Transcript Select all that apply

Final Review Part 1&2
http://www.rwpoll.com
Dopamine is a neurotransmitter that is able to
cross the blood brain barrier.
1. True
2. False
0%
Fa
lse
Tr
ue
0%
The relationship between dosage and plasma drug level
of Phenytoin (Dilantin) is unique; small increases in
dosage produce sharp decreases in plasma drug levels.
1. True
2. False
0%
Fa
lse
Tr
ue
0%
Adding Carbidopa to Levodopa (Sinemet) inhibits
the peripheral breakdown of levodopa thereby
making more levodopa available for the CNS.
A. True
B. False
0%
Fa
lse
Tr
ue
0%
Donepezil (Aricept) inhibits acetylcholinesterase
A. True
B. False
0%
Fa
lse
Tr
ue
0%
Carbidopa/Levodopa modulates the effect of
glutamate
A. True
B. False
0%
Fa
lse
Tr
ue
0%
All of the following are true regarding
antiepileptic drug(AED) therapy except for:
A. With regard to therapeutic outcomes,
traditional AEDs are more effective than the
newer AEDs.
B. It will be important to monitor plasma drug
levels of medication with some drugs.
C. When treating epilepsy, the drug prescribed
will be matched to the type of seizure.
D. Newer AEDs are likely to result in fewer drug
interactions than the traditional AEDs.
re
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th
e
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ile
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tr
ea
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rd
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.
on
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rp
...
0% 0% 0% 0%
AEDs work through all of the following
mechanisms except for:
A. Bind to sodium channels in the cell membrane
to prolong channel inactivation
B. Inhibit influx of calcium ions in the cell
membrane
C. Inhibiting GABA release
D. Decrease neuronal excitability and thereby
suppress seizure activity
.
a.
ex
cit
ab
ili
ty
re
le
as
e
AB
A
ne
ur
on
al
ng
G
De
cr
ea
se
In
hi
bi
ti
ciu
m
in
flu
xo
fc
al
In
hi
bi
t
Bi
nd
to
so
di
um
ch
an
ne
ls
in
io
ns
i
n
th
e
c.
t ..
..
0% 0% 0% 0%
A 47-year-old patient has been taking phenytoin (Dilantin) for
years without significant adverse effects or seizures. Serum
levels usually are 12 to 16 mcg/mL. The patient is admitted with
sudden onset of multiple seizures. Serum phenytoin levels now
are 7 mcg/mL. What question is of highest priority for the nurse
to ask?
..
ed
in
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ea
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ed
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y
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ou
ra
sh
ch
an
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an
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in
...
0% 0% 0%
a
no
t ic
ed
ou
ou
ch
an
ge
d
fr o
m
br
a.
.
A. A. “Have you changed from brand name to
generic phenytoin?”
B. B. “Have you noticed a rash anywhere on your
body?”
C. C. “Have you had any change in or addition of any
other medications?”
0%
D. D. “Have you noticed increased or decreased
appetite?”
A patient who has begun taking levodopa/carbidopa
(Sinemet) reports feeling lightheaded and dizzy,
especially when standing up from a sitting position.
What will the nurse recommend?
A. A. An alpha-adrenergic antagonist
medication
B. B. Discussing amantadine with the
prescriber
C. C. Increasing the salt and water intake
D. D. Taking a drug holiday
E.
ad
re
ne
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ic
an
ta
am
go
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ta
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ith
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sa
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an
d
w
Ta
at
er
ki
ng
...
a
dr
ug
ho
lid
ay
0% 0% 0% 0% 0%
A 5-year-old patient who weighs 35 lb is newly
prescribed phenytoin 20 mg every 12 hours. The
suggested initial dose is 2.5 mg/kg/day in divided doses.
Is this a safe and effective dose for this child?
A. True
B. False
0%
Fa
lse
Tr
ue
0%
The nurse is caring for a group of patients diagnosed
with Alzheimer’s disease (AD). Which neurotransmitter
level is decreased by as much as 90% in patients with
severe AD?
