Pharmacology Midterm Test Bank 1

A patient with schizophrenia has been nonadherent 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

Which response by the nurse is accurate when a patient who has been on lamotrigine (Lamictal) for seizure control reports a skin rash and urticaria?

Advise the patient that this adverse effect usually resolves but should be reported to the health care provider.

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

Which substance(s) may increase the toxic effects of benzodiazepines?

Alcohol Antihistamines Analgesics Sedatives Hypnotics

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

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

Which disorder(s) would indicate the use of anticholinergic agents?

Bradycardia Parkinson's disease Preparation for surgery

The physician has written an order for a drug with which the nurse is unfamiliar. Which section of the Physicians' Desk Reference (PDR) is most helpful to get information about this drug?

Brand and Generic Name section

What will the nurse need to determine first in order to mix two drugs in the same syringe?

Compatibility of the drugs

Which nursing assessment(s) is/are important before the initiation of antidepressant therapy?

Compliance with medication therapy within the last 2 months Nonverbal interactions among patient and significant others present Evaluation of the coherency, relevancy, and organization of thoughts in responses Appearance and posture

A patient on anticonvulsant therapy confides to the nurse at an outpatient clinic that she suspects she may be pregnant. The nurse should encourage the patient to take which action(s)?

Consult an obstetrician. Carry an identification card. Provide a list of seizure medications.

Which area(s) should be addressed by the nurse when obtaining a history of a patient admitted with depression?

Current medications and medical history Recent stressors and support system Family history of mood disorder Dietary patterns

Which online drug reference makes available to health care providers and the public a standard, comprehensive, up-to-date look up and downloadable resource about medicines?

DailyMed

In addition to facilitating sleep, what is another benefit of sedatives?

Decreased patient anxiety

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

Drowsiness

is the most comprehensive reference available to research a drug interaction?

Drug Interaction Facts

The nurse must be sure to instruct the patient about which potential adverse effect(s) of tricyclic antidepressants?

Dryness of mouth, nose, and throat Constipation Urinary retention Blurred vision

What will the nurse include in a teaching plan for a patient with depression being treated with amitriptyline (Elavil)?

Dryness of the mouth is normal; sucking on sugar free hard candy and ice chips or chewing gum may help alleviate this problem. Rise slowly from a supine or sitting position to avoid dizziness and orthostatic hypotension. Avoid alcohol and barbiturates.

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 information is most accurate regarding the nurse's understanding of pain management?

Encourage patients to report pain before the pain becomes too severe.

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

The nurse is completing an assessment on a nonverbal adult patient. Which type of pain scale assessment tool is the most accurate to use?

FLACC

Which sign(s) and symptom(s) may occur in neuroleptic malignant syndrome?

Fever Hypertension Severe extrapyramidal symptoms Alterations in consciousness

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 condition is associated with hydantoin therapy?

Gingival hyperplasia

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

Hallucinations

A patient receiving diazepam (Valium) is complaining of nausea and vomiting and is becoming jaundiced. Which type of blood work will be performed?

Liver function tests

The nurse is transcribing new orders written for a patient with a substance abuse history. Choose the medication ordered that has the greatest risk for abuse.

Lortab

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

Measure the patient's waist circumference.

To what does potency of an antipsychotic medication refer? what does potency of an antipsychotic medication refer?

Milligram doses used for the medication

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

Which medication would the nurse administer to a patient who is rating the pain at 8 on a 0 to 10 scale?

Morphine (Roxanol)

Parkinson's disease has which characteristic symptom(s)?

Muscle tremors Posture alterations Slow body movement

Which disease is associated with insufficient sleep?

Myocardial infarction

Which adverse effect(s) is/are common when a patient is receiving a cholinergic agent?

Nausea Dizziness Bradycardia

What information would be most important for the nurse to provide to a patient when teaching about the adverse effects of succinimide therapy?

Nausea, vomiting, and indigestion are common during the initiation of therapy.

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

The nurse assesses hives in a patient started on a new medication. What is the nurse's priority action?

Notify physician of allergic reaction.

