Pharmacology Exam 2 Questions and Answers,100% CORRECT

Pharmacology Exam 2 Questions and Answers Ch 10-15 PPT Questions 1. A patient with bone cancer tells the nurse that he is in pain. The nurse knows that bone pain is classified as which type of pain? a. Somatic pain b. Referred pain c. Visceral pain d. Neuropathic pain 2. A patient is recovering from an appendectomy. She also has asthma and allergies to shellfish and iodine. To manage her postoperative pain, the physician has prescribed patient-controlled analgesia (PCA) with hydromorphone (Dilaudid). Which vital sign is of greatest concern? a. Pulse b. Blood pressure c. Temperature d. Respirations 3. A patient who has metastasized bone cancer has been on transdermal fentanyl patches for pain management for 3 months. He has been hospitalized for tests and has told the nurse that his pain is becoming “unbearable.” The nurse is reluctant to give him the ordered pain medication because the nurse does not want the patient to get addicted to the medication. What do the nurse’s actions reflect? a. Appropriate concern for the patient’s best welfare b. Appropriate caution for a patient who is already on a long-term opioid c. An uncaring attitude toward the patient d. A failure to manage the patient’s pain properly 4. A patient with a history of heavy alcohol use needs a medication for pain. The recommended maximum daily dose of acetaminophen for this patient would be a. 1000 mg. b. 2000 mg. c. 3000 mg. d. 4000 mg. 5. The nurse anesthetist is planning to use balanced anesthesia during a surgical procedure. A characteristic of this type of anesthesia is the a. administration of minimal doses of multiple anesthetic drugs. b. administration of inhaled anesthetics. c. intravenous (IV) administration of anesthetics. d. administration of anesthetics to cause muscle relaxation. 6. When assessing a patient under general anesthesia, which change to organ systems does the nurse expect? a. Nystagmus b. Skeletal muscle contraction c. Hypertension d. Decreased intracranial pressure 7. During surgery, the anesthetist notes that the patient’s heart rate is gradually increasing and becoming more irregular, the patient’s blood pressure is becoming unstable, and the patient is starting to sweat profusely. What other assessment should the anesthetist note immediately? a. Pupillary reactions b. Respiratory effort c. Temperature d. Urinary output 8. Which statement regarding conscious sedation does the nurse identify as being accurate? a. The IV route of drug administration is commonly used in pediatric patients to provide conscious sedation. b. Mild amnesia is a common effect of midazolam. c. Patients receiving conscious sedation must be intubated with an endotracheal tube. d. Effects of propofol include relief of anxiety and pain 9. When teaching a patient about spinal headaches, which statement will the nurse include? a. “Spinal headaches can be prevented with bed rest after the epidural procedure.” b. “Patients who have a spinal headache should have very limited fluid intake.” c. “A graft of skin from the patient’s hand can be used to seal the leaking area causing the headache.” d. “High Fowler’s positioning should be used for patients who have a spinal headache.” 10. A patient is to receive a NMBD while on mechanical ventilation. While the patient is receiving this medication, the nurse should expect the patient to be a. Sedated. b. resisting the ventilator. c. awake but unable to move. d. pain free. 11. A patient in the ICU will be receiving an NMBD. Which piece of equipment is essential to have nearby when the nurse initiates this therapy? a. Defibrillator b. Sphygmomanometer c. Mechanical ventilator d. Oxygen source 12. When providing education to the patient on the use of a benzodiazepine medication, the nurse will include which information? a. These medications have little effect on the normal sleep cycle. b. Using this medication may cause drowsiness the next day. c. It is safe to drive while taking this medication. d. These drugs are safe to use with alcohol. 13. Barbiturates have a low therapeutic index. How does the nurse interpret this? a. Low doses are not therapeutic. b. The toxic range is narrow. c. They are habit forming. d. The effective, safe dosage range is narrow. 14. An older adult patient taking multiple medications has a barbiturate added to his medication regimen. When administering a barbiturate to an older adult, what should the nurse expect? a. A decrease in dosages of the other medications b. The patient will experience increased amounts of REM sleep c. To administer half of the usual dose of the barbiturate d. Total relief of anxiety 15. Which statement regarding muscle relaxants does the nurse identify as being accurate? a. Baclofen (Lioresal) is available as an injectable form for use with an implantable pump device. b. Cyclobenzaprine (Flexeril) produces little sedation. c. Patients taking muscle relaxants are at high risk of developing hypertension. d. Patients taking muscle relaxants should be told to stop taking the medication if they feel sleepy. 16. A patient comes to the health care provider’s office with complaints of feeling anxious and having difficulty sleeping. The patient tells the nurse that he wants to start taking valerian and Kava because he heard that these work well to help the problems he is experiencing. The patient has the following questions about valerian and Kava. What is the best response by the nurse? a. The patient asks, “Is there anything I have to worry about when taking Kava?” The best response by the nurse is: i. “Kava is a natural product which has no side effects.” ii. “You need a prescription to take Kava.” iii. “No worries, Kava is recommended for patients with depression.” iv. “It is best to inform your health care provider of any additional medication or supplements you plan to take to check for interactions that may be harmful.” 17. The patient tells the nurse that his friend has been taking valerian for a long period of time and that he isn’t feeling so well. The patient asks the nurse what the adverse effects of valerian are. a. What adverse effect with valerian would the nurse discuss with the patient? i. Insomnia ii. Yellow skin iii. Bruising iv. Increased appetite 18. A teenage boy will be receiving atomoxetine (Strattera) as part of treatment for ADHD. Which statement about this drug therapy is accurate? a. Strattera is highly addictive. b. Psychotherapy is rarely helpful in cases of ADHD. c. The patient should be monitored for possible suicidal thoughts and behavior. d. Strattera is used to treat narcolepsy as well as ADHD. 19. A patient wants to take Orlistat (Xenical) to assist in her weight loss program, but she is wary of its unpleasant adverse effects. What measure can be suggested to reduce these effects? a. Restrict dietary intake of fat. b. Restrict dietary intake of fiber. c. Increase intake of dairy products. d. Avoid intake of carbonated beverages. 20. What is important for the nurse to assess the patient’s history before administering a serotonin agonist? a. Hypertension b. Allergy to penicillin c. Chronic bronchitis d. Cataracts 21. A patient is prescribed an anorexiant. Which statement will the nurse include in patient teaching? a. “Take the medication with your evening meal.” b. “You will need to take this drug for at least 2 years.” c. “If you develop a dry mouth, stop taking the drug immediately.” d. “Avoid intake of caffeine.” 