Pharm 2 unit 3 practice questions
A patient tells the nurse that he likes to drink kava herbal tea to help him relax. Which statement by the patient indicates that additional teaching about this herbal product is needed?
"I will be able to drive my car after drinking this tea."
The nurse has given medication instructions to a patient receiving phenytoin (Dilantin). Which statement by the patient indicates that the patient has an adequate understanding of the instructions?
"I will need to take extra care of my teeth and gums while on this medication."
The nurse is teaching a patient how to self-administer triptan injections for migraine headaches. Which statement by the patient indicates that he needs further teaching?
"I will take this medication regularly to prevent a migraine headache from occurring."
The wife of a patient who has been diagnosed with depression calls the office and says, "It's been an entire week since he started that new medicine for his depression, and there's no change! What's wrong with him?" What is the nurse's best response?
"It may take up to 6 weeks to notice any therapeutic effects. Let's wait a little longer to see how he does."
A patient with the diagnosis of schizophrenia is hospitalized and is taking a phenothiazine drug. Which statement by this patient indicates that he is experiencing a common adverse effect of phenothiazines?
"My mouth has been so dry lately."
When teaching a patient about taking a newly prescribed antiepileptic drug (AED) at home, the nurse will include which instruction?
"Regular, consistent dosing is important for successful treatment."
A patient has been taking an AED for several years as part of his treatment for partial seizures. His wife has called because he ran out of medication this morning and wonders if he can go without it for a week until she has a chance to go to the drugstore. What is the nurse's best response?
"Stopping this medication abruptly may cause withdrawal seizures. A refill is needed right away."
A patient has been taking the selective serotonin reuptake inhibitor (SSRI) sertraline (Zoloft) for about 6 months. At a recent visit, she tells the nurse that she has been interested in herbal therapies and wants to start taking St. John's wort. Which response by the nurse is appropriate?
"Taking St. John's wort with Zoloft may cause severe interactions and is not recommended."
A 38-year-old male patient stopped smoking 6 months ago. He tells the nurse that he still feels strong cigarette cravings and wonders if he is ever going to feel "normal" again. Which statement by the nurse is correct?
"These cravings may persist for several months."
A patient has been taking temazepam (Restoril) for intermittent insomnia. She calls the nurse to say that when she takes it, she sleeps well, but the next day she feels "so tired." Which explanation by the nurse is correct?
"These drugs affect the sleep cycle, resulting in daytime sleepiness."
A patient has been taking the monoamine oxidase inhibitor (MAOI) phenelzine (Nardil) for 6 months. The patient wants to go to a party and asks the nurse, "Will just one beer be a problem?" Which advice from the nurse is correct?
"You need to avoid all foods that contain tyramine, including beer, while taking this medication."
A patient is receiving instructions regarding the use of caffeine. The nurse shares that caffeine should be used with caution if which of these conditions is present?
A history of peptic ulcers
The nurse notes in the patient's medication history that the patient is taking cyclobenzaprine (Flexeril). Based on this finding, the nurse interprets that the patient has which disorder?
A musculoskeletal injury
The nurse is reviewing antiepileptic drug (AED) therapy. Which statements about AED therapy are accurate? (Select all that apply.) AED therapy can be stopped when seizures are stopped. AED therapy is usually lifelong. Consistent dosing is the key to controlling seizures. A dose may be skipped if the patient is experiencing adverse effects. Do not abruptly discontinue AEDs because doing so may cause rebound seizure activity.
AED therapy is usually lifelong. Consistent dosing is the key to controlling seizures. Do not abruptly discontinue AEDs because doing so may cause rebound seizure activity.
A patient who has been taking a selective serotonin reuptake inhibitor (SSRI) is complaining of "feeling so badly" when he started taking an over-the-counter St. John's wort herbal product at home. The nurse suspects that he is experiencing serotonin syndrome. Which of these are symptoms of serotonin syndrome? (Select all that apply.) a. Agitation b. Drowsiness c. Tremors d. Bradycardia e. Sweating f. Constipation
Agitation Tremors Sweating
Which drug used for the management of the patient with PD is most likely to cause postural hypotension?
Amantadine (Symmetrel)
Before beginning a patient's therapy with selective serotonin reuptake inhibitor (SSRI) antidepressants, the nurse will assess for concurrent use of which medications or medication class?
