pharmacology exam 3
drugs to support alcohol withdrawal
1. benzodiazepines (diazepam, lorazepam) 2. adjunct to treatment w/ benzodiazepines (propranolol, atenolol, carbamazepine, clonidine)
administration: *aluminum hydroxide*
1. chew tablet thoroughly 2. drink 8 oz of water after
which medication(s) if ordered by the physician, should the nurse question in a client who is taking *phenytoin*
1. cimetidine 2. valproic acid 3. warfarin
do not administer a cholinesterase inhibiter with drugs that block cholinergic receptors. examples include (3 answers apply)
1. first-gen antihistamines 2. tricyclic antidepressants *amitriptyline* 3. conventional antipsychotics
what is the *name* and *classification* of the drug that reduces gastrointestinal motility and nausea
*name*: metoclopramide *type*: pro kinetic
a client who has a gastric ulcer is about to start taking *sucralfate*. the nurse determines that teaching was effective when the client states the he will this medication
1 hr before meals and at bedtime
NCELX patient safety: *antidepressants*
1. increased risk for suicide 2. slow onset and slow taper off *never stop abruptly* 3. *NEVER mix SSRI + st. johns wort and MAOI and antidepressants (TCA, SSRI, SNRI)* 4. ALL psych drugs usually decrease BP and can cause weight gain
which types of foods can trigger headache?
1. tyramine containing food 2. cured meat 3. chocolate 4. yellow food coloring
which nursing action(s) are appropriate for a nurse preparing to administer *phenytoin*via a NG tube? (select all that apply) A. hold tube feedings for at least one hour prior to administration B. flush the NG with 30 mL tap water before and after administration C. monitor blood pressure and HR every 15 minutes for two hours after administration D. monitor liver function tests on a regular basis for patients taking phenytoin E. administer phenytoin at the onset of new seizure activity
A, B, D
patient teaching for *diazepam*? (select all that apply) A. avoid valerian root B. avoid ginkgo and ginseng C. avoid muscle relaxants D. report history of reaction midazolam E. naloxone is the antidote for this medication F. decrease alcohol consumption
A, C, D
the health care professional is providing instructions to the client on taking aluminum hydroxide. which information should be included? (select all that apply) A. check labels for sodium and phosphate content B. decrease activity and exercise C. increase fluid and fiber intake D. report whitish colored stools E. monitor for signs of constipation
A, C, E
a client is about to start taking aluminum hydroxide tablets to reduce gastric acid. which instructions should you include when talking with the client about taking this drug? (select all that apply): A. take the drug with a large meal B. chew the tablets thoroughly C. drink a glass of water after taking it D. increase fluid and fiber intake E. take it once daily
B, C, D
which instruction(s) should the nurse include in the plan of care for patient newly prescribed *levodopa/carbidopa* for the treatment of parkinson disease? (select all that apply) A. "if you don't notice improvement in your symptoms within one week, notify your provider" B. "when going from a sitting to a standing position, be sure to change your position slowly" C. "it is a good idea to remove any extra clutter from your home that could cause you to trip and fall D. "call your provider if you notice that your urine changes to a slightly reddish color E. "avoid eating meals that contain large amounts of protein while taking this medication
B, C, E
knowing the adverse effects of cimetidine, the primary care provider's assistant should instruct a client to watch for and report which of the following? A. hyperactivity B. confusion C. hypertension D. bone pain
B. confusion other effects include *drowsiness or dizziness*
you are about to administer *ondansetron* to a client to prevent anesthesia-induced nausea and vomiting. you prepare to monitor the client for which adverse effects of the drug? A. bronchospasm B. dizziness C. hypertension D. anxiety
