Exam 3
Patient should be cautioned to avoid which when taking skeletal muscle relaxants?
Alcohol
A client who has been taking valproic acid (sodium valproate) for a seizure disorder is asking the nurse about getting pregnant. Why is pregnancy discouraged in women who are being treated for seizure disorders?
Antiepilepsy drugs are teratogenic
The nurse is giving instructions to a client who has just been prescribed sumatriptan for the treatment of migraine headaches. The client will be instructed to take this medication at what time?
At the onset of migraine symptoms
Which instruction should the nurse specifically stress when administering drugs used for muscle spasm and cramping?
Avoid alcohol or other CNS depressants.
A patient is prescribed Phenelzine for the treatment of depression. Which foods should the patient be taught to avoid?
Bananas, smoked fish, and cheese
A patient who experiences panic attacks in social situations has been prescribed an antianxiety medication. What should the nurse check before administering the drug?
Blood pressure
A client has been prescribed phenelzine sulfate (Nardil), which is an MAO inhibitor. Which food should the client be instructed to avoid eating?
Cheddar cheese and bratwurst
A patient is diagnosed with type 2 diabetes mellitus and schizophrenia. The nurse will closely monitor the blood sugar if the patient receives which medication for the treatment of schizophrenia?
Clozapine [Clozaril]
The nurse works in a long-term care facility. When administering narcotics to clients, the nurse must monitor for which side effect?
Constipation
Before administering ramelteon [Rozerem] to a patient on the medical unit, which action by the nurse is best?
Consult the prescriber if the patient has chronic hepatitis
The client is scheduled for surgery. The nurse administers diazepam (Valium) preoperatively for what purpose?
Decreased anxiety
What is the prototype for the classification of drugs referred to as benzodiazepines?
Diazepam
A patient is prescribed doxepin [Sinequan] for the treatment of depression. Which over-the-counter medication should the nurse teach the patient to avoid?
Diphenhydramine [Benadryl]
A patient is brought to the emergency department for the treatment of an overdose of alprazolam [Xanax]. Which medication should the nurse prepare to administer to this patient?
Flumazenil [Romazicon]
The nurse cares for a patient who is receiving lithium. Which medication, if prescribed by the healthcare provider, should the nurse question?
Furosemide [Lasix]
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 teaches a 16-year-old female patient about methylphenidate (Ritalin). Which statement by the patient indicates that more teaching is needed?
I can have an unlimited number of noncola soft drinks
The nurse teaches a patient about bupropion [Wellbutrin]. Which statement by the patient indicates that more teaching is indicated?
I had a serious head injury 3 years ago
A patient with BPD is prescribed lithium. Which statement, if made by the patient, indicates the need for further teaching?
I will reduce my salt intake while taking this medication
The nurse is aware that CNS stimulants are prescribed for clients with ADHD because these medications have what effect on behavior and attention?
Improving
The nurse cares for a patient with depression who has been prescribed an antidepressant. When would the nurse expect the medication to reach its full therapeutic effect?
In 2 to 3 weeks
A nurse is reviewing a bipolar client's serum lithium level, which is 1.8 mEq/L. What is the nurse's best action?
Inform the prescriber and monitor for GI and CNS effects
The nurse is formulating a care plan for a client with a seizure disorder. Which intervention would be an appropriate for the nurse to include?
Informing the client and family that seizure control is not gained immediately
The physician prescribes propranolol [Inderal] for a patient with migraine headaches. It is most important for the nurse to do what?
Instruct the patient that the medication will prevent migraines
A male client's physician orders levodopa for the treatment of the client's Parkinson's disease. The client asks the nurse whether the levodopa will cure his condition. Which is a correct statement about the effects of levodopa?
It does not alter the underlying disease process, but it may improve a client's quality of life.
A patient with depression has been prescribed fluoxetine [Prozac]. Which statement made by the patient indicates an understanding of the medication teaching?
It may take 3 to 4 weeks before my mood is elevated
The most effective drug to treat major symptoms associated with Parkinson's is:
Levodopa.
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.
