NRS204 Test 4: Neuro Pharmacology

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A client has a prescription to receive valproic acid daily. To ensure the client's safety, when is the best time for the nurse to schedule the administration of this medication? 1.At bedtime 2.Mid-afternoon 3.Two hours after lunch 4.Two hours before breakfast

Answer: 1.At bedtime

A client has a prescription for valproic acid. To maximize the client's safety, the nurse should plan to monitor for which potential complications of this medication? Select all that apply. 1.Pancreatitis 2.Hypotension 3.Renal failure 4.Hepatotoxicity 5.Cardiotoxicity

Answer: 1.Pancreatitis 4.Hepatotoxicity

The client with a head injury is experiencing signs of increased intracranial pressure (ICP), and mannitol is prescribed. The nurse administering this medication expects which as intended effects of this medication? Select all that apply. 1.Reduced ICP 2.Increased diuresis 3.Increased osmotic pressure of glomerular filtrate 4.Reduced tubular reabsorption of water and solutes 5.Reabsorption of sodium and water in the loop of Henle

Answer: 1.Reduced ICP 2.Increased diuresis 3.Increased osmotic pressure of glomerular filtrate 4.Reduced tubular reabsorption of water and solutes

The nurse has a prescription to administer phenytoin 100 mg mixed in 5% dextrose in water by the intravenous (IV) route to a client. After reading this prescription, which action should the nurse take? 1.Prepare the solution for administration. 2.Contact the agency pharmacy to obtain the medication. 3.Contact the primary health care provider (PHCP) to question the prescription. 4.Mix the medication in the prescribed solution and attach an in-line filter.

Answer: 3.Contact the primary health care provider (PHCP) to question the prescription.

A home care nurse visits a client at home. Clonazepam has been prescribed for the client, and the nurse teaches the client about the medication. Which client statement indicates that further teaching is necessary? 1."My drowsiness will decrease over time with continued treatment." 2."I should take my medicine with food to avoid any stomach problems." 3."I can take my medicine at bedtime if it tends to make me feel drowsy." 4."If I experience slurred speech, this problem will disappear in about 8 weeks."

Answer: 4."If I experience slurred speech, this problem will disappear in about 8 weeks."

A hospitalized client has a prescription for dextroamphetamine daily. The unit nurse collaborates with the dietitian to limit the amount of which item on the client's dietary trays? 1.Fat 2.Starch 3.Protein 4.Caffeine

Answer: 4.Caffeine

A client who is taking phenytoin for a seizure disorder is being admitted to the hospital because of an increase in seizure activity. The client reports severe vomiting for the last 24 hours and an inability to take phenytoin during that time. The nurse anticipates that the primary health care provider will most likely prescribe which medication? 1.Clonazepam 2.Phenobarbital 3.Carbamazepine 4.Fosphenytoin sodium

Answer: 4.Fosphenytoin sodium

The nurse is providing instructions to a client beginning medication therapy with divalproex sodium for treatment of absence seizures. The nurse instructs the client that which represents the most frequent side or adverse effect of this medication? 1.Tinnitus 2.Irritability 3.Blue vision 4.Nausea and vomiting

Answer: 4.Nausea and vomiting

A client is taking benztropine mesylate orally daily. In monitoring this client for medication side effects, the nurse should plan to focus the assessment on which item? 1.Pupil response 2.Voiding pattern 3.Prothrombin time 4.Muscle strength and mobility

Answer: 2.Voiding pattern

A client with myasthenia gravis becomes increasingly weaker. The primary health care provider injects a dose of edrophonium to determine whether the client is experiencing a myasthenic crisis or a cholinergic crisis. The nurse expects that the client will have which reaction if in cholinergic crisis? 1.No change in the condition 2.Complaints of muscle spasms 3.An improvement of the weakness 4.A temporary worsening of the condition

Answer: 4.A temporary worsening of the condition

The nurse is providing instructions to a client who will be taking phenytoin. Which statement, if made by the client, would indicate an understanding of the information about this medication? 1."I need to perform good oral hygiene, including flossing and brushing my teeth." 2."I should try to avoid alcohol, but if I'm not able to, I can drink alcohol in moderation." 3."I should take my medication before coming to the laboratory to have a blood level drawn." 4."I should monitor for side effects and adjust my medication dose depending on how severe the side effects are."

