232 Medications

Methylprednisone sodium succinate (Solu-Medrol®) is used to treat which of the following conditions? (Select all that apply.)

a.    Diabetes mellitus type 2

b.    Cerebral edema

c.     Severe allergic reaction

d.    Cushing’s syndrome

e.    Post kidney transplant

B, C, E

What is the drug of choice for the immediate treatment of status epilepticus?

a.    diazepam (Valium®)

b.    midazolam

c.     valproic acid (Depakene)

d.    carbamazepine (Tegretol)

Diazepam (valium)

The nurse is caring for a postoperative craniotomy patient. Which prescribed drug does the nurse make sure is readily available to treat acute seizure activity?

a.    pregabalin (Lyrica®)

b.    ethosuximide (Zarontin®)

c.     gabapentin (Neurontin®)

d.    diazepam (Valium®)

Diazepam (valium)

A patient with a history of epilepsy experiences status epilepticus. What medication can the nurse expect to prepare for this condition?

a.    Phenobarbital

b.    Diazepam (Valium)

c.     Valproic acid (Depakene) 

d.    Phenytoin (Dilantin)

Diazepam (valium)

The nurse is administering midazolam to a patient. Which of the following desired effects is most likely to occur with this medication?

a.    Short acting anaesthesia effect and amnesia 

b.    Induction and maintenance of anaesthesia

c.     Analgesia and prevention of intraoperative vomiting

d.    Relaxation of skeletal muscles and facilitation of endotracheal intubation

short acting anesthesia effect and amnesia

An intravenous dose of midazolam has been prescribed for a patient before a colonoscopy. The nurse informs the patient that one of the most common adverse effects of this medication is which of the following?

a.    Chest pain

b.    Amnesia

c.     Dry mouth

d.    Constipation

amnesia

A patient receiving valproic acid (Depakote) should be monitored for which adverse effects? (Select all that apply.)

a.    Insomnia

b.    Tremors

c.     Weight gain

d.    Hepatoxicity

e.    Hypoglycemia

b, c, d

The nurse is reviewing the drugs currently taken by a patient who will be starting drug therapy with carbamazepine (Tegretol). Which drug may raise a concern for interactions?

a.    digoxin (Lanoxin®)

b.    acetaminophen (Tylenol®)

c.     diazepam (Valium)

d.    warfarin sodium (Coumadin®)

acetaminophen (tylenol)

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?

a.    The initial dose was not sufficient to prevent seizures.

b.    Auto-induction results in lower-than-expected drug concentrations.

c.     Because the seizures are difficult to manage, increased doses are needed to control them.

d.    Forgetting to take the medication as prescribed led to a need for increased dosage.

auto-induction results in lower than expected drug concentrations

When administering phenytoin (Dilantin®) intravenously, what must the nurse remember?

a.    Normal saline is the only solution to be used with phenytoin.

b.    Intravenous (IV) doses must be given rapidly to raise blood levels quickly.

c.     The patient should be monitored closely for tachycardia and increased blood pressure.

d.    Phenytoin can be combined with other solutions without fear of precipitate formation.

normal saline is the only solution to be used with phenytoin

The nurse instructs a patient who is receiving phenytoin (Dilantin®) to visit the dentist regularly and to perform frequent oral hygiene. What common adverse effect is the nurse educating the patient about for this medication?

a.    Gingival hyperplasia

b.    Increased risk of tooth abscess

c.     Oral candidiasis

d.    Increased incidence of dental caries

Gingival hyperplasia

A patient prescribed a tube feeding has a history of a seizure disorder. The absorption of which antiepileptic medication is reduced when given with tube feedings?

a.    Levetiracetam

b.    Pregabalin

c.     Phenytoin

d.    lamotrigine

Phenytoin

While admitting a patient for treatment of an acetaminophen (Tylenol®) overdose, the nurse prepares to administer which medication to prevent toxicity?

a.   Acetylcysteine

b.   phytonadione (vitamin K)

c.    naloxone hydrochloride

d.   ibuprofen

Acetylcysteine

A patient who has been taking phenobarbital for 2 weeks as part of therapy for epilepsy reports feeling tense and that the "least little thing" is a bother now. What is the nurse's best explanation to the patient?

a.    These adverse effects will often subside after a few weeks.

b.    The drug should be stopped immediately because of possible adverse effects.

c.     This drug causes the rapid eye movement (REM) sleep period to increase, resulting in nightmares and restlessness.

d.    This drug causes deprivation of REM sleep and may cause the patient's inability to deal with normal stress.

This drug causes deprivation of REM sleep and may cause the patients inability to deal with normal stress

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?

a.    Trying to establish set sleep patterns

b.    Exercising before bedtime to become tired

c.     Consuming heavy meals in the evening to promote sleepiness

d.    Drinking warm beverages, such as tea or coffee, just before bedtime

trying to establish set sleep patterns

The nurse is teaching a patient about the possible adverse effects of donepezil (Aricept) for Alzheimer’s disease. Which of these are possible adverse effects? (Select all that apply.)

a.    Constipation

b.    GI upset

c.     Drowsiness

d.    Dizziness

e.    Blurred vision 

b, c, d

The nurse administering donepezil (Aricept®) to a patient with Alzheimer’s disease understands that this drug is expected to do which of the following?

a.    Increase the levels of acetylcholine in the brain by blocking the drug’s breakdown

b.    Block the effect of norepinephrine at the presynaptic cell membrane

c.     Help control associated urinary and fecal incontinence

d.    Relieve the patient’s anxiety and restlessness

increase the levels of acetylcholine in the brain by blocking the drugs breakdown

The health care provider prescribes donepezil for a patient. The patient states to the nurse, “I have no idea why I take this medication.” The nurse knows that the administration of donepezil is most commonly associated with what condition?

a.    Alzheimer’s disease

b.    Parkinson’s disease

c.     Urinary retention

d.    Bladder retention

alzheimers disease

A 62 year old patient started taking donepezil hydrochloride (Aricept) for early stages of Alzheimer's disease. The patient's daughter expresses relief that "there is finally a pill to cure Alzheimer's disease." What is the most appropriate response by the nurse?

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

b.    "The dosage should be increased if no improvement is noted."

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

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

this drug may help to improve symptoms, but it is not intended as a cure