576 Exam 2

The nurse is reviewing antiepileptic drug (AED) therapy. Which statements about AED therapy are accurate? (select all that apply)

a. Consistent dosing is the key to controlling seizures
b. Do not abruptly discontinue AEDs because doing so may cause rebound seizure activity
c. A dose may be skipped if the patient is experiencing adverse effects
d. AED therapy is usually lifelong
e. AED therapy can be stopped when seizures are stopped
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The nurse is reviewing antiepileptic drug (AED) therapy. Which statements about AED therapy are accurate? (select all that apply)

a. Consistent dosing is the key to controlling seizures
b. Do not abruptly discontinue AEDs because doing so may cause rebound seizure activity
c. A dose may be skipped if the patient is experiencing adverse effects
d. AED therapy is usually lifelong
e. AED therapy can be stopped when seizures are stopped
a. Consistent dosing is the key to controlling seizures
b. Do not abruptly discontinue AEDs because doing so may cause rebound seizure activity
d. AED therapy is usually lifelong
When teaching a patient about taking a newly prescribed antiepileptic drug (AED) at home, the nurse will include which instruction?

a. "Regular, consistent dosing is important for successful treatment."
b. "If seizures recur, take a double dose of the medication."
c. "Driving is allowed after 2 weeks of therapy."
d. "Antacids can be taken with the AED to reduce GI adverse effects."
a. "Regular, consistent dosing is important for successful treatment."
A patient has been taking an AED for several years as part of his treatment for partial seizures. His wife has called because he ran out of medication this morning and wonders if he can go w/out it for a week until she has a chance to go to the drugstore. What is the nurse's best response?

a. "He can stop all medications because he has been treated for several years now."
b. "Stopping this medication abruptly may cause withdrawal seizures. A refill is needed right away."
c. "He is taking another antiepileptic drug, so he can go without the medication for a week."
d. "He can temporarily increase dosage of his other antiseizure medications until you can get the refill."
b. "Stopping this medication abruptly may cause withdrawal seizures. A refill is needed right away."
A patient has been treated with antiparkinson medications for 3 months. What therapeutic responses should the nurse look for when assessing this patient?

a. Improved ability to perform activities of daily living
b. Gradual development of cogwheel rigidity
c. Decreased appetite
d. Newly developed dyskinesias
a. Improved ability to perform activities of daily living
A patient is being brought in to the ED by paramedics with altered mental status after being found at home with an empty bottle of prescribed benzodiazepines. The ER nurse anticipates that the patient will need

a. Narcan
b. Fluconazole
c. Flumazenil
d. Finasteride
c. Flumazenil
While a patient is receiving drug therapy for Parkinson's disease, the nurse monitors for dyskinesia, which is manifested by which finding?

a. Confusion and altered mental status
b. Difficulty in performing voluntary movements
c. Limp extremities with weak muscle tone
d. Rigid, tense muscles
b. Difficulty in performing voluntary movements
A nurse is admitting a patient to the hospital. The patient reports taking oral baclofen but stopped taking the drug the day before admission. The nurse would be correct to anticipate which adverse effects?

a. Withdrawal symptoms
b. Fatigue and drowsiness
c. Respiratory depression and coma
d. Weakness and dizziness
a. Withdrawal symptoms
A patient has been given a prescription for levodopa-carbidopa (Sinemet) for her newly diagnosed Parkinson's disease. She asks the nurse, "Why are there two drugs in this pill?" The nurse's best response reflects which fact?

a. There are concerns about drug-food interactions with levodopa therapy that do not exist with the combination therapy.
b. Carbidopa is the biologic precursor of dopamine and can penetrate into the CNS
c. Carbidopa prevents the breakdown of levodopa in the periphery and allows more levadopa to cross the BBB
d. Carbidopa allows for larger doses of levodopa to be given.
c. Carbidopa prevents the breakdown of levodopa in the periphery and allows more levadopa to cross the BBB
The nurse is caring for a patient with new onset seizure. The following interventions are included (select all that apply)

a. The patient has received Lorazapam IV per emergency standing orders by the charge nurse
b. Oxygen mask has been placed in front of the patient's mouth
c. Patient has been positioned on his side
d. Patient's LOC after seizure
e. Documentation after the seizure includes the length of time of the seizure
a. The patient has received Lorazapam IV per emergency standing orders by the charge nurse
b. Oxygen mask has been placed in front of the patient's mouth
c. Patient has been positioned on his side
d. Patient's LOC after seizure
e. Documentation after the seizure includes the length of time of the seizure
Carbidopa-levopdoa (Sinemet) is prescribed for a patient with PD. The nurse informs the patient that which common adverse effects can occur with this medication?

