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A patient diagnosed with migraine headache is experiencing what type of pain?
Vascular pain
3 multiple choice options
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 non-opioid analgesic, such as tramadol
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?
Respiration rate
3 multiple choice options
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?
Administration of naloxone, an opioid reversal agent
3 multiple choice options
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 prevent constipation
3 multiple choice options
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 tolerance
3 multiple choice options
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?
Hepatic necrosis
3 multiple choice options
The drug pentazocine (Talwin®) is a narcotic agonist-antagonist. Which statement describes a characteristic of this type of medication?
It has a lower addiction potential than opiate narcotics.
3 multiple choice options
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?
The baseline dose of the narcotic may need to be increased in increments
3 multiple choice options
For which situation is the herb feverfew commonly used?
Headaches
3 multiple choice options
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?
Disguising the flavour with a soft drink or flavoured water
3 multiple choice options
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
3 multiple choice options
A patient has been diagnosed with shingles and is experiencing postherpetic neuralgia. What
would the nurse expect to administer for pain relief?
Transdermal lidocaine (EMLA®)
3 multiple choice options
Which is a true statement about sedatives and hypnotics?
A hypnotic causes sleep
3 multiple choice options
A patient who has been taking phenobarbital for 2 weeks as part of therapy for epilepsy reports feeling tense and says that the least little thing is a bother now. What is the nurse's best explanation to the patient?
This drug causes deprivation of REM sleep and may cause the patient's inability to deal with normal stress
3 multiple choice options
A 50-year-old male who has been taking a benzodiazepine for 1 week is found unresponsive. His wife states that he takes no other prescription drugs and that he did not take an
overdose—the correct number of pills is in the bottle. What might have happened?
He drank a glass of wine
3 multiple choice options
A patient has been taking temazepam (Restoril®) for intermittent insomnia. She tells the nurse that when she takes it, she sleeps well, but the next day she feels ―so tired.‖ What is the
nurse's best explanation to the patient?
Benzodiazepines affect the sleep cycle, thus causing a hangover effect.
3 multiple choice options
A patient who is recovering from a minor automobile accident that occurred 1 week ago is
taking cyclobenzaprine (Novo-Cycloprine®) for muscular pain and goes to physical therapy
three times a week. Which nursing diagnosis would be appropriate for him?
Risk for falls related to decreased sensorium
3 multiple choice options
A patient is taking flurazepam (Apo-Flurazepam®) 3 to 4 nights a week for sleeplessness. She is concerned that she cannot get to sleep without taking the medication. What measures are appropriate for this patient?
Trying to establish set sleep patterns
3 multiple choice options
Which is the best treatment of an acute overdose of diazepam?
Administration of flumazenil
3 multiple choice options
A 45-year-old female has been taking dantrolene as part of the treatment for multiple sclerosis. Which laboratory value should the nurse monitor while the patient receives dantrolene?
Liver function studies
3 multiple choice options
What is an adverse effect of barbiturate administration?
Thrombocytopenia
3 multiple choice options
Which natural health product is used by some people to promote sleep and to relieve anxiety
and restlessness?
Kava
3 multiple choice options
Which condition is an indication for a central nervous system (CNS) stimulant drug?
Appetite suppression
3 multiple choice options
Caffeine should be used with caution in which patient?
A male with a history of peptic ulcers
3 multiple choice options
A patient has a new prescription for orlistat as part of his treatment for weight loss. What important information should the nurse include when providing patient education about orlistat?
This medication reduces fat absorption by about 30%.
3 multiple choice options
6-year-old boy has been started on methylphenidate hydrochloride (Ritalin) for the treatment of attention deficit hyperactivity disorder (ADHD). His mother tells the nurse that she has been giving the medication at bedtime so that it will be ―in his system‖ when he goes
to school the next morning.
The medication should be given 4 to 6 hours before bedtime to diminish the insomnia it causes.
3 multiple choice options
A 22-year-old nursing student has been taking Excedrin Extra-Strength tablets for the past few weeks to ―make it through‖ the end of the semester and examination week. The feeling of being ―exhausted‖ has brought the patient to the clinic today. Which nursing diagnosis is
appropriate?
