questions - Drugs Affecting the Neurological System Part 2

Which of the following is a characteristic feature of status epilepticus?

A) Brief, isolated convulsions

B) Hypertension and bradycardia

C) Prolonged, continuous seizures

D) Consciousness regained between seizures

Rationale:

A) Incorrect. Status epilepticus is characterized by prolonged, continuous seizures, not brief, isolated convulsions.

B) Incorrect. Status epilepticus typically presents with hypotension, hypoxia, and cardiac dysrhythmias, not hypertension and bradycardia.

C) Correct. Status epilepticus is defined by prolonged, continuous seizures without regaining consciousness in between.

D) Incorrect. In status epilepticus, consciousness is typically not regained between seizures, making this statement incorrect.

Which of the following is a potential cause of status epilepticus?

A) Controlled medication adherence

B) CNS infections

C) Moderate alcohol consumption

D) Genetic disorders

Rationale:

A) Incorrect. Controlled medication adherence would not typically lead to status epilepticus. Abruptly stopping medications in diagnosed seizure disorders can precipitate status epilepticus.

B) Correct. CNS infections are among the potential causes of status epilepticus.

C) Incorrect. Moderate alcohol consumption is not typically associated with status epilepticus. However, alcohol withdrawal can be a trigger.

D) Incorrect. While genetic disorders can predispose individuals to seizures, they are not directly linked to status epilepticus.

Which type of seizure is characterized by generalized tonic–clonic convulsions lasting for several minutes?

A) Absence (petit mal)

B) Myoclonic

C) Tonic-clonic

D) Simple partial

Rationale:

A) Incorrect. Absence (petit mal) seizures are characterized by brief periods of staring or decreased responsiveness, not generalized tonic–clonic convulsions.

B) Incorrect. Myoclonic seizures involve sudden, brief jerks or twitches of a muscle or muscle group, not generalized tonic–clonic convulsions.

C) Correct. Tonic-clonic seizures are characterized by generalized tonic–clonic convulsions lasting for several minutes.

D) Incorrect. Simple partial seizures involve localized symptoms without loss of consciousness or convulsions.

What is the primary danger associated with status epilepticus?

A) Temporary memory loss

B) Permanent brain damage

C) Emotional instability

D) Reduced pain tolerance

Rationale:

A) Incorrect. While temporary memory loss can occur during or after a seizure, it is not the primary danger associated with status epilepticus.

B) Correct. Status epilepticus poses a high risk of permanent brain damage if prompt, appropriate treatment is not instituted.

C) Incorrect. Emotional instability may be a consequence of epilepsy but is not the primary danger associated with status epilepticus.

D) Incorrect. Reduced pain tolerance is not a primary concern in status epilepticus.

Which of the following is a potential cause of a focus for partial (focal) seizures?

A) Proper brain development

B) Hypoxia at birth

C) Adequate oxygen supply

D) Healthy lifestyle choices

Rationale:

A) Incorrect. Proper brain development would not lead to the formation of a focus for partial seizures. Congenital defects, hypoxia at birth, and other factors can contribute to the formation of a focus.

B) Correct. Hypoxia at birth is one of the potential causes of a focus for partial seizures.

C) Incorrect. While adequate oxygen supply is important for brain health, it does not contribute to the formation of a focus for partial seizures.

D) Incorrect. Healthy lifestyle choices are not directly linked to the formation of a focus for partial seizures.

Which statement accurately describes the action of barbiturates such as Phenobarbital?

A) They increase motor activity and enhance cognitive function.

B) They inhibit transmission in the nervous system and raise the seizure threshold.

C) They primarily act on the sensory cortex to heighten sensory perception.

D) They induce CNS excitation and promote wakefulness.

Rationale:

A) Incorrect. Barbiturates like Phenobarbital typically depress the sensory cortex and decrease motor activity, contradicting this statement.

B) Correct. Barbiturates inhibit transmission in the nervous system and raise the seizure threshold, which is a fundamental mechanism of action for antiseizure medications.

C) Incorrect. Barbiturates do not primarily act to heighten sensory perception; rather, they depress the sensory cortex.

D) Incorrect. Barbiturates have a sedative effect on the CNS, inducing CNS depression rather than excitation.

What is a contraindication for the use of Phenobarbital?

A) Hypertension

B) Controlled respiratory disease

C) Presence of angioedema

D) Hypersensitivity

Rationale:

A) Incorrect. Hypertension is not a contraindication for Phenobarbital use. However, hypotension may occur due to its CNS depressant effects.

B) Incorrect. Controlled respiratory disease is not typically a contraindication; however, uncontrolled severe respiratory disease with dyspnea or obstruction is a contraindication.

C) Incorrect. Presence of angioedema is not listed as a specific contraindication for Phenobarbital use.

D) Correct. Hypersensitivity is a contraindication for Phenobarbital use, as indicated in the provided information.

Which adverse effect is associated with the use of Phenobarbital?

A) CNS excitation

B) Hypertension

C) Respiratory depression

D) Increased cognitive function

Rationale:

A) Incorrect. CNS excitation is not an adverse effect of Phenobarbital; instead, CNS depression, including respiratory depression, is common.

B) Incorrect. Phenobarbital typically causes hypotension rather than hypertension.

