Pharm Exam 3

The parents of a child receiving a central nervous system stimulant for treatment of attention deficit disorder asks the nurse why they are stopping the drug for a time. Which statement by the nurse would be most appropriate?

"We need to check and see if he still has symptoms that require drug therapy."

A female client's physician orders a low-dose antipsychotic to manage her acute agitation. Her daughter states that her mother is improved but her cognitive functions are the same, if not worse, than last month. What is the best explanation for this development?

Antipsychotics do not improve memory loss and may further impair cognitive functioning.

Clozapine

Blocks dopamine and serotonin receptors, depresses the RAS, anticholinergic, antihistaminic, alpha-adrenergic blocking.

Chlorpromazine

Blocks postsynaptic dopamine receptors in the brain, depresses those parts of the brain involved in wakefulness and emesis, anticholinergic, antihistaminic, alpha-adrenergic blocking.

The nurse educator is teaching a class of community leaders about immunologic agents. To minimize the concern regarding adverse effects of vaccinations, the nurse should include which mild reactions in the teaching plan?

Chills and fever

A group of students are role-playing scenarios involving biological weapon exposure. Which medication would the students identify as using for a client with cutaneous anthrax?

Ciprofloxacin

An adolescent client has been taking dextroamphetamine for the treatment of attention deficit hyperactivity disorder (ADHD) for 3 years, achieving significant improvements in behavior and mood. When assessing the child during a scheduled follow-up appointment, the nurse should prioritize what physical assessment to monitor for a potential adverse reaction to the therapy?

Measurement of height and body weight

Serotonin abnormalities are thought to be involved in the following disorders:

Mental depression and sleep disorders.

The nurse observes that a client with a long history of chlorpromazine therapy demonstrates lip smacking and appears to be chewing continually. The nurse should recognize that this client is likely experiencing what adverse effect of the medication?

Tardive dyskinesia

A 65-year-old client is being seen in the emergency department for exposure to rabies. The nurse checks the electronic health record and discovers the client has had no history of allergic reactions to immunization agents. The client's history guides the nurse to take which action?

Teach the client that the agent of choice is rabies immune globulin

The nurse is providing wellness information to a 50-year-old client who is employed as a paramedic. The client asks what, if any, vaccines the client should get. What is the nurse's best response?

Tetanus-diphtheria-pertussis; hepatitis B vaccine once; influenza vaccine annually

The nurse admits a client who has been newly diagnosed with schizophrenia to the inpatient mental health unit. What is the priority reason why the nurse includes the family when collecting the nursing history?

The client may not be able to provide a sufficient history.

A young client has been prescribed an antipsychotic agent to relieve psychotic symptoms. Which goal of care is the priority?

The client will remain safe.

bipolar disorder:

behavioral disorder that involves extremes of depression alternating with hyperactivity and excitement

attention deficit disorder:

behavioral syndrome characterized by an inability to concentrate for longer than a few minutes and excessive activity

A client is to start receiving chemotherapy at 10:00 AM. The client has an order for intravenous metoclopramide. The nurse would expect to give the drug at which time?

9:30 AM

A health care worker has received an annual influenza vaccination and has remained at the clinic after administration so that the nurse may observe for adverse reactions. The worker reports pain at the site of IM injection. What should the nurse recommend?

Acetaminophen

A client who is being treated with a typical antipsychotic reports frequent nasal congestion are urinary hesitation. To what should the nurse most likely attribute these symptoms?

Anticholinergic effects

Moderate CNS depression is characterized by:

Drowsiness or sleep; decreased muscle tone; decreased ability to move; and decreased perception of sensations such as pain, heat, and cold.

Adverse Effects: Chlorpromazine

Drowsiness, insomnia, vertigo, extrapyramidal symptoms, orthostatic hypotension, photophobia, blurred vision, dry mouth, nausea, vomiting, anorexia, urinary retention, photosensitivity.

Adverse Effects:Clozapinec

Drowsiness, sedation, seizures, dizziness, syncope, headache, tachycardia, nausea, vomiting, fever, neuroleptic malignant syndrome.

