NURSING NSG6005CH 17-23 Test Questions-[2020]/NURSING NSG6005CH 17-23 Test Questions[

NURSING NSG6005CH 17-23 Test QuestionsNURSING NSG6005, CH 17-23 Test Questions Test Prep Ch. 17 1. The nurse is preparing to administer enteral nutrition to a patient. Which assessment finding would prompt the nurse to hold the nutrition and notify the patient’s provider? a. Blood pressure of 90/60 mm Hg b. Decreased bowel sounds c. A productive cough d. A temperature of 37.8° C 2. The nurse is preparing to administer an enteral feeding to a patient who receives 300 mL of Isocal over 30 minutes every 4 hours. The nurse checks the residual prior to initiating the feeding and notes a residual amount of 50 mL of formula. Which action will the nurse take next? a. Administer the feeding as ordered. b. Administer the feeding over 60 minutes. c. Hold the feeding and notify the patient’s provider. d. Wait 1 hour and recheck the residual again. 3. The provider calculates the enteral nutrition needs for a nonambulatory patient and determines that the patient will need 300 mL of Ultracal every 4 hours. Which method of delivery will the nurse use to administer these feedings? a. 300 mL every 4 hours given via syringe as a 10-minute bolus b. 300 mL every 4 hours given via enteral pump as a 45-minute infusion c. 75 mL per hour via enteral pump as a continuous infusion d. 150 mL every 2 hours via gravity infusion 4. The nurse is preparing a patient who will receive intermittent enteral nutrition at home with a hyperosmolar solution. What information will the nurse include when teaching this patient? a. How to perform the Valsalva maneuver b. The need to consume extra fluids between feedings c. The need to decrease dietary fiber d. The need to remain supine during infusion of the enteral solution 5. The nurse assumes care of a patient who has been receiving intermittent enteral feedings of 240 mL of Osmolite every 4 hours for the past 48 hours. The patient is in bed with the head of the bed elevated 60 degrees. The enteral tubing is intact, and the enteral pump is infusing at 360 mL per hour. The nurse notes 60 mL of solution left in the bag. The tubing is not labeled. What will the nurse do? a. Change and label the enteral tubing when this infusion is complete. b. Increase the infusion rate to 480 mL per hour to complete the infusion. c. Lower the head of the bed to 30 degrees. d. Stop the infusion and check for residual before resuming the infusion. 6. The nurse dilutes an antibiotic before administering it through a patient’s nasogastric tube. The patient asks why this is necessary. The nurse explains that diluting the antibiotic helps to a. improve absorption. b. improve hydration. c. prevent diarrhea. d. prevent emboli. 7. The nurse is caring for a patient who is receiving total parenteral nutrition (TPN). The nurse will carefully monitor this patient for which symptom(s)? a. Coughing and shortness of breath b. Decreased breath sounds c. Diarrhea d. Nausea and abdominal distension 8. The nurse is preparing to hang a new bag for a patient who is receiving total parenteral nutrition (TPN). During this procedure, the nurse will instruct the patient to take a deep breath and then perform which action? a. Exhale slowly and bear down. b. Exhale slowly to the count of 10. c. Hold the breath and bear down. d. Take several rapid, shallow breaths. 9. Which patient is most likely to be a candidate for total parenteral nutrition (TPN) rather than enteral nutrition? a. A patient who is comatose after having had a stroke b. A patient who has a fractured mandible following a motor vehicle accident c. A patient who has cerebral palsy and severe dysphagia d. A patient who is pregnant and has intractable hyperemesis gravidarum 10. The nurse is preparing to administer enteral nutrition to a patient who has had a stroke and who cannot swallow. A family member asks why the patient isn’t receiving intravenous nutrition. What information will the nurse provide to the family member? a. Parenteral nutrition carries a higher risk of infection. b. Parenteral nutrition does not provide sufficient calories. c. Parenteral nutrition increases the risk of aspiration. d. Parenteral nutrition is hyperosmolar and increases the risk of dehydration. 11. A patient who has been receiving continuous enteral nutrition has had several large, watery stools. The nurse will contact the provider to discuss which intervention? a. Administering antidiarrheal medications b. Slowing the rate of infusion c. Starting total parenteral nutrition d. Thickening the nutrition solution 12. A patient who has been receiving total parenteral nutrition (TPN) for several days accidently removes the intravenous (IV) line. While waiting for the IV therapy nurse, the nurse caring for this patient will monitor for which complication? a. Air embolism b. Dehydration c. Hypoglycemia d. Infection 13. The nurse is preparing to discontinue total parenteral nutrition (TPN) therapy for a patient who has been receiving TPN for several days. The nurse will contact the provider to discuss an order for a. antibiotics. b. intravenous insulin. c. isotonic dextrose. d. nasogastric feedings. 