C) Correct. Respiratory depression is an adverse effect associated with the use of Phenobarbital, particularly in higher doses.

D) Incorrect. Increased cognitive function is not an expected effect of Phenobarbital; instead, cognitive impairment with sedation (hangover) is common.

What nursing consideration is essential for patients receiving intravenous (IV) Phenobarbital?

A) Monitor for signs of CNS excitation.

B) Assess for increased cognitive function.

C) Check for signs of angioedema frequently.

D) Administer concurrently with other CNS stimulants.

Rationale:

A) Incorrect. CNS excitation is not an expected effect of Phenobarbital; instead, CNS depression is typical.

B) Incorrect. Increased cognitive function is not an expected effect of Phenobarbital; instead, cognitive impairment with sedation is common.

C) Correct. Monitoring for signs of angioedema, such as swelling of the lips, face, or throat, is essential in patients receiving IV Phenobarbital.

D) Incorrect. Phenobarbital is a CNS depressant, and administering it concurrently with other CNS depressants, not stimulants, can lead to additive effects and increased risk of adverse reactions.

What patient teaching point is important regarding the use of Phenobarbital?

A) Increase the dose if you experience mild drowsiness.

B) Stop the medication abruptly if you notice any rash or skin eruptions.

C) Use only one form of contraception if you are of childbearing age.

D) Wear a medical alert bracelet indicating your seizure disorder and medication.

Rationale:

A) Incorrect. Increasing the dose without medical supervision can be dangerous, especially if experiencing drowsiness, as it may indicate CNS depression.

B) Incorrect. Abruptly stopping Phenobarbital can lead to withdrawal symptoms and an increased risk of seizures; therefore, gradual tapering is recommended.

C) Incorrect. Using two forms of contraception is advised for individuals of childbearing age to prevent pregnancy while taking Phenobarbital, as it can interfere with hormonal contraceptives.

D) Correct. Wearing a medical alert bracelet or necklace indicating the seizure disorder and the medications being taken, including Phenobarbital, is crucial for emergency responders to provide appropriate care.

What is the primary action of benzodiazepines in the central nervous system (CNS)?

A) Stimulation of excitatory neurotransmitter release

B) Inhibition of GABA, an inhibitory neurotransmitter

C) Activation of voltage-gated sodium channels

D) Blockade of NMDA receptors

Rationale:

A) Incorrect. Benzodiazepines do not stimulate excitatory neurotransmitter release; instead, they typically depress the CNS by potentiating GABA, an inhibitory neurotransmitter.

B) Correct. Benzodiazepines primarily depress the CNS by potentiating GABA, enhancing its inhibitory effects.

C) Incorrect. Benzodiazepines do not directly affect voltage-gated sodium channels.

D) Incorrect. Benzodiazepines do not block NMDA receptors; their primary action is on GABA receptors.

In which condition would benzodiazepines be contraindicated?

A) Chronic anxiety disorder

B) Acute narrow-angle glaucoma

C) Mild alcohol intoxication

D) Stable coma

Rationale:

A) Incorrect. Benzodiazepines are commonly used in the treatment of chronic anxiety disorders, so they would not be contraindicated for this condition.

B) Correct. Acute narrow-angle glaucoma is a contraindication for benzodiazepine use due to the potential for exacerbating intraocular pressure.

C) Incorrect. While benzodiazepines and alcohol should generally not be used together due to additive CNS depression, mild alcohol intoxication is not a specific contraindication for benzodiazepines.

D) Incorrect. Stable coma does not necessarily contraindicate benzodiazepine use, especially if they are being used for sedation or management of seizures in the context of coma.

What is a potential adverse effect of Neurontin (Gabapentin) therapy?

A) Hypertension

B) Paradoxical excitement

C) Suicidal ideation

D) Hyperglycemia

Rationale:

A) Incorrect. Hypertension is not a common adverse effect of Neurontin (Gabapentin) therapy.

B) Incorrect. Paradoxical excitement is more commonly associated with benzodiazepine therapy, not Neurontin (Gabapentin).

C) Correct. Suicidal ideation is a potential adverse effect associated with Neurontin (Gabapentin) therapy, as indicated by the provided information.

D) Incorrect. Hyperglycemia is not a common adverse effect of Neurontin (Gabapentin) therapy.

What patient teaching point is important for individuals prescribed Neurontin (Gabapentin)?

A) Stop taking the medication if nausea occurs to avoid further discomfort.

B) Notify the prescriber immediately if experiencing dizziness or somnolence.

C) Crush or chew extended-release capsules if swallowing is difficult.

D) Use two forms of contraception to prevent pregnancy while taking the medication.

Rationale:

A) Incorrect. Abruptly stopping Neurontin (Gabapentin) can lead to withdrawal symptoms; therefore, patients should not stop taking it without consulting their prescriber.

B) Correct. Dizziness and somnolence are common adverse effects of Neurontin (Gabapentin) therapy, and patients should notify their prescriber if they experience these symptoms.

C) Incorrect. Extended-release capsules should not be crushed or chewed, as this can alter the drug's release profile and lead to adverse effects.

D) Incorrect. While contraception may be necessary for women of childbearing age, using two forms of contraception is typically recommended with medications like Phenobarbital, not Neurontin (Gabapentin).