Disturbed sleep pattern
3 multiple choice options
Which CNS stimulant drug is used to treat acute migraines?
zolmitriptan (Zomig®)
3 multiple choice options
A 10-year-old boy has been on methylphenidate hydrochloride (Ritalin) for almost 6 months.
His mother reports that he seems to have stopped growing.
Which is the nurse's best answer to the patient's mother?
Temporary slowing of growth is expected with Ritalin therapy
3 multiple choice options
A 10-year-old will be started on methylphenidate hydrochloride (Ritalin) therapy. What
important baseline assessment should be done before therapy with this drug is started?
Height and weight
3 multiple choice options
Before administering sumatriptan (Imitrex®) to a patient for the treatment of a migraine
headache, the nurse should assess for the presence of which condition?
Coronary artery disease
3 multiple choice options
The nurse is evaluating a patient who is taking modafinil (Alertec). Which is an intended therapeutic effect?
Increased wakefulness
3 multiple choice options
Ginkgo biloba is a natural health product that is used for treatment of which condition what purpose?
Improving memory
3 multiple choice options
Which CNS stimulant is commonly used in conjunction with supportive measures to treat the
respiratory depression that may occur in postoperative recovery?
theophylline
3 multiple choice options
Which antiepileptic drug allows once-a-day dosing?
Phenobarbital sodium
3 multiple choice options
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?
Generalized tonic-clonic seizure
3 multiple choice options
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?
Contact the physician for another dosage form of the medication
3 multiple choice options
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?
Autoinduction results in lower-than-expected drug concentrations
3 multiple choice options
When administering phenytoin (Dilantin®) intravenously, what must the nurse remember?
Normal saline is the only solution to be used with phenytoin
3 multiple choice options
Which teaching tips is appropriate for the nurse to give a patient taking topiramate (Topamax®)?
Do not chew, crush, or break the tablet
3 multiple choice options
Whatis the drug of choice for the immediate treatment of status epilepticus?
diazepam (Valium®)
3 multiple choice options
Phenytoin (Dilantin) has a narrow therapeutic index. Which statement defines this characteristic?
The safe and toxic plasma levels are very close
3 multiple choice options
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?
Stopping this medication abruptly may cause withdrawal seizures.
3 multiple choice options
Adrenergic drugs produce effects similar to which of the body's systems?
The sympathetic nervous system
3 multiple choice options
When an adrenergic drug stimulates 1-adrenergic receptors, the result is an increased force of contraction, which is known as what type of positive effect?
Inotropic
3 multiple choice options
When a patient is taking an adrenergic drug, the nurse expects to see which effect?
Increased heart rate
3 multiple choice options
An adrenergic agonist is ordered for a patient in shock. The nurse notes that this drug has had
its primary intended effect when which condition occurs?
Increased blood pressure
3 multiple choice options
Which condition is an indication for epinephrine (Adrenalin®)?
Acute asthma attacks
3 multiple choice options
After a near-fatal motor vehicle accident, a family has given permission for their 6-year-old
son's organs to be donated. Which medication will be given to the child to maintain the blood
pressure in his organs until transplantation can be carried out?
dopamine hydrochloride
3 multiple choice options
A female patient is on a low-dose dobutamine drip for heart failure. She had been feeling
―better‖ but now reports tightness in her chest and a bit of anxiety. Her heart rate, which was
86, is now up to 110, and her blood pressure, which was 120/80, is now 150/98. What is the
nurse's immediate assessment of the patient's condition?
The dobutamine may be causing a worsening of a pre-existing cardiac disorder.
3 multiple choice options
A 14-year-old female patient has been treated for asthma for almost 4 months. Two weeks ago, she was given salmeterol xinafoate as part of her medication regimen. However, her mother has called the clinic to report that it does not seem to work when her daughter is
experiencing acute symptoms. What does the nurse think in response to the mother's concerns?
Salmeterol is indicated for prevention of bronchospasms; it is not to be used for
relief of acute symptoms.
