Test Bank Lehnes Pharmacotherapeutics for
Advanced Practice Nurses and Physician
Assistants 2nd Edition.Pharmacology
nursing.Q&A complete guide A+.
LEHNE’S PHARMACOTHERAPEUTICS FOR
ADVANCED PRACTICE NURSES AND
PHYSICIAN ASSISTANTS 2ND EDITION
ROSENTHAL TEST BANK.
All chapters
Prescriptive Authority
Test Bank
Multiple Choice
2nd
Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Providers, Ed.
Chapter: Central Nervous System Stimulants and Attention-
Deficit/Hyperactivity Disorder
• A child will begin taking methylphenidate [Ritalin] for attention-
deficit/hyperactivity disorder. Important baseline information about this patient will
include:
A. results of an electrocardiogram (ECG).
B. family history of psychosis.
C. height and weight.
D. renal function.
,ANS: C
Side effects of methylphenidate include a reduced appetite, and children taking these
drugs should be monitored for growth suppression. Baseline height and weight
measurements help with this ongoing assessment. The value of an ECG for children
has not been proved, except when known heart disease is a factor. Excessive use of
stimulants can produce a state of psychosis but is not related to the family history.
Renal function tests are not indicated.DIF: Cognitive Level: ApplicationREF: pp.
298TOP: Nursing Process: Assessment MSC: NCLEX Client Needs Category:
Physiologic Integrity: Reduction of Risk Potential
• A child has been taking SD methylphenidate [Ritalin], 10 mg at 0800 and 1200 and
5 mg at 1600, for 2 months. The parents tell the nurse that the child sometimes
misses the noon dose while at school. The child’s appetite is normal. The teacher
has reported a slight improvement in hyperactivity and impulsivity. What will the
nurse do?
A. Ask the prescriber whether this child could be given methylphenidate [Concerta].
B. Contact the prescriber to suggest using a nonstimulant medication.
C. Reinforce the need to take all doses as prescribed.
D. Suggest drug holidays for the child on weekends.
ANS: A
This child is showing slight improvement with the medication but has trouble taking the
noon dose; therefore, a once-daily formulation would increase compliance and improve
effects. There is no indication to use a nonstimulant medication, because the child’s
appetite is normal. If 3 times/day dosing were the only option available, reinforcing the
need to take all doses would be necessary; however, some children avoid taking
medication at school because of the stigma attached to being different from their peers.
The use of drug holidays is controversial; this approach is used when growth
suppression is a problem.DIF: Cognitive Level: ApplicationREF: pp. 295TOP:
Nursing Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic
Integrity: Pharmacologic and Parenteral Therapies
• An adult patient will begin taking atomoxetine [Strattera] for attention-
deficit/hyperactivity disorder. What will the nurse teach this patient?
A. Appetite suppression does not occur, because this drug is not a stimulant.
B. Stopping the drug abruptly will cause an abstinence syndrome.
C. Suicidal thoughts may occur and should be reported to the provider.
D. Therapeutic effects may not be felt for 1 to 3 weeks after beginning therapy.
ANS: D
,Atomoxetine is a selective inhibitor of norepinephrine (NE) reuptake, and its effects
probably are the result of adaptive changes that occur after uptake blockade, which can
take 1 to 3 weeks. Appetite suppression is an adverse effect of this drug. Atomoxetine
does not have abuse potential, and abstinence syndrome does not occur when it is
withdrawn. Suicidal thoughts may occur in children and adolescents, but not in
adults.DIF: Cognitive Level: ApplicationREF: pp. 298TOP: Nursing Process:
Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
• A child is diagnosed with attention-deficit/hyperactivity disorder (ADHD). The
prescriber orders a central nervous system stimulant. Which statement by the
child’s parent indicates a need for further teaching?
A. “I should report insomnia and poor appetite to his provider.”
B. “I will make sure he takes his medication after breakfast every day.”
C. “This drug will make him less impulsive while he’s at school.”
D. “This medication will help my child focus so he can learn new behaviors.”
ANS: C
Stimulants do not suppress negative behaviors directly and do not directly cause a
decrease in hyperactivity. They act by improving attention and focus so that positive
behaviors can be learned to replace negative behaviors. Insomnia and poor appetite are
common side effects and should be reported to the provider, because alternate dosing
regimens often counteract these effects. Taking the medication either during or after
breakfast prevents morning appetite suppression at breakfast time. Stimulants improve
focus and allow new, more positive behaviors to be learned.DIF: Cognitive Level:
ApplicationREF: pp. 298TOP: Nursing Process: Evaluation MSC: NCLEX Client
Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
• A university student who is agitated and restless and has tremors is brought to the
emergency department. The patient’s heart rate is 110 beats/minute, the respiratory
rate is 18 breaths/minute, and the blood pressure is 160/95 mm Hg. The patient
reports using concentrated energy drinks to stay awake during finals week. What
complication will the nurse monitor for in this patient?