Answer: 1."I need to perform good oral hygiene, including flossing and brushing my teeth."

A client with a diagnosis of trigeminal neuralgia is started on a regimen of carbamazepine. The nurse provides instructions to the client about the side and adverse effects of the medication. Which client statement indicates an understanding of the side and adverse effects of the medication? 1."I will report a fever or sore throat to my primary health care provider." 2."I must brush my teeth frequently to avoid damage to my gums." 3."If I notice ringing in my ears that doesn't stop, I'll seek medical attention." 4."If I notice a pink color to my urine, I will stop the medication and call my health care provider."

Answer: 1."I will report a fever or sore throat to my primary health care provider."

Phenytoin 100 mg to be given orally 3 times daily has been prescribed to a client. The home health nurse visits the client and provides instructions regarding the medication. Which statement, if made by the client, would indicate an understanding of the instructions? 1."I will use a soft toothbrush to brush my teeth." 2."It's okay to break the capsules to make it easier for me to swallow them." 3."If I forget to take my medication, I can wait until the next dose and eliminate that dose." 4."If my throat becomes sore, it's a normal effect of the medication, and it's nothing to be concerned about."

Answer: 1."I will use a soft toothbrush to brush my teeth."

The nurse has given medication instructions to a client beginning carbamazepine. The nurse determines that the client understands the use of the medication if he makes which statement? 1."I will use sunscreen when outdoors." 2."I can drive a car as long as it is not at night." 3."I will keep tissues handy because of excess salivation." 4."I will discontinue the medication if fever or sore throat occurs."

Answer: 1."I will use sunscreen when outdoors."

The nurse is caring for a client with myasthenia gravis who has received edrophonium by the intravenous route to test for myasthenic crisis. The client asks the nurse how long the improvement in muscle strength will last. Which response should the nurse make to the client? 1."It will last for 4 to 5 minutes." 2."It will last for about 30 minutes." 3."It will last longer than 60 minutes." 4."It will last approximately 10 minutes."

Answer: 1."It will last for 4 to 5 minutes."

The nurse has completed discharge teaching for a client prescribed carbamazepine. Which statement by the client indicates that education about the main effect of the medication was effective? 1."This medication has an anticonvulsant effect." 2."This medication interferes with DNA production." 3."The main effect is a decrease in intraocular pressure." 4."The main action of this medication is prevention of cellular division."

Answer: 1."This medication has an anticonvulsant effect."

A client with status epilepticus has been prescribed phenytoin to be given by the intravenous (IV) route. The nurse administering the medication is careful not to exceed which recommended infusion rate? 1.50 mg/min 2.60 mg/min 3.100 mg/min 4.750 mg/min

Answer: 1.50 mg/min

The nurse who is caring for a client with myasthenia gravis has a prescription to perform an edrophonium test. After obtaining edrophonium the nurse should be certain that which also is available at the bedside? 1.Atropine sulfate 2.Protamine sulfate 3.Calcium gluconate 4.Magnesium sulfate

Answer: 1.Atropine sulfate

A client has a medication prescription for phenytoin to be administered by the intravenous route. After drawing up the medication, the nurse notes the presence of precipitate in the syringe. Which action should the nurse take? 1.Discard the syringe and begin again. 2.Add sterile water to dissolve the precipitate. 3.Draw up an additional 1 mL of normal saline into the syringe. 4.Chart the medication as "not given," and write a note in the medical record.

Answer: 1.Discard the syringe and begin again.

A client is receiving phenobarbital sodium. Which finding on the nursing assessment would indicate that the client is experiencing a common side or adverse effect of this medication? 1.Drowsiness 2.Hypocalcemia 3.Blurred vision 4.Seizure activity

Answer: 1.Drowsiness

The nurse is caring for a client who is taking oral benztropine mesylate daily. What is the priority nursing assessment for the client? 1.Intake and output 2.The prothrombin time 3.The pupillary response 4.The partial thromboplastin time

Answer: 1.Intake and output

A client is scheduled to begin medication therapy with valproic acid. The nurse looks for the results of which laboratory test(s) before administering the first dose? 1.Liver function tests 2.Renal function tests 3.Pulmonary function test 4.Pancreatic enzyme studies