What is the mechanism of action of Neurontin (Gabapentin) in the central nervous system?

A) Inhibition of GABA, an inhibitory neurotransmitter

B) Stimulation of excitatory neurotransmitter release

C) Activation of NMDA receptors

D) Inhibition of postsynaptic responses and post-tetanic potentiation

Rationale:

A) Incorrect. Neurontin (Gabapentin) is not known to directly inhibit GABA; instead, it is structurally related to GABA but acts through different mechanisms.

B) Incorrect. Neurontin (Gabapentin) does not stimulate excitatory neurotransmitter release; its effects are primarily mediated through modulation of calcium channels.

C) Incorrect. Neurontin (Gabapentin) does not directly activate NMDA receptors; its primary actions involve inhibition of postsynaptic responses and post-tetanic potentiation.

D) Correct. Neurontin (Gabapentin) inhibits postsynaptic responses and blocks post-tetanic potentiation, contributing to its anticonvulsant and analgesic effects.

What is the primary action of Phenytoin (Dilantin) in the treatment of seizures?

A) Increasing the release of inhibitory neurotransmitters

B) Inhibiting the influx of sodium ions into neurons

C) Enhancing the activity of excitatory neurotransmitters

D) Blocking the action of gamma-aminobutyric acid (GABA)

Rationale:

A) Incorrect. Phenytoin (Dilantin) does not increase the release of inhibitory neurotransmitters; instead, it stabilizes the neuronal membrane by inhibiting the influx of sodium ions into neurons.

B) Correct. Phenytoin (Dilantin) stabilizes the neuronal membrane by delaying the influx of sodium ions into neurons, thereby preventing excessive stimulation and abnormal discharges associated with seizures.

C) Incorrect. Phenytoin (Dilantin) does not enhance the activity of excitatory neurotransmitters; its primary action is to suppress abnormal neuronal activity.

D) Incorrect. Phenytoin (Dilantin) does not directly block the action of GABA; instead, it affects sodium channels.

In which condition is the use of Phenytoin (Dilantin) contraindicated?

A) Chronic hypertension

B) Seizures related to hypoglycemia

C) Bradycardia

D) History of gastric ulcers

Rationale:

A) Incorrect. Chronic hypertension is not a contraindication for the use of Phenytoin (Dilantin).

B) Correct. Phenytoin (Dilantin) is contraindicated in seizures related to hypoglycemia due to the risk of exacerbating bradycardia and heart block.

C) Incorrect. Bradycardia is not listed as a specific contraindication for the use of Phenytoin (Dilantin).

D) Incorrect. While caution may be necessary in individuals with a history of gastric ulcers due to potential gastric irritation, it is not a contraindication for Phenytoin (Dilantin) use.

Which adverse effect is associated with high doses of Phenytoin (Dilantin) therapy?

A) Hypertension

B) Weight gain

C) Gingival hyperplasia

D) Hyperactivity

Rationale:

A) Incorrect. Hypertension is not typically associated with high doses of Phenytoin (Dilantin); instead, hypotension may occur as an adverse effect.

B) Incorrect. Weight gain is not a common adverse effect of Phenytoin (Dilantin) therapy; in fact, weight loss is listed as a potential adverse effect.

C) Correct. Gingival hyperplasia, characterized by overgrowth of the gums, is a common adverse effect associated with long-term Phenytoin (Dilantin) therapy, particularly at high doses.

D) Incorrect. Hyperactivity is not a common adverse effect of Phenytoin (Dilantin) therapy; instead, lethargy and drowsiness are more typical.

What nursing intervention is important to prevent gingival hyperplasia in patients taking Phenytoin (Dilantin)?

A) Encourage the use of hard-bristled toothbrushes for thorough cleaning.

B) Advise against regular dental checkups to minimize irritation.

C) Instruct the patient to avoid oral hygiene practices to prevent gum irritation.

D) Recommend the use of a soft-bristled toothbrush for gentle gum care.

Rationale:

A) Incorrect. Hard-bristled toothbrushes can exacerbate gum irritation and gingival hyperplasia; therefore, they should be avoided.

B) Incorrect. Regular dental checkups are important for monitoring oral health, including the development of gingival hyperplasia, so advising against them would be inappropriate.

C) Incorrect. Avoiding oral hygiene practices altogether can lead to poor oral health and exacerbate gingival hyperplasia.

D) Correct. Recommending the use of a soft-bristled toothbrush for gentle gum care can help prevent gum irritation and reduce the risk of gingival hyperplasia in patients taking Phenytoin (Dilantin).

What laboratory parameter should be monitored more closely in patients taking Phenytoin (Dilantin)?

A) Serum potassium levels

B) Serum creatinine levels

C) Serum glucose levels

D) Serum albumin levels

Rationale:

A) Incorrect. While monitoring serum potassium levels may be important for certain medications or conditions, it is not specifically indicated for patients taking Phenytoin (Dilantin).

B) Incorrect. Monitoring serum creatinine levels is important for assessing renal function but is not specifically indicated for patients taking Phenytoin (Dilantin).

C) Correct. Monitoring serum glucose levels more closely is important in patients taking Phenytoin (Dilantin) because Phenytoin may inhibit insulin release, leading to potential hyperglycemia.