A nurse is administering a mumps vaccine to an adolescent. Which medication should be available when administering an immunization?

Epinephrine

Administration of the tetanus toxoid in adults involves two initial injections given four weeks apart, a booster injection given six months to a year later, and periodic injections thereafter. What is the recommended interval for the periodic injections for a 66 year old client ?

Every 10 years

The nurse is caring for a client who has just had an episode of vomiting. What is the first intervention that the nurse would complete after the client has finished vomiting?

Help the client rinse his mouth.

A nurse is receiving post-exposure prophylaxis for hepatitis B. What would the nurse most likely receive?

Immune globulin

Which would be most important for the nurse to do when administering a phenothiazine antiemetic to a patient?

Institute safety precautions.

When providing client teaching to parents regarding measles, mumps, and rubella vaccine administration, which is most important regarding the schedule for administration?

It is administered at 12 to 15 months.

An infant is being administered an immunization. Which statement provides an accurate description of an immunization

It is the administration of an antigen for an antibody response.

The public health nurse is reviewing immunity with a group of school nurses prior to an immunization campaign. What should the public health nurse teach this group of school nurses?

Passive immunity is limited, lasting only as long as the antibodies circulate.

Bacille Calmette-Guerin

Prevention of TB with high risk exposure

The school nurse is participating in a program to immunize students against human papillomavirus (HPV). What benefit should the nurse describe to students and their families?

Reduced risk for cervical cancer

The nurse is providing education to a client who has been prescribed clozapine. The nurse should emphasize the importance of what monitoring routine during teaching?

Regular complete blood counts

A nurse is planning the care of a client who has been diagnosed with schizophrenia and who will begin treatment with a typical antipsychotic. The nurse should identify what nursing diagnosis?

Risk for injury related to central nervous system depression

Metoclopramide is classified as a nonphenothiazine antiemetic. True or False

True -The only nonphenothiazine currently available for use as an antiemetic is metoclopramide.

A primiparous woman tells the nurse that she and her partner are highly reluctant to have their infant vaccinated, stating, "We've read that vaccines can potentially cause a lot of harm, so we're not sure we want to take that risk." How should the nurse respond to this family's concerns?

Vaccinations are not without some risks, but these are far exceeded by the potential benefits."

When describing the use of vaccines to a local community group, what would the nurse include?

Vaccines are used to provide active immunity.

Which test should be scheduled every week for a patient taking clozapine?

WBC count

A 70-year-old client is seen in the family practice clinic. Which vaccine should be administered to prevent herpes zoster?

Zoster vaccine Zoster vaccine is administered to adults 60 years and older to prevent herpes zoster (shingles). The Haemophilus influenzae type B is not administered to prevent herpes zoster. HPV and pneumococcal vaccine do not address the risk factors for shingles.

neuroleptic:

a drug with many associated neurological adverse effects that is used to treat disorders that involve thought processes (e.g., schizophrenia)

tardive dyskinesia

abnormal muscle movements such as lip smacking, tongue darting, chewing movements, slow and aimless arm and leg movements

A client was bitten by a poisonous snake. Which treatment would be most appropriate to administer?

antivenin

A nursing instructor is describing the effects of CNS stimulants and their potential for addiction due to their euphoric sensations. The instructor determines that the discussion was successful when the students identify which substance as being involved with this pleasurable feeling?

dopamine

antipsychotic:

drug used to treat disorders involving thought processes; dopamine receptor blocker that helps affected people to organize their thoughts and respond appropriately to stimuli

The nurse administers hydroxyzine to a client with nausea. After administration, the nurse should monitor for what adverse effect?

dry mouth

Patients with schizophrenia should be advised to avoid the use of

evening primrose. This herb has been associated with increased symptoms and CNS hyperexcitability.