a. Drowsiness, headache, weight loss
b. Dizziness, insomnia, nausea
c. Peripheral edema, fatigue, syncope
d. Heart palpitations, hypotension, urinary retention
d. Heart palpitations, hypotension, urinary retention.
When assessing the medication history of a patient with a new diagnosis of Parkinson's disease, which conditions are contraindications for the patient who will be taking carbidopa-levodopa? (select all that apply) a. Hypertension b. Concurrent use of monoamine oxidase inhibitors c. Angle-closure glaucoma d. Benign prostatic hyperplasia e. History of malignant melanomab. Concurrent use of monoamine oxidase inhibitors c. Angle-closure glaucoma e. History of malignant melanomaThe nurse notes in the patient's medication history that the patient is taking cyclobenzaprine. Based on this finding, the nurse interprets that the patient has which disorder? a. A musculoskeletal injury b. Insomnia c. Epilepsy d. Agitationa. Musculoskeletal injuryA patient is taking gabapentin, and the nurse notes that there is no history of seizures on his medical record. What is the best possible rationale for this medication order? a. The medication is used for the treatment of neuropathic pain. b. The medication is helpful for the treatment of multiple sclerosis. c. The medication is used to reduce the symptoms of Parkinson's disease. d. The medical record is missing the correct information about the patient's history of seizures.a. The medication is used for the treatment of neuropathic pain.Phenytoin has a narrow therapeutic index/range. The nurse recognizes that this characteristic indicates which of these? a. The safe and the toxic plasma levels of the drug are very close to each other. b. The phenytoin has a low chance of being effective. c. There is no difference between safe and toxic plasma levels. d. A very small dosage can result in the desired therapeutic effect.a. The safe and the toxic plasma levels of the drug are very close to each other.When reviewing the health history of a patient who will be receiving antacids, the nurse recalls that antacids containing Mg need to be used cautiously in patients with which conditions? a. Peptic ulcer disease b. Renal failure c. Hypertension d. Heart failureb. Renal failureAt 0900, the nurse is about to give morning medications, and the patient has asked for a dose of antacid for severe heartburn. Which schedule for the antacid and medications is correct? a. Give both the antacid and medications at 0900. b. Give the antacid at 0900, and then the medications at 0930. c. Give the medications at 0900, and then the antacid at 1000. d. Give the medications at 0900, and then the antacid at 0915.c. Give the medications at 0900, and then the antacid at 1000.The nurse is providing patient teaching about antacids. Which statements about antacids are accurate? a. Antacids reduce the production of acid in the stomach. b. Antacids neutralize acid in the stomach. c. Rebound hyperacidity may occur with calcium-based antacids. d. Aluminum-based antacids cause diarrhea. e. Magnesium-based antacids cause diarrhea.b. Antacids neutralize acid in the stomach. c. Rebound hyperacidity may occur with calcium-based antacids. e. Magnesium-based antacids cause diarrhea. *brain dump says only C and E, but other quizlet says B, C, and EThe nurse is reviewing the mechanism of action of antidiarrheal drugs. Which type of antidiarrheal medication works by decreasing the intestinal muscle tone and peristalsis of the intestines? a. Adsorbents such as Pepto-Bismol b. Anticholinergics such as belladonna alkaloids c. Probiotics such as Lactinex d. Lubricants such as mineral oilb. Anticholinergics such as belladonna alkaloidsA patient is on chemo regimen in an outpatient clinic and is receiving a chemo drug that is known to be highly emetogenic. The nurse will implement which interventions regarding the pharmacologic management of nausea and vomiting? (select all that apply) a. Giving antinausea drugs at the beginning of the chemotherapy infusion b. Administering antinausea drugs 30 to 60 minutes before chemotherapy is started c. For best therapeutic effects, medicating for nausea once the symptoms begin d. Observing carefully for the adverse effects of restlessness and anxiety e. Instructing the patient that the antinausea drugs may cause extreme drowsiness f. Instructing the patient to rise slowly from a sitting or lying position because of possible orthostatic hypotensionb. Administering antinausea drugs 30 to 60 minutes before chemotherapy is started e. Instructing the patient that the antinausea drugs may cause extreme drowsiness f. Instructing the patient to rise slowly from a sitting or lying position because of possible orthostatic hypotensionThe nurse is caring for a patient that is taking loperamide for diarrhea. The nurse is educating on the side effects of this drug which include (select all