include as a common adverse reaction?
Drowsiness
A nurse is caring for a client who is receiving alprazolam. The nurse would be alert for which symptom as an initial adverse reaction with this drug?
Headache
Signs and symptoms of what would necessitate discontinuation of dantrolene therapy?
Hepatic dysfunction
The nurse is caring for a client diagnosed with HIV. The nurse should question a new order for clozapine due to which currently prescribed drug? Select all that apply.
Immunologics
An older adult client has been prescribed an antiseizure medication and is experiencing central nervous system depression. What is the nurse's most appropriate action?
Implement falls precautions
An 11-year-old client has been hospitalized on the adolescent psychiatry unit with severe depression. For the past several weeks, the client has been prescribed a selective serotonin reuptake inhibitor (SSRI). What is the priority nursing action?
Implement suicide precautions.
A nurse is caring for a patient who is prescribed flurazepam. Which is an effect of flurazepam?
Induces sleep
A client is prescribed flurazepam. When explaining the drug to the client, the nurse would include which actions as its effect?
Induction of sleep
The nurse is preparing a care plan for a client receiving a hypnotic who is experiencing confusion and excessive drowsiness in the mornings. Which nursing diagnosis should the nurse prioritize for this client?
Injury Risk
The nurse is reviewing a client's current drug regimen and notes that the client takes 30 mg flurazepam daily. The nurse should suspect what health problem?
Insomnia
A client calls the clinic reporting only being able to get a 1-month supply of pills for the client's son, who takes a CNS stimulant for ADHD. The nurse understands that these medications are given in limited numbers for what reason?
It reduces the likelihood of drug dependence or diversion.
The nurse is aware that there is some research that reveals that anxiety may be treated with nutritional and herbal supplements. Which nutritional and/or herbal supplement is used in this treatment?
Kava
Which of the following herbal products is thought to treat anxiety, relieve stress and promote sleep? (Choose one)
Kava
A client is receiving allopurinol. Which instruction would be most important for the nurse to include in the client's plan of care?
Liberal fluid intake
What should the nurse include as a possible adverse effect when teaching a client about phenytoin?
Liver toxicity
An operating room nurse is assisting the anesthesiologist in the preparation of an intravenous dose of dantrolene. What emergent issue most likely prompted the need to give the patient dantrolene?
Malignant hyperthermia
A nurse is preparing an in-service presentation about hypnotics. Which factor would the nurse plan to include?
Most likely administered at bedtime
A patient has been prescribed lithium therapy. Which of the following signs and symptoms will the nurse tell the patient to report immediately?
Muscle twitching
Which drug would be classified as a hallucinogen?
PCP
The nurse has administered anakinra to a client. Which assessment finding should the nurse prioritize?
Pancytopenia
Ms. Buller is a 28-year-old patient who has been admitted to the hospital for abdominal pain. She puts on her call light because she is having difficulty breathing, palpitations, and increasing sweating. As the nurse caring for Ms. Buller, you complete a physical assessment, and you note her blood pressure, pulse, and respirations are elevated. You inquire about her symptoms; she states that she is afraid to be in the hospital because something bad will happen to her. What is Ms. Buller most likely suffering from?
Panic attack
A group of students are reviewing information about antidepressants that inhibit the activity of monoamine oxidase, leading to increase in epinephrine, norepinephrine, dopamine, and serotonin. The students demonstrate understanding when they identify which drug as acting in this manner?
Phenelzine
A patient admitted to the health care facility for insomnia related to stress is prescribed a sedative. What intervention should the nurse perform to promote the effects of the sedative?
Provide back rubs
A client admitted for insomnia related to stress is prescribed a sedative. Which actions would the nurse include in the plan of care to promote the effectiveness of the drug?
Provide back rubs.
A nurse is preparing to administer buspirone to a client with anxiety. The nurse should question this order if which disorder is noted in the client's past history?
Psychoses
The nurse is providing education to a client regarding healthy sleeping habits. What statement most accurately describes an aspect of rapid eye movement (REM) sleep?
REM deprivation can lead to serious psychological problems.
A nurse is preparing a teaching plan for a client with schizophrenia who is prescribed olanzapine in a disintegrating tablet form. Which instruction should the nurse include in the teaching?
