For best results when treating severe pain associated with pathologic spinal fractures related to metastatic bone cancer, the nurse should remember that the best type of dosage schedule is to administer the pain medication
a) as needed.
b) around the cloc
d) around the clock, with additional doses as needed for breakthrough pain.
A patient is receiving an opioid via a PCA pump as part of his postoperative pain management program. During rounds, the nurse finds him unresponsive, with respirations of 8 breaths/min and blood pressure of 102/58 mm Hg. After stopping the opioid infusio
c) Administer an opiate antagonist per standing orders
A patient with bone pain caused by metastatic cancer will be receiving transdermal fentanyl patches. The patient asks the nurse what benefits these patches have. The nurse's best response includes which of the following features?
a) More analgesia for lon
c) Less drowsiness than with oral opioids
The nurse suspects that a patient is showing signs of respiratory depression. Which drug could be the cause of this complication?
a) naloxone (Narcan)
b) hydromorphone (Dilaudid)
c) acetaminophen (Tylenol)
d) ziconotide (Prialt)
b) hydromorphone (Dilaudid)
Several patients have standard orders for acetaminophen as needed for pain. When the nurse reviews their histories and assessments, the nurse discovers that one of the patients has a contraindication to acetaminophen therapy. Which patient is the one who
c) A patient admitted with severe hepatitis
The nurse is administering an intravenous dose of morphine sulfate to a 48-year-old postoperative patient. The dose ordered is 3 mg every 3 hours as needed for pain. The medication is supplied in vials of 4 mg/mL. How much will be drawn into the syringe f
0.75 mL
A patient has been admitted to the emergency department because of an overdose of an oral benzodiazepine. He is very drowsy but still responsive. The nurse should prepare for which immediate intervention?
a) Hemodialysis to remove the medication
b) Admini
b) Administration of flumazenil
An older adult has been given a benzodiazepine for sleep induction, but the night nurse noted that the patient was awake most of the night, watching television and reading in bed. This type of reaction is known as
a) an allergic reaction.
b) a teratogenic
c) a paradoxical reaction.
The nurse is preparing to administer a medication for sleep. Which intervention applies to the administration of a nonbenzodiazepine, such as zolpidem?
a) These drugs need to be taken about 1 hour before bedtime.
b) Because of their rapid onset, they shou
b) Because of their rapid onset, they should be taken just before bedtime.
The nurse should monitor the patient who is taking a muscle relaxant for which adverse effect?
a) CNS depression
b) Hypertension
c) Peripheral edema
d) Blurred vision
a) CNS depression
A patient on a cardiac medical-surgical unit is complaining of having difficulty sleeping. Which action should the nurse take first to address this problem?
a) Administer a sedative-hypnotic drug if ordered
b) Offer tea made with the herbal preparation va
d) Provide an environment that is restful and reduce loud noises
Which considerations are important for the nurse to remember when administering a benzodiazepine as a sedative-hypnotic drug? (Select all that apply.)
a) These drugs are intended for long-term management of insomnia.
b) The drugs can be administered safel
c) The dose should be given about an hour before the patient's bedtime.
e) The patient should be evaluated for the drowsiness that may occur the morning after a benzodiazepine is taken.
A patient with narcolepsy will begin treatment with a CNS stimulant. The nurse expects to see which adverse effect?
a) Bradycardia
b) Nervousness
c) Mental clouding
d) Drowsiness at night
b) Nervousness
2) A patient at a weight management clinic who was given a prescription for orlistat (Xenical) calls the clinic hotline complaining of a "terrible side effect." The nurse suspects that the patient is referring to
a) nausea.
b) sexual dysfunction.
c) urina
d) fecal incontinence.
