Lilley's Pharmacology 4th Edition TEST BANK (Final Comprehensive Textbook bank)
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167 Terms
A patient diagnosed with migraine headache is experiencing what type of pain?
Acute pain
Persistent pain
Vascular pain
Phantom pain
Vascular pain
Vascular pain is thought to account for a large percentage of migraine headaches. It is believed to originate from vascular or perivascular tissues. It is characterized by persistent and recurring pain lasting 3 to 6 months. Acute pain is sudden and usually subsides when treated. Phantom pain occurs in the area of a body part that has been removed—surgically or traumatically—and is often described as burning, itching, tingling, or stabbing. It can also occur in paralyzed limbs following spinal cord injury.
An 18-year-old basketball player fell and twisted his ankle during a game. Which type of analgesic is he likely to be given?
A synthetic opioid, such as meperidine hydrochloride
An opium alkaloid, such as morphine sulphate
An opioid antagonist, such as naloxone hydrochloride (Suboxone®)
A non-opioid analgesic, such as tramadol
A non-opioid analgesic, such as tramadol
Pain originating from skeletal muscles, ligaments, and joints usually responds to non-opioid analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs). All drugs in the NSAID class are especially useful for pain associated with inflammatory conditions because these drugs have analgesic and anti-inflammatory effects.
A patient is in the recovery room following abdominal surgery. He is groggy but reports severe pain around his incision. What is the most important factor for the nurse to consider during her patient assessment before administering a dose of morphine sulphate?
Temperature
Respiration rate
Appearance of the incision
Time of last bowel movement
Respiration rate
One of the most serious side effects of opioids is respiratory depression, so respiration must be assessed prior to administering a dose of morphine.
A 78-year-old patient is in the recovery room after lengthy hip surgery. While gradually awakening, the patient requests pain medication. Within 10 minutes after receiving a dose of morphine sulphate, the patient is very lethargic; respiration is shallow, at a rate of nine respirations per minute. What necessary action may the nurse need to perform?
Close observation for signs of opioid tolerance
Immediate intubation and artificial ventilation
Administration of naloxone, an opioid
reversal agent
Administration of an agonist opioid, such as fentanyl (Duragesic Mat)
Administration of naloxone, an opioid reversal agent
Naloxone, an opioid reversal agent, is used to reverse the effects of acute opioid overdose and is the drug of choice for reversal of opioid-induced respiratory depression.
A patient will be discharged with a 1-week supply of an opioid analgesic for pain management after his abdominal surgery. What should the nurse teach this patient in regard to this drug?
How to manage diarrhea
How to access drug addiction programs
How to prevent constipation
How to avoid dehydration due to polyuria
How to prevent constipation
Gastrointestinal occurrences such as nausea, vomiting, and constipation are the most common adverse effects associated with opioid analgesics. Physical dependence usually occurs in patients undergoing long-term treatment.
A patient who has been treated for lung cancer for 3 years has noticed that over the past few months the opioid analgesic that is being used is not helping as much, and says that taking more medication is needed for the same pain relief. What is this patient experiencing?
Opioid toxicity
Addiction
Opioid tolerance
Abstinence syndrome
Opioid tolerance
Opioid tolerance is a common physiological result of long-term opioid use. Patients with opioid tolerance require larger doses of the opioid agent to maintain the same level of analgesia.
A 38-year-old male has arrived at the urgent care centre with severe hip pain after falling from a ladder at work. He has taken several pain pills over the past few hours but cannot remember how many he has taken. He hands the nurse an empty bottle of acetaminophen (Tylenol®). What is the most serious toxic effect of acute acetaminophen overdose?
Tachycardia
Central nervous system (CNS) depression
Hepatic necrosis
Nephrotic necrosis
Hepatic necrosis
Hepatic necrosis is the most serious acute toxic effect of an acute overdose of acetaminophen. Tachycardia and CNS depression are not side effects of acute acetaminophen overdose. Long-term, not short-term, ingestion of large doses is more likely to result in nephropathy.
The drug pentazocine (Talwin®) is a narcotic agonist-antagonist. Which statement describes a characteristic of this type of medication?
It has minimal analgesic effects.
It works to reverse the effects of opiates.
Its adverse effects differ from those of the opiate narcotics.
It has a lower addiction potential than opiate narcotics.
It has a lower addiction potential than opiate narcotics.
Opioid agonist-antagonist drugs generally have lower addiction potentials than opiate narcotics.
A 57-year-old patient has been on a transdermal narcotic analgesic as part of the management of pain for end-stage breast cancer. Lately, she has experienced "breakthrough" pain. How should this pain be addressed?
She should be given NSAIDs.
Her current therapy should not be changed.
The baseline dose of the narcotic may need to be increased in increments.
The narcotic route should be changed to the rectal route, to increase absorption.
The baseline dose of the narcotic may need to be increased in increments.
If a patient is requiring larger doses for breakthrough pain, the baseline dose of the narcotic may need to be titrated upward.
For which situation is the herb feverfew commonly used?
a. Muscle aches
b. Headaches
c. Leg cramps
d. Incisional pain after surgery
b. Headaches
Feverfew is commonly used to treat migraine headaches, menstrual problems, arthritis, and fever. Possible adverse effects include muscle stiffness and muscle and joint pain.
A patient is to receive acetylcysteine as part of treatment for an acetaminophen overdose. Which action by the nurse is appropriate when administering this medication?
Giving the medication undiluted for full effect
Avoiding the use of a straw when giving the medication
Disguising the flavour with a soft drink or flavoured water
Preparing to give the medication via a nebulizer
Disguising the flavour with a soft drink or flavoured water
Acetylcysteine has the flavour of rotten eggs. It is better tolerated when the taste is disguised by mixing it with a soft drink or flavoured water to increase its palatability. Giving this medication undiluted is not recommended. The use of a straw will help minimize contact with mucous membranes of the mouth and is recommended. The nebulizer form of this medication is used for certain types of pneumonia, not acetaminophen overdose.
A patient is receiving an anticonvulsant but has no history of seizures. What is the most likely reason the patient is receiving this drug?
Pain associated with peripheral neuropathy
Inflammation pain
Depression associated with chronic pain
Prevention of possible seizures
Pain associated with peripheral neuropathy
Transdermal lidocaine is indicated for the treatment of postherpetic neuralgia, a painful skin condition that remains after a skin outbreak of shingles. Tramadol hydrochloride, naloxone hydrochloride, and fentanyl are not indicated for postherpetic neuralgia.