Anticoagulants
The barbiturate phenobarbital is prescribed for a patient with epilepsy. While assessing the patient's current medications, the nurse recognizes that interactions may occur with which drugs? (Select all that apply.) Antihistamines Opioids Diuretics Anticoagulants Oral contraceptives Insulin
Antihistamines Opioids Anticoagulants Oral contraceptives
The nurse reads in the patient's medication history that the patient is taking buspirone (BuSpar). The nurse interprets that the patient may have which disorder?
Anxiety disorder
A patient has been given a prescription for levodopa-carbidopa (Sinemet) for her newly diagnosed Parkinson's disease. She asks the nurse, "Why are there two drugs in this pill?" The nurse's best response reflects which fact?
Carbidopa prevents the breakdown of levodopa in the periphery.
A patient has been admitted to the emergency department with a suspected overdose of a tricyclic antidepressant. The nurse will prepare for what immediate concern?
Cardiac dysrhythmias
When assessing the medication history of a patient with a new diagnosis of Parkinson's disease, which conditions are contraindications for the patient who will be taking carbidopa-levodopa? (Select all that apply.) Angle-closure glaucoma History of malignant melanoma Hypertension Benign prostatic hyperplasia Concurrent use of monoamine oxidase inhibitors (MAOIs)
Concurrent use of monoamine oxidase inhibitors (MAOIs) Angle-closure glaucoma History of malignant melanoma
A patient has a 9-year history of a seizure disorder that has been managed well with oral phenytoin (Dilantin) therapy. He is to be NPO (consume nothing by mouth) for surgery in the morning. What will the nurse do about his morning dose of phenytoin?
Contact the prescriber for another dosage form of the medication.
When a patient is receiving a second-generation antipsychotic drug, such as risperidone (Risperdal), the nurse will monitor for which therapeutic effect?
Decreased paranoia and delusions
When evaluating a patient who is taking orlistat (Xenical), which is an intended therapeutic effect?
Decreased weight
A patient is experiencing status epilepticus. The nurse prepares to give which drug of choice for the treatment of this condition?
Diazepam (Valium)
A patient who has received some traumatic news is panicking and asks for some medication to help settle down. The nurse anticipates giving which drug that is most appropriate for this situation?
Diazepam (Valium)
While a patient is receiving drug therapy for Parkinson's disease, the nurse monitors for dyskinesia, which is manifested by which finding?
Difficulty in performing voluntary movements
A 22-year-old nursing student has been taking NoDoz (caffeine) tablets for the past few weeks to "make it through" the end of the semester and exam week. She is in the university clinic today because she is "exhausted." What nursing diagnosis may be appropriate for her?
Disturbed sleep pattern
When providing teaching to a patient receiving an anticholinergic for the treatment of PD, the nurse will include which information?
Do not take this medication at the same time as other medications.
A patient has experienced insomnia for months, and the physician has prescribed a medication to help with this problem. The nurse expects which drug to be used for long-term treatment of insomnia?
Eszopiclone (Lunesta), a nonbenzodiazepine sleep aid
The nurse is presenting a substance-abuse lecture for teenage girls and is asked about "roofies." The nurse recognizes that this is the slang term for which substance?
Flunitrazepam
A 50-year-old man who has been taking phenobarbital for 1 week is found very lethargic and unable to walk after eating out for dinner. His wife states that he has no other prescriptions and that he did not take an overdose—the correct number of pills is in the bottle. The nurse suspects that which of these may have happened?
He drank a glass of wine.
A patient is being treated for ethanol alcohol abuse in a rehabilitation center. The nurse will include which information when teaching him about disulfiram (Antabuse) therapy?
He needs to know about the common over-the-counter substances that contain alcohol.
Carbidopa-levodopa (Sinemet) is prescribed for a patient with Parkinson's disease. The nurse informs the patient that which common adverse effects can occur with this medication?
Heart palpitations, hypotension, urinary retention
A 10-year-old patient will be started on methylphenidate hydrochloride (Ritalin) therapy. The nurse will perform which essential baseline assessment before this drug is started?
Height and weight
A patient has been taking selegiline (Eldepryl), 20 mg/day for 1 month. Today, during his office visit, he tells the nurse that he forgot and had a beer with dinner last evening, and "felt awful." What did the patient most likely experience?
Hypertension
A patient has been taking naltrexone (ReVia) as part of the treatment for addiction to heroin. The nurse expects that the naltrexone will have which therapeutic effect for this patient?