22. A patient in a long-term care facility has a new order for carbamazepine (Tegretol) for seizure management. The nurse is correct when recognizing autoinduction as which response? a. Toxic levels of carbamazepine (Tegretol) b. Lower than expected drug levels c. Gingival hyperplasia d. Cessation of seizure activity 23. The nurse is assessing the current medication list of a newly admitted patient. The drug gabapentin (Neurontin) is listed, but the patient states that he does not have any problems with seizures. What does the nurse suspect? a. The patient is unaware of his own disease history. b. The patient has been taking his wife’s medication by mistake. c. The patient may be taking this drug for neuropathic pain. d. The patient is reluctant to admit to having a seizure disorder. 24. Before a patient is to receive phenytoin (Dilantin), the nurse practitioner orders lab work. Which lab result is of greatest concern? a. High white blood cell count b. Low serum albumin levels c. Low platelet levels d. High hemoglobin levels 25. A patient with unstable epilepsy is receiving IV doses of phenytoin (Dilantin). The latest drug level is 12 μg/mL. Which administration technique will the nurse use? a. Administer the drug by rapid IV push. b. Infuse slowly, not exceeding 50 mg/min. c. Mix the medication with dextrose solution. d. Administer via continuous infusion. 26. Which information will the nurse provide to the patient who is receiving antiepileptic drug therapy? a. If you feel sleepy when taking the drug, decrease the dose by half. b. Take the drug on an empty stomach. c. Call your health care provider if you experience a sore throat or fever. d. Patients with epilepsy are not able to hold a job and work, so you should apply for benefits. 27. How can the nurse best explain the “off-on phenomenon” that some patients with PD experience? a. The need to take a drug holiday to improve response to medications b. The variable response to levodopa, resulting in periods of good control and periods of poor control of PD symptoms c. The alternating schedule of medications needed to control PD d. The fluctuation of emotions that often occurs with PD 28. Which drug used for the management of the patient with PD is most likely to cause postural hypotension? a. Amantadine (Symmetrel) b. Selegiline (Eldepryl) c. Tolcapone (Tasmar) d. Entacapone (Comtan) 29. When providing teaching to a patient receiving an anticholinergic for the treatment of PD, the nurse will include which information? a. Take the medication first thing in the morning. b. Limit fluid intake when taking this drug. c. The tremors you experience will be reduced within 24 hours of taking this drug. d. Do not take this medication at the same time as other medications. 30. A patient has been diagnosed with PD. Medication therapy is started for this patient. a. What teaching should the nurse include to the patient and caregiver regarding pharmacologic therapy of PD? i. The medication should be stopped when the patient’s symptoms improve. ii. Alcohol, over-the-counter drugs, and herbals are to be avoided unless approved by the prescriber. iii. A common side effect of anticholinergics is drooling. iv. Improvements in symptoms are expected within 5 days of medication therapy. 31. The patient diagnosed with PD has been started on dopaminergic replacement drug therapy with carbidopa-levodopa. a. What is a priority action for the nurse? i. Assess the patient for dizziness and syncope when the patient is walking. ii. Administer the medication first thing in the morning. iii. Administer the medication on an empty stomach. iv. Omit protein from the patient’s diet. 32. The patient has now been ordered an oral disintegrating form of the MAO-B inhibitor drug selegiline. a. What should the nurse consider when administering this drug? i. Tell the patient to take the medication with liquids. ii. Tell the patient to take the medication with a meal. iii. Assess the patient for hypertension, a common side effect of this medication. iv. Tell the patient to place oral disintegrating dosage forms on the tongue, and do not swallow dosage form until it is completely melted. Ch 16-21 PPT Questions 1. 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. Hematocrit 2. When patients are taking selective SSRIs 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 3. When providing teaching for a patient who is prescribed a selective 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 cases of depression. d. The SSRI may take several weeks to have a beneficial effect. 4. A patient is admitted to the emergency department. The patient’s heart rate is 112 beats/min. He is sweating and has muscle tremors and is agitated. The patient says, “I was depressed and took more of the pills the doctor gave me so I would feel better.” a. What does the nurse suspect is happening with this patient? 5. What treatment does the nurse expect to implement? 6. The patient was admitted to the hospital for observation and has now recovered. a. Which information will the nurse include in patient teaching about SSRIs? i. It usually takes 4 to 6 weeks until you will experience benefits from the medication. ii. The patient must avoid foods that contain tyramine. iii. If the patient develops an upset stomach when taking this medication, he should discontinue use. iv. The patient should take the medication at bedtime to enhance sleep. 7. Several months later, the patient returns to the health care provider’s office for follow-up regarding use of the SSRI. The patient tells the nurse that he is feeling better and stopped taking the SSRI yesterday. He doesn’t plan on taking the medication again. a. When talking with the patient, which knowledge should guide the nurse’s response? i. Drug dependency will develop, so it is appropriate to stop therapy after a few months. ii. Drug therapy must be stopped as soon as the patient feels better to avoid serotonin syndrome. iii. The patient is the best person to determine when the drug therapy should end. iv. A 1- to 2-month taper period is indicated to prevent adverse effects of abrupt drug discontinuation. 8. Which drug will the nurse anticipate administering to a patient experiencing benzodiazepine overdose? a. Flumazenil b. Naltrexone c. Vivitrol d. Flunitrazepam 9. 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. Somnalence 10. 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.” 11. 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.” 12. A patient has two inhalers that are due to be taken at the same time. One is a bronchodilator; the other is a corticosteroid. Which inhaler should the patient take first? a. The bronchodilator b. The corticosteroid c. It does not matter which one is taken first. 13. A patient is experiencing bronchospasms after running half a mile. He has several inhalers with him. Which one would be appropriate for treatment at this time? a. Albuterol b. Salmeterol c. Fluticasone d. Salmeterol and fluticasone combination (Advair Diskus) 14. A patient on a dobutamine drip starts to complain that her intravenous line “hurts.” The nurse checks the insertion site and sees that the area is swollen and cool. What will the nurse do first? a. Slow the intravenous infusion. b. Stop the intravenous infusion. c. Inject the area with phentolamine. d. Notify the physician health care provider. 15. A patient on a dobutamine drip starts to complain that he feels a “tightness” in his chest that he had not felt before. What will the nurse do first? a. Check the infusion site for possible extravasation. b. Increase the infusion rate. c. Check the patient’s vital signs. d. Order an electrocardiogram. 