(2042) Exam #2 Questions

question
Which mood-stabilizing drugs are used to treat bipolar disorder? Select all that apply. 1. Bupropion 2. Imipramine 3. Isocarboxazid 4. Oxcarbazepine 5. Lithium carbonate
answer
4. Oxcarbazepine 5. Lithium carbonate
question
The nurse notes lithium on a patient's drug history upon admission. Which condition would the nurse suspect that this patient has been diagnosed with? 1. Bipolar disorder 2. Absence seizures 3. Paranoid schizophrenia 4. Obsessive-compulsive disorder
answer
1. Bipolar disorder
question
The nurse notes that the patient has an increased blood glucose level, increased blood pressure (BP), and abnormal cholesterol levels. What does the nurse infer from these observations? 1. The patient has mania. 2. The patient has dystonia. 3. The patient has dyskinesia. 4. The patient has metabolic syndrome
answer
4. The patient has metabolic syndrome
question
Which anxiolytic drug promotes agonistic activity at both the serotonin and dopamine receptors? 1. Buspirone 2. Alprazolam 3. Lorazepam 4. Amitriptyline
answer
1. Buspirone
question
Which are common symptoms of serotonin syndrome? Select all that apply. 1. Delirium 2. Myoclonus 3. Drowsiness 4. Coarse tremors 5. Suicidal thoughts
answer
1. Delirium 2. Myoclonus 4. Coarse tremors
question
What are the current indications for tricyclic antidepressants (TCAs)? Select all that apply. 1. Seizures 2. Insomnia 3. Depression 4. Childhood enuresis 5. Neuropathic pain syndrome
answer
2. Insomnia 4. Childhood enuresis 5. Neuropathic pain syndrome
question
Which phenomena does the nurse recognize as positive symptoms of schizophrenia? Select all that apply. 1. Catatonia 2. Delusions 3. Hallucinations 4. Poverty of speech 5. Social withdrawal 6. Conceptual disorganization
answer
2. Delusions 3. Hallucinations 6. Conceptual disorganization
question
Which patient is a poor candidate for therapy with diazepam to treat generalized anxiety disorder? 1. One with a history of alcoholism 2. One with type 2 diabetes mellitus 3. One who had convulsions as a child 4. One who has had a myocardial infarction
answer
1. One with a history of alcoholism
question
What is another approved and indicated use for bupropion, a second-generation antidepressant? 1. Smoking cessation 2. Orthostatic hypotension 3. Nocturnal enuresis in children 4. Anorexia in patients undergoing chemotherapy
answer
1. Smoking cessation
question
A patient who has taken fluoxetine for 2 weeks to treat an anxiety disorder expresses dissatisfaction with the therapy. What is the best information for the nurse to include in patient education to promote adherence to the therapeutic regimen? 1. This medication usually requires titration. 2. The adverse effects can be managed well. 3. Relaxation exercises can offer some relief. 4. A therapeutic effect can be expected in another 2 to 4 weeks.
answer
4. A therapeutic effect can be expected in another 2 to 4 weeks.
question
The nurse is assessing a patient who has been prescribed alprazolam to treat panic disorder. Which adverse effects does the nurse monitor for in the patient? Select all that apply. 1. Ataxia 2. Dizziness 3. Confusion 4. Blurred vision 5. Paradoxical anxiety
answer
1. Ataxia 2. Dizziness 3. Confusion
question
Which activity should the patient be cautioned to avoid while taking a monoamine oxidase (MAO) inhibitor? 1. Eating aged cheese 2. Sunbathing at the pool 3. Participating in a bowling league 4. Smoking a low-nicotine cigarette
answer
1. Eating aged cheese
question
A patient is detoxifying from alcohol abuse. Which type of medication is indicated to help the patient manage withdrawal symptoms? 1. Phenothiazine 2. Dibenzazepine 3. Benzisoxazole 4. Benzodiazepine
answer
4. Benzodiazepine
question
What atypical antipsychotic medication would the nurse anticipate a health care provider prescribing for treatment of refractory schizophrenia? 1. Trazodone 2. Phenelzine 3. Amoxapine 4. Risperidone
answer
4. Risperidone
question
Which adverse effects result from antipsychotic drugs' action on alpha-adrenergic receptors? Select all that apply. 1. Weight gain 2. Lightheadedness 3. Reflex tachycardia 4. Tardive dyskinesia 5. Postural hypotension
answer
2. Lightheadedness 3. Reflex tachycardia 5. Postural hypotension
question
Which theory states that depression and mania are caused by alterations in the concentration of dopamine and norepinephrine and serotonin and histamine in the brain? 1. Dopamine hypothesis 2. Permissive hypothesis 3. Dysregulation hypothesis 4. Biogenic amine hypothesis
answer
4. Biogenic amine hypothesis
question
Which instruction does a nurse provide to a patient who is taking a selective serotonin reuptake inhibitor (SSRI)? 1. "Change positions frequently." 2. "Avoid foods or beverages rich in tyramine." 3. "Avoid hot baths, saunas, and hot climates." 4. "Increase the intake of dietary fiber supplements."
answer
4. "Increase the intake of dietary fiber supplements."
question
The nurse is assessing a patient with depression who has been prescribed nortriptyline. Following the assessment, the nurse finds that the patient has constipation and urinary retention due to interaction between the prescribed medications. Which class of medication found in the patient's prescription is responsible for these effects? 1. Diuretics 2. Anxiolytics 3. Anticholinergics 4. Antihypertensives
answer
3. Anticholinergics
question
hich medication increases the rate of urinary elimination of tricyclic antidepressants (TCAs) in the event of an overdose? 1. Diazepam 2. Antidysrhythmic 3. Activated charcoal 4. Sodium bicarbonate
answer
4. Sodium bicarbonate
question
In caring for a patient experiencing ethanol withdrawal, the nurse expects to administer which medication or medication class as treatment for this condition? a. lithium (Eskalith) b. Benzodiazepines c. buspirone (BuSpar) d. Antidepressants
answer
b. Benzodiazepines
question
Patient teaching for a patient receiving an MAOI would include instructions to avoid which food product? a. Orange juice b. Milk c. Shrimp d. Swiss cheese
answer
d. Swiss cheese
question
After a patient has been treated for depression for 4 weeks, the nurse calls the patient to schedule a follow-up visit. What concern will the nurse assess for during the conversation with the patient? a. Weakness b. Hallucinations c. Suicidal ideation d. Difficulty with urination
answer
c. Suicidal ideation
question
The nurse is caring for a patient who has been taking clozapine (Clozaril) for 2 months. Which laboratory test(s) should be performed regularly while the patient is taking this medication? a. Platelet count b. WBC count c. Liver function studies d. Renal function studies
answer
b. WBC count
question
The nurse is giving medications to a patient. Which drug or drug class, when administered with lithium, increases the risk for lithium toxicity? a. Thiazides b. levofloxacin c. calcium citrate d. Beta blockers
answer
a. Thiazides
question
The nurse is teaching a patient about treatment with an SSRI antidepressant. Which teaching considerations are appropriate? (Select all that apply.) a. The patient should be told which foods contain tyramine and instructed to avoid these foods. b. The patient should be instructed to use caution when standing up from a sitting position. c. The patient should not take any products that contain the herbal product St. John's wort. d. This medication should not be stopped abruptly. e. Drug levels may become toxic if dehydration occurs. f. The patient should be told to check with the prescriber before taking any over-the-counter medications.
answer
b. The patient should be instructed to use caution when standing up from a sitting position. c. The patient should not take any products that contain the herbal product St. John's wort. d. This medication should not be stopped abruptly. f. The patient should be told to check with the prescriber before taking any over-the-counter medications.
question
A patient with a feeding tube will be receiving risperidone (Risperdal) 8 mg in 2 divided doses via the feeding tube. The medication is available in a 1 mg/mL solution. How many milliliters will the nurse administer for each dose?
answer
4 mL per dose
question
A patient who has been taking lithium for 6 months has had severe vomiting and diarrhea from a gastrointestinal flu. The nurse will assess for which potential problem at this time? a. Anxiety b. Chest pain c. Agitation d. Dehydration
answer
d. Dehydration
question
A 68-year-old patient has been taking an SSRI antidepressant for 3 weeks. His wife calls and expresses concern because he has started to give away some of his keepsakes. What is the nurse's priority action at this time?
answer
The priority is to watch this patient closely for suicidal ideations, which may increase during the first weeks after antidepressant therapy is started. The nurse should instruct the wife to bring her husband in for a follow-up visit immediately and not to leave him alone.
question
A patient has been admitted to the hospital because of a suspected overdose of a tricyclic antidepressant. What two problems are the nurse's priorities at this time?
answer
The two priority problems that may occur after an overdose of tricyclic antidepressants are cardiac dysrhythmias and seizures, and both may lead to death. Overdoses of these medications can be lethal.
question
A friend has revealed to the nurse that she has used crack cocaine often in the past few months and states that even though she enjoys the sensations she can "stop at any time." What is the nurse's priority action in this situation?
answer
This situation brings up an ethical difficulty in that a friend has confided in the nurse, yet the friend is participating in an illegal and harmful activity. First of all, she will not change her behavior unless she wants to change. The priority is the safety of the friend. The nurse can try to educate her about the dangers of taking illicit drugs, specifically the cocaine, and how an overdose or bad batch could kill her. If she wants help, the nurse can aid her in seeking professional medical care and counseling to assist with withdrawal and psychologic dependence. She also needs to realize that this will be a lifelong issue. The nurse will try to involve her family in an intervention to help her to recognize her problem.
question
A patient is admitted to the hospital for major abdominal surgery, and the physician has ordered that a transdermal nicotine patch be used while the patient is hospitalized because the patient was a heavy smoker. While the patch is applied, the patient asks, "Why in the world would you want to give me nicotine when I'm trying to stop smoking?" What is the nurse's priority when answering the patient's question?
answer
The nurse needs to explain how the expected nicotine withdrawal will affect his recovery from surgery. Nicotine withdrawal may be manifested in a hospitalized patient by irritability, restlessness, and decreases in both heart rate and blood pressure. In addition, a patient may experience severe cravings for cigarettes. During the postoperative period, the symptoms of nicotine withdrawal may mask other underlying problems, such as hypoxia or even bleeding. He will also be more comfortable if the cravings are curbed. The transdermal administration of nicotine provides nicotine without the carcinogens found in tobacco; the patches are part of a stepwise reduction in subcutaneous delivery. Over time, the nicotine dosage is gradually decreased.
