NR 293 QUiz 2 review Questions and answers + rationales

1.The nurse is administering an antipsychotic drug clozapine (Clozaril) and should monitor the patient for what long-term problem(s) associated with this drug?

A. mood swings

B. agranulocytosis

C. weight gain

D. photosensitivity

E. increased appetite

b,c,e

2.During therapy for depression with a selective serotonin reuptake inhibitor, it is most important for the nurse to instruct the family to monitor for which adverse effect?

A. suicidal thoughts

B. visual disturbances

C. tardive dyskinesia

D. bleeding tendencies

a

.The wife of a patient who has started taking anti-depressant therapy asks, "How long will it take for him to feel better?" What is the nurse's best response?

A."Well, depression rarely responds to medication therapy."

B."He should feel better in a few days."

C."It may take 4 to 6 weeks for you to see an improvement."

D."You may not see effects for several months."

C

When administering certain antipsychotic drugs, the nurse monitors for extrapyramidal effects such as: (select all that apply)

A. tremors

B. elation and sense of well being

C. painful muscle spasms

D. monitor restlessness

E. bradycardia

a,c,d

The nurse instructs a patient who is undergoing therapy with monoamine oxidase inhibitors to avoid tryamine- containing food. What medical emergency may occur if the atient eats these foods?

A. gastric hemmorhage

B. toxic shock

C. cardiac arrest

D. hypertensive crisis

D

A patient has been taking antipsychotic drugs for years, and his wife has noticed that he has had some new physical symptoms. She describes him as having odd facial movements, sticking out is tongue, and having movements of his arms that cannot be controlled. The nurse suspects the patient is exhibiting signs of which condition?

A. hypomania

B. serotonin syndrome

C. tardive dyskinesia

D. neuroleptic malignant syndrome

C

.Which outcome represents the most serious adverse effect of lithium?

A. renal failure

B. hyponatremia

C. respiratory syndrome

D. cardiac dysyrhythmia

D

Primary side effects of SSRIs include which of the following symptoms?

A. rash and alopecia

B. gastritis and diarrhea

C. weight gain and sexual dysfunction

D. photosensitivity and discoloration of the skin

C

a patient will be receiving benztropine (coegentin) 1.5 mg PO daily. the med comes in 0.5mg tabs how many tabs will the nurse give?

3

busprione (BuSpar)

tyramine

aged foods; pts taking MAOI need to avoid this

tricyclics

an older class of antidepressant drugs

mania

state characterized by an expansive emotional state i.e. extreme excitement and elation and hyperactivity

Diazepam (Valium)

long lasting benzo

Amitriptyline (Elavil)

most widely used tricyclic antidepressant

Risperidone (risperdal)

atypical antipsychotic used to treat schizophrenia

Benzodiazepines (benzo)

group of psychotropic drug prescribed to alleviate anxiety

Lithium (Eskalith)

Medication use for Mania symptoms of bipolar

anxiety

unpleasant emotional state of mind in which real or imaginary dangers are anticipated or exaggerated

affective disorders

Emotional disorders that are characterized by changes in mood.

depression

abnormal emotional state characterized by exaggerated feelings of sadness, melancholy, and worthlessness out of proportion to reality

bipolar affective disorder

A major psychological disorder characterized by episodes of mania or hypomania, cycling with depression

extrapyramidal

Term for the symptoms/adverse effects that often occur with antipsychotic medications

cocaine

stimulant that is either "snorted" through the nose or injected intravenously

ecstasy

stimulant that is popular at "raves" with college age students

Flumazenil

use to antagonize the action of benzo and reverse sedation

Heroin

an opioid that is injected by mainlining or skin popping

Disulfiram

used to deter the use of alcohol during alcohol treatment

nicotine

addictive chemical in Tabaco products

Naltrexone

opioid antagonist use for opioid abuse or dependence

buptopion

nicotine free treatment for nicotine dependence

Methamphetamine

substance commonly manufactured from the OTC decongestant pseudoephedrine

Roofies

AKA date rape drug

a patient who has been taking disulfiram therapy for 3 months has been off the therapy for 2 days. he decides to go out with friends and have a beer. what effects may he experience? (select all that apply)

a. diaphoresis

b. diarrhea

c. vomiting

d. euphoria

e. drowsiness

f. facial flushing

a,c,f

during an information session about drug abuse, the nurse relates that the most common drug effect that leads to abuse of opioids is....

