Pharmacology Made Easy 5.0 The Neurological System (Part 1) Test

A nurse is teaching a client who has a prescription for modafinil to treat narcolepsy. Which of the following instructions should the nurse include?

Take the drug in the morning

Modafinil is a nonamphetamine stimulant. Taking it in the morning helps improve wakefulness for clients who have narcolepsy. Clients taking the medication for shift-work sleepiness should take it 1 hr before work.

Alzheimers disease and their caregiver about memantine. Which of the following instructions should the nurse include?

Avoid taking over-the-counter antacids.

Antacids that contain sodium bicarbonate increase urine alkalinity and can decrease drug excretion, ultimately leading to toxicity.

A nurse is taking care of a client who is receiving methohexital sodium. The nurse should monitor the client for which of the following adverse effects?

Respiratory Depression

Methohexital, a short-acting barbiturate, causes respiratory depression. Mechanical ventilation and continuous monitoring are essential for clients receiving the medication.

A nurse is administering fentanyl to a client to reduce pain. Which of the following drugs should the nurse have available to reverse the effects of fentanyl?

Naloxone

Naloxone is an opioid antagonist that reverses the effects of opioids. Fentanyl, an opioid agonist, can cause severe respiratory depression. The nurse should also have resuscitation equipment available when administering fentanyl to a client.

A nurse is teaching a client who has a new diagnosis of Parkinson's disease about how levodopa carbidopa can help control symptoms. The nurse should identify that the drug has which of the following pharmacologic effects?

Increases available dopamine in the brain

Levodopa/carbidopa, a dopaminergic agent, can increase dopamine in the extrapyramidal center of the brain, reducing involuntary motion, or tremors, associated with Parkinson's disease.

A nurse is teaching a client who has a prescription for carbamazepine. Which of the following instructions should the nurse include to help the client to avoid adverse effects of this drug?

Begin taking the drug at a low dosage

Visual disturbances, vertigo, and ataxia can result from taking carbamazepine, a drug that treats seizure disorders. Dosages should be low to minimize or prevent these adverse effects.

A nurse is reviewing the medical record of a client who has a newly diagnosed seizure disorder and a new prescription for valproic acid and phenytoin. The nurse should identify what which of the following can occur as a result of an interaction between these drugs?

Phenytoin toxicity

Valproic acid can cause an increase in phenytoin blood levels, resulting in phenytoin toxicity. The nurse should monitor serum phenytoin levels and notify the provider if levels begin to exceed the therapeutic range.

A nurse is caring for a client who has a new prescription for pramipexole to treat Parkinson's disease. The nurse should recognize that which of the following laboratory tests requires monitoring?

Creatinine clearance

Pramipexole, a direct-acting dopamine receptor agonist, should be used with caution for clients who have renal disease. Therefore, the nurse should monitor the client's renal function.

A nurse is caring for a client who is taking donepezil to treat Alzheimer's disease. For which of the following adverse effects should the nurse monitor?

Nausea

The most common adverse effects of donepezil, a cholinesterase inhibitor, are nausea, vomiting, and diarrhea. Taking donepezil with food can help minimize adverse effects.

A nurse is caring for a client who has a new prescription for amphetamine sulfate. The nurse should monitor the client for which of the following adverse effects?

Tachycardia

Amphetamine sulfate is an amphetamine stimulant. It can cause tachycardia and dysrhythmias. The client should notify the nurse if they develop palpitations or chest pain.

A nurse is providing teaching for a client who had a new prescription for valproic acid to treat a seizure disorder. The nurse should instruct the client to monitor for which of the following adverse effects?

Jaundice

Valproic acid can cause hepatic toxicity, characterized by jaundice, abdominal pain, and nausea. Clients taking the drug should report these manifestations, and the nurse should monitor liver function studies prior to treatment and periodically during therapy.

A nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle spasms. The nurse should instruct the client to report which of the following adverse effects?

Diarrhea

Prolonged diarrhea can cause dehydration and other serious effects. Diarrhea, nausea, and vomiting are adverse effects of dantrolene. The client should report these effects so the nurse can monitor fluid balance and intervene accordingly.

A nurse is teaching a client who has new prescription for valproic acid to treat a seizure disorder. The nurse should instruct the client to monitor for which of the following adverse effects?

Drowsiness: Clients taking valproic acid should report CNS depressant effects, such as sedation or drowsiness, because these adverse effects can indicate the need for a reduction in dose.
Headache: Valproic acid can cause headache, along with other CNS adverse effects, such as sleep disturbances.
Rash: Skin rash is an adverse effect of valproic acid and other antiepileptic medications.