14. The nurse is caring for a patient with severe burns who will begin receiving total parenteral nutrition (TPN). The patient asks why TPN is necessary. The nurse explains that TPN is used for which reason? a. To minimize pulmonary complications b. To prevent hyperglycemia and fluid overload c. To promote wound healing and maintain cell integrity d. To restore fluid and electrolyte imbalance 15. The nurse is caring for an adult with severe burns who weighs 60 kg. Prior to initiating total parenteral nutrition (TPN) therapy, the nurse reviews the orders. Which TPN order is correct for this patient? a. 3000 kcal, 120 g amino acids per day b. 2400 kcal, 50 g amino acids per day c. 1500 kcal, 100 g amino acids per day d. 3600 kcal, 150 g amino acids per day 16. The nurse is caring for a patient who is receiving total parenteral nutrition (TPN). The patient reports nausea, headache, and thirst. The nurse will contact the provider to discuss a. giving acetaminophen for headache pain. b. obtaining a serum glucose level. c. ordering an antiemetic to prevent vomiting. d. starting intravenous isotonic dextrose. 17. The nurse is caring for a patient who is receiving total parenteral nutrition (TPN) and notes that the patient becomes dyspneic when transferring from the bed to a chair. The nurse auscultates rales in both lungs. Which action will the nurse take next? a. Ask the patient to perform the Valsalva maneuver. b. Decrease the TPN rate and request an order for a diuretic medication. c. Obtain an order for a chest radiograph and an antibiotic. d. Stop the TPN and request an order for intravenous isotonic dextrose. 18. The nurse is caring for a patient who is being treated with total parenteral nutrition (TPN). The patient is experiencing chest pain, and the nurse observes shortness of breath and coughing along with cyanosis. The nurse understands that this patient is most likely experiencing which condition? a. Air embolism b. Pneumonia c. Pneumothorax d. Pulmonary edema 19. A patient receiving total parenteral nutrition (TPN) begins having cough and dyspnea. The nurse auscultates rales and notes neck vein engorgement and weight gain. The nurse suspects that the patient is experiencing which condition? a. Air embolism b. Fluid overload c. Pneumonia d. Pneumothorax 20. The nurse assumes care for a patient who is being treated with enteral feeding. When performing the initial assessment, the nurse finds the patient supine and asleep. The nurse will perform which action? a. Elevate the head of the bed 30 degrees. b. Flush the tubing with water. c. Position the patient to the left side. d. Temporarily discontinue the infusion. MULTIPLE RESPONSE 1. Patients with which conditions would benefit from enteral feedings? (Select all that apply.) a. Burns of face, chest, and neck b. Cerebral palsy with severe dysphagia c. Crohn’s disease d. Facial fractures e. Gluten enteropathy f. Stroke Chapter 18: Adrenergic Agonists and Adrenergic Blockers 1. The nurse is caring for a patient who has asthma and administers a selective beta2-adrenergic agonist to treat bronchospasm. The nurse will expect this drug to also cause which side effect? a. Increased blood glucose b. Increased blood pressure c. Increased heart rate d. Increased gastrointestinal (GI) motility 2. A patient who has asthma is diagnosed with hypertension. The nurse understands that which drug will be safe to give this patient? a. Pindolol (Visken) b. Metoprolol (Lopressor) c. Nadolol (Corgard) d. Propranolol (Inderal) 3. The nurse administers subcutaneous epinephrine to a patient who is experiencing an anaphylactic reaction. The nurse should expect to monitor the patient for which symptom? a. Bradycardia b. Decreased urine output c. Hypotension d. Nausea and vomiting 4. An adult patient is brought to the emergency department for treatment of an asthma exacerbation. The patient uses inhaled albuterol as needed to control wheezing. The nurse notes expiratory wheezing, tremors, restlessness, and a heart rate of 120 beats per minute. The nurse suspects that the patient has a. over-used the albuterol. b. not been using albuterol. c. taken a beta-adrenergic blocker. d. taken a monoamine oxidase (MAO) inhibitor. 5. The nurse is caring for a patient who is receiving intravenous dopamine (Intropin). The nurse notes erythema and swelling at the IV insertion site. What is the nurse’s initial action? a. Apply warm soaks to the area. b. Monitor the patient closely for hypertension. c. Obtain an order for an electrocardiogram. d. Notify the provider of a need for phentolamine mesylate (Regitine). 