D) Incorrect. While monitoring serum albumin levels may be important in certain clinical contexts, it is not specifically indicated for patients taking Phenytoin (Dilantin).

Which statement accurately describes the pharmacodynamics of Carbamazepine (Tegretol)?

A) It primarily increases concentrations of excitatory neurotransmitters in the brain.

B) Its mechanism of action is fully understood and primarily involves GABA modulation.

C) It affects sodium channels within neurons, potentially inhibiting post-synaptic responses.

D) Its action is unrelated to neurotransmitter modulation and primarily involves calcium channel blockade.

Rationale:

A) Incorrect. Carbamazepine (Tegretol) does not primarily increase concentrations of excitatory neurotransmitters; instead, it is known to affect sodium channels within neurons.

B) Incorrect. While Carbamazepine (Tegretol) does modulate neurotransmitter activity, its exact mechanism of action is not fully understood.

C) Correct. Carbamazepine (Tegretol) affects sodium channels within neurons, which may lead to inhibition of post-synaptic responses, contributing to its antiepileptic effects.

D) Incorrect. Carbamazepine (Tegretol) primarily affects sodium channels rather than calcium channels.

In which condition is the use of Valproic Acid (Depakote) contraindicated due to increased risk of bleeding?

A) Bipolar disorder

B) Seizure disorders

C) Migraine prophylaxis

D) Concurrent use with warfarin

Rationale:

A) Incorrect. Valproic Acid (Depakote) is commonly used in the treatment of bipolar disorder and is not specifically contraindicated in this condition due to bleeding risk.

B) Incorrect. Valproic Acid (Depakote) is indicated for seizure disorders, but its use is contraindicated when concurrent use with warfarin increases the risk of bleeding.

C) Incorrect. While Valproic Acid (Depakote) is used for migraine prophylaxis, its use is not specifically contraindicated in this condition due to bleeding risk.

D) Correct. Valproic Acid (Depakote) is contraindicated when used concurrently with warfarin due to the increased risk of bleeding associated with this combination.

What is a potential adverse effect of Carbamazepine (Tegretol) therapy that warrants immediate medical attention?

A) Minimal sedation and cognitive impairment

B) Mild gastrointestinal upset

C) Aplastic anemia and agranulocytosis

D) Rare hepatotoxicity and pancreatitis

Rationale:

A) Incorrect. Minimal sedation and cognitive impairment are common adverse effects of many antiepileptic drugs, including Carbamazepine (Tegretol), but they do not typically require immediate medical attention.

B) Incorrect. Mild gastrointestinal upset is a common adverse effect of Carbamazepine (Tegretol) therapy but does not typically require immediate medical attention.

C) Correct. Aplastic anemia and agranulocytosis are rare but serious adverse effects associated with Carbamazepine (Tegretol) therapy, requiring immediate medical attention if suspected.

D) Incorrect. Rare hepatotoxicity and pancreatitis are serious adverse effects associated with Valproic Acid (Depakote) therapy, not Carbamazepine (Tegretol) therapy.

What is a potential therapeutic use of Valproic Acid (Depakote) besides seizure disorders?

A) Treatment of anemia

B) Prophylaxis of migraine headaches

C) Management of hypothyroidism

D) Prevention of osteoporosis

Rationale:

A) Incorrect. Valproic Acid (Depakote) is not indicated for the treatment of anemia.

B) Correct. Valproic Acid (Depakote) is commonly used for the prophylaxis of migraine headaches, as indicated in the provided information.

C) Incorrect. Valproic Acid (Depakote) is not indicated for the management of hypothyroidism.

D) Incorrect. Valproic Acid (Depakote) is not indicated for the prevention of osteoporosis.

What nursing intervention is important when monitoring patients taking Carbamazepine (Tegretol) for seizures?

A) Assess for mood, ideation, and behavior frequently.

B) Evaluate frequency and intensity of migraine headaches.

C) Institute seizure precautions and assess seizure activity.

D) Monitor serum glucose levels closely.

Rationale:

A) Incorrect. Assessing mood, ideation, and behavior frequently is more relevant for patients with bipolar disorder than those taking Carbamazepine (Tegretol) for seizures.

B) Incorrect. Evaluating frequency and intensity of migraine headaches is more relevant for patients taking Valproic Acid (Depakote) for migraine prophylaxis.

C) Correct. Instituting seizure precautions and assessing seizure activity are essential nursing interventions when monitoring patients taking Carbamazepine (Tegretol) for seizures.

D) Incorrect. Monitoring serum glucose levels closely is important for patients taking Phenytoin (Dilantin), not Carbamazepine (Tegretol), due to its potential to inhibit insulin release.

What is the primary indication for Levetiracetam (Keppra) therapy?

A) Treatment of muscle spasm

B) Management of bipolar disorder

C) Partial onset and tonic-clonic seizures

D) Prevention of migraine headaches

Rationale:

A) Incorrect. Levetiracetam (Keppra) is not indicated for the treatment of muscle spasm; its primary indication is for the management of partial onset and tonic-clonic seizures.

B) Incorrect. Levetiracetam (Keppra) is not indicated for the management of bipolar disorder.

C) Correct. Levetiracetam (Keppra) is primarily indicated for the treatment of partial onset and tonic-clonic seizures, as stated in the provided information.