Nalbuphine (Nubain®) is a partial opioid agonist. What characterizes this type of medication? (Select all that apply.)
Used for mild pain
Used for moderate to severe pain
Drug of choice for reversing the effects of opioids in cases of overdose
Usually used for long-term conditions
Usually used for short-term conditions
Sometimes used in those who have a history of opioid addiction
Used for moderate to severe pain
Usually used for short-term conditions
Sometimes used in those who have a history of opioid addiction
Partial opioid agonists are used for moderate to severe pain in conditions requiring short-term pain control, such as after surgery and for obstetric procedures. They are sometimes chosen for patients who have a history of opioid addiction.
Which antiepileptic drug allows once-a-day dosing?
topiramate (Topamax®)
phenobarbital sodium
valproic acid (Depakene®)
gabapentin (Neurontin®)
phenobarbital sodium
Phenobarbital has the longest half-life of all standard antiepileptic drugs, which allows once-a-day dosing.
During the nurse's assessment, the patient describes her seizures as initial muscular contractions throughout her body, then alternating between contractions and relaxation. What kind of seizure is she describing?
Convulsion
Partial seizure
Simple seizure
Generalized tonic-clonic seizure
Generalized tonic-clonic seizure
Generalized tonic-clonic seizures are seizures that involve initial muscular contraction throughout the body (tonic phase) and that then progress to alternating contraction and relaxation (clonic phase).
While teaching a patient about taking a newly prescribed antiepileptic drug (AED) at home, what information should the nurse emphasize?
Driving will be allowed after 2 weeks of therapy.
If seizures recur, the patient should take a double dose of the medication.
Antacids can be taken with the AED to reduce gastrointestinal adverse effects.
Regular consistent dosing is important for successful treatment.
Regular consistent dosing is important for successful treatment.
Consistent medication regularly taken at the same time of day at the recommended dose and with meals to reduce the common gastrointestinal adverse effects, is the key to successful management of seizures with AEDs. Nonadherence is the most notable factor leading to treatment failure.
A patient has a 9-year history of a seizure disorder that has been managed well with phenytoin therapy. He is to receive nothing by mouth because he has surgery in the morning. What should the nurse do about his morning dose of phenytoin?
Give the same dose intravenously.
Give the morning dose with a small sip of water.
Contact the physician for another dosage form of the medication.
Notify the operating room that the medication has been withheld.
Contact the physician for another dosage form of the medication.
The physician should be contacted for an order of the appropriate dosage form of the medication. The route should not be changed without a physician's order. The morning dose should not be given with a small sip of water. Withholding the medication may lead to seizure activity during the surgical procedure.
A patient has been taking carbamazepine (Tegretol®) for several months and is worried because the physician has increased the dose twice since the beginning of therapy. Which is the nurse's best explanation to the patient?
The initial dose was not sufficient to prevent seizures.
Autoinduction results in lower-than-expected drug concentrations.
Because the seizures are difficult to manage, increased doses are needed to control them.
Forgetting to take the medication as prescribed led to a need for increased dosage.
Autoinduction results in lower-than-expected drug concentrations.
With carbamazepine, autoinduction occurs and leads to lower-than-expected drug concentrations. Therefore, the dose may need to be adjusted over time.
When administering phenytoin (Dilantin®) intravenously, what must the nurse remember?
Normal saline is the only solution to be used with phenytoin.
Intravenous (IV) doses must be given rapidly to raise blood levels quickly.
The patient should be monitored closely for tachycardia and increased blood pressure.
Phenytoin can be combined with other solutions without fear of precipitate formation.
Normal saline is the only solution to be used with phenytoin.
IV phenytoin should be given with normal saline solution only. The IV dose must be given slowly. The patient must be monitored for bradycardia and decreased blood pressure. To prevent precipitation formation due to incompatibilities, phenytoin cannot be combined with other solutions.
Which teaching tips is appropriate for the nurse to give a patient taking topiramate (Topamax®)?
Do not chew, crush, or break the tablet.
Take the medication on an empty stomach.
Crush the medication if needed to facilitate swallowing.
If adverse effects are too severe, a dose may be skipped.
Do not chew, crush, or break the tablet.
Topiramate and valproic acid tablets and delayed- or extended-release dosage forms are not to be altered in any way and must be taken as prescribed. Topiramate should be taken whole, not crushed or broken. Taking this medication with meals may help reduce the nausea that may occur. The medication should be taken at the same time each day, and doses should not be skipped. If adverse effects become a problem, the patient should contact the prescriber.
What is the drug of choice for the immediate treatment of status epilepticus?
diazepam (Valium®)
midazolam
valproic acid (Depakene)
carbamazepine (Tegretol)
diazepam (Valium®)
Diazepam rectally administered is an initial emergent drug for status epilepticus.
Phenytoin (Dilantin) has a narrow therapeutic index. Which statement defines this characteristic?
The safe and toxic plasma levels are very close.
Phenytoin has a narrow chance of being effective.
No difference exists between safe and toxic plasma levels.
A very small dosage can result in the desired therapeutic effect.
The safe and toxic plasma levels are very close.
A narrow therapeutic index means that a narrow difference exists between safe and toxic drug levels. These drugs require monitoring of therapeutic plasma levels.
A patient has been taking gabapentin (Neurontin®) for several years as part of the treatment for partial seizures. His wife has called because he ran out of medication this morning, and she wonders whether he can go without it for a week until she can go to the drugstore. Which statement is true in this situation?
Because the patient is taking another antiepileptic drug, he can go a week without the gabapentin.
Stopping this medication abruptly may cause withdrawal seizures.
The patient should temporarily increase the dosage of his other medications.
The patient can probably stop all medication because he has been treated for several years now.
Stopping this medication abruptly may cause withdrawal seizures.
Abrupt discontinuation of the gabapentin can lead to withdrawal seizures.
Which statements about antiepileptic drug (AED) therapy are true? (Select all that apply.)
AED therapy can be stopped when seizures are under control.
AED therapy is usually lifelong.
Consistent dosing is key to control of seizures.
A dose may be skipped if the patient is experiencing adverse effects.
Abrupt withdrawal from AEDs may cause rebound seizure activity.
AED therapy is usually lifelong.
Consistent dosing is key to control of seizures.
Abrupt withdrawal from AEDs may cause rebound seizure activity.