If opioid drugs are used while taking naltrexone, euphoria is not produced; thus, the opioid's desired effects are lost.
A patient is brought to the emergency department for treatment of a suspected overdose. The patient was found with an empty prescription bottle of a barbiturate by his bedside. He is lethargic and barely breathing. The nurse would expect which immediate intervention?
Implementing measures to maintain the airway and support respirations
A patient has been treated with antiparkinson medications for 3 months. What therapeutic responses should the nurse look for when assessing this patient?
Improved ability to perform activities of daily living
The U.S. Food and Drug Administration has issued a warning for users of antiepileptic drugs. Based on this report, the nurse will monitor for which potential problems with this class of drugs?
Increased risk of suicidal thoughts and behaviors
A patient with unstable epilepsy is receiving IV doses of phenytoin (Dilantin). The latest drug level is 12 mcg/mL. Which administration technique will the nurse use?
Infuse slowly, not exceeding 50 mg/min.
A patient has a new order for a catechol ortho-methyltransferase (COMT) inhibitor as part of treatment for Parkinson's disease. The nurse recognizes that which of these is an advantage of this drug class?
It is associated with fewer wearing-off effects.
When admitting a patient with a suspected diagnosis of chronic alcohol use, the nurse will keep in mind that chronic use of alcohol might result in which condition?
Korsakoff's psychosis
Ramelteon (Rozerem) is prescribed for a patient with insomnia. The nurse checks the patient's medical history, knowing that this medication is contraindicated in which disorder?
Liver disease
The nurse is assessing the medication history of a patient with a new diagnosis of Parkinson's disease. Which condition is a contraindication for the patient, who will be taking tolcapone (Tasmar)?
Liver failure
Before a patient is to receive phenytoin (Dilantin), the nurse practitioner orders lab work. Which lab result is of greatest concern?
Low serum albumin levels
A patient in a long-term care facility has a new order for carbamazepine (Tegretol) for seizure management. The nurse is correct when recognizing autoinduction as which response?
Lower than expected drug levels
A patient in a rehabilitation center is beginning to experience opioid withdrawal symptoms. The nurse expects to administer which drug as part of the treatment?
Methadone
The nurse is giving an intravenous dose of phenytoin (Dilantin). Which action is correct when administering this drug?
Mix the drug with normal saline, and give it as a slow IV push.
The nurse is reviewing the use of central nervous system stimulants. Which of these are indications for this class of drugs? (Select all that apply.) Narcolepsy Depression Panic attacks Neonatal apnea Attention deficit hyperactivity disorder (ADHD) Appetite suppression
Narcolepsy Attention deficit hyperactivity disorder (ADHD) Appetite suppression
A nurse is providing teaching for a patient who will be taking varenicline (Chantix) as part of a smoking-cessation program. Which teaching points are appropriate for a patient taking this medication? (Select all that apply.) This drug is available as a chewing gum that can be taken to reduce cravings. Use caution when driving because drowsiness may be a problem. There have been very few adverse effects reported for this drug. Notify the prescriber immediately if feelings of sadness or thoughts of suicide occur.
Notify the prescriber immediately if feelings of sadness or thoughts of suicide occur. Use caution when driving because drowsiness may be a problem.
A patient wants to take a ginseng dietary supplement. The nurse instructs the patient to look for which potential adverse effect?
Palpitations and anxiety
The nurse is reviewing the dosage schedule for several different antiepileptic drugs (AEDs). Which antiepileptic drug allows for once-a-day dosing?
Phenobarbital
A patient is taking flurazepam (Dalmane) three to four nights a week for sleeplessness. She is concerned that she cannot get to sleep without taking the medication. What nonpharmacologic measures should the nurse suggest to promote sleep for this patient?
Providing a quiet environment
The nurse is conducting a smoking-cessation program. Which statement regarding drugs used in cigarette-smoking-cessation programs is true?
Rapid chewing of the nicotine gum releases an immediate dose of nicotine.
. A patient is recovering from a minor automobile accident that occurred 1 week ago. He is taking cyclobenzaprine (Flexeril) for muscular pain and goes to physical therapy three times a week. Which nursing diagnosis would be appropriate for him?
Risk for injury related to decreased sensorium
The nurse is reviewing the food choices of a patient who is taking a monoamine oxidase inhibitor ( MAOI). Which food choice would indicate the need for additional teaching?
