Pharm Nursing Lab Test 2 – Flashcards

The nurse at the university health clinic is completing a health assessment for a female client who reports feelings of "sadness" that have persisted for three months. The client reports that she broke up with her boyfriend two months ago; she has no children. She lives in an apartment near campus with two roommates. She denies hallucinations, delusions, and changes in her speech patterns. Based on this limited information, thus far, which mood disorders does the nurse suspect? Major depression Dysthymic disorder Postpartum depression Situational depression Psychotic depression

While discussing antidepressant pharmacotherapy with the client, the nurse explains that antidepressant medications target three major neurotransmitters. Which neurotransmitters does the nurse discuss? Select all that apply. Norepinephrine Serotonin Potassium Dopamine Calcium

The nurse is assessing an adult client with a diagnosis of bipolar disorder. Which symptoms are characteristics of mania? Select all that apply Inflated self-esteem Decreased need to sleep or eat Increased psychomotor activity Decreased talkativeness Hallucinations or delusions

The nurse observes that the newly admitted adult client is talkative and appears to be excessive in both her conversation and actions. How long must an adult client appear manic before a diagnosis and treatment plan are usually initiated? 1 week 1 month 1 day Diagnosis depends on the health care provider and the type of excessive activity noted

The nurse is assessing a 6-year-old child with newly diagnosed attention deficit/hyperactivity disorder (ADHD). What symptoms would the nurse expect to discuss with the parent of this child? Select all that apply Poor listening skills Poor focus Excessive fidgeting or squirming Excessive careless mistakes Decreased talking

The nurse is discussing medications that are often prescribed for children with newly diagnosed attention deficit/hyperactivity disorder (ADHD). What is the most common class of medication used to treat ADHD? Antihistamines Antidepressants Amphetamines Antipyretics

The nurse is assessing an adult client who appears depressed. When taking the client's medical history, the nurse should be alert for what factors that might be contributing to depression? Select all that apply. Early signs of Alzheimer disease A deficiency in vitamin C History of thyroid disease Use of birth control pills Use of corticosteroids

The nurse is providing care for several clients in the clinic with mood disorders. When assessing these clients, the nurse should be aware of what underlying conditions that may contribute to a mood disorder? Select all that apply. Alcohol or substance abuse History of thyroid dysfunction Family history of depression Recent diagnosis of osteoporosis Current prescription and nonprescription medications

The nurse is caring for a client with psychotic behaviors. The client states, "I see snakes crawling down from the ceiling." Which term best describes what the client is experiencing? Paranoia Delusion Hallucination Dystonia

The nurse is performing an admission assessment on a client with a diagnosis of schizophrenia. Which statement by a family member best correlates with the diagnosis? "He is hyperactive one minute and in a deep sleep the next minute." "He received a job promotion two weeks ago." "He is always very neat in appearance." "He attends most of his children's school functions."

A client taking the drug olanzapine (Zyprexa) is exhibiting the following adverse effects. Which causes the nurse the most concern? Pain in the back and joints A weight gain of 2 pounds in one week A total cholesterol level of 200 mg/dL Numbness and inability to move right arm

The nurse is planning a post-conference seminar for a group of nursing students on atypical antipsychotic medication. Which medication would the nurse include in the teaching plan? Thiothixene hydrochloride (Navane) Haloperidol (Haldol) Clozapine (Clozaril) Chlorpromazine hydrochloride (Thorazine)

The nurse is performing an assessment on a client who has been taking aripiprazole (Abilify). Which assessment finding warrants health care provider notification? Reports of increased social activities History of frequent heartburn and dysphagia Borderline hypertensive blood pressure Sleeps 8 hours a night

The nurse is preparing a teaching plan for clients with a diagnosis of schizophrenia and their family members. Which instruction would be included in the teaching plan? An increase in the frequency of the original symptoms is no cause for concern. Follow-up will be unnecessary after discharge from the facility. Psychosis can be cured after 6 months of medication use. The goal of treatment is to allow maintenance of normal activity and self-care.