Which action will the nurse take when a patient receiving morphine sulfate via percutaneous coronary angioplasty (PCA) has a shallow, irregular respiratory rate of 6 breaths/min?

Notify the health care provider and prepare to administer naloxone (Narcan).

Which condition would indicate to the nurse that a patient has phenytoin (Dilantin) toxicity?

Nystagmus

What is the name under which a drug is listed by the U.S. Food and Drug Administration (FDA)?

Official

When performing a baseline neurologic assessment prior to the administration of an NSAID medication, the nurse will assess which patient characteristic(s)?

Orientation to date, time, and place Mental alertness

Which adverse effects associated with levodopa therapy would support the nursing diagnosis risk for injury?

Orthostatic hypotension

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

Oxazepam (Serax)

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.

An older adult patient received a hypnotic agent at 9:00 PM. At 2:00 AM, the nurse discovers that the patient has removed her gown and is attempting to get out of bed without assistance. What type of medication effect is the patient exhibiting?

Paradoxical

On what is the choice of tricyclic antidepressants based?

Patient age and gender

What term is used to define an awareness of pain?

Perception

When categorizing, the nurse is aware that which drug(s) would be considered Schedule II?

Percodan Amphetamines

Which assessment(s) would be included in the evaluation of a patient with anxiety?

Physical examination Psychological evaluation History of precipitation stressors Medication history Substance abuse history

In addition to the relief of mild to moderate anxiety, hydroxyzine (Vistaril) has which additional therapeutic outcome(s)?

Reduced need for sedation and analgesia before and after surgery Control of itching in allergic reactions Control of vomiting

What is the pharmacologic action of entacapone, a potent catechol O methyl transferase (COMT) inhibitor?

Reduces the destruction of dopamine in peripheral tissues

In which case would the nurse be correct in withholding an opiate agonist?

Respiratory rate of 10 breaths/min

Dopamine agonists have been linked with which adverse effects in patients with Parkinson's disease?

Sudden sleep events

Which condition(s) may be managed by salicylates?

Swollen joints Fever Muscle aches Myocardial infarction

The nurse planning patient teaching regarding drug names would include which statement(s)?

The official name is the name under which the drug is listed by the U.S. Food and Drug Administration (FDA). Brand names are easier to pronounce, spell, and remember. The first letter of the generic name is not capitalized.

Which statement is true about neuropathic pain?

The pain is a result of nerve injury.

What is the advantage of taking a nonsteroidal anti-inflammatory drug (NSAID) that is a COX 2 inhibitor?

There are fewer GI adverse effects.

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.

Which statement is true about over-the-counter (OTC) drugs?

They are sold without a prescription.

What do drug blood levels indicate?

They determine if the amount of drug in the body is in a therapeutic range.

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.

Which statement(s) is/are true about efferent nerves?

They leave the CNS to carry impulses to other body parts. They are part of the peripheral nervous system. They transmit signals that control contractions of smooth and skeletal muscle. They transmit signals that control contractions of some glandular secretions.

Which patient assessment would indicate to the nurse that salicylate toxicity is occurring?

Tinnitus

Which medication is used to control seizures or prevent migraine headaches?

Topiramate (Topamax)

Which drug(s) interact(s) with SSRI agents?

Tranylcypromine (Parnate) Lithium (Eskalith) Warfarin (Coumadin) Propranolol (Inderal)

Which cholinergic symptoms of Parkinson's disease are reduced with anticholinergic drugs?

Tremors and drooling

For which condition may carbamazepine (Tegretol) be used?

Trigeminal neuralgia pain

Which source contains information specific to nutritional supplements?

United States Pharmacopoeia/National Formulary (USP NF)

What is the drug of choice when treating a generalized tonic-clonic seizure?

Valproic acid (Depakene)

What is the best way for the nurse to evaluate the effectiveness of the patient's opiate agonist?

Verbal report of 2 on a 1 to 10 scale

When teaching a patient who is starting therapy with NSAIDs, the nurse must be sure to mention drug interactions with which drug(s)?

Warfarin (Coumadin) Lithium (Eskalith) Diuretics

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.