Patients need to know that AED therapy is usually lifelong, and compliance (with consistent dosing) is important for effective seizure control. Antiepileptic drugs must never be abruptly discontinued as it may precipitate rebound seizure activity.
A patient has been taking selegiline (Anipril) for a month and says he understands the "cheese effect" that the doctor explained to him. When the nurse questions him about it, he tells her (correctly) that the cheese effect results in which symptom?
Hypotension
Hypertension
Urinary discomfort
Gastrointestinal upset
Hypertension
The cheese effect causes severe hypertension. This is a major adverse effect of monoamine oxidase inhibitors (MAOIs) because they interact with tyramine-containing foods (cheese, red wine, beer, and yogourt).
A patient newly diagnosed with Parkinson's disease has been given a prescription for levodopa-carbidopa (Sinemet®). The patient comments, however, that a friend was given a prescription for "plain levodopa." What should the nurse explain to this patient about her prescription?
Levodopa alone cannot cross the blood-brain barrier.
There is no real difference between the two prescriptions.
The combination drug is more efficient in increasing the dopamine level in the brain.
Concerns about drug-food interactions with levodopa therapy do not exist with the combination therapy.
The combination drug is more efficient in increasing the dopamine level in the brain.
The addition of carbidopa allows for more of the levodopa to reach the site of action without being broken down. Thus, lower doses of levodopa are needed, and the combination is more efficient in increasing the dopamine level in the brain. Dopamine, unlike levodopa, cannot cross the blood-brain barrier. Drug-food interactions with levodopa therapy alone are not a concern. If a substance interacts with levodopa, it will also interact with the combination of levodopa-carbidopa because the levodopa is the common component in both drugs.
When a patient is taking an anticholinergic, such as benztropine, as part of treatment for Parkinson's disease, what important information should the nurse give the patient as part of the teaching plan?
Avoid vitamin B6 supplements and vitamin-fortified foods.
Discontinue the medication immediately if adverse effects occur.
Take the medication on an empty stomach to enhance absorption.
Take the medication at bedtime to prevent drowsiness during the day.
Take the medication at bedtime to prevent drowsiness during the day.
Anticholinergics should be taken at bedtime to prevent drowsiness during the day. Vitamin B6 interferes with dopaminergics, not anticholinergics. Anticholinergics should not be discontinued suddenly and should be taken with or after meals in order to minimize gastrointestinal upset.
A patient has been treated with antiparkinsonian medications for 3 months. What therapeutic responses should the nurse look for when assessing this patient?
Decreased appetite
Gradual development of cogwheel rigidity
Adverse effects such as confusion, anxiety, irritability, and headache
Improved mental status and an improved ability to think clearly and to perform activities of daily living
Improved mental status and an improved ability to think clearly and to perform activities of daily living
Therapeutic responses to antiparkinsonian drugs include improved mental status and an increased ability to concentrate, think clearly, and perform activities of daily living. Antiparkinsonian drugs result in an increase in appetite, less intense parkinsonian manifestations, and an improved sense of well-being.
Which statement is true in regard to amantadine (Symmetrel) therapy?
It increases the production of dopamine in the basal ganglia.
It works by eliciting the release of dopamine from nerve endings.
It is most effective in the later stages of Parkinson's disease.
It is considered a long-term therapy for Parkinson's disease.
It works by eliciting the release of dopamine from nerve endings.
Amantadine works by eliciting the release of dopamine from nerve endings, not by increasing the production of dopamine in the basal ganglia. Amantadine is most effective in the earlier stages of Parkinson's disease and is usually effective for only 6 to 12 months because the population of functioning nerves diminishes as the disease progresses.
When assessing the past medication history of a patient with a new diagnosis of Parkinson's disease, what is the nurse's concern regarding the patient who will be taking levodopa-carbidopa (Sinemet)?
Glaucoma
Seizure disorder
Bladder difficulties
Benign prostatic hypertrophy
Glaucoma
Glaucoma is a contraindication to the use of levodopa-carbidopa. Seizure disorder is a contraindication to the use of dopaminergic drugs. Bladder difficulties and benign prostatic hypertrophy are contraindications to anticholinergic drugs.
Which nursing diagnosis is appropriate for patients taking anticholinergic drugs?
Diarrhea
Urinary retention
Risk for infection
Ineffective tissue perfusion
Urinary retention
Patients receiving anticholinergic drugs are at risk for urinary retention.
Which statement describes an advantage of catechol ortho-methyltransferase (COMT) inhibitors during the treatment of Parkinson's disease?
They have a shorter duration of action.
They cause less gastrointestinal distress.
They have a slower onset than traditional Parkinson's disease drugs.
They are associated with fewer "wearing-off" effects and have prolonged therapeutic benefits.
They are associated with fewer "wearing-off" effects and have prolonged therapeutic benefits.
COMT inhibitors are associated with fewer "wearing-off" effects and have prolonged therapeutic benefits. COMT inhibitors have a longer duration of action and a quicker onset than traditional drugs and also have gastrointestinal adverse effects.
A patient taking a levodopa preparation for the first time calls the clinic to report dark discoloration of his urine. Which statement is true in this situation?
The discoloration of urine is a harmless effect of the drug.
The patient has taken this drug with red wine or cheese.
The patient is having an allergic reaction to the drug.
The patient has most likely taken extra drug doses.
The discoloration of urine is a harmless effect of the drug.
Levodopa preparations may darken the patient's urine and sweat.
During drug therapy for Parkinson's disease, the nurse monitors for which signs of dyskinesia?
Rigid, tense muscles
Involuntary movements
Limp extremities with weak muscle tone
Confusion and altered mental status
Involuntary movements
Dyskinesia is the difficulty in performing voluntary movements that is experienced by some patients with Parkinson's disease.
When administering an intramuscular injection of risperidone (Risperdal Consta®), the nurse tells the patient that this medication dosage will be effective for how long?
24 hours
48 hours
1 week
2 weeks
2 weeks
The long-acting injectable form of risperidone Risperdal Consta®, and one intramuscular injection lasts approximately 2 weeks.
Before beginning therapy with fluoxetine (Prozac), the nurse should assess for concurrent use of which medication?
acetylsalicylic acid
warfarin sodium
Diuretics
Nonsteroidal anti-inflammatory drugs
warfarin sodium
The use of second-generation antidepressants (such as fluoxetine) with warfarin results in an increased anticoagulant effect.