6. The nurse is teaching a patient how to use phenylephrine HCl (Neo-Synephrine) nasal spray to treat congestion from a viral upper respiratory infection. What instruction will the nurse give the patient? a. Stop using the medication after 3 days. b. Spray the medication into the nose while lying supine. c. Use frequently since systemic side effects do not occur. d. Use the medication with any other over-the-counter medications. 7. The nurse is caring for a patient who will begin taking atenolol (Tenormin). What information will the nurse include when teaching the patient about taking this medication? a. The drug must be taken twice daily. b. The patient must rise slowly from a chair or bed. c. The medication is safe to take during pregnancy. d. Use NSAIDs as needed for mild to moderate pain. 8. The nurse is caring for a patient who has recently begun taking atenolol (Tenormin) to treat hypertension. The patient reports dizziness, nausea, vomiting, and decreased libido since beginning the medication. What will the nurse do? a. Hold the next dose until the provider can be notified of these side effects. b. Reassure the patient that these symptoms are common and not worrisome. c. Recommend that the patient discuss these effects with the provider. d. Suggest that the patient request a different beta-adrenergic blocker. 9. A patient will begin taking albuterol (Proventil) to treat asthma. When teaching the patient about this drug, the nurse will make which recommendation? a. Report rapid or irregular heart rate. b. Drink 8 to 16 extra ounces of fluid each day. c. Monitor serum glucose daily. d. Take a calcium supplement. 10. A patient is taking doxazosin mesylate (Cardura) 1 mg per day to treat hypertension. The nurse notes a blood pressure of 110/72 mm Hg and a heart rate of 92 beats per minute. The nurse will contact the provider to discuss which change to the drug regimen? a. Changing to a beta-adrenergic blocker b. Decreasing the drug dose c. Increasing the drug dose d. Adding a diuretic 11. A patient who has Raynaud’s disease will begin taking an alpha-adrenergic blocker. The patient asks the nurse how the drug works to treat symptoms. The nurse explains that alpha-adrenergic blockers treat Raynaud’s disease by causing a. decreased peripheral vascular resistance. b. orthostatic hypotension. c. reflex tachycardia. d. vasodilation. 12. A nurse is teaching a patient how to use phenylephrine (Neo-Synephrine) nasal spray. To avoid systemic absorption, the nurse teaches the patient to perform which action? a. Apply pressure to the nose after spraying. b. Administer the spray while in the supine position. c. Insert the spray while sitting up. d. Exhale deeply while injecting the nasal spray. 13. A patient will be discharged on beta blockers. Which skill is essential for the nurse to teach the patient’s family? a. How to prepare a low-sodium diet b. Assessments to detect fluid retention c. How to monitor heart rate and blood pressure d. Early signs of changing level of consciousness 14. The nurse is caring for a patient whose provider has just ordered a switch from atenolol (Tenormin) to reserpine. When preparing the patient to take this medication, what will the nurse do? a. Ask about herbal supplements. b. Counsel that NSAIDs are safe to take with reserpine. c. Teach about potential side effects of mood elevation and euphoria. d. Tell the patient to expect immediate therapeutic effects. 15. The patient has been started on a treatment regimen that includes atenolol (Tenormin) and complains to the nurse of feeling weak. Which is the best response from the nurse? a. “I will hold your next dose of the medication.” b. “You may need an increase in your next dose of the medication.” c. “This is an adverse reaction to the medication. I will stop the drug.” d. “This is a side effect of the medication. I will notify your physician.” 16. The nurse is performing an admission assessment on a patient who has recently begun taking reserpine. The patient reports using St. John’s wort. The nurse anticipates that the patient will have a. hypotension. b. hypertension. c. bradycardia. d. tachycardia. 17. The patient has been ordered to receive Sudafed to treat nasal congestion. The nurse performing an admission assessment learns that the patient has diabetes mellitus. What action is appropriate for the nurse to take? a. Administer the medication as ordered. b. Contact the provider to discuss a lower dose. c. Give the medication and monitor serum glucose closely. d. Hold the medication and contact the provider. MULTIPLE RESPONSE 1. The nurse caring for a patient who is taking an adrenergic agent will expect which side effects? (Select all that apply.) a. Dilated pupils b. Increased heart rate c. Increase gastrointestinal motility d. Vasodilation e. Bronchospasm f. Relaxed uterine muscles Chapter 19: Cholinergic Agonists and Anticholinergics MULTIPLE CHOICE 1. The nurse is preparing to administer a drug and learns that it is an indirect-acting cholinergic agonist. The nurse understands that this drug a. acts on muscarinic receptors. b. acts on nicotinic receptors. c. inhibits cholinesterase. d. inhibits cholinergic receptors. 