pharm hesi v1 315 210 questions
and correct answers graded A+
A 20-year-old female patient has been diagnosed with multiple sclerosis.
What drug will most likely be prescribed?
A)Baclofen (Lioresal) B)Cyclobenzaprine (Flexeril) C)Metaxalone (Skelaxin)
D)Orphenadrine (Banflex)
Ans:A
Feedback:
Baclofen is used for treatment of muscle spasticity associated with
neuromuscular diseases such as multiple sclerosis. Cyclobenzaprine,
metaxalone, and orphenadrine are used for relief of discomfort associated
with painful, acute musculoskeletal conditions.
`•
The nurse is caring for four patients. Which patient would have the highest
risk for hepatotoxicity from dantrolene (Dantrium)?
A)An 87-year-old man who is taking a cardiac glycosideh
B)A 32-year-old man who is taking an antipsychotic drug
C)A 65-year-old woman who is on hormone replacement therapy
D)A 48-year-old woman who is taking an antihypertensive agent
Ans:C Feedback:
If dantrolene is combined with estrogen, the incidence of hepatocellular
toxicity is increased. This combination should be avoided. Nothing indicates
that patients taking a cardiac glycoside, an antipsychotic drug, and an
antihypertensive would have serious adverse effects when combined with
dantrolene therapy.
,The nurse alerts the patient to what adverse effect of tizanidine (Zanaflex)
that could cause injury?
A)Constipation B)Dry mouth C)Fatigue D)Hypotension
Ans:D Feedback:
Tizanidine has been associated with hypotension, which could be a safety
risk especially if the patient is also taking an antihypertensive drug.
Constipation, dry mouth, and fatigue are common adverse effects that do not
pose a safety risk.
A young woman attends a "Botox Party" and is injected with botulinum toxin
type A to decrease "frown lines" between her eyebrows. Later that evening
the patient is admitted to the emergency department and is hysterical,
because she cannot move her eyebrows. The nurse explains that that toxin
causes what?
A)"The toxin causes muscle death, which smoothes wrinkles in the area."
B)"The toxin causes muscle paralysis, preventing movement and relieving
wrinkles."
C)"The drug is a toxin to nerves in the area."
D)"The drug is a permanent muscle relaxant and the muscles will never
move again."
Ans:B Feedback:
Botulinum toxin types A and B bind directly to the receptor sites of motor
nerve terminals and inhibit the release of acetylcholine, leading to local
muscle paralysis. These two drugs are injected locally and used to paralyze
or prevent the contractions of specific muscle groups. The action smoothes
wrinkles in the area, but does not cause muscle death. The effect is
temporary and does not cause nerve death. The other options are false
statements.
,A patient has stepped on a rusty nail and is exhibiting signs of muscle rigidity
and contractions. The patient's wife called the
emergency department (ED) and the triage nurse told her to bring him in.
The ED nurse will have which drug available for administration when the
patient arrives?
A)Carisoprodol (Soma) B)Cyclobenzaprine (Flexeril) C)Metaxalone (Skelaxin)
D)Methocarbamol (Robaxin)
Ans:D
Feedback:
The patient is exhibiting signs of tetanus and methocarbamol (Robaxin) is
indicated for treatment. Carisoprodol, cyclobenzaprine, and metaxalone are
not used to treat tetanus.
The nurse assesses a newly admitted patient and finds the muscle tone in
his left leg has sustained muscle contraction. How will the nurse document
this finding?
A)Tonus B)Flaccid C)Atonic D)Spastic
Ans:D Feedback:
Muscle spasticity is defined as a sustained muscle contraction. Soft and
flabby muscle tone is defined as atonic. A limp muscle without tone is
described as flaccid. The state of readiness, known as muscle tone (tonus), is
produced by the maintenance of some of the muscle fibers in a contracted
state.
A patient comes to the clinic to receive a Botox injection in her forehead. The
patient has adult acne across her forehead. What is the nurse's priority
action?
A)Hold the injection and consult the health care provider.
B)Cleanse the area well with an antibacterial soap.
, C)Apply a topical antibiotic after administering the Botox.
D)Provide patient information about post- Botox injection care.
Ans:A Feedback:
Botulinum toxins should not be injected into any area with an active infection
because of the risk of exacerbation of the infection. As a result, the nurse
would hold the injection and consult with the physician, with the expectation
the medication would be held until the acne resolved. Cleansing the area
well, applying a topical antibiotic, and providing information about
postinjection care would not resolve the problem and are not indicated.
`•
The patient presents to the emergency department with muscle spasms in
the back. What types of injury would the nurse recognize can result in
muscle spasm? (Select all that apply.)
A)Overstretching a muscle B)Wrenching a jointC)Tearing a tendon or
ligament D)Breaking a bone E)Exercising too vigorously.
Ans:A, B, C
Feedback:
Muscle spasms often result from injury to the musculoskeletal system (e.g.,
overstretching a muscle, wrenching a joint, tearing a tendon or ligament).
These injuries can cause violent and painful involuntary muscle contractions.
Breaking a bone or exercising would not cause muscle spasms unless one of
the other options was involved.
`•
The nurse is giving discharge instructions to a patient who just had Botox A
injections around her eyes. What adverse effects would
the nurse include in her discharge instructions? (Select all that apply.)