question
A patient is experiencing withdrawal from opioids. The nurse expects to see which assessment finding most commonly associated with acute opioid withdrawal? a. Elevated blood pressure b. Decreased pulse c. Lethargy d. Constipation
answer
a. Elevated blood pressure
question
During treatment for withdrawal from opioids, the nurse expects which medication to be ordered? a. amphetamine (Dexedrine) b. clonidine (Catapres) c. diazepam (Valium) d. disulfiram (Antabuse)
answer
b. clonidine (Catapres)
question
The nurse is presenting a seminar on substance abuse. Which drug is the most commonly used illicit drug in the United States? a. Crack cocaine b. Heroin c. Marijuana d. Methamphetamine
answer
c. Marijuana
question
A patient who is taking disulfiram as part of an alcohol treatment program accidentally takes a dose of cough syrup that contains a small percentage of alcohol. The nurse expects to see which symptom as a result of acetaldehyde syndrome? a. Lethargy b. Copious vomiting c. Hypertension d. No ill effect because of the small amount of alcohol in the cough syrup
answer
b. Copious vomiting
question
The nurse is assessing a patient for possible substance abuse. Which assessment finding indicates possible use of amphetamines? a. Lethargy and fatigue b. Cardiovascular depression c. Talkativeness and euphoria d. Difficulty swallowing and constipation
answer
c. Talkativeness and euphoria
question
A patient experiencing ethanol withdrawal is beginning to show severe manifestations of delirium tremens. The nurse will plan to implement which interventions for this patient? (Select all that apply.) a. Doses of an oral benzodiazepine b. Doses of an intravenous benzodiazepine c. Restraints if the patient becomes confused, agitated, or a threat to himself or others d. Thiamine supplementation e. Oral disulfiram (Antabuse) treatment f. Monitoring in the intensive care unit
answer
b. Doses of an intravenous benzodiazepine c. Restraints if the patient becomes confused, agitated, or a threat to himself or others d. Thiamine supplementation f. Monitoring in the intensive care unit
question
A patient has been admitted to the emergency department after a suspected overdose of benzodiazepines mixed with alcohol. The patient is lethargic and cannot speak. The nurse expects which immediate measures to be implemented? (Select all that apply.) a. Prepare to administer naloxone (Narcan). b. Prepare to administer flumazenil. c. Monitor the patient for convulsions. d. Prepare for potential respiratory arrest. e. Apply restraints.
answer
b. Prepare to administer flumazenil. c. Monitor the patient for convulsions. d. Prepare for potential respiratory arrest.
question
The nurse is teaching a class about the effects of alcohol. Long-term excessive use of alcohol is associated with which of these problems? (Select all that apply.) a. Coronary artery disease b. Wernicke's encephalopathy c. Polyneuritis d. Seizures e. Cirrhosis of the liver f. Korsakoff's psychosis
answer
b. Wernicke's encephalopathy c. Polyneuritis e. Cirrhosis of the liver f. Korsakoff's psychosis
question
Which mood-stabilizing drugs are used to treat bipolar disorder? Select all that apply. 1 Bupropion 2 Imipramine 3 Isocarboxazid 4 Oxcarbazepine 5 Lithium carbonate
answer
Correct4 Oxcarbazepine Correct5 Lithium carbonate
question
The nurse notes lithium on a patient's drug history upon admission. Which condition would the nurse suspect that this patient has been diagnosed with? 1 Bipolar disorder 2 Absence seizures 3 Paranoid schizophrenia 4 Obsessive-compulsive disorder
answer
Correct1 Bipolar disorder
question
The nurse notes that the patient has an increased blood glucose level, increased blood pressure (BP), and abnormal cholesterol levels. What does the nurse infer from these observations? 1 The patient has mania. 2 The patient has dystonia. 3 The patient has dyskinesia. 4 The patient has metabolic syndrome.
answer
Correct4 The patient has metabolic syndrome.
question
Which anxiolytic drug promotes agonistic activity at both the serotonin and dopamine receptors? 1 Buspirone 2 Alprazolam 3 Lorazepam 4 Amitriptyline
answer
Correct1 Buspirone
question
Which are common symptoms of serotonin syndrome? Select all that apply. 1 Delirium 2 Myoclonus 3 Drowsiness 4 Coarse tremors 5 Suicidal thoughts
answer
Correct1 Delirium Correct2 Myoclonus Correct4 Coarse tremors
question
What are the current indications for tricyclic antidepressants (TCAs)? Select all that apply. 1 Seizures 2 Insomnia 3 Depression 4 Childhood enuresis 5 Neuropathic pain syndrome
answer
Correct2 Insomnia Correct4 Childhood enuresis Correct5 Neuropathic pain syndrome
question
Which phenomena does the nurse recognize as positive symptoms of schizophrenia? Select all that apply. 1 Catatonia 2 Delusions 3 Hallucinations 4 Poverty of speech 5 Social withdrawal 6 Conceptual disorganization
answer
Correct2 Delusions Correct3 Hallucinations Correct6 Conceptual disorganization
question
Which patient is a poor candidate for therapy with diazepam to treat generalized anxiety disorder? 1 One with a history of alcoholism 2 One with type 2 diabetes mellitus 3 One who had convulsions as a child 4 One who has had a myocardial infarction
answer
Correct1 One with a history of alcoholism
question
What is another approved and indicated use for bupropion, a second-generation antidepressant? 1 Smoking cessation 2 Orthostatic hypotension 3 Nocturnal enuresis in children 4 Anorexia in patients undergoing chemotherapy
answer
Correct1 Smoking cessation
question
A patient who has taken fluoxetine for 2 weeks to treat an anxiety disorder expresses dissatisfaction with the therapy. What is the best information for the nurse to include in patient education to promote adherence to the therapeutic regimen? 1 This medication usually requires titration. 2 The adverse effects can be managed well. 3 Relaxation exercises can offer some relief. 4 A therapeutic effect can be expected in another 2 to 4 weeks.
answer
Correct4 A therapeutic effect can be expected in another 2 to 4 weeks.
question
The nurse is assessing a patient who has been prescribed alprazolam to treat panic disorder. Which adverse effects does the nurse monitor for in the patient? Select all that apply. 1 Ataxia 2 Dizziness 3 Confusion 4 Blurred vision 5 Paradoxical anxiety
answer
Correct1 Ataxia Correct2 Dizziness Correct3 Confusion
question
Which activity should the patient be cautioned to avoid while taking a monoamine oxidase (MAO) inhibitor? 1 Eating aged cheese 2 Sunbathing at the pool 3 Participating in a bowling league 4 Smoking a low-nicotine cigarette
answer
Correct1 Eating aged cheese
question
A patient is detoxifying from alcohol abuse. Which type of medication is indicated to help the patient manage withdrawal symptoms? 1 Phenothiazine 2 Dibenzazepine 3 Benzisoxazole 4 Benzodiazepine
answer
Correct4 Benzodiazepine
question
What atypical antipsychotic medication would the nurse anticipate a health care provider prescribing for treatment of refractory schizophrenia? 1 Trazodone 2 Phenelzine 3 Amoxapine 4 Risperidone
answer
Correct4 Risperidone
question
Which adverse effects result from antipsychotic drugs' action on alpha-adrenergic receptors? Select all that apply. 1 Weight gain 2 Lightheadedness 3 Reflex tachycardia 4 Tardive dyskinesia 5 Postural hypotension
answer
Correct2 Lightheadedness Correct3 Reflex tachycardia Correct5 Postural hypotension
question
Which theory states that depression and mania are caused by alterations in the concentration of dopamine and norepinephrine and serotonin and histamine in the brain? 1 Dopamine hypothesis 2 Permissive hypothesis 3 Dysregulation hypothesis 4 Biogenic amine hypothesis
answer
Correct4 Biogenic amine hypothesis
question
Which instruction does a nurse provide to a patient who is taking a selective serotonin reuptake inhibitor (SSRI)? 1 "Change positions frequently." 2 "Avoid foods or beverages rich in tyramine." 3 "Avoid hot baths, saunas, and hot climates." 4 "Increase the intake of dietary fiber supplements."
answer
Correct4 "Increase the intake of dietary fiber supplements."
question
The nurse is assessing a patient with depression who has been prescribed nortriptyline. Following the assessment, the nurse finds that the patient has constipation and urinary retention due to interaction between the prescribed medications. Which class of medication found in the patient's prescription is responsible for these effects? 1 Diuretics 2 Anxiolytics 3 Anticholinergics 4 Antihypertensives
answer
Correct3 Anticholinergics
question
Which medication increases the rate of urinary elimination of tricyclic antidepressants (TCAs) in the event of an overdose? 1 Diazepam 2 Antidysrhythmic 3 Activated charcoal 4 Sodium bicarbonate
answer
Correct4 Sodium bicarbonate
question
What assessment finding is the result of parasympathetic nervous system stimulation? 1 Bradycardia 2 Pupil dilation 3 Urine retention 4 Bronchial dilation
answer
Correct1 Bradycardia
question
A patient is prescribed tolterodine. What should the nurse assess to determine the therapeutic effect of this medication? 1 Increased heart rate 2 Decreased urination 3 Increased blood pressure 4 Decreased bowel movements
answer
Correct2 Decreased urination
question
What instructions should the nurse give a patient who has constipation from prolonged use of anticholinergic medications? Select all that apply. 1 "Get adequate rest." 2 "Increase your daily intake of fluids." 3 "Include nuts and legumes in your diet." 4 "Increase the amount of fiber in your diet." 5 "Take fiber supplements such as psyllium."
answer
Correct2 "Increase your daily intake of fluids." Correct4 "Increase the amount of fiber in your diet." Correct5 "Take fiber supplements such as psyllium."
question
A patient has been receiving donepezil for several weeks. Which finding indicates the medication is having a therapeutic effect? 1 The patient is awake. 2 The patient is relaxed. 3 The patient has urinated. 4 The patient has increased cognition.
answer
Correct4 The patient has increased cognition.
question
Which medication is a noncholinergic drug used in the treatment of Alzheimer's disease? 1 Atropine 2 Memantine 3 Donepezil 4 Rivastigmine
answer
Correct2 Memantine
question
Which assessment finding in a patient who has received an anticholinergic drug requires immediate intervention? 1 Hallucinations 2 Motion sickness 3 Decreased urination 4 Increased respiratory rate
answer
Correct1 Hallucinations
question
Which are contraindications for administration of cholinergic-blocking medications? Select all that apply. 1 Renal failure 2 Peptic ulcers 3 Down syndrome 4 Bronchial asthma 5 Recent heart surgery
answer
Correct1 Renal failure Correct3 Down syndrome Correct5 Recent heart surgery
question
Which medication is used for the treatment of irritable bowel syndrome? 1 Atropine 2 Oxybutynin 3 Dicyclomine 4 Glycopyrrolate
answer
Correct3 Dicyclomine
question
The nurse is caring for a patient who is taking a cholinergic drug. Which assessment is caused by stimulation of the parasympathetic nervous system? 1 Mydriasis 2 Vasoconstriction 3 Urinary retention 4 Increased gastrointestinal (GI) motility
answer
Correct4 Increased gastrointestinal (GI) motility
question
What are potential side effects of administering high doses of a cholinergic-blocking medication? Select all that apply. 1 Disorientation 2 Decreased heart rate 3 Constriction of pupils 4 Decreased gastric secretions 5 Constriction of internal sphincter
answer
Correct1 Disorientation Correct4 Decreased gastric secretions Correct5 Constriction of internal sphincter
question
The nurse is providing education about cholinergic-blocking drug therapy to an older patient. What should the nurse include in the teaching plan about maximizing the therapeutic effects and minimizing the adverse effects of these drugs? Select all that apply. 1 "Eliminate high-fiber foods." 2 "Brush your teeth frequently." 3 "Drink 6 to 8 glasses of water daily." 4 "Avoid exposure to high temperatures." 5 "Begin an exercise program three times a week."
answer
Correct2 "Brush your teeth frequently." Correct3 "Drink 6 to 8 glasses of water daily." Correct4 "Avoid exposure to high temperatures."
