NURS-6521N-37,Advanced Pharmacology.2021 Summer Qtr 05/29-08/19-PT27

benzodiazepines, opioids, and amphetamines does not cause such severe and potentially fatal withdrawal symptoms. A nurse is assigned to a patient who is taking lithium. Which of the following drug serum levels would indicate that the patient is at risk for adverse effects of the drug? Response Feedback: The therapeutic range for lithium is 0.6 to 1.2 mEq/L. A level of 0.3 mEq/L would not be in the therapeutic range and would therefore not produce a therapeutic response. Levels of 0.6 and 1.2 mEq/L would be within the therapeutic range and would not be expected to produce adverse effects. A level of 1.7 mEq/L would be a high level and place the patient at risk for adverse effects or overdose. A trauma patient has been receiving frequent doses of morphine in the 6 days since his accident. This pattern of analgesic administration should prompt the nurse to carefully monitor the patient's Response Feedback: Morphine, like most opioid analgesics, creates a risk for constipation. The drug is unlikely to influence the patient's temperature, skin integrity, or urine specific gravity. A patient who is experiencing withdrawal from heavy alcohol use have developed psychosis and been treated with haloperidol. Which of the following assessment findings should prompt the care team to assess the patient for neuroleptic malignant syndrome? Response Feedback: Neuroleptic malignant syndrome is characterized by fever, sweating, tachycardia, muscle rigidity, tremor, incontinence, stupor, leukocytosis, elevated creatinine phosphokinase levels, and renal failure. Agitation, pruritis, thirst, and increased urine output are not indicative of neuroleptic malignant syndrome. A nurse who works at an outpatient mental health clinic follows numerous clients who have schizophrenia, many of whom are being treated with olanzapine (Zyprexa). Which of the following clients likely has the highest susceptibility to the adverse effects of olanzapine? Response The use of olanzapine creates a significant risk of hyperglycemia. Feedback : This is of particular concern in patients and clients who have diabetes mellitus. Smoking affects the pharmacodynamics of olanzapine, but this is less likely to result in serious adverse effects. Obesity, low BMI, and recent antibiotic use are not associated with a significantly increased risk of adverse effects. Morphine has been prescribed for a 28-year-old man with severe pain due to a back injury. The nurse will advise the patient to avoid Response Feedback: The nurse should advise the patient to avoid alcohol and any other CNS depressants while taking morphine. These combinations can cause serious respiratory depression and sedation. Vitamin C, fatty foods, and dairy products are not known to interact with morphine. A male patient has been brought to the emergency department during an episode of status epilepticus. Diazepam is to be administered intravenously. The nurse will be sure to Response Feedback: When diazepam is administered intravenously during status epilepticus, the small veins in the dorsum of the hand or the wrist should be avoided. It should be injected slowly, no faster than 5 mg in 1 minute. Diazepam should not be mixed or diluted with other solutions or drugs, either in the syringe or in intravenous solutions. A nurse works in a sleep disorder clinic and is responsible for administering medications to the patients. Which of the following patients would be most likely to receive zaleplon (Sonata)? Response Feedback: The nurse will most likely administer the zaleplon to the 35-year-old man who is having difficulty falling asleep, but once asleep can stay asleep. Zolpidem would most likely be administered to the 20-year- old who will take a sleep aid only once a week. Eszopiclone (Lunesta) will be given to the 52-year-old woman who needs to fall asleep quickly and has trouble staying asleep. The 46-year-old man will likely receive trazodone (Desyrel). This drug is given as a sleep aid for a patient who is taking an antidepressant. A postsurgical patient has been provided with a morphine patient-controlled analgesic (PCA) but has expressed her reluctance to use it for fear of becoming addicted. How can the nurse best respond to this patient's concerns? Response Feedback: Addiction to opioids is a rare occurrence among hospital patients who do not have a history of drug abuse. It would be inappropriate to downplay the patient's concerns, however. A more appropriate response would be to explain the phenomenon of dependence and to differentiate it from addiction. A patient has been prescribed zolpidem (Ambien) for short-term treatment of insomnia. Which of the following will the nurse include in a teaching plan for this patient? (Select all that apply.) Response Feedback: Zolpidem generally is not used for more than 7 to 10 days at a time. It induces sleep rapidly and should be taken immediately before going to bed. It is true that the drug does not seem to produce residual effects the next morning or cause prolonged rebound effects when it is discontinued. It is available in both quick-onset and continuous-release oral forms, and common adverse effects of the drug are headache, prolonged drowsiness, and dizziness. A 62-year-old woman has been prescribed a fentanyl transdermal patch for chronic cancer pain. The patient asks the nurse how long it will take for her to experience pain relief. The nurse will instruct the patient that she should feel pain relief in approximately Response Feedback: The nurse will instruct the patient that it will take approximately 24 hours for the full pain-relieving effect of a fentanyl transdermal patch to occur. Which of the following would be an expected outcome in a patient who has been given atropine during a medical emergency? Response Feedback: Atropine is used to help restore normal sinus rhythm in emergency situations, such as symptomatic bradycardia, pulseless electrical activity, ventricular asystole, or cardiopulmonary resuscitation. It does not resolve acid-based imbalances or decreased level of consciousness and atropine increases, rather than decreases, blood pressure.