that apply): Hypotension N/V Constipation Respiratory depression Increased HR Flushing HypertensionConstipation *couldn't retrieve the answers from brain dump and other quizletsA patient will be taking Pepto-Bismol to control diarrhea. When reviewing the patient's other ordered medications, the nurse recognizes that which medication will interact significantly with Pepto-Bismol? a. Acetaminophen (Tylenol), an analgesic b. Levothyroxine (Synthroid), a thyroid replacement drug c. Warfarin (Coumadin), an anticoagulant d. Fluoxetine (Prozac), an antidepressantc. Warfarin (Coumadin), an anticoagulantThe nurse is discussion the use of adsorbents such as Pepto-Bismol with a patient who has diarrhea. The nurse will warn the patient about which possible adverse effects? a. Dark stools and blue gums b. Urinary hesitancy c. Drowsiness and dizziness d. Blurred vision and headachea. Dark stools and blue gumsWhen administering a bulk-forming laxative such as psyllium, the nurse instructs the patient to drink the medication mixed in a full 8-oz glass of water as the laxative thickens up when drinking. Which statement best explains the rationale for this instruction? a. The water acts to stimulate bowel movements. b. The water will help to reduce the bulk of the intestinal contents. c. These laxatives may cause esophageal obstruction if taken with insufficient water. d. The water acts as a lubricant to produce bowel movements.c. These laxatives may cause esophageal obstruction if taken with insufficient water.A patient wants to prevent problems with constipation and asks the nurse for advice about which type of laxative is safe to use for this purpose. Which class of laxative is considered safe to use on a long-term basis? a. Emollient laxatives b. Bulk-forming laxatives c. Hyperosmotic laxatives d. Stimulant laxativesb. Bulk-forming laxativesA patient who has been taking cimetidine (Tagamet) for hyperacidity calls the clinic to say that the medication has not been effective. The nurse reviews his history and notes that which factor may be influencing the effectiveness of this drug? a.He takes the cimetidine with meals. b.He smokes two packs of cigarettes a day. c.He drinks a glass of water with each dose. d.He takes an antacid 3 hours after the cimetidine dose.b.He smokes two packs of cigarettes a day.An older adult patient had gastric surgery due to a gastrointestinal bleed 3 days ago, and he has been stable since the surgery. This evening, his daughter tells the nurse, "He seems to be more confused this afternoon. He's never been like this. What could be the problem?" The nurse reviews the patient's medication record and suspects that which drug could be the cause of the patient's confusion? a. cimetidine (Tagamet) b. pantoprazole (Protonix) c. clarithromycin (Biaxin) d. sucralfate (Carafate)a. cimetidine (Tagamet)A patient will be taking a 2-week course of combination therapy with omeprazole (Prilosec) and another drug for a peptic ulcer caused by Helicobacter pylori. The nurse expects a drug from which class to be ordered with the omeprazole? a. An antibiotic b. A nonsteroidal antiinflammatory drug c. An antacid d. An antiemetica. An antibioticA patient is receiving lactulose (Enulose) three times a day. The nurse knows that the patient is not constipated and is receiving this drug for which reason? a. High ammonia levels due to liver failure b. Prevention of constipation c. Chronic renal failure d. Chronic diarrheaa. High ammonia levels due to liver failureList two expected outcomes of giving Lactulose (two different patient types) One GI patient and one Liver patient (has nothing to do with the labs).A patient asks the nurse about the difference between diphenoxylate with atropine (Lomotil) and the over-the-counter drug loperamide (Imodium). Which response by the nurse is correct? a. "Lomotil acts faster than Imodium." b. "Imodium does not cause physical dependence." c. "Lomotil is available in suppository form." d. "Imodium is a natural antidiarrheal drug."b. "Imodium does not cause physical dependence."A patient who has severe nausea and vomiting following a case of food poisoning comes to the urgent care center. When reviewing his medication history, the nurse notes that he has an allergy to procaine. The nurse would question an order for which antiemetic drug if ordered for this patient? a. metoclopramide (Reglan) b. promethazine (Phenergan) c. phosphorated carbohydrate solution (Emetrol) d. palonosetron (Aloxi)a. metoclopramide (Reglan)A patient on chemotherapy is using ondansetron (Zofran) for treatment of nausea. The nurse will instruct the patient to watch for which adverse effect of this drug? a. Dizziness b. Diarrhea c. Dry mouth d. Blurred visionb. Diarrhea *brain dump says constipationA patient is taking chemotherapy with a drug that has a high potential for causing nausea and vomiting. The nurse