16. A 10-year-old child is brought to the emergency department while having an asthma attack. She is given a nebulizer treatment with albuterol. What is the nurse’s immediate assessment priority? a. Determine the time of the child’s last meal. b. Monitor Spo2 with a pulse oximeter. c. Monitor the child’s temperature. d. Provide education on asthma management. 17. A patient has two inhalers that are due to be taken at the same time. One is a bronchodilator; the other is a corticosteroid. Which inhaler should the patient take first? a. The bronchodilator b. The corticosteroid c. It does not matter which one is taken first. 18. A patient is experiencing bronchospasms after running half a mile. He has several inhalers with him. Which one would be appropriate for treatment at this time? a. Albuterol b. Salmeterol c. Fluticasone d. Salmeterol and fluticasone combination (Advair Diskus) 19. A patient on a dobutamine drip starts to complain that her intravenous line “hurts.” The nurse checks the insertion site and sees that the area is swollen and cool. What will the nurse do first? a. Slow the intravenous infusion. b. Stop the intravenous infusion. c. Inject the area with phentolamine. d. Notify the physician health care provider. 20. A patient on a dobutamine drip starts to complain that he feels a “tightness” in his chest that he had not felt before. What will the nurse do first? a. Check the infusion site for possible extravasation. b. Increase the infusion rate. c. Check the patient’s vital signs. d. Order an electrocardiogram. 21. A 10-year-old child is brought to the emergency department while having an asthma attack. She is given a nebulizer treatment with albuterol. What is the nurse’s immediate assessment priority? a. Determine the time of the child’s last meal. b. Monitor Spo2 with a pulse oximeter. c. Monitor the child’s temperature. d. Provide education on asthma management. 22. When phentolamine is used to diagnose the presence of pheochromocytoma, the nurse will assess for what indicative finding? a. Rapid decrease in blood pressure b. Steady increase in blood pressure c. Slower heart rate d. Reduced cardiac ectopy 23. When administering an alpha blocker for the first time, it is most important for the nurse to assess the patient for the development of what adverse effect? a. Renal failure b. Hypotension c. Blood dyscrasia d. Dysrhythmias 24. A 58-year-old patient is recovering in the intensive care unit after a myocardial infarction (MI). The nurse notes an order for the beta blocker metoprolol (Lopressor). What is the purpose of this drug? a. Dilate the coronary arteries. b. Inhibit stimulation of the myocardium by circulating catecholamines. c. Provide a positive inotropic effect. d. Maintain the patient’s BP. 25. The nurse knows that the adverse effects of a nonselective beta blocker are likely to be the most immediately life threatening in which patient? a. Patient with type I diabetes b. Patient with asthma c. Patient with gastroesophageal reflux disease d. Patient with hypertension 26. A patient with type 2 diabetes is taking a beta blocker as part of treatment for hypertension. Which complication is most likely to develop? a. Hypertension b. Hyperkalemia c. Hypoglycemia d. Angina 27. 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. What is the patient 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 28. 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 29. A patient is scheduled to have lunch at 1200. The nurse will administer the pyridostigmine (Mestinon) at what time for optimal therapeutic effect? a. 1100 b. 1130 c. 1200 d. 1230 30. 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 31. MJ is a 36 y/o female who was diagnosed with myasthenia gravis 4 years ago. She recently went through a divorce and has been under significant emotional stress the last few months. MJ presents to the ED with sudden onset of muscle weakness, drooling, and inability to articulate words. a. After the ABCs are stabilized, what history should the nurse gather from MJ? 32. To differentiate between disease exacerbation and cholinergic crisis, what medication would the nurse anticipate administering? 33. If the prescriber suspects the patient is experiencing disease exacerbation, how would the patient respond to this medication management? 34. What reversal agent should the nurse have available when giving the medication selected in question 2? 35. Which finding would the nurse anticipate when assessing a patient with an atropine overdose? a. Moist skin b. Miosis c. Bradycardia d. Urinary retention 36. Glycopyrrolate (Robinul) and an opioid are administered to a patient before surgery in the preoperative area. What is the intended effect of the glycopyrrolate (Robinul)? a. Potentiate the action of the opioid. b. Assist the patient in retaining urine during surgery. c. Control secretions during surgery. d. Prevent nausea. 37. 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 CH 10 Questions 1. A patient was diagnosed with pancreatic cancer last month, and has complained of a dull ache in the abdomen for the past 4 months. This pain has been gradually increasing, and the pain relievers taken at home are no longer effective. What type of pain is the patient experiencing? a. Acute pain b. Chronic pain c. Somatic pain d. Neuropathic pain 2. An 18-year-old basketball player fell and twisted his ankle during a game. The nurse will expect to administer which type of analgesic? a. Synthetic opioid, such as meperidine (Demerol) b. Opium alkaloids, such as morphine sulfate c. Opioid antagonist, such as naloxone HCL (Narcan) d. Nonopioid analgesic, such as indomethacin (Indocin) 3. A patient is recovering from abdominal surgery, which he had this morning. He is groggy but complaining of severe pain around his incision. What is the most important assessment data to consider before the nurse administers a dose of morphine sulfate to the patient? a. His pulse rate b. His respiratory rate c. The appearance of the incision d. The date of his last bowel movement 4. A 78-year-old patient is in the recovery room after having a lengthy surgery on his hip. As he is gradually awakening, he requests pain medication. Within 10 minutes after receiving a dose of morphine sulfate, he is very lethargic and his respirations are shallow, with a rate of 7 per minute. The nurse prepares for which priority action at this time? a. Assessment of the patient’s pain level b. Immediate intubation and artificial ventilation c. Administration of naloxone (Narcan) d. Close observation of signs of opioid tolerance 5. A patient will be discharged with a 1-week supply of an opioid analgesic for pain management after abdominal surgery. The nurse will include which information in the teaching plan? a. How to prevent dehydration due to diarrhea b. The importance of taking the drug only when the pain becomes severe c. How to prevent constipation d. The importance of taking the drug on an empty stomach 6. A patient has been treated for lung cancer for 3 years. Over the past few months, the patient has noticed that the opioid analgesic is not helping as much as it had previously and more medication is needed for the same pain relief. The nurse is aware that this patient is experiencing which of these? a. Opioid addiction b. Opioid tolerance c. Opioid toxicity d. Opioid abstinence syndrome 7. A 38-year-old man has come into the urgent care center with severe hip pain after falling from a ladder at work. He says he has taken several pain pills over the past few hours but cannot remember how many he has taken. He hands the nurse an empty bottle of acetaminophen (Tylenol). The nurse is aware that the most serious toxic effect of acute