A. CNS depression
B. Cardiac arrest
C. Respiratory failure
D. Seizures
ANS: D
, In large doses, caffeine produces nervousness and tremors; in very large doses, it can
cause seizures. This patient has been drinking concentrated energy drinks which are
high in caffeine.
Caffeine is a stimulant and produces CNS excitation, not depression. Although cardiac
side effects are common with caffeine, cardiac arrest is not. Respiratory failure is not an
effect of caffeine toxicity.DIF: Cognitive Level: AnalysisREF: pp. 296TOP: Nursing
Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic Integrity:
Reduction of Risk Potential
• A patient who is morbidly obese is admitted for treatment. The prescriber orders
lisdexamfetamine [Vyvanse]. The nurse will be concerned if this patient shows
signs of:
A. anorexia.
B. dyspnea.
C. insomnia.
D. loquaciousness.
ANS: B
Stimulants can produce cardiovascular effects. Any patient reporting shortness of
breath needs to be evaluated for cardiovascular problems. Anorexia, or poor appetite,
is an expected effect of stimulants and is the desired effect when these drugs are used
for obesity. Stimulants increase alertness and can cause insomnia, which is an expected
effect at therapeutic doses. Loquaciousness is an expected effect at therapeutic
doses.DIF: Cognitive Level: ApplicationREF: pp. 293TOP: Nursing Process:
Evaluation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of
Risk Potential
• A nurse is providing education to a group of patients regarding amphetamines. To
evaluate the group’s understanding, the nurse asks a participant what effects
amphetamines would have on her. The participant shows that she understands the
effects of these drugs if she gives which answers?
Select all that apply.
A. “Amphetamines increase fatigue.”
B. “Amphetamines suppress the perception of pain.”
C. “Amphetamines increase appetite.”
D. “Amphetamines increase the heart rate.”
E. “Amphetamines elevate mood.”
ANS: B , D , E
Advanced Practice Nurses and Physician
Assistants 2nd Edition.Pharmacology
nursing.Q&A complete guide A+.
LEHNE’S PHARMACOTHERAPEUTICS FOR
ADVANCED PRACTICE NURSES AND
PHYSICIAN ASSISTANTS 2ND EDITION
ROSENTHAL TEST BANK.
All chapters
Prescriptive Authority
Test Bank
Multiple Choice
2nd
Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Providers, Ed.
Chapter: Central Nervous System Stimulants and Attention-
Deficit/Hyperactivity Disorder
• A child will begin taking methylphenidate [Ritalin] for attention-
deficit/hyperactivity disorder. Important baseline information about this patient will
include:
A. results of an electrocardiogram (ECG).
B. family history of psychosis.
C. height and weight.
D. renal function.
,ANS: C
Side effects of methylphenidate include a reduced appetite, and children taking these
drugs should be monitored for growth suppression. Baseline height and weight
measurements help with this ongoing assessment. The value of an ECG for children
has not been proved, except when known heart disease is a factor. Excessive use of
stimulants can produce a state of psychosis but is not related to the family history.
Renal function tests are not indicated.DIF: Cognitive Level: ApplicationREF: pp.
298TOP: Nursing Process: Assessment MSC: NCLEX Client Needs Category:
Physiologic Integrity: Reduction of Risk Potential
• A child has been taking SD methylphenidate [Ritalin], 10 mg at 0800 and 1200 and
5 mg at 1600, for 2 months. The parents tell the nurse that the child sometimes
misses the noon dose while at school. The child’s appetite is normal. The teacher
has reported a slight improvement in hyperactivity and impulsivity. What will the
nurse do?
A. Ask the prescriber whether this child could be given methylphenidate [Concerta].
B. Contact the prescriber to suggest using a nonstimulant medication.
C. Reinforce the need to take all doses as prescribed.
D. Suggest drug holidays for the child on weekends.
ANS: A
This child is showing slight improvement with the medication but has trouble taking the
noon dose; therefore, a once-daily formulation would increase compliance and improve
effects. There is no indication to use a nonstimulant medication, because the child’s
appetite is normal. If 3 times/day dosing were the only option available, reinforcing the
need to take all doses would be necessary; however, some children avoid taking
medication at school because of the stigma attached to being different from their peers.