question
What is an expected therapeutic outcome assessment for a patient who has Parkinson's disease and dementia and is prescribed rivastigmine? 1 Decreased tremors 2 Decreased salivation 3 Improvement in memory 4 Increased muscle strength
answer
Correct3 Improvement in memory
question
Before starting therapy with pyridostigmine, the nurse assesses the patient's history for which conditions? Select all that apply. 1 Asthma 2 Emphysema 3 Hypothyroidism 4 Psoriatic arthritis 5 Coronary artery disease
answer
Correct1 Asthma Correct5 Coronary artery disease
question
What are the side effects of scopolamine? Select all that apply. 1 Dry mouth 2 Drowsiness 3 Blurred vision 4 Altered mental status 5 Respiratory depression
answer
Correct1 Dry mouth Correct2 Drowsiness Correct3 Blurred vision
question
What medications are used for overactive bladder because of their decreased incidence of side effects such as dry mouth? Select all that apply. 1 Trospium 2 Solifenacin 3 Darifenacin 4 Oxybutynin 5 Fesoterodine
answer
Correct1 Trospium Correct2 Solifenacin Correct3 Darifenacin Correct5 Fesoterodine
question
Which assessment finding should the nurse interpret as a therapeutic effect of atropine? 1 Lethargy 2 Hypertension 3 Increased heart rate 4 Constriction of pupils
answer
Correct3 Increased heart rate
question
The nurse is caring for a patient with Parkinson disease who is receiving cholinergic-blocking drug therapy. What is the reason for prescribing this drug therapy to the patient? 1 The drug decreases the urinary bladder spasms. 2 The drug decreases muscle rigidity and tremors. 3 The drug increases the patient's apical heart rate. 4 The drug decreases gastrointestinal (GI) secretions.
answer
Correct2 The drug decreases muscle rigidity and tremors.
question
Which medications are direct-acting cholinergic drugs? Select all that apply. 1 Pilocarpine 2 Galantamine 3 Neostigmine 4 Edrophonium 5 Succinylcholine
answer
Correct1 Pilocarpine Correct5 Succinylcholine
question
Which drugs are used to reverse the effects of nondepolarizing neuromuscular-blocking drugs after surgery? Select all that apply. 1 Donepezil 2 Memantine 3 Neostigmine 4 Pyridostigmine 5 Physostigmine
answer
Correct3 Neostigmine Correct4 Pyridostigmine Correct5 Physostigmine
question
For which therapeutic effect should the nurse assess a patient taking dicyclomine? 1 Increase in heart rate 2 Increase in blood pressure 3 Decrease in urinary frequency 4 Decrease in gastrointestinal (GI) motility
answer
Correct4 Decrease in gastrointestinal (GI) motility
question
Which route of administration is preferred for treating xerostomia with pilocarpine? 1 Oral 2 Ocular 3 Intravenous 4 Intramuscular
answer
Correct1 Oral
question
Which assessment finding in a patient receiving memantine indicates a significant side effect? 1 Patient is unable to sleep 2 Raised, erythematous rash 3 Blood pressure 70/40 mm Hg 4 Respiratory rate 30 breaths per minute
answer
Correct3 Blood pressure 70/40 mm Hg
question
After administering bethanechol to a patient after surgery, what system should the nurse assess to determine a therapeutic effect? 1 Urinary 2 Neurologic 3 Musculoskeletal 4 Gastrointestinal
answer
Correct1 Urinary
question
What is the medication dose of atropine that is used for symptomatic bradycardia? 1) 0.3 mg 2) 0.5 mg 3) 1.25 mg 4) 2 mg
answer
Correct2 0.5 mg
question
What is the difficulty in using physostigmine as an antidote to an overdose of a cholinergic-blocking agent? 1 It requires hospitalization. 2 It requires supportive therapy. 3 It can cause severe side effects. 4 It requires increased fluid intake.
answer
Correct3 It can cause severe side effects.
question
What is the expected therapeutic effect after the administration of atropine to a patient with cholinergic-blocker poisoning? 1 Decrease in gastric secretions 2 Immediate increase in heart rate 3 Immediate decrease in heart rate 4 Increase in respiratory rate within 1 minute
answer
Correct2 Immediate increase in heart rate
question
What is dicyclomine typically administered to treat? 1 Enterocolitis 2 Constipation 3 Irritable bowel disease 4 A neuromuscular blockade
answer
Correct3 Irritable bowel disease
question
Which medication should be administered to a patient who has a cholinergic crisis? 1 Atropine 2 Donepezil 3 Echothiophate 4 Pyridostigmine
answer
Correct1 Atropine
question
What is the rationale behind administering ginkgo to a patient? 1 To prevent memory loss 2 To treat myasthenia gravis 3 To reverse cholinergic drug effects 4 To treat postpartum urinary retention
answer
Correct1 To prevent memory loss
question
Which condition is a contraindication to the administration of bethanechol? 1 Gastric atony 2 Hyperthyroidism 3 Urinary retention 4 Chronic refractory heartburn
answer
Correct2 Hyperthyroidism
question
Which drug may be administered to a patient who has a tricyclic antidepressant overdose? 1 Tacrine 2 Carbachol 3 Memantine 4 Physostigmine
answer
Correct4 Physostigmine
question
Which condition is treated with bethanechol in a postoperative patient? 1 Urinary atony 2 Respiratory atelectasis 3 Postoperative hypotension 4 Postoperative ischemic colitis
answer
Correct1 Urinary atony
question
What should the nurse teach a patient about potential effects of a newly prescribed cholinergic-blocking drug? 1 "The drug will decrease muscle rigidity." 2 "The drug will cause a very slow heart rate." 3 "You may have problems with urinary retention." 4 "You will have increased saliva production and sweating."
answer
Correct3 "You may have problems with urinary retention."
question
What precaution is needed when physostigmine is administered to treat a cholinergic blocker overdose? 1 Increased fluid intake 2 Insertion of a Foley catheter 3 Assessment of bowel sounds 4 Frequent cardiac assessments
answer
Correct4 Frequent cardiac assessments
question
The nurse administers psyllium to a patient. Which assessment finding indicates a therapeutic response to this medication? 1 Decreased urination 2 A nonproductive cough 3 A formed bowel movement 4 No complaints of motion sickness
answer
Correct3 A formed bowel movement
question
Which medication may be administered to a patient who has myasthenia gravis? 1 Donepezil 2 Memantine 3 Bethanechol 4 Pyridostigmine
answer
Correct4 Pyridostigmine
question
Which finding in a patient's history is a contraindication to the administration of a cholinergic-blocking medication? 1 Anxiety 2 Irritable bowel disease 3 Angle-closure glaucoma 4 Gastrointestinal hypersecretory state
answer
Correct3 Angle-closure glaucoma
question
A patient who is taking a cholinergic-blocking medication is having difficulty urinating. What is the nurse's best action? 1 Insert a Foley catheter. 2 Increase the patient's fluid intake. 3 Assess the patient's medication therapy. 4 Encourage the patient to ambulate frequently.
answer
Correct3 Assess the patient's medication therapy.
question
Which patient would be unable to receive donepezil to treat symptoms of Alzheimer disease? 1 The patient with constipation 2 The patient with urinary retention 3 The patient exhibiting heart block 4 The patient diagnosed with hypertension
answer
Correct3 The patient exhibiting heart block
question
The nurse is caring for a patient who received atropine tablets for diarrhea. The nurse observes that the patient has mydriasis, altered mental status, and fever. What is the best action for the nurse to take? 1 Administer fluids. 2 Administer aspirin. 3 Administer dicyclomine. 4 Administer physostigmine.
answer
Correct4 Administer physostigmine.
question
A patient has taken an anticholinergic agent along with an atypical antipsychotic drug. Which instruction should the nurse ensure the patient follows? 1 "Avoid sun and warm places." 2 "Avoid caffeinated beverages." 3 "Drink additional fluids each day." 4 "Expectorate oral secretions frequently."
answer
Correct1 "Avoid sun and warm places."
question
The nurse should teach a patient receiving anticholinergic medications to avoid which medications that can lead to potential additive effects? Select all that apply. 1 Digoxin 2 Antibiotics 3 Amantadine 4 Antihistamines 5 Tricyclic antidepressants
answer
Correct1 Digoxin Correct3 Amantadine Correct4 Antihistamines Correct5 Tricyclic antidepressants
question
The nurse administers oxybutynin. What assessment is essential to determine therapeutic effect? 1 Bowel sounds 2 Urinary output 3 Blood pressure 4 Pupillary response
answer
Correct2 Urinary output
question
What should the nurse assess as a therapeutic effect of the administration of pyridostigmine to a patient who has myasthenia gravis? 1 Patient is no longer dizzy 2 Patient has improved memory 3 Patient is able to walk long distances 4 Patient has increased muscle strength
answer
Correct4 Patient has increased muscle strength
question
The nurse is caring for a patient who is receiving anticholinergic drug therapy. What information should the nurse include in the teaching plan? 1 "Decrease your fluid intake." 2 "Stay out of the heat and humidity." 3 "Include vitamin D in your daily diet." 4 "Take the medication first thing in the morning."
answer
Correct2 "Stay out of the heat and humidity."
question
A patient has been prescribed oxybutynin. What will the nurse assess before administering the patient's next dose? 1 Whether the patient has hypotension 2 Whether the patient is able to urinate 3 Whether the patient reports alcoholism 4 Whether the patient has light sensitivity
answer
Correct2 Whether the patient is able to urinate
question
A patient receives a prescription for oxybutynin for the treatment of overactive bladder. Which instruction should the nurse include in patient teaching to help prevent adverse effects of therapy? 1 "Empty your bladder at least every hour." 2 "Manage increased salivation by drinking less." 3 "Treat diarrhea with diphenoxylate and atropine." 4 "Do not take antihistamines without your primary health care provider's approval."
answer
Correct4 "Do not take antihistamines without your primary health care provider's approval."
question
What is the antidote to a cholinergic overdose? 1 Atropine 2 Memantine 3 Epinephrine 4 Rivastigmine
answer
Correct1 Atropine
question
The nurse has administered atropine intravenously to a patient who has sinus bradycardia. After administration of the medication, the patient's heart rate has not increased. What is the nurse's next course of action? 1 Call a code. 2 Call the respiratory team stat. 3 Have the patient get up and move around. 4 Administer another dose of the medication.
answer
Correct4 Administer another dose of the medication.
question
An older adult receiving anticholinergic therapy should be assessed for what potential side effects of therapy? Select all that apply. 1 Coma 2 Diarrhea 3 Constipation 4 Restlessness 5 Blurred vision 6 Pupil constriction
answer
Correct3 Constipation Correct4 Restlessness Correct5 Blurred vision
question
A patient who is going on a cruise is prescribed scopolamine transdermal patch. What will the nurse instruct the patient? Select all that apply. 1 "Do not drive a motor vehicle." 2 "You should eat a low-fiber diet." 3 "Do not consume too much water." 4 "You should abstain from alcohol." 5 "You should not use heavy machinery."
answer
Correct1 "Do not drive a motor vehicle." Correct4 "You should abstain from alcohol." Correct5 "You should not use heavy machinery."
question
A patient is prescribed atropine. For what medication should the nurse assess the patient's history? 1 Digoxin 2 Cephalexin 3 Erythromycin 4 Aspirin therapy
answer
Correct1 Digoxin
question
The nurse is caring for a patient who has a low-level spinal cord injury. What assessments and interventions are necessary? 1 Muscular assessment and antispasmodic therapy 2 Respiratory assessment and stimulant drug therapy 3 Pain assessment and administration of intraspinal pain medication 4 Urinary assessment and administration of cholinergic-blocking agents
answer
Correct4 Urinary assessment and administration of cholinergic-blocking agents
question
The primary health care provider has prescribed transdermal scopolamine patches to treat motion sickness in a patient. What instructions should the nurse give to the patient about the medication? Select all that apply. 1 "Wear gloves when you put on the patch." 2 "It is safe to take this medication with alcohol." 3 "Apply the patch on the same area every time." 4 "Place the patch on the nonhairy area behind your ear." 5 "Apply the patch 4 to 5 hours before the activity that causes motion sickness."