a. halluciniations

b. sleepiness

c. stimulation

d. euphoria

d

the nurse is assisting a patient who is experiencing opioid withdrawal and anticipates the possible use of which med to lesson the symptoms of withdrawal? (select all that apply)

a. disulfiram

b. clonidine

c. methadone

d. bupropion

e. naloxone

b,c,e

when teaching a patient bout drug interactions, the nurse is aware that combining benzos with ethanol or barbiturates may lead to death from....

a. cardiac dysrhythmia

b. convulsions

c. respiratory arrest

d. stroke

c

a patient with a known history of chronic excessive ingestion of ethanol has developed memory problems and comes to the health clinic with hard to believe stories of what happened to him. the nurse recognizes that these symptoms are associated with which disorder?

a. cerebrovascular accident

b. Korsakoff's psychosis

c. encephalopathy

d. bipolar disorder

b

the nurse is teaching a class to high school students regarding the negative effects of nicotine on the body. The nurse would include which effects? (select all that apply)

a. stimulation followed by depression

b. increased HR and BP

c. constipation

d. vomiting

e. insomnia

a,b

a patient is to receive flumazenil 0.2 mg, IV push over 30 seconds as initial treatment for a possible benzo OD. the med is available in a 0.1 mg/ mL vial. how many mL will the nurse draw up?

2 mL

what is another name for the adrenergic drug?

a. anticholinergic drug

b. parasympathetic drug

c. CNS drug

d. sympathomimetic drug

D

the nurse is administering an adrenergic drug and will monitor for which possible effect?

a. hypotension

b. Tachycardia

c. decreased respiratory rate

d. diarrhea

b

the nurse is aware that adrenergic drug may be used to treat which conditions? (select all that apply)

a. asthma

b. open angle glaucoma

c. hypertension

d. nasal congestion

e. seizures

f. N/V

a,b,d

a women who is allergic to bees has just been stung while out in her garden, she reaches for her beestings kit, which would most likely contain which drug?

a. epinephrine

b. phenylephrine

c. formoterol

d. norepinephrine

a

a 13 year old girl was diagnosed with asthma 2 years ago. today her doctor wants to start her on a salmeterol administered via inhaler. the nurse needs to remember to include which statement when teaching the girl and her family about this drug?

a. "it should be taken at the first sign of an asthma attack"

b. "the dosage is two puffs q 4 or any time needed for asthma attacks"

c. "this inhaler is for prevention of asthma attacks, not for an acute attack"

d. "be sure to take your steroid inhaler first"

c

which instruction should the nurse provide to the patient taking salmeterol by inhaler?

a. increase fluid intake

b. rinse mouth after use

c. monitor HR

d. remain upright for 30 minutes

b

the nurse is reviewing the med orders of a newly admitted patient who has an infusion of the adrenergic drug dopamine. which of these drugs or drug classes, if also given to the patient may cause an interaction? (select all that apply)

a. tricyclic antidepressants

b. MAOIs

c. anticoagulants

d. corticosteroids

e. antihistamine

a,b,e

the nurse is administering dopamine to the patient in cardiogenic shock after a MVA. which assessment finding indicates the dopamine is achieving its desired effect? (select all that apply)

a. BP is 90/60

b. hyperactive bowel sounds

c. decreased in HR to 100bpm

d. presence if adventitious lung sounds

e. increase in urine output to 30mL/hr

a,c,e

during pharm class, a nursing student asks about the use of beta2 agonist against pregnancy. the most appropriate response by the nursing facility member would be which of the following?

a. they lower bp in pregnancy induced hypertension

b. they increase milk production during lactation

c. they interrupt premature labor contractions

d. they facilitate uterine involution

C

an infant is having an allergic reaction and it to receive two doses of epinephrine 10mcg/kg subcutaneously. the infant weighs 11lb. how many mcg will the nurse give baby?