D) Incorrect. Levetiracetam (Keppra) is not indicated for the prevention of migraine headaches.

Which adverse effect is commonly associated with Levetiracetam (Keppra) therapy?

A) Bradycardia

B) Hypertension

C) Emotional lability

D) Hyperglycemia

Rationale:

A) Incorrect. Bradycardia is not a common adverse effect of Levetiracetam (Keppra) therapy.

B) Incorrect. Hypertension is not commonly associated with Levetiracetam (Keppra) therapy.

C) Correct. Emotional lability, characterized by rapid and exaggerated changes in mood, is a common adverse effect associated with Levetiracetam (Keppra) therapy, as indicated in the provided information.

D) Incorrect. Hyperglycemia is not typically associated with Levetiracetam (Keppra) therapy.

What is a contraindication for the use of Levetiracetam (Keppra)?

A) History of epilepsy

B) Known hypersensitivity to the medication

C) Chronic muscle spasm

D) Pregnancy and lactation

Rationale:

A) Incorrect. A history of epilepsy is not a contraindication for the use of Levetiracetam (Keppra); in fact, it is one of the primary indications for its use.

B) Correct. Known hypersensitivity to Levetiracetam (Keppra) is a contraindication for its use, as stated in the provided information.

C) Incorrect. Chronic muscle spasm is not listed as a contraindication for the use of Levetiracetam (Keppra).

D) Incorrect. Pregnancy and lactation are contraindications for the use of Levetiracetam (Keppra) due to potential risks to the fetus or infant.

What is a potential cause of drug therapy failure in the management of seizures?

A) Comorbid bipolar disorder

B) Inadequate drug dosage

C) Concurrent use of muscle relaxants

D) Regular physical therapy sessions

Rationale:

A) Incorrect. Comorbid bipolar disorder is not a direct cause of drug therapy failure in the management of seizures.

B) Correct. Inadequate drug dosage is a potential cause of drug therapy failure in the management of seizures, as stated in the provided information.

C) Incorrect. Concurrent use of muscle relaxants may contribute to drug interactions, but it is not a primary cause of drug therapy failure in the management of seizures.

D) Incorrect. Regular physical therapy sessions are not typically associated with drug therapy failure in the management of seizures.

Which physical measure is commonly used in the therapy of muscle spasm?

A) Intravenous fluid administration

B) Immobilization of affected muscle

C) Heat therapy

D) Massage therapy

Rationale:

A) Incorrect. Intravenous fluid administration is not a primary physical measure used in the therapy of muscle spasm.

B) Correct. Immobilization of the affected muscle is a common physical measure used in the therapy of muscle spasm, as stated in the provided information.

C) Incorrect. Heat therapy may be used for certain musculoskeletal conditions but is not a primary physical measure for muscle spasm.

D) Incorrect. While massage therapy may provide relief for muscle tension, it is not typically considered a primary physical measure for muscle spasm therapy.

What is the primary mechanism of action of Baclofen (Lioresal)?

A) Stimulation of reflexes at the spinal level

B) Direct muscle relaxation at the neuromuscular junction

C) Inhibition of reflexes at the spinal level

D) Activation of GABA receptors in the brain

Rationale:

A) Incorrect. Baclofen (Lioresal) does not stimulate reflexes at the spinal level; instead, it inhibits reflexes, contributing to its muscle-relaxing effects.

B) Incorrect. Baclofen (Lioresal) does not directly relax muscles at the neuromuscular junction.

C) Correct. Baclofen (Lioresal) primarily acts by inhibiting reflexes at the spinal level, leading to decreased muscle spasticity, as stated in the provided information.

D) Incorrect. While Baclofen (Lioresal) affects GABA receptors, its primary mechanism of action is the inhibition of reflexes at the spinal level.

In which condition is the use of Baclofen (Lioresal) contraindicated?

A) Chronic pain syndromes

B) Multiple sclerosis or spinal cord lesions

C) Chronic obstructive pulmonary disease (COPD)

D) History of generalized anxiety disorder

Rationale:

A) Incorrect. Baclofen (Lioresal) is not contraindicated in chronic pain syndromes.

B) Correct. Baclofen (Lioresal) is contraindicated in patients with a known hypersensitivity to the medication, as well as in pregnant or lactating individuals and pediatric patients. Additionally, caution should be exercised in patients with impaired renal or hepatic function.

C) Incorrect. Chronic obstructive pulmonary disease (COPD) is not a contraindication for the use of Baclofen (Lioresal).

D) Incorrect. A history of generalized anxiety disorder is not a contraindication for the use of Baclofen (Lioresal).

What is a potential adverse effect of Baclofen (Lioresal) therapy that requires monitoring?

A) Hypertension

B) Hyperglycemia

C) Seizures

D) Hypokalemia

Rationale:

A) Incorrect. Hypertension is not a common adverse effect of Baclofen (Lioresal) therapy.

B) Incorrect. Hyperglycemia is not typically associated with Baclofen (Lioresal) therapy.

C) Correct. Seizures are a potential adverse effect of Baclofen (Lioresal) therapy, as stated in the provided information, and require monitoring.

D) Incorrect. Hypokalemia is not a common adverse effect of Baclofen (Lioresal) therapy.

