NCLEX RN PHARMACOLOGY - NEUROLOGICAL MEDICATIONS - Complete Solutions With Answers.

NCLEX RN PHARMACOLOGY - NEUROLOGICAL MEDICATIONS Carbidopa-levodopa (Sinemet) is prescribed for a client with Parkinson's disease. The nurse monitors the client for side/adverse effects to the medication. Which finding indicates that the client is experiencing an adverse effect? 1. Pruritus 2. Tachycardia 3. Hypertension 4. Impaired voluntary movements 4. Impaired voluntary movements The home health nurse visits a client who is taking phenytoin (Dilantin) for control of seizures. During the assessment, the nurse notes that the client is taking birth control pills. Which information should the nurse include in the teaching plan? 1. Pregnancy should be avoided while taking phenytoin. 2. The client may stop the medication if it is causing severe gastrointestinal effects. 3. There is the potential of decreased effectiveness of birth control pills while taking phenytoin. 4. There is the increased risk of thrombophlebitis while taking phenytoin and birth control pills together. 3. There is the potential of decreased effectiveness of birth control pills while taking phenytoin. The nurse is caring for a client in the emergency department who has been diagnosed with Bell's palsy. The client has been taking acetaminophen (Tylenol), and acetaminophen overdose is suspected. Which antidote should the nurse anticipate to be prescribed? 1. Pentostatin (Nipent) 2. Auranofin (Ridaura) 3. Fludarabine (Fludara) 4. Acetylcysteine (Mucomyst) 4. Acetylcysteine (Mucomyst) Meperidine hydrochloride (Demerol) has been prescribed for a client to treat pain. Which are side/adverse effects of this medication? Select all that apply. 1. Diarrhea 2. Tremors 3. Drowsiness 4. Hypotension 5. Urinary frequency 6. Increased respiratory rate 2. Tremors 3. Drowsiness 4. Hypotension A client is taking the prescribed dose of phenytoin (Dilantin) to control seizures. Results of a phenytoin blood level study reveal a level of 35 mcg/mL. Which finding would be expected as a result of this laboratory result? 1. Hypotension 2. Tachycardia 3. Slurred speech 4. No abnormal finding 3. Slurred speech The client arrives at the emergency department complaining of back spasms. The client states, "I have been taking two to three aspirin every 4 hours for the last week, and it hasn't helped my back." Since aspirin intoxication is suspected, the nurse should assess the client for which manifestation? 1. Tinnitus 2. Diarrhea 3. Constipation 4. Photosensitivity 1. Tinnitus A client with trigeminal neuralgia is being treated with carbamazepine (Tegretol), 400 mg orally daily. Which value indicates that the client is experiencing an adverse effect to the medication? 1. Uric acid level, 5 mg/dL 2. Sodium level, 140 mEq/L 3. Blood urea nitrogen level, 15 mg/dL 4. White blood cell count, 3000 cells/mm3 4. White blood cell count, 3000 cells/mm3 The nurse is caring for a client with severe back pain. Codeine sulfate has been prescribed for the client. Specific to this medication, which intervention should the nurse include in the plan of care while the client is taking this medication? 1. Monitor radial pulse. 2. Monitor bowel activity. 3. Monitor apical heart rate. 4. Monitor peripheral pulses. 2. Monitor bowel activity. The nurse has given medication instructions to a client receiving phenytoin (Dilantin). Which statement indicates that the client has an adequate understanding of the instructions? 1. "Alcohol is not contraindicated while taking this medication." 2. "Good oral hygiene is needed, including brushing and flossing." 3. "The medication dose may be self-adjusted, depending on side effects." 4. "The morning dose of the medication should be taken before a serum drug level is drawn." 2. "Good oral hygiene is needed, including brushing and flossing." A client with myasthenia gravis has become increasingly weaker. The health care provider prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or an increasing severity of the disease (myasthenic crisis). An injection of edrophonium is administered. Which finding would indicate that the client is in cholinergic crisis? 1. No change in the condition 2. Complaints of muscle spasms 3. An improvement of the weakness 4. A temporary worsening of the condition 4. A temporary worsening of the condition A client with trigeminal neuralgia tells the nurse that acetaminophen (Tylenol) is taken daily for the relief of generalized discomfort. Which laboratory value would indicate toxicity associated with the medication? 