B. dizziness
which of the following are adverse effects of *cimetidine*? A. increased libido B. insomnia C. enlarged of breast tissue D. confusion E. decreased sperm count
C, D, E *cimetidine has CNS effects and androgen effects
a patient is prescribed *ergotamine tartrate* for migraine headaches. which statement made by the patient indicates a need for further teaching? A. "i should place the tablet under my tongue" B. "i need to use birth control pills while taking this medication" C. "i am not at risk for physical dependence with this drug" D. "i should avoid drinking grapefruit juice with this medication`"
C. "i am not risk for physical dependence with this drug"
a nurse is teaching a client who takes pain medication and was recently prescribed *docusate sodium*. which of the following statements indicates the client understands he information? A. "i will take the medication for diarrhea" B. "i drink 4 oz of water of when i take the medication" C. "i am to have 1 to 2 soft stools each day" D. "i may occasionally take with mineral oil"
C. "i am to have 1 to 2 soft stools each day"
a client who is taking phenytoin has a new prescription for sucralfate tablets. which of the following instructions should the nurse include? A. take an antacid with the sucralfate B. take sucralfate with a glass of milk C. allow 2-hr interval between these medications D. chew the sucralfate thoroughly before swallowing
C. allow a 2-hr interval between these medications *sucralfate can be dissolved in water but not chewed
a patient with MS is prescribed *interferon beta [Betaseron]* what is a priority for teaching at this time? A. provide information about myelosuppression B. teach symptoms of hepatotoxicity C. educate about self-injection technique
C. educate about self-injection technique
a patient with mild symptoms of AD is prescribed *donepezil [Aricept]*. which statement made by the patient indicates the need for further teaching? A. "the drug will improve transmission by neurons in my brain" B. "i may experience an upset stomach while taking this drug" C. "i will take the drug every night at bedtime with a snack" D. "the drug will stop damage to the neurons in my brain"
D. "the drug will stop damage to the neurons in my brain" *transmission by neurons that have not yet been destroyed will be enhanced. the drug will not stop disease progression, but it may slow progression by a few months
a patient is brought to the emergency department for the treatment of an overdose of *alprazolam [xanax]*. which medication should the nurse prepare to administer to this patient? A. protamine sulfate B. acetylcysteine C. naloxone D. flumazenil
D. flumazenil
types of antidepressants (3)
SSRI, MAOI, TCA
monitor phosphorus levels in clients taking ____ for PUD
aluminum hydroxide *hypophosphatemia* can occur
which *type of medication* will increase gastric pH and neutral stomach acid?
antacids
amitriptyline, a tricyclic antidepressant can cause ____ effects such as blurred vision, urinary hesitancy, dry mouth, constipation, and tachycardia
anticholinergic
which instruction should a nurse provide to a client with a new prescription for *loperamide*?
avoid activities that require alertness *loperamide is an opioid agonist, which can cause sedation and dizziness*
*disulfiram* is used for abstinence maintenance. what should you avoid ingesting when taking this medication?
avoid ingesting or applying any products that contain alcohol (eg; cough syrup, sauces, mouthwash, aftershave lotion, colognes, hand sanitizer)
mixing phenytoin and warfarin would cause what type of drug-drug interaction?
decreased effectiveness of warfarin
what is the name of the drug that helps to prevent and treat motion sickness
dimenhydrinate
T/F: sucralfate needs to be administered with a lot of water
false *can be administered with little or no water*
___ is the antidote to benzodiazepines
flumazenil
the nurse should teach the patient who is prescribed *carbamazepine* to avoid?