is preparing to administer an antiemetic drug that affects the chemoreceptor trigger zone. Which class of antiemetic drugs is most commonly used to prevent nausea and vomiting for patients receiving chemotherapy? a. Prokinetic drugs, such as metoclopramide (Reglan) b. Serotonin blockers, such a ondansetron (Zofran) c. Anticholinergic drugs, such as scopolamine d. Neuroleptic drugs, such as promethazine (Phenergan)b. Serotonin blockers, such a ondansetron (Zofran)A patient is taking omeprazole (Prilosec) for the treatment of gastroesophageal reflux disease (GERD). The nurse will include which statement in the teaching plan about this medication? a. "Take this medication once a day after breakfast." b. "You will be on this medication for only 2 weeks for treatment of the reflux disease." c. "The medication may be dissolved in a liquid for better absorption." d. "The entire capsule must be taken whole, not crushed, chewed, or opened."d. "The entire capsule must be taken whole, not crushed, chewed, or opened."The nurse is teaching a patient who will be taking a proton pump inhibitor as long-term therapy about potential adverse effects. Which statement is correct? a. Proton pump inhibitors can cause diarrhea. b. These drugs can cause nausea and anorexia. c. Proton pump inhibitors cause drowsiness. d. Long-term use of these drugs may contribute to osteoporosis.d. Long-term use of these drugs may contribute to osteoporosis.Reported adverse effects of proton pump inhibitors (ex: Protonix) include: Select all that apply:Osteoporosis GI tract infections Pneumonia???? Tf????A patient in the intensive care unit has a nasogastric tube and is also receiving a proton pump inhibitor (PPI). The nurse recognizes that the purpose of the PPI is which effect? a. Prevent stress ulcers b. Reduce bacteria levels in the stomach c. Reduce gastric gas formation (flatulence) d. Promote gastric motilitya. Prevent stress ulcersDuring an admission assessment, the patient tells the nurse that he has been self-treating his heartburn for 1 year with over-the-counter Prilosec OTC (omeprazole, a proton pump inhibitor). The nurse is aware that this self-treatment may have which result? a. No serious consequences b. Prevention of more serious problems, such as an ulcer c. Chronic constipation d. Masked symptoms of serious underlying diseasesd. Masked symptoms of serious underlying diseasesA patient is receiving a tube feeding through a gastrostomy. The nurse expects that which type of drug will be used to promote gastric emptying for this patient? a. Prokinetic drugs, such as metoclopramide (Reglan) b. Serotonin blockers, such as ondansetron (Zofran) c. Anticholinergic drugs, such as scopolamine (Scopace) d. Neuroleptic drugs, such as chlorpromazine (Thorazine)a. Prokinetic drugs, such as metoclopramide (Reglan)When administering Promethazine IV to a post-operative patient, what adverse effect could be attributed to the medication?Respiratory depressionA patient is complaining of excessive and painful gas. The nurse checks the patient's medication orders and prepares to administer which drug for this problem? a. famotidine (Pepcid) b. aluminum hydroxide and magnesium hydroxide (Maalox or Mylanta) c. calcium carbonate (Tums) d. simethicone (Mylicon)d. simethicone (Mylicon)A 75-year-old woman comes into the clinic with complaints of muscle twitching, nausea, and headache. She tells the nurse that she has been taking sodium bicarbonate five or six times a day for the past 3 weeks. The nurse will assess for which potential problem that may occur with overuse of sodium bicarbonate? a. Constipation b. Metabolic acidosis c. Metabolic alkalosis d. Excessive gastric mucusc. Metabolic alkalosisWhile recovering from surgery, a 74-year-old woman started taking a stimulant laxative, senna (Senokot), to relieve constipation caused by the pain medications. Two weeks later, at her follow-up appointment, she tells the nurse that she likes how "regular" her bowel movements are now that she is taking the laxative. Which teaching principle is appropriate for this patient? a. She needs to be sure to take this medication with plenty of fluids. b. It is important to have a daily bowel movement to promote bowel health. c. Long-term use of laxatives often results in decreased bowel tone and may lead to dependency. d. She needs to switch to glycerin suppositories to continue having daily bowel movements.c. Long-term use of laxatives often results in decreased bowel tone and may lead to dependency.The gastrointestinal agent Sucralfate can be given in a nasoduodenal tube True FalseFalseThe nurse is caring for a patient who has nausea that has been unrelieved by other antiemitics. The nurse is preparing to give the patient prescribed promethazine (Phenergan) IV. Prior to administering this medication through the IV, the nurse will need to:__________________________