1. Sodium level of 140 mEq/L 2. Prothrombin time of 11.8 seconds 3. Direct bilirubin level of 2 mg/dL 4. Platelet count of 400,000 cells/mm3 3. Direct bilirubin level of 2 mg/dL The nurse is caring for a client receiving mannitol (Osmitrol) via intravenous (IV) infusion. A vial is sent from the pharmacy, and in preparing the medication the nurse notes that the vial contains crystals. What is the most appropriate nursing action? 1. Discard the vial. 2. Place the vial in warm water. 3. Send the vial back to the pharmacy. 4. Shake the vial to dissolve the crystals. 2. Place the vial in warm water. The nurse in a long-term care facility is reviewing the health care provider's (HCP) prescriptions on an assigned client. The nurse notes that the HCP prescribed ropinirole hydrochloride (Requip). The nurse determines that this medication has been prescribed to treat which condition in the client? 1. Depression 2. Diabetes mellitus 3. Coronary artery disease 4. Parkinsonian syndrome 4. Parkinsonian syndrome A client is receiving phenobarbital sodium (Luminal) for the treatment of a seizure disorder. Which finding on the nursing assessment would indicate that the client is experiencing a common side effect of this medication? 1. Drowsiness 2. Hypocalcemia 3. Blurred vision 4. Seizure activity 1. Drowsiness A client with suspected opioid overdose has received a dose of naloxone hydrochloride (Narcan). The client subsequently becomes restless, starts to vomit, and complains of abdominal cramping. The blood pressure increases from 110/72 mm Hg to 160/86 mm Hg. The nurse provides emotional support and reassurance while administering care to the client, knowing which piece of information? 1. The client may next become suicidal. 2. These are signs of opioid withdrawal. 3. These effects will last only a few moments. 4. The client may otherwise sign out against medical advice. 2. These are signs of opioid withdrawal. The nurse is preparing to give a postcraniotomy client medication for incisional pain. The family asks the nurse why the client is receiving codeine sulfate and not "something stronger." In formulating a response, the nurse incorporates which information about codeine sulfate? 1. Is one of the strongest opioid analgesics available 2. Cannot lead to physical or psychological dependence 3. Does not alter respirations or mask neurological signs as do other opioids 4. Does not cause gastrointestinal (GI) upset or constipation as do other opioids 3. Does not alter respirations or mask neurological signs as do other opioids The nurse is administering medications to a client with trigeminal neuralgia. The nurse expects that which medication will be prescribed for pain relief? 1. Oxycodone plus aspirin (Percodan) 2. Acetaminophen (Tylenol) and codeine sulfate 3. Carbamazepine (Tegretol) and gabapentin (Neurontin) 4. Meperidine hydrochloride (Demerol) and hydroxyzine (Vistaril) 3. Carbamazepine (Tegretol) and gabapentin (Neurontin) The nurse is caring for a client with an exacerbation of multiple sclerosis. Which medication(s) will the nurse expect to be prescribed to hasten recovery from the exacerbation? 1. Methylprednisolone (Solu-Medrol) intravenously 2. Carbamazepine (Tegretol) and phenytoin (Dilantin) by mouth 3. Phenytoin (Dilantin) intravenously, then tapered to oral route 4. Lioresal (Baclofen) by mouth and diazepam (Valium) intravenously 1. Methylprednisolone (Solu-Medrol) intravenously The nurse is observing a new nursing graduate who is preparing an intermittent intravenous (IV) infusion of phenytoin (Dilantin) for a client with a diagnosis of seizures. Which solution used by the nursing graduate should indicate to the nurse an understanding of proper preparation of this medication? 1. 5% dextrose in water 2. Lactated Ringer's solution 3. 0.9% sodium chloride (normal saline) 4. 5% dextrose and 0.45% sodium chloride 3. 0.9% sodium chloride (normal saline) The nurse has given instructions for taking codeine sulfate to a client with a severe headache. Which statement by the client indicates the teaching has been effective? 1. "I should increase fluid intake." 2. "I should maintain a low-fiber diet." 3. "I should avoid all exercise to prevent lightheadedness." 4. "I should avoid the use of stool softeners to prevent diarrhea." 1. "I should increase fluid intake." A client experiencing spasticity as a result of spinal cord injury has a new prescription for dantrolene (Dantrium). Before administering the first dose, the nurse checks to see if which baseline study has been done? 1. Liver function studies 2. Renal function studies 3. Otoscopic examination 4. Blood glucose measurements