Remove the tablet with dry hands.
While taking the vital signs of a hospitalized client admitted for seizure control due to epilepsy, the nurse notices a bloody toothbrush on the client's bedside table and scattered bruising over the client's extremities. What is the nurse's best action?
Report the findings to the primary health care provider immediately.
The nurse is assessing a client who is brought to the emergency department by some friends who admit that the client used cocaine. What should the nurse expect to assess?
Tachycardia
A client with major depression has not experienced an improvement after treatment with SSRIs and electroconvulsive therapy. Consequently, the provider has prescribed isocarboxazid. When planning this client's care, what nursing diagnosis should the nurse prioritize?
Risk for injury related to adverse drug effects
A nurse is planning the care of a client who has been diagnosed with schizophrenia and who will begin treatment with a typical antipsychotic. The nurse should identify what nursing diagnosis?
Risk for injury related to central nervous system depression
During his assessment, Drew reveals that he is a frequent user of crack and has been on a binge for several days. The nurse realizes that he requires frequent cardiac assessments. The reason for this increased assessment of the cardiac system is because of the major risk for what condition as a result of crack cocaine use?
Rupture of the aorta
The nurse is interviewing a 75-year-old client and knows that what antidepressant drug class is the first choice for older adults?
SSRIs
Which of the following is a clinical manifestation of alcohol withdrawal?
Seizures
When questioned about her alcohol usage, a female client states that she drinks three martinis a night. What assessment should the nurse make of this statement?
She may have understated the amount of alcohol consumed.
A client taking modafinil (Provigil), for narcolepsy has recently needed an increased dosage. At a follow-up visit, the client is combative, confused, and has a low-grade fever. The nurse knows that this clinical presentation is most likely which?
Signs of toxicity from the medication
A client receiving antianxiety drug therapy reports constipation. The nurse explains this is the result of which factor?
Slowed intestinal transit time
A client with depression is prescribed venlafaxine. Which action will the nurse take when the client is unable to swallow the extended-release capsule?
Sprinkle the contents on applesauce.
A nurse is caring for an older adult client who has been prescribed amoxapine for depression accompanied by anxiety. After administration of the drug, the nurse observes muscle rigidity and sweating. Which action should the nurse prioritize?
Stop the drug and contact the health care provider.
A client who has been receiving treatment for psychosis presents to the clinic for follow up. On assessment, the nurse discovers the client is currently displaying rhythmic, involuntary facial movements to include chewing-like movements and tongue protrusion. The nurse interprets these findings as an indication of which disorder?
Tardive dyskinesia
A nurse observes rhythmic, involuntary facial movements in a patient who has been administered antipsychotic drugs. The patient also makes chewing movements and, at times, his tongue protrudes. What is the most likely reason for the patient's behavior?
Tardive dyskinesia
A client with a history of partial seizures has been taking lamotrigine for the past several days. The client calls the clinic and reports the development of a facial and torso rash to the nurse. What is the nurse's best action?
Tell the client to take no further doses and come be assessed at the clinic immediately.
Which of the following refers to the reduction in a drug's effect that follows persistent use?
Tolerance
A client is prescribed topiramate. The nurse cautions the client to avoid the intake of alcohol for which reason?
The client is at risk for increased CNS depression.
The nurse administers promethazine to the client before sending the client to the preoperative holding area. What outcome demonstrates therapeutic effects?
The client is conscious but drowsy.
A client was prescribed oral hydromorphone two weeks ago for the treatment of cancer pain. The client was able to achieve pain relief with 2 mg doses for the first 10 days, but has recently needed 3-4 mg to achieve the same effect. The client has expressed concern to the nurse that he is becoming addicted to hydromorphone. What should the nurse teach the client?
The client is developing a tolerance, which is not the same as addiction.
During initial admission assessment, a 79-year-old client's family mention the client's spouse died 4 months ago. One family member notes, "the healthcare provider had prescribed antidepressant medication" but the client is "talking to people who aren't there." What would the nurse suspect is happening to the client?
The client is having hallucinations as an adverse effect of antidepressant therapy.
A 24-year-old client is being seen in the emergency department because of a high fever and cannot move the right arm. During the history-taking process, The nurse discovers the client is being treated with an antipsychotic medication for schizophrenia. The nurse knows that what may be happening with this client?