The nurse is providing discharge teaching to a patient prescribed phenytoin (Dilantin) for management of a seizure disorder. Which patient statement indicates a need for further teaching?

"If I develop enlarged gums, I will stop taking the medication."

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."

The nurse is providing education to a patient recently prescribed pregabalin (Lyrica). Which statement by the patient indicates a need for further instruction?

"Once my pain improves, I will stop taking this medication."

What is the recommended time over which antianxiety 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

The nurse administers 50 mg of a drug at 6:00 AM that has a half-life of 8 hours. What time will it be when 25 mg of the drug has been eliminated from the body?

2:00 PM

What dose is within the acceptable range for administering IV phenytoin (Dilantin) to a patient with a seizure disorder?

30 mg/min

How long after the administration of a parenteral pain medication will the nurse complete the next pain assessment to evaluate the effectiveness of the medication?

30 minutes

A patient experiencing chronic pain as a result of metastatic cancer has a new order for fentanyl (Duragesic) transdermal patch. The initial patch is applied at 8 AM on Monday. At 8 PM on Monday, the patient reports a pain level of 8. The nurse's best response is to

provide a PRN analgesic medication as ordered.

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.

The prenatal nurse is educating a woman regarding preconception care. The patient informs the nurse that she is currently taking a benzodiazepine drug for management of anxiety. Appropriate teaching for this patient will include that benzodiazepines

readily cross into breast milk. enter fetal circulation.

The nurse is administering Somnote to a patient. When providing medication education to the patient, the nurse will include that Somnote should be

taken with a full glass of water.

A physician's order indicates to administer a medication to the patient via the percutaneous route. The nurse can anticipate that the patient will receive this medication

topically.

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 developed hives and itching after receiving a drug for the first time. Which instruction by the nurse is accurate?

Stop the medication and encourage the patient to wear a medical alert bracelet that explains the allergy.

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.

Which instruction(s) is/are most pertinent to include in the discharge teaching of a patient on lithium (Eskalith) who is being discharged?

"Persistent vomiting and profuse diarrhea are signs of toxicity and must be reported to the health care provider immediately." "It is important to comply with schedules for blood tests to assess therapeutic levels." "The common adverse effects to expect, which are excessive nausea, anorexia, and abdominal cramps, tend to resolve." "Take the medication with food or milk."

The nurse is teaching a patient with Parkinson's disease about levodopa. Which statement by the nurse is accurate regarding drug administration?

"Take this medication with food or antacids to reduce GI upset."

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 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."

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."

The nurse is assessing a patient who is being evaluated in an outpatient clinic for complaints of back pain. The patient reports taking diphenhydramine for insomnia related to job stress. Which statement by the nurse is accurate regarding this medication?

"This medication should only be taken for 1 week."

An 86-year-old patient who was admitted with GI bleeding as a result of salicylate therapy is being discharged. As the nurse reviews the discharge medication list, the patient states that she doesn't understand why Tylenol doesn't work as well as the aspirin she had been taking. What would be the nurse's best response?

"Tylenol does not help with inflammatory discomfort."

The nurse is administering Lomotil, a Schedule V drug. Which statement is true about this drug's classification?

Abuse potential for this drug is low.

Which adverse effect(s) may occur as a result of antipsychotic drug therapy?

Acute dystonia Akathisia Neuroleptic malignant syndrome Tardive dyskinesia

What is a guideline for the nurse when administering phenytoin (Dilantin) intravenously?

Administer without mixing with other medications.

What point(s) should be included when teaching a patient about the use of apomorphine for treatment of Parkinson's disease?

Apomorphine does not have any opioid activity. A multidose injector pen is commonly used to administer apomorphine. You may experience nausea and vomiting, which can be treated with trimethobenzamide (Tigan). You may experience sleep attacks or episodes of daytime sleepiness.

The health care provider orders diazepam (Valium) 10 mg IV stat for a patient who was admitted with status epilepticus. What important nursing interventions(s) associated with administration of this medication IV should the nurse perform?

