Ch.13 CNS Stimulants, and Related Drugs (Exam 1)

A patient wants to take Orlistat (Xenical) to assist in her weight loss program, but she is wary of its unpleasant adverse effects. What measure can be suggested to reduce these effects?

A. Restrict dietary intake of fat.

B. Restrict dietary intake of fiber.

C. Increase intake of dairy products.

D. Avoid intake of carbonated beverages.

A. Restrict dietary intake of fat.

What is important for the nurse to assess in the patient's history before administering a serotonin agonist?

A. Hypertension

B. Allergy to penicillin

C. Chronic bronchitis

D. Cataracts

A. Hypertension

Which action occurs within the central nervous system (CNS) with the use of amphetamines?

Select all that apply.

A. Block the reuptake of dopamine and norepinephrine

B. Stimulate the release of dopamine and norepinephrine

C. Stimulate the reuptake of dopamine and norepinephrine

D. Block the release of dopamine and norepinephrine

E. Block the release of dopamine and stimulate the release of norepinephrine

F. Block the release of norepinephrine and stimulate the release of dopamine

A. Block the reuptake of dopamine and norepinephrine

B. Stimulate the release of dopamine and norepinephrine

Which groups of medications are classified as central nervous system (CNS) stimulants?

Select all that apply.

A. Analgesics

B. Analeptics

C. Anorexiants

D. Antiemetics

E. Anesthetics

F. Amphetamines

B. Analeptics

C. Anorexiants

F. Amphetamines

For which condition are central nervous system (CNS) stimulants most commonly used in children?

A. Treatment of childhood obesity

B. Treatment of psychological disorders

C. Treatment of life-threatening allergic reactions

D. Treatment of attention-deficit/hyperactivity disorder (ADHD)

D. Treatment of attention-deficit/hyperactivity disorder (ADHD)

Through which mechanism does phentermine act to suppress appetite?

A. Stimulation of the limbic center in the brain

B. Suppression of the chemoreceptor trigger zone in the medulla

C. Suppression of the hypothalamus

D. Increasing secretion of endocrine hormones from the pituitary gland

A. Stimulation of the limbic center in the brain

Which finding is an indication that Christine is experiencing therapeutic effects of methylphenidate?

A. She completes school assignments on time.

B. She submits her homework after the deadlines.

C. She stays awake most of the night.

D. She gets restless during dance practice.

A. She completes school assignments on time.

Which health issue is a contraindication to the use of methylphenidate?

A. Asthma

B. Gastric ulcers

C. Hyperthyroidism

D. Diabetes mellitus

C. Hyperthyroidism

The use of phentermine may counteract the effects of which other medication?

A. Methimazole

B. Furosemide

C. Metoprolol

D. Phenytoin

C. Metoprolol

Doxapram is contraindicated in patients with which medical condition?

A. Peptic ulcer disease

B. Seizure disorder

C. Orthostatic hypotension

D. Asthma

B. Seizure disorder

For which reason would the nurse instruct patients taking central nervous system (CNS) stimulants to read labels on over-the-counter (OTC) products?

A. Many OTC products contain aspirin.

B. Many OTC products contain caffeine.

C. Many OTC products cause drowsiness.

D. Many OTC products contain acetaminophen.

B. Many OTC products contain caffeine.

A patient taking long-term amphetamines is ready to be weaned off of the medication. Which information is most important for the nurse to provide the patient about medication discontinuation?

A. Abrupt discontinuation can cause rapid weight gain.

B. Abrupt discontinuation can cause respiratory distress.

C. Abrupt discontinuation can cause worsening attention-deficit/hyperactivity disorder (ADHD) symptoms.

D. Abrupt discontinuation can cause depression.

D. Abrupt discontinuation can cause depression.

Which information would the nurse emphasize when educating a patient about anorexiants for weight loss?

A. The patient must avoid all forms of sugar when taking an anorexiant.

B. A nutritious diet is one of the most important components to weight loss.

C. The patient should keep a journal of daily weights and waist size measurements.

D. The patient should contact the health care provider if rapid weight loss is not experienced.

B. A nutritious diet is one of the most important components to weight loss.

Amphetamines should be prescribed for short-term use because of which potential effect?

A. Amphetamines can cause permanent behavior changes.

B. Amphetamines are very expensive medications and are not covered by insurance.

C. Amphetamines have a high potential for tolerance.

D. Amphetamine treatment requires significant laboratory testing during therapy.

C. Amphetamines have a high potential for tolerance.

Which use of analeptics is appropriate?