DIF: Cognitive Level: Comprehension
When the nurse is teaching the patient about monoamine oxidase inhibitors (MAOIs), which is important to emphasize?
Serum blood levels should be drawn every 2 weeks.
If drowsiness occurs, stop the medication immediately.
Drowsiness should decrease after the first few weeks of therapy.
Foods high in tyramine—such as cheese, beer, and wine—must be avoided.
Foods high in tyramine—such as cheese, beer, and wine—must be avoided.
If a patient is taking an MAOI, caution the patient to avoid over-the-counter (OTC) cold and flu products. Foods or beverages high in tyramine must also be avoided.
A patient has been taking haloperidol for 3 months for a psychotic disorder. Because the nurse is concerned about the development of extrapyramidal symptoms, the patient will be monitored for which symptom?
Cogwheel rigidity and blurred vision
Drowsiness and dizziness
Motor restlessness and muscle spasms
Dry mouth and constipation
Motor restlessness and muscle spasms
Extrapyramidal symptoms are involuntary motor symptoms similar to those associated with Parkinson's disease. This drug-induced state is known as pseudoparkinsonism and is characterized by symptoms such as akathisia (distressing motor restlessness) and acute dystonia (painful muscle spasms).
A patient has been taking the MAOI phenelzine (Nardil®) for 6 months. The patient says he's going out to the local bar to meet a few friends for a beer. What important information should the nurse tell this patient?
Drinking beer is permitted as long as there is a designated driver.
He has no further dietary restrictions because he has taken the last dosage.
If he begins to experience a throbbing headache, rapid pulse, or nausea, he should stop drinking.
He needs to avoid foods with tyramine while on this medication.
He needs to avoid foods with tyramine while on this medication.
Patients taking an MAOI need to be cautioned about avoiding OTC cold and flu products as well as foods or beverages high in tyramine.
A 22-year-old female has been taking lithium (Carbolith®) for 6 months. She has blood work every month, and the nurse assesses her for signs of toxicity. What are the indications of toxicity?
Serum lithium level of 0.8 mmol/L and excitability
Serum lithium level of 1.0 mmol/L and palpitations
Serum lithium level of 1.3 mmol/L and hypertension
Serum lithium level of 2.3 mmol/L and cardiac dysrhythmias
Serum lithium level of 2.3 mmol/L and cardiac dysrhythmias
Lithium levels exceeding 2.0 mmol/L produce moderate to severe toxicity, and cardiac dysrhythmias are possible adverse effects.
A patient taking clozapine has shown marked improvement. Which statement by this patient indicates the experiencing of a common adverse effect of clozapine?
"I have been losing weight."
"I don't feel like eating at all."
"Look at how red my hands are."
"My mouth has been so dry lately."
"My mouth has been so dry lately."
Adverse effects of clozapine include tachycardia, akathisia, agitation, asthenia, ataxia, seizures, dyskinesia, dizziness, drowsiness, headache, insomnia, dry mouth, dyspepsia, anxiety, increased appetite, and weight gain.
A 44-year-old patient has been taking sertraline (Zoloft®), a selective serotonin reuptake inhibitor (SSRI), for 4 months. The patient tells the nurse about having an interest in natural health products and wants to start taking St. John's wort. Which statement to the patient is an appropriate response from the nurse?
"That should be no problem."
"Soon you'll be able to stop taking the Zoloft!"
"Be sure to stop taking the herb if you notice a change in adverse effects."
"Taking St. John's wort with Zoloft may cause severe interactions and is not recommended."
"Taking St. John's wort with Zoloft may cause severe interactions and is not recommended."
The herbal product St. John's wort should not be used with SSRIs. Potential interactions include confusion, agitation, muscle spasms, twitching, and tremors.
Which ethnic group often requires lower doses of benzodiazepines and tricyclic antidepressants?
Indigenous peoples
Asians
Latin Americans
Somalis
Asians
Asians have a lower activity of drug metabolism and thus often require lower doses of benzodiazepines and tricyclic antidepressants than with White people require.
St. John's wort is a natural health product that some people use for the treatment of mild to moderate symptoms of depression. Use of St. John's wort is contraindicated in patients with which conditions?
Schizophrenia, Alzheimer's disease
Benign prostatic hypertrophy, diabetes
Dementia, emphysema
Heart disease, schizophrenia
Schizophrenia, Alzheimer's disease
St. John's Wort is contraindicated in patients with bipolar disorder, schizophrenia, Alzheimer's disease, and other forms of dementia.
A nurse is monitoring a depressed patient who has just started antidepressant therapy. During which time period does the patient have the highest potential for self-injury and suicide?
At the beginning, before drug therapy is started
The period between the start of therapy and symptomatic improvement
Between 1 and 4 weeks of drug therapy
After 6 months of drug therapy
The period between the start of therapy and symptomatic improvement
Several weeks may pass before the therapeutic effects of antidepressants are evident. After the start of therapy and before symptomatic improvement, careful monitoring of the patient (being readily available) and providing supportive care are critical to the therapeutic approach because during this time period, the patient may be at highest risk for self-harm and suicide.
Which is a reason that SSRIs are more widely prescribed today than are tricyclic antidepressants (TCAs)?
SSRIs have fewer sexual adverse effects.
Unlike TCAs, SSRIs do not have drug-food interactions.
TCAs can cause serious cardiac toxicities if an overdose occurs.
SSRIs therapeutically respond faster than tricyclic antidepressants.
TCAs can cause serious cardiac toxicities if an overdose occurs.
These newer antidepressants offer several attractive advantages over the traditional TCAs and MAOIs. SSRIs are associated with significantly fewer and less-severe adverse effects and systemic adverse effects.
The wife of a patient who has been diagnosed with depression calls the office and says, "It's been an entire week since he started that new medicine for his depression, and there's no change! What's wrong with him?" Which statement is the best response from the nurse?
"The medication may not be effective for him. He may need to try another type."
"It may take up to 4 weeks to notice any therapeutic effects. Let's wait a little longer to see how he does."
"It sounds like he is tolerant to the drug. I'll check about increasing the dosage."
"Some patients never recover from depression. He may not respond to this therapy."
"It may take up to 4 weeks to notice any therapeutic effects. Let's wait a little longer to see how he does."
Patients should be told that antidepressant drugs commonly require several weeks before full therapeutic effects can be noted and that these drugs can take up to 6 weeks to reach their full therapeutic effect.
