PHARM 1 FINAL
The nurse is assessing a client for the effectiveness of the antiparkinson drug. If the nurse determines the client has improvement in these movements, which factor will the nurse point out has improved?
Bradykinesia
Which patient will be at the greatest risk for anemia and be the most likely candidate for epoetin alfa therapy?
A 62-year-old male with cancer
Indications for use of anticholinergic drugs in the treatment for Parkinsonism include to:
decrease salivation, spasticity, and tremors.
After the effector cell has been stimulated by acetylcholine (ACh), what enzyme stops this stimulation and allows the effector membrane to repolarize?
Acetylcholinesterase
A client who is prescribed a hypnotic asks the nurse, "About how long will I be taking this medication?" Which time frame would the nurse most likely include in the response?
2 weeks
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
The nurse is providing information about how to care for clients during a bioterrorism attack. The nurse knows that which drug will be administered in the case of a sarin attack?
Atropine
A male client asks the nurse why he needs the preoperative anticholinergic medication ordered by the anesthesiologist. The nurse explains that anticholinergic drugs are given preoperatively to prevent which anesthesia associated complication?
Bradycardia
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?"
A client prescribed epoetin alfa asks how the medication works. Which is the nurse's best response?
"Increases the release of cells to increase the hemoglobin and hematocrit levels."
A client reports insomnia and wants to be able to take a medication every night. Which medication for sleep has been approved for long-term use?
Eszopiclone
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
A client has been receiving regular doses of epoetin alfa for several weeks, and the home care nurse has been monitoring the client's condition closely. When taking the client's vital signs, the nurse should pay particular attention to what assessment datum?
blood pressure
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).
The nurse is caring for a client who has been taking an oral neuroleptic medication for several years. What assessment should the nurse prioritize to best address the risk for adverse effects?
monitoring the client for involuntary facial movements
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
A client who is being treated with an antineoplastic medication for cancer is prescribed Kepivance. The client is refusing this medication, stating that "all these drugs are making everything worse," including the inside of her mouth. What would be an appropriate response from the nurse?
"Kepivance is used to protect the normal cells in your body from the chemotherapy.
The nurse is providing health education for a client who has been prescribed a benzodiazepine. What adverse effect should the nurse discuss in the teaching?
dependence
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 client's depression is believed to exist because of a deficiency of biogenic amines in key areas of the client's brain. What phenomenon would be most likely to cause this deficiency?
increase in the number or sensitivity of postsynaptic receptors
What is the nurse's best action when administering zaleplon to a client?
Administer on an empty stomach.
When reviewing the medication record of a client with Parkinson disease, the nurse notes that the client is receiving a cholinergic blocking drug. Which drug would the nurse note?
Benztropine
A group of students are reviewing information about tricyclic antidepressants and demonstrate understanding of the material when they identify which drug as also being indicated for the treatment of obsessive-compulsive disorder.
Clomipramine
A client is receiving lithium and informs the nurse that they are also taking antacids for heartburn. The nurse would be alert for which reaction?
Decreased effectiveness of lithium
A group of nursing students answers correctly if they identify which medication as the prototype benzodiazepine?
Diazepam
A 70-year-old female patient has just been diagnosed with Alzheimer's disease. What cholinergic drug is used for the treatment of Alzheimer's disease?
Donepezil (Aricept)
A client is using a scopolamine patch for treatment of motion sickness. The nurse would instruct the client to change the patch at which frequency?
Every 3 days
A client was emergently administered bethanechol. Which finding on ongoing assessment should the nurse prioritize and notify the health care provider immediately?
Failure to void
A nurse is caring for a patient with urinary retention. Which of the following conditions should the nurse notify the primary healthcare provider as part of the ongoing assessment?
Failure to void after drug administration
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 action by the new nurse would alert the charge nurse that more education is needed for the new nurse, after administering an anxiolytic to a client?
Having the client walk to the bathroom
What would be the priority nursing diagnosis for a patient who is prescribed epoetin alfa?
Impaired tissue oxygenation related to anemia
The pharmacology class learns that epoetin alfa is an immunosuppressant drug that is designed to have what expected outcome?
Increased RBC count
The caregiver of a client diagnosed with AD asks the nurse about the prescribed therapy with rivastigmine and about how the drug works. The nurse would integrate knowledge of which action in the response to the caregiver?
Increases the level of acetylcholine in the CN
The caregiver of a client diagnosed with AD asks the nurse about the prescribed therapy with rivastigmine and about how the drug works. The nurse would integrate knowledge of which action in the response to the caregiver?
Increases the level of acetylcholine in the CNS
Stomatitis:
Inflammation of the mouth
A 39-year-old client has begun taking tamoxifen to reduce the risk of contralateral breast cancer. The client is now reporting hot flashes and dysmenorrhea. What is the nurse's best action?
Inform the client that these are likely adverse effects of drug therapy.
The nurse is caring for a client with Alzheimer's disease who has been prescribed a cholinesterase inhibitor. What symptom of the disorder does the nurse expect the medication is intended to treat?
Mild to moderate dementia
A client who has been receiving long-term levodopa therapy tells the nurse, "I was making good progress and then it was like the drug stopped working." The nurse interprets this as which of the following?
On-off phenomenon
The nurse is aware that which medication taken by a client for treatment of mood disorder requires a diet that restricts the amount of tyramine eaten?
Phenelzine
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
Anticholinergic drugs are used in ophthalmology because they produce which effect?
Pupil dilation
Mrs. Cybil Smith, a 64-year-old retired teacher, is having symptoms of muscle weakness with exercise. The client has undergone an extensive workup for this condition. Her family health care provider has prescribed neostigmine to confirm the diagnosis of myasthenia gravis. What would be an age-related risk factor?
Restlessness, anxiety, and agitation
What is the "on-off" phenomenon of levodopa?
Return on symptoms as medication wears off. This is theorized to be due to troughs and peaks of the plasma concentration throughout the day (the drug is taken multiple times a day).
The nurse is teaching a client and caregiver about the antipsychotic medication which has been prescribed. The nurse determines the teaching is successful when they correctly choose which reaction should be reported immediately to the health care provider?
Rigidity
After assessing the client receiving erythropoietin drug therapy, the nurse suspects what finding is an adverse effect of erythropoietin drug therapy?
The client has peripheral edema to the feet and lower legs.
A student asks the pharmacology instructor to explain the action of anticholinergic agents. What would be the instructor's best response?
They act to block the effects of the parasympathetic nervous system
A client is having a stress response that is causing the release of norepinephrine. This norepinephrine will be made from what dietary precursor?
Tyrosine
The client is ordered bethanechol subcutaneously. After giving the client the injection of bethanechol, the nurse should make sure that what is available?
Urinal, bed pan, and call light
A male client is prescribed interferon. What is his probable diagnosis?
Viral hepatitis
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 10-year-old child is being administered CNS stimulants for ADHD. What should the nurse instruct the parents to record periodically?
Weight and growth
A client has a neurologic disorder characterized by a deficiency of acetylcholine. In what location is acetylcholine normally synthesized?
Within cholinergic nerves themselves
A client is receiving ramelteon for insomnia. The nurse would instruct the client to take the drug at which time?
½ hour before going to bed