A. Attention-deficit/hyperactivity disorder (ADHD)

B. Narcolepsy

C. Stimulation of respirations

D. Obesity

C. Stimulation of respirations

Parents report they are giving their child methylphenidate at breakfast and at dinnertime for the treatment of attention-deficit/hyperactivity disorder (ADHD). Which education would the nurse provide regarding this dosing schedule?

A. “Give methylphenidate at least 6 hours before bedtime because it may cause insomnia.”

B. “Do not administer methylphenidate with meals because it should be taken on an empty stomach.”

C. “Methylphenidate should be given at breakfast and at bedtime to allow equal time between doses.”

D. “Methylphenidate should be given with breakfast and then again when the symptoms of ADHD return.”

A. “Give methylphenidate at least 6 hours before bedtime because it may cause insomnia.”

Which assessments would the nurse conduct before initiating methylphenidate for a child?

Select all that apply.

A. Height

B. Heart sounds

C. Urine output

D. Bowel sounds

E. Weight

F. Growth

A. Height

E. Weight

F. Growth

A patient ran out of methylphenidate 8 days ago. Which symptoms would the nurse assess for in this patient?

Select all that apply.

A. Hives

B. Fever

C. Nausea

D. Itching

E. Vomiting

F. Headache

C. Nausea

E. Vomiting

F. Headache

Which interaction would the nurse monitor for in a patient who is taking methylphenidate concurrently with antihypertensives?

A. Methylphenidate may reduce the effect of antihypertensives.

B. Methylphenidate and antihypertensives both decrease blood pressure.

C. Antihypertensives may increase the effect of methylphenidate.

D. Methylphenidate and antihypertensives both increase the heart rate.

A. Methylphenidate may reduce the effect of antihypertensives.

A patient who routinely takes methylphenidate asks the nurse if pseudoephedrine can be taken to help treat a sinus infection. Which response by the nurse is appropriate?

A. “It is okay to take pseudoephedrine and methylphenidate together because there are no adverse reactions.”

B. “Pseudoephedrine taken with methylphenidate can lead to significant gastrointestinal (GI) upset and possible gastric ulcers.”

C. “Pseudoephedrine taken with methylphenidate increases the sedative effect and can lead to drowsiness or respiratory depression.”

D. “Pseudoephedrine taken with methylphenidate increases the stimulatory effects of irritability, nervousness, tremors, and insomnia.”

D. “Pseudoephedrine taken with methylphenidate increases the stimulatory effects of irritability, nervousness, tremors, and insomnia.”

Which assessments would the nurse perform when evaluating methylphenidate therapy?

Select all that apply.

A. Vital signs

B. Attention level

C. Level of hyperactivity

D. Presence of side effects

E. Signs or symptoms of infection

A. Vital signs

B. Attention level

C. Level of hyperactivity

D. Presence of side effects

The nurse explains to the patient that tremors and increased heart rate are possible side effects of central nervous system (CNS) stimulants. Which information would the nurse provide the patient regarding these side effects?

A. “Take the medication with meals.”

B. “Stop taking the CNS stimulant medication.”

C. “Decrease the dose until the side effects improve.”

D. “Report these side effects to the health care provider.”

D. “Report these side effects to the health care provider.”

A nursing mother asks to take an anorexiant to assist with weight loss. Which education would the nurse provide to this patient?

A. “Nursing mothers should avoid central nervous system stimulants because these drugs are excreted in breast milk.”

B. “As long as the patient monitors her nutrition, anorexiant medications are safe for nursing mothers.”

C. “Nursing mothers taking central nervous system stimulants should pump and freeze the breast milk for 24 hours before feeding.”

D. “Nursing mothers should not take an anorexiant because they cannot restrict their calorie intake while breastfeeding.”

A. “Nursing mothers should avoid central nervous system stimulants because these drugs are excreted in breast milk.”

Which strategy is appropriate for a patient taking a central nervous system (CNS) stimulant to use to monitor for weight loss?

A. Weigh twice a week.

B. Weigh morning and night.

C. Pay attention to how clothes fit.

D. Weigh monthly.

A. Weigh twice a week.

Which statement describes the rationale for providing calorie-dense meals to a child taking a central nervous system (CNS) stimulant?