grapefruit juice *inhibits the metabolism and can increase peak and trough levels by 40%
first sign of hypertensive crisis
headache
which adverse effects of *phenytoin* should the nurse immediately report to the provider? (select all that apply) A. new reports of feeling "unsteady" when ambulating B. the appearance of a new rash on the patient's chest C. reports of feeling hopeless and apathetic D. a morning phenytoin level of 26 mg/dL E. difficulty forming words and sentences
A-E
a nurse is providing instructions to a client who has a new prescription for *zolpidem*. which of the following instructions should the nurse include? A. "notify the provider if you plan to become pregnant" B. "take the medication 1 hr before you plan to go to sleep" C. "allow at least 6 hr for sleep when taking zolpidem" D. "to increase the effectiveness of zolpidem, take it with a bedtime snack"
A. "notify the provider if you plan to become pregnant
the nurse instructs a young adult patient about *triazolam* (a benzodiazepine) for the short-term management of insomnia. which statement, if made by the patient, indicates an understanding of the instructions? A. "the medication will not affect my breathing" B. "i can safely drink wine while taking this drug" C. "my chance of addiction to this drug is high" D. "this drug is safe to use if I am pregnant"
A. "the medication will not affect my breathing"
you are instructing a client about taking *phenelzine* to treat depression. which of the following foods should you tell the client to avoid? A. aged cheese B. milk C. potato chips D. candy
A. aged cheese *tyramine-rich foods may trigger severe HTN in clients taking phenelzine
when talking with a patient about taking *cimetidine*, the nurse should include which of the following instructions? A. take the medication with an antacid to minimize stomach upset B. do not take this medication if you start taking blood-thinning medications C. take the medication on an empty stomach for better absorption D. do not stop taking this medication after a few days or weeks
B. do not take this medication if you start taking blood-thinning medications
which of the following is a paradoxical effect of buspirone? A. chest pain B. insomnia C. diaphoresis D. fever
B. insomnia
a patient taking *levodopa/carbidopa* for Parkinson's disease experiences frequent "on-off" episodes (i.e., the abrupt loss of effect). which action by the nurse is best? A. administer the medication when the patient has an empty stomach B. instruct the patient to avoid high-protein foods C. have the patient increase the intake of vitamin B6 D. discontinue the drug for 10 days (for a "drug holiday")
B. instruct the patient to avoid high-protein foods
A nurse at an ophthalmology clinic is caring for a client who has *open-angle glaucoma*. the client is started on a treatment regimen of *timolol* and pilocarpine eye drops. the nurse should understand that these medications will be administered A. until the client's intraoular pressure returns to normal B. on a regular schedule for the rest of the client's life
B. on a regular schedule for the rest of the client's life
a nurse is teaching a client who has a new prescription for *levodopa/carbidopa* for Parkinson disease. which of the following instructions should the nurse include? A. increase intake of protein-rich foods B. expect muscle twitching to occur C. take this medication with food D. anticipate relief on manifestations in 24 hours
C. take this medication with food
the nurse is caring for a patient with migraine headaches. Which assessment best indicates that *sumatriptan [Imitrex]* is exerting the desired therapeutic effect? A. the patient experiences decreased frequency of migraine headaches B. the patient does not experience any more migraine headaches C. the patient reports the termination of the migraine headache after the drug is is administered D. the patient experiences decreased nausea associated with the migraine headache
C. the patient reports the termination of the migraine after the drug is administered
which of the following assessments of this client is most important immediately following the administration of IV diazepam? A. ECG B. seizure activity C. blood pressure D. respiratory rate
D. respiratory rate
a nurse is instructing a pediatric client and his family about how *methylphenidate* will help manage ADHD. the nurse should explain that this medication therapy will help A. increase focus B. promote rest C. improve appetite D. prevent panic
A. increase focus
the primary care provider prescribes *timolol* for a client with open-angle glaucoma. which of the following information should he include when instructing the client about instilling the eye drops? A. apply gentle pressure to the nasolacrimal duct after instillation B. massage the eyelid after installation C. cover the eye with a patch after instillation D. blink rapidly to dispense the eye drops after instillation
A. apply gentle pressure to the nasolacrimal duct after instillation
a client is about to start taking aluminum hydroxide to treat heartburn. the nurse should explain to the client that this medication can cause A. constipation B. diarrhea
A. constipation
the health care professional instructs a client about the therapeutic actions of sucralfate. she explains that this drug promotes ulcer healing by which action? A. creates a protective barrier B. increases gastric pH C. inhibits the proton pump D. neutralizes gastric acid