answer
Correct4 "Place the patch on the non-hairy area behind your ear." Correct5 "Apply the patch 4 to 5 hours before the activity that causes motion sickness."
question
A patient who has undergone treatment for spinal cord injury has been prescribed oxybutynin. What should the nurse teach the patient about taking this drug? 1 "Take the medication after rinsing your mouth thoroughly." 2 "Take the medication 1 hour before or 2 hours after meals." 3 "Make sure you drink at least 6 to 8 glasses of water daily." 4 "Suck on a piece of hard sugar candy after you take the pill."
answer
Correct2 "Take the medication 1 hour before or 2 hours after meals."
question
What should the nurse teach a patient to decrease the effects of dry mouth from an anticholinergic medication? Select all that apply. 1 Chew on ice chips. 2 Brush teeth twice a day. 3 Use artificial saliva drops. 4 Maintain regular dental visits. 5 Chew on sugarless candy or gum.
answer
Correct2 Brush teeth twice a day. Correct3 Use artificial saliva drops. Correct4 Maintain regular dental visits. Correct5 Chew on sugarless candy or gum.
question
What information regarding exercise should the nurse teach a patient who is receiving anticholinergic medications? 1 "Only perform isometric exercise daily." 2 "Exercise regularly to reach a target heart rate." 3 "Avoid excessive sweating and strenuous exercise." 4 "Exercise using large muscles such as with jogging or swimming."
answer
Correct3 "Avoid excessive sweating and strenuous exercise."
question
Cholinergic agonist drugs have the potential to cause which effects? Select all that apply. 1 Pupil dilation 2 Decreased heart rate 3 Decreased gastric motility 4 Increased respiratory secretions 5 Decreased sweat gland secretion
answer
Correct2 Decreased heart rate Correct4 Increased respiratory secretions
question
Which drug is indicated in the treatment of myasthenia gravis? 1 Pilocarpine 2 Neostigmine 3 Rivastigmine 4 Succinylcholine
answer
Correct2 Neostigmine
question
What assessment finding indicates the patient may have symptoms of anticholinergic drug overdose? 1 Macular rash 2 Severe headache 3 Irregular heart rate 4 Muscular weakness
answer
Correct3 Irregular heart rate
question
Which indirect-acting cholinergic drug is used to treat a patient who has both Parkinson's disease and dementia? 1 Donepezil 2 Memantine 3 Galantamine 4 Rivastigmine
answer
Correct4 Rivastigmine
question
When providing teaching for a patient who is prescribed an SSRI, which statement will the nurse include? a. The SSRI will work faster than the older tricyclic antidepressants. b. The SSRI will have an immediate beneficial effect on the patient's depression symptoms. c. The SSRI will not work well for severe causes of depression. d. The SSRI may take several weeks to have a beneficial effect.
answer
d. The SSRI may take several weeks to have a beneficial effect.
question
When patients are taking SSRI's for the first time for depression, which is most important to monitor for during the first few weeks of therapy? a. Hypertensive crisis b. Suicidal thoughts c. Convulsions d. Orthostatic hypotension
answer
b. Suicidal thoughts
question
Before administering lithium to a patient, it is most important for the nurse to assess which laboratory value? a. Blood sugar b. Sodium c. Urine osmolality d. Potassium
answer
b. Sodium
question
A patient is admitted to the emergency department. The patient's heart rate 112 beats/min. The patient is sweating profusely, has muscle tremors and is agitated. The patient says " I was depressed and I took more of the pills the doctor gave me so I would feel better." 1 .What does the nurse suspect is happening with this patient? 2. What treatment does the nurse expect to implement?
answer
1. Along with a full assessment, the nurse would need to ask what medications the patient is taking, how long and how much is the patient currently taking. Based on the presenting signs & symptoms the nurse would include serotonin syndrome as a highly possible reason for the patient's presenting symptoms. 2. The treatment for serotonin syndrome includes discontinuation of all SSRI's and providing supportive care to maintain homeostasis.
question
The patient was admitted to the hospital for observation and has now recovered. Which information will the nurse include in patient teaching about SSRI's? a. It usually takes 4-6 weeks until you experience benefits from the medication. b. Avoid all foods containing tyramine. c. Stop taking the medication if you develop an upset stomach. d. Take the medication at bedtime to enhance sleep.
answer
a. It usually takes 4-6 weeks until you experience benefits from the medication SSRI's need 4-6 weeks to reach their maximum effectiveness. These meds can cause GI upset and should be taken with food. SSRIs should be taken in the morning to prevent sleep disturbances.
question
Several months later, the patient returns to the health care providers office for a follow-up regarding the use of the SSRI. The patient tells the nurse that he is feeling better and stopped taking the SSRI yesterday. The patient doesn't plan on taking the medication again. When talking with the patient, which knowledge should guide the nurse's response? a. Drug dependency will develop, so it's appropriate to stop therapy after a few months. b. Drug therapy must be stopped as soon as the patient feels better to avoid serotonin syndrome. c. The patient is the best person to determine when the drug therapy should end. d. A possible 1-2 month taper period is indicated to prevent adverse effects of abrupt drug discontinuation.
answer
d. A possible 1-2 month taper period is indicated to prevent adverse effects of abrupt drug discontinuation. A taper period of 1-2 months may be needed to prevent serotonin discontinuation syndrome with symptoms like: dizziness, diarrhea, and worsening of the depressive mood disorder. Serotonin syndrome is a result of taking too much serotonin altering medication. The patient and provider should work together to determine the optimal time for discontinuation. There is no evidence of drug dependency associated with the use of SSRI's.
question
Which drug will the nurse anticipate administering to a patient experiencing benzodiazepine overdose? a. Flumazenil b. Naltrexone c. Vivitrol d. Flunitrazepam
answer
a. Flumazenil
question
A patient with a diagnosis of delirium tremens is admitted to the acute care facility. Which finding does the nurse expect upon assessment of the patient? a. Hyperthermia b. Hypotension c. Bradycardia d. Somnolence
answer
a. Hyperthermia
question
Which statement does the nurse include when teaching a patient about disulfiram (Antabuse) therapy? a. "Disulfiram (Antabuse) will cure your alcoholism if you take it as directed." b. "If you drink alcohol after taking disulfiram (Antabuse), your blood pressure will get very high." c. "You cannot drink alcohol for at least 3 or 4 days after taking disulfiram (Antabuse)." d. "If you miss a dose of disulfiram (Antabuse), double the dose the next time it is due."
answer
c. "You cannot drink alcohol for at least 3 or 4 days after taking disulfiram (Antabuse)."
question
The nurse is explaining the differences between transdermal nicotine and nicotine gum programs. Which statement by the nurse is correct? a. "The nicotine patch will give you quick relief from cravings." b. "Chewing the gum rapidly will release an immediate dose of nicotine." c. "It seems that patients have better treatment compliance with the gum than the patch." d. "The dose of nicotine in the gum is approximately twice the dose the average smoker receives in one cigarette."
answer
b. "Chewing the gum rapidly will release an immediate dose of nicotine."
question
The nurse is assessing a patient who has been taking a cholinergic drug for 3 days. The patient has flushed skin and orthostatic blood pressure changes and is complaining of abdominal cramps and nausea. The nurse recognizes that the patient is most likely experiencing a. early signs of a cholinergic crisis. b. late signs of a cholinergic crisis. c. an allergic reaction to the drug. d. expected adverse effects.
answer
a. early signs of a cholinergic crisis.
question
A 60-year-old woman asks the nurse about taking ginkgo to help with her memory. The patient has a history of arthritis, type 2 diabetes, thyroid disease, and hypertension. She is currently taking NSAIDs for arthritis, oral antidiabetic medications, thyroid replacement hormone, and a beta blocker for blood pressure. What potential adverse effect from the gingko would be of most concern for this patient? a. Stomach upset b. Diarrhea c. Bleeding d. Drowsiness
answer
c. Bleeding
question
A patient is scheduled to have lunch at 1200. The nurse will administer the pyridostigmine (Mestinon) at what time for optimal therapeutic effect? 1) 1100 2) 1130 3) 1200 4) 1230
answer
4) 1230
question
A patient with Alzheimer's disease accidentally took 2 weeks' worth of a cholinergic medication. He is brought to the emergency department, is going into shock, and experiencing severe hypotension and vomiting. The nurse will expect which initial treatment? a. Administration of physostigmine b. Administration of atropine c. Administration of epinephrine d. Cardiovascular support with dopamine
answer
b. Administration of atropine
question
Which finding would the nurse anticipate when assessing a patient with an atropine overdose? a. Moist skin b. Miosis c. Bradycardia d. Urinary retention
answer
d. Urinary retention
question
Glycopyrrolate (Robinul) and an opioid are administered to a patient before surgery in the preoperative area. The anticholinergic is used to a. potentiate the action of the opioid. b. assist the patient in retaining urine during surgery. c. control secretions during surgery. d. prevent nausea.
answer
c. control secretions during surgery.
question
Before administering tolterodine (Detrol), it is most important for the nurse to assess the patient for a history of which condition? a. Angle-closure glaucoma b. Cataracts c. Hypothyroidism d. Hyponatremia
answer
a. Angle-closure glaucoma
question
Which condition does the nurse anticipate when assessing a patient with tumor lysis syndrome? a. Hyperuricemia b. Hypophosphatemia c. Hypokalemia d. Hypercalcemia
answer
a. Hyperuricemia
question
A pregnant woman has been diagnosed with cancer and is meeting with her oncologist to plan treatment. Which statement about chemotherapy and pregnancy is true? a. She will have to wait until the baby is born before starting chemotherapy. b. The greatest risk of fetal harm from chemotherapy is during the third trimester. c. Chemotherapy treatment during the second or third trimester poses less risk to the fetus. d. Chemotherapy is unsafe during pregnancy, but radiation therapy is safe in low doses.
answer
c. Chemotherapy treatment during the second or third trimester poses less risk to the fetus.
question
The nurse is caring for a patient who received chemotherapy 24 hours ago. The patient's white blood cell count is 4,400 mcL. Which symptom, if experienced by the patient, should the nurse report to the prescriber immediately? a. Fatigue b. Diarrhea c. Fever d. Nausea and vomiting
answer
c. Fever
question
When working with a patient who is neutropenic, the nurse identifies which as the most effective measure to prevent the patient from developing an infection? a. Administer prophylactic antibiotics. b. Stop administration of the chemotherapeutic drug. c. Perform hand hygiene. d. Vaccinate the patient to prevent bacterial infection.
answer
c. Perform hand hygiene.
question
Which cytotoxic antibiotic does the nurse identify as most likely to cause pulmonary fibrosis? a. plicamycin b. mitoxantrone c. mitomycin d. bleomycin
answer
d. bleomycin
question
Bevacizumab (Avastin) is an angiogenesis inhibitor. Which statement correctly describes the mechanism of action of an angiogenesis inhibitor? a. It inhibits the formation of blood cells. b. It inhibits the creation of new blood vessels in the tumor mass. c. It interferes with the synthesis of DNA in the cancer tumor. d. It causes cell death by inhibiting enzymes.
answer
b. It inhibits the creation of new blood vessels in the tumor mass.
question
When handling and administering vesicant drugs, the nurse will: a. double flush the patient's bodily secretions in the commode. b. use sterile towels to clean up after chemotherapy spills. c. mix chemotherapeutic drugs in the patient's room. d. teach the patient how to administer parenteral chemotherapeutic drugs.
answer
a. double flush the patient's bodily secretions in the commode.