50 mcg/dose

adrenergic blockade at the aplha-adrenergic recptors lead to which effects? (select all that apply)

a. vasodilation

b. decreased bp

c. increased bp

d. constriction of the pupil

e. tachycardia

a,b,d

the nurse discovers that IV infusion of a patient who has been receiving IV vasopressor has infiltrated. the nurse will expect which drug to be used to reverse the effect of the vasopressor in the infiltrated area?

a. phentolamine

b. prazosin

c. epi

d. metoprolol

a

a patient has a new prescription for a beta blocker as part of treatment for hypotension. the nurse is reviewing the patient current meds and notes that there may be a concern regarding interactions with which med?

a. thyroid hormone supplement

b. antibiotic for sinus infection

c. oral hypoglycemic for type 2 diabetes

d. oral birth control

c

a patient has been given an alpha blocker as treatment for BPH. which instruction is important to include when the nurse is teaching him about the effects of the med?

a. avoid foods and drinks that contain caffeine

b. change to sitting or standing slowly, to avoid a sudden drop in bp

c. watch for wt loss of 2lb in 1 week

d. take extra supplements for calsium

b

a patient who had been taking a beta blocker for 6 months tells the nurse during a follow up visit that she wants to stop taking the med. she is wondering if there is any problem with stopping the med today. what is the nurses best reply?

a. no, there are no ill effect if this med is stopped

b. there should be only minimal effect if yo stop this med

c. you may experience orthostatic hypotension if you stop this med abruptly

d. if you stop this med suddenly, there is a possibility you may experience chest pain our rebound HTN

d

a patient has been taking Tamsulosin for about 1 year. during todays office visit, he asks the doctor about taking a during for erectile dysfunction. how does the nurse expect the doctor to reply?

a. these drugs are safe to take together

b. you can take them together but the dosage of the flomax will need to be reduced

c. taking these 2 drugs together may lead to dangerously low bp

d. you will be able to try taking these 2 drugs together but watch for side effects

c

which instruction should take priority in teaching patients how to manage the adverse effect in alpha blockers?

a. avoid the intake of grapefruit or grapefruit juice

b. drink plenty of fluid through out the day

c. eat plenty of green leafy vegetables

d. change positions slowly

d

which statement correctly describes the method of action of the drug in treating Benign prostatic hypertrophy?

a. it reduces smooth muscle contraction of the bladder neck and the urethra, decreasing resistance to urine outflow

b. it reverses prostatic hypertrophy, reducing the size of the prostate gland

c. it inhibits production of prostate specific antigen decreasing gland size

d. in enhances the diameter of the urinary meatus, improving urine flow

b

which of the following drug orders should alert the nurse to the possibility of drug errors?

a. tamsulosin for a 65 year old woman

b. inderal for a 35 year old patient with asthma

c. carvedilol for a 50 year old with hypertension

d. metoprolol for a 55 year old woman with hypertension

a

an admission order reads "start IV of 0.9% NS and infuse 1 L over the next 12 hours. what rate will the nurse set the pump up for?

