Pharmacology Exam 2 Study

A female client is crying and states that everyone thinks she is a "drug addict," and that no one will listen to her. She states she has abdominal pain and must have something for the pain. What is the best response of the nurse?

"Do you take a lot of pain medication."
"You do not seem to be in pain right now."
"Tell me more about your pain."
"Your behavior drives our perception."
Click the card to flip 👆
1 / 88
Terms in this set (88)
A female client is crying and states that everyone thinks she is a "drug addict," and that no one will listen to her. She states she has abdominal pain and must have something for the pain. What is the best response of the nurse?

"Do you take a lot of pain medication."
"You do not seem to be in pain right now."
"Tell me more about your pain."
"Your behavior drives our perception."
"Tell me more about your pain."
The nurse is providing medication education to a client prescribed an adrenergic blocker. Which nervous system is the specific focus of this classification of medications?

peripheral
central
sympathetic
parasympathetic
sympathetic
A client has recently received a diagnosis of depression and has been prescribed citalopram. The nurse is providing health education and the client states, "I'm relieved to have some medication to help with my mood, because it's my daughter's wedding next weekend and I'll be feeling better." What is the nurse's best response?


"Antidepressants will help your mood but it usually takes a few weeks to experience the benefits."
"This is very good timing for you, but remember that you might have some side effects, especially for the first couple of weeks."
"Antidepressants help relieve the lack of energy and concentration during depression but your mood might not be affected."
"You'll likely be feeling significantly better by the weekend, but remember to avoid drinking alcohol at the wedding."
"Antidepressants will help your mood but it usually takes a few weeks to experience the benefits."
When preparing to administer a cholinergic drug, the nurse understands which is responsible for activating the primary neurotransmitter in the parasympathetic nervous system.

Protease
Acetylcholinesterase
DNA gyrase
Lipase
Acetylcholinesterase
A 40-year-old client with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing diagnosis should the nurse prioritize for the nursing care plan for this client?

Risk for Injury related to CNS depressant effects
Diarrhea related to anticholinergic effects
Impaired Swallowing related to increased muscle tone
Altered Nutrition, Less than Body Requirements, related to appetite suppression
Risk for Injury related to CNS depressant
A client who has been taking medication for a seizure disorder is asking the nurse about getting pregnant. Why is pregnancy discouraged in women who are being treated for seizure disorders?

Seizure disorders are genetic.
Antiepilepsy drugs decrease fertility.
Antiepilepsy drugs are teratogenic.
Seizure disorders are familial.
Antiepilepsy drugs are teratogenic.
A client received atropine and meperidine preoperatively. After surgery, the client reports mouth dryness. What is the nurse's best response?


"The preoperative medication often causes a temporary electrolyte imbalance making your mouth feel dry."
"You are likely dehydrated, which is common after surgery. The IV fluids you are receiving will correct the problem."
"Your medications decreased saliva production, but it is temporary and will improve."
"This is likely the result of the blood and fluid you lost during surgery, coupled with the fact that the operating room is very dry."
"Your medications decreased saliva production, but it is temporary and will improve."
When a client who has been taking opioids becomes less sensitive to the drug's analgesic properties, that client is said to have developed a(n)

addiction.
dependence.
tolerance.
balanced analgesia.
tolerance.
A patient expresses that being diagnosed with narcolepsy has been devastating for him. Which statement by the patient should the nurse focus on initially during the assessment?

"I hate being so dependent. I have to have somebody drive me everywhere I go."
"I don't like the way the stimulant medication makes me feel."
"I sometimes wonder if it is worth living a life that has so many restrictions."
"I have had to change my job. I now work from home."
"I sometimes wonder if it is worth living a life that has so many restrictions."
An adolescent taking oral contraceptives has been prescribed an anticonvulsant medication. The nurse should tell the client to do which?