Norepinephrine
Serotonin
Acetylcholine
Dopamine
0%
m
in
e
0%
ol
in
e
0%
to
ni
n
0%
hr
in
e
A.
B.
C.
D.
Pramipexole (Mirapex) 1.5 mg by mouth is prescribed.
The hospital pharmacy stocks pramipexole 0.25 mg.
How many tablets should the nurse administer?
0%
5
0%
5.
0%
4
0%
6
5
4
6
5.5
5
A.
B.
C.
D.
An older adult patient has confusion, memory loss, and
disorientation in familiar surroundings. The patient has
been taking donepezil (Aricept) 10 mg once daily for 6
months. The patient’s symptoms have begun to worsen,
and the patient’s spouse asks if the medication dose can
be increased. What will the nurse tell the spouse
A. The dose can be increased as the patient has
been taking the drug for > 3 months.
B. B. The dose can be increased to twice daily
dosing instead of once daily dosing.
C. The increase in symptoms is the result of
hepatotoxicity from the medication’s side
effects.
Th
e
f..
ta
ke
pa
tie
nt
m
us
t
sy
m
pt
om
si
th
e
st
he
dr
ug
...
...
to
ed
in
e
in
cr
ea
s
Th
e
do
se
ca
n
be
in
cr
ea
s
be
B.
Th
e
ca
n
do
se
Th
e
D. The patient must take the drug for longer
in
cr
ea
s
ed
as
th
...
0% 0% 0% 0%
The nurse should be particularly cautious when
administering Donepezil (Aricept) to any patient with a
history of which condition? (Select all that apply.)
A. Asthma
B. B. Chronic obstructive pulmonary
disease (COPD)
C. C. Heart failure (HF)
D. D. Hypertension
E. E. Peptic ulcer disease
B.
C
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on
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a.
.
ar
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ai
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re
(H
D.
F)
Hy
pe
rt
E.
en
Pe
si o
pt
n
ic
ul
ce
rd
i se
as
e
0% 0% 0% 0% 0%
A patient is admitted to the hospital for a new onset seizure
disorder, and the prescriber orders carbamazepine
(Tegretol). The nurse reviewing the patient’s medical history
notes that the patient is taking warfarin. The nurse will
contact the provider to discuss doing what?
w
ar
fa
rin
0%
th
e
in
g
th
e
th
e
in
g
In
cr
ea
s
rin
w
ar
fa
0%
az
ep
in
e
0%
In
cr
ea
s
Re
du
cin
g
th
e
ca
rb
am
az
ep
in
e
0%
ca
rb
am
Reducing the carbamazepine
Reducing the warfarin
Increasing the carbamazepine
Increasing the warfarin
Re
du
cin
g
A.
B.
C.
D.
A nurse is completing a discharge plan for a 24-year-old
patient who will begin taking a traditional AED. Which
information is important to teach this patient?
to
us
e
an
ef
f..
.
th
e.
..
be
sh
ou
ld
m
ay
Sh
e
Sh
e
ne
ed
to
ed
ica
m
su
re
tio
n
w
ill
di
sc
on
tin
ue
w
h.
.
dr
ug
th
e
ta
ki
ng
Ta
ki
ng
th
e
m
ay
Sh
e
en
su
r ..
.
0% 0% 0% 0%
st
op
A. She may stop taking the drug when
she is seizure free for a year.
B. Taking the medication will ensure that
she no longer has seizures.
C. She may need to discontinue the drug
if serious side effects occur.
D. She should be sure to use an effective
contraceptive method.
A nurse is preparing to teach a forgetful older adult
patient about a multiple drug regimen to follow after
discharge from the hospital. To help promote
adherence, what will the nurse do?
te
a.
..
th
e
sh
ar
e
Cl
th
e
pa
tie
nt
t
o
nt
t
As
k
th
e
As
k
o
us
sh
te
ar
rm
e
th
ed
e
ica
te
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tio
..