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question
Which mood-stabilizing drugs are used to treat bipolar disorder? Select all that apply. 1. Bupropion 2. Imipramine 3. Isocarboxazid 4. Oxcarbazepine 5. Lithium carbonate
answer
4. Oxcarbazepine 5. Lithium carbonate
question
The nurse notes lithium on a patient's drug history upon admission. Which condition would the nurse suspect that this patient has been diagnosed with? 1. Bipolar disorder 2. Absence seizures 3. Paranoid schizophrenia 4. Obsessive-compulsive disorder
answer
1. Bipolar disorder
question
The nurse notes that the patient has an increased blood glucose level, increased blood pressure (BP), and abnormal cholesterol levels. What does the nurse infer from these observations? 1. The patient has mania. 2. The patient has dystonia. 3. The patient has dyskinesia. 4. The patient has metabolic syndrome
answer
4. The patient has metabolic syndrome
question
Which anxiolytic drug promotes agonistic activity at both the serotonin and dopamine receptors? 1. Buspirone 2. Alprazolam 3. Lorazepam 4. Amitriptyline
answer
1. Buspirone
question
Which are common symptoms of serotonin syndrome? Select all that apply. 1. Delirium 2. Myoclonus 3. Drowsiness 4. Coarse tremors 5. Suicidal thoughts
answer
1. Delirium 2. Myoclonus 4. Coarse tremors
question
What are the current indications for tricyclic antidepressants (TCAs)? Select all that apply. 1. Seizures 2. Insomnia 3. Depression 4. Childhood enuresis 5. Neuropathic pain syndrome
answer
2. Insomnia 4. Childhood enuresis 5. Neuropathic pain syndrome
question
Which phenomena does the nurse recognize as positive symptoms of schizophrenia? Select all that apply. 1. Catatonia 2. Delusions 3. Hallucinations 4. Poverty of speech 5. Social withdrawal 6. Conceptual disorganization
answer
2. Delusions 3. Hallucinations 6. Conceptual disorganization
question
Which patient is a poor candidate for therapy with diazepam to treat generalized anxiety disorder? 1. One with a history of alcoholism 2. One with type 2 diabetes mellitus 3. One who had convulsions as a child 4. One who has had a myocardial infarction
answer
1. One with a history of alcoholism
question
What is another approved and indicated use for bupropion, a second-generation antidepressant? 1. Smoking cessation 2. Orthostatic hypotension 3. Nocturnal enuresis in children 4. Anorexia in patients undergoing chemotherapy
answer
1. Smoking cessation
question
A patient who has taken fluoxetine for 2 weeks to treat an anxiety disorder expresses dissatisfaction with the therapy. What is the best information for the nurse to include in patient education to promote adherence to the therapeutic regimen? 1. This medication usually requires titration. 2. The adverse effects can be managed well. 3. Relaxation exercises can offer some relief. 4. A therapeutic effect can be expected in another 2 to 4 weeks.
answer
4. A therapeutic effect can be expected in another 2 to 4 weeks.
question
The nurse is assessing a patient who has been prescribed alprazolam to treat panic disorder. Which adverse effects does the nurse monitor for in the patient? Select all that apply. 1. Ataxia 2. Dizziness 3. Confusion 4. Blurred vision 5. Paradoxical anxiety
answer
1. Ataxia 2. Dizziness 3. Confusion
question
Which activity should the patient be cautioned to avoid while taking a monoamine oxidase (MAO) inhibitor? 1. Eating aged cheese 2. Sunbathing at the pool 3. Participating in a bowling league 4. Smoking a low-nicotine cigarette
answer
1. Eating aged cheese
question
A patient is detoxifying from alcohol abuse. Which type of medication is indicated to help the patient manage withdrawal symptoms? 1. Phenothiazine 2. Dibenzazepine 3. Benzisoxazole 4. Benzodiazepine
answer
4. Benzodiazepine
question
What atypical antipsychotic medication would the nurse anticipate a health care provider prescribing for treatment of refractory schizophrenia? 1. Trazodone 2. Phenelzine 3. Amoxapine 4. Risperidone
answer
4. Risperidone
question
Which adverse effects result from antipsychotic drugs' action on alpha-adrenergic receptors? Select all that apply. 1. Weight gain 2. Lightheadedness 3. Reflex tachycardia 4. Tardive dyskinesia 5. Postural hypotension
answer
2. Lightheadedness 3. Reflex tachycardia 5. Postural hypotension
question
Which theory states that depression and mania are caused by alterations in the concentration of dopamine and norepinephrine and serotonin and histamine in the brain? 1. Dopamine hypothesis 2. Permissive hypothesis 3. Dysregulation hypothesis 4. Biogenic amine hypothesis
answer
4. Biogenic amine hypothesis
question
Which instruction does a nurse provide to a patient who is taking a selective serotonin reuptake inhibitor (SSRI)? 1. "Change positions frequently." 2. "Avoid foods or beverages rich in tyramine." 3. "Avoid hot baths, saunas, and hot climates." 4. "Increase the intake of dietary fiber supplements."
answer
4. "Increase the intake of dietary fiber supplements."
question
The nurse is assessing a patient with depression who has been prescribed nortriptyline. Following the assessment, the nurse finds that the patient has constipation and urinary retention due to interaction between the prescribed medications. Which class of medication found in the patient's prescription is responsible for these effects? 1. Diuretics 2. Anxiolytics 3. Anticholinergics 4. Antihypertensives
answer
3. Anticholinergics
question
hich medication increases the rate of urinary elimination of tricyclic antidepressants (TCAs) in the event of an overdose? 1. Diazepam 2. Antidysrhythmic 3. Activated charcoal 4. Sodium bicarbonate
answer
4. Sodium bicarbonate
question
In caring for a patient experiencing ethanol withdrawal, the nurse expects to administer which medication or medication class as treatment for this condition? a. lithium (Eskalith) b. Benzodiazepines c. buspirone (BuSpar) d. Antidepressants
answer
b. Benzodiazepines
question
Patient teaching for a patient receiving an MAOI would include instructions to avoid which food product? a. Orange juice b. Milk c. Shrimp d. Swiss cheese
answer
d. Swiss cheese
question
After a patient has been treated for depression for 4 weeks, the nurse calls the patient to schedule a follow-up visit. What concern will the nurse assess for during the conversation with the patient? a. Weakness b. Hallucinations c. Suicidal ideation d. Difficulty with urination
answer
c. Suicidal ideation
question
The nurse is caring for a patient who has been taking clozapine (Clozaril) for 2 months. Which laboratory test(s) should be performed regularly while the patient is taking this medication? a. Platelet count b. WBC count c. Liver function studies d. Renal function studies
answer
b. WBC count
question
The nurse is giving medications to a patient. Which drug or drug class, when administered with lithium, increases the risk for lithium toxicity? a. Thiazides b. levofloxacin c. calcium citrate d. Beta blockers
answer
a. Thiazides
question
The nurse is teaching a patient about treatment with an SSRI antidepressant. Which teaching considerations are appropriate? (Select all that apply.) a. The patient should be told which foods contain tyramine and instructed to avoid these foods. b. The patient should be instructed to use caution when standing up from a sitting position. c. The patient should not take any products that contain the herbal product St. John's wort. d. This medication should not be stopped abruptly. e. Drug levels may become toxic if dehydration occurs. f. The patient should be told to check with the prescriber before taking any over-the-counter medications.
answer
b. The patient should be instructed to use caution when standing up from a sitting position. c. The patient should not take any products that contain the herbal product St. John's wort. d. This medication should not be stopped abruptly. f. The patient should be told to check with the prescriber before taking any over-the-counter medications.
question
A patient with a feeding tube will be receiving risperidone (Risperdal) 8 mg in 2 divided doses via the feeding tube. The medication is available in a 1 mg/mL solution. How many milliliters will the nurse administer for each dose?
answer
4 mL per dose
question
A patient who has been taking lithium for 6 months has had severe vomiting and diarrhea from a gastrointestinal flu. The nurse will assess for which potential problem at this time? a. Anxiety b. Chest pain c. Agitation d. Dehydration
answer
d. Dehydration
question
A 68-year-old patient has been taking an SSRI antidepressant for 3 weeks. His wife calls and expresses concern because he has started to give away some of his keepsakes. What is the nurse's priority action at this time?
answer
The priority is to watch this patient closely for suicidal ideations, which may increase during the first weeks after antidepressant therapy is started. The nurse should instruct the wife to bring her husband in for a follow-up visit immediately and not to leave him alone.
question
A patient has been admitted to the hospital because of a suspected overdose of a tricyclic antidepressant. What two problems are the nurse's priorities at this time?
answer
The two priority problems that may occur after an overdose of tricyclic antidepressants are cardiac dysrhythmias and seizures, and both may lead to death. Overdoses of these medications can be lethal.
question
A friend has revealed to the nurse that she has used crack cocaine often in the past few months and states that even though she enjoys the sensations she can "stop at any time." What is the nurse's priority action in this situation?
answer
This situation brings up an ethical difficulty in that a friend has confided in the nurse, yet the friend is participating in an illegal and harmful activity. First of all, she will not change her behavior unless she wants to change. The priority is the safety of the friend. The nurse can try to educate her about the dangers of taking illicit drugs, specifically the cocaine, and how an overdose or bad batch could kill her. If she wants help, the nurse can aid her in seeking professional medical care and counseling to assist with withdrawal and psychologic dependence. She also needs to realize that this will be a lifelong issue. The nurse will try to involve her family in an intervention to help her to recognize her problem.
question
A patient is admitted to the hospital for major abdominal surgery, and the physician has ordered that a transdermal nicotine patch be used while the patient is hospitalized because the patient was a heavy smoker. While the patch is applied, the patient asks, "Why in the world would you want to give me nicotine when I'm trying to stop smoking?" What is the nurse's priority when answering the patient's question?
answer
The nurse needs to explain how the expected nicotine withdrawal will affect his recovery from surgery. Nicotine withdrawal may be manifested in a hospitalized patient by irritability, restlessness, and decreases in both heart rate and blood pressure. In addition, a patient may experience severe cravings for cigarettes. During the postoperative period, the symptoms of nicotine withdrawal may mask other underlying problems, such as hypoxia or even bleeding. He will also be more comfortable if the cravings are curbed. The transdermal administration of nicotine provides nicotine without the carcinogens found in tobacco; the patches are part of a stepwise reduction in subcutaneous delivery. Over time, the nicotine dosage is gradually decreased.