Answer: 1.Liver function tests

A client with myasthenia gravis who is taking neostigmine is experiencing frequent exacerbations of myasthenic crisis and cholinergic crisis. The nurse teaches the client that it is most important that this medication be taken in which manner? 1.On time 2.On an empty stomach 3.Double-dosed if 1 dose is missed 4.Titrated for dosage, depending on symptoms

Answer: 1.On time

The nurse has given medication instructions to a client receiving phenytoin. Which statement indicates that the client has an adequate understanding of the instructions? 1."Alcohol is not contraindicated while taking this medication." 2."Good oral hygiene is needed, including brushing and flossing." 3."The medication dose may be self-adjusted, depending on side effects." 4."The morning dose of the medication should be taken before a serum medication level is drawn."

Answer: 2."Good oral hygiene is needed, including brushing and flossing."

The nurse teaches the wife of a client who is receiving levodopa/carbidopa to avoid pyridoxine medications. Which statement by the wife indicates an understanding of the instructions? 1."Vitamin B6 will change perspiration and urine to a dark color, which may stain clothing." 2."Vitamin B6 reverses the effectiveness of the medication, meaning a higher dose is needed." 3."The medication competes with vitamin B6 for absorption in the intestine, blocking absorption." 4."The two medications in combination will cause the blood sugar to drop, causing hypoglycemia."

Answer: 2."Vitamin B6 reverses the effectiveness of the medication, meaning a higher dose is needed."

The nurse is observing a new nursing graduate who is preparing an intermittent intravenous (IV) infusion of phenytoin for a client with a diagnosis of seizures. Which solution used by the nursing graduate should indicate to the nurse an understanding of proper preparation of this medication? 1.5% dextrose in water 2.0.9% sodium chloride 3.Lactated Ringer's solution 4.5% dextrose and 0.45% sodium chloride

Answer: 2.0.9% sodium chloride

The nurse is told that the result of a serum carbamazepine level for a client who is receiving the medication for the control of seizures is 13 mcg/mL (55.03 mmol/L). Based on this laboratory result, the nurse anticipates that the primary health care provider (PHCP) will document which prescription? 1.Discontinuation of the medication 2.A decrease of the dosage of the medication 3.An increase of the dosage of the medication 4.Continuation of the presently prescribed dosage

Answer: 2.A decrease of the dosage of the medication

A client receiving therapy with carbidopa/levodopa is upset and tells the home health nurse that his urine has turned a darker color since he started taking this medication. The client wants to discontinue its use. In formulating a response to the client's concerns, the nurse interprets that this change is indicative of which condition? 1.Developing toxicity 2.A harmless side effect of the medication 3.A result of taking the medication with milk 4.A sign of interaction with another medication

Answer: 2.A harmless side effect of the medication

The primary health care provider is preparing to administer edrophonium to the client with myasthenia gravis. In planning care, the nurse understands which about the administration of edrophonium? Select all that apply. 1.Edrophonium is a long-acting cholinesterase inhibitor. 2.Atropine is used to reverse the effects of edrophonium. 3.If symptoms worsen following administration of edrophonium, the crisis is cholinergic. 4.Edrophonium is used to distinguish between a myasthenic crisis and a cholinergic crisis. 5.An improvement in symptoms following administration of edrophonium indicates myasthenic crisis.

Answer: 2.Atropine is used to reverse the effects of edrophonium. 3.If symptoms worsen following administration of edrophonium, the crisis is cholinergic. 4.Edrophonium is used to distinguish between a myasthenic crisis and a cholinergic crisis. 5.An improvement in symptoms following administration of edrophonium indicates myasthenic crisis.

The nurse is administering medications to a client with trigeminal neuralgia. The nurse expects that which medication will be prescribed for pain relief? 1.Oxycodone plus aspirin 2.Carbamazepine and gabapentin 3.Acetaminophen and codeine sulfate 4.Meperidine hydrochloride and hydroxyzine

Answer: 2.Carbamazepine and gabapentin

A client who has been taking phenytoin for seizure control has a serum phenytoin level of 8 mcg/mL (35.71 mmol/L). On the basis of this finding, which note should the nurse enter in the client's health record? 1.Client is experiencing a toxic level. 2.Client has an inadequate medication level. 3.Client's result is at the low end of therapeutic range. 4.Client's result is at the high end of therapeutic range.