2. A nursing student asks why a direct-acting cholinergic agonist drug that is selective to muscarinic receptors is described as being non-specific. The nurse will explain that this is because a. muscarinic receptors are present in many different tissues. b. the action of cholinesterase alters the bioavailability at different sites. c. these drugs can also affect nicotinic receptors. d. they vary in their reversible and irreversible effects. 3. The nurse is preparing to administer bethanechol (Urecholine) to a patient who is experiencing urinary retention. The nurse notes that the patient has a blood pressure of 90/60 mm Hg and a heart rate of 98 beats per minute. The nurse will perform which action? a. Administer the drug and monitor urine output. b. Administer the medication and monitor vital signs frequently. c. Give the medication and notify the provider of the increased heart rate. d. Hold the medication and notify the provider of the decreased blood pressure. 4. The nurse administers bethanechol (Urecholine) to a patient to treat urinary retention. After 30 minutes, the patient voids 800 mL of urine and reports having a loose stool but no cramping or gastrointestinal pain. The patient’s blood pressure is 110/70 mm Hg. The nurse will perform which action? a. Notify the provider of bethanechol adverse effects. b. Record the urine output and the blood pressure and continue to monitor. c. Request an order for intravenous atropine sulfate. d. Suggest another dose of bethanechol to the provider. 5. The nurse is teaching a patient who will begin taking bethanechol (Urecholine). Which statement by the patient indicates a need for further teaching? a. “Excessive sweating is a normal reaction to this medication.” b. “Excess salivation is a serious side effect.” c. “I should get out of bed slowly while taking this drug.” d. “I will not take the drug if my heart rate is less than 60 beats per minute.” 6. The nurse is caring for a male patient with myasthenia gravis who will begin taking ambenonium chloride (Mytelase). When performing a health history, the nurse will be concerned about a history of which condition in this patient? a. Benign prostatic hypertrophy b. Chronic constipation c. Erectile dysfunction d. Upper respiratory infection 7. The nurse is preparing to administer the anticholinergic medication benztropine (Cogentin) to a patient who has Parkinson’s disease. The nurse understands that this drug is used primarily for which purpose? a. To decrease drooling and excessive salivation b. To improve mobility and muscle strength c. To prevent urinary retention d. To suppress tremors and muscle rigidity 8. The nurse is caring for a postoperative patient and notes that the patient received atropine sulfate preoperatively. Which assessment finding would prompt the nurse to notify the provider? a. Absent bowel sounds b. Drowsiness c. Dry mouth d. Heart rate of 78 beats per minute 9. A patient who has irritable bowel syndrome would most likely receive which type of drug to treat this condition? a. An anticholinergic b. A cholinergic esterase inhibitor c. A muscarinic agent d. A nicotinic agent 10. The nurse is teaching a patient about the use of an anticholinergic medication. What information will the nurse include when teaching this patient about this medication? a. “Check your heart rate frequently to monitor for bradycardia.” b. “Drink extra fluids while you are taking this medication.” c. “Rise from a chair slowly to avoid dizziness when taking this drug.” d. “Use gum or lozenges to decrease dry mouth caused by this drug.” 11. Which cholinesterase inhibitor would be prescribed for a patient who has Alzheimer’s disease? a. Ambenonium chloride (Myletase) b. Benztropine (Cogentin) c. Donepezil HCl (Aricept) d. Neostigmine methylsulfate (Prostigmin) 12. The nurse is teaching a patient who is going on a cruise about the use of transdermal scopolamine . What information will the nurse include when teaching this patient? a. “Apply the patch as needed for nausea and vomiting.” b. “Apply the patch to your upper arm.” c. “Change the patch every 3 days.” d. “Restrict fluids while using this patch.” 13. The nurse is preparing to administer benztropine (Cogentin) to a patient who has Parkinson’s disease. When performing an assessment, which aspect of the patient’s history would cause the nurse to hold the medication and notify the provider? a. Asthma b. Glaucoma c. Irritable bowel syndrome d. Motion sickness 14. The nurse is caring for a patient in the post-anesthesia recovery unit. The nurse notes that the patient received atropine sulfate 2 mg 30 minutes prior to anesthesia induction. The patient has received 1,000 mL of intravenous fluids and has 700 mL of urine in the urinary catheter bag. The patient reports having a dry mouth. The nurse notes a heart rate of 82 beats per minute. What action will the nurse perform? a. Administer a fluid bolus. b. Give the patient ice chips. c. Palpate the patient’s bladder. d. Reassess the patient in 15 minutes. 