PHARM. Chapter 19 and 26
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 nurse has entered a patient's room at the beginning of a shift in order to quickly assess the patient's airway, breathing, circulation, and consciousness. The nurse observes that the patient is wincing, stating, "I'm having a lot of pain right now." What question should the nurse next ask this patient?
"Where exactly are you having pain right now?"
A hospice patient has been ordered morphine (Roxanol) 5 mg every 2 hours. Roxanol contains 10 mg/mL. How many mL will be administered?
0.5 mL
After studying for a test on the brain and spinal cord, the students demonstrate understanding when they identify the spinal cord as being made up of how many pairs of nerves?
31
After teaching a group of students about the blood-brain barrier, the instructor determines that the teaching was successful when the group states which of the following?
A mechanism to protect the brain from toxins
When administering an opioid antagonist drug to a client, the primary goal of the therapy is to provide which of the following?
A return to normal respiratory rate, rhythm, and depth
The nurse enters the client's room and he is sitting up in bed laughing and visiting with family. He states that his pain is a "10" on a pain scale of 0 to 10. He is requesting his pain medication. What is the best response by the nurse?
Administer the pain medication as ordered.
A neurotransmission system is a communication network composed of which of the following?
All of the above
The nurse is caring for a postoperative client receiving an opioid medication for pain management. The nurse finds the client lethargic with a respiratory rate of 6 breaths per minute. Which of the following actions should be performed first?
Attempt to arouse the client and coach his or her breathing pattern.
Which of the following would a nurse identify as being responsible for carrying information from the nerve to the effector cell?
Axon
A nurse is preparing to assess a patient's cerebellar function. Which of the following would the nurse expect to test?
Balance
Which of the following would a nurse identify as a component of the hindbrain?
Brain stem
Which of the following ions is required for neurotransmitter release from storage sites in the small sacs, called synaptic vesicles?
Calcium ion
The nurse is providing a continuing education program to teenagers about the nervous system. The nurse is reviewing the parts of the neuron with the students. Based on this information, the nurse asks a student to describe the axon of a neuron. Which explanation by the student best describes the axon?
Carries impulses away from the neuron cell body
Neurotransmitters are chemical substances that:
Carry messages from one neuron to another.
What part of the brain controls and coordinates muscle movement?
Cerebellum
Neurotransmission is important in the function of the central nervous system. Which of the following is a characteristic of neurons that allows them to communicate with other cells?
Conductivity
After teaching a group of students about the functions of the nervous system, the instructor determines that the teaching was effective when the students identify which of the following as a function?
Control of body functions
A patient has sustained an injury to the cerebellum. Which area would be the primary area for assessment?
Coordination
Which of the following best describes the blood-brain barrier?
Defensive mechanism
Which of the following would a nurse identify as being responsible for bringing information into the neuron from other neurons?
Dendrite
Which of the following is responsible for carrying nerve impulses from the central nervous system to stimulate a muscle?
Efferent fibers
Dendrites route information away from the nerve cell while axons bring information to the nerve.
False
A client is to receive a narcotic that will be applied transdermally. The nurse identifies this as which agent?
Fentanyl
Naloxone (Narcan) will reverse the effects of which of the following drugs? (Choose one)
Fentanyl (Duragesic)
Which of the following substances is required for brain cell metabolism?
Glucose
A patient has been administered an opioid. For which of the following effects should the patient be assessed?
Hypotension
After teaching a group of students about major divisions of the brain, the instructor determines that additional teaching is needed when the students identify which of the following as part of the hindbrain?
Hypothalamus
A 10-year-old child has been playing soccer and sustains a closed head injury in a collision with another player. The parent states that the child was unconscious for 5 minutes. Upon admission to the emergency department, the child has difficulty breathing. What area of the brain will have developed cerebral edema?
Medulla oblongata
Which of the following occurs when the cell is at rest?
Membrane is permeable to potassium ions
Which agent would be used as part of a treatment plan for narcotic detoxification?
Methadone
The limbic system seems to control emotions and is located in which part of the central nervous system?