M
n
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m
su
in
ist
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th
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pa
...
tie
nt
un
de
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ta
n.
.
0% 0% 0% 0%
pa
tie
A. Ask the patient to share the teaching
with a neighbor or friend soon after
discharge.
B. Ask the patient to share the teaching
with a neighbor or friend soon after
discharge.
C. Cluster medication administration times
as much as possible.
D. Make sure the patient understands the
actions and side effects of each drug.
An older adult patient is admitted to the hospital for treatment
of an exacerbation of a chronic illness. Admission laboratory
work reveals an extremely low serum drug level of the drug
used to treat this condition. The patient has brought the
medication to the hospital, along with other medications taken.
The patient’s renal and hepatic function tests are normal. What
might the nurse suspect as a likely cause of this finding?
se
d
bi
lit
yt
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ns
dr
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co
to
nt
ler
ain
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ict
...
io
nt
ha
tt
he
dr
ug
..
0% 0% 0% 0%
Fi n
an
cia
l
A. Financial concerns
B. Inability to open drug containers
C. Increased tolerance to the drug’s
effects
D. Patient’s conviction that the drug
is unnecessary
The nurse teaches a patient about antiepileptic drugs
taken during pregnancy. Which statement by the
patient is correct?
“M
yb
ab
yc
ou
ld
ha
Ri
ve
sk
bl
of
ee
bi
di
rth
ng
de
...
fe
cts
“B
irt
ca
h
nb
de
ed
fe
ec
cts
...
us
“A
ua
nt
lly
ise
oc
izu
cu
ri
re
nt
dr
..
ug
sc
an
ca
us
eh
e..
.
A. “My baby could have bleeding problems
right after birth.”
B. Risk of birth defects can be decreased by
taking a low dose.”
C. “Birth defects usually occur in the last 0% 0% 0% 0%
part of pregnancy.”
D. “Antiseizure drugs can cause heart
defects in my baby.”
.
ef
f ..
sid
e
m
on
he
sa
re
a
co
m
al
co
ho
l
“R
as
co
ns
um
e
ca
n
“I
in
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ve
l
s.
m
od
e.
..
..
.
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oo
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er
ap
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tic
an
d
br
us
h
D.
“O
nc
e
C.
sh
ou
ld
B.
“I
A.
A nurse counsels a patient who is to begin taking
phenytoin (Dilantin) for epilepsy. Which statement by
the patient indicates understanding of the teaching?
“I should brush and floss my teeth
regularly.”
“Once therapeutic blood levels are
reached, they are easy to maintain.”
“I can consume alcohol in moderation
while taking this drug.”
0% 0% 0% 0%
“Rashes are a common side effect but
are not serious.”
When administering a thrombolytic drug to someone
experiencing a myocardial infarction; the expected
outcome of this drug is to:
Promote hydration
Dissolve clots
Prevent kidney failure
Treat dysrhythmias
0%
Tr
ea
t
dy
sr
fa
ilu
re
hy
th
m
ia
s
0%
Pr
ev
en
tk
id
ne
y
ol
ve
clo
ts
0%
Di
ss
ot
e
hy
dr
at
io
n
0%
Pr
om
A.
B.
C.
D.
A patient is prescribed nitroglycerin tablet 0.3mg
SL. The drugs principal effects are produced by:
A. Antispasmodic effects on the
pericardium
B. Causing an increased myocardial
oxygen demand
C. Vasodilation of peripheral
vasculature
va
sc
m
yo
ca
la
tio
n
ed
Va
so
di
in
cr
ea
s
an
Ca
us
in
g
of
pe
r ip
he
ra
l
..
pe
.
th
e
ct
so
n
ffe
od
ic
e
An
tis
pa
sm
0%
u.
..
0%
rd
ia
...
0%
Furosemide is administered IV for heart failure. How
soon after administration should the nurse expect to
see evidence of the drugs desired effect?