The nurse is caring for a client who is experiencing severe anxiety. The nurse educates the client that severe anxiety can likely adversely affect which body system? Urinary Gastrointestinal Skeletal Muscular

The nurse is caring for a client who came to the emergency department because of an episode that was diagnosed as a panic attack. The nurse should tell the client that panic attacks will typically resolve within what period of time? 4 minutes 6 minutes 8 minutes 10 minutes

The nurse is caring for a client who has been prescribed a selective serotonin reuptake inhibitor (SSRI) for the treatment of anxiety. The nurse teaches the client that this type of medication belongs to what class of drugs? Benzodiazepine Barbiturate Antidepressant Central nervous system (CNS) depressant

The nurse is caring for a client who has been prescribed duloxetine hydrochloride (Cymbalta). Which anxiety disorder does the nurse anticipate that this client is most likely experiencing? Obsessive-compulsive disorder (OCD) Panic disorder Generalized anxiety disorder (GAD) Posttraumatic stress disorder (PTSD)

The nurse is collecting a health history from a client who is being treated for insomnia. The nurse is currently addressing medications that the client uses. Which questions are appropriate to include in a medication history? Select all that apply. A)"What factors make your insomnia worse?" B)"Do you use any herbal products?" C)"What over-the-counter medications do you take on a regular basis?" D)"What prescriptions do you currently take?" E)"What coping mechanisms help your insomnia?"

The nurse is educating a client with insomnia about good sleep habits. Which item would the nurse include in the teaching session? Avoid any product with caffeine. Take long naps during the day to make up for missed sleep. Get regular exercise. Have a glass of wine just before bed to help with sleep.

The nurse on a medical-surgical unit is busy assessing newly admitted clients. Which client conditions or medical diagnoses indicate that a client may experience a seizure? Select all that apply. A)Multiple trauma and a closed head injury as a result of a motor vehicle crash (MVC) B)Abnormally high glucose level and a 33-year history of type 1 diabetes C)Fever of undetermined origin (FUO), 103.5°F (rectal) (40°C), for past 2 hours in a toddler D)Abdominal pain, diarrhea, fever of 100°F (38.1°C), nausea, vomiting, and reduced appetite in an otherwise healthy 24-year-old female E)Meningitis in a 4-year-old child

The nurse is performing the morning assessment on Frank, a 7-year-old client. Frank stares off into space for a few seconds and does not seem to hear the nurse as she says his name. A few seconds pass, then Frank continues as if nothing happened. Which type of seizure is this child experiencing? Myoclonic seizure Tonic-clonic seizure Absence seizure Atonic seizure

The neurologist diagnosed a 23-year-old male client with epilepsy several days ago. At age 20, this client was diagnosed with viral meningitis, which precipitated his seizures. The client tells the nurse that his older sister had one single seizure that lasted for one minute, several years ago, when she was in treatment for alcohol withdrawal. She was given one dose of diazepam (Valium), which stopped the seizure. She has not had any subsequent seizures. The client asks the nurse why his neurologist ordered phenytoin (Dilantin) for his epilepsy instead of diazepam. Which response by the nurse is least complex and still answers the client's question? A)Diazepam (Valium) is a benzodiazepine that enhances or improves the effects of gamma aminobutyric acid (GABA) in the brain, thereby inhibiting further seizures. B)Diazepam (Valium) is often ordered to control a one-time seizure event, whereas phenytoin (Dilantin) is one of the most commonly prescribed antiseizure medications for epilepsy. C)Phenytoin (Dilantin) acts by desensitizing neurologic channels that are responsible for the seizure activity and disrupting or suppressing that seizure activity. Phenytoin does not have the addictive potential associated with diazepam. D)Diazepam (Valium) is a benzodiazepine. Benzodiazepines are used to gain short term control of seizure activity rather than long-term treatment of seizures.