acetaminophen overdose is which condition? a. Tachycardia b. Central nervous system depression c. Hepatic necrosis d. Nephropathy 8. A 57-year-old woman being treated for end-stage breast cancer has been using a transdermal opioid analgesic as part of the management of pain. Lately, she has been experiencing breakthrough pain. The nurse expects this type of pain to be managed by which of these interventions? a. Administering NSAIDs b. Administering an immediate-release opioid c. Changing the opioid route to the rectal route d. Making no changes to the current therapy 9. The nurse is reviewing herbal therapies. Which is a common use of the herb feverfew? a. Muscle aches b. Migraine headaches c. Leg cramps d. Incision pain after surgery 10. A patient is to receive acetylcysteine (Mucomyst) as part of the treatment for an acetaminophen (Tylenol) overdose. Which action by the nurse is appropriate when giving this medication? a. Giving the medication undiluted for full effect b. Avoiding the use of a straw when giving this medication c. Disguising the flavor with soda or flavored water d. Preparing to give this medication via a nebulizer 11. A patient is receiving gabapentin (Neurontin), an anticonvulsant, but has no history of seizures. The nurse expects that the patient is receiving this drug for which condition? a. Inflammation pain b. Pain associated with peripheral neuropathy c. Depression associated with chronic pain d. Prevention of seizures 12. The nurse is assessing a patient who has been admitted to the emergency department for a possible opioid overdose. Which assessment finding is characteristic of an opioid drug overdose? a. Dilated pupils b. Restlessness c. Respiration rate of 6 breaths/min d. Heart rate of 55 beats/min 13. The drug nalbuphine (Nubain) is an agonist-antagonist (partial agonist). The nurse understands that which is a characteristic of partial agonists? a. They have anti-inflammatory effects. b. They are given to reverse the effects of opiates. c. They have a higher potency than agonists. d. They have a lower dependency potential than agonists. 14. The nurse is assessing a patient for contraindications to drug therapy with acetaminophen (Tylenol). Which patient should not receive acetaminophen? a. A patient with a fever of 101° F (38.3° C) b. A patient who is complaining of a mild headache c. A patient with a history of liver disease d. A patient with a history of peptic ulcer disease 15. A patient arrives at the urgent care center complaining of leg pain after a fall when rock climbing. The x-rays show no broken bones, but he has a large bruise on his thigh. The patient says he drives a truck and does not want to take anything strong because he needs to stay awake. Which statement by the nurse is most appropriate? a. “It would be best for you not to take anything if you are planning to drive your truck.” b. “We will discuss with your doctor about taking an opioid because that would work best for your pain.” c. “You can take acetaminophen, also known as Tylenol, for pain, but no more than 1000 mg per day.” d. “You can take acetaminophen, also known as Tylenol, for pain, but no more than 3000 mg per day.” 16. A patient is suffering from tendonitis of the knee. The nurse is reviewing the patient’s medication administration record and recognizes that which adjuvant medication is most appropriate for this type of pain? a. Antidepressant b. Anticonvulsant c. Corticosteroid d. Local anesthesia 17. Vicodin (acetaminophen/hydrocodone) is prescribed for a patient who has had surgery. The nurse informs the patient that which common adverse effects can occur with this medication? (Select all that apply.) a. Diarrhea b. Constipation c. Lightheadedness d. Nervousness e. Urinary retention f. Itching Ch 11 Questions 1. During a fishing trip, a patient pierced his finger with a large fishhook. He is now in the emergency department to have it removed. The nurse anticipates that which type of anesthesia will be used for this procedure? a. No anesthesia b. Topical benzocaine spray on the area c. Topical prilocaine (EMLA) cream around the site d. Infiltration of the puncture wound with lidocaine 2. While monitoring a patient who had surgery under general anesthesia 2 hours ago, the nurse notes a sudden elevation in body temperature. This finding may be an indication of which problem? a. Tachyphylaxis b. Postoperative infection c. Malignant hypertension d. Malignant hyperthermia 3. When assessing patients in the preoperative area, the nurse knows that which patient is at a higher risk for an altered response to anesthesia? a. The 21-year-old patient who has never had surgery before b. The 35-year-old patient who stopped smoking 8 years ago c. The 40-year-old patient who is to have a kidney stone removed d. The 82-year-old patient who is to have gallbladder removal 4. A patient is undergoing abdominal surgery and has been anesthetized for 3 hours. Which nursing diagnosis would be appropriate for this patient? a. Anxiety related to the use of an anesthetic b. Risk for injury related to increased sensorium from general anesthesia c. Decreased cardiac output related to systemic effects of local anesthesia d. Impaired gas exchange related to central nervous system depression produced by general anesthesia 5. When administering a neuromuscular blocking drug, the nurse needs to remember which principle? a. It is used instead of general anesthesia during surgery. b. Only skeletal muscles are paralyzed; respiratory muscles remain functional. c. It causes sedation and pain relief while allowing for lower doses of anesthetics. d. Artificial mechanical ventilation is required because of paralyzed respiratory muscles. 6. A patient is being prepared for an oral endoscopy, and the nurse anesthetist reminds him that he will be awake during the procedure but probably will not remember it. What type of anesthetic technique is used in this situation? a. Local anesthesia b. Moderate sedation c. Topical anesthesia d. Spinal anesthesia 7. During the immediate postoperative period, the Post Anesthesia Care Unit nurse is assessing a patient who had hip surgery. The patient is experiencing tachycardia, tachypnea, and muscle rigidity, and his temperature is 103° F (39.4° C). The nurse will prepare for what immediate treatment? a. Naltrexone hydrochloride (Narcan) injection, an opioid reversal drug b. Dantrolene (Dantrium) injection, a skeletal muscle relaxant c. An anticholinesterase drug, such as neostigmine d. Cardiopulmonary resuscitation (CPR) and intubation 8. The nurse is preparing to administer dexmedetomidine (Precedex) to a patient. Which is an appropriate indication for dexmedetomidine? (Select all that apply.) a. Procedural sedation b. Surgeries of short duration c. Surgeries of long duration d. Postoperative anxiety e. Sedation of mechanically ventilated patients Ch 12 Questions 1. A patient who has received some traumatic news is panicking and asks for some medication to help settle down. The nurse anticipates giving which drug that is most appropriate for this situation? a. Diazepam (Valium) b. Zolpidem (Ambien) c. Phenobarbital d. Cyclobenzaprine (Flexeril) 2. A patient has been taking phenobarbital for 2 weeks as part of his therapy for epilepsy. He tells the nurse that he feels tense and that “the least little thing” bothers him now. Which is the correct explanation for this problem? a. These are adverse effects that usually subside after a few weeks. b. The drug must be stopped immediately because of possible adverse effects. c. This drug causes the rapid eye movement (REM) sleep period to increase, resulting in nightmares and restlessness. d. This drug causes deprivation of REM sleep and may cause the inability to deal with normal stress. 