3 multiple choice options
A patient is experiencing a severe anaphylactic reaction to an antibiotic. Which drug would be
used to treat this condition?
epinephrine (Adrenalin)
3 multiple choice options
Adrenergic drugs that cause relaxation of the bronchi (i.e., bronchodilation) stimulate which
receptors?
B2-Adrenergic receptors
3 multiple choice options
Inhaled salmeterol is indicated for which condition?
Asthma
3 multiple choice options
When an older adult is taking an adrenergic drug, what must the nurse carefully monitor?
Blood pressure and pulse rate
3 multiple choice options
Which drug is used to help establish the diagnosis of pheochromocytoma?
phentolamine (Rogitine®)
3 multiple choice options
A patient is going home with a new prescription for the -blocker atenolol (Tenormin®). What
important information should the nurse tell the patient about this drug?
Never abruptly stop taking this medication
3 multiple choice options
A patient has been on a dopamine drip, and the nurse notices that the infusion has extravasated into the tissue of the forearm. After stopping the infusion, the nurse immediately
injects phentolamine into the interstitial catheter. What is the effect of this action?
It increases blood flow to the ischemic site by vasodilation and prevents permanent
tissue damage.
3 multiple choice options
A 58-year-old male has had a myocardial infarction (MI). He has begun rehabilitation and is
ready for discharge. When he is given a prescription for metoprolol (Lopressor ®), he becomes
upset and says, ―I don't have high blood pressure! Why did my doctor give me this
medicine?‖ What is the nurse's best explanation to the patient?
Studies have shown that this medication greatly increases survival in post-MI
patients.
3 multiple choice options
A patient has received a prescription for prazosin (Minipress) to reduce urinary obstruction
due to benign prostatic hyperplasia (BPH). What important information about this medication
should the nurse give this patient?
Until a tolerance is built up, lightheadedness may occur when standing up after
sitting or lying down.
3 multiple choice options
A female patient has been admitted to the emergency department after an accidental overdose
of an a-blocker. Her daughter states that her mother called to tell her that she had taken two
double doses that morning because the headache ―just would not go away.‖ The patient is now
dizzy, nauseated, and very weak. What should the nurse do immediately?
Empty the stomach by gastric lavage
3 multiple choice options
Which B-blocker is indicated for the treatment of heart failure?
carvedilol
3 multiple choice options
The nurse is teaching a patient about self-monitoring while taking a -blocker at home. The
nurse should teach the patient to measure apical pulse daily for 1 minute. What does the nurse
instruct the patient to do if the pulse rate decreases to less than 60 beats per minute?
Contact the physician for instructions
3 multiple choice options
The physician has ordered doxazosin mesylate (Cardura®) for a female patient. What important information should the nurse give this patient?
She should take her first dose while lying down, because prazosin has a first-dose effect.
3 multiple choice options
Which is the best angiotensin-converting enzyme (ACE) inhibitor for a patient who has liver
dysfunction in addition to an acute myocardial infarction?
captopril (Capoten®) because it is not a prodrug
3 multiple choice options
Why does a physician examine the fundus of a patient's eyes during antihypertensive therapy?
To evaluate the long-term effectiveness of the treatment
3 multiple choice options
Which parameters determine the regulation of arterial blood pressure?
Cardiac output and vascular resistance
3 multiple choice options
Which adverse effect commonly occurs in male patients who are taking antihypertensive
medications?
Erectile dysfunction
3 multiple choice options
Antihypertensive drug therapy has been prescribed for a Black male patient newly diagnosed
with stage 1 hypertension. What is most likely included in his medication therapy?
Calcium channel blockers with thiazide diuretic
3 multiple choice options
Which is a potential nursing diagnosis for a patient taking antihypertensive medications?
Sexual dysfunction
3 multiple choice options
A patient with primary hypertension is prescribed drug therapy for the first time. The patient
asks how long drug therapy will be needed. What is the best answer to the patient's question?
Lifelong
3 multiple choice options
A persistent cough is an adverse effect of which class of antihypertensive drugs?