A patient with a history of anxiety attacks is given a medication for these episodes. Which medication is appropriate for this problem?
fluphenazine
phenobarbital
bupropion
buspirone hydrochloride
buspirone hydrochloride
Buspirone hydrochloride is a nonbenzodiazepine that is indicated for treatment of anxiety.
Which breakfast choice by a patient taking an MAOI indicates the need for additional teaching?
Orange juice
Fried eggs
Cheddar cheese omelet
French toast
Cheddar cheese omelet
Aged cheeses, such a cheddar cheese, contain tyramine. Patients who are taking MAOIs need to avoid tyramine-containing foods because of a severe hypertensive reaction that may occur.
Which statements are true regarding SSRIs? (Select all that apply.)
Foods and beverages containing tyramine should be avoided.
The nurse should monitor for extrapyramidal symptoms.
A potentially hazardous effect called serotonin syndrome may occur.
Therapeutic effects may not be seen for about 8 weeks after the medication is started.
If the patient has been on an MAOI, a 2- to 5-week or longer span of time should elapse before beginning an SSRI medication.
These drugs have anticholinergic effects, including constipation, urinary
retention, dry mouth, and blurred vision.
SSRIs are associated with fewer side effects than are the older first-generation antidepressants.
St. John's Wort is often recommended to reduce the side effects that may occur with SSRIs.
A potentially hazardous effect called serotonin syndrome may occur.
Therapeutic effects may not be seen for about 8 weeks after the medication is started.
If the patient has been on an MAOI, a 2- to 5-week or longer span of time should elapse before beginning an SSRI medication.
SSRIs are associated with fewer side effects than are the older first-generation antidepressants.
"A potentially hazardous effect called serotonin syndrome may occur," "Therapeutic effects may not be seen for about 8 weeks after the medication is started," "If the patient has been on an MAOI, a 2- to 5-week or longer span of time should elapse before beginning an SSRI medication," and "SSRIs are associated with fewer side effects than are the older first-generation antidepressants" are true statements that apply to SSRIs. The other statements apply to other classes of psychotherapeutic agents. St. John's Wort is contraindicated when a patient is taking an SSRI.
A patient newly diagnosed with hypothyroidism received a prescription for a thyroid drug. In addition to assessing for hypersensitivity and myocardial infarction, for what should the nurse also assess before administering the thyroid drug?
Infections
Diabetes mellitus
Lupus erythematosus
Adrenal insufficiency
Adrenal insufficiency
Adrenal insufficiency is a contraindication to the administration of thyroid drugs.
A patient with hypothyroidism is given a prescription for levothyroxine (Synthroid®). When the nurse explains that levothyroxine is a synthetic form of the thyroid hormone, the patient states that a more natural form of drug would be personally preferred. What is the nurse's best explanation to the patient for the use of levothyroxine?
The synthetic form has a stronger effect than the natural forms.
Levothyroxine is less expensive than the natural forms.
The oral form has fewer adverse effects on the gastrointestinal tract.
Because the half-life of levothyroxine is longer than that of the natural forms, once-a-day dosing is possible.
Because the half-life of levothyroxine is longer than that of the natural forms, once-a-day dosing is possible.
An advantage of levothyroxine over the natural forms is that it needs to be administered only once a day because of its long half-life. As well, its effects are more predictable than those of natural thyroid preparations.
The nurse is discussing thyroid replacement therapy and establishing treatment goals with a patient. What important adverse effects should the nurse discuss with the patient?
Edema, anemia, and hepatitis
Pruritus, myalgia, leukopenia, and paresthesia
Tachycardia, dysrhythmias, weight loss, and fever
Skin pigment changes, bleeding, and menstrual irregularities
Tachycardia, dysrhythmias, weight loss, and fever
Some of the more serious adverse effects of thyroid drugs are tachycardia, dysrhythmias, weight loss, and fever.
When teaching a patient on antithyroid medication about diet, which direction should be included?
Use iodized salt when cooking.
Avoid foods containing iodine.
Increase fluid intake to 2 500 mL per day.
Increase intake of sodium- and potassium-containing foods.
Avoid foods containing iodine.
Clients on antithyroid therapy should avoid iodine-containing foods.
A patient is taking propylthiouracil for hyperthyroidism and asks the nurse how this medication works. In answer to the patient's question, the nurse tells the patient that propylthiouracil
Blocks the action of thyroid hormone
Impedes the formation of thyroid hormone
Destroys overactive cells in the thyroid gland
Inactivates already existing thyroid hormone in the bloodstream
Impedes the formation of thyroid hormone
Propylthiouracil impedes the formation of thyroid hormone but has no effect on already existing thyroid hormone.
A patient has been diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine (Synthroid®). After 1 week, the patient tells the nurse that she feels no better. The nurse would best tell the patient that
she will probably require surgery for a cure.
levothyroxine does not reach its peak effect for several months.
she probably did not take her medication as instructed.
her diet may be causing absorption problems.
levothyroxine does not reach its peak effect for several months.
The therapeutic effects of thyroid drugs may take several months to occur. Patients taking thyroid drugs should be aware of this fact.
7. Which drugs should be avoided while taking thyroid replacement preparations?
Vitamin supplements
Antibiotics
Anticoagulants
β-Blockers
Anticoagulants
Drugs that interact with thyroid replacement preparations include anticoagulants, cholestyramine, hypoglycemic drugs, and digoxin.
Which symptoms indicate a too-high dose of thyroid replacement hormone?
Bradycardia, somnolence, and ataxia
Anxiety, weight loss, and insomnia
Dry skin, weakness, and weight gain
Drowsiness, coughing, and neck pain
Anxiety, weight loss, and insomnia
The adverse effects of thyroid medications are usually the result of overdose. Anxiety, weight loss, and insomnia are a few of the more common adverse effects.
Which condition may be caused by low levels of thyroid hormone in youth?
Goiter
Myxedema
Cretinism
Addison's disease
Cretinism
Hyposecretion of thyroid hormone during youth may lead to cretinism.
A patient has been taking levothyroxine (Synthroid) for more than a decade for primary hypothyroidism. She tells the nurse that her cousin can get her the same medication in a generic form from a pharmaceutical supply company. What would be best for the nurse to say to the patient?
"That would be a great way to save money."
"There's no difference in brands of this medication."
"Switching the form of medication should never be done; once you start with a certain brand, you must stay with it."
"It's better not to switch brands until we check with your doctor."