3. A 50-year-old man who has been taking phenobarbital for 1 week is found very lethargic and unable to walk after eating out for dinner. His wife states that he has no other prescriptions and that he did not take an overdose—the correct number of pills is in the bottle. The nurse suspects that which of these may have happened? a. He took a multivitamin. b. He drank a glass of wine. c. He took a dose of aspirin. d. He developed an allergy to the drug. 4. A patient has been taking temazepam (Restoril) for intermittent insomnia. She calls the nurse to say that when she takes it, she sleeps well, but the next day she feels “so tired.” Which explanation by the nurse is correct? a. “Long-term use of this drug results in a sedative effect.” b. “If you take the drug every night, this hangover effect will be reduced.” c. “These drugs affect the sleep cycle, resulting in daytime sleepiness.” d. “These drugs increase the activity of the central nervous system, making you tired the next day.” 5. A patient is recovering from a minor automobile accident that occurred 1 week ago. He is taking cyclobenzaprine (Flexeril) for muscular pain and goes to physical therapy three times a week. Which nursing diagnosis would be appropriate for him? a. Risk for injury related to decreased sensorium b. Risk for addiction related to psychologic dependency c. Decreased fluid volume related to potential adverse effects d. Disturbed sleep pattern related to the drug’s interference with REM sleep 6. A patient is taking flurazepam (Dalmane) three to four nights a week for sleeplessness. She is concerned that she cannot get to sleep without taking the medication. What nonpharmacologic measures should the nurse suggest to promote sleep for this patient? a. Providing a quiet environment b. Exercising before bedtime to become tired c. Consuming heavy meals in the evening to promote sleepiness d. Drinking hot tea or coffee just before bedtime 7. A patient is brought to the emergency department for treatment of a suspected overdose. The patient was found with an empty prescription bottle of a barbiturate by his bedside. He is lethargic and barely breathing. The nurse would expect which immediate intervention? a. Starting an intravenous infusion of diluted bicarbonate solution b. Administering medications to increase blood pressure c. Implementing measures to maintain the airway and support respirations d. Administrating naloxone (Narcan) as an antagonist 8. Ramelteon (Rozerem) is prescribed for a patient with insomnia. The nurse checks the patient’s medical history, knowing that this medication is contraindicated in which disorder? a. Coronary artery disease b. Renal insufficiency c. Liver disease d. Anemia 9. The nurse notes in the patient’s medication history that the patient is taking cyclobenzaprine (Flexeril). Based on this finding, the nurse interprets that the patient has which disorder? a. A musculoskeletal injury b. Insomnia c. Epilepsy d. Agitation 10. A patient has experienced insomnia for months, and the physician has prescribed a medication to help with this problem. The nurse expects which drug to be used for long-term treatment of insomnia? a. Secobarbital (Seconal), a barbiturate b. Diazepam (Valium), a benzodiazepine c. Midazolam (Versed), a benzodiazepine d. Eszopiclone (Lunesta), a nonbenzodiazepine sleep aid 11. A patient tells the nurse that he likes to drink kava herbal tea to help him relax. Which statement by the patient indicates that additional teaching about this herbal product is needed? a. “I will not drink wine with the kava tea.” b. “If I notice my skin turning yellow, I will stop taking the tea.” c. “I will not take sleeping pills if I have this tea in the evening.” d. “I will be able to drive my car after drinking this tea.” 12. The nurse is preparing to administer a barbiturate. Which conditions or disorders would be a contraindication to the use of these drugs? (Select all that apply.) a. Gout b. Pregnancy c. Epilepsy d. Severe chronic obstructive pulmonary disease e. Severe liver disease f. Diabetes mellitus 13. The barbiturate phenobarbital is prescribed for a patient with epilepsy. While assessing the patient’s current medications, the nurse recognizes that interactions may occur with which drugs? (Select all that apply.) a. Antihistamines b. Opioids c. Diuretics d. Anticoagulants e. Oral contraceptives f. Insulin Ch 13 Questions 1. A patient is receiving instructions regarding the use of caffeine. The nurse shares that caffeine should be used with caution if which of these conditions is present? a. A history of peptic ulcers b. Migraine headaches c. Asthma d. A history of kidney stones 2. A patient who started taking orlistat (Xenical) 1 month ago calls the clinic to report some “embarrassing” adverse effects. She tells the nurse that she has had episodes of “not being able to control my bowel movements.” Which statement is true about this situation? a. These are expected adverse effects that will eventually diminish. b. The patient will need to stop this drug immediately if these adverse effects are occurring. c. The patient will need to increase her fat intake to prevent these adverse effects. d. The patient will need to restrict fat intake to less than 30% to help reduce these adverse effects. 3. A 6-year-old boy has been started on an extended-release form of methylphenidate hydrochloride (Ritalin) for the treatment of attention deficit hyperactivity disorder (ADHD). During a follow-up visit, his mother tells the nurse that she has been giving the medication at bedtime so that it will be “in his system” when he goes to school the next morning. What is the nurse’s appropriate evaluation of the mother’s actions? a. She is giving him the medication dosage appropriately. b. The medication should not be taken until he is at school. c. The medication should be taken with meals for optimal absorption. d. The medication should be given 4 to 6 hours before bedtime to diminish insomnia. 4. A 22-year-old nursing student has been taking NoDoz (caffeine) tablets for the past few weeks to “make it through” the end of the semester and exam week. She is in the university clinic today because she is “exhausted.” What nursing diagnosis may be appropriate for her? a. Noncompliance b. Impaired physical mobility c. Disturbed sleep pattern d. Imbalanced nutrition: less than body requirements 5. A 10-year-old patient will be started on methylphenidate hydrochloride (Ritalin) therapy. The nurse will perform which essential baseline assessment before this drug is started? a. Eye examination b. Height and weight c. Liver function studies d. Hearing test 6. When evaluating a patient who is taking orlistat (Xenical), which is an intended therapeutic effect? a. Increased wakefulness b. Increased appetite c. Decreased weight d. Decreased hyperactivity 7. The nurse is teaching a patient how to self-administer triptan injections for migraine headaches. Which statement by the patient indicates that he needs further teaching? a. “I will take this medication regularly to prevent a migraine headache from occurring.” b. “I will take this medication when I feel a migraine headache starting.” c. “This medication does not reduce the number of migraines I will have.” d. “I will keep a journal to record the headaches I have and how the injections are working.” 