A. CNS stimulants may have anorexic effects.

B. Taking CNS stimulants with food prevents gastrointestinal (GI) upset.

C. CNS stimulants are better absorbed when taken with food.

D. A nutritious breakfast will help the patient focus throughout the day.

A. CNS stimulants may have anorexic effects.

A parent expresses concern about using a controlled substance to treat their child's diagnosed attention deficit hyperactivity disorder (ADHD) and asks the nurse about using a noncontrolled substance. The nurse knows ADHD can be treated with which noncontrolled substance?

A. Atomoxetine

B. Methylphenidate

C. Amphetamine aspartate

D. Dextroamphetamine sulfate

A. Atomoxetine

A patient diagnosed with narcolepsy is prescribed a central nervous system (CNS) stimulant. Which statement best describes the action of CNS stimulants?

A. CNS stimulants block or reduce the activity of inhibitory neurons.

B. CNS stimulants activate cyclic adenosine monophosphate.

C. CNS stimulants decrease the production of excitatory neurotransmitters.

D. CNS stimulants increase release of and block reuptake of neurotransmitters.

D. CNS stimulants increase release of and block reuptake of neurotransmitters.

Which patient assessment finding noted in a patient's medical history, would alert the nurse to be concerned with use of prescribed caffeine?

A. Heart block

B. Constipation

C. Myelin degeneration

D. Cardiac dysrhythmias

D. Cardiac dysrhythmias

Which instructions would the nurse include in teaching a patient to reduce the gastrointestinal (GI) adverse effects of orlistat?

A. Limit dietary intake of fat.

B. Increase fluid and fiber in the diet.

C. Advise to take vitamin C supplement.

D. Take the medication with an antacid.

A. Limit dietary intake of fat.

Ergot alkaloids exert their therapeutic effect by which action?

A. Vasodilation

B. Vasoconstriction

C. Blockade of the beta2 receptors

D. Simulation of the alpha receptors

B. Vasoconstriction

A nurse working with patients who are diagnosed with attention deficit hyperactivity disorder (ADHD) is aware that such patients often take central nervous system (CNS) stimulant drugs increasing the risk for abuse and dependence. Based on this potential, how are these medications classified?

A. Schedule I

B. Schedule II

C. Schedule III

D. Schedule IV

B. Schedule II

A patient diagnosed with narcolepsy is prescribed methylphenidate. Which adverse effects would the nurse include when teaching about this drug? (Select all that apply.)

A. Insomnia

B. Headache

C. Weight Loss

D. Increased oral secretions

E. Decreased blood pressure

A. Insomnia

B. Headache

C. Weight Loss

The nurse is providing care for a neonate diagnosed with apnea of prematurity. The prescription by the health care provider is for caffeine citrate intravenously 5 mg/kg once daily. The infant's weight is 5.4 lb. What is the correct dosage to administer to the patient?

12.3 mg

5.4 lb/2.2 = 2.45 kg x 5mg/kg = 12.27 mg. Doses are rounded to tenths for neonates.

A teenage boy will be receiving atomoxetine (Strattera) as part of treatment for ADHD. Which statement about this drug therapy is accurate?

A.Strattera is highly addictive.

B.Psychotherapy is rarely helpful in cases of ADHD.

C.The patient should be monitored for possible suicidal thoughts and behavior.

D.Strattera is used to treat narcolepsy as well as ADHD.

C.The patient should be monitored for possible suicidal thoughts and behavior.

A patient wants to take Orlistat (Xenical) to assist in her weight loss program, but she is wary of its unpleasant adverse effects. What measure can be suggested to reduce these effects?

A.Restrict dietary intake of fat.

B.Restrict dietary intake of fiber.

C.Increase intake of dairy products.

D.Avoid intake of carbonated beverages.

A.Restrict dietary intake of fat.

What is important for the nurse to assess in the patient's history before administering a serotonin agonist?

A.Hypertension

B.Allergy to penicillin

C.Chronic bronchitis

D.Cataracts

A.Hypertension

A patient is prescribed an anorexiant. Which statement will the nurse include in patient teaching?

A."Take the medication with your evening meal."

B."You will need to take this drug for at least 2 years."

C."If you develop a dry mouth, stop taking the drug immediately."

D."Avoid intake of caffeine."

D."Avoid intake of caffeine."

What drug class does Methylphenidate (Ritalin) belong to?

A. CNS depressant

B. CNS stimulant

C. Antidepressant

D. Antipsychotic

B. CNS stimulant (Amphetamine)

What is the primary use of Methylphenidate?