The students are learning about medications to treat ADHD. The pharmacology instructor discusses the medication methylphenidate, used to treat attention deficit hyperactivity disorder. According to the instructor, methylphenidate is which?
a central CNS stimulant
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 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.
A trauma client has been receiving frequent doses of morphine in the 6 days since his accident. This pattern of analgesic administration should prompt the nurse to carefully monitor the client's what?
bowel patterns.
A client is to receive a narcotic cough syrup. The nurse would expect this preparation to contain:
codeine.
A nurse administrating an opioid medication should assess for what related side effect?
drowsiness
Which adverse effect should the nurse assess for when administering cyclobenzaprine?
drowsiness
Common side effects of anticholinergics include:
dry mouth, urinary retention, constipation, and increased pulse rate.
The home care nurse is caring for an 80-year-old patient who is receiving carbidopa-levodopa, a dopaminergic drug used to treat Parkinson's disease. The nurse knows that this drug may place the patient at increased risk for:
falls
An older adult client is diagnosed with generalized anxiety disorder. The use of benzodiazepines in this client population creates a specific need for which intervention?
falls risk assessment
Antipsychotic drugs are contraindicated in clients with:
liver damage, coronary artery disease, severe hypertension, bone marrow depression, or cerebrovascular disease.
The nurse gives a 68-year-old client diphenhydramine to help the client sleep the night before surgery. At midnight, the nurse notes the client is awake and agitated. What pharmacologic principle would be the cause of this reaction?
paradoxical excitement, which is the opposite reaction than what was expected
A client experiencing cancer pain is receiving morphine every 2 hours. What assessment should the family be taught to make while caring for this client at home?
respiratory depression
The nurse should prioritize which assessment when caring for a teenager who has recently been prescribed a selective serotonin reuptake inhibitor (SSRI)?
suicidal ideation
A client is prescribed phenytoin and reports gastrointestinal (GI) upset. The nurse should tell the client to:
take the medication with meals.
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.
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.
For clients taking clozapine, it is necessary to regularly monitor what lab test during the initial months of therapy and periodically thereafter?
white blood cell (WBC) count
Which conditions would occur due to the administration of an opioid antagonist in a client who is physically dependent on opioids?
withdrawal symptoms
A client with diagnoses of Parkinson's disease and hepatic disease is to begin tolcapone therapy. What monitoring intervention should be included in the client's plan of care?
a baseline liver function test
A patient is prescribed ergotamine tartrate [Ergomar] for migraine headaches. Which statement made by the patient indicates a need for further teaching?
"I am not at risk for physical dependence with this drug."
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's medication regimen for treatment of anxiety has been changed from a benzodiazepine. The client asks the nurse what likely prompted the health care provider to change the medication. What is the nurse's best response?
"Long-term use of benzodiazepines can result in dependency."
A 50-year-old woman has been prescribed sumatriptan for the treatment of migraines. What instructions should then the nurse provide to the patient about the safe and effective use of this drug?
"Take this drug as soon as you feel the first signs of a migraine."
A client has been diagnosed with depression. The provider has ordered sertraline. The client asks, "How soon will it be until I feel better?" What would be the best response by the nurse?
"The medication will start to work in about 10 days, but it may take up to 4 weeks to be fully effective."
A physician has prescribed an antidepressant medication for a 15-year-old client. Which statement would be appropriate for inclusion in medication teaching?
"There may be an increased risk of suicide while taking this drug."
The nurse is providing care for a 72-year-old female client whose diagnosis of bipolar disorder is treated with lithium. What nursing responsibility should be prioritized?
Monitor the client's fluid balance and sodium intake
A client is admitted to the emergency department for an opioid overdose. What would the nurse expect to administer to this client?
Naloxone
A client needs to be administered topical anesthesia. The nurse would administer the anesthetic at which location?
On the surface of the skin
An elderly patient is admitted to the medical division after a fall. At home he is taking amitriptyline 25 mg three times per day. What adverse effect could be related to the patient's fall?
Orthostatic hypotension
Gas anesthetics such as nitrous oxide must be combined with what element before they can be administered to the client?
Oxygen
After teaching an in-service program about nervous system conditions, the nurse determines that the teaching was successful when the group identifies which condition or disease as a group of symptoms involving motor movement characterized by tremors, rigidity, and bradykinesia?