8. The nurse is reviewing the use of central nervous system stimulants. Which of these are indications for this class of drugs? (Select all that apply.) a. Narcolepsy b. Depression c. Panic attacks d. Neonatal apnea e. Attention deficit hyperactivity disorder (ADHD) f. Appetite suppression 9. A patient has a new prescription for phentermine (Ionamin) as part of the treatment for weight loss. Which information will the nurse include when teaching this patient about a stimulant such as phentermine? (Select all that apply.) a. Take this medication after meals. b. Take this medication in the morning. c. This drug is taken along with supervised exercise and suitable diet. d. Use mouth rinses, sugarless gum, or hard candies to minimize dry mouth. e. Avoid foods that contain caffeine, such as coffee, tea, and colas. Ch 14 Questions 1. The nurse is reviewing the dosage schedule for several different antiepileptic drugs (AEDs). Which antiepileptic drug allows for once-a-day dosing? a. Levetiracetam (Keppra) b. Phenobarbital c. Valproic acid (Depakote) d. Gabapentin (Neurontin) 2. The nurse has given medication instructions to a patient receiving phenytoin (Dilantin). Which statement by the patient indicates that the patient has an adequate understanding of the instructions? a. “I will need to take extra care of my teeth and gums while on this medication.” b. “I can go out for a beer while on this medication.” c. “I can skip doses if the side effects bother me.” d. “I will be able to stop taking this drug once the seizures stop.” 3. When teaching a patient about taking a newly prescribed antiepileptic drug (AED) at home, the nurse will include which instruction? a. “Driving is allowed after 2 weeks of therapy.” b. “If seizures recur, take a double dose of the medication.” c. “Antacids can be taken with the AED to reduce gastrointestinal adverse effects.” d. “Regular, consistent dosing is important for successful treatment.” 4. A patient has a 9-year history of a seizure disorder that has been managed well with oral phenytoin (Dilantin) therapy. He is to be NPO (consume nothing by mouth) for surgery in the morning. What will the nurse do about his morning dose of phenytoin? a. Give the same dose intravenously. b. Give the morning dose with a small sip of water. c. Contact the prescriber for another dosage form of the medication. d. Notify the operating room that the medication has been withheld. 5. The nurse is monitoring a patient who has been taking carbamazepine (Tegretol) for 2 months. Which effects would indicate that autoinduction has started to occur? a. The drug levels for carbamazepine are higher than expected. b. The drug levels for carbamazepine are lower than expected. c. The patient is experiencing fewer seizures. d. The patient is experiencing toxic effects from the drug 6. The nurse is giving an intravenous dose of phenytoin (Dilantin). Which action is correct when administering this drug? a. Give the dose as a fast intravenous (IV) bolus. b. Mix the drug with normal saline, and give it as a slow IV push. c. Mix the drug with dextrose (D5W), and give it as a slow IV push. d. Mix the drug with any available solution as long as the administration rate is correct. 7. The U.S. Food and Drug Administration has issued a warning for users of antiepileptic drugs. Based on this report, the nurse will monitor for which potential problems with this class of drugs? a. Increased risk of suicidal thoughts and behaviors b. Signs of bone marrow depression c. Indications of drug addiction and dependency d. Increased risk of cardiovascular events, such as strokes 8. A patient is experiencing status epilepticus. The nurse prepares to give which drug of choice for the treatment of this condition? a. Diazepam (Valium) b. Midazolam (Versed) c. Valproic acid (Depakote) d. Carbamazepine (Tegretol) 9. Phenytoin (Dilantin) has a narrow therapeutic index. The nurse recognizes that this characteristic indicates which of these? a. The safe and the toxic plasma levels of the drug are very close to each other. b. The phenytoin has a low chance of being effective. c. There is no difference between safe and toxic plasma levels. d. A very small dosage can result in the desired therapeutic effect. 10. A patient has been taking an AED for several years as part of his treatment for partial seizures. His wife has called because he ran out of medication this morning and wonders if he can go without it for a week until she has a chance to go to the drugstore. What is the nurse’s best response? a. “He is taking another antiepileptic drug, so he can go without the medication for a week.” b. “Stopping this medication abruptly may cause withdrawal seizures. A refill is needed right away.” c. “He can temporarily increase the dosage of his other antiseizure medications until you get the refill.” d. “He can stop all medications because he has been treated for several years now.” 11. During a routine appointment, a patient with a history of seizures is found to have a phenytoin (Dilantin) level of 23 mcg/mL. What concern will the nurse have, if any? a. The patient is at risk for seizures because the drug level is not at a therapeutic level. b. The patient’s seizures should be under control because this is a therapeutic drug level. c. The patient’s seizures should be under control if she is also taking a second antiepileptic drug. d. The drug level is at a toxic level, and the dosage needs to be reduced. 12. A patient is taking gabapentin (Neurontin), and the nurse notes that there is no history of seizures on his medical record. What is the best possible rationale for this medication order? a. The medication is used for the treatment of neuropathic pain. b. The medication is helpful for the treatment of multiple sclerosis. c. The medication is used to reduce the symptoms of Parkinson’s disease. d. The medical record is missing the correct information about the patient’s history of seizures. 13. The nurse is reviewing antiepileptic drug (AED) therapy. Which statements about AED therapy are accurate? (Select all that apply.) a. AED therapy can be stopped when seizures are stopped. b. AED therapy is usually lifelong. c. Consistent dosing is the key to controlling seizures. d. A dose may be skipped if the patient is experiencing adverse effects. e. Do not abruptly discontinue AEDs because doing so may cause rebound seizure activity. Ch 15 Questions 1. A patient has been taking selegiline (Eldepryl), 20 mg/day for 1 month. Today, during his office visit, he tells the nurse that he forgot and had a beer with dinner last evening, and “felt awful.” What did the patient most likely experience? a. Hypotension b. Hypertension c. Urinary discomfort d. Gastrointestinal upset 2. A patient has been given a prescription for levodopa-carbidopa (Sinemet) for her newly diagnosed Parkinson’s disease. She asks the nurse, “Why are there two drugs in this pill?” The nurse’s best response reflects which fact? a. Carbidopa allows for larger doses of levodopa to be given. b. Carbidopa prevents the breakdown of levodopa in the periphery. c. There are concerns about drug-food interactions with levodopa therapy that do not exist with the combination therapy. d. Carbidopa is the biologic precursor of dopamine and can penetrate into the central nervous system. 3. When a patient is taking an anticholinergic such as benztropine (Cogentin) as part of the treatment for Parkinson’s disease, the nurse should include which information in the teaching plan? a. Minimize the amount of fluid taken while on this drug. b. Discontinue the medication if adverse effects occur. c. Take the medication on an empty stomach to enhance absorption. d. Use artificial saliva, sugarless gum, or hard candy to counteract dry mouth. 