The client may be having a neuroleptic malignant syndrome reaction to his antipsychotic medication and needs treatment immediately.
To best assure client safety, what information should the nurse provide to a client whose fluoxetine therapy has been discontinued?
The dosage of the medication will be gradually reduced over a period of 6 to 8 weeks.
A female client is diagnosed with renal insufficiency. The nurse develops a teaching plan based on the diagnosis and antipsychotic drug usage. The client asks the nurse why it is so important to have renal function tests routinely. The nurse replies that if renal function test results become abnormal, what may be a consequence?
The drug may need to be lowered in dosage or discontinued.
The nurse is caring for a patient who is receiving drug therapy for a psychotic disorder. Which goals should the nurse include in a care plan for the patient following discharge from the hospital?
The patient will take medications as prescribed.
The home health nurse is gathering a client's medication prior to going to see the physician. The nurse cannot find the bottle for the methylphenidate, Daytrana. What would be the reason for this?
This is a transdermal patch medication.
Charlie, a homeless heroin addict, has been admitted into care and needs immediate intervention. A visiting health care provider has begun Charlie on methadone maintenance. What fact should the nurse consider during this client's treatment for substance use?
Using methadone maintenance may lead to a dependence on methadone.
The nurse is preparing to teach a client with psychosis about clozapine. The nurse will point out the importance of which weekly laboratory test to this client?
WBC count
A nurse emphasizes the need to avoid caffeine and caffeinated beverages with a client undergoing treatment for insomnia based on which known caffeine effect?
Wakefulness
A client who is obese is to start receiving amphetamine as part of the treatment. Which factor should the nurse prioritize in the preadministration assessment?
Weight
The nurse knows the medication methylphenidate is used to treat attention deficit hyperactivity disorder(ADHD). What type of medication is methylphenidate?
a central CNS stimulant
A school nurse provides care in a large elementary school. Many of the students have diagnoses of ADHD. For which child with ADHD would the use of methylphenidate most likely be safe and effective?
a child who had Hodgkin lymphoma four years ago
Which client should the nurse identify as having an absence seizure?
a client whose alterations in consciousness last a few seconds
Which client should the nurse expect to receive a lower-than-usual dose of benzodiazepines?
a client with alcoholic liver disease
A 64-year-old-client has been prescribed lorazepam because of increasing periods of anxiety. The nurse should be careful to assess for which?
a history of current or past alcohol use.
A nurse is working with a client who is taking an MAOI. What would be the most important instruction to the client?
avoid use of soy sauce in the diet.
The client reports using an over-the-counter (OTC) drug to treat insomnia. What classification of OTC medications is often used for this purpose?
antihistamines
The nurse is conducting a follow-up assessment of a school-aged child whose ADHD is being treated with dextroamphetamine. In addition to assessing for desired effects, what assessment should the nurse prioritize?
assessing the child's appetite
A client reports sensing an unusual smell just prior to experiencing a tonic-clonic seizure. What term is used to describe this event?
aura
A truck driver has been diagnosed with a generalized anxiety disorder (GAD) and lorazepam has been prescribed. The client asked the nurse how this medication will affect his job. The nurse would advise him how?
avoid driving until he is aware of the adverse effects.
The nurse is preparing to give prescribed haloperidol to an acutely dehydrated client. After administration, the nurse should prioritize what nursing assessment?
blood pressure
Following an extensive diagnostic workup, a 20-year-old man has been diagnosed with bipolar disorder and begun lithium therapy. The nurse's priority assessment in the care of the patient is
careful monitoring of the patient's serum lithium levels.
A client is experiencing acute alcohol withdrawal. What medication does the nurse anticipate the prescriber to order?
chlordiazepoxide
A client with chronic pain was prescribed oxycodone several months ago and has developed a tolerance, requiring gradual increases in dose. As well, the client admits to experiencing psychological dependence and is showing signs and symptoms of physical dependence. The nurse should advocate for what approach?
close monitoring and gradual tapering down of the dose
A 28-year-old patient comes into the emergency department with chest pain. The client's blood pressure is 170/108, heart rate 116, and respiratory rate 32. The client states having "used drugs." The nurse would question the client about the use of:
cocaine.