Answer: 2.Client has an inadequate medication level.

A client has been prescribed benztropine. The nurse should assess for which gastrointestinal (GI) problems as a side or adverse effect of this medication? 1.Diarrhea 2.Dry mouth 3.Increased appetite 4.Hyperactive bowel sounds

Answer: 2.Dry mouth

A client is having the dosage of clonazepam adjusted. The nurse should plan to perform which action? 1.Weigh the client daily. 2.Institute seizure precautions. 3.Monitor blood glucose levels. 4.Observe for areas of ecchymosis.

Answer: 2.Institute seizure precautions.

The nurse is preparing an intravenous (IV) infusion of phenytoin as prescribed by the primary health care provider for the client with seizures. Which solution should the nurse plan to use to dilute this medication? 1.Dextrose 5% 2.Normal saline solution 3.Lactated Ringer's solution 4.Dextrose 5% and half-normal saline (0.45%)

Answer: 2.Normal saline solution

The clinic nurse is reviewing the record of a client scheduled to be seen in the clinic. The nurse notes that the client is taking selegiline hydrochloride. The nurse suspects that the client has which disorder? 1.Diabetes mellitus 2.Parkinson's disease 3.Alzheimer's disease 4.Coronary artery disease

Answer: 2.Parkinson's disease

The nurse is caring for a client receiving mannitol via intravenous (IV) infusion. A vial is sent from the pharmacy, and in preparing the medication the nurse notes that the vial contains crystals. What is the most appropriate nursing action? 1.Discard the vial. 2.Place the vial in warm water. 3.Send the vial back to the pharmacy. 4.Shake the vial to dissolve the crystals.

Answer: 2.Place the vial in warm water.

A client is taking trihexyphenidyl hydrochloride. The nurse should assess for which side or adverse effect of this medication? 1.Diarrhea 2.Urinary retention 3.Urinary incontinence 4.Excessive perspiration

Answer: 2.Urinary retention

The nurse is assisting in the care of a client being discharged on phenytoin 100 mg three times daily. When providing client teaching about this medication, the nurse should be sure to include which points? Select all that apply. 1.Break the capsules so they are easier to swallow. 2.Use a soft toothbrush while taking this medication. 3.If a dose is missed, just wait until the next one is due. 4.The medication may turn the urine pink, red, or brown. 5.Alcohol should be avoided while taking this medication. 6.Sore throat is a common side effect of the medication and is nothing to worry about.

Answer: 2.Use a soft toothbrush while taking this medication. 4.The medication may turn the urine pink, red, or brown. 5.Alcohol should be avoided while taking this medication.

The nurse has a prescription to administer diazepam 5 mg by the intravenous (IV) route to a client. The nurse should administer the medication over a period of at least how long? 1.15 seconds 2.30 seconds 3.1 minute 4.5 minutes

Answer: 3. 1 minute

The nurse in the primary health care provider's office is reviewing the results of a client's phenytoin level determination performed that morning. The nurse identifies that a therapeutic medication level has been achieved if which result is noted? 1. 3 mcg/mL (11.9 mmol/L) 2. 8 mcg/mL (31.74 mmol/L) 3. 15 mcg/mL (59.52 mmol/L) 4. 24 mcg/mL (95.23 mmol/L)

Answer: 3. 15 mcg/mL (59.52 mmol/L)

Benztropine mesylate is prescribed for a client. What statement by the client indicates that the client needs further teaching about the medication? 1."I will avoid driving if I get drowsy or dizzy." 2."I will watch my urinary output and look for signs of constipation." 3."I will sit in the sun for an hour a day to enhance medication effectiveness." 4."I will call the primary health care provider if I have difficulty swallowing or if I start vomiting."

Answer: 3."I will sit in the sun for an hour a day to enhance medication effectiveness."

