Pharm II Exam I

The nurse is teaching a patient who is taking clozapine (Clozaril) to have weekly blood tests for the first 6 months of treatment to monitor for which potential complication?

Agranulocytosis

The autonomic nervous system can be subdivided into which types of adrenergic receptors?

Alpha and beta

Which category of medications is used for peripheral vascular diseases characterized by excessive vasoconstriction, such as Raynaud's disease?

Alpha-adrenergic blocking agents

Which disorders would indicate the use of anticholinergic agents?

Anticholinergic drugs block the action of a neurotransmitter called acetylcholine. This inhibits nerve impulses responsible for involuntary muscle movements and various bodily functions. These drugs can treat a variety of conditions, from overactive bladder to chronic obstructive pulmonary disorder.

Which nursing action is most important when providing care to a patient diagnosed with a mood disorder?

Assess the patient for thoughts of suicide.

Lithium (Eskalith) is the drug of choice for which of the following disorders?

Bipolar disorders

What is the action of MAOIs on neurotransmitters?

Blocking their destruction

Prior to the administration of metoprolol, a beta-adrenergic blocking agents, which is most important for the nurse to assess?

Blood pressure

The nurse is caring for a patient who is taking a newly prescribed drug, nefazodone, for treatment of depression. Which physical assessment finding is most important for the nurse to report to the health care provider immediately?

Bradycardia

For which reason will betamethasone IM be administered to the mother in premature labor?

To stimulate lung maturity in the fetus

What is the primary response to alpha-1 receptor stimulation?

Vasoconstriction (of blood vessels)

An older adult patient is to receive atenolol, a beta-adrenergic blocking agent. Prior to administration of the drug, the nurse assesses an apical pulse rate of 58 and notes ankle edema. Which action will the nurse take first?

Withhold the medication.

To what does potency of an antipsychotic medication refer?

Milligram doses used for the medication

A patient hospitalized in an acute care setting reports to the nurse that since starting on an adrenergic medication, he has been feeling "dizzy and weak." The most appropriate action for the nurse is to:

Monitor the blood pressure in both the supine and standing positions.

Which postoperative narcotic analgesic will most likely be prescribed to a patient whose current medications include a monoamine oxidase inhibitor (MAOI), a thyroid hormone, and a multivitamin?

Morphine

A patient who is taking an MAOI to treat depression admits to eating pickled herring and cheese and drinking red wine. Which assessment finding alerts the nurse to a potential complication?

Neck stiffness

Which is a benzodiazepine of choice when treating anxiety associated with alcohol withdrawal?

Oxazepam (Serax)

Which drug is administered after delivery to reduce the risk of postpartum hemorrhage after the placenta has been delivered?

Oxytocin (Pitocin)

Which statement is true regarding the adverse effects associated with antipsychotic medications?

Painful dystonic reactions can occur in the first 72 hours of initiation of therapy.

On what is the choice of tricyclic antidepressants based?

Patient age and gender

The outcome statement for a patient suffering from anxiety disorder reads, "After 1 week on alprazolam (Xanax) therapy, patient will exhibit a manageable level of anxiety." Which assessment finding validates that this outcome is met?

Patient reports sleeping better and increased interest in activities.

Which patient is most likely to respond quickly to antianxiety therapy with benzodiazepines?

Patient with recent anxiety reactions

What will the nurse caution a patient about when providing information about the prescribed azaspirone antidepressant?

Risk of injury when using machinery

Which psychological manifestation of depression will improve in response to antidepressant therapy?

Social withdrawal

A 26 year old patient with preeclampsia is receiving IV mag sulfate. The 1400 assessment includes blood pressure, 100/70 mm hg, respiration, 10, fetal heart tone, 100/min, urine output 20 ml/hr, absent patellar reflex. What is they priority nursing action ?

Stop the mag and administer calcium gluconate 5Meq IV over 3 minutes

The nurse is developing a teaching plan for patients prescribed buspirone (BuSpar). Which information about this medication should be included?

There is minimal potential for abuse.

A patient with Parkinson's disease asks the nurse why anticholinergics are used in the treatment. Which response by the nurse is most accurate?

These drugs inhibit the action of acetylcholine.

What is the major advantage of selective serotonin reuptake inhibitors (SSRIs) over other types of antidepressant therapy?

They do not cause the anticholinergic and cardiovascular adverse effects

Why are beta blockers used cautiously in patients with respiratory conditions?

They may produce severe bronchoconstriction.

which drug is administered when a patient is experiencing premature labor?

terbutaline (brethine)

The nurse is caring for a patient taking a cholinergic agent. When auscultating lung sounds, the nurse notes inspiratory and expiratory wheezing bilaterally. The best action for the nurse to take would be to:

withhold the next dose and notify the physician.

A patient is a gravdia 1, 28 weeks gestation, Rh-negative woman. The father of her child is Rh-positive. The mother is asking about the effect on her unborn child of rhoGAM that has been ordered. What's the nurse's best reply?

your baby may be rh-postive and cause you to make antibodies. These wont affect this baby, but could affect future children if RhoGAM isn't given

A patient with chronic obstructive pulmonary disease (COPD) reports having insomnia and a racing heart after starting terbutaline therapy. Which explanation by the nurse is most accurate?