Salami and Swiss cheese sandwich
While monitoring a depressed patient who has just started SSRI antidepressant therapy, the nurse will observe for which problem during the early time frame of this therapy?
Self-injury or suicidal tendencies
A patient has been taking disulfiram (Antabuse) as part of his rehabilitation therapy. However, this evening, he attended a party and drank half a beer. As a result, he became ill and his friends took him to the emergency department. The nurse will look for which adverse effects associated with acetaldehyde syndrome? (Select all that apply.) Euphoria Severe vomiting Diarrhea Pulsating headache Difficulty breathing Sweating
Severe vomiting Pulsating headache Difficulty breathing Sweating
. A 29-year-old male patient is admitted to the intensive care unit with the following symptoms: restlessness, hyperactive reflexes, talkativeness, confusion and periods of panic and euphoria, tachycardia, and fever. The nurse suspects that he may be experiencing the effects of taking which substance?
Stimulants
A patient has a new prescription for phentermine (Ionamin) as part of the treatment for weight loss. Which information will the nurse include when teaching this patient about a stimulant such as phentermine? (Select all that apply.) Take this medication after meals. Take this medication in the morning. This drug is taken along with supervised exercise and suitable diet. Use mouth rinses, sugarless gum, or hard candies to minimize dry mouth. Avoid foods that contain caffeine, such as coffee, tea, and colas.
Take this medication in the morning. This drug is taken along with supervised exercise and suitable diet. Use mouth rinses, sugarless gum, or hard candies to minimize dry mouth. Avoid foods that contain caffeine, such as coffee, tea, and colas.
During a routine appointment, a patient with a history of seizures is found to have a phenytoin (Dilantin) level of 23 mcg/mL. What concern will the nurse have, if any?
The drug level is at a toxic level, and the dosage needs to be reduced.
The nurse is monitoring a patient who has been taking carbamazepine (Tegretol) for 2 months. Which effects would indicate that autoinduction has started to occur?
The drug levels for carbamazepine are lower than expected.
A 22-year-old patient has been taking lithium for 1 year, and the most recent lithium level is 0.9 mEq/L. Which statement about the laboratory result is correct?
The lithium level is therapeutic.
A patient is taking gabapentin (Neurontin), and the nurse notes that there is no history of seizures on his medical record. What is the best possible rationale for this medication order?
The medication is used for the treatment of neuropathic pain.
A 6-year-old boy has been started on an extended-release form of methylphenidate hydrochloride (Ritalin) for the treatment of attention deficit hyperactivity disorder (ADHD). During a follow- up visit, his mother tells the nurse that she has been giving the medication at bedtime so that it will be "in his system" when he goes to school the next morning. What is the nurse's appropriate evaluation of the mother's actions?
The medication should be given 4 to 6 hours before bedtime to diminish insomnia.
When treating patients with medications for Parkinson's disease, the nurse knows that the wearing-off phenomenon occurs for which reason?
The medications begin to lose effectiveness against Parkinson's disease.
Chlorpromazine (Thorazine) is prescribed for a patient, and the nurse provides instructions to the patient about the medication. The nurse includes which information?
The patient needs to wear sunscreen while outside because of photosensitivity.
A patient who started taking orlistat (Xenical) 1 month ago calls the clinic to report some "embarrassing" adverse effects. She tells the nurse that she has had episodes of "not being able to control my bowel movements." Which statement is true about this situation?
The patient will need to restrict fat intake to less than 30% to help reduce these adverse effects.
Phenytoin (Dilantin) has a narrow therapeutic index. The nurse recognizes that this characteristic indicates which of these?
The safe and the toxic plasma levels of the drug are very close to each other.
Which statements are true regarding the selective serotonin reuptake inhibitors (SSRIs)? (Select all that apply.) Avoid foods and beverages that contain tyramine. Monitor the patient for extrapyramidal symptoms. Therapeutic effects may not be seen for about 4 to 6 weeks after the medication is started. If the patient has been on an MAOI, a 2- to 5-week or longer time span is required before beginning an SSRI medication. These drugs have anticholinergic effects, including constipation, urinary retention, dry mouth, and blurred vision. Cogentin is often also prescribed to reduce the adverse effects that may occur.
Therapeutic effects may not be seen for about 4 to 6 weeks after the medication is started. If the patient has been on an MAOI, a 2- to 5-week or longer time span is required before beginning an SSRI medication.