ACE inhibitors
3 multiple choice options
A patient diagnosed with prehypertension has which blood pressure reading?
Systolic blood pressure between 120 and 139 mm Hg and diastolic blood pressure between 80 and 89 mm Hg
3 multiple choice options
A patient has hypertension, together with type I diabetes mellitus and proteinuria. Which drug
is considered to have renal-protective effects for these medical diagnoses?
ACE inhibitors
3 multiple choice options
Why do patients on -adrenergic agonists require close assessment of pulse, blood pressure, and weight?
Because of strong vasodilating properties
3 multiple choice options
Which is a true statement concerning the administration of topical nitroglycerin ointment?
The old ointment should be removed before the new ointment is applied
3 multiple choice options
The nurse is administering intravenous nitroglycerin to a patient who has just been admitted
for an acute myocardial infarction.
Which statement is true in regard to the administration of this medication?
It must be contained in special non-polyvinyl chloride (non-PVC) intravenous
(IV) bags.
3 multiple choice options
A 53-year-old male patient has been admitted for evaluation of chest pain. He has been diagnosed with angina and prescribed sublingual nitroglycerin tablets. What important
instructions for using this medication should the nurse give the patient?
Sit or lie down when taking a tablet; change positions slowly to avoid falling or fainting.
3 multiple choice options
A 74-year-old professional golfer has chest pain that occurs toward the end of his golf games.
He says the pain usually goes away after he takes one or two sublingual nitroglycerin tablets
and rests. What type of angina does he have?
Classic angina
3 multiple choice options
A female patient arrives in the emergency department with severe chest pain. She has had pain
off and on for a week. Which assessment finding indicates a need for cautious use of nitrates
and nitrites?
Anemia
3 multiple choice options
A patient is taking a calcium channel blocker as part of his therapy after a myocardial infarction. What important information or instructions should the nurse give the patient about this medication?
A high-fibre diet with plenty of fluids will help to prevent the constipation that
may occur
3 multiple choice options
A patient has been prescribed transdermal nitroglycerin patches. What important instructions
for applying these patches should the nurse give the patient?
Use the patches on any nonhairy area on the body.
3 multiple choice options
A patient has developed tolerance to transdermal nitroglycerin therapy. Which instruction is
the best one for the nurse to give the patient?
Remove the patch at bedtime, then apply a new one in the morning.
3 multiple choice options
A patient about to receive his morning dose of digoxin (Lanoxin®) has an apical pulse of 70
beats per minute. What should the nurse do?
Administer the dose
3 multiple choice options
The nurse is assessing the patient before administration of a cardiac glycoside. Which
condition can predispose a patient to digitalis toxicity?
Hypokalemia
3 multiple choice options
The nurse who is assessing a patient who is receiving intravenous (IV) digitalis recognizes
that the drug has a negative chronotropic effect. How is a negative chronotropic effect evident
in a patient?
By a decreased heart rate
3 multiple choice options
A patient has been taking digoxin (Lanoxin) at home but has developed toxicity. The physician has ordered digoxin immune Fab. The patient asks the nurse why the medication
has been changed. Which is the nurse's best response?
"his new drug is an antidote to digoxin and will help to lower the blood levels
3 multiple choice options
A patient has been placed on a milrinone infusion as part of the therapy for end-stage heart
failure. What risk should the nurse keep in mind while assessing this patient during the
infusion?
Hypotension
3 multiple choice options
Which medication results in a drug interaction if given to a patient taking digitalis?
quinidine sulphate
3 multiple choice options
A patient is beginning digoxin (Lanoxin) therapy. Which food should the nurse tell this patient to avoid when taking the digoxin dose?
Bran muffins
3 multiple choice options
The nurse is administering the phosphodiesterase inhibitor milrinone. What is the drug's positive inotropic effect?
Increased force of cardiac contraction
3 multiple choice options
Which condition predisposes a patient to digitalis toxicity?
Hypercalcemia and advanced age
3 multiple choice options
Which assessment result is the most important indicator of an exacerbation of heart failure?
Increased weight
3 multiple choice options