5 to 10 minutes
30-60 minutes
2 to 4 hours
6 to 8 hours
8
to
6
2
to
4
in
ut
es
m
0%
ho
ur
s
0%
ho
ur
s
0%
30
-6
0
to
10
m
in
ut
es
0%
5
A.
B.
C.
D.
A client had acute arterial occlusion and is prescribed IV
heparin. Before starting the medication, the nurse
should:
A. Review the blood coagulation labs
B. Test the client’s stool for occult
blood
C. Count the apical pulse for 1 minute
D. Check the 24 hour urine output
record
..
ou
tp
ut
.
rin
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m
in
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e
fo
r1
..
lse
or
oc
cu
lt.
oo
lf
oa
gu
la
t io
n
la
bs
0% 0% 0% 0%
The client with pneumonia develops mild constipation,
the nurse administers docusate sodium (Colace). This
drug works by:
Softening the stool
Lubricating the stool
Increasing stool bulk
Stimulating peristalsis
pe
r is
ta
l si
s
0%
St
im
ul
at
in
g
In
cr
ea
s
at
in
g
Lu
br
ic
in
g
th
e
st
oo
l
th
e
ni
ng
0%
st
oo
lb
ul
k
0%
st
oo
l
0%
So
fte
A.
B.
C.
D.
0%
or
e
go
in
gt
o.
..
..
ho
ur
.
di
ca
tio
ns
be
f
og
et
he
r1
br
ea
kf
as
t..
.
di
ca
tio
ns
t
be
fo
re
yn
th
ro
id
Sy
nt
hr
oi
d
w
ith
br
ea
kf
as
t
a.
.
The nurse is instructing a client with hypothyroidism
who takes levothyroxine(Synthroid), digoxin(Lanoxin),
and simvastatin(Zocor). How will you teach your client
to take these medications?
A. Take Synthroid with breakfast and the
other medications after breakfast
B. Take Synthroid before breakfast and
the other medications 4 hours later
C. All medications together 1 hour after
eating breakfast
D. All medications before going to bed
0% 0% 0%
The nurse is administering the initial dose of a Regular
insulin to a client with diabetes mellitus type 1. The
nurse should assess for hypoglycemia within:
0.5 hours
1 hour
3 hours
4 hours
ho
ur
s
0%
4
ho
ur
s
0%
3
ho
ur
0%
1
5
ho
ur
s
0%
0.
A.
B.
C.
D.
Insulin glargine is prescribed for a hospitalized patient
who is diabetic. When will the nurse administer this
drug?
A. Approximately 15 to 30 minutes before
each meal
B. In the morning and at 4 PM
C. Once daily at bedtime
D. After meals and at bedtime
be
dt
im
e
an
d
rm
ea
ls
ly
Af
te
da
i
at
im
e
at
be
dt
4
at
an
d
On
ce
th
e
In
Ap
pr
ox
im
at
el
y
15
m
or
ni
to
ng
30
m
in
ut
es
..
.
PM
0% 0% 0% 0%
A nurse counsels a patient with diabetes who is starting
therapy with an alpha-glucosidase inhibitor. The patient
should be educated about the potential for which
adverse reaction?
Hyperglycemia
Flatulence
Elevated iron levels
Fluid Retention
Constipation
Co
ns
tip
at
io
n
Re
te
nt
io
n
ui
d
le
ve
ls
iro
n
ed
Fl
at
ul
en
ce
0% 0% 0% 0% 0%
yp
er
gly
ce
m
ia
A.
B.
C.
D.
E.
Nurse is caring for a patient who is scheduled for an
adrenalectomy. What drug would you expect to give
post operatively to prevent Addison’s crisis?
Hydrocortisone
Fludrocortisone
Spironolactone
Testosterone
to
st
er
on
e
0%
Te
s
Sp
iro
no
l
Fl
0%
ac
to
ne
0%
ud
ro
co
rt
i so
ne
0%
Hy
dr
oc
or
tis
on
e
A.
