Pharm ch25
A 20-year-old female patient has been diagnosed with multiple sclerosis. What drug will most likely be prescribed? A) Baclofen (Lioresal) B) Cyclobenzaprine (Flexeril) C) Metaxalone (Skelaxin) D) Orphenadrine (Banflex)
A
A 3-year-old girl with a diagnosis of spasticity caused by cerebral palsy has been admitted to the unit. The physician has ordered dantrolene to see if it relieves the spasticity in the child's arms and hands. The nurse would schedule this child for what routine screenings? A) Central nervous system and gastrointestinal (GI) function B) Respiratory and cardiovascular (CV) function C) Growth and development D) Renal and hepatic function
A
A nurse is providing discharge teaching for a patient who will be going home on cyclobenzaprine (Flexeril) prescribed for his acute musculoskeletal pain. The nurse will stress that the patient should avoid what? A) Drinking alcohol B) Taking antiemetics C) Taking antihistamines D) Taking antibiotics
A
A patient comes to the clinic to receive a Botox injection in her forehead. The patient has adult acne across her forehead. What is the nurse's priority action? A) Hold the injection and consult the health care provider. B) Cleanse the area well with an antibacterial soap. C) Apply a topical antibiotic after administering the Botox. D) Provide patient information about post-Botox injection care.
A
A patient has been diagnosed with multiple sclerosis and experiences spasticity in several muscle groups. What drug would the nurse anticipate will be ordered as the drug of choice to manage spasticity associated with neuromuscular diseases? A) Dantrolene (Dantrium) B) Baclofen (Lioresal) C) Carisoprodol (Soma) D) Botulinum toxin type B (Myobloc)
A
A patient is admitted to the unit with central spasticity after a terrible motor vehicle accident. The doctor places an intrathecal delivery pump. What medication can be administered via this route to treat the central spasticity? A) Baclofen (Lioresal) B) Cyclobenzaprine (Flexeril) C) Dantrolene (Dantrium) D) Carisoprodol (Soma)
A
A patient with severe spasticity sees his physician. The physician orders dantrolene. In what circumstances is the drug dantrolene contraindicated? A) Spasticity that contributes to upright position B) Spasticity that involves both legs C) Spasticity that involves the arm and the leg on the same side D) Spasticity that contributes to mobility
A
After administering a centrally acting skeletal muscle relaxant, what other independent nursing measures might the nurse implement to relieve pain and reduce spasm? A) Rest of the affected muscle B) Application of cold C) Physical therapy D) Order of a nonsteroidal anti-inflammatory drug
A
The nurse admits a child diagnosed with tetanus. What medication will the nurse expect to administer? A) Methocarbamol (Robaxin) B) Baclofen (Lioresal) C) Dantrolene (Dantrium) D) Diphenhydramine (Benadryl)
A
The nurse is teaching a class on muscular coordination and explains it is the movement of what electrolyte that contributes to the process of muscle contraction and relaxation? A) Calcium B) Chloride C) Magnesium D) Hydrogen
A
What part of the brain does the nurse recognize the patient is using when making precise, intentional movements? A) Pyramidal tract B) Substantia nigra C) Broca's area D) Extrapyramidal tract
A
When spinal reflexes involve synapses with interneurons within the spinal cord, what physiological adjustments are made? A) Coordinate movement and position B) Adjust response and recovery C) Adjust to upright position D) Coordinate balance
A
The nurse is giving discharge instructions to a patient who just had Botox A injections around her eyes. What adverse effects would the nurse include in her discharge instructions? (Select all that apply.) A) Respiratory infections B) Flu-like syndrome C) Droopy eyelids D) Cough E) Diarrhea
A,B,C
The patient presents to the emergency department with muscle spasms in the back. What types of injury would the nurse recognize can result in muscle spasm? (Select all that apply.) A) Overstretching a muscle B) Wrenching a joint C) Tearing a tendon or ligament D) Breaking a bone E) Exercising too vigorously.
A,B,C
The nurse is caring for a patient who is having a pump placed to deliver intrathecal baclofen and another patient who will receive dantrolene as a muscle relaxant. What nursing diagnosis would be appropriate for both care plans? (Select all that apply.) A) Acute pain related to GI effects of drug B) Risk for injury related to central nervous system (CNS) effects C) Disturbed body image related to muscle pain D) Disturbed thought processes related to CNS effects E) Deficient knowledge related to procedure
A,B,D
A young woman attends a "Botox Party" and is injected with botulinum toxin type A to decrease "frown lines" between her eyebrows. Later that evening the patient is admitted to the emergency department and is hysterical, because she cannot move her eyebrows. The nurse explains that that toxin causes what? A) "The toxin causes muscle death, which smoothes wrinkles in the area." B) "The toxin causes muscle paralysis, preventing movement and relieving wrinkles." C) "The drug is a toxin to nerves in the area." D) "The drug is a permanent muscle relaxant and the muscles will never move again."
B
The nurse is caring for a patient taking dantrolene. How would the nurse assess the therapeutic effects of this drug? A) Observe the patient when emotionally stressed to assess for exacerbation of spasticity. B) Discontinue the drug for 2 to 4 days and assess for exacerbation of spasticity. C) Measure the amount of spasticity before and after administration of medication. D) Collect a thorough history to ask the patient any improvement has been noticed.