83 mL/hr

Atropine

antidote for OD of cholinergic drug

Indirect-Acting Cholinergic drugs

act by making more acetylcholine (ACh) available at the receptor site, thus allowing ACh to bind to and stimulate the receptor

direct acting cholinergic drugs

bind to cholinergic receptors and activate them

muscarine

Receptors located postsynaptically in the effector organs (smooth muscle, cardiac muscle, glands) supplied by the parasympathetic fibers

nicotinic

Receptors located in the ganglia of the parasympathetic nervous system (PSNS) and the sympathetic nervous system (SNS)

"rest and digest"

A description of the action of the PSNS

Acetylcholine

The neurotransmitter responsible for the transmission of nerve impulses to the effector cells in the PSNS

Cholinesterase

The enzyme responsible for breaking down ACh

The desired effects of cholinergic drugs come from stimulation of which receptors?

a. Cholinergic

b. Nicotinic

c. Muscarinic

d. Ganglionic

c

The undesirable effects of cholinergic drugs come from stimulation of which receptors?

a. Cholinergic

b. Nicotinic

c. Muscarinic

d. Ganglionic

b

The patient mentions bethanechol when asked about his medication history. The nurse recognizes that this drug is used for the treatment of which condition?

a. Diarrhea

b. Urinary retention

c. Urinary incontinence

d. Bladder spasms

b

Which existing condition in a patient would cause the nurse to question an order for bethanechol? (Select all that apply.)

a. Asthma

b. Peptic ulcer disease

c. Pernicious anemia

d. Hyperthyroidism

e. Diabetes

a,b,d

When caring for a patient with a diagnosis of myasthenia gravis, the nurse can expect to see which drug ordered for the symptomatic treatment of this disease?

a. Bethanechol

b. Tacrine

c. Donepezil

d. Pyridostigmine

d

A 62-year-old woman has started taking donepezil for early-stage Alzheimer's disease. Her daughter expresses relief that "there is finally a pill to cure Alzheimer's disease." What is the nurse's best response?

a. "She can expect reversal of symptoms within a few days."

b. "The dosage will need to be increased if no improvement is noted."

c. "This drug may help to improve symptoms, but it is not intended as a cure."

d. "Yes, it has been a great help for many patients."

c

A patient has received an inadvertent overdose of a cholinergic drug. The nurse will monitor for which early signs of a cholinergic crisis? (Select all that apply.)

a. Dry mouth

b. Salivation

c. Flushing of the skin

d. Abdominal cramps

e. Constipation

f. Dyspnea

b,c,d,f

The nurse will prepare to give which drug to a patient who is experiencing a cholinergic crisis?

a. Atropine

b. Tacrine

c. Donepezil

d. Physostigmine

a

Which of the following patients would benefit from administration of atropine?

a. A patient with a blood pressure of 218/110 mmHg and complaining of headache

b. A patient with a heart rate of 40 beats/min and complaining of lightheadedness

c. A patient who is 3 hours postoperative and has not voided.

d. A patient with glaucoma and complaining of eye pain.

b

The nurse is monitoring a patient who has been receiving bethanechol after abdominal surgery. Which of these are therapeutic outcomes for this medication? (Select all that apply.)

a. Decreased heart rate

b. Passage of flatus

c. Decreased temperature

d. A bowel movement

e. Decreased respiratory secretions

b,d

Before giving an anticholinergic drug, the nurse will check the patient's history for which conditions? (Select all that apply.)

a. Glaucoma

b. Osteoporosis

c. Acute asthma

d. Thyroid disease

e. Diabetes mellitus

f. Benign prostatic hyperplasia

a,c,f

The nurse will monitor for which adverse effects of anticholinergic drugs? (Select all that apply.)

a. Dilated pupils

b. Hypertension

c. Dry mouth

d. Urinary retention

e. Dysphagia

f. Diarrhea

a,c,d

In reviewing the medication orders for a newly admitted patient, the nurse recognizes that which is an indication for atropine sulfate?

a. Myasthenia gravis

b. Sinus bradycardia

c. Pitting edema

d. Narrow-angle glaucoma

b

During patient teaching for a 70-year-old man who will be taking an anticholinergic drug, the nurse will reinforce that this medication places the patient at higher risk for which problem?

a. Angina

b. Fluid overload

c. Delirium

d. Hypothermia

c

. A 28-year-old woman is preparing to take a cruise and has asked for a prescription drug to prevent motion sickness. The physician orders scopolamine transdermal patches. The nurse will include which statement when teaching the patient about this drug?

