ATI pharm made easy 4.0

a nurse is providing teaching to a client who is about to begin amitriptyline therapy to treat major depressive disorder. which of the following instructions should the nurse include? SATA

- change positions slowly -do not stop abruptly - take @ bedtime - increase fiber & fluid A tricyclic anti-depressant such as amitriptyline can cause orthostatic hypotension. Relapse and withdrawal symptoms can occur with abrupt discontinuation. It is important to reduce the dosage over a two-week period to prevent or minimize withdrawal symptoms. This medication can cause drowsiness and should be taken at bedtime. Avoid activities that require alertness until it is known how the drug will affect. This medication causes anti-cholinergic affect such as dry mouth, constipation, and urinary retention. Increase fiber and fluid and urinate before taking the drug.

a nurse is providing teaching for a client who has a prescription for phenelzine. the nurse should instruct the client to avoid tyramine-enriched foods because of an increased risk for which of the following adverse reactions?

- hypertensive crisis Tyramine in Riched foods, such as aged cheese and processed meat, can trigger severe hypertension in clients who are taking MAOIs such as phenelzine. Manifestations include hypertension, headache, and nausea.

a nurse is caring for a client who is taking venlafaxine to treat major depressive disorder. the nurse should identify that which of the following drugs can cause serotonin syndrome when taken concurrently with venlafaxine?

-Phenelzine Clients should not take venlafaxine, a serotonin norepinephrine reuptake inhibitor, within 14 days of taking phenelzine, or other MAOIs, or serotonergic drugs. Serotonin syndrome is a life-threatening complication characterized by anxiety, confusion, hallucinations, and fever.

a nurse is providing teaching to a client who has a new prescription for diazepam for anxiety disorders. which of the following client statements indicates an understanding of the teaching?

-if i become pregnant, it is important to let my healthcare provider know Diazepam can increase the risk of congenital malformations and is contraindicated for clients who are pregnant.

a nurse is reviewing the medical history of a client who has a new prescription for a reduced dosage of alprazolam for anxiety. which of the following findings should indicate to the nurse the reason for the prescription modification?

-renal function impairment Dosage should be decreased for clients who have renal or hepatic impairment. Glaucoma is a contraindication for receiving alprazolam. Clients over 65 years of age might require a decreased dosage. Weight gain is an adverse drug reaction. Smoking can decrease the levels and effects of alprazolam.

a nurse is assessing a client who has been taking alprazolam for several days. which of the following findings should the nurse identify as an adverse drug reaction caused by alprazolam?

anxiety The client can experience a paradoxical effect when taking benzodiazepines or buspirone, indicated by increased anxiety rather than relief of anxiety. This should be reported to the provider who may consider a different medication.

a nurse should identify timolol is contraindicated for client who has which of the following disorders?

asthma This medication can cause bronchospasm and difficulty breathing. Clients who have asthma or any disorder that compromises respiratory function should not use this drug.

a nurse is providing teaching for a client who has a new prescription for betaxolol eye drops. which of the following adverse effects should the nurse include in the teaching?

bradycardia Betaxolol and timolol can cause bradycardia because of the blockade of cardiac beta 1 receptors. Client should check their pulse rate regularly and report sustained decreases.

a nurse is caring for a client who has a prescription for fluoxetine and who reports self-administering St. John's wort daily for the past 2 weeks. which of the following findings should the nurse report to the provider as an indication of serotonin syndrome?

hallucinations Hallucinations are an expected finding of serotonin syndrome. SSRIs are contraindicated with St. John's wort because the combination can increase the risk of developing serotonin syndrome.

A nurse is providing teaching to a client who has a new prescription for fluoxetine. which of the following instructions should the nurse include?

if you have persistent headaches, let the provider know Should report persistent headaches, anxiety or insomnia to the provider as an adverse drug reaction.

a nurse is providing teaching to a client about adverse effects of drug therapy. the nurse should include that orthostatic hypotension is a common adverse reaction of which of the following drugs?

imipramine This drug is a tricyclic antidepressant and can cause orthostatic hypotension. Clients should change position slowly.

a nurse is providing teaching to a client who has a prescription for buspirone to treat anxiety. which of the following instructions should the nurse include?

take a missed dose as soon as you remember Buspirone should be taken on a regular schedule to be therapeutic. If a dose is messed they should take as soon as they remember as long as it is not close to time for the next dose.

a nurse is caring for a client who has been taking alprazolam for an extended period of time to treat anxiety. the nurse should identify that abruptly stopping alprazolam therapy can result in which of the following adverse effects?

withdrawal symptoms Physical dependence can develop with extended use of alprazolam, a benzo diazepam. To prevent withdrawal symptoms clients should taper the dose slowly over several weeks.

a nurse is caring for a client who recently began taking chloroprozamine to treat schizophrenia and who was admitted to the emergency room w/ spasms of their face & back. which of the following adverse reactions should the nurse suspect?