4. A patient has been treated with antiparkinson medications for 3 months. What therapeutic responses should the nurse look for when assessing this patient? a. Decreased appetite b. Gradual development of cogwheel rigidity c. Newly developed dyskinesias d. Improved ability to perform activities of daily living 5. Carbidopa-levodopa (Sinemet) is prescribed for a patient with Parkinson’s disease. The nurse informs the patient that which common adverse effects can occur with this medication? a. Drowsiness, headache, weight loss b. Dizziness, insomnia, nausea c. Peripheral edema, fatigue, syncope d. Heart palpitations, hypotension, urinary retention 6. The nurse is assessing the medication history of a patient with a new diagnosis of Parkinson’s disease. Which condition is a contraindication for the patient, who will be taking tolcapone (Tasmar)? a. Glaucoma b. Seizure disorder c. Liver failure d. Benign prostatic hyperplasia 7. The nurse is developing a care plan for a patient who is taking an anticholinergic drug. Which nursing diagnosis would be appropriate for this patient? a. Diarrhea b. Urinary retention c. Risk for infection d. Disturbed sleep pattern 8. A patient has a new order for a catechol ortho-methyltransferase (COMT) inhibitor as part of treatment for Parkinson’s disease. The nurse recognizes that which of these is an advantage of this drug class? a. It has a shorter duration of action. b. It causes less gastrointestinal distress. c. It has a slower onset than traditional Parkinson’s disease drugs. d. It is associated with fewer wearing-off effects. 9. A patient taking entacapone (Comtan) for the first time calls the clinic to report a dark discoloration of his urine. After listening to the patient, the nurse realizes that what is happening in this situation? a. This is a harmless effect of the drug. b. The patient has taken this drug along with red wine or cheese. c. The patient is having an allergic reaction to the drug. d. The ordered dose is too high for this patient 10. While a patient is receiving drug therapy for Parkinson’s disease, the nurse monitors for dyskinesia, which is manifested by which finding? a. Rigid, tense muscles b. Difficulty in performing voluntary movements c. Limp extremities with weak muscle tone d. Confusion and altered mental status 11. When treating patients with medications for Parkinson’s disease, the nurse knows that the wearing-off phenomenon occurs for which reason? a. There are rapid swings in the patient’s response to levodopa. b. The patient cannot tolerate the medications at times. c. The medications begin to lose effectiveness against Parkinson’s disease. d. The patient’s liver is no longer able to metabolize the drug. 12. When assessing the medication history of a patient with a new diagnosis of Parkinson’s disease, which conditions are contraindications for the patient who will be taking carbidopa-levodopa? (Select all that apply.) a. Angle-closure glaucoma b. History of malignant melanoma c. Hypertension d. Benign prostatic hyperplasia e. Concurrent use of monoamine oxidase inhibitors (MAOIs) Ch 16 Questions 1. The nurse reads in the patient’s medication history that the patient is taking buspirone (BuSpar). The nurse interprets that the patient may have which disorder? a. Anxiety disorder b. Depression c. Schizophrenia d. Bipolar disorder 2. Before beginning a patient’s therapy with selective serotonin reuptake inhibitor (SSRI) antidepressants, the nurse will assess for concurrent use of which medications or medication class? a. Aspirin b. Anticoagulants c. Diuretics d. Nonsteroidal anti-inflammatory drugs 3. When a patient is receiving a second-generation antipsychotic drug, such as risperidone (Risperdal), the nurse will monitor for which therapeutic effect? a. Fewer panic attacks b. Decreased paranoia and delusions c. Decreased feeling of hopelessness d. Improved tardive dyskinesia 4. A patient has been taking haloperidol (Haldol) for 3 months for a psychotic disorder, and the nurse is concerned about the development of extrapyramidal symptoms. The nurse will monitor the patient closely for which effects? a. Increased paranoia b. Drowsiness and dizziness c. Tremors and muscle twitching d. Dry mouth and constipation 5. A patient has been taking the monoamine oxidase inhibitor (MAOI) phenelzine (Nardil) for 6 months. The patient wants to go to a party and asks the nurse, “Will just one beer be a problem?” Which advice from the nurse is correct? a. “You can drink beer as long as you have a designated driver.” b. “Now that you’ve had the last dose of that medication, there will be no further dietary restrictions.” c. “If you begin to experience a throbbing headache, rapid pulse, or nausea, you’ll need to stop drinking.” d. “You need to avoid all foods that contain tyramine, including beer, while taking this medication.” 6. A 22-year-old patient has been taking lithium for 1 year, and the most recent lithium level is 0.9 mEq/L. Which statement about the laboratory result is correct? a. The lithium level is therapeutic. b. The lithium level is too low. c. The lithium level is too high. d. Lithium is not usually monitored with blood levels. 7. A patient with the diagnosis of schizophrenia is hospitalized and is taking a phenothiazine drug. Which statement by this patient indicates that he is experiencing a common adverse effect of phenothiazines? a. “I can’t sleep at night.” b. “I feel hungry all the time.” c. “Look at how red my hands are.” d. “My mouth has been so dry lately.” 8. A patient has been taking the selective serotonin reuptake inhibitor (SSRI) sertraline (Zoloft) for about 6 months. At a recent visit, she tells the nurse that she has been interested in herbal therapies and wants to start taking St. John’s wort. Which response by the nurse is appropriate? a. “That should be no problem.” b. “Good idea! Hopefully you’ll be able to stop taking the Zoloft.” c. “Be sure to stop taking the herb if you notice a change in side effects.” d. “Taking St. John’s wort with Zoloft may cause severe interactions and is not recommended.” 9. While monitoring a depressed patient who has just started SSRI antidepressant therapy, the nurse will observe for which problem during the early time frame of this therapy? a. Hypertensive crisis b. Self-injury or suicidal tendencies c. Extrapyramidal symptoms d. Loss of appetite 10. A patient has been admitted to the emergency department with a suspected overdose of a tricyclic antidepressant. The nurse will prepare for what immediate concern? a. Hypertension b. Renal failure c. Cardiac dysrhythmias d. Gastrointestinal bleeding 11. The wife of a patient who has been diagnosed with depression calls the office and says, “It’s been an entire week since he started that new medicine for his depression, and there’s no change! What’s wrong with him?” What is the nurse’s best response? a. “The medication may not be effective for him. He may need to try another type.” b. “It may take up to 6 weeks to notice any therapeutic effects. Let’s wait a little longer to see how he does.” c. “It sounds like the dose is not high enough. I’ll check about increasing the dosage.” d. “Some patients never recover from depression. He may not respond to this therapy.” 12. Chlorpromazine (Thorazine) is prescribed for a patient, and the nurse provides instructions to the patient about the medication. The nurse includes which information? a. The patient needs to avoid caffeine while on this drug. b. The patient needs to wear sunscreen while outside because of photosensitivity. c. Long-term therapy may result in nervousness and excitability. d. The medication may be taken with an antacid to reduce gastrointestinal upset. 