B
The nurse provides patient teaching about chlorzoxazone (Paraflex) in preparation for the patient's discharge to home. The nurse evaluates the patient understands potential adverse effects when the patient makes what statement? A) "This drug can cause diarrhea." B) "My urine may turn orange to purple red while taking this drug." C) "My skin may turn yellow but that will go away when I stop taking the drug." D) "After I take a pill it will take 2 to 3 hours before I feel the effects."
B
What are the simplest nerve pathways in the body? A) Arc reflexes B) Spinal reflexes C) Afferent nerve reflexes D) Spindle gamma loop
B
What is the drug of choice for an older adult or a patient with hepatic or renal impairment? A) Baclofen B) Carisoprodol C) Chlorzoxazone D) Cyclobenzaprine
B
Baclofen is a prototype drug for the centrally acting skeletal muscle relaxants. What adverse effects do drugs in this class have? (Select all that apply.) A) Coronary artery disease B) Hypotension C) Urinary frequency D) Dizziness E) Bone marrow suppression
B,C,D
When caring for a patient taking dantrolene, what adverse effects would the nurse monitor for? (Select all that apply.) A) Bradycardia B) Hepatitis C) Urinary retention D) Fatigue E) Rash
B,D,E
The anatomy and physiology instructor is discussing reflex systems with the prenursing class. What system would the instructor say causes a muscle fiber contraction that relieves the stretch? A) Arch reflex system B) Spinal reflex system C) Spindle gamma loop system D) Stretch receptor system
C
The nurse is caring for a patient who is being discharged home from the rehabilitation unit. Baclofen will be discontinued and the patient will begin taking carisoprodol as an outpatient. What is the nurse's primary consideration about discontinuing administration of baclofen? A) "Taper drug over 72 hours to reduce dependence on the drug." B) "Alternate doses of baclofen and soma over 10 days to prevent drug withdrawal." C) "Taper drug slowly over 1 to 2 weeks to prevent psychoses and hallucinations." D) "Start carisoprodol immediately while continuing baclofen at full dose to establish carisoprodol level."
C
The nurse is caring for four patients. Which patient would have the highest risk for hepatotoxicity from dantrolene (Dantrium)? A) An 87-year-old man who is taking a cardiac glycosideh B) A 32-year-old man who is taking an antipsychotic drug C) A 65-year-old woman who is on hormone replacement therapy D) A 48-year-old woman who is taking an antihypertensive agent
C
A mother brings her 9-year-old son to the clinic for a routine check up. The 9-year-old boy has cerebral palsy and is very spastic. The mother asks the nurse what causes the spasticity in her son. What is the nurse's best response? A) "Your son's spasticity is caused by injury to the muscle tissue." B) "Your son's spasticity is caused by deficiency of a neurotransmitter called serotonin." C) "Your son's spasticity is caused by damaged sensory neurons." D) "Your son's spasticity is caused by damaged motor neurons."
D
A patient has stepped on a rusty nail and is exhibiting signs of muscle rigidity and contractions. The patient's wife called the emergency department (ED) and the triage nurse told her to bring him in. The ED nurse will have which drug available for administration when the patient arrives? A) Carisoprodol (Soma) B) Cyclobenzaprine (Flexeril) C) Metaxalone (Skelaxin) D) Methocarbamol (Robaxin)
D
The nurse alerts the patient to what adverse effect of tizanidine (Zanaflex) that could cause injury? A) Constipation B) Dry mouth C) Fatigue D) Hypotension
D
The nurse assesses a newly admitted patient and finds the muscle tone in his left leg has sustained muscle contraction. How will the nurse document this finding? A) Tonus B) Flaccid C) Atonic D) Spastic
D
The nurse is caring for a patient receiving intrathecal baclofen via pump while participating in rigorous rehabilitation therapy. What is the nurse's priority to monitor related to adverse effects of this drug? A) Blood pressure B) Pulse pressure C) Spasticity D) Respiratory status
D
The nurse is caring for a patient with an infusing IV who is allowed noting by mouth due to a paralytic ileus. What centrally acting medication could the nurse administer to this patient? A) Chlorzoxazone (Paraflex) B) Carisoprodol (Soma) C) Cyclobenzaprine (Flexeril) D) Orphenadrine (Banflex)
D
The patient reports pain caused by muscle spasms in his back. The nurse assesses the patient as being very anxious and notes how the anxiety results in tensing of muscles. What medication would be most effective in treating this patient? A) Baclofen (Lioresal) B) Botulinum toxin type B (Myobloc) C) Dantrolene (Dantrium) D) Diazepam (Valium)
D
What drug would the nurse expect to administer to the patient experiencing malignant hyperthermia? A) Orphenadrine B) Metaxalone C) Chlorzoxazone D) Dantrolene
D
What is the maximum daily dose of cyclobenzaprine (Flexeril) the nurse can administer? A) 20 mg B) 30 mg C) 40 mg D) 60 mg
D
Which muscle relaxant was found to be embryotoxic in animal studies? A) Carisoprodol (Soma) B) Botulinum toxin A (Botox) C) Cyclobenzaprine (Flexeril) D) Dantrolene (Dantrium)
D