What is an important nursing consideration when administering Baclofen (Lioresal)?

A) Assessing vital signs before administration

B) Monitoring muscle spasticity before and periodically during therapy

C) Instructing the patient to take the medication with food

D) Administering the medication via intravenous bolus injection

Rationale:

A) Incorrect. While assessing vital signs is important in general nursing care, it is not a specific consideration for Baclofen (Lioresal) administration.

B) Correct. Monitoring muscle spasticity before and periodically during therapy is an important nursing consideration for Baclofen (Lioresal) to assess treatment efficacy and adjust dosage as needed.

C) Incorrect. Baclofen (Lioresal) may be taken with or without food, and specific dietary instructions are not typically necessary.

D) Incorrect. Baclofen (Lioresal) is not administered via intravenous bolus injection but rather orally or intrathecally.

What is an essential patient education point regarding the discontinuation of Baclofen (Lioresal) therapy?

A) Discontinue the medication abruptly to avoid withdrawal symptoms

B) Gradually decrease the dosage over 2 weeks or more to prevent withdrawal reactions

C) Double the dose if a dose is missed to maintain therapeutic levels

D) Take the medication only when experiencing severe muscle spasticity

Rationale:

A) Incorrect. Abrupt discontinuation of Baclofen (Lioresal) can precipitate withdrawal symptoms, making option A incorrect.

B) Correct. Gradually decreasing the dosage over 2 weeks or more is essential to prevent withdrawal reactions such as hallucinations, increased spasticity, seizures, and mental changes, as stated in the provided information.

C) Incorrect. Doubling the dose if a dose is missed is not recommended and may increase the risk of adverse effects or toxicity.

D) Incorrect. Baclofen (Lioresal) should be taken regularly as prescribed, not only when experiencing severe muscle spasticity, to maintain therapeutic levels and prevent withdrawal symptoms.

What is the primary mechanism of action of Benzodiazepine (Diazepam)?

A) Potentiation of excitatory neurotransmitters in the CNS

B) Inhibition of GABA receptors in the brain

C) Depression of the CNS by potentiating GABA, an inhibitory neurotransmitter

D) Stimulation of adrenergic receptors in the spinal cord

Rationale:

A) Incorrect. Benzodiazepines like Diazepam do not potentiate excitatory neurotransmitters; instead, they enhance the effects of inhibitory neurotransmitters such as GABA.

B) Incorrect. Benzodiazepines like Diazepam do not inhibit GABA receptors; they actually potentiate the effects of GABA.

C) Correct. Benzodiazepines like Diazepam primarily depress the CNS by potentiating GABA, an inhibitory neurotransmitter, as stated in the provided information.

D) Incorrect. Benzodiazepines like Diazepam do not stimulate adrenergic receptors; their primary action is on GABAergic neurotransmission.

For which condition is Benzodiazepine (Diazepam) contraindicated?

A) Anxiety disorders

B) Skeletal muscle relaxation

C) Comatose patients

D) Hypertension

Rationale:

A) Incorrect. Benzodiazepines like Diazepam are commonly used for the relief of anxiety disorders.

B) Incorrect. Benzodiazepines like Diazepam are indicated for skeletal muscle relaxation.

C) Correct. Benzodiazepines like Diazepam are contraindicated in comatose patients, as stated in the provided information.

D) Incorrect. Hypertension is not a contraindication for the use of Benzodiazepine (Diazepam).

What adverse effect should the nurse monitor for when administering Benzodiazepine (Diazepam)?

A) Bradycardia

B) Hypotension

C) Respiratory depression

D) Hyperglycemia

Rationale:

A) Incorrect. Bradycardia is not a common adverse effect of Benzodiazepine (Diazepam) therapy.

B) Incorrect. While hypotension can occur as a result of Benzodiazepine (Diazepam) therapy, respiratory depression is a more immediate concern and requires close monitoring.

C) Correct. Respiratory depression is a potential adverse effect of Benzodiazepine (Diazepam) therapy, as stated in the provided information.

D) Incorrect. Hyperglycemia is not typically associated with Benzodiazepine (Diazepam) therapy.

What is an essential nursing consideration when administering Benzodiazepine (Diazepam)?

A) Monitoring liver function tests periodically

B) Assessing deep tendon reflexes before and after administration

C) Monitoring blood glucose levels regularly

D) Monitoring BP, HR, and respiratory rate before and during therapy

Rationale:

A) Incorrect. While monitoring liver function tests may be necessary for certain medications, it is not a specific consideration for Benzodiazepine (Diazepam) administration.

B) Incorrect. Assessing deep tendon reflexes is not a specific consideration for Benzodiazepine (Diazepam) administration.

C) Incorrect. Monitoring blood glucose levels regularly is not a specific consideration for Benzodiazepine (Diazepam) administration.

D) Correct. Monitoring BP, HR, and respiratory rate before and during therapy is an essential nursing consideration for Benzodiazepine (Diazepam) administration to assess for potential adverse effects and therapeutic response.

Which symptom should alert the nurse to the possibility of Neuroleptic Malignant Syndrome in a patient receiving Benzodiazepine (Diazepam)?