A patient has been taking phenobarbital for 2 weeks as part of his therapy for epilepsy. He tells the nurse that he feels tense and that "the least little thing" bothers him now. Which is the correct explanation for this problem?
This drug causes deprivation of REM sleep and may cause the inability to deal with normal stress.
A patient taking entacapone (Comtan) for the first time calls the clinic to report a dark discoloration of his urine. After listening to the patient, the nurse realizes that what is happening in this situation?
This is a harmless effect of the drug.
A patient has been taking haloperidol (Haldol) for 3 months for a psychotic disorder, and the nurse is concerned about the development of extrapyramidal symptoms. The nurse will monitor the patient closely for which effects?
Tremors and muscle twitching
The nurse is reviewing medications used for depression. Which of these statements is a reason that selective serotonin reuptake inhibitors (SSRIs) are more widely prescribed today than tricyclic antidepressants?
Tricyclic antidepressants cause serious cardiac dysrhythmias if an overdose occurs.
The nurse is developing a care plan for a patient who is taking an anticholinergic drug. Which nursing diagnosis would be appropriate for this patient?
Urinary retention
When a patient is taking an anticholinergic such as benztropine (Cogentin) as part of the treatment for Parkinson's disease, the nurse should include which information in the teaching plan?
Use artificial saliva, sugarless gum, or hard candy to counteract dry mouth.
what should be include in teaching of lisdexamfetamine
adverse effect; cns stimulation monitor BP med can raise levels of dopamine in brain
nurse is caring for client who takes paroxetine to treat ptsd and reports that they grind their teeth during night, nurse should identify what as interventions to manage bruxism
concurrent admistration of busprione use of mouth guard changing to different class of antidepressant med
teaching for patient who is withdrawing from alcohol and has prescription for propranolo
decrease craving
nurse teach client taking amitriptyline for treatment of depression. what should include in teaching
discontinue med after week of improved mood chew sugarless gum to prevent dry mouth
adverse effect of clonidine that helps maintenance of abstinence from opioids
dry mouth
nurse should expect admin what med for client absence seizures
ethosuximide valproic acid lamotrigine
client taking sertraline past 2 days. what shows developing serotonin syndrome
fever
adverse effect of pramipexole med used for parkinsons
hallucinations
client prescribed escitalopram for generalized anxiety. which indicates understanding of teaching
i need to discontinue this medication slowly
what indicates understanding of tobacco use disorder about nicotine replacement therapy
i should avoid eating righy before i chew a piece of nicotine gum
what is nurse's priority when caring for patient with benzodiazepine toxicity
identify client's level of orientation
nurse teaching client with OCD and has prescription for paroxetine. what instruction should nurse include
it can take several weeks before you feel like med is helping
instruction for transdermal methylphenidate
leave patch on for 9 hr
child taking atomoexetine. monitor what for adverse effect
liver damage
what meds use for alcohol withdraw
lorazepam diazepam
adverse effects of venlafaxine
mydriasis dizziness decreased libido
nurse caring for client taking nondepolarizing neuromuscular blocking agent and has muscle weakness. nurse should expect what to be prescribed
neostigmine
what is priority when caring for patient with withdrawal from opioid use and is taking clonidine
obtain baseline VS
nurse caring for client who has prescription phenelizine for treatment of depression. what adverse effect of this med
orthostatic hypotension
The nurse is preparing to administer a barbiturate. Which conditions or disorders would be a contraindication to the use of these drugs? (Select all that apply.) a. Gout Pregnancy Epilepsy Severe chronic obstructive pulmonary disease Severe liver disease Diabetes mellitus
pregnancy severe copd severe liver disease
adverse effects of desipramine
suicidal thoughts
instructions for med levodopa/carbidopa med used for parkinsons
take this med with food
nurse is providing teaching to a client who has prescription for buspirone to treat anxiety. what information should nurse include
this med has a low risk for dependency
what instructions be include for taking oxcarbazepine for partial seizures
use caution if given a prescription for diuretic meds consider using an alternate form of contraception if you are using oral contraceptives avoid driving until see how med affects you notify HCP if develop skin rash
how to minimize adverse effects of clomipramine
wear sunglasses when outdoors
nurse providing discharge teaching taking fluoxetine for ptsd. what include in teaching
you can have a decreased desire for intimacy while taking this med