After reviewing the various frequently abused street drugs, a group of students demonstrates understanding of the information when they identify gamma-hydroxybutyrate as which class?
depressant
What is the prototype for the classification of drugs referred to as benzodiazepines?
diazepam
A 30-year-old client is taking phenelzine 30mg PO tid. The nurse knows that at that dosage, the client will need to be carefully monitored for which?
dizziness.
A 26-year-old professional began using cocaine recreationally several months ago and has begun using the drug on a daily basis over the past few weeks. He has noticed that he now needs to take larger doses of cocaine in order to enjoy the same high that he used to experience when he first used the drug. A nurse should recognize that this pattern exemplifies
drug tolerance.
A nurse has admitted a client diagnosed with substance abuse intoxication to the unit. The nursing assessment will first be directed toward data regarding:
drug use.
A nurse is obtaining baseline physical data from a 7-year-old patient who is to be started on dextroamphetamine for ADHD. After obtaining vital signs, height, and weight, the nurse will prepare the patient for an
electrocardiogram (ECG).
A client being treated for schizophrenia with a traditional antipsychotic medication is taking an herbal preparation for arthritis. The client buys the herbal remedy at the local retail store. Which herbal medication should the nurse caution the client about taking for arthritic pain?
evening primrose
A parenteral form of an antipsychotic is prescribed for a client who has become aggressive. When administering the drug, which site would be appropriate for the nurse to use?
gluteus
A nurse is assessing a client who is suspected of having attention deficit hyperactivity disorder (ADHD). Which is a characteristic of ADHD?
impulsiveness.
Antipsychotic drugs are contraindicated in clients with:
liver damage, coronary artery disease, severe hypertension, bone marrow depression, or cerebrovascular disease.
A school-aged client has been diagnosed with ADHD and the care team agrees that pharmacologic treatment is necessary. The client is unable and unwilling to swallow capsules or tablets and the team agrees that accommodating this limitation is in the client's best short-term interests. Which medication is most appropriate for this client?
methylphenidate
A client has recently been placed on modafinil 200 mg PO once daily. Modafinil (Provigil) is first-line pharmacologic therapy for:
narcolepsy.
A nurse is caring for a client with trigeminal neuralgia at a health care facility. The health care provider has prescribed carbamazepine. In which case is the use of carbamazepine contraindicated in clients with:
renal impairment.
A client prescribed fluoxetine 1 week ago presents for a scheduled follow-up appointment. What should be the focus of the client's nursing assessment to best assure client safety?
presence of suicidal ideation
The family of a child with ADHD who is being treated with methylphenidate is shocked that their health care provider mentioned the possibility of withholding the child's medication once the child's school year is completed. What rationale for this change in therapy should the nurse describe?
prevention of weight loss and growth suppression
A client comes to the mental health clinic for a regular appointment. The client tells the nurse he has been taking oral fluoxetine 20 mg daily for the past 3 weeks and that he has lost 3 lb during that time due to a loss of appetite. What action should the nurse take?
reassuring the client that this is a common adverse effect with this medication
The nurse is planning care for a client who has been prescribed a CNS stimulant. What should the nurse establish as the primary goal of therapy?
relieve the symptoms for which they were prescribed.
A nurse is administering a prescribed dose of chlordiazepoxide to a client. The nurse should closely assess the client for what adverse reaction?
respiratory depression
The nurse is caring for a client who experiences anxiety and insomnia and is prescribed lorazepam. When developing the plan of care, what would be an appropriate nursing diagnosis related to potential adverse effects of the drug?
risk for injury related to central nervous system (CNS) effects
When caring for a client with alcohol dependence who is prescribed a benzodiazepine, which side effects is it most important that the nurse monitor for?
sedation
While caring for a client who is receiving antipsychotic therapy, the nurse observes lip smacking, a darting tongue, and slow and aimless arm movements. The nurse interprets this as:
tardive dyskinesia.
The nurse is providing health education to a client who has been newly diagnosed with schizophrenia. What subject should be the primary focus?
the importance of adherence to prescribed treatment
An adolescent taking oral contraceptives has been prescribed an anticonvulsant medication. The nurse should tell the client to do which?
use another form of birth control, such as condoms.