Major Tranquilizers

former name of antipsychotic drugs; the name is no longer used because it implies that the primary effect of these drugs is sedation, which is no longer thought to be the desired therapeutic action

A 10-year-old boy is taking dextroamphetamine (Dexedrine) daily for ADHD. At each clinic visit, the nurse must assess the child. The priority assessment since he is on this medication would be which?

height and weight

antitoxins:

immune sera that contain antibodies to specific toxins produced by invaders; may prevent the toxin from adhering to body tissues and causing disease

antivenins:

immune sera that contain antibodies to specific venins produced by poisonous snakes or spiders; may prevent the venom from causing cell death

vaccine:

immunization containing weakened or altered protein antigens to stimulate a specific antibody formation against a specific disease; refers to a product used to stimulate active immunity

A diabetic patient being treated for obesity tells the nurse that the patient is having adverse effects from the drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which adverse effects would need the nurse's immediate attention?

increased blood glucose

A nurse is caring for a patient who is taking haloperidol. The patient has orders for a new drug, and the nurse notes that it is highly protein bound. The nurse will plan care based on a(n):

increased risk for toxic effects of haloperidol therapy.

The nurse is assessing a 6-month-old infant prior to scheduled immunizations. What finding would the nurse immediately recognize as a reason to reschedule administration?

low grade fever

Narcolepsy

mental disorder characterized by daytime sleepiness and periods of sudden loss of wakefulness

Pseudoparkinsonism

muscle tremors, cogwheel rigidity, drooling, shuffling gait, slow movements

Phenothiazines

often turn the urine pink to reddish brown as a result of their excretion.

immune sera:

preformed antibodies found in immune globulin from animals or humans who have had a specific disease and developed antibodies to it

While caring for a client receiving antipsychotic therapy, the nurse observes cogwheel rigidity, tremors, and drooling. The nurse interprets this as:

pseudoparkinsonism

serum sickness:

reaction of a host to injected antibodies or foreign sera; host cells make antibodies to the foreign proteins, and a massive immune reaction can occur

Akathisia

restlessness, inability to sit still. Constant moving, foot tapping, hand movements may be seen.

A client has received a rubella immunization. The client was unaware that she was pregnant. What risk is associated with the administration of the rubella immunization in this client?

risk of birth defects

A nurse is providing care for a client diagnosed with attention deficit hyperactivity disorder (ADHD) who has been taking methylphenidate for several months. When monitoring for potential adverse effects, the nurse should include what assessments?

sleep patterns

Dystonia

spasms of the tongue, neck, back, and legs. Spasms may cause unnatural positioning of the neck, abnormal eye movements, excessive salivation.

mania

state of hyperexcitability; one phase of bipolar disorders, which alternate between periods of severe depression and mania

A nurse observes rhythmic, involuntary facial movements in a patient who has been administered antipsychotic drugs. The patient also makes chewing movements and, at times, his tongue protrudes. What is the most likely reason for the patient's behavior?

tardive dyskinesia

active immunity:

the formation of antibodies secondary to exposure to a specific antigen; leads to the formation of plasma cells, antibodies, and memory cells to immediately produce antibodies if exposed to that antigen in the future; imparts lifelong immunity

The nurse is providing health education to a client who has been newly diagnosed with schizophrenia. What subject should be the primary focus?

the importance of adherence to prescribed treatment

passive immunity:

the injection of preformed antibodies into a host at high risk for exposure to a specific disease; immunity is limited by the amount of circulating antibody

schizophrenia:

the most common type of psychosis; characteristics include hallucinations, paranoia, delusions, speech abnormalities, and affective problems

immunization:

the process of stimulating active immunity by exposing the body to weakened or less toxic proteins associated with specific disease-causing organisms; the goal is to stimulate immunity without causing the full course of a disease

When educating a group of nursing students on immunologic agents, the nurse refers to a substance that is attenuated (or weakened) but still capable of stimulating the formation of antitoxins. The nurse is referring to

toxoids

To prevent meningococcal infections, the nurse would administer:

vaccine

biological:

vaccines, immune sera, and antitoxins that are used to stimulate the production of antibodies, to provide preformed antibodies to facilitate an immune reaction, or to react specifically with the toxins produced by an invading pathogen