The nurse is providing instructions to an adolescent prescribed phenytoin for the control of seizures. Which statement by the adolescent indicates a need for further teaching regarding the medication? 1."The medication may cause acne or oily skin." 2."Drinking alcohol may affect the medication." 3."If my gums become sore and swollen, I need to stop the medication." 4."Birth control pills may not be effective when I take this medication."

Answer: 3."If my gums become sore and swollen, I need to stop the medication."

The nurse is assisting in the care of a client who is being evaluated for possible myasthenia gravis. The primary health care provider gives a test dose of edrophonium. Evaluation of the results indicates that the test is positive. Which would be the expected response noted by the nurse? 1.Joint pain for the next 15 minutes 2.An immediate increase in blood pressure 3.An increase in muscle strength within 1 to 3 minutes 4.Feelings of faintness or dizziness for 5 to 10 minutes

Answer: 3.An increase in muscle strength within 1 to 3 minutes

The nurse is assisting in the care of a client with myasthenia gravis who is receiving pyridostigmine. Which medication should the nurse plan to have readily available should the client develop cholinergic crisis because of excessive medication dosage? 1.Vitamin K 2.Acetylcysteine 3.Atropine sulfate 4.Protamine sulfate

Answer: 3.Atropine sulfate

A client began taking amantadine approximately 2 weeks ago. The nurse determines that the medication is having a therapeutic effect if the client exhibits which finding? 1.Decreased voiding 2.Decreased blood pressure 3.Decreased rigidity and akinesia 4.Decreased white blood cell count

Answer: 3.Decreased rigidity and akinesia

The nurse preparing to administer carbamazepine notices a number of items on the client's breakfast tray. Which item should be a cause for concern and should be removed from the tray? 1.Carton of milk 2.Scrambled eggs 3.Grapefruit juice 4.Toast with honey

Answer: 3.Grapefruit juice

A client is taking clorazepate. The client asks the nurse if there is a risk of addiction with this medication. Which information should the nurse provide? 1.It is not habit forming either physically or psychologically. 2.It leads to physical tolerance, but only after 10 or more years of therapy. 3.It leads to physical and psychological dependence with prolonged high-dose therapy. 4.It can result in psychological dependence only because of the nature of the medication.

Answer: 3.It leads to physical and psychological dependence with prolonged high-dose therapy.

The nurse is preparing to ambulate a client with Parkinson's disease who has recently been started on levodopa/carbidopa. Before performing this activity with the client, the nurse should include which most important assessment in the client's plan of care? 1.History of falls 2.Use of assistive devices 3.Postural (orthostatic) vital signs 4.Degree of exhibited intention tremor

Answer: 3.Postural (orthostatic) vital signs

A client is taking the prescribed dose of phenytoin to control seizures. Results of a phenytoin blood level study reveal a level of 35 mcg/mL (140 mcmol/L). Which finding would be expected as a result of this laboratory result? 1.Hypotension 2.Tachycardia 3.Slurred speech 4.No abnormal finding

Answer: 3.Slurred speech

A client taking carbamazepine asks the nurse what to do if a dose is inadvertently missed. The nurse responds that which action should be taken? 1.Withhold until the next scheduled dose. 2.Withhold and call the primary health care provider (PHCP). 3.Take the dose as long as it is not close to the time for the next dose. 4.Withhold until the next scheduled dose, which should then be doubled.

Answer: 3.Take the dose as long as it is not close to the time for the next dose.

After review of the client's laboratory values, the nurse notes that a phenytoin level for a client receiving phenytoin is 7 mcg/mL (27.78 mmol/L). The nurse makes which interpretation regarding this laboratory result? 1.The level is within the expected therapeutic range. 2.The level indicates the medication should be stopped. 3.The level is lower than the expected therapeutic range. 4.The level is higher than the expected therapeutic range.

Answer: 3.The level is lower than the expected therapeutic range.

The home health nurse visits a client who is taking phenytoin for control of seizures. During the assessment, the nurse notes that the client is taking birth control pills. Which information should the nurse include in the teaching plan? 1.Pregnancy must be avoided while taking phenytoin. 2.The client may stop the medication if it is causing severe gastrointestinal effects. 3.There is the potential of decreased effectiveness of birth control pills while taking phenytoin. 4.There is the increased risk of thrombophlebitis while taking phenytoin and birth control pills together.