B.
C.
D.
Your patient with breast cancer is on the SERM
Tamoxifen. She asks you why she needs to take this
medication. the nurses best response is:
is
pa
rt
of
hi
yo
sd
ur
ru
ch
gs
em
ha
sb
o.
..
ee
hi
n
sd
fo
un
ru
d
gs
to
ac
de
ts
...
lik
e
hi
a
sd
n
es
ru
tro
g
w
ge
ill
n
pr
i..
ev
.
en
th
ot
fla
sh
e.
..
0% 0% 0% 0%
hi
sd
ru
g
A. This drug is part of your
chemotherapy program
B. This drugs has been found to
decrease risk for recurrent or
metastatic breast cancer
C. This drugs acts like an estrogen in
your breast tissue
D. This drug will prevent hot flashes
since you cannot take hormone
replacement
A client has an epidural catheter inserted for post
operative pain management. Client rates his pain as a 4
on a scale of 0-5. What should the nurse do first?
A. Check to make sure the PCA
pump is functioning
B. Adjust the epidural catheter
C. Assess vital signs
D. Notify the physician
th
e
Ad
ju
st
Ch
ec
kt
o
m
ak
e
su
re
th
e
PC
A
pu
m
...
ep
id
ur
al
ca
th
et
er
As
se
ss
vi
ta
ls
ig
No
ns
tif
yt
he
ph
ys
ici
an
0% 0% 0% 0%
Your client had a total knee replacement 3 days ago and
is on a heparin. Labs notifies you that aPTT is
significantly elevated. What drug would the nurse
anticipate getting a prescription for?
Vitamin K
Protamine Sulfate
Warfarin
Packed red blood cells
ce
lls
0%
od
0%
ar
fa
r in
te
0%
Su
lfa
K
0%
ita
m
in
A.
B.
C.
D.
A 16 year old client is prescribed and SSRI for major
depression. The nurse instructs the client and parents
to monitor closely for which adverse effect?
Headache
Nausea
Fatigue
Agitation
0%
Ag
ita
t io
n
0%
Fa
tig
ue
a
0%
Na
us
e
0%
He
ad
ac
he
A.
B.
C.
D.
You are preparing a teaching plan for client starting a
tricyclic antidepressant. Which of the following
substances should the client avoid while taking this
medication?
Caffeinated coffee
Sunscreen
Alcohol
Artificial tears
0%
Ar
t if
ici
al
te
ar
s
0%
Al
co
ho
l
0%
Su
ns
cr
ee
n
co
ffe
e
0%
Ca
ffe
in
at
ed
A.
B.
C.
D.
Your client is on a tricyclic antidepressant. Which of the
following symptoms would alert the nurse that the
client is experiencing anticholinergic effects?
A. Tremors and cardiac arrhythmias
B. Sedation and delirium
C. Respiratory depression and
convulsions
D. Urinary retention and blurred vision
nd
ca
rd
ia
ca
rr
hy
th
Se
m
da
ia
s
tio
n
an
d
de
lir
ep
iu
re
m
ss
io
n
an
d
co
nt
nv
io
...
n
an
d
bl
ur
re
d
vi
...
0% 0% 0% 0%
A client with panic disorder is taking a benzodiazepine
(alprazolam). This medication acts on which
neurotransmitter?
A. Gamma aminobutyrate
B. Serotonin
C. Dopamine
D. Norepinephrine
0%
in
e
0%
Do
pa
m
in
e
Se
ro
to
ni
n
0%
No
re
pi
ne
ph
r
Ga
m
m
a
am
in
ob
ut
yr
a
te
0%
The biguanide glucophage(Metformin) works in
diabetes type 2 by promoting insulin release.
A. True
B. False
0%
0%
I am going to have a great day
A. True
B. False
0%
Fa
lse
Tr
ue
0%