a. "The patch can be applied anywhere on the upper body."

b. "Apply the patch 4 to 5 hours before travel."

c. "Apply the patch just before boarding the ship."

d. "Be sure to change the patch daily."

b

Patient teaching regarding scopolamine transdermal patches should include which side effects? (Select all that apply.)

a. Drowsiness

b. Blurred vision

c. Constipation

d. Dry mouth

e. Bradycardia

a,b,d

A patient has a new prescription for tolterodine. Which condition, if present, would make it necessary to reduce the usual dosage of this drug?

a. Coronary artery disease

b. Diabetes mellitus

c. Hypertension

d. Cirrhosis of the liver

d

secondary

High blood pressure associated with renal, pulmonary, endocrine, and vascular diseases is known as_________ hypertension

orthostatic

A common adverse effect of adrenergic drugs involving a sudden drop in blood pressure when patients change position is known as ______________ hypotension.

Vasodilators

These drugs are used in the management of hyper-tensive emergencies.

primary

Elevated systemic arterial pressure for which no cause can be found is known as ______________ hypertension.

Diuretics

The primary effect of these drugs is to decrease plasma and extracellular fluid volumes.

ACE

Drugs that are often used as first-line drugs in the treatment of both heart failure and hypertension are known by the acronym ______________ inhibitors.

A 46-year-old man has been taking clonidine for 5 months. For the past 2 months, his blood pressure has been normal. During this office visit, he tells the nurse that he would like to stop taking the drug. What is the nurse's best response?

a. "I'm sure the doctor will stop it—your blood pressure is normal now." b. "Your doctor will probably have you stop taking the drug for a month, and then we'll see how you do."

c. "This drug should not be stopped suddenly; let's talk to your doctor." d. "It's likely that you can stop the drug if you exercise and avoid salty foods."

c

When administering angiotensin-converting enzyme (ACE) inhibitors, the nurse keeps in mind that which are possible adverse effects? (Select all that apply.)

a. Diarrhea

b. Fatigue

c. Restlessness

d. Headaches

e. A dry cough

f. Tremors

b,d,e

A patient with type 2 diabetes mellitus has developed hypertension. What is the blood pressure goal for this patient?

a. Less than 110/80 mm Hg

b. Less than 130/80 mm Hg

c. Less than 130/84 mm Hg

d. Less than 140/90 mm Hg

b

A patient is being treated for a hypertensive emer-gency. The nurse expects which drug to be used?

a. Sodium nitroprusside

b. Losartan

c. Captopril

d. Prazosin

a

A patient in her eighth month of pregnancy has preeclampsia. Her blood pressure is 210/100 mm Hg this morning. This is classified as which type of hypertension?

a. Primary

b. Idiopathic

c. Essential

d. Secondary

d

A beta1 blocker is prescribed for a patient with heart failure and hypertension. Which adverse effects, if present, may indicate a serious problem is develop-ing while the patient is taking this medication? (Select all that apply.)

a. Edema

b. Nightmares

c. Shortness of breath

d. Nervousness

e. Constipation

a,c

The nurse is obtaining a drug history on a patient being treated for hypertension. The prescriber has chosen the angiotensin receptor blocker losartan to treat the patient's hypertension. Which drug on the patient's current drug list would most concern the nurse?

a. Furosemide

b. Albuterol

c. Ibuprofen

d. Augmentin

c

Given the nurse's knowledge of the side effects of alpha blockers, which instruction should the nurse provide to the patient with a new order for an alpha blocker to treat hypertension?

a. Drink plenty of fluids.

b. Wear sunscreen outside.

c. Change positions slowly.

d. Increase intake of potassium-rich foods.

c

Which finding in the patent taking Lisinopril would be an indication to discontinue the drug immediately and avoid taking it in the future?

a. Heart failure

b. Albuminuria

c. Angioedema

d. Cough

c