"It's better not to switch brands until we check with your doctor."
Switching between different brands of levothyroxine during treatment can destabilize the course of treatment and should be minimized. If a switch is made, the patient should be closely monitored.
A patient has been diagnosed with primary hypothyroidism. Which statement accurately describes this condition?
The hypothalamus is not secreting thyrotropin-releasing hormone; therefore, thyroid-stimulating hormone (TSH) is not released from the pituitary gland.
The pituitary gland is dysfunctional and is not secreting TSH.
The abnormality is in the thyroid gland itself.
The abnormality is caused by an excess intake of iodine.
The abnormality is in the thyroid gland itself.
Primary hypothyroidism stems from an abnormality in the thyroid gland itself and occurs when the thyroid gland is not able to perform one of its many functions.
Which are the two thyroid hormones produced by the thyroid gland?
Di-iodothyronine (T2) and tri-iodothyronine (T3)
Thyroxine and tri-iodothyronine
Levothyroxine and thyroxine
Thyronine and liothyronine
Thyroxine and tri-iodothyronine
Thyroxine (T4) and tri-iodothyronine (T3) are the two hormones produced by the thyroid gland.
The nurse is giving morning medications. The medication administration record has an order for levothyroxine 75 mcg. The drug dispensing cabinet contains levothyroxine tablets in milligrams, not in micrograms. Calculate the milligram equivalent dose of 75 micrograms.
0.075 mg
There are 1 000 micrograms in 1 milligram. 75 mcg = 1000 mcg x = 0.075 mg
x mg 1 mg
Which is a true statement about Humulin-N® insulin?
It is a long-acting insulin.
It is a rapid-acting insulin.
It is an intermediate-acting insulin.
It is given based on blood glucose levels measured before meals.
It is an intermediate-acting insulin.
Humulin-N insulin is an intermediate-acting insulin.
What early signs of hypoglycemia should the nurse should tell the patient about?
Urticaria and rash
Nausea and diarrhea
Irritability and confusion
Fruity, acetone odour to the breath
Irritability and confusion
Irritability and confusion are early signs of hypoglycemia.
A patient has just been prescribed insulin.What should the nurse tell this patient to do to take the insulin correctly?
Use the injection site that is the most accessible.
During times of illness, increase insulin dosage by 25%.
When mixing insulins, draw the cloudy insulin (such as neutral protamine
Hagedorn [NPH] insulin) up into the syringe first.
When mixing insulins, draw the clear insulin (such as regular insulin) up into the syringe first.
When mixing insulins, draw the clear insulin (such as regular insulin) up into the syringe first.
When mixing insulins, the regular insulin should always be drawn up into the syringe first. Patients taking insulin should always rotate the injection sites and should notify their physician if they become ill.
Which is a true statement regarding acarbose, a glucose-elevating drug?
It is also naturally synthesized by the pancreas.
It is used for the treatment of hypotensive emergencies.
It is only available as an α-glucosidase inhibitor.
It stimulates insulin release from the pancreas.
It is only available as an α-glucosidase inhibitor.
Acarbose (Glucobay®) is the only available α-glucosidase inhibitor. Acarbose works by blunting the elevation of blood glucose levels after a meal.
A 75-year-old patient with type 2 diabetes mellitus has recently been placed on glyburide (DiaBeta®) 10 mg daily. When is the best time to take this medication?
At night
With breakfast
After the midday meal
Any time of day
With breakfast
The medication should be taken in the morning with breakfast to prevent hypoglycemia at night.
A patient who has type 2 diabetes is scheduled for a laparoscopy and has been NPO (nil per os [taking nothing by mouth]) since midnight. The patient is concerned about having to hold the medication. What is the best action for the nurse to take regarding the administration of the patient's oral antidiabetic drug?
Give the patient half the original dose.
Hold all medications as ordered.
Contact the physician for further orders.
Give the patient the medication with a sip of water.
Contact the physician for further orders.
When a patient with diabetes is NPO, the physician should be contacted for further orders regarding the administration of the oral antidiabetic drugs.
A patient with type 2 diabetes self-administers insulin injections as part of therapy. What should the nurse tell this patient to do if she has hypoglycemia?
Call the physician.
Administer regular insulin.
Take an oral form of glucose.
Rest until the symptoms pass.
Take an oral form of glucose.
Hypoglycemia can be reversed if the patient uses glucagon. The patient can take glucose tablets (liquid or gel), corn syrup, or honey; drink fruit juice or a nondiet soft drink; or eat a small snack, such as crackers or half a sandwich.
The nurse is teaching a patient about self-injection of insulin.What should the nurse tell the patient to do regarding injection sites?
Avoid the abdomen because absorption is irregular.
Choose a different site at random for each injection.
Give the injection in the same area each time to promote consistent absorption.
Rotate sites within the same location for about 1 week before rotating to a new location.
Rotate sites within the same location for about 1 week before rotating to a new location.
Patients taking insulin injections should be instructed to rotate sites within the same location for about 1 week. That is, all injections should be rotated in one area, such as the right arm, for about 1 week before rotating to a new location, such as the left arm, the following week. Each injection should be at least 1.25 to 2.5 cm away from the previous site.
A patient has been prescribed a rapid-acting insulin, such as insulin lispro. What important information should the nurse give this patient about taking this type of insulin?
It should be taken within 15 minutes of beginning a meal.
It should be taken after the meal.
Dosing is once daily at the midday meal.
It is taken only in the evenings with a snack before bedtime.
It should be taken within 15 minutes of beginning a meal.
Rapid-acting insulins such as insulin lispro and insulin aspart are able to more closely mimic the body's natural rapid insulin output after a meal. For this reason, both are usually dosed within 15 minutes of beginning a meal.
Six months after starting treatment for type 2 diabetes, a patient has a follow-up examination. Which laboratory test will best reflect the patient's adherence to the antidiabetic therapy over the past few months?
Hemoglobin and hematocrit levels
Hemoglobin A1c level
Fingerstick fasting blood glucose
Serum insulin levels
Hemoglobin A1c level
The hemoglobin A1c level reflects the patient's adherence to the therapy regimen for several months previously, thus evaluating the patient's progress with diet and drug therapy.
A patient with a history of chronic obstructive pulmonary disease (COPD) and type 2 diabetes has been treated for pneumonia for the past week. He has been receiving corticosteroids intravenously and antibiotics as part of his therapy. His pneumonia has resolved, but when the nurse monitors his blood glucose levels, his blood glucose is still elevated and he requires small amounts of sliding scale insulin coverage. What is the best explanation for this elevation?