question
A patient is experiencing withdrawal from opioids. The nurse expects to see which assessment finding most commonly associated with acute opioid withdrawal? a. Elevated blood pressure b. Decreased pulse c. Lethargy d. Constipation
answer
a. Elevated blood pressure
question
During treatment for withdrawal from opioids, the nurse expects which medication to be ordered? a. amphetamine (Dexedrine) b. clonidine (Catapres) c. diazepam (Valium) d. disulfiram (Antabuse)
answer
b. clonidine (Catapres)
question
The nurse is presenting a seminar on substance abuse. Which drug is the most commonly used illicit drug in the United States? a. Crack cocaine b. Heroin c. Marijuana d. Methamphetamine
answer
c. Marijuana
question
A patient who is taking disulfiram as part of an alcohol treatment program accidentally takes a dose of cough syrup that contains a small percentage of alcohol. The nurse expects to see which symptom as a result of acetaldehyde syndrome? a. Lethargy b. Copious vomiting c. Hypertension d. No ill effect because of the small amount of alcohol in the cough syrup
answer
b. Copious vomiting
question
The nurse is assessing a patient for possible substance abuse. Which assessment finding indicates possible use of amphetamines? a. Lethargy and fatigue b. Cardiovascular depression c. Talkativeness and euphoria d. Difficulty swallowing and constipation
answer
c. Talkativeness and euphoria
question
A patient experiencing ethanol withdrawal is beginning to show severe manifestations of delirium tremens. The nurse will plan to implement which interventions for this patient? (Select all that apply.) a. Doses of an oral benzodiazepine b. Doses of an intravenous benzodiazepine c. Restraints if the patient becomes confused, agitated, or a threat to himself or others d. Thiamine supplementation e. Oral disulfiram (Antabuse) treatment f. Monitoring in the intensive care unit
answer
b. Doses of an intravenous benzodiazepine c. Restraints if the patient becomes confused, agitated, or a threat to himself or others d. Thiamine supplementation f. Monitoring in the intensive care unit
question
A patient has been admitted to the emergency department after a suspected overdose of benzodiazepines mixed with alcohol. The patient is lethargic and cannot speak. The nurse expects which immediate measures to be implemented? (Select all that apply.) a. Prepare to administer naloxone (Narcan). b. Prepare to administer flumazenil. c. Monitor the patient for convulsions. d. Prepare for potential respiratory arrest. e. Apply restraints.
answer
b. Prepare to administer flumazenil. c. Monitor the patient for convulsions. d. Prepare for potential respiratory arrest.
question
The nurse is teaching a class about the effects of alcohol. Long-term excessive use of alcohol is associated with which of these problems? (Select all that apply.) a. Coronary artery disease b. Wernicke's encephalopathy c. Polyneuritis d. Seizures e. Cirrhosis of the liver f. Korsakoff's psychosis
answer
b. Wernicke's encephalopathy c. Polyneuritis e. Cirrhosis of the liver f. Korsakoff's psychosis
question
Which mood-stabilizing drugs are used to treat bipolar disorder? Select all that apply. 1 Bupropion 2 Imipramine 3 Isocarboxazid 4 Oxcarbazepine 5 Lithium carbonate
answer
Correct4 Oxcarbazepine Correct5 Lithium carbonate
question
The nurse notes lithium on a patient's drug history upon admission. Which condition would the nurse suspect that this patient has been diagnosed with? 1 Bipolar disorder 2 Absence seizures 3 Paranoid schizophrenia 4 Obsessive-compulsive disorder
answer
Correct1 Bipolar disorder
question
The nurse notes that the patient has an increased blood glucose level, increased blood pressure (BP), and abnormal cholesterol levels. What does the nurse infer from these observations? 1 The patient has mania. 2 The patient has dystonia. 3 The patient has dyskinesia. 4 The patient has metabolic syndrome.
answer
Correct4 The patient has metabolic syndrome.
question
Which anxiolytic drug promotes agonistic activity at both the serotonin and dopamine receptors? 1 Buspirone 2 Alprazolam 3 Lorazepam 4 Amitriptyline
answer
Correct1 Buspirone
question
Which are common symptoms of serotonin syndrome? Select all that apply. 1 Delirium 2 Myoclonus 3 Drowsiness 4 Coarse tremors 5 Suicidal thoughts
answer
Correct1 Delirium Correct2 Myoclonus Correct4 Coarse tremors
question
What are the current indications for tricyclic antidepressants (TCAs)? Select all that apply. 1 Seizures 2 Insomnia 3 Depression 4 Childhood enuresis 5 Neuropathic pain syndrome
answer
Correct2 Insomnia Correct4 Childhood enuresis Correct5 Neuropathic pain syndrome
question
Which phenomena does the nurse recognize as positive symptoms of schizophrenia? Select all that apply. 1 Catatonia 2 Delusions 3 Hallucinations 4 Poverty of speech 5 Social withdrawal 6 Conceptual disorganization
answer
Correct2 Delusions Correct3 Hallucinations Correct6 Conceptual disorganization
question
Which patient is a poor candidate for therapy with diazepam to treat generalized anxiety disorder? 1 One with a history of alcoholism 2 One with type 2 diabetes mellitus 3 One who had convulsions as a child 4 One who has had a myocardial infarction
answer
Correct1 One with a history of alcoholism
question
What is another approved and indicated use for bupropion, a second-generation antidepressant? 1 Smoking cessation 2 Orthostatic hypotension 3 Nocturnal enuresis in children 4 Anorexia in patients undergoing chemotherapy
answer
Correct1 Smoking cessation
question
A patient who has taken fluoxetine for 2 weeks to treat an anxiety disorder expresses dissatisfaction with the therapy. What is the best information for the nurse to include in patient education to promote adherence to the therapeutic regimen? 1 This medication usually requires titration. 2 The adverse effects can be managed well. 3 Relaxation exercises can offer some relief. 4 A therapeutic effect can be expected in another 2 to 4 weeks.
answer
Correct4 A therapeutic effect can be expected in another 2 to 4 weeks.
question
The nurse is assessing a patient who has been prescribed alprazolam to treat panic disorder. Which adverse effects does the nurse monitor for in the patient? Select all that apply. 1 Ataxia 2 Dizziness 3 Confusion 4 Blurred vision 5 Paradoxical anxiety
answer
Correct1 Ataxia Correct2 Dizziness Correct3 Confusion
question
Which activity should the patient be cautioned to avoid while taking a monoamine oxidase (MAO) inhibitor? 1 Eating aged cheese 2 Sunbathing at the pool 3 Participating in a bowling league 4 Smoking a low-nicotine cigarette
answer
Correct1 Eating aged cheese
question
A patient is detoxifying from alcohol abuse. Which type of medication is indicated to help the patient manage withdrawal symptoms? 1 Phenothiazine 2 Dibenzazepine 3 Benzisoxazole 4 Benzodiazepine
answer
Correct4 Benzodiazepine
question
What atypical antipsychotic medication would the nurse anticipate a health care provider prescribing for treatment of refractory schizophrenia? 1 Trazodone 2 Phenelzine 3 Amoxapine 4 Risperidone
answer
Correct4 Risperidone
question
Which adverse effects result from antipsychotic drugs' action on alpha-adrenergic receptors? Select all that apply. 1 Weight gain 2 Lightheadedness 3 Reflex tachycardia 4 Tardive dyskinesia 5 Postural hypotension
answer
Correct2 Lightheadedness Correct3 Reflex tachycardia Correct5 Postural hypotension
question
Which theory states that depression and mania are caused by alterations in the concentration of dopamine and norepinephrine and serotonin and histamine in the brain? 1 Dopamine hypothesis 2 Permissive hypothesis 3 Dysregulation hypothesis 4 Biogenic amine hypothesis
answer
Correct4 Biogenic amine hypothesis
question
Which instruction does a nurse provide to a patient who is taking a selective serotonin reuptake inhibitor (SSRI)? 1 "Change positions frequently." 2 "Avoid foods or beverages rich in tyramine." 3 "Avoid hot baths, saunas, and hot climates." 4 "Increase the intake of dietary fiber supplements."
answer
Correct4 "Increase the intake of dietary fiber supplements."
question
The nurse is assessing a patient with depression who has been prescribed nortriptyline. Following the assessment, the nurse finds that the patient has constipation and urinary retention due to interaction between the prescribed medications. Which class of medication found in the patient's prescription is responsible for these effects? 1 Diuretics 2 Anxiolytics 3 Anticholinergics 4 Antihypertensives
answer
Correct3 Anticholinergics
question
Which medication increases the rate of urinary elimination of tricyclic antidepressants (TCAs) in the event of an overdose? 1 Diazepam 2 Antidysrhythmic 3 Activated charcoal 4 Sodium bicarbonate
answer
Correct4 Sodium bicarbonate
question
What assessment finding is the result of parasympathetic nervous system stimulation? 1 Bradycardia 2 Pupil dilation 3 Urine retention 4 Bronchial dilation
answer
Correct1 Bradycardia
question
A patient is prescribed tolterodine. What should the nurse assess to determine the therapeutic effect of this medication? 1 Increased heart rate 2 Decreased urination 3 Increased blood pressure 4 Decreased bowel movements
answer
Correct2 Decreased urination
question
What instructions should the nurse give a patient who has constipation from prolonged use of anticholinergic medications? Select all that apply. 1 "Get adequate rest." 2 "Increase your daily intake of fluids." 3 "Include nuts and legumes in your diet." 4 "Increase the amount of fiber in your diet." 5 "Take fiber supplements such as psyllium."
answer
Correct2 "Increase your daily intake of fluids." Correct4 "Increase the amount of fiber in your diet." Correct5 "Take fiber supplements such as psyllium."
question
A patient has been receiving donepezil for several weeks. Which finding indicates the medication is having a therapeutic effect? 1 The patient is awake. 2 The patient is relaxed. 3 The patient has urinated. 4 The patient has increased cognition.
answer
Correct4 The patient has increased cognition.
question
Which medication is a noncholinergic drug used in the treatment of Alzheimer's disease? 1 Atropine 2 Memantine 3 Donepezil 4 Rivastigmine
answer
Correct2 Memantine
question
Which assessment finding in a patient who has received an anticholinergic drug requires immediate intervention? 1 Hallucinations 2 Motion sickness 3 Decreased urination 4 Increased respiratory rate
answer
Correct1 Hallucinations
question
Which are contraindications for administration of cholinergic-blocking medications? Select all that apply. 1 Renal failure 2 Peptic ulcers 3 Down syndrome 4 Bronchial asthma 5 Recent heart surgery
answer
Correct1 Renal failure Correct3 Down syndrome Correct5 Recent heart surgery
question
Which medication is used for the treatment of irritable bowel syndrome? 1 Atropine 2 Oxybutynin 3 Dicyclomine 4 Glycopyrrolate
answer
Correct3 Dicyclomine
question
The nurse is caring for a patient who is taking a cholinergic drug. Which assessment is caused by stimulation of the parasympathetic nervous system? 1 Mydriasis 2 Vasoconstriction 3 Urinary retention 4 Increased gastrointestinal (GI) motility
answer
Correct4 Increased gastrointestinal (GI) motility
question
What are potential side effects of administering high doses of a cholinergic-blocking medication? Select all that apply. 1 Disorientation 2 Decreased heart rate 3 Constriction of pupils 4 Decreased gastric secretions 5 Constriction of internal sphincter
answer
Correct1 Disorientation Correct4 Decreased gastric secretions Correct5 Constriction of internal sphincter
question
The nurse is providing education about cholinergic-blocking drug therapy to an older patient. What should the nurse include in the teaching plan about maximizing the therapeutic effects and minimizing the adverse effects of these drugs? Select all that apply. 1 "Eliminate high-fiber foods." 2 "Brush your teeth frequently." 3 "Drink 6 to 8 glasses of water daily." 4 "Avoid exposure to high temperatures." 5 "Begin an exercise program three times a week."
answer
Correct2 "Brush your teeth frequently." Correct3 "Drink 6 to 8 glasses of water daily." Correct4 "Avoid exposure to high temperatures."