15. A patient who has Parkinson’s disease will begin treatment with benztropine (Cogentin). Which symptom of Parkinson’s disease would be a contraindication for this drug? a. Drooling b. Muscle rigidity c. Muscle weakness d. Tardive dyskinesia 16. A patient who is intubated develops bradycardia because of vagal stimulation. Which medication will the nurse anticipate administering to treat this symptom? a. Atropine sulfate (Atropine) b. Benztropine (Cogentin) c. Bethanechol chloride (Urecholine) d. Metoclopramide (Reglan) 17. The nurse is preparing to administer tolterodine tartrate (Detrol LA) to a patient who has incontinence. Which symptom would be a contraindication for this drug? a. Decreased bowel sounds b. Drooling c. Gastric upset d. Pain MULTIPLE RESPONSE 1. Cholinergic drugs have specific effects on the body. What are the actions of cholinergic medications? (Select all that apply.) a. Dilate pupils b. Decrease heart rate c. Stimulate gastric muscle d. Dilate blood vessels e. Dilate bronchioles f. Increase salivation g. Constrict pupils Chapter 20: Central Nervous System Stimulants 1. The nurse is performing a medication history on a patient who reports using phentermine HCl (Suprenza) 15 mg/day for the past 3 months as an appetite suppressant. The nurse will contact the patient’s provider to discuss a. changing the medication to phentermine-topiramate (Qsymia). b. increasing the dose to 37.5 mg/day since tolerance has likely occurred. c. initiating a slow taper of the phentermine. d. stopping the drug immediately since long-term use is not recommended. 2. A patient reports having recurring headaches described as 1 to 2 headaches per day for several weeks. The nurse understands that these headaches are most likely descriptive of which type of headache? a. Cluster headache b. Migraine headache c. Simple headache d. Tension headache 3. The nurse is caring for a patient who has migraine headaches. The patient reports having these headaches more frequently. Which is an appropriate recommendation for this patient? a. “Avoid chocolate and caffeine.” b. “Engage in strenuous exercise.” c. “Have a glass of red wine with dinner.” d. “Take ibuprofen prophylactically.” 4. The nurse is caring for a 7-year-old child who has difficulty concentrating and completing tasks and who cannot seem to sit still. Which diagnostic test may be ordered to assist with a diagnosis of attention deficit/hyperactivity disorder (ADHD) in this child? a. Computerized tomography (CT) of the head b. Electrocardiogram (ECG) c. Electroencephalogram (EEG) d. Magnetic resonance imaging (MRI) of the brain 5. A patient has been using an amphetamine drug as an anorexiant for several weeks and asks the nurse about long-term adverse effects of this type of medication. The nurse will explain to the patient that these drugs a. can cause cardiac dysrhythmias. b. contribute to the development of narcolepsy. c. do not have severe effects when used properly. d. will cause orthostatic hypotension. 6. The nurse is teaching a child and a parent about taking methylphenidate (Ritalin) to treat attention deficit/hyperactivity disorder (ADHD). Which statement by the parent indicates understanding of the teaching? a. “I should give this drug to my child at bedtime.” b. “My child should avoid products containing caffeine.” c. “The drug should be stopped immediately if my child develops aggression.” d. “We should monitor my child’s weight since weight gain is common.” 7. The parent of a child who is taking amphetamine (Adderall) to treat attention deficit/hyperactivity disorder (ADHD) asks the provider to recommend an over-the-counter medication to treat a cold. What will the nurse tell the parent? a. “Avoid any products containing pseudoephedrine or caffeine.” b. “Never give over-the-counter medications with Adderall.” c. “Sudafed is a safe and effective decongestant.” d. “Use any over-the-counter medication from the local pharmacy.” 8. The nurse is checking an 8-year-old child who has attention deficit/hyperactivity disorder (ADHD) into a clinic for an annual well-child visit. The child takes methylphenidate HCl (Ritalin). Which assessments are especially important for this child? a. Heart rate, respiratory rate, and oxygen saturation b. Height, weight, and blood pressure c. Measures of fine- and gross-motor development d. Nausea, vomiting, and gastrointestinal upset 9. The parent of an adolescent who has taken methylphenidate 20 mg/day for 6 months for attention deficit/hyperactivity disorder (ADHD) brings the child to clinic for evaluation of a recent onset of nausea, vomiting, and headaches. The parent expresses concern that the child seems less focused and more hyperactive than before. What will the nurse do next? a. Ask the child whether the drug is being taken as prescribed. b. Contact the provider to discuss increasing the dose to 30 mg/day. c. Recommend taking the drug with meals to reduce gastrointestinal side effects. d. Report signs of drug toxicity to the patient’s provider. 