Apply a cardiac monitor to the patient to assess for continuous heart rate, if not already done. Continuously assess the patient's airway. Obtain the correct dose (10 mg) and administer over slow IV push.

Which medication is contraindicated when a patient is taking warfarin (Coumadin)?

Aspirin

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

Assess the patient for thoughts of suicide.

A patient has been prescribed lorazepam (Ativan), a benzodiazepine used to treat insomnia. Which action will the nurse take?

Assess the patient's blood pressure in sitting and lying positions.

Which vitamin will reduce the therapeutic effects of levodopa?

B6

A patient admitted to a psychiatric facility is hallucinating, pacing, and acting highly suspicious. Based on this information, the nurse will take which action(s)?

Be open and direct when handling the patient. Encourage a variety of interactions with others. Provide high-protein, high-calorie foods.

Which food(s) containing significant amounts of tyramine will be contraindicated when a patient is on MAOI therapy?

Beer Aged cheeses Bananas

Why is a combination of antipsychotic agents with benzodiazepines useful in initial treatment of the agitated patient?

Benzodiazepines allow for lower dosages of antipsychotic agents to be used, thereby decreasing serious adverse effects seen with high-dose therapy. It assists in calming the psychotic patient.

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

Patients taking phenytoin (Dilantin) for control of seizures must be aware of the risk for which adverse effect(s)?

Blood dyscrasias Hyperglycemia Gingival hyperplasia Sedation

A patient admitted to the hospital is exhibiting psychotic behavior. Which sign(s) and/or symptom(s) would support the diagnosis of psychosis?

Deterioration of social functioning Reporting that the FBI has solicited important secret information from his phone conversations Confirmation of hearing voices in his head Changing the topic of conversation inappropriately

Which premedication assessment by the nurse is most important prior to the initiation of carbamazepine (Tegretol) therapy?

Determine patient's ancestry.

Which sign or symptom displayed by a patient would be indicative of opiate withdrawal?

Diarrhea

The nurse is preparing to educate a patient and significant other about antianxiety 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

What occurs when two drugs compete for the same receptor site, resulting in increased activity of the first drug?

Displacement

What occurs with mania associated with bipolar disorder?

Distinct episodes of elation

What is the process by which a drug is transported by circulating body fluids to receptor sites?

Distribution

Which common adverse effect(s) is/are associated with opiate agonists?

Dizziness Orthostatic hypotension Respiratory depression Confusion

The nurse is preparing 0800 medications for a patient with the medical diagnosis of end stage renal disease. When reviewing the medication administration record (MAR), the nurse notices the patient is scheduled to receive an MAOI drug. Which intervention(s) will the nurse perform before administering the drug?

Hold the MAOI drug. Consult with the prescribing health care provider.

The nurse is preparing discharge instructions for a patient with a history of diabetes who has just been diagnosed with seizure disorder. The patient has been prescribed hydantoin therapy. What will the patient most likely experience?

Hyperglycemia

Meperidine (Demerol) is a narcotic with a high potential for physical and psychological dependency. Under which classification does this drug fall?

II

An older adult experiencing shortness of breath is brought to the hospital by her daughter. While obtaining the medication history from the patient and her daughter, the nurse discovers that neither has a list of the patient's current medications or prescriptions. All the patient has is a weekly pill dispenser that contains four different pills. The prescriptions are filled through the local pharmacy. Which resource(s) would be appropriate to use in determining the medication names and doses?

Physicians' Desk Reference, Section 4 Senior citizens' center Patient's home pharmacy

What is included in the nursing management of the patient with generalized tonic-clonic seizure activity?

Placing padding around or under the patient's head Positioning the patient on the side once the relaxation stage is entered to allow oral secretions to drain Requesting additional assistance and/or necessary equipment in case the patient does not begin breathing spontaneously when the seizure is over

For what conditions are benzodiazepines prescribed?

Preoperative sedation

Which additional nursing intervention(s) would be effective with pain management in the pediatric population?

Provide diversional activities such as coloring, puzzles, and games. Allow uninterrupted sleep and rest. Perform hygiene measures. Encourage parental participation with caregiving to diminish the child's anxiety.