Parkinsonism
A patient who is diagnosed with BPD is prescribed lithium. To monitor for lithium toxicity, the nurse should observe the patient for which signs and symptoms?
Polydipsia, slurred speech, and fine hand tremors
A patient undergoing treatment with barbiturates is showing symptoms of barbiturate toxicity. Which intervention should the nurse perform?
Provide respiratory assistance
A client is receiving levodopa as treatment for Parkinson disease. The nurse would instruct the client to avoid foods high in which vitamin to prevent a reduction in the effect of levodopa?
Pyridoxine (vitamin B6)
A child takes Adderall XR (amphetamine/dextroamphetamine mixture) for ADHD. The nurse should assess the child for which adverse effects?
Weight loss, restlessness, and chest pain
A nurse is caring for a patient who is receiving cyclobenzaprine. Which of is the action of the drug on the patient?
Reduction of muscle spasm
A child with ADHD has been prescribed Daytrana (a transdermal methylphenidate patch). When teaching the child's caregiver how to administer the medication, which instruction should the nurse include in the teaching?
Remove the patch within 9 hours of application
The nurse is administering opioid analgesics to a client for postoperative pain. What is the nurse's most important assessment prior to administering the medication?
Respiratory rate
A patient newly diagnosed with depression has been prescribed fluoxetene, a selective serotonin reuptake inhibitor (SSRI). Why would the physician order an SSRI for a newly diagnosed patient?
SSRIs usually produce fewer and milder adverse effects than other antidepressants.
A client who is receiving an antiseizure agent reports feeling sleepy and tired and reports dizziness when standing up. Which intervention would the nurse most likely implement as the priority?
Safety precautions
After teaching a group of nursing students about antidepressants, the instructor determines that the teaching was successful when the students identify which as inhibiting the reuptake of serotonin?
Selective serotonin reuptake inhibitors
A patient with schizophrenia is prescribed chlorpromazine oral concentrate. Which instruction should the nurse include in the teaching plan?
Sexual arousal may be enhanced with this medication
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
The nurse teaches a patient about eszopiclone [Lunesta]. Which statement by the patient indicates that the teaching has been effective?
The drug may leave a bitter taste in my mouth
A nurse instructs a parent about the administration schedule forAdderall XR (amphetamine/dextroamphetamine mixture) to treat the child's ADHD. The nurse determines that teaching is successful if the parent makes which statement?
The drug should be given in the morning, before school
What instructions should the nurse provide to a client who has expressed dissatisfaction with lorazepam therapy and wants to safely discontinue the drug?
The drug should be tapered gradually to prevent severe symptoms of withdrawal.
A patient has been taking a medication for 2 months. Which statement, if made by the patient, would indicate to the nurse that drug tolerance is occurring?
The medication does not seem to be working as well
The nurse instructs a young adult patient about triazolam [Halcion] for the short-term management of insomnia. Which statement, if made by the patient, indicates an understanding of the instructions?
The medication will not affect my breathing
The nurse receives a phone call from a patient who has been taking a CNS drug for 3 days. The patient tells the nurse that the medication causes nausea. Which response by the nurse is best?
The nausea will most likely decrease over time
The nurse prepares to administer the first dose of an antipsychotic agent to a patient. One hour after administration, it is most important for the nurse to assess what?
The orthostatic blood pressure measurements
The nurse is caring for a patient with migraine headaches. Which assessment best indicates that sumatriptan [Imitrex] is exerting the desired therapeutic effect?
The patient reports the termination of the migraine headache after the drug is administered
A 52-year-old male client is being treated for Parkinson's disease. The nurse is aware that Parkinson's disease results in several physical manifestations. What occurs in the neurons that causes these symptoms?
There is an imbalance between dopamine and acetylcholine.
Respiratory distress is a contraindication for the use of barbiturates.
True
Which manifestations does the nurse associate with tardive dyskinesia?
Twisting, worm-like movements of the tongue and face
The nurse prepares to administer lithium to a patient. Which laboratory result should first be assessed?
Urinary creatinine clearance