13. The nurse is reviewing the food choices of a patient who is taking a monoamine oxidase inhibitor ( MAOI). Which food choice would indicate the need for additional teaching? a. Orange juice b. Fried eggs over-easy c. Salami and Swiss cheese sandwich d. Biscuits and honey 14. A patient wants to take a ginseng dietary supplement. The nurse instructs the patient to look for which potential adverse effect? a. Drowsiness b. Palpitations and anxiety c. Dry mouth d. Constipation 15. The nurse is reviewing medications used for depression. Which of these statements is a reason that selective serotonin reuptake inhibitors (SSRIs) are more widely prescribed today than tricyclic antidepressants? a. SSRIs have fewer sexual side effects. b. Unlike tricyclic antidepressants, SSRIs do not have drug-food interactions. c. Tricyclic antidepressants cause serious cardiac dysrhythmias if an overdose occurs. d. SSRIs cause a therapeutic response faster than tricyclic antidepressants. 16. A patient who has been taking a selective serotonin reuptake inhibitor (SSRI) is complaining of “feeling so badly” when he started taking an over-the-counter St. John’s wort herbal product at home. The nurse suspects that he is experiencing serotonin syndrome. Which of these are symptoms of serotonin syndrome? (Select all that apply.) a. Agitation b. Drowsiness c. Tremors d. Bradycardia e. Sweating f. Constipation 17. Which statements are true regarding the selective serotonin reuptake inhibitors (SSRIs)? (Select all that apply.) a. Avoid foods and beverages that contain tyramine. b. Monitor the patient for extrapyramidal symptoms. c. Therapeutic effects may not be seen for about 4 to 6 weeks after the medication is started. d. If the patient has been on an MAOI, a 2- to 5-week or longer time span is required before beginning an SSRI medication. e. These drugs have anticholinergic effects, including constipation, urinary retention, dry mouth, and blurred vision. f. Cogentin is often also prescribed to reduce the adverse effects that may occur. Ch 17 Questions 1. A 38-year-old male patient stopped smoking 6 months ago. He tells the nurse that he still feels strong cigarette cravings and wonders if he is ever going to feel “normal” again. Which statement by the nurse is correct? a. “It’s possible that these cravings will never stop.” b. “These cravings may persist for several months.” c. “The cravings tell us that you are still using nicotine.” d. “The cravings show that you are about to experience nicotine withdrawal.” 2. A patient in a rehabilitation center is beginning to experience opioid withdrawal symptoms. The nurse expects to administer which drug as part of the treatment? a. Diazepam (Valium) b. Methadone c. Disulfiram (Antabuse) d. Bupropion (Zyban) 3. A patient has been taking naltrexone (ReVia) as part of the treatment for addiction to heroin. The nurse expects that the naltrexone will have which therapeutic effect for this patient? a. Naltrexone prevents the cravings for opioid drugs. b. Naltrexone works as a safer substitute for the heroin until the patient completes withdrawal. c. The patient will experience flushing, sweating, and severe nausea if he takes heroin while on naltrexone. d. If opioid drugs are used while taking naltrexone, euphoria is not produced; thus, the opioid’s desired effects are lost. 4. The nurse is presenting a substance-abuse lecture for teenage girls and is asked about “roofies.” The nurse recognizes that this is the slang term for which substance? a. Cocaine b. Flunitrazepam c. Secobarbital d. Methamphetamine 5. A 29-year-old male patient is admitted to the intensive care unit with the following symptoms: restlessness, hyperactive reflexes, talkativeness, confusion and periods of panic and euphoria, tachycardia, and fever. The nurse suspects that he may be experiencing the effects of taking which substance? a. Opioids b. Alcohol c. Stimulants d. Depressants 6. When admitting a patient with a suspected diagnosis of chronic alcohol use, the nurse will keep in mind that chronic use of alcohol might result in which condition? a. Renal failure b. Cerebrovascular accident c. Korsakoff’s psychosis d. Alzheimer’s disease 7. A patient is being treated for ethanol alcohol abuse in a rehabilitation center. The nurse will include which information when teaching him about disulfiram (Antabuse) therapy? a. He should not smoke cigarettes while on this drug. b. He needs to know about the common over-the-counter substances that contain alcohol. c. This drug will cause the same effects as the alcohol did, without the euphoric effects. d. Mouthwashes and cough medicines that contain alcohol are safe because they are used in small amounts. 8. The nurse is conducting a smoking-cessation program. Which statement regarding drugs used in cigarette-smoking–cessation programs is true? a. Rapid chewing of the nicotine gum releases an immediate dose of nicotine. b. Quick relief from withdrawal symptoms is most easily achieved by using a transdermal patch. c. Compliance with treatment is higher with use of the gum rather than the transdermal patch. d. The nicotine gum can be used only up to six times per day. 9. A nurse is providing teaching for a patient who will be taking varenicline (Chantix) as part of a smoking-cessation program. Which teaching points are appropriate for a patient taking this medication? (Select all that apply.) a. This drug is available as a chewing gum that can be taken to reduce cravings. b. Use caution when driving because drowsiness may be a problem. c. There have been very few adverse effects reported for this drug. d. Notify the prescriber immediately if feelings of sadness or thoughts of suicide occur. e. Avoid caffeine while on this drug 10. A patient has been taking disulfiram (Antabuse) as part of his rehabilitation therapy. However, this evening, he attended a party and drank half a beer. As a result, he became ill and his friends took him to the emergency department. The nurse will look for which adverse effects associated with acetaldehyde syndrome? (Select all that apply.) a. Euphoria b. Severe vomiting c. Diarrhea d. Pulsating headache e. Difficulty breathing f. Sweating 11. The nurse is monitoring a patient who is experiencing severe ethanol withdrawal. Which are signs and symptoms of severe ethanol withdrawal? (Select all that apply.) a. Agitation b. Drowsiness c. Tremors d. Systolic blood pressure higher than 200 mm Hg e. Temperature over 100° F (37.7° C) f. Pulse rate 110 beats/min Ch 18 Questions 1. The nurse is aware that adrenergic drugs produce effects similar to which of these nervous systems? a. Central nervous system b. Somatic nervous system c. Sympathetic nervous system d. Parasympathetic nervous system 2. When an adrenergic drug stimulates beta1-adrenergic receptors, the result is an increased force of contraction, which is known as what type of effect? a. Positive inotropic b. Anti-adrenergic c. Negative dromotropic d. Positive chronotropic 3. When a patient is taking an adrenergic drug, the nurse expects to observe which effect? a. Increased heart rate b. Bronchial constriction c. Constricted pupils d. Increased intestinal peristalsis 4. An adrenergic agonist is ordered for a patient in shock. The nurse will note that this drug has had its primary intended effect if which expected outcome occurs? a. Volume restoration b. Increased cardiac output c. Decreased urine output d. Reduced anxiety 5. The nurse is administering a stat dose of epinephrine. Epinephrine is appropriate for which situ