The antibiotics may have caused an increase in glucose levels.
The corticosteroids may have caused an increase in glucose levels.
His type 2 diabetes has converted to type 1 diabetes.
The hypoxia from the COPD has caused an increased need for insulin.
The corticosteroids may have caused an increase in glucose levels.
Corticosteroids can antagonize the hypoglycemic effects of insulin, resulting in elevated blood glucose levels.
When should the nurse administer acarbose (Glucobay), an α-glucosidase inhibitor?
Thirty minutes before breakfast
With the first bite of each main meal
Thirty minutes after breakfast
Once daily, at bedtime
With the first bite of each main meal
When an α-glucosidase inhibitor is taken with the first bite of a meal, excessive postprandial blood glucose elevation (a glucose "spike") can be reduced or prevented.
A 48-year-old male patient is diagnosed with metabolic syndrome and is started on biguanide metformin (Glucophage®). He asks the nurse why he needs this drug. The nurse's best explanation of the purpose of the metformin is that it
increases the pancreatic secretion of insulin.
decreases glucose production by the liver.
increases intestinal absorption of glucose.
decreases the pancreatic secretion of insulin.
decreases glucose production by the liver.
Metformin works by decreasing glucose production by the liver. It may also decrease intestinal absorption of glucose and improve insulin receptor sensitivity. This results in increased peripheral glucose uptake and use and in decreased liver product ion of triglycerides and cholesterol.
When administering morning medications for a newly admitted patient, the nurse notes that the patient has an allergy to sulfa drugs. The patient has an order for sulfonylurea gliclazide (Diamicron®). What is the best action for the nurse to take?
Give the drug as ordered 30 minutes before breakfast.
Hold the drug, and check the order with the physician.
Give the drug and monitor for adverse effects.
Give a reduced dose of the drug with breakfast.
Hold the drug, and check the order with the physician.
There is an increased risk of cross-allergy when a patient who is allergic to sulfa drugs takes a sulfonylurea drug for diabetes. Therefore, the drug should be held and the order checked with the physician.
Which types of insulin can be administered intravenously?
Regular insulin
NPH insulin
insulin glargine (Lantus®)
insulin detemir (Levemir®)
Regular insulin
Regular insulin is the only insulin product that can be administered intravenously.
For each insulin product listed below, identify the type of action by using these designations:
MATCH:
Rapid-acting: RA
Short-acting: SA
Intermediate-acting: IA
Long-acting: LA
Glargine insulin
Aspart insulin
Regular insulin
NPH insulin
Glargine insulin - Long-acting: LA
Aspart insulin - Rapid-acting: RA
Regular insulin - Short-acting: SA
NPH insulin - Intermediate-acting: IA
Which is a true statement about prednisone (Winpred®)?
It is a short-acting glucocorticoid.
It has potent mineralocorticoid activity.
It is the preferred oral glucocorticoid for anti-inflammatory purposes.
It may be administered by inhalation for the treatment of bronchial asthma.
It is the preferred oral glucocorticoid for anti-inflammatory purposes.
Prednisone is the preferred oral glucocorticoid for anti-inflammatory purposes and is intermediate acting.
What important information about taking adrenal drugs is appropriate for the nurse to give a patient?
To maximize their absorption, oral drugs should be taken before meals.
The patient should rinse the oral cavity after using the steroid inhalers.
Corticosteroids should be taken before bedtime to minimize adrenal suppression.
The medication is to be immediately discontinued if a weight gain of more than 2.25 kg occurs in 1 week.
The patient should rinse the oral cavity after using the steroid inhalers.
After using the steroid inhalers, rinsing the oral cavity helps to prevent oral fungal infections from developing. Adrenal drugs should be taken with meals in order to minimize gastrointestinal upset and in the morning to minimize adrenal suppression. Adrenal drugs should be discontinued by weaning, not by stopping abruptly.
Which type of drugs can have an adverse interaction with corticosteroids?
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Antibiotics
Narcotic analgesics
Oral anticoagulants
Nonsteroidal anti-inflammatory drugs (NSAIDs)
The use of corticosteroids with NSAIDs produces adverse gastrointestinal effects.
A patient is concerned about the body changes that have resulted from long-term prednisone (Winpred®) therapy for the treatment of lupus erythematosus. Which effect of this drug therapy supports the nursing diagnosis of disturbed body image?
Weight loss
Weight gain
Pale skin colour
Loss of hair
Weight gain
Facial erythema, weight gain, hirsutism, and "moon face" (characteristic of Cushing's syndrome) are body changes that may occur with long-term prednisone therapy.
A patient is taking fludrocortisone (Florinef®) for Addison's disease. His wife is concerned about all the problems that may occur with this therapy.Which is a true statement about fludrocortisone therapy?
It may cause severe postural hypotension.
To minimize gastrointestinal upset, the medication should be taken with food or milk.
The medication should be stopped immediately if nausea or vomiting occurs.
Weight gain of 2.3 kg or more in 1 week is an expected adverse effect.
To minimize gastrointestinal upset, the medication should be taken with food or milk.
To minimize gastrointestinal upset, patients receiving fludrocortisone should take it with food or milk. Hypotension is a sign and symptom of Addison's disease or adrenal insufficiency; it will not result from taking fludrocortisone. Weight gain of more than 1 kg in 24 hours or 2.3 kg in 1 week should be reported to the physician. Abrupt withdrawal is not recommended, because it may precipitate an adrenal crisis.
What may be caused by systemically administered glucocorticoids?
a. Dehydration
b. Hypokalemia
c. Hyperkalemia
d. Hypoglycemia
c. Hyperkalemia
Systemic glucocorticoid drugs may cause hyperkalemia.
Which are the expected symptoms of undersecretion of adrenocortical hormones?
Osteoporosis
Steroid psychosis
Dehydration and weight loss
Water retention
Dehydration and weight loss
Dehydration and weight loss are associated with undersecretion of adrenocortical hormones (Addison's disease).
Which are contraindications to the administration of glucocorticoid drugs?
Glaucoma and mental health illnesses
Peptic ulcer disease and dizziness
Varicella and headaches
Cataracts and nausea
Glaucoma and mental health illnesses
Contraindications to the administration of glucocorticoids include glaucoma, mental health illnesses, drug allergies, cataracts, peptic ulcer disease, and diabetes; glucocorticoids can intensify these diseases and conditions. These drugs are also often avoided in cases of infection.
