Pharm Test 2

Prior to the administration of metoprolol, a beta-adrenergic blocking agent, which is most important for the nurse to assess?

Blood Pressure

Which disorder(s) would indicate the use of anticholinergic agents? (Select all that apply.)

C, D, E c. Bradycardia d. Parkinson's disease e. Preparation for surgery

Before the initiation of anticholinergic medications, its important for the nurse to screen patients for which condition?

Closed angle Glaucoma

Which statement is true about neuropathic pain?

The pain is a result of nerve injury.

What is the advantage of taking a nonsteroidal anti-inflammatory drug (NSAID) that is a COX-2 inhibitor?

There are fewer GI adverse effects.

Why are beta-blockers used cautiously in patients with respiratory conditions?

They may produce serve bronchoconstriction

Which patient assessment would indicate to the nurse that salicylate toxicity is occurring?

Tinnitus

What is the drug of choice when treating a generalized tonic-clonic seizure?

Valproic acid (Depakene)

What is the primary response to alpha 1 receptor stimulation?

Vasoconstriction

What is the best way for the nurse to evaluate the effectiveness of the patient's opiate agonist?

Verbal report of 2 on a 1 to 10 scale

An older adult is to receive atenolol, a beta-adrenergic blocking agent. Prior to administration of the drug, the nurse assesses the apical pulse rate of 58 and notes ankle edema. Which action will the nurse take first?

Withhold the medication

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.

For which condition may carbamazepine (Tegretol) be used?

c. Trigeminal neuralgia pain

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?

"If I develop enlarged gums, I will stop taking the medication."

The nurse is providing education to a patient recently prescribed pregabalin (Lyrica). Which statement by the patient indicates a need for further instruction?

"Once my pain improves, I will stop taking this medication."

A patient with a history of type 1 diabetes after myocardial infraction has been placed on beta adrenergic blocking agent. which statement by the patient indicates a further need for teaching?

"This medication is lowering my blood pressure by helping me get rid of fluid"

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?

"Tylenol does not help with inflammatory discomfort."

What dose is within the acceptable range for administering IV phenytoin (Dilantin) to a patient with a seizure disorder?

30 mg/min

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?

30 minutes

Which additional nursing intervention(s) would be effective with pain management in the pediatric population? (Select all that apply.)

A B C D 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.

A patient is being discharged on an adrenergic bronchodilator. Which common adverse effect(s) will the nurse include in discharge teaching? (Select all that apply.)

A B C E a. Palpitations b. Dizziness c. Orthostatic hypotension e. Tremors

Patients taking phenytoin (Dilantin) for control of seizures must be aware of the risk for which adverse effect(s)? (Select all that apply.)

A B D F a. Blood dyscrasias b. Hyperglycemia d. Gingival hyperplasia f. Sedation

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 C D a. Consult an obstetrician. c. Carry an identification card. d. Provide a list of seizure medications.

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 D E a. Apply a cardiac monitor to the patient to assess for continuous heart rate, if not already done. d. Continuously assess the patient's airway. e. Obtain the correct dose (10 mg) and administer over slow IV push.

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 D E a. Skin rash d. Allergy to Bactrim e. Pruritus

Neurotransmitter(s) include: (Select all that apply.)

A, B, C, E, F a. gamma aminobutyric acid. b. acetylcholine. c. serotonin. e. histamine. f. epinephrine.

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, B, E a. Warfarin (Coumadin) b. Lithium (Eskalith) e. Diuretics

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.)

B C b. Orientation to date, time, and place c. Mental alertness

What is a guideline for the nurse when administering phenytoin (Dilantin) intravenously?

Administer without mixing with other medications.

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?

Advise the patient that this adverse effect usually resolves but should be reported to the healthcare provider.

The autonomic nervous system can be subdivided into which types of adrenergic receptors?

Alpha and Beta

Which category of medication is used for peripheral vascular disease characterized by excessive vasoconstriction, such as Raynaud's disease?

Alpha-adrenergic blocking agents

Which premedication assessment by the nurse is most important prior to the initiation of carbamazepine (Tegretol) therapy?

Determine patient's ancestry.

Which sign or symptom displayed by a patient would be indicative of opiate withdrawal?

Diarrhea

What condition would alert the nurse of the need to use beta adrenergic blockers cautiously?

Emphysema

What information is most accurate regarding the nurse's understanding of pain management?

Encourage patients to report pain before the pain becomes too severe.

Which condition is associated with hydantoin therapy?

Gingival hyperplasia

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 be experiencing?

Hyperglycemia

A patient hospitalized in an acute care setting reports to the nurse that since starting on an adrenergic medication, he has been feeling "dizzing and weak" The most appropriate action for the nurse is to?

Monitor the blood pressure in both supine and standing position

Which medication would the nurse administer to a patient who is rating the pain at 8 on a 0 to 10 scale?

Morphine (Roxanol)

Which adverse effect(s) is/are common when a patient is receiving a cholinergic agent?

Nausea, Dizziness, and bradycardia

A long-term care resident is taking an anticholinergic agent. The nurse observes the resident to be disoriented and hallucinating. The priority nursing action is to ?

Provide for resident's safety

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?

Quality

In which case would the nurse be correct in withholding an opiate agonist?

Respiratory rate of 10 breaths/min

The nurse is completing an assessment on a nonverbal adult patient. Which type of pain scale assessment tool is the most accurate to use?

b. FLACC

Which condition would indicate to the nurse that a patient has phenytoin (Dilantin) toxicity?

b. Nystagmus

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?

d. Notify the healthcare provider and prepare to administer naloxone (Narcan).

What term is used to define an awareness of pain?

perception

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:

provide a PRN analgesic medication as ordered.

The nurse is caring for a patient taking cholinergic agent. When auscultating lung sounds, the notes inspiratory and expiration wheezing bilaterally. The best action the nurse should take is what ?

withhold the next dose and notify the physician

Which common adverse effect(s) is/are associated with opiate agonists? (Select all that apply.)

A B C D a. Dizziness b. Orthostatic hypotension c. Respiratory depression d. Confusion

Which body function(s) is controlled by the autonomic nervous system? (Select all that apply.)

A, C, D, E a. Blood pressure c. GI secretion d. Body temperature e. Urination

Which statement(s) is/are true about efferent nerves? (Select all that apply.)

B C D E b. They leave the CNS to carry impulses to other body parts. c. They are part of the peripheral nervous system. d. They transmit signals that control contractions of smooth and skeletal muscles. e. They transmit signals that control contractions of some glandular secretions.

Which instruction(s) given by the nurse will assist a patient to cope with the common adverse effects of anticholinergic medications? (Select all that apply.)

B D b. "Increase fluids daily." d. "Suck on candy or ice chips."

What is included in the nursing management of the patient with generalized tonic-clonic seizure activity? (Select all that apply.)

B D E b. Placing padding around or under the patient's head 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

Which condition(s) may be managed by salicylates? (Select all that apply.)

B, C, D, E b. Swollen joints c. Fever d. Muscle aches e. Myocardial infarction

A patient with Parkinson disease ask the nurse why is anticholinergics are used in the treatment. Which response is accurate by the nurse ?

The drug inhibits the action of acetylcholine

A patient with COPD reports having insomnia and racing heart after starting terbutaline Therapy. Which explanation from the nurse is accurate?

The symptoms will resolve with continued therapy

Which medication is used to control seizures or prevent migraine headaches?

a. Topiramate (Topamax)

Which nerve endings liberate norepinephrine?

adrenergic

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:

altered breathing pattern.

Which medication is contraindicated when a patient is taking warfarin (Coumadin)?

aspirin

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:

carbohydrates.