A) Bradycardia and hypotension

B) Diaphoresis and muscle rigidity

C) Hyperactivity and euphoria

D) Increased appetite and weight gain

Rationale:

A) Incorrect. Bradycardia and hypotension are not typically associated with Neuroleptic Malignant Syndrome.

B) Correct. Symptoms of Neuroleptic Malignant Syndrome include diaphoresis (excessive sweating) and muscle rigidity, as stated in the provided information.

C) Incorrect. Hyperactivity and euphoria are not characteristic symptoms of Neuroleptic Malignant Syndrome.

D) Incorrect. Increased appetite and weight gain are not characteristic symptoms of Neuroleptic Malignant Syndrome.

What is a characteristic clinical manifestation of ADHD?

A) Disturbed nocturnal sleep

B) Cataplexy

C) Symptoms improving in situations requiring sustained attention

D) Abnormal daytime sleep pattern

Rationale:

A) Incorrect. Disturbed nocturnal sleep is a characteristic clinical manifestation of narcolepsy, not ADHD.

B) Incorrect. Cataplexy is a characteristic clinical manifestation of narcolepsy, not ADHD.

C) Correct. Symptoms of ADHD tend to worsen in situations that require sustained attention, as stated in the provided information.

D) Incorrect. An abnormal daytime sleep pattern is a characteristic clinical manifestation of narcolepsy, not ADHD.

What is a goal of therapy for narcolepsy?

A) Prevention of sleep deprivation

B) Facilitating academic performance

C) Promoting social development

D) Controlling symptoms of hyperactivity

Rationale:

A) Correct. Prevention of sleep deprivation is a goal of therapy for narcolepsy, as stated in the provided information.

B) Incorrect. Facilitating academic performance is a goal of therapy for ADHD, not narcolepsy.

C) Incorrect. Promoting social development is a goal of therapy for ADHD, not narcolepsy.

D) Incorrect. Controlling symptoms of hyperactivity is a goal of therapy for ADHD, not narcolepsy.

Which class of drugs acts by facilitating the initiation and transmission of nerve impulses in conditions like ADHD and narcolepsy?

A) Selective norepinephrine reuptake inhibitors

B) CNS depressants

C) Amphetamines

D) Sympatholytics

Rationale:

A) Incorrect. Selective norepinephrine reuptake inhibitors are not known for facilitating the initiation and transmission of nerve impulses.

B) Incorrect. CNS depressants have the opposite effect of stimulating nerve impulses and are not used to treat ADHD or narcolepsy.

C) Correct. Amphetamines act by facilitating the initiation and transmission of nerve impulses in conditions like ADHD and narcolepsy, as stated in the provided information.

D) Incorrect. Sympatholytics work by inhibiting the sympathetic nervous system and are not used to treat ADHD or narcolepsy.

What is a characteristic feature of amphetamines and amphetamine-related drugs?

A) Low potential for abuse and dependence

B) Schedule IV classification

C) Exclusive use for ADHD treatment

D) High potential for abuse and dependence

Rationale:

A) Incorrect. Amphetamines and amphetamine-related drugs have a high potential for abuse and dependence, not a low potential.

B) Incorrect. Amphetamines and amphetamine-related drugs are classified as Schedule II controlled substances, not Schedule IV.

C) Incorrect. Amphetamines and amphetamine-related drugs are used for the treatment of both ADHD and narcolepsy, not exclusively for ADHD.

D) Correct. Amphetamines and amphetamine-related drugs have a high potential for abuse and dependence, as stated in the provided information.

What is a potential risk associated with the misuse and abuse of stimulants used in ADHD and narcolepsy treatment?

A) Respiratory depression

B) Decreased performance of daily activities

C) Decreased academic performance

D) Overdoses and dependence

Rationale:

A) Incorrect. Respiratory depression is not typically associated with the misuse and abuse of stimulants used in ADHD and narcolepsy treatment.

B) Incorrect. Misuse and abuse of stimulants can lead to increased performance of daily activities rather than decreased performance.

C) Incorrect. Misuse and abuse of stimulants can lead to increased academic performance rather than decreased performance.

D) Correct. Overdoses and dependence are potential risks associated with the misuse and abuse of stimulants used in ADHD and narcolepsy treatment, as stated in the provided information.

What is a characteristic effect of xanthines like caffeine when consumed in low to moderate amounts?

A) Inducing sleep

B) Increasing fatigue

C) Decreasing alertness

D) Enhancing wakefulness

Rationale:

A) Incorrect. Xanthines like caffeine in low to moderate amounts do not induce sleep; they actually delay sleep onset.

B) Incorrect. Xanthines like caffeine do not increase fatigue; they decrease fatigue.

C) Incorrect. Xanthines like caffeine increase alertness rather than decreasing it.

D) Correct. Xanthines like caffeine, when consumed in low to moderate amounts, enhance wakefulness and increase alertness, as stated in the provided information.

What adverse effect can occur with the consumption of large amounts of caffeine?

A) Decreased heart rate

B) Constipation

C) Hyperactivity

D) Hypotension

Rationale:

A) Incorrect. Large amounts of caffeine typically lead to increased heart rate (tachycardia), not decreased heart rate.

B) Incorrect. Constipation is not a common adverse effect associated with large amounts of caffeine consumption.

C) Correct. Large amounts of caffeine can cause hyperactivity, as stated in the provided information.