10. The nurse is teaching a parent about methylphenidate (Ritalin) to treat attention deficit/hyperactivity disorder (ADHD). Which statement by the parent indicates understanding of the teaching? a. “I should consult a pharmacist when giving my child OTC medications.” b. “I will only give my child diet soft drinks while administering this medication.” c. “Medication therapy means that behavioral therapy will not be necessary.” d. “Weight gain is a common side effect of this medication.” 11. The parent of an obese 10-year-old child asks the nurse about medications to aid in weight loss. Which response by the nurse is correct? a. “Anorexiants are often used to ‘jump start’ a weight loss regimen in children.” b. “Children are able to use over-the-counter anorexiants on a long-term basis.” c. “Children under 12 years of age should not use weight loss drugs.” d. “Side effects of anorexiants occur less often in children.” 12. The nurse is working in a neonatal intensive care unit and is caring for an infant who is experiencing multiple periods of apnea and bradycardia. Which drug will the nurse expect to administer? a. Albuterol (Proventil) b. Caffeine (Cafcit) c. Doxapram (Dopram) d. Methylphenidate (Ritalin) 13. A college-age student is brought to the emergency department by friends after consuming NoDoz tablets along with several cups of coffee and a few energy drinks. The patient is complaining of nausea and diarrhea and appears restless. The nurse understands that a. arrhythmias and convulsions may occur. b. caffeine dependence does not occur. c. effects of the substances will wear off shortly. d. severe adverse effects do not occur. 14. A patient is brought to the emergency department with a drug overdose causing respiratory depression. Which drug will the nurse expect to administer? a. Albuterol (Proventil) b. Caffeine (Cafcit) c. Doxapram (Dopram) d. Methylphenidate (Ritalin) 15. A patient reports difficulty staying awake during the daytime in spite of getting adequate sleep every night. Which medication will the nurse expect the provider to order for this patient? a. Caffeine (NoDoz) b. Methylphenidate (Ritalin) c. Modafinil (Provigil) d. Theophylline Chapter 21: Central Nervous System Depressants 1. A patient describes having vivid dreams to the nurse. The nurse understands that these occur during which stage of sleep? a. Rapid eye movement (REM) sleep b. Stage 2 nonrapid eye movement sleep c. Stage 3 nonrapid eye movement sleep d. Stage 4 nonrapid eye movement sleep 2. Children who experience nightmares have these during which stage of sleep? a. Early morning sleep b. Nonrapid eye movement sleep c. Rapid eye movement sleep d. Sleep induction 3. A patient reports difficulty falling asleep most nights and is constantly fatigued. The patient does not want to take medications to help with sleep. What nonpharmacologic measure will the nurse recommend? a. “Exercise in the evening to promote bedtime fatigue.” b. “Get out of bed at the same time each morning.” c. “Have a glass of wine at bedtime to help you relax.” d. “Take daytime naps to minimize daytime fatigue.” 4. The nurse is caring for a patient who reports being able to fall asleep but has difficulty staying asleep. The nurse will contact the provider to obtain an order for which medication? a. Butabarbital (Butisol) b. Flurazepam (Dalmane) c. Secobarbital (Seconal) d. Temazepam (Restoril) 5. The nurse is teaching a patient who will begin taking butabarbital (Butisol). What information will the nurse include when teaching this patient? a. “Avoid alcohol while taking this drug.” b. “This drug may be used long-term.” c. “This medication will take effect immediately.” d. “You will not experience a hangover effect.” 6. The nurse is caring for a young adult patient who is receiving a first dose of flurazepam (Dalmane) as a sedative-hypnotic medication. What intervention will be included in the nurse’s plan of care for this patient? a. Instituting a bed alarm system to prevent falls b. Reassuring the patient that nightmares are not a usual effect c. Reporting a urine output greater than 1500 mL/day d. Teaching the patient that this drug may be used for 6 to 8 weeks 7. An older adult has difficulty falling asleep. The nurse understands that which sedative hypnotic is appropriate for this patient? a. Butabarbital (Butisol) b. Flurazepam (Dalmane) c. Secobarbital (Seconal) d. Temazepam (Restoril) 8. A patient asks the nurse about taking over-the-counter sleeping aids. The nurse will tell the patient that the active ingredient in these products is often a(n) a. antiemetic. b. antihistamine. c. barbiturate. d. benzodiazepine. 