A. creates a protective barrier
a nurse is planning care for a client who is receiving chemotherapy and has a new prescription for ondansetron. which of the following actions should the nurse plan to take? (select all that apply) A. infused the drug 30 min prior to chemotherapy B. administer the drug when the client reports nausea C. infuse the drug slowly over 15 minutes D. administer the drug immediately following chemotherapy E. repeat the dose 4hr after chemotherapy
A. infused 30 min prior to *prevent* nausea C. administer slowly to prevent nausea E. repeat the dose 4 hr and 8hr after chemotherapy
a nurse is caring for an older adult client who has kidney disease and a new prescription for cimetidine. the nurse should instruct the client to report which of the following manifestations? A. lethargy B. cellulitis C. dry mouth D. myalgia
A. lethargy
a client tells the nurse she took a dose of *dimenhydrinate* before coming to the health care clinic. the nurse determines that the medication is effective when the client reports relief of A. nausea B. dry mouth C. headache D. diarrhea
A. nausea
the health care professional is now assessing the client. which of the following findings can be an early indication of phenytoin toxicity? A. nystagmus B. tachycardia C. tachypnea D. jaundice
A. nystagmus nystagmus is characterized by repetitive, uncontrolled eye movements
a nurse is caring for a client who has just begun therapy with *alprazolam* (xanax) to treat anxiety. the nurse should observe the client for which of the following adverse effects of this medication? A. sedation B. bradycarida C. hearing loss D. abdominal pain
A. sedation
a client has started to take lithium carbonate to treat bipolar disorder. the nurse should make sure the client understands that he must maintain consistency in his intake of which of the following dietary elements? A. sodium B. potassium C. vitamin K D. vitamin C
A. sodium
a patient is concerned about developing AD. what should the nurse include in the teaching plan? A. estrogen replacement therapy improves cognitive functioning B. no solid evidence supports the use of drugs to prevent AD C. naproxen taken daily after the age of 50 years decreases the risk of AD D. daily doses of ginkgo biloba can prevent cognitive decline.
B. no solid evidence indicates that drugs, nutrients, supplements, exercise, cognitive training, or any other intervention can prevent AD or delay cognitive decline
a patient with multiple sclerosis is prescribed *baclofen [Lioresal]* which assessment by the nurse indicates that the medication is exerting its desired effect? A. decreased strength B. suppression of spasticity C. improved muscle tone D. increased muscle resistance
B. suppression of spasticity
a client is about to start taking *omeprazole* to treat a duodenal ulcer. which of the following instructions should you include when talking with the client about taking this drug? A. take it with food B. avoid using aluminum-based antacids C. consume adequate amounts of fluid D. do not drink grapefruit juice
C. consume adequate amounts of fluids
a nurse has just administered a dose of *diazepam* to a client. which of the following actions should the nurse take before she leaves the room? A. turn off the overhead lights B. reduce the ringer on the volume of the patient's phone C. put up the side rails the clients bed D. turn off the client's television
C. put up the side rails on the client's bed *this medication is a benzodiazepine that causes sedation and has anti anxiety and muscle reaction properties
the nurse prepares to administer *dantrolene [Dantrium]* to a patient. before the administration of the drug, it is most important for the nurse to assess which laboratory value? A. serum amylase B. creatinine clearance C. blood glucose D. aminotransferases
D. aminotransferases *to reduce the risk of liver damage, liver function tests should be performed at baseline and periodically thereafter. these tests include levels of aspartate and alanine aminotransferases. if the liver function tests indicate liver injury, dantrolene should be withdrawn
which instructions should the health care professional give a client about taking sucralfate to rest acute duodenal ulcer? A. take it with a prescribed antacid B. reduce potassium intake C. take it with food D. increase fluid and fiber intake
D. increase fluid and fiber intake
a patient is prescribed *phenytoin [Dilantin]* for epileptic seizures. which of the following is the *priority* for patient teaching? A. teach the patient to adjust the dose according to the presence of symptoms B. tell the patient to take the medication with meals C. inform the patient about the prevention of gingival hyperplasia D. teach the patient to avoid the abrupt cessation of treatment
D. teach the patient to avoid the abrupt cessation of treatment *both B and C are correct, however they are not priority
which types of headaches have no identifiable cause?
migraine and cluster
what are early signs of lithium toxicity?
nausea, muscle weakness, vomiting, fine muscle tremors, thirst
which medication will reduce gastric acid secretion by inhibiting the acid pump?
omeprazole
how often should a client take aluminum hydroxide?
take aluminum hydroxide tablets one and three hours after meals and at bed time
which medication will the nurse administer to a client who has *absence seizures*?
valproic acid