3) The nurse is developing a plan of care for a patient receiving an anorexiant. Which nursing diagnosis is most appropriate?
a) Deficient fluid volume
b) Sleep deprivation
c) Impaired memory
d) Imbalanced nutrition, more than body requirements
d) Imbalanced nutrition, more than body requirements
4) A patient has a new prescription for sumatriptan (Imitrex). The nurse providing patient teaching on self-administration will include which information?
a) Correct technique for subcutaneous injections
b) Correct technique for intramuscular injections
c
a) Correct technique for subcutaneous injections
5) The nurse is reviewing the history of a patient who will be starting the triptan sumatriptan (Imitrex) as part of treatment for migraine headaches. Which condition, if present, may be a contraindication to triptan therapy?
a) Cardiovascular disease
b)
a) Cardiovascular disease
6) The nurse is reviewing medication therapy with the parents of an adolescent with ADHD. Which statement is correct? (Select all that apply.)
a) "Be sure to have your child blow his nose before administering the nasal spray."
b) "This medication is used
c) "The last dose should be taken 4 to 6 hours before bedtime to avoid interference with sleep."
d) "Be sure to contact the physician right away if you notice expression of suicidal thoughts."
e) "We will need to check your child's height and weight perio
1) The nurse caring for a patient who is receiving beta1 agonist drug therapy needs to be aware that these drugs cause
a) increased cardiac contractility.
b) decreased heart rate.
c) bronchoconstriction.
d) increased GI tract motility.
a) increased cardiac contractility.
2) During a teaching session for a patient who is receiving inhaled salmeterol, the nurse emphasizes that the drug is indicated for
a) rescue treatment of acute bronchospasms.
b) prevention of bronchospasm.
c) reduction of airway inflammation.
d) long-ter
b) prevention of bronchospasm.
3) For a patient receiving a vasoactive drug such as intravenous dopamine, which action by the nurse is most appropriate?
a) Monitor the gravity drip infusion closely and adjust as needed
b) Assess the patient's cardiac function by checking the radial pul
c) Assess the intravenous site hourly to rule out infiltration
4) A patient is receiving dobutamine for shock and is complaining of feeling more "skipping beats" than yesterday. The nurse's next action should be to:
a) monitor for other signs of a therapeutic response to the drug.
b) titrate the drug to a higher dose
d) assess the patient's vital signs and cardiac rhythm.
5) When a drug is characterized as having a negative chronotropic effect, the nurse knows to expect
a) improved sinoatrial nodal firing.
b) decreased heart rate.
c) decreased ectopic beats.
d) increased force of cardiac contractions.
b) decreased heart rate.
6) The nurse is monitoring a patient who is receiving an infusion of a beta-adrenergic agonist. Which adverse effects may occur with this infusion? (Select all that apply.)
a) Mild tremors
b) Bradycardia
c) Tachycardia
d) Palpitations
e) Drowsiness
f) Ner
a) Mild tremors
c) Tachycardia
d) Palpitations
f) Nervousness
1) Which is the most appropriate nursing action for intravenous (IV) phenytoin (Dilantin)?
a) Give IV doses via rapid IV push
b) Administer in normal saline solutions
c) Administer in dextrose solutions
d) Ensure continuous infusion of the drug
b) Administer in normal saline solutions
The nurse is reviewing the drugs currently taken by a patient who will be starting drug therapy with carbamazepine. Which drug may raise a concern for interactions?
a) Digoxin (Lanoxin)
b) Acetaminophen (Tylenol)
c) Diazepam (Valium)
d) Warfarin (Coumadin
d) Warfarin (Coumadin)
3) Which response would the nurse expect to find in a patient with a phenytoin (Dilantin) level of 35 mcg/mL?
a) Ataxia
b) Hypertension
c) Seizures
d) No unusual response; this level is therapeutic.
a) Ataxia
4) A patient is taking pregabalin (Lyrica) but does not have a history of seizures. The nurse recognizes that this drug is also indicated for
a) postherpetic neuralgia.
b) viral infections.
c) Parkinson's disease.
d) depression.
a) postherpetic neuralgia.
5) The nurse is assessing a newly admitted patient who has a history of seizures. During the assessment, the patient has a generalized seizure that does not stop for several minutes. The nurse expects that which drug will be ordered for this condition?
a)
d) Diazepam (Valium)
6) The nurse is administering an antiepileptic drug and will follow which guidelines? (Select all that apply.)
a) Monitor the patient for drowsiness.
b) Medications may be stopped if seizure activity disappears.
c) Give the medication at the same time eve
a) Monitor the patient for drowsiness.
c) Give the medication at the same time everyday.
e) Notify the prescriber if the patient is unable to take the medication.