"The symptoms will tend to resolve with continued therapy."

A patient with a history of type 1 diabetes after myocardial infarction has been placed on a beta-adrenergic blocking agent. Which statement by the patient indicates a need for further teaching?

"This medication lowers my blood pressure by helping me get rid of fluid."

What instruction is most important for the nurse to teach the patient who has recently been prescribed alprazolam (Xanax)?

"You may feel dizzy or unsteady when rising to a standing position."

When caring for the neonate immediately following delivery, the priority nursing diagnosis will be

...

The nurse administers hydralazine IV to control the blood pressure of a woman diagnosed with preeclampsia. If the nurse administered this medication at 0800, the next assessment of blood pressure should occur at

0803.

What is the recommended time over which anti-anxiety medications must be gradually tapered before discontinuation?

1 month

The nurse is teaching a patient about medication treatment for depression. The patient asks how long it will take before sleep and appetite will begin to improve. Which response by the nurse is most accurate?

1 week

Which is an appropriate nursing intervention for a patient who has recently been prescribed clozapine (Clozaril)?

Measure the patient's waist circumference.

A patient with schizophrenia has been non-adherent with his home medication regimen. He requires frequent admissions to the intensive psychiatric unit for treatment of acute psychotic episodes. Which medication regimen would be appropriate for this patient?

Administration of depot antipsychotic medication

Which nerve endings liberate norepinephrine?

Adrenergic

Before the initiation of anticholinergic medications, it is important for the nurse to screen patients for which condition?

Closed-angle glaucoma

Which drug will the health care provider prescribe to soften the cervix of a woman who is at 42 weeks gestation?

Dinoprostone (prepidil)

The nurse is preparing to educate a patient and significant other about anti-anxiety medications before the patient's discharge. What is pertinent information to be included in the teaching plan?

Discuss, review, and validate the behavior monitoring system and intervention flow sheet the patient and significant other will continue to use following discharge.

What occurs with mania associated with bipolar disorder?

Distinct episodes of elation

Which assessment would the nurse expect to observe in a patient who has been prescribed trazodone for treatment anxiety?

Drowsiness

Which type of adverse effects is present when a patient displays prolonged tonic contractions of the tongue, oculogyric crisis, and torticollis?

Dystonic reactions

Which condition would alert the nurse of the need to use beta-adrenergic blockers cautiously?

Emphysema

What is the most common cause of nonadherence to antipsychotic pharmacologic treatment?

Extrapyramidal effects

Dystonic reactions, pseudoparkinsonism, akathisia, and tardive dyskinesia are types of which effect?

Extrapyramidal symptoms

A male patient becomes verbally aggressive and insists the nurse is poisoning him as she attempts to administer haloperidol (Haldol). Which action will the nurse take?

Firmly redirect the patient to take the medication.

Which is the drug of choice to treat a patient with obsessive compulsive disorder (OCD)?

Fluvoxamine (Luvox)

The nurse is assessing a patient who is complaining of hearing voices. What is this patient experiencing?

Hallucinations

The nurse is providing education to a patient who has been prescribed bupropion (Wellbutrin) for smoking cessation. Which statement by the patient would indicate the need for further teaching?

If I have the urge to smoke, I will take more medication.

Which is true regarding psychological drug dependence?

It requires medical intervention to treat.

A woman is 32 weeks pregnant and has been examined by the health care provider on June 1. She is scheduling her next appointment. The most appropriate day for the nurse to schedule the appointment is

June 16.

which emergency drug must be available when caring for a patient on mag sulfate?

calcium gluconate

A young male patient taking an antipsychotic is experiencing an oculogyric crisis. The nurse prepares to administer

diphenhydramine.

Which is characterized by seizures?

eclampsia

which medication is used to treat a patient with atonic uterus?

ergovine

which drug will the nurse administer to prevent neonatal conjunctivitis in the newborn?

erythromycin

which test would the nurse anticipate to be done if preterm labor is present in a patient whose symptoms are questionable?

fetal fibronectin test

A patient taking vilazodone has been vomiting persistently for 12 hours. The priority nursing diagnosis for this patient is:

fluid volume deficit.

A patient is admitted to a long term psychiatric setting. The MAOI medication previously prescribed is discontinued by the physician. New orders are obtained to initiate imipramine therapy. The nurse will provide the first dose of imipramine to the patient _____ the MAOI drug.

in 14 days following the last dose of

The nurse transcribes an order for lorazepam for a patient experiencing nausea and vomiting as a result of alcohol withdrawal. The most appropriate route of administration for lorazepam with this patient would be:

intramuscularly

A 36 week old primigravida patient has been admitted to the unit with a BP of 200/120 mm Hg, severe headache, and edema. Which medication does the nurse anticipate that the health care provider will order ?

mag sulfate

A newly admitted psychiatric patient repetitively states, "I wish I were dead. I just want to kill myself." The priority nursing at this time is to:

provide for patient safety.

A long term care resident is taking an anticholinergic agent. The nurse observes the resident to be disoriented and hallucinating. The priority nursing action is to:

provide for resident's safety.