question
What is an expected therapeutic outcome assessment for a patient who has Parkinson's disease and dementia and is prescribed rivastigmine? 1 Decreased tremors 2 Decreased salivation 3 Improvement in memory 4 Increased muscle strength
answer
Correct3 Improvement in memory
question
Before starting therapy with pyridostigmine, the nurse assesses the patient's history for which conditions? Select all that apply. 1 Asthma 2 Emphysema 3 Hypothyroidism 4 Psoriatic arthritis 5 Coronary artery disease
answer
Correct1 Asthma Correct5 Coronary artery disease
question
What are the side effects of scopolamine? Select all that apply. 1 Dry mouth 2 Drowsiness 3 Blurred vision 4 Altered mental status 5 Respiratory depression
answer
Correct1 Dry mouth Correct2 Drowsiness Correct3 Blurred vision
question
What medications are used for overactive bladder because of their decreased incidence of side effects such as dry mouth? Select all that apply. 1 Trospium 2 Solifenacin 3 Darifenacin 4 Oxybutynin 5 Fesoterodine
answer
Correct1 Trospium Correct2 Solifenacin Correct3 Darifenacin Correct5 Fesoterodine
question
Which assessment finding should the nurse interpret as a therapeutic effect of atropine? 1 Lethargy 2 Hypertension 3 Increased heart rate 4 Constriction of pupils
answer
Correct3 Increased heart rate
question
The nurse is caring for a patient with Parkinson disease who is receiving cholinergic-blocking drug therapy. What is the reason for prescribing this drug therapy to the patient? 1 The drug decreases the urinary bladder spasms. 2 The drug decreases muscle rigidity and tremors. 3 The drug increases the patient's apical heart rate. 4 The drug decreases gastrointestinal (GI) secretions.
answer
Correct2 The drug decreases muscle rigidity and tremors.
question
Which medications are direct-acting cholinergic drugs? Select all that apply. 1 Pilocarpine 2 Galantamine 3 Neostigmine 4 Edrophonium 5 Succinylcholine
answer
Correct1 Pilocarpine Correct5 Succinylcholine
question
Which drugs are used to reverse the effects of nondepolarizing neuromuscular-blocking drugs after surgery? Select all that apply. 1 Donepezil 2 Memantine 3 Neostigmine 4 Pyridostigmine 5 Physostigmine
answer
Correct3 Neostigmine Correct4 Pyridostigmine Correct5 Physostigmine
question
For which therapeutic effect should the nurse assess a patient taking dicyclomine? 1 Increase in heart rate 2 Increase in blood pressure 3 Decrease in urinary frequency 4 Decrease in gastrointestinal (GI) motility
answer
Correct4 Decrease in gastrointestinal (GI) motility
question
Which route of administration is preferred for treating xerostomia with pilocarpine? 1 Oral 2 Ocular 3 Intravenous 4 Intramuscular
answer
Correct1 Oral
question
Which assessment finding in a patient receiving memantine indicates a significant side effect? 1 Patient is unable to sleep 2 Raised, erythematous rash 3 Blood pressure 70/40 mm Hg 4 Respiratory rate 30 breaths per minute
answer
Correct3 Blood pressure 70/40 mm Hg
question
After administering bethanechol to a patient after surgery, what system should the nurse assess to determine a therapeutic effect? 1 Urinary 2 Neurologic 3 Musculoskeletal 4 Gastrointestinal
answer
Correct1 Urinary
question
What is the medication dose of atropine that is used for symptomatic bradycardia? 1) 0.3 mg 2) 0.5 mg 3) 1.25 mg 4) 2 mg
answer
Correct2 0.5 mg
question
What is the difficulty in using physostigmine as an antidote to an overdose of a cholinergic-blocking agent? 1 It requires hospitalization. 2 It requires supportive therapy. 3 It can cause severe side effects. 4 It requires increased fluid intake.
answer
Correct3 It can cause severe side effects.
question
What is the expected therapeutic effect after the administration of atropine to a patient with cholinergic-blocker poisoning? 1 Decrease in gastric secretions 2 Immediate increase in heart rate 3 Immediate decrease in heart rate 4 Increase in respiratory rate within 1 minute
answer
Correct2 Immediate increase in heart rate
question
What is dicyclomine typically administered to treat? 1 Enterocolitis 2 Constipation 3 Irritable bowel disease 4 A neuromuscular blockade
answer
Correct3 Irritable bowel disease
question
Which medication should be administered to a patient who has a cholinergic crisis? 1 Atropine 2 Donepezil 3 Echothiophate 4 Pyridostigmine
answer
Correct1 Atropine
question
What is the rationale behind administering ginkgo to a patient? 1 To prevent memory loss 2 To treat myasthenia gravis 3 To reverse cholinergic drug effects 4 To treat postpartum urinary retention
answer
Correct1 To prevent memory loss
question
Which condition is a contraindication to the administration of bethanechol? 1 Gastric atony 2 Hyperthyroidism 3 Urinary retention 4 Chronic refractory heartburn
answer
Correct2 Hyperthyroidism
question
Which drug may be administered to a patient who has a tricyclic antidepressant overdose? 1 Tacrine 2 Carbachol 3 Memantine 4 Physostigmine
answer
Correct4 Physostigmine
question
Which condition is treated with bethanechol in a postoperative patient? 1 Urinary atony 2 Respiratory atelectasis 3 Postoperative hypotension 4 Postoperative ischemic colitis
answer
Correct1 Urinary atony
question
What should the nurse teach a patient about potential effects of a newly prescribed cholinergic-blocking drug? 1 "The drug will decrease muscle rigidity." 2 "The drug will cause a very slow heart rate." 3 "You may have problems with urinary retention." 4 "You will have increased saliva production and sweating."
answer
Correct3 "You may have problems with urinary retention."
question
What precaution is needed when physostigmine is administered to treat a cholinergic blocker overdose? 1 Increased fluid intake 2 Insertion of a Foley catheter 3 Assessment of bowel sounds 4 Frequent cardiac assessments
answer
Correct4 Frequent cardiac assessments
question
The nurse administers psyllium to a patient. Which assessment finding indicates a therapeutic response to this medication? 1 Decreased urination 2 A nonproductive cough 3 A formed bowel movement 4 No complaints of motion sickness
answer
Correct3 A formed bowel movement
question
Which medication may be administered to a patient who has myasthenia gravis? 1 Donepezil 2 Memantine 3 Bethanechol 4 Pyridostigmine
answer
Correct4 Pyridostigmine
question
Which finding in a patient's history is a contraindication to the administration of a cholinergic-blocking medication? 1 Anxiety 2 Irritable bowel disease 3 Angle-closure glaucoma 4 Gastrointestinal hypersecretory state
answer
Correct3 Angle-closure glaucoma
question
A patient who is taking a cholinergic-blocking medication is having difficulty urinating. What is the nurse's best action? 1 Insert a Foley catheter. 2 Increase the patient's fluid intake. 3 Assess the patient's medication therapy. 4 Encourage the patient to ambulate frequently.
answer
Correct3 Assess the patient's medication therapy.
question
Which patient would be unable to receive donepezil to treat symptoms of Alzheimer disease? 1 The patient with constipation 2 The patient with urinary retention 3 The patient exhibiting heart block 4 The patient diagnosed with hypertension
answer
Correct3 The patient exhibiting heart block
question
The nurse is caring for a patient who received atropine tablets for diarrhea. The nurse observes that the patient has mydriasis, altered mental status, and fever. What is the best action for the nurse to take? 1 Administer fluids. 2 Administer aspirin. 3 Administer dicyclomine. 4 Administer physostigmine.
answer
Correct4 Administer physostigmine.
question
A patient has taken an anticholinergic agent along with an atypical antipsychotic drug. Which instruction should the nurse ensure the patient follows? 1 "Avoid sun and warm places." 2 "Avoid caffeinated beverages." 3 "Drink additional fluids each day." 4 "Expectorate oral secretions frequently."
answer
Correct1 "Avoid sun and warm places."
question
The nurse should teach a patient receiving anticholinergic medications to avoid which medications that can lead to potential additive effects? Select all that apply. 1 Digoxin 2 Antibiotics 3 Amantadine 4 Antihistamines 5 Tricyclic antidepressants
answer
Correct1 Digoxin Correct3 Amantadine Correct4 Antihistamines Correct5 Tricyclic antidepressants
question
The nurse administers oxybutynin. What assessment is essential to determine therapeutic effect? 1 Bowel sounds 2 Urinary output 3 Blood pressure 4 Pupillary response
answer
Correct2 Urinary output
question
What should the nurse assess as a therapeutic effect of the administration of pyridostigmine to a patient who has myasthenia gravis? 1 Patient is no longer dizzy 2 Patient has improved memory 3 Patient is able to walk long distances 4 Patient has increased muscle strength
answer
Correct4 Patient has increased muscle strength
question
The nurse is caring for a patient who is receiving anticholinergic drug therapy. What information should the nurse include in the teaching plan? 1 "Decrease your fluid intake." 2 "Stay out of the heat and humidity." 3 "Include vitamin D in your daily diet." 4 "Take the medication first thing in the morning."
answer
Correct2 "Stay out of the heat and humidity."
question
A patient has been prescribed oxybutynin. What will the nurse assess before administering the patient's next dose? 1 Whether the patient has hypotension 2 Whether the patient is able to urinate 3 Whether the patient reports alcoholism 4 Whether the patient has light sensitivity
answer
Correct2 Whether the patient is able to urinate
question
A patient receives a prescription for oxybutynin for the treatment of overactive bladder. Which instruction should the nurse include in patient teaching to help prevent adverse effects of therapy? 1 "Empty your bladder at least every hour." 2 "Manage increased salivation by drinking less." 3 "Treat diarrhea with diphenoxylate and atropine." 4 "Do not take antihistamines without your primary health care provider's approval."
answer
Correct4 "Do not take antihistamines without your primary health care provider's approval."
question
What is the antidote to a cholinergic overdose? 1 Atropine 2 Memantine 3 Epinephrine 4 Rivastigmine
answer
Correct1 Atropine
question
The nurse has administered atropine intravenously to a patient who has sinus bradycardia. After administration of the medication, the patient's heart rate has not increased. What is the nurse's next course of action? 1 Call a code. 2 Call the respiratory team stat. 3 Have the patient get up and move around. 4 Administer another dose of the medication.
answer
Correct4 Administer another dose of the medication.
question
An older adult receiving anticholinergic therapy should be assessed for what potential side effects of therapy? Select all that apply. 1 Coma 2 Diarrhea 3 Constipation 4 Restlessness 5 Blurred vision 6 Pupil constriction
answer
Correct3 Constipation Correct4 Restlessness Correct5 Blurred vision
question
A patient who is going on a cruise is prescribed scopolamine transdermal patch. What will the nurse instruct the patient? Select all that apply. 1 "Do not drive a motor vehicle." 2 "You should eat a low-fiber diet." 3 "Do not consume too much water." 4 "You should abstain from alcohol." 5 "You should not use heavy machinery."
answer
Correct1 "Do not drive a motor vehicle." Correct4 "You should abstain from alcohol." Correct5 "You should not use heavy machinery."
question
A patient is prescribed atropine. For what medication should the nurse assess the patient's history? 1 Digoxin 2 Cephalexin 3 Erythromycin 4 Aspirin therapy
answer
Correct1 Digoxin
question
The nurse is caring for a patient who has a low-level spinal cord injury. What assessments and interventions are necessary? 1 Muscular assessment and antispasmodic therapy 2 Respiratory assessment and stimulant drug therapy 3 Pain assessment and administration of intraspinal pain medication 4 Urinary assessment and administration of cholinergic-blocking agents
answer
Correct4 Urinary assessment and administration of cholinergic-blocking agents
question
The primary health care provider has prescribed transdermal scopolamine patches to treat motion sickness in a patient. What instructions should the nurse give to the patient about the medication? Select all that apply. 1 "Wear gloves when you put on the patch." 2 "It is safe to take this medication with alcohol." 3 "Apply the patch on the same area every time." 4 "Place the patch on the nonhairy area behind your ear." 5 "Apply the patch 4 to 5 hours before the activity that causes motion sickness."