Which of the following should alert the nurse to a potential caution or contraindication regarding the use of a dopaminergic drug for treatment of mild Parkinson's disease?
a) Diarrhea
b) Tremors
c) Angle-closure glaucoma
d) Unstable gait
c) Angle-closure glaucoma
A patient is taking entacapone as part of the therapy for Parkinson's disease. Which intervention by the nurse is appropriate at this time?
a) Notify the patient that this drug causes discoloration of the urine.
b) Limit the patient's intake of tyramine-c
a) Notify the patient that this drug causes discoloration of the urine
3) During a patient teaching session about antiparkinsonian drugs, the nurse will include which statement?
a) The drug should be stopped when tremors and weakness are relieved.
b) If a dose is missed, take two doses to avoid significant decreases in blood
d) Change positions slowly to prevent falling due to postural hypotension.
4) A patient will be taking selegiline, 10 mg daily, in addition to dopamine replacement therapy for Parkinson's disease. The nurse will implement which precautions regarding selegiline?
a) Teach the patient to avoid foods containing tyramine.
b) Monitor
d) Monitor for tachycardia and palpitations.
5) A patient with Parkinson's disease will start taking entacapone along with the carbidopa-levodopa therapy he has been taking for a few years. The nurse recognizes that the advantage of taking entacapone is that
a) the entacapone can reduce on-off effec
a) the entacapone can reduce on-off effects.
6) The nurse is assessing a patient who is going to begin therapy with apomorphine for Parkinson's disease. Which condition would be a concern if identified in the patient? (Select all that apply.)
a) Severe cardiovascular disease
b) Inability to swallow
a) Severe cardiovascular disease
e) Allergy to sulfa drugs
In caring for a patient experiencing alcohol withdrawal, the nurse knows that which medication or medication class is most likely to be ordered as treatment for this condition?
a) Lithium (Eskalith)
b) Benzodiazepines
c) Buspirone (BuSpar)
d) Antidepressa
b) Benzodiazepines
Patient teaching for a patient receiving an MAOI would include instructions to the patient to avoid which food product?
a) Grapefruit juice
b) Milk
c) Shrimp
d) Swiss cheese
d) Swiss cheese
After a patient has been treated for depression for 4 weeks, the nurse calls the patient to schedule a follow-up visit. What concern should the nurse know to look for during the conversation with the patient?
a) Weakness
b) Hallucinations
c) Suicidal idea
c) Suicidal ideations
The nurse is caring for a patient who has been taking clozapine (Clozaril) for 2 months. Which laboratory test(s) should be performed regularly while the patient is taking this medication?
a) Platelet count
b) WBC count
c) Liver function studies
d) Renal
b) WBC count
The nurse is giving medications to a patient. Which drug(s), when administered with lithium, increases the risk for lithium toxicity?
a) Thiazides
b) Levofloxacin
c) Calcium citrate
d) Beta-blockers
a) Thiazides
The nurse is teaching a patient about treatment with an SSRI antidepressant. Which teaching considerations are appropriate? (Select all that apply.)
a) The patient should be told which foods contain tyramine and instructed to avoid these foods.
b) The pat
b) The patient should be instructed to use
caution when standing up from a sitting position.
d) This medication should not be stopped abruptly
f) The patient should be told to check with the prescriber before taking any over-the-counter medications.
When a patient has experienced infiltration of a peripheral infusion of dopamine, the nurse knows that injecting the alpha-blocker phentolamine (Regitine) will result in local
a) vasoconstriction.
b) vasodilation.
c) analgesia.
d) hypotension.
b) vasodilation.
When administering beta-blockers, the nurse knows that which guideline for administration and monitoring is correct?
a) The drug may be discontinued at any time.
b) Postural hypotension is not a problem with this drug.
c) Weaning off the medication is nec
c) Weaning off the medication is necessary to prevent rebound hypertension.