Midbrain
A patient has been given MS Contin. You enter the room and the patient is unresponsive. His respirations are 8 per minute. What medication will be ordered for the patient?
Naloxone (Narcan)
A client is brought to the emergency room following a motor vehicle accident in which he sustained head trauma. The patient is complaining of blindness in the left eye. The nurse would be correct in documenting this abnormal finding as corresponding to which of the following cerebral lobes?
Occipital
Opioid antagonists may produce withdrawal symptoms in patients physically dependent on which of the following? (Choose one)
Opioids
Which of the following would the nurse expect to assess in a client receiving a narcotic for pain relief?
Orthostatic hypotension
Which of the following is responsible for releasing a chemical into the synaptic cleft?
Presynaptic nerve
Which of the following is an important function of serotonin?
Prevents depression
Which of the following occurs when the cell returns to the resting membrane potential?
Repolarization
Which of the following would be the highest priority problem to be addressed when caring for a client who is to receive a dose of naloxone (Narcan)?
Respiratory depression
The nurse is administering morphine sulfate to a client who had a myocardial infarction. What vital sign would the nurse monitor that directly relates to the use of this narcotic?
Respiratory rate
A client has had an injury to the cerebellum. The nurse is collecting data from the client and family to document in preparing an individualized nursing care plan. Which is the best description of the function of the cerebellum that has to be considered when collecting data from the client?
Responsible for muscle control
Opioids exert widespread pharmacologic effects, especially in the CNS and the gastrointestinal (GI) system. What are two major adverse effects of opioids that are potentially life threatening?
Sedation and respiratory depression
A client is diagnosed with a sleep disorder. Which of the following neurotransmitters is most likely to be dysfunctional for this client?
Serotonin
A patient suffers from mental depression and insomnia. A patient with these complaints could have an abnormality of which of the following neurotransmitters?
Serotonin
The nursing instructor is talking with their clinical group about the central nervous system. What should the instructor tell the students about the function of the spinal cord?
Serves as a conduit for impulses to and from the brain
When levels of serotonin are high in the RAS, the system shuts off and what occurs?
Sleep
Which of the following are mainly responsible for coordinating internal and external responses?
Thalamus and hypothalamus
Characteristics that allow neurons to communicate with other body cells include:
The ability to be stimulated and to convey electrical impulses.
The CNS structure involved in all higher order functions, including conscious processes containing both motor and sensory areas, is:
The cerebral cortex.
The nurse is caring for a postoperative client with a history of opioid abuse who has been ordered to receive a dose of an opioid antagonist medication. Which of the following issues should the nurse be prepared to address?
The client may begin to demonstrate symptoms of withdrawal.
The CNS structure containing groups of neurons responsible for vital cardiac, respiratory, and vasomotor functions is:
The medulla oblongata.
Morphine, an opioid agonist, is administered for both acute and chronic pain. Along with the administered dosage, which of the following determines the patient's response to morphine?
The route of administration
The A-delta fibers are myelinated and found in the skin and muscle to transmit sharp, well-localized pain signals. True or false?
True
The circle of Willis distributes blood to the brain as needed.
True
A 46-year-old male client sustained a closed head injury four hours ago. He now presents to the emergency department because he is having difficulty breathing. This is a result of swelling around the
medulla oblongata.
Which of the following would be associated with the hindbrain? Select all that apply.
• Cranial nerves • Chemoreceptor trigger zone
When administering a dose of naloxone (Narcan), which of the following would indicate that the medication is having a therapeutic effect?
• The client's respiratory rate increases. • Oxygen saturation levels increase.
Which agent would be least likely used for pain relief in a child?
Levorphanol
A client is experiencing major depressive disorder. Which of the following neurotransmitters is most likely implicated?
Serotonin
A nurse is reading an article about sleep and arousal that includes a discussion of a neurotransmitter. Which neurotransmitter would most likely be discussed?
Serotonin
Which of the following areas are responsible for speech comprehension?
Wernicke's area