Which are indications for glucocorticoid drugs? (Select all that apply.)
Glaucoma
Cerebral edema
Chronic obstructive pulmonary disease and asthma
Organ transplantation
Varicella
Spinal cord injury
Septicemia
Rhinitis
Cerebral edema
Chronic obstructive pulmonary disease and asthma
Organ transplantation
Spinal cord injury
Rhinitis
Cerebral edema, chronic obstructive pulmonary disease and asthma, organ transplantation, spinal cord injury, and rhinitis are indications for glucocorticoid therapy. Glaucoma, varicella, and septicemia are contraindications to glucocorticoid therapy.
Which instruction is correct for a patient taking an antihistamine?
Eat chocolate bars to ease the discomfort of dry mouth.
Antihistamines are generally safe to take with over-the-counter (OTC)
medications.
Take the medication on an empty stomach to maximize absorption of the drug.
Take the medication with food, even though doing so may slightly reduce the absorption of the drug.
Take the medication with food, even though doing so may slightly reduce the absorption of the drug.
Antihistamines should be taken with food to minimize the gastrointestinal upset that can occur, even though doing so slightly reduces the absorption of the drug. The patient can suck on candy or chew gum to ease dry mouth discomfort. OTC medications should not be taken with an antihistamine unless approved by the physician; taking antihistamines with OTC medications may lead to serious drug interactions.
How does the antitussive dextromethorphan (Benylin DM-E®) work to suppress the cough reflex?
By causing central nervous system (CNS) depression
By anaesthetizing the stretch receptors
Through a direct action on the cough centre
By decreasing the viscosity of the bronchial secretions
Through a direct action on the cough centre
Dextromethorphan suppresses the cough reflex through direct action on the cough centre.
Which antihistamine is commonly used in the treatment of motion sickness?
cyproheptadine hydrochloride
Loratadine (Claritin)
Reactine®
Codeine phosphate
cyproheptadine hydrochloride
Cyproheptadine hydrochloride is commonly used in the treatment of motion sickness.
During a routine checkup, the patient reports an inability to take the prescribed antihistamine because of one of its most common adverse effects. The physician prescribes another antihistamine, loratadine (Claritin®). What adverse effect has probably been bothering this patient?
Diarrhea
Urticaria
Drowsiness
Decreased libido
Drowsiness
People who take antihistamines chiefly report drowsiness. Loratadine is a unsedating antihistamine which eliminates many of the adverse effects of the older antihistamines, particularly drowsiness.
A gardener needs a decongestant because of seasonal allergy problems. Which is a benefit of orally administered decongestants?
Onset is immediate.
The effect is more potent.
Rebound congestion is almost nonexistent.
The adverse effects of restlessness and nervousness are reduced.
Rebound congestion is almost nonexistent.
Rebound congestion is almost nonexistent with the use of oral decongestants. Compared with topically applied decongestants, the onset of orally administered decongestants is more delayed, and the effect is less potent. Nervousness is an adverse effect of decongestants.
A patient is taking guaifenesin (Balminil®) as part of treatment of influenza. What should the nurse also instruct the patient to do?
Increase fluids to help loosen and liquefy secretions.
Report a fever to the doctor if body temperature is above 38.3°C.
Avoid driving a car or operating heavy machinery, because of the drug’s sedating effects.
To retain the effects of the medication for a longer period, avoid coughing.
Increase fluids to help loosen and liquefy secretions.
Increasing fluids helps to loosen and liquefy secretions.
What systemic effect may occur with the administration of a topically applied adrenergic nasal decongestant?
a. Heartburn
b. Bradycardia
c. Hypotension
d. Nervousness
d. Nervousness
If a topically administered adrenergic nasal decongestant is absorbed into the bloodstream, CNS effects such as nervousness may occur; hypertension and palpitations may also occur. Heartburn is not an adverse effect of topically applied adrenergic nasal decongestants.
Which drug is most likely to be chosen to aid in the removal of excessive mucus in the respiratory tract?
a. guaifenesin
b. benzonatate
c. codeine
d. dextromethorphan
a. guaifenesin
Expectorants, such as guaifenesin, work to loosen and thin sputum and bronchial secretions, thereby indirectly diminishing the tendency to cough. Benzonatate, codeine, and dextromethorphan are antitussives (cough suppressants).
The nurse knows that an antitussive drug is most appropriate for which patient?
A patient with pneumonia who has a productive cough
A patient who has a tracheostomy and thick mucus secretions
A patient who has had a productive cough for 2 weeks
A patient who has developed bronchitis 2 days after hernia repair surgery
A patient who has developed bronchitis 2 days after hernia repair surgery
In a patient who has developed bronchitis 2 days after hernia repair surgery, antitussive drugs help to prevent coughing that is considered harmful rather than useful. Coughing is beneficial in a patient with pneumonia who has a productive cough, in a patient who has a tracheostomy and thick mucus secretions, and in a patient who has had a productive cough for 2 weeks.
A patient has been advised to add a nasal spray (an adrenergic decongestant) to treat a cold. What should the nurse tell the patient in regard to the nasal spray?
Expect the spray's effects to be delayed for at least 1 week.
Administer as ordered with no increase in frequency.
Continue using the spray until the nasal stuffiness has resolved.
Avoid using the spray if a fever develops.
Administer as ordered with no increase in frequency.
Counsel patients to use nasal decongestant dosage forms exactly as ordered and with no increase in frequency. Excessive use of decongestant nasal sprays or drops may lead to rebound congestion.
Because of many reported adverse events, which groups of children should not be given cough and cold medications?
Children younger than 2 years of age
Children younger than 4 years of age
Children younger than 6 years of age
Children younger than 8 years of age
Children younger than 6 years of age
Children younger than 6 years of age should not be given cough and cold medication. Many adverse events have been reported in regard to these medications and children younger than 6 years of age. Insufficient research has been done into the use of these medications in children.
A patient is taking aminophylline intravenously for a severe exacerbation of chronic obstructive pulmonary disease. Which effect does the nurse expect to note when evaluating for a therapeutic response to the medication?
Drowsiness
Increased heart rate
Increased respiratory rate
Increased ease of breathing
Increased ease of breathing
The therapeutic effects of bronchodilating drugs such as xanthine derivatives include increased ease of breathing.