NURS 6521N Advanced Pharmacology: Final Exam Questions and Answers | Latest 2023/2024 (GRADED)

A 4-year-old child is brought to the emergency department by her mother. The mother reports that the child has been vomiting, and the nurse notes that the child's face is flushed and she is diaphoretic. The mother thinks that the child may have swallowed carbachol drops. A diagnosis of cholinergic poisoning is made. Which of the following drugs would be administered? ● ● ● ● ● ● Respo nse Feedb ack: ● Acetylcholine and cevimeline are both cholinergic agonists, and, like carbachol, would be contraindicated in this patient. Administration of either of these drugs could be fatal. Nicotine is a direct-acting nicotinic agonist and is not indicated in cholinergic poisoning. Atropine is considered the antidote for cholinergic poisoning. The actions of atropine are a reduction in salivary, bronchial, and sweat gland secretions; mydriasis; cycloplegia; changes in heart rate; contraction of the bladder detrusor muscle and of the gastrointestinal smooth muscle; decreased gastric secretion; and decreased gastrointestinal motility. ● ● ● ● ● Question 2 ● 1 out of 1 points ● ● ● ● 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 ● ● ● ● ● ● ● ● ● Respo nse Feedb ack: ● 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. ● ● Question 3 ● 1 out of 1 points ● ● ● ● A middle-aged patient was diagnosed with major depression after a suicide attempt several months ago and has failed to respond appreciably to treatment with SSRIs. As a result, his psychiatrist has prescribed phenelzine. When planning this patient's subsequent care, what nursing diagnosis should the nurse prioritize? ● ● ● ● ● ● Respo nse Feedb ack: ● MAOIs such as phenelzine carry a significant risk of injury that results from the multiple interactions associated with these drugs. Infection, impaired tissue perfusion, and constipation are less common, and less serious, adverse effects. ● ● ● ● ● Question 4 ● 1 out of 1 points ● ● ● ● Which of the following would be an expected outcome in a patient who has been given atropine during a medical emergency? ● ● ● ● ● ● Respo nse Feedb ack: ● 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. ● ● ● ● ● Question 5 ● 1 out of 1 points ● ● ● ● A nurse is providing care for a patient who suffered extensive burns to his extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all his burns in order to achieve adequate pain control. When considering this order, the nurse should be ● ● ● aware that ● ● ● Respo nse Feedb ack: ● Applying lidocaine preparations to severely traumatized mucosa (large skin abrasions, eczema, and burns) can increase its absorption, which in turn increases the risk of systemic toxicity. Intravenous lidocaine is not normally used for analgesia. The destruction of nerve endings in a burn site does not mitigate the need for topical pain control and lidocaine does not need to be potentiated with another anesthetic. ● ● ● ● ● Question 6 ● 1 out of 1 points ● ● ● ● A 30-year-old woman is taking phenelzine (Nardil) 30mg PO tid. The nurse knows that at that dosage, the patient will need to be carefully monitored for ● ● ● ● ● ● Respo nse Feedb ack: ● The nurse will closely monitor for the adverse effects of phenelzine related to the anticholinergic effect of the drug, such as dizziness that tends to be more pronounced at dosages above 45 mg/day. Dizziness is also a sign of a phenelzine drug overdose. Constipation and dry mouth are also adverse effects, not diarrhea and increased secretions. Facial flushing is not an identified adverse effect of phenelzine. ● ● ● ● ● Question 7 ● 1 out of 1 points ● ● ● ● A 20-year-old man has begun treatment of the psychotic symptoms of schizophrenia using olanzapine (Zyprexa). Which of the following symptoms would be categorized as a negative symptom of schizophrenia? ● ● ● ● ● ● Respo nse Feedb ack: ● The negative symptoms of schizophrenia include flat or blunted emotions, lack of pleasure or interest in things (anhedonia), and limited speech. The positive symptoms of schizophrenia, and the most recognizable symptoms, ● ● ● include delusions (e.g., paranoia or distorted perceptions of other people's intentions) and hallucinations. ● ● Question 8 ● 1 out of 1 points ● ● ● ● 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? ● ● ● ● ● ● Respo nse Feedb ack: ● 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. ● ● ● ● ● Question 9 ● 1 out of 1 points ● ● ● ● A nurse is caring for a patient who abuses marijuana. The treatment for marijuana abuse consists mainly of ● ● ● ● ● ● Respo nse Feedb ack: ● Treatment for marijuana abuse consists mainly of nonpharmacologic interventions combined with an exercise program to help deal with withdrawal symptoms and cravings for the drug. Treatment of LSD and PCP use is necessary only when the user experiences a “bad trip.” Parlodel is given for cocaine addiction. Patients with acute inhalant intoxication may need respirator assistance. ● ● ● ● ● Question 10 ● 1 out of 1 points ● ● ● ● Which of the following drugs used to treat anxiety would be appropriate for a patient who is a school teacher and is concerned about feeling sedated at work? ● ● ● ● ● ● Respo nse Feedb ack: ● Buspirone does not cause as much sedation and functional impairment as lorazepam, alprazolam, and diazepam. However, it can cause dizziness, nausea, headache, nervousness, lightheadedness, or excitement. ● ● ● ● ● Question 11 ● 1 out of 1 points ● ● ● ● A patient who has been taking buspirone (BuSpar) for 1 week calls the clinic and reports to the nurse that the drug is not working. The patient informs the nurse that she is still having symptoms of anxiety. The nurse will tell the patient that ● ● ● ● ● ● Respo nse Feedb ack: ● The nurse will inform the patient that it will likely take 3 to 4 weeks of treatment before she notices consistent relief of her anxiety. However, some improvement is often seen within 7 to 10 days of starting therapy. Since the patient had only been taking the drug 1 week, there is no need to inform the physician. The nurse would not make the assumption that the medication is not going to work for ● ● ● the patient nor would she tell her that it would take up to 6 months to see therapeutic results. ● ● Question 12 ● 1 out of 1 points ● ● ● ● A homeless man who is well known to care providers at the local hospital has been admitted to the emergency department after having a seizure outside a mall. The man is known to be a heavy alcohol user and is malnourished with a very low body mass index. How are this patient's characteristics likely to influence possible treatment with phenytoin? ● ● ● ● ● ● Respo nse Feedb ack: ● A protein deficit puts the patient at greater risk for having greater amounts of free, active drug in the blood because less protein albumin is available for binding than would normally be expected. Alcohol does not compete with phenytoin for binding sites and the drug is not necessarily contraindicated with recent alcohol intake, though alcohol does influence the metabolism of