The use of drug holidays is controversial; this approach is used when growth
suppression is a problem.DIF: Cognitive Level: ApplicationREF: pp. 295TOP:
Nursing Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic
Integrity: Pharmacologic and Parenteral Therapies
• An adult patient will begin taking atomoxetine [Strattera] for attention-
deficit/hyperactivity disorder. What will the nurse teach this patient?
A. Appetite suppression does not occur, because this drug is not a stimulant.
B. Stopping the drug abruptly will cause an abstinence syndrome.
C. Suicidal thoughts may occur and should be reported to the provider.
D. Therapeutic effects may not be felt for 1 to 3 weeks after beginning therapy.
ANS: D
,Atomoxetine is a selective inhibitor of norepinephrine (NE) reuptake, and its effects
probably are the result of adaptive changes that occur after uptake blockade, which can
take 1 to 3 weeks. Appetite suppression is an adverse effect of this drug. Atomoxetine
does not have abuse potential, and abstinence syndrome does not occur when it is
withdrawn. Suicidal thoughts may occur in children and adolescents, but not in
adults.DIF: Cognitive Level: ApplicationREF: pp. 298TOP: Nursing Process:
Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
• A child is diagnosed with attention-deficit/hyperactivity disorder (ADHD). The
prescriber orders a central nervous system stimulant. Which statement by the
child’s parent indicates a need for further teaching?
A. “I should report insomnia and poor appetite to his provider.”
B. “I will make sure he takes his medication after breakfast every day.”
C. “This drug will make him less impulsive while he’s at school.”
D. “This medication will help my child focus so he can learn new behaviors.”
ANS: C
Stimulants do not suppress negative behaviors directly and do not directly cause a
decrease in hyperactivity. They act by improving attention and focus so that positive
behaviors can be learned to replace negative behaviors. Insomnia and poor appetite are
common side effects and should be reported to the provider, because alternate dosing
regimens often counteract these effects. Taking the medication either during or after
breakfast prevents morning appetite suppression at breakfast time. Stimulants improve
focus and allow new, more positive behaviors to be learned.DIF: Cognitive Level:
ApplicationREF: pp. 298TOP: Nursing Process: Evaluation MSC: NCLEX Client
Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
• A university student who is agitated and restless and has tremors is brought to the
emergency department. The patient’s heart rate is 110 beats/minute, the respiratory
rate is 18 breaths/minute, and the blood pressure is 160/95 mm Hg. The patient
reports using concentrated energy drinks to stay awake during finals week. What
complication will the nurse monitor for in this patient?
A. CNS depression
B. Cardiac arrest
C. Respiratory failure
D. Seizures
ANS: D
, In large doses, caffeine produces nervousness and tremors; in very large doses, it can
cause seizures. This patient has been drinking concentrated energy drinks which are
high in caffeine.
Caffeine is a stimulant and produces CNS excitation, not depression. Although cardiac
side effects are common with caffeine, cardiac arrest is not. Respiratory failure is not an
effect of caffeine toxicity.DIF: Cognitive Level: AnalysisREF: pp. 296TOP: Nursing
Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic Integrity:
Reduction of Risk Potential
• A patient who is morbidly obese is admitted for treatment. The prescriber orders
lisdexamfetamine [Vyvanse]. The nurse will be concerned if this patient shows
signs of:
A. anorexia.
B. dyspnea.
C. insomnia.
D. loquaciousness.
ANS: B
Stimulants can produce cardiovascular effects. Any patient reporting shortness of
breath needs to be evaluated for cardiovascular problems. Anorexia, or poor appetite,
is an expected effect of stimulants and is the desired effect when these drugs are used
for obesity. Stimulants increase alertness and can cause insomnia, which is an expected
effect at therapeutic doses. Loquaciousness is an expected effect at therapeutic
doses.DIF: Cognitive Level: ApplicationREF: pp. 293TOP: Nursing Process:
Evaluation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of
Risk Potential
• A nurse is providing education to a group of patients regarding amphetamines. To
evaluate the group’s understanding, the nurse asks a participant what effects
amphetamines would have on her. The participant shows that she understands the
effects of these drugs if she gives which answers?
Select all that apply.
A. “Amphetamines increase fatigue.”
B. “Amphetamines suppress the perception of pain.”
C. “Amphetamines increase appetite.”
D. “Amphetamines increase the heart rate.”
E. “Amphetamines elevate mood.”
ANS: B , D , E