A)Respiratory infections B)Flu-like syndrome C)Droopy eyelids D)Cough
and correct answers graded A+
A 20-year-old female patient has been diagnosed with multiple sclerosis.
What drug will most likely be prescribed?
A)Baclofen (Lioresal) B)Cyclobenzaprine (Flexeril) C)Metaxalone (Skelaxin)
D)Orphenadrine (Banflex)
Ans:A
Feedback:
Baclofen is used for treatment of muscle spasticity associated with
neuromuscular diseases such as multiple sclerosis. Cyclobenzaprine,
metaxalone, and orphenadrine are used for relief of discomfort associated
with painful, acute musculoskeletal conditions.
`•
The nurse is caring for four patients. Which patient would have the highest
risk for hepatotoxicity from dantrolene (Dantrium)?
A)An 87-year-old man who is taking a cardiac glycosideh
B)A 32-year-old man who is taking an antipsychotic drug
C)A 65-year-old woman who is on hormone replacement therapy
D)A 48-year-old woman who is taking an antihypertensive agent
Ans:C Feedback:
If dantrolene is combined with estrogen, the incidence of hepatocellular
toxicity is increased. This combination should be avoided. Nothing indicates
that patients taking a cardiac glycoside, an antipsychotic drug, and an
antihypertensive would have serious adverse effects when combined with
dantrolene therapy.
,The nurse alerts the patient to what adverse effect of tizanidine (Zanaflex)
that could cause injury?
A)Constipation B)Dry mouth C)Fatigue D)Hypotension
Ans:D Feedback:
Tizanidine has been associated with hypotension, which could be a safety
risk especially if the patient is also taking an antihypertensive drug.
Constipation, dry mouth, and fatigue are common adverse effects that do not
pose a safety risk.
A young woman attends a "Botox Party" and is injected with botulinum toxin
type A to decrease "frown lines" between her eyebrows. Later that evening
the patient is admitted to the emergency department and is hysterical,
because she cannot move her eyebrows. The nurse explains that that toxin
causes what?
A)"The toxin causes muscle death, which smoothes wrinkles in the area."
B)"The toxin causes muscle paralysis, preventing movement and relieving
wrinkles."
C)"The drug is a toxin to nerves in the area."
D)"The drug is a permanent muscle relaxant and the muscles will never
move again."
Ans:B Feedback:
Botulinum toxin types A and B bind directly to the receptor sites of motor
nerve terminals and inhibit the release of acetylcholine, leading to local
muscle paralysis. These two drugs are injected locally and used to paralyze
or prevent the contractions of specific muscle groups. The action smoothes
wrinkles in the area, but does not cause muscle death. The effect is
temporary and does not cause nerve death. The other options are false
statements.
,A patient has stepped on a rusty nail and is exhibiting signs of muscle rigidity
and contractions. The patient's wife called the
emergency department (ED) and the triage nurse told her to bring him in.
The ED nurse will have which drug available for administration when the
patient arrives?
A)Carisoprodol (Soma) B)Cyclobenzaprine (Flexeril) C)Metaxalone (Skelaxin)
D)Methocarbamol (Robaxin)
Ans:D
Feedback:
The patient is exhibiting signs of tetanus and methocarbamol (Robaxin) is
indicated for treatment. Carisoprodol, cyclobenzaprine, and metaxalone are
not used to treat tetanus.
The nurse assesses a newly admitted patient and finds the muscle tone in
his left leg has sustained muscle contraction. How will the nurse document
this finding?
A)Tonus B)Flaccid C)Atonic D)Spastic
Ans:D Feedback:
Muscle spasticity is defined as a sustained muscle contraction. Soft and
flabby muscle tone is defined as atonic. A limp muscle without tone is
described as flaccid. The state of readiness, known as muscle tone (tonus), is
produced by the maintenance of some of the muscle fibers in a contracted
state.
A patient comes to the clinic to receive a Botox injection in her forehead. The
patient has adult acne across her forehead. What is the nurse's priority
action?
A)Hold the injection and consult the health care provider.
B)Cleanse the area well with an antibacterial soap.
, C)Apply a topical antibiotic after administering the Botox.
D)Provide patient information about post- Botox injection care.
Ans:A Feedback:
Botulinum toxins should not be injected into any area with an active infection
because of the risk of exacerbation of the infection. As a result, the nurse
would hold the injection and consult with the physician, with the expectation
the medication would be held until the acne resolved. Cleansing the area
well, applying a topical antibiotic, and providing information about
postinjection care would not resolve the problem and are not indicated.
`•
The patient presents to the emergency department with muscle spasms in
the back. What types of injury would the nurse recognize can result in
muscle spasm? (Select all that apply.)
A)Overstretching a muscle B)Wrenching a jointC)Tearing a tendon or
ligament D)Breaking a bone E)Exercising too vigorously.
Ans:A, B, C
Feedback:
Muscle spasms often result from injury to the musculoskeletal system (e.g.,
overstretching a muscle, wrenching a joint, tearing a tendon or ligament).
These injuries can cause violent and painful involuntary muscle contractions.
Breaking a bone or exercising would not cause muscle spasms unless one of
the other options was involved.
`•
The nurse is giving discharge instructions to a patient who just had Botox A
injections around her eyes. What adverse effects would
the nurse include in her discharge instructions? (Select all that apply.)
A)Respiratory infections B)Flu-like syndrome C)Droopy eyelids D)Cough