9. An older adult patient reports frequent nighttime awakening because of arthritis pain and asks the nurse about taking an over-the-counter product to help with this problem. The nurse will recommend that the patient discuss which medication with the provider? a. Ibuprofen (Motrin) b. Nytol c. Sominex d. Tylenol PM 10. A patient who has been taking butabarbital (Butisol) for several weeks reports being drowsy and having difficulty performing tasks at work most mornings. The nurse suspects that which drug effects have occurred? a. Dependence b. Hangover c. Tolerance d. Withdrawal 11. The nurse is providing teaching for a patient who will begin taking zolpidem tartrate (Ambien) 10 mg at bedtime as a sleep aid. Which statement by the patient indicates understanding of the teaching? a. “I should take this medication with food to avoid stomach upset.” b. “I will take this medication within 30 minutes of bedtime.” c. “If this medication is not effective, I may increase the dose to 15 mg.” d. “Tolerance and drug dependence do not occur with this medication.” 12. A patient who has been taking a benzodiazepine as a sleep aid for several months wishes to stop taking the medication. The nurse will suggest that the patient taper the dose gradually to avoid which effect? a. Depression b. Hangover c. Hypnotic rebound d. Withdrawal 13. The nurse is preparing a patient for surgery. The patient received a hypnotic medication the night prior and the nurse is administering midazolam (Versed) and atropine. The patient asks why all of these medications are necessary. The nurse will tell the patient that they are given for which reason? a. To decrease the amount of general anesthesia needed b. To minimize post-operative drowsiness c. To prolong the anesthetized state d. To speed up anesthesia induction 14. During balanced anesthesia, which type of medication is given while the surgery is performed? a. Anticholinergics b. Benzodiazepines c. Hypnotics d. Inhaled anesthetic 15. The nurse performs a preoperative assessment on a patient and asks about alcohol use. The patient asks why this information is important. The nurse will explain that patients who consume increased amounts of alcohol a. may have a prolonged postoperative recovery time. b. may not be eligible for surgery. c. may not receive inhaled gases for anesthesia. d. may require changes in anesthesia drug doses. 16. The nurse is caring for a patient in the post-anesthesia care unit and notes that the patient received isoflurane (Forane) to induce anesthesia. When will the nurse expect the patient to recover consciousness? a. Immediately b. In 15 to 30 minutes c. In 1 hour d. In hours 17. The nurse is caring for a patient in the post-anesthesia care unit who has received a spinal anesthetic. Which action will the nurse perform? a. Ambulate the patient as soon as consciousness returns. b. Elevate the head of the bed to a semi-Fowler’s position. c. Have the patient lay flat for 6 to 8 hours after the surgery. d. Turn the patient from side to side every 15 minutes.. Chapter 23: Drugs for Neurological Disorders: Parkinsonism and Alzheimer’s Disease 1. An older patient exhibits a shuffling gait, lack of facial expression, and tremors at rest. The nurse will expect the provider to order which medication for this patient? a. Carbidopa-levodopa (Sinemet) b. Donepezil (Aricept) c. Rivastigmine (Exelon) d. Tacrine (Cognex) 2. A nursing student asks the nurse to differentiate the pathology of Alzheimer’s disease from that of Parkinson’s disease. Which description is correct? a. Alzheimer’s disease involves a possible excess of acetylcholine and neuritic plaques. b. Alzheimer’s disease is caused by decreased amounts of dopamine and degeneration of cholinergic neurons. c. Parkinson’s disease is characterized by an imbalance of dopamine and acetylcholine. d. Parkinson’s disease involves increased dopamine production and decreased acetylcholine. 3. The spouse of a patient newly diagnosed with mild, unilateral symptoms of Parkinson’s disease (PD) asks the nurse what, besides medication, can be done to manage the disease. The nurse will a. counsel the spouse that parkinsonism is a normal part of the aging process in some people. b. recommend exercise, nutritional counseling, and group support to help manage the disease. c. tell the spouse that the disease will not progress if mild symptoms are treated early. d. tell the spouse that medication therapy can be curative if drugs are begun in time. 4. A patient who has Parkinson’s disease is being treated with the anticholinergic medication benztropine (Cogentin). The nurse will tell the patient that this drug will have which effect? a. Helping the patient to walk faster b. Improving mental function c. Minimizing symptoms of bradykinesia d. Reducing some of the tremors 5. The nurse is preparing to administer a first dose of benztropine (Cogentin) to a patient diagnosed with parkinsonism. The nurse would notify the patient’s provider if the patient had a history of which condition? a. Asthma b. Glaucoma c. Hypertension d. Irritable bowel disease 6. The nurse is caring for a patient who is receiving trihexyphenidyl (Artane) to treat parkinsonism. The patient reports having a dry mouth, and the nurse notes a urine output of 300 mL in the past 8 hours. Which action will the nurse perform? a. Encourage increased oral fluids. b. Obtain an order for intravenous fluids. c. Report the urine output to the provider. d. Request an order for renal function tests. 