D) Incorrect. Large amounts of caffeine usually cause increased blood pressure (hypertension), not hypotension.

What is a characteristic of substance abuse?

A) Controlled drug administration

B) Enhanced ability to function in daily activities

C) Reduced motivation to function as a productive member of society

D) Improved physical and psychological well-being

Rationale:

A) Incorrect. Substance abuse is characterized by self-administration of drugs for prolonged periods or in excessive amounts, not controlled administration.

B) Incorrect. Substance abuse impairs the ability to function in daily activities rather than enhancing it.

C) Correct. Substance abuse often leads to reduced motivation to function as a productive member of society, as stated in the provided information.

D) Incorrect. Substance abuse typically results in deteriorating physical and psychological well-being rather than improvement.

Which category of drugs is commonly abused and includes substances like cocaine and methamphetamine?

A) CNS depressants

B) Opioids

C) Mind-altering drugs

D) CNS stimulants

Rationale:

A) Incorrect. CNS depressants include drugs like alcohol and sedatives, not cocaine and methamphetamine.

B) Incorrect. Opioids include drugs like heroin and prescription painkillers, not cocaine and methamphetamine.

C) Incorrect. Mind-altering drugs include substances like marijuana and ecstasy, not cocaine and methamphetamine.

D) Correct. Cocaine and methamphetamine belong to the category of CNS stimulants, as stated in the provided information.

What is a consequence of repeated substance use leading to tolerance?

A) Decreased risk of dependence

B) Reduced pleasure from substance use

C) Lower likelihood of withdrawal symptoms

D) Need to increase dosing to achieve pleasure and avoid withdrawal symptoms

Rationale:

A) Incorrect. Repeated substance use leading to tolerance does not decrease the risk of dependence; it increases it.

B) Incorrect. Tolerance does not result in reduced pleasure from substance use; it necessitates higher doses to achieve the same effect.

C) Incorrect. Tolerance does not lower the likelihood of withdrawal symptoms; it often exacerbates them.

D) Correct. Tolerance requires individuals to increase dosing to achieve pleasure and avoid withdrawal symptoms, as stated in the provided information.

Which characteristic is commonly associated with drug dependence?

A) Enhanced control over drug use

B) Absence of withdrawal symptoms

C) Decreased craving for the drug

D) Compulsive drug-seeking behavior

Rationale:

A) Incorrect. Drug dependence is characterized by a loss of control over drug use, not enhanced control.

B) Incorrect. Drug dependence typically results in withdrawal symptoms when drug use is decreased or stopped.

C) Incorrect. Drug dependence often leads to increased craving for the drug, not decreased craving.

D) Correct. Compulsive drug-seeking behavior is a common characteristic of drug dependence, as stated in the provided information.

What neurotransmitter sites of action are affected by drugs like cocaine and nicotine?

A) Serotonergic

B) Cholinergic

C) Dopaminergic

D) GABAergic

Rationale:

A) Incorrect. Serotonergic sites of action are not typically affected by drugs like cocaine and nicotine.

B) Incorrect. Cholinergic sites of action are not primarily targeted by drugs like cocaine and nicotine.

C) Correct. Drugs like cocaine and nicotine primarily affect dopaminergic sites of action, as stated in the provided information.

D) Incorrect. GABAergic sites of action are not the primary target of drugs like cocaine and nicotine.

What is a factor in developing drug dependence?

A) Decreased genetic influence

B) Reduced environmental characteristics

C) Limited availability of the drug

D) High frequency of drug administration

Rationale:

A) Incorrect. Genetic factors, including predispositions to addiction, can increase the likelihood of developing drug dependence.

B) Incorrect. Environmental characteristics, such as exposure to peer pressure and availability of drugs, play a significant role in developing drug dependence.

C) Incorrect. Limited availability of the drug may reduce the risk of developing drug dependence.

D) Correct. The amount, frequency, and route of administration of a drug are factors in developing drug dependence, as stated in the provided information.

What is the primary goal of therapy for substance use disorders?

A) Maintenance of drug dependence

B) Promotion of drug availability

C) Prevention of substance abuse

D) Encouragement of drug misuse

Rationale:

A) Incorrect. The primary goal of therapy for substance use disorders is not the maintenance of drug dependence.

B) Incorrect. Therapy aims to decrease drug availability, not promote it.

C) Correct. Prevention of substance abuse is a primary goal of therapy for substance use disorders, as stated in the provided information.

D) Incorrect. Therapy does not aim to encourage drug misuse; rather, it focuses on deterring it.

Which drug is classified as an opioid antagonist and is commonly used to reverse opioid overdose?

A) Varenicline (Chantix)

B) Bupropion (Wellbutrin)

C) Naloxone (Narcan)

D) Disulfiram (Antabuse)

Rationale:

A) Incorrect. Varenicline and bupropion are used in smoking cessation therapy, not as opioid antagonists.

B) Incorrect. Bupropion is used in smoking cessation therapy, not as an opioid antagonist.

C) Correct. Naloxone is classified as an opioid antagonist and is commonly used to reverse opioid overdose, as stated in the provided information.

D) Incorrect. Disulfiram is used in the treatment of alcohol use disorder, not as an opioid antagonist.