The nurse is assessing a patient's pain. When the patient describes his pain

Quality

The psychiatric nurse is educating an elderly patient and family about antipsychotic drug therapy. When providing this education, the nurse will include which statement(s)?

Rapid increase in dosages will increase frequency of adverse effects. Tardive dyskinesia may be reversible in early stages. Full therapeutic response may require 6 to 8 weeks to be achieved.

Which statement(s) is/are true regarding the pharmacologic actions of certain antidepressant drugs?

SSRIs inhibit the destruction and reuptake of serotonin at the synaptic cleft. Monocyclic antidepressants such as bupropion (Wellbutrin) have an unknown mechanism of action. SNRIs prolong the action of neurotransmitters by decreasing the destruction of serotonin and norepinephrine.

A female patient is admitted to the adult psychiatric floor with a diagnosis of generalized anxiety disorder. Anxiolytic medications and group therapy have been prescribed. Evaluation of therapeutic outcomes related to her acute stay can be measured by which assessment(s)?

She is able to sleep 5 hours during the night. The tremor and pacing she exhibited on admission are reduced. She is able to attend and actively participate in group sessions.

The nurse is preparing to administer zonisamide (Zonegran) to a newly admitted patient with the diagnosis of adult partial seizures. The nurse should hold this medication if the patient has which sign(s) or symptom(s)?

Skin rash Allergy to Bactrim Pruritus

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

Social withdrawal

Which is/are extrapyramidal adverse effect(s) of antipsychotic agents?

Spasmodic movements of muscle groups Masklike expression Lip smacking Inability to sit in one place for an extended period

The nurse finds that a patient is extremely agitated, yells frequently, and is attempting to get out of bed without assistance. What is the nurse's initial action?

Spend uninterrupted time listening to the patient.

Which sleep pattern stage diminishes as an effect of aging?

Stage IV

A patient is taking meperidine (Demerol) as needed for moderate to severe pain following an open appendectomy. The nurse assesses the following: current pain level 2, temperature 99° F, BP 130/76, respirations 10, lung sounds clear, abdomen soft and tender, bowel sounds present. Based on this assessment information, the priority nursing diagnosis is

altered breathing pattern.

The pediatric nurse is caring for a patient diagnosed with refractory seizures. The physician orders a ketogenic diet. When the child receives his food tray, the nurse should remove any food containing high levels of

carbohydrates.

When a patient taking a monoamine oxidase B inhibitor receives his dietary tray, the nurse knows to remove the

cheese.

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

diphenhydramine.

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

fluid volume deficit

Neurotransmitter(s) include:

gamma aminobutyric acid. acetylcholine. serotonin. histamine. epinephrine.

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 is providing education to a patient recently placed on selegiline disintegrating tablets. Which statement by the patient indicates a need for further teaching?

"I will place the tablet on my tongue before breakfast."

Which instruction(s) given by the nurse will assist a patient to cope with the common adverse effects of anticholinergic medications?

"Increase fluids daily." "Suck on candy or ice chips."

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."

A patient receives 200 mg of a medication that has a half-life of 12 hours. How many mg of the drug would remain in the patient's body after 24 hours?

50

Which statement(s) about liberation of drugs is/are true?

A drug must be dissolved in body fluids before it can be absorbed into body tissues. A solid drug taken orally must disintegrate and dissolve in GI fluids to allow for absorption into the bloodstream for transport to the site of action. The process of converting the drug into a soluble form can be controlled to a certain degree by the dosage form. Converting the drug to a soluble form can be influenced by administering the drug with or without food in the patient's stomach.

Which is the best description of when drug interactions occur?

On the alteration of the effect of one drug by another drug

Which factor(s) affect(s) drug actions?

Age Body weight Metabolic rate Illness

What can occur as a result of rapid withdrawal from long-term use of barbiturate therapy?

Anxiety Delirium Weakness Grand mal seizures

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

Blood pressure

Which body function(s) is/are controlled by the autonomic nervous system?

Blood pressure GI secretion Body temperature Urination

Which statement(s) about variables that influence drug action is/are true?