7. A nursing student asks the nurse why patients who have parkinsonism receive a combination of carbidopa and levodopa. The nurse will explain that the combination product a. allows larger doses of levodopa to be given without causing increased adverse reactions. b. causes more levodopa to be converted to dopamine before crossing the blood-brain barrier. c. eliminates almost all drug side effects of both levodopa and carbidopa. d. reduces peripheral side effects by inhibiting decarboxylase in the peripheral nervous system. 8. Which antiviral medication improves symptoms of Parkinson’s disease in some patients? a. Acyclovir (Zovirax) b. Amantadine HCl (Symmetrel) c. Interferon (INF) d. Zanamivir (Relenza) 9. A patient who has parkinsonism has been taking carbidopa-levodopa and has shown improvement in symptoms but develops dystonic movements, nausea, and vomiting. Which medication will the nurse expect the provider to order for this patient to replace carbidopa-levodopa? a. Amantadine HCl (Symmetrel) b. Benztropine (Cogentin) c. Bromocriptine mesylate (Parlodel) d. Tacrine (Cognex) 10. A patient who has parkinsonism will begin taking selegiline HCl (Eldepryl) to treat symptoms. What information will the nurse include when teaching this patient about this drug? a. “Avoid consuming foods that are high in tyramine.” b. “This drug will prevent the need to take levodopa.” c. “You may have red wine with dinner on occasion.” d. “You will not have serious drug interactions with this drug.” 11. A patient who has parkinsonism will begin taking carbidopa-levodopa. What information will the nurse include when teaching this patient about this medication? a. “Call your health care provider immediately if your urine or perspiration turn a dark color.” b. “Rise slowly from your bed or your chair to avoid dizziness and falls.” c. “Take the drug with foods high in protein to improve drug delivery.” d. “Discontinue the drug if you experience insomnia.” 12. The nurse is teaching a patient who has Parkinson’s disease about the side effects of carbidopa-levodopa. Which statement by the patient indicates a need for further teaching? a. “I may experience urinary retention, dry mouth, and constipation.” b. “I may feel dizzy at first, but this side effect will go away with time.” c. “I should report nightmares and mental disturbances to my provider.” d. “I should take the drug with food to increase absorption.” 13. A patient is taking entacapone (Comtan) along with carbidopa-levodopa to treat parkinsonism. The nurse notes that the patient’s urine is orange in color. The nurse will a. notify the provider of possible drug toxicity. b. reassure the patent that this is a harmless side effect. c. request an order for liver function tests. d. request an order for a urinalysis. 14. The nurse is caring for an 80-year-old patient who has Alzheimer’s disease who will begin taking rivastigmine (Exelon). What will the nurse include in the plan of care for this patient? a. Administer the drug once daily. b. Assist the patient to stand and walk. c. Give the drug with food to increase absorption. d. Use nonsteroidal anti-inflammatory drugs (NSAIDs) instead of acetaminophen for pain. 15. The nurse is providing teaching for the family of a patient who has been newly diagnosed with Alzheimer’s disease (AD). Which statement by the family member indicates understanding of the teaching? a. “Alzheimer’s disease is a chronic, progressive condition.” b. “Alzheimer’s disease affects memory but not personality.” c. “The onset of Alzheimer’s disease is usually between 65 and 75 years.” d. “With proper treatment, symptoms of this disease can be arrested.” 16. The nurse is teaching a family member about an elderly parent’s new prescription for tacrine (Cognex) to treat Alzheimer’s disease (AD). The family member asks what to expect from this drug. The nurse will respond that the patient will a. demonstrate improved ambulation. b. have reversal of all symptoms. c. have decreased deterioration of cognition. d. show improved communication ability. 17. The nurse is helping to develop a plan of care for a patient who has advanced Alzheimer’s disease. The patient will be taking a new medication. Which is a realistic goal for this patient? a. Demonstrate improved cognitive function. b. Exhibit improved ability to provide self-care. c. Receive appropriate assistance for care needs. d. Show improved memory for recent events.