- acute dystonia Acute dystonia can develop during the first few days of treatment with chlorpromazine. Manifestations include muscle spasms of the back, neck, face, and tongue. Treatment includes immediate administration of an anti-cholinergic drug such as diphenhydramine.

a nurse is providing teaching to a client about instilling pilocarpine for managing open-angle glaucoma. which of the following instructions should the nurse include in the teaching? SATA

- apply gentle pressure to the nasolacrimal duct for 1 min - do not touch the tip - remove contact lenses prior to instill The tip of the dropper shouldn't remain sterile. Wash hands before instilling eyedrops. Remove contact lenses before installing eyedrops because they can cause further irritation if left in place.

a nurse is caring for a client who is about to begin taking lithium carbonate to treat bipolar disorder. the nurse should instruct the client to monitor for which of the following findings as indications of lithium toxicity? SATA

- tremors -confusion - nausea - muscle weakness A course tremor indicates advanced toxicity that can lead to seizure activity. Confusion, slurred speech, and ataxia are indications of lithium toxicity. Nausea, vomiting, and diarrhea or early indications of lithium toxicity. Muscle weakness is an early indication of lithium toxicity.

a nurse is providing teaching to a client who has a prescription for chlorprozamine. which of the following instructions should the nurse include?

- wear sunscreen when exposed to sunlight Chlorpromazine is a conventional antipsychotic and can cause photo sensitivity or increased susceptibility to sunburn. Limit exposure to sunlight and wear sunscreen and protective clothing.

When reviewing the indications for various antidepressants, a nurse should identify that bupropion hydrochloride is an appropriate choice for clients who have which of the following?

-Seasonal affective disorder -nicotine addiction -depression

a nurse is providing teaching to a client who has a prescription for buspirone. which of the following instructions should the nurse include?

-allow 2-4 weeks for full therapeutic effects

a nurse is caring for a client who has a prescription for alprazolam. for which of the following adverse effects should the nurse monitor? SATA

-tolerance -anxiety -sedation -respiratory depression Clients should use these drugs only as needed and for short periods of time. Clients should take a benzodiazepine 30 minutes prior to bedtime. It is important to monitor for respiratory depression and recommend the lowest effective dose. Alcohol and other CNS depressants should be avoided.

a nurse is caring for a client who has schizoaffective disorder and who has been prescribed chlorpromazine. which of the following laboratory values should the nurse monitor during and immediately after IV administration?

Blood Pressure Client to receive chlorpromazine are at risk for hypotension during and immediately after IV administration. The client should remain supine for 30 minutes while the nurse monitors their blood pressure. The client should change position slowly as a safety precaution to prevent injury.

a nurse is reviewing the drug history of a client who is taking lithium carbonate for bipolar disorder. which of the following findings should indicate to the nurse to monitor for lithium toxicity?

Furosemide for hypertension For us tonight is a high ceiling loop diuretics and increases sodium loss and can cause lithium reabsorption.

a nurse is providing teaching to a client who has a prescription for lithium carbonate about reducing the risk for lithium toxicity. which of the following instructions should the nurse include?

avoid taking NSAIDS NSAIDs increase renal reabsorption of lithium and sodium. Client to take with him should not take NSAIDs

a nurse is caring for a client who was admitted to the emergency department with a head injury. the nurse notes that the client has an existing prescription for bupropion hydrochloride to treat depression. for which of the following adverse effects is the client at increased risk?

seizure activity Bupropion is an atypical anti-depressant that can cause seizure activity when clients take high doses or have a CNS disorder, a CNS tumor, or a history of head trauma.

a nurse is caring for a client who is taking lithium bicarbonate to treat bipolar disorder. which of the following diagnostic tests should the nurse recommend that the client undergo periodically

thyroid function test Hypothyroidism is an adverse effect of lithium carbonate. Client should report neck enlargement, weight gain, lethargy, and constipation. They should also have their thyroid function checked before they begin taking lithium and annually there after.