A nurse is preparing to administer memantine to a client who has Alzheimer's disease. Which of the following findings in the client's medical history indicates a need to withhold the drug and notify the provider?

Cirrhosis

Memantine should be used cautiously in clients who have severe hepatic impairment. The nurse should contact the provider about the client's history of cirrhosis to see if laboratory testing is required before starting the medication or if the dosage needs to be adjusted.

A nurse is caring for a client who is taking interferon beta 1b. The nurse should identify that which of the following findings indicates a potential serious adverse effect of this drug?

Fatigue

The nurse should identify that potential serious adverse effects of interferon beta-1b include unexplained bruising, bleeding, and fatigue. Clients should report these adverse effects to their provider immediately because they can indicate bone marrow suppression and decreased platelet count.

Before the client leaves the office, the provider prescribes a new medication for the client to use for migraine headaches. Which of the following instructions should the nurse include when teaching the client about administration of their newly prescribed medication?

Select all that apply.

The client should use sumatriptan, a serotonin agonist for abortive therapy of migraine headaches after the onset of a migraine headache. They should spray the medication once into one nostril. They may repeat the dose once, 1 hr after the initial dose by the intranasal route.

When evaluating the client's response to the prescribed muscle relaxant, the nurse should understand that the mechanism of action is to

alter intracellular calcium exchange at the muscle cells

When evaluating the client’s response to the prescribed muscle relaxant, the nurse should recognize that the therapeutic effect of dantrolene, a peripherally acting muscle relaxant, results from its direct action to inhibit muscle contraction by preventing the release of calcium in skeletal muscles. Anticholinergic medications or muscarinic antagonists block acetylcholine at the neuromuscular junction. Centrally acting muscle relaxants relieve spasticity by interrupting nerve signals from the spinal cord. Cholinesterase inhibitors prevent the breakdown of acetylcholine in cholinergic receptors. Traditional anti-seizure medications prevent sodium from entering neurons.

Which of the following findings should the nurse identify as possible adverse effects of the medication that has been prescribed?

AST

ALT

Platelets

WBC

When identifying possible adverse effects caused by interferon beta-1a, the nurse recognizes that decreased WBC and platelets indicate myelosuppression, and increased ALT and AST indicate hepatotoxicity.

A nurse is teaching a client who is taking levodopa carbidopa to treat Parkinson's disease. Which of the following instructions should the nurse include?

Change position slowly to prevent orthostatic hypotension

Levodopa/carbidopa can cause orthostatic hypotension.

A nurse is teaching a client who has a prescription for baclofen. Which of the following instructions should the nurse include?

Avoid driving until the drugs effects are evident

Baclofen, a centrally-acting muscle relaxant, causes CNS depression. Clients taking the medication should avoid alcohol and other CNS depressants, and should not drive a vehicle until they know how the medication will affect them.

A nurse is teaching the family of a client who has a new diagnosis of Alzheimer's disease about donepezil. Which of the following information should the nurse include?

Avoid the use of NSAIDs for pain

Combining NSAIDs with donepezil can cause gastrointestinal bleeding. Therefore, the nurse should instruct the client's family to avoid the use of NSAIDs.

A nurse is teaching a client who is about to genii sumatriptan therapy to treat migraine headaches. The nurse should instruct the client to monitor for which of the following adverse effects?

Chest pain

Sumatriptan, a serotonin agonist, can cause coronary vasospasm and chest pain. Clients should report any pressure, pain, or tightness in the jaw, chest, or back. Sumatriptan is not an appropriate choice for clients who have a history of coronary artery disease.

A nurse is teaching a client about interferon beta 1a. Which of the following instructions should the nurse give to help the client avoid the adverse effects of this drug?

Premeditate with acetaminophen

Interferon beta drugs can cause fever, chills, headaches, and muscle aches. Acetaminophen can help minimize these manifestations.

A nurse is caring for a client who has been taking selegiline to treat Parkinson disease. The provider is considering the use of analgesics for the client but should be aware that a drug interaction between selegiline and meperidine cane result in which of the following?

Muscular rigidity

An interaction between selegiline and opioids, especially meperidine, can result in rigidity, stupor, agitation, hypertension, and fever.

A nurse is caring for a client who has been taking amphetamine dextroamphetamine sulfate for the treatment of attention deficit hyperactivity disorder ADHD for 2 weeks. The nurse should report which of the following finding to the provider?

Weight loss of 2.3 kg

Amphetamine/dextroamphetamine sulfate can cause a decreased appetite and weight loss. The nurse should instruct the client to weigh themself twice weekly and report unintended weight loss.