Body weight can affect the therapeutic response of a medication. Chronic smokers may metabolize drugs more rapidly than nonsmokers. A patient's attitude and expectations affect the response to medication.

Which legislation authorizes the FDA to determine the safety of a drug before its marketing?

Federal Food, Drug, and Cosmetic Act (1938)

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

Closed-angle glaucoma

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

Fluvoxamine (Luvox)

The nurse is assessing an older patient with Parkinson's disease who was started on entacapone 1 week ago. The patient has a history of coronary artery disease and takes an antihypertensive and aspirin. Which information would support the need for a reduction in medication dosage by the health care provider?

Dizziness

What is the rationale for administering levodopa instead of dopamine for treatment of Parkinson's disease?

Dopamine does not cross the blood-brain barrier when administered orally.

The nurse is providing information to a patient recently prescribed entacapone. Which statement is correct?

Dosage is adjusted according to the patient's response.

The nurse assesses which blood level to determine the amount of circulating medication in a patient?

Drug

What would the FDA do to expedite drug development and approval for an outbreak of smallpox, for which there is no known treatment?

Fast track the investigational drug.

Which are routes of drug excretion?

GI tract; feces Genitourinary (GU) tract; urine Respiratory system; exhalation

Which is the most authoritative reference for medications that are injected?

Handbook on Injectable Drugs

When obtaining a patient's health history, which assessment data would the nurse identify as having the most effect on drug metabolism?

History of liver disease

Which route(s) enable(s) drug absorption more rapidly than the subcut route?

IV route IM route Inhalation/sublingual

The nurse administers an initial dose of a steroid to a patient with asthma. Thirty minutes after administration, the nurse finds the patient agitated and stating that "everyone is out to get me." What is the term for this unusual reaction?

Idiosyncratic reaction

The nurse is explaining the use of medications to a patient with insomnia. Which statement about sedatives is true?

Increased relaxation occurs with sedatives.

Which is true regarding psychological drug dependence?

It requires medical intervention to treat.

The nurse is assessing a patient prior to discharge from same day surgery following an incisional breast biopsy. When assessing the patient's central nervous system (CNS) function following sedative-hypnotic therapy, what will the nurse include?

Level of alertness Orientation Ability to perform motor functions

A nurse is preparing to administer tetracycline to a patient diagnosed with an infection. Which medication should not be administered with tetracycline?

Mylanta

A patient is being discharged on an adrenergic bronchodilator. Which common adverse effect(s) will the nurse include in discharge teaching?

Palpitations Dizziness Orthostatic hypotension Tremors

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

The nurse is caring for an older patient recently admitted to an assisted living center who is experiencing insomnia associated with the recent relocation. At bedtime, which nursing action will assist the patient to sleep?

Performing back massage

The nurse recognizes that which factor(s) would contribute to digoxin toxicity in a 92-year-old patient?

Prolonged half-life of the drug digoxin Impaired renal function

Which two phases make up normal sleep?

Rapid eye movement (REM) and non REM

Barbiturates have which common adverse effect(s)?

Residual daytime sedation Headache Blurred vision Impaired coordination

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

Risk of injury when using machinery

Why are benzodiazepines often preferred over barbiturates?

They have selective action at specific receptor sites. There is a wide range of safety between therapeutic and lethal levels. REM sleep is decreased to a lesser extent. Accidental overdoses are well tolerated.

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

They may produce severe bronchoconstriction.

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

Vasoconstriction

The nurse is preparing to begin administration of apomorphine to a patient. Before administering, the nurse will perform a baseline assessment of the patient's

mobility. orientation. alertness. vital signs.

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.

A patient taking rasagiline is assessed by the nurse to have a lasting significant increase in blood pressure. When reviewing the patient's current list of medications, the nurse decides to hold the next dose of

ciprofloxacin.

When reviewing a patient's history and physical information, the nurse notes that the patient has physician's orders for chloral hydrate and warfarin. During assessment of this patient, the nurse observes areas of petechiae and ecchymosis on the upper and lower extremities. The most appropriate lab work for the nurse to assess next is

prothrombin time.