use another form of birth control, such as condoms.
be aware that these two drugs will interact and increase seizure activity initially.
watch for signs of hyperglycemia, such as increased thirst, hunger, and urination.
stop driving due to the increased depressant effects and excessive drowsiness.
use another form of birth control, such as condoms.
Antipsychotic drugs are contraindicated in clients with: nausea, severe hypotension, or intractable hiccups. liver damage, coronary artery disease, severe hypertension, bone marrow depression, or cerebrovascular disease. kidney damage, chronic obstructive lung disease, mild hypotension, and chronic bone pain. peptic ulcer disease, mild hypertension, chronic joint pain, and kidney failure.liver damage, coronary artery disease, severe hypertension, bone marrow depression, or cerebrovascular disease.The nurse administers a nonopioid analgesic to a client. What is the most effective way for the nurse to evaluate the pain response following administration? Ask another nurse to assess the client's response to the medication. Ask the family to determine the client's response to the pain. Observe the client when he or she is not aware of the assessment. Using a pain scale, ask the client to describe the pain.Using a pain scale, ask the client to describe the pain.The nurse knows that which class of drugs prevents epinephrine and norepinephrine from occupying receptor sites on the cell membranes? Beta-helping drugs Beta-blocking agonist Beta-adrenergic drugs Beta-adrenergic blocking drugsBeta-adrenergic blocking drugsA client has been diagnosed with partial seizures and has been prescribed carbamazepine. When providing health education about the safe and effective use of this medication, what should the nurse teach the client? "It's important to take a dose as soon as possible if you feel a seizure is coming." "I'll explain the foods that you should avoid while you're taking this drug." "It's safest if you avoid drinking alcohol while you're taking this drug." "I'll be showing you how to safely self-inject this drug.""It's safest if you avoid drinking alcohol while you're taking this drug."While caring for a client who is receiving antipsychotic therapy, the nurse observes lip smacking, a darting tongue, and slow and aimless arm movements. The nurse interprets this as: akathisia. dystonia. pseudoparkinsonism. tardive dyskinesia.tardive dyskinesia.An adult client, diagnosed with depression several weeks ago, began taking citalopram 10 days ago. The client has told the nurse of the intent to stop taking the drug, stating, "I don't feel any less depressed than I did before I started taking these pills." How should the nurse best respond to the client's statement? "I'll pass that information along to your health care provider; a different drug might be more appropriate for you." "I'd encourage you to continue with the drug; it can take several weeks before it improves your mood." "It could be that one of the other medications or supplements you're taking is negating the effects of citalopram." "People often have unrealistic expectations about how the drug will make them feel.""I'd encourage you to continue with the drug; it can take several weeks before it improves your mood."A 12-year-old client who has been taking sertraline for the past 2 weeks has returned to the clinic to be seen. It will be critical for the nurse to assess for which? weight loss. feelings of grandiosity. onset of suicidal ideation. decreased sleep.onset of suicidal ideation.A client prescribed phenytoin for a seizure disorder has recently run out of medication and has not obtained a refill. What is the client at risk for developing? Migraine headaches Status epilepticus Depression HypotensionStatus epilepticusWhich agent would a nurse expect to administer transdermally? Scopolamine Propantheline Atropine DicyclomineScopolamineA client is admitted to the emergency department for an opioid overdose. What would the nurse expect to administer to this client? Corticosteroids Naloxone Normeperidine OxycodoneNaloxoneAdrenergic drugs mimic the effects of stimulating what part of the nervous system? sympathetic parasympathetic autonomic centralsympatheticThe client is receiving a cholinergic agonist. Which assessment finding in a client warrants immediate action by the nurse? Urination 300 ml at 1 p.m. One loose stool at 2 p.m. Increased bowel sounds Blood pressure decreased from 110/90 mm Hg to 80/50 mm HgBlood pressure decreased from 110/90 mm Hg to 80/50 mm HgA client with Parkinson's disease began treatment with dopaminergics two weeks ago and has now presented for a follow-up assessment. What finding best suggests to the nurse that the treatment is having a therapeutic effect? The client is able to walk more briskly and stably than two weeks ago The client is oriented to person, place and time The client describes an increase in appetite compared with two weeks ago The client denies shortness of breath and adventitious lung sounds are absent on auscultationThe client is able to walk more briskly and stably than two weeks agoThe client is scheduled for surgery. The nurse administers diazepam (Valium) preoperatively for what purpose? Decreased secretions Decreased anxiety Decreased nausea Decreased painDecreased anxietyA client is at the clinic for a follow-up appointment related to treatment for depression. The client had began taking fluoxetine 2 weeks ago. The client states, "This medication must not be working, because I don't feel better at all." What would be the nurse's best response? "I'll talk to the health care provider about ordering a different drug." "I'll talk to the health care provider about increasing your dosage." "You may just be one of those people who don't get better with this drug." "You may have to take this drug for a few more days before you feel its effects.""You may have to take this drug for a few more days before you feel its effects."A client has been started on cyclobenzaprine. For the duration of treatment with cyclobenzaprine, the nurse should teach the client to eliminate what? Over-the-counter vitamin supplements Alcohol Fatty foods Stool softenersAlcoholWhile assessing clients receiving opioid analgesics for pain management, what finding would alert the nurse and require healthcare provider notification? The client with a pulse of 118, a respiratory rate of 8, and a BP of 80/60 The client with a pulse of 100, a respiratory rate of 18, and a BP of 120/80 The client with a pulse of 70, a respiratory rate of 12, and a BP of 110/68 The client with a pulse of 65, a respiratory rate of 14, and a BP of 104/72The client with a pulse of 118, a respiratory rate of 8, and a BP of 80/60A client presents at the emergency department