A. Treatment of anxiety

B. Treatment of ADHD and narcolepsy

C. Migraine prevention

D. Seizure control

B. Treatment of ADHD and narcolepsy

What is the most important safety concern when administering Methylphenidate?

A. Risk of respiratory depression

B. Risk of cardiovascular effects (hypertension, tachycardia)

C. Risk of renal failure

D. Risk of hypoglycemia

B. Risk of cardiovascular effects (hypertension, tachycardia)

Which assessment finding requires immediate intervention for a patient taking Methylphenidate?

A. Decreased appetite

B. Insomnia

C. Chest pain and palpitations

D. Mild irritability

C. Chest pain and palpitations

What drug class does Caffeine belong to?

A. CNS depressant

B. CNS stimulant

C. Sedative-hypnotic

D. Antidepressant

B. CNS stimulant

What is a primary therapeutic use of Caffeine?

A. Treatment of seizures

B. Treatment of migraine headaches and apnea of prematurity

C. Anxiety management

D. Muscle relaxation

B. Treatment of migraine headaches and apnea of prematurity

What is the most important safety concern with excessive Caffeine use?

A. Risk of respiratory depression

B. Risk of cardiac stimulation and arrhythmias

C. Risk of hypothermia

D. Risk of constipation

B. Risk of cardiac stimulation and arrhythmias

Which assessment finding requires immediate intervention for a patient with caffeine toxicity?

A. Restlessness

B. Tremors

C. Irregular heart rhythm

D. Insomnia

C. Irregular heart rhythm

What drug class does Sumatriptan belong to?

A. Beta-adrenergic blocker

B. Selective serotonin (5-HT₁) receptor agonist

C. NSAID

D. Ergot alkaloid

B. Selective serotonin (5-HT₁) receptor agonist

What is the primary use of Sumatriptan?

A. Prevention of migraines

B. Acute treatment of migraine headaches

C. Treatment of chronic tension headaches

D. Seizure management

B. Acute treatment of migraine headaches

What is the most important safety concern when administering Sumatriptan?

A. Risk of hepatotoxicity

B. Risk of coronary vasospasm

C. Risk of respiratory depression

D. Risk of hypoglycemia

B. Risk of coronary vasospasm

Which assessment finding requires immediate intervention after administering Sumatriptan?

A. Mild dizziness

B. Flushing

C. Chest tightness or pain

D. Nausea

C. Chest tightness or pain

What drug class does Propranolol belong to?

A. Selective beta-1 blocker

B. Alpha-adrenergic agonist

C. Nonselective beta-adrenergic blocker

D. Calcium channel blocker

C. Nonselective beta-adrenergic blocker

What is the primary use of Propranolol in migraine management?

A. Acute migraine treatment

B. Migraine prevention

C. Treatment of migraine-related nausea

D. Abortive therapy

B. Migraine prevention

What is the most important safety concern when administering Propranolol?

A. Risk of respiratory depression

B. Risk of bradycardia and hypotension

C. Risk of hyperglycemia

D. Risk of kidney injury

B. Risk of bradycardia and hypotension

Which assessment finding requires immediate intervention for a patient taking Propranolol?

A. Fatigue

B. Cold extremities

C. Heart rate of 42 beats per minute

D. Mild dizziness

C. Heart rate of 42 beats per minute

What drug class do Ergot alkaloids belong to?

A. Beta blockers

B. Selective serotonin agonists

C. Vasoconstrictors

D. NSAIDs

C. Vasoconstrictors

What was the primary use of Ergot alkaloids?

A. Migraine prevention

B. Acute migraine treatment

C. Tension headache treatment

D. Anxiety management

B. Acute migraine treatment

What is the most important safety concern with Ergot alkaloids?

A. Risk of respiratory depression

B. Risk of severe vasoconstriction and ischemia

C. Risk of renal toxicity

D. Risk of hyperglycemia

B. Risk of severe vasoconstriction and ischemia

Which assessment finding requires immediate intervention in a patient taking Ergot alkaloids?

A. Nausea

B. Dizziness

C. Cold, pale extremities with numbness

D. Fatigue

C. Cold, pale extremities with numbness

Why are Ergot alkaloids rarely used today?

A. They are less effective than placebo

B. They cause severe vasoconstriction and have safer alternatives available C. They are too expensive

D. They require IV administration only

B. They cause severe vasoconstriction and have safer alternatives available