Answer: 3.There is the potential of decreased effectiveness of birth control pills while taking phenytoin.

A client with trigeminal neuralgia is being treated with carbamazepine, 400 mg orally daily. Which value indicates that the client is experiencing an adverse effect to the medication? 1.Sodium level, 140 mEq/L (140 mmol/L) 2.Uric acid level, 4.0 mg/dL (240 mcmol/L) 3.White blood cell count, 3000 mm3 (3.0 × 109/L) 4.Blood urea nitrogen level, 10 mg/dL (3.6 mmol/L)

Answer: 3.White blood cell count, 3000 mm3 (3.0 × 109/L)

The nurse is reading the laboratory results for a client being treated with carbamazepine for prophylaxis of complex partial seizures. When evaluating the client's laboratory data, the nurse determines that which value is consistent with a side or adverse effect of this medication? 1.Sodium level, 136 mEq/L (136 mmol/L) 2.Platelet count, 350,000 mm3 (350 × 109/L) 3.White blood cell count, 3200 mm3 (3.2 × 109/L) 4.Blood urea nitrogen (BUN), 19 mg/dL (6.84 mmol/L)

Answer: 3.White blood cell count, 3200 mm3 (3.2 × 109/L)

A client with Parkinson's disease has begun therapy with levodopa/carbidopa. The nurse determines that the client understands the action of the medication if he or she verbalizes that results may not be apparent for how long? 1. 1 week 2. 24 hours 3. 2 to 3 days 4. 2 to 3 weeks

Answer: 4. 2 to 3 weeks

A client is suspected of having myasthenia gravis. Edrophonium is administered intravenously to determine the diagnosis. Which indicates that the client may have myasthenia gravis? 1.Joint pain following administration of the medication 2.Feelings of faintness, dizziness, hypotension, and signs of flushing in the client 3.A decrease in muscle strength within 30 to 60 seconds following administration of the medication 4.An increase in muscle strength within 30 to 60 seconds following administration of the medication

Answer: 4. An increase in muscle strength within 30 to 60 seconds following administration of the medication

A client is receiving phenytoin. To monitor for side and adverse effects of this medication, the nurse assesses the results of which laboratory test? 1.Serum sodium 2.Serum potassium 3.Blood urea nitrogen 4.Complete blood count (CBC)

Answer: 4. Complete blood count (CBC)

A client with myasthenia gravis has difficulty chewing and has received a prescription for pyridostigmine. The nurse should check to see that the client takes the medication at what time? 1.With meals 2.Between meals 3.Just after meals 4.30 minutes before meals

Answer: 4.30 minutes before meals

A client with myasthenia gravis has become increasingly weaker. The primary health care provider prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or an increasing severity of the disease (myasthenic crisis). An injection of edrophonium is administered. Which finding would indicate that the client is in cholinergic crisis? 1.No change in the condition 2.Complaints of muscle spasms 3.An improvement of the weakness 4.A temporary worsening of the condition

Answer: 4.A temporary worsening of the condition

A client has been prescribed dextroamphetamine. The client complains to the nurse that the client cannot sleep well at night and does not want to take the medication any longer. Before making any specific comment, the nurse plans to investigate whether the client takes the medication at which proper time schedule? 1. 2 hours before bedtime 2. After supper each night 3. Just before going to sleep 4. At least 6 hours before bedtime

Answer: 4.At least 6 hours before bedtime

The primary health care provider (PHCP) writes a prescription for carbamazepine for a client who was admitted to the hospital. The nurse contacts the PHCP to verify the prescription if which condition is noted in the assessment data? 1.Hypertension 2.Tonic-clonic seizures 3.Trigeminal neuralgia 4.Bone marrow depression

Answer: 4.Bone marrow depression

A client began taking amantadine approximately 2 weeks ago. The client reports to the clinic for a follow-up evaluation. The nurse determines that the client is experiencing a side or adverse effect related to the use of this medication if which is noted? 1.Decreased rigidity 2.Decreased akinesia 3.A blood pressure of 118/74 mm Hg 4.Client complaints of urinary retention

Answer: 4.Client complaints of urinary retention

Carbamazepine has been prescribed for a client. The nurse should tell the client that which blood test will be done periodically while the client is taking this medication? 1.Lipase level 2.Amylase level 3.Ammonia level 4.Complete blood cell (CBC) count