answer
Correct4 "Place the patch on the non-hairy area behind your ear." Correct5 "Apply the patch 4 to 5 hours before the activity that causes motion sickness."
question
A patient who has undergone treatment for spinal cord injury has been prescribed oxybutynin. What should the nurse teach the patient about taking this drug? 1 "Take the medication after rinsing your mouth thoroughly." 2 "Take the medication 1 hour before or 2 hours after meals." 3 "Make sure you drink at least 6 to 8 glasses of water daily." 4 "Suck on a piece of hard sugar candy after you take the pill."
answer
Correct2 "Take the medication 1 hour before or 2 hours after meals."
question
What should the nurse teach a patient to decrease the effects of dry mouth from an anticholinergic medication? Select all that apply. 1 Chew on ice chips. 2 Brush teeth twice a day. 3 Use artificial saliva drops. 4 Maintain regular dental visits. 5 Chew on sugarless candy or gum.
answer
Correct2 Brush teeth twice a day. Correct3 Use artificial saliva drops. Correct4 Maintain regular dental visits. Correct5 Chew on sugarless candy or gum.
question
What information regarding exercise should the nurse teach a patient who is receiving anticholinergic medications? 1 "Only perform isometric exercise daily." 2 "Exercise regularly to reach a target heart rate." 3 "Avoid excessive sweating and strenuous exercise." 4 "Exercise using large muscles such as with jogging or swimming."
answer
Correct3 "Avoid excessive sweating and strenuous exercise."
question
Cholinergic agonist drugs have the potential to cause which effects? Select all that apply. 1 Pupil dilation 2 Decreased heart rate 3 Decreased gastric motility 4 Increased respiratory secretions 5 Decreased sweat gland secretion
answer
Correct2 Decreased heart rate Correct4 Increased respiratory secretions
question
Which drug is indicated in the treatment of myasthenia gravis? 1 Pilocarpine 2 Neostigmine 3 Rivastigmine 4 Succinylcholine
answer
Correct2 Neostigmine
question
What assessment finding indicates the patient may have symptoms of anticholinergic drug overdose? 1 Macular rash 2 Severe headache 3 Irregular heart rate 4 Muscular weakness
answer
Correct3 Irregular heart rate
question
Which indirect-acting cholinergic drug is used to treat a patient who has both Parkinson's disease and dementia? 1 Donepezil 2 Memantine 3 Galantamine 4 Rivastigmine
answer
Correct4 Rivastigmine
question
When providing teaching for a patient who is prescribed an SSRI, which statement will the nurse include? a. The SSRI will work faster than the older tricyclic antidepressants. b. The SSRI will have an immediate beneficial effect on the patient's depression symptoms. c. The SSRI will not work well for severe causes of depression. d. The SSRI may take several weeks to have a beneficial effect.
answer
d. The SSRI may take several weeks to have a beneficial effect.
question
When patients are taking SSRI's for the first time for depression, which is most important to monitor for during the first few weeks of therapy? a. Hypertensive crisis b. Suicidal thoughts c. Convulsions d. Orthostatic hypotension
answer
b. Suicidal thoughts
question
Before administering lithium to a patient, it is most important for the nurse to assess which laboratory value? a. Blood sugar b. Sodium c. Urine osmolality d. Potassium
answer
b. Sodium
question
A patient is admitted to the emergency department. The patient's heart rate 112 beats/min. The patient is sweating profusely, has muscle tremors and is agitated. The patient says " I was depressed and I took more of the pills the doctor gave me so I would feel better." 1 .What does the nurse suspect is happening with this patient? 2. What treatment does the nurse expect to implement?
answer
1. Along with a full assessment, the nurse would need to ask what medications the patient is taking, how long and how much is the patient currently taking. Based on the presenting signs & symptoms the nurse would include serotonin syndrome as a highly possible reason for the patient's presenting symptoms. 2. The treatment for serotonin syndrome includes discontinuation of all SSRI's and providing supportive care to maintain homeostasis.
question
The patient was admitted to the hospital for observation and has now recovered. Which information will the nurse include in patient teaching about SSRI's? a. It usually takes 4-6 weeks until you experience benefits from the medication. b. Avoid all foods containing tyramine. c. Stop taking the medication if you develop an upset stomach. d. Take the medication at bedtime to enhance sleep.
answer
a. It usually takes 4-6 weeks until you experience benefits from the medication SSRI's need 4-6 weeks to reach their maximum effectiveness. These meds can cause GI upset and should be taken with food. SSRIs should be taken in the morning to prevent sleep disturbances.
question
Several months later, the patient returns to the health care providers office for a follow-up regarding the use of the SSRI. The patient tells the nurse that he is feeling better and stopped taking the SSRI yesterday. The patient doesn't plan on taking the medication again. When talking with the patient, which knowledge should guide the nurse's response? a. Drug dependency will develop, so it's appropriate to stop therapy after a few months. b. Drug therapy must be stopped as soon as the patient feels better to avoid serotonin syndrome. c. The patient is the best person to determine when the drug therapy should end. d. A possible 1-2 month taper period is indicated to prevent adverse effects of abrupt drug discontinuation.
answer
d. A possible 1-2 month taper period is indicated to prevent adverse effects of abrupt drug discontinuation. A taper period of 1-2 months may be needed to prevent serotonin discontinuation syndrome with symptoms like: dizziness, diarrhea, and worsening of the depressive mood disorder. Serotonin syndrome is a result of taking too much serotonin altering medication. The patient and provider should work together to determine the optimal time for discontinuation. There is no evidence of drug dependency associated with the use of SSRI's.
question
Which drug will the nurse anticipate administering to a patient experiencing benzodiazepine overdose? a. Flumazenil b. Naltrexone c. Vivitrol d. Flunitrazepam
answer
a. Flumazenil
question
A patient with a diagnosis of delirium tremens is admitted to the acute care facility. Which finding does the nurse expect upon assessment of the patient? a. Hyperthermia b. Hypotension c. Bradycardia d. Somnolence
answer
a. Hyperthermia
question
Which statement does the nurse include when teaching a patient about disulfiram (Antabuse) therapy? a. "Disulfiram (Antabuse) will cure your alcoholism if you take it as directed." b. "If you drink alcohol after taking disulfiram (Antabuse), your blood pressure will get very high." c. "You cannot drink alcohol for at least 3 or 4 days after taking disulfiram (Antabuse)." d. "If you miss a dose of disulfiram (Antabuse), double the dose the next time it is due."
answer
c. "You cannot drink alcohol for at least 3 or 4 days after taking disulfiram (Antabuse)."
question
The nurse is explaining the differences between transdermal nicotine and nicotine gum programs. Which statement by the nurse is correct? a. "The nicotine patch will give you quick relief from cravings." b. "Chewing the gum rapidly will release an immediate dose of nicotine." c. "It seems that patients have better treatment compliance with the gum than the patch." d. "The dose of nicotine in the gum is approximately twice the dose the average smoker receives in one cigarette."
answer
b. "Chewing the gum rapidly will release an immediate dose of nicotine."
question
The nurse is assessing a patient who has been taking a cholinergic drug for 3 days. The patient has flushed skin and orthostatic blood pressure changes and is complaining of abdominal cramps and nausea. The nurse recognizes that the patient is most likely experiencing a. early signs of a cholinergic crisis. b. late signs of a cholinergic crisis. c. an allergic reaction to the drug. d. expected adverse effects.
answer
a. early signs of a cholinergic crisis.
question
A 60-year-old woman asks the nurse about taking ginkgo to help with her memory. The patient has a history of arthritis, type 2 diabetes, thyroid disease, and hypertension. She is currently taking NSAIDs for arthritis, oral antidiabetic medications, thyroid replacement hormone, and a beta blocker for blood pressure. What potential adverse effect from the gingko would be of most concern for this patient? a. Stomach upset b. Diarrhea c. Bleeding d. Drowsiness
answer
c. Bleeding
question
A patient is scheduled to have lunch at 1200. The nurse will administer the pyridostigmine (Mestinon) at what time for optimal therapeutic effect? 1) 1100 2) 1130 3) 1200 4) 1230
answer
4) 1230
question
A patient with Alzheimer's disease accidentally took 2 weeks' worth of a cholinergic medication. He is brought to the emergency department, is going into shock, and experiencing severe hypotension and vomiting. The nurse will expect which initial treatment? a. Administration of physostigmine b. Administration of atropine c. Administration of epinephrine d. Cardiovascular support with dopamine
answer
b. Administration of atropine
question
Which finding would the nurse anticipate when assessing a patient with an atropine overdose? a. Moist skin b. Miosis c. Bradycardia d. Urinary retention
answer
d. Urinary retention
question
Glycopyrrolate (Robinul) and an opioid are administered to a patient before surgery in the preoperative area. The anticholinergic is used to a. potentiate the action of the opioid. b. assist the patient in retaining urine during surgery. c. control secretions during surgery. d. prevent nausea.
answer
c. control secretions during surgery.
question
Before administering tolterodine (Detrol), it is most important for the nurse to assess the patient for a history of which condition? a. Angle-closure glaucoma b. Cataracts c. Hypothyroidism d. Hyponatremia
answer
a. Angle-closure glaucoma
question
Which condition does the nurse anticipate when assessing a patient with tumor lysis syndrome? a. Hyperuricemia b. Hypophosphatemia c. Hypokalemia d. Hypercalcemia
answer
a. Hyperuricemia
question
A pregnant woman has been diagnosed with cancer and is meeting with her oncologist to plan treatment. Which statement about chemotherapy and pregnancy is true? a. She will have to wait until the baby is born before starting chemotherapy. b. The greatest risk of fetal harm from chemotherapy is during the third trimester. c. Chemotherapy treatment during the second or third trimester poses less risk to the fetus. d. Chemotherapy is unsafe during pregnancy, but radiation therapy is safe in low doses.
answer
c. Chemotherapy treatment during the second or third trimester poses less risk to the fetus.
question
The nurse is caring for a patient who received chemotherapy 24 hours ago. The patient's white blood cell count is 4,400 mcL. Which symptom, if experienced by the patient, should the nurse report to the prescriber immediately? a. Fatigue b. Diarrhea c. Fever d. Nausea and vomiting
answer
c. Fever
question
When working with a patient who is neutropenic, the nurse identifies which as the most effective measure to prevent the patient from developing an infection? a. Administer prophylactic antibiotics. b. Stop administration of the chemotherapeutic drug. c. Perform hand hygiene. d. Vaccinate the patient to prevent bacterial infection.
answer
c. Perform hand hygiene.
question
Which cytotoxic antibiotic does the nurse identify as most likely to cause pulmonary fibrosis? a. plicamycin b. mitoxantrone c. mitomycin d. bleomycin
answer
d. bleomycin
question
Bevacizumab (Avastin) is an angiogenesis inhibitor. Which statement correctly describes the mechanism of action of an angiogenesis inhibitor? a. It inhibits the formation of blood cells. b. It inhibits the creation of new blood vessels in the tumor mass. c. It interferes with the synthesis of DNA in the cancer tumor. d. It causes cell death by inhibiting enzymes.
answer
b. It inhibits the creation of new blood vessels in the tumor mass.
question
When handling and administering vesicant drugs, the nurse will: a. double flush the patient's bodily secretions in the commode. b. use sterile towels to clean up after chemotherapy spills. c. mix chemotherapeutic drugs in the patient's room. d. teach the patient how to administer parenteral chemotherapeutic drugs.
answer
a. double flush the patient's bodily secretions in the commode.