A client tells the nurse that her neurologist said that phenytoin (Dilantin) is the drug of choice for treatment of seizures and asks how this medication works. The nurse explains that phenytoin inhibits seizure activity how? By slowing neuronal firing rates via increasing gamma aminobutyric acid (GABA) levels in the brain By enhancing the action of gamma aminobutyric acid (GABA) in the brain, which decreases neuronal activity By desensitizing the sodium channels in the brain; this limits rapid firing of brain cells, thereby suppressing seizure activity By suppressing the flow of sodium ions in the brain

The nurse is admitting a new 7-year-old male client with a diagnosis of epilepsy. Which actions by the nurse would be contraindicated? Select all that apply. A)Restrain the child's arms and legs. Position the client on his side. B)If the child has a seizure, slide a tongue blade or spoon into the child's mouth between the teeth. C)Pad the side rails and remove clutter from the bedside. D)Protect the child's head during a seizure.

The nurse is providing care to a 27-year-old client admitted with epilepsy. A student nurse is also working with this nurse and client. The student nurse is assessing the client prior to administering an antiseizure medication. Which nursing actions are appropriate for this client? Select all that apply. A)Correctly identify the client using at least two sources of identification. B)Assess for any drug allergies. C)Teach the client to ask for help with ambulation to prevent a fall or injury. D)Give all medications via intravenous access (IV). E)Review the medication orders and clarify any orders that are not clear.

The nurse is discussing the pathophysiology of pain with a postsurgical client who is prescribed narcotic analgesics. Which phase is the actual experience of pain of which the client will be conscious? Pain perception Pain transduction Pain transmission Pain modulation

A client asks for pain medication and the nurse confirms that the health care provider has ordered morphine sulfate 5 mg IV every 4-6 hours prn for pain. The client's vital signs are pulse: 87 and regular, respiratory rate: 16, blood pressure: 126/78. The nurse should take which priority action before administering the medication? Check the last time the client received pain medication. Check the client's chart for a history of addiction. Try nonpharmacologic pain relief measures. Ask the client about the intensity, character, and location of the pain.

The nurse knows that opioids act by interacting with several different types of receptors. Which responses are produced by activation of the kappa receptor? Select all that apply. A)Analgesia B)Euphoria C)Miosis D)Decreased GI motility E)Respiratory depression

The nurse is caring for an adult client who has an order for morphine sulfate (Astramorph PF) 6 mg IV every 3-4 hours prn for postoperative pain. The nurse should consider withholding the medication until further assessment in which situation? The client's level of consciousness (LOC) changes from alert to disoriented. The client complains of acute pain from a fractured right tibia prior to surgery. The client is restless, anxious, and has cool, clammy skin. The client's vital signs are pulse 92, respirations 26, and blood pressure 146/90.

The nurse is performing discharge teaching regarding pain relief measures with a client who is prescribed sumatriptan (Imitrex) for chronic migraines. Which comment by the client indicates that further teaching is necessary? "I will try to relax and avoid stimulation when I have a migraine." "When I feel a migraine starting, I will lie in a quiet, cool, darkened room." "I will take my medication after I've tried all other pain relief measures." "I will utilize relaxation techniques that I've just learned when I feel a migraine starting."

The nurse is performing discharge teaching with a client newly diagnosed with chronic migraines and has been prescribed sumatriptan (Imitrex). Which client statement indicates that further teaching is necessary? "I will take this medication as soon as I feel a migraine coming on." "I will take this medication every day so I don't get a migraine." "I will let my health care provider know if I experience any chest pain." "I will try to limit the amount of coffee I drink."

The nurse has administered morphine sulfate (Astramorph PF) 10 mg IV push to an adult client for postoperative pain. Upon reassessment, the client's vital signs are pulse: 66, respirations: 6, blood pressure: 96/66, and the client is resting with eyes closed. What action should the nurse take? Administer oxygen via face mask Let the client rest undisturbed Notify the health care provider and obtain an order to administer naloxone (Narcan) Administer flumazenil (Romazicon)

In addition to regular assessment of pain, what additional effects should the nurse assess for in adult clients with chronic pain? Select all that apply. A)Depression B)Location of pain C)Intensity of pain, using an 11-point scale D)Impact on ADLs E)Intensity of pain with use of FLACC scale