The nurse providing teaching for a patient who has a new prescription for beta1-blockers will keep in mind that these drugs may result in which effect?
a) Tachycardia
b) Tachypnea
c) Bradycardia
d) Bradypnea
c) Bradycardia
A patient who has recently had an MI has started therapy with a beta-blocker. The nurse explains that the main purpose of the beta-blocker for this patient is to
a) cause vasodilation of the coronary arteries.
b) prevent hypertension.
c) increase conducti
d) protect the heart from circulating catecholamines.
Before initiating therapy with a nonselective beta-blocker, the nurse should assess the patient for the presence of
a) hypertension.
b) liver disease.
c) pancreatitis.
d) asthma.
d) asthma.
A patient is taking an alpha-blocker as treatment for benign prostatic hypertrophy. The nurse monitors for which potential drug effects? (Select all that apply.)
a) Orthostatic hypotension
b) Increased blood pressure
c) Increased urine flow
d) Headaches
e
a) Orthostatic hypotension
c) Increased urine flow
d) Headaches
A patient is taking the direct-acting cholinergic drug bethanechol (Urecholine) before meals. After 3 days, he calls his health care provider's office and complains of occasional nausea and vomiting. The nurse should give which instruction?
a) "Continue t
d) "Take this medication with meals to reduce GI upset.
The family of a patient who has recently been diagnosed with Alzheimer's disease is asking about the new drug prescribed to treat this disease. The patient's wife says, "I'm so excited that there are drugs that can cure this disease! I can't wait for him
c) "These drugs do not cure Alzheimer's disease. Let's talk about what the physician said to expect with this drug therapy.
The nurse is giving a dose of bethanechol (Urecholine) to a postoperative patient. The nurse is aware that contraindications to bethanechol include:
a) Bladder atony
b) Peptic ulcer
c) Urinary retention
d) Gastric retention
b) Peptic ulcer
A patient took an accidental overdose of a cholinergic drug while at home. He comes to the emergency department with severe abdominal cramping and bloody diarrhea. The nurse expects that which drug will be used to treat this patient?
a) Atropine
b) Physos
a) Atropine
A patient with myasthenia gravis has received a prescription for pyridostigmine (Mestinon). The nurse should include which teaching point for this patient?
a) The drug is taken once in the mornings for maximum effect.
b) The drug should be taken 30 minute
b) The drug should be taken 30 minutes before eating meals.
When giving intravenous cholinergic drugs, the nurse must watch for symptoms of a cholinergic crisis, such as: (Select all that apply.)
a) Peripheral tingling
b) Hypotension
c) Dry mouth
d) Syncope
e) Dyspnea
f) Tinnitus
b) Hypotension
d) Syncope
e) Dyspnea
The nurse is providing education about anticholinergic drug therapy to an elderly patient. An important point to emphasize would be to
a avoid exposure to high temperatures.
b limit liquid intake to avoid fluid overload.
c begin an exercise program to avo
a avoid exposure to high temperatures.
When giving anticholinergic drugs, the nurse keeps in mind that contraindications include:
a Chronic bronchitis
b Peptic ulcer disease
c Irritable bowel syndrome
d Benign prostatic hyperplasia
d Benign prostatic hyperplasia
When assessing for adverse effects of anticholinergic drug therapy, the nurse would expect to find that the patient complains of which drug effect?
a Diaphoresis
b Dry mouth
c Diarrhea
d Urinary frequency
b Dry mouth
The nurse administering a cholinergic-blocking drug to a patient who is experiencing drug-induced extrapyramidal effects would assess for which therapeutic effect?
a Decreased muscle rigidity and tremors
b Increased heart rate
c Decreased bronchial secret
a Decreased muscle rigidity and tremors
5 During the assessment of a patient about to receive a cholinergic-blocking drug, the nurse should determine whether the patient is taking any drugs that may potentially interact with the anticholinergic, including:
a Opioids, such as morphine sulfate
b
c Tricyclic antidepressants, such as amitriptyline
A patient has been given a prescription for transdermal scopolamine patches for motion sickness for use during a vacation cruise. The nurse will include which instructions? (Select all that apply.)
a "Apply the patch as soon as you board the ship."
b "App
b "Apply the patch 3 to 4 hours before boarding the ship."
d "The patch should be placed on a nonhairy area just behind your ear."
e "Change the patch every 3 days."
f "Rotate the application sites.