Answer: 4.Complete blood cell (CBC) count

A client is scheduled to begin therapy with carbamazepine. The nurse should assess the results of which test(s) before administering the first dose of this medication to the client? 1.Liver function tests 2.Renal function tests 3.Pancreatic enzyme studies 4.Complete blood cell count

Answer: 4.Complete blood cell count

The nurse is reviewing the results of a test on a sample drawn from a child who is receiving carbamazepine for the control of seizures. The results indicate a serum carbamazepine level of 10 mcg/mL (42.33 mmol/L). The nurse analyzes the results and anticipates that the primary health care provider (PHCP) will note which prescription? 1.Discontinuation of the medication 2.A decreased dose of the medication 3.An increased dose of the medication 4.Continuation of the presently prescribed dosage

Answer: 4.Continuation of the presently prescribed dosage

Carbidopa-levodopa is prescribed for a client with Parkinson's disease. The nurse monitors the client for side and adverse effects of the medication. Which finding indicates that the client is experiencing an adverse effect? 1.Pruritus 2.Tachycardia 3.Hypertension 4.Impaired voluntary movements

Answer: 4.Impaired voluntary movements

The nurse is giving medication instructions to a client who is receiving phenytoin for epilepsy. Which instruction should the nurse include to promote adherence to the medication? 1.Discuss the self-limiting nature of epilepsy. 2.Explain how nonadherence does not account for treatment failure. 3.Involve one other person only in promoting adherence to prevent confusion. 4.Monitor plasma medication levels to provide information about compliance.

Answer: 4.Monitor plasma medication levels to provide information about compliance.

A client has received a dose of dimenhydrinate. The nurse evaluates the effect of the medication by noting whether the client obtained relief from what symptom? 1.Chills 2.Headache 3.Ringing in the ears 4.Nausea and vomiting

Answer: 4.Nausea and vomiting

The nurse in a long-term care facility is reviewing the primary health care provider's (PHCP's) prescriptions on an assigned client. The nurse notes that the PHCP prescribed ropinirole hydrochloride. The nurse determines that this medication has been prescribed to treat which condition in the client? 1.Depression 2.Diabetes mellitus 3.Coronary artery disease 4.Parkinsonian syndrome

Answer: 4.Parkinsonian syndrome

The nurse is speaking with a client taking phenytoin for seizure control. The client states that she has started using birth control pills to prevent pregnancy. Which would be an important point for the nurse to emphasize to the client? 1.Oral contraceptives decrease the effectiveness of phenytoin. 2.Severe gastrointestinal side effects can occur when phenytoin and oral contraceptives are taken together. 3.There is an increased risk of thrombophlebitis when phenytoin and oral contraceptives are taken at the same time. 4.Phenytoin may decrease the effectiveness of birth control pills, and additional measures should be taken to avoid pregnancy.

Answer: 4.Phenytoin may decrease the effectiveness of birth control pills, and additional measures should be taken to avoid pregnancy.

Propofol is being administered to induce sedation in a client who is intubated and is being mechanically ventilated. The nurse should monitor for which adverse effect during infusion of the medication? 1.Itching 2.Skin redness 3.Elevated triglyceride levels 4.Signs of respiratory depression

Answer: 4.Signs of respiratory depression

A client who was started on clonazepam tells the nurse of increasing clumsiness and unsteadiness since starting the medication. The client is visibly upset by these manifestations and asks the nurse what to do. The nurse's response is based on which understanding? 1.These symptoms probably result from interaction with another medication. 2.These symptoms usually occur when the client takes the medication with food. 3.These symptoms indicate that the client is experiencing a severe adverse reaction to the medication. 4.These symptoms are most severe during initial therapy and decrease or disappear with long-term use.

Answer: 4.These symptoms are most severe during initial therapy and decrease or disappear with long-term use.

The nurse is collecting data from a client and notes that the client is taking carbamazepine. The nurse determines that this medication has been prescribed to treat which condition? 1.Glaucoma 2.Diabetes mellitus 3.Parkinson's disease 4.Trigeminal neuralgia

Answer: 4.Trigeminal neuralgia


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