with respiratory depression and excessive sedation. The family tells the nurse that the client has been taking medication throughout the evening and gives the nurse an almost empty bottle of benzodiazepines. The nurse addresses potential factors that could exacerbate the effects of the benzodiazepines with which assessment question? "Are there any allergies that you know about?" "Does the client have any history of kidney disease?" "Has the client had any alcohol to drink?" "Is the client currently taking any blood pressure medications?""Has the client had any alcohol to drink?"A 34-year-old executive for an insurance company has been taking lorazepam for the last 6 months for anxiety. The client abruptly stopped the medication. The client then calls the health care provider and reports feeling irritable, and increased heart rate, and restlessness. What would explain the client's current symptoms? psychological addiction to lorazepam anxiety has increased in severity withdrawal from stopping the medication difficulty at workwithdrawal from stopping the medicationA nurse is teaching a client about musculoskeletal medication that has been prescribed. The client needs further teaching about the medication when making which statements? "I take my medicine with three to four beers each evening." "I take my medication right after dinner." "I usually lie down for a few minutes after taking my medication." "I made an appointment in two to three weeks to be reevaluated.""I take my medicine with three to four beers each evening."A client experiencing cancer pain is receiving morphine every 2 hours. What assessment should the nurse teach family members to make while caring for this client at home? Lung sounds Respiratory depression Diarrhea Urinary incontinenceRespiratory depressionA client experiencing a serious allergic reaction to a bee sting is brought to the emergency department. The client's right hand is swollen, red, and painful. She is extremely upset, short of breath, and the nurse detects wheezing and stridor. The nurse is ordered to administer epinephrine to relieve which of the clients symptoms? acute anxiety. pain and swelling around the sting site. acute bronchospasm. discoloration in her hand.acute bronchospasm.A 50-year-old client received atropine preoperatively. The nurse explains the symptom of dry mouth to client as which effect? "The medication caused a loss of body fluid." "The medication caused an electrolyte imbalance." "The medication temporarily decreased your salivation." "You are probably dehydrated.""The medication temporarily decreased your salivation."A client taking carbidopa-levodopa for the treatment of Parkinson's disease reports blurred vision and the nurse observes that the client has worsening ataxia. Which nursing diagnosis should the nurse prioritize? Disturbed body image Risk for injury Ineffective role performance Impaired verbal communicationRisk for injuryWhich anticholinergic agent is sometimes used to manage motion sickness when delivered by transdermal patch? Atropine Scopolamine Hyoscyamine TolterodineScopolamineWhat represents the two types of receptors that are found in the adrenergic nervous system? Select all that apply. Delta receptors Gamma receptors Omega receptors Alpha receptors Beta receptorsAlpha receptors Beta receptorsAn opioid naive patient experiences acute pain after surgery and is put on opioid therapy. Which severe adverse reactions of opioid treatment should the nurse monitor for in the patient? Pruritus Severe headache Urticaria Respiratory depressionRespiratory depressionThe nurse administers an oral opioid analgesic to a client at 6 PM for pain documented as 6 on a scale of 0 to 10. At 6:30 PM, the client states that the pain level is 3 on a scale of 0 to 10, and that level is acceptable to him. The client asks the nurse why another assessment was necessary after the administration of the pain medication. What is the nurse's best response to this client about proper pain management? "We assess every client in relation to pain according to hospital policy." "We assess every client in relation to pain, initially to determine appropriate interventions and later to determine whether the interventions were effective in preventing or relieving pain." "We assess every client in relation to pain and their activity level." "We assess every client in relation to pain, initially to determine if the medication is the correct dose.""We assess every client in relation to pain, initially to determine appropriate interventions and later to determine whether the interventions were effective in preventing or relieving pain."A group of nursing students are reviewing information about antianxiety drugs. The students demonstrate understanding of the information when they identify which as another name for this group of drugs? Anxiolytics Anesthetics Opioids NSAIDsAnxiolyticsWhich of the following is a required nursing intervention for a client receiving morphine sulfate? Do not administer if respiratory rate is less than 12. Avoid caffeine. Report bleeding gums. Monitor the client's weight.Do not administer if respiratory rate is less than 12.After teaching an in-service program about nervous system conditions, the nurse determines that the teaching was successful when the group identifies which condition or disease as a group of symptoms involving motor movement characterized by tremors, rigidity, and bradykinesia? Anxiety Myasthenia gravis Seizure disorder ParkinsonismParkinsonismA 28-year-old client has been experiencing muscle spasms in the neck from a four-wheeler accident. The client is receiving 10 mg of cyclobenzaprine PO tid. The nurse's teaching plan should include which instruction? Stop the drug if dizziness occurs. Do not drive or operate heavy machinery for the first week. Increase the dosage if necessary. Take the medication with a small amount of water.Do not drive or operate heavy machinery for the first week.A patient has been administered dobutamine HCL. Which adverse reactions should the nurse monitor for in the patient? Elevated temperature Cardiac arrhythmias Sleeplessness Urinary retentionCardiac arrhythmiasThe most effective drug to treat major symptoms associated with Parkinson's is: Apomorphine. Levodopa. Amantadine. MAO inhibitors.LevodopaPatient should be cautioned to avoid which when taking skeletal muscle relaxants? Cranberry juice Potassium Green, leafy vegetables AlcoholAlcoholA nurse is assessing a client with Parkinson's disease. The nurse determines that the client's drug therapy is effective when the client exhibits what? Decreased aggression Decreased tremors Improved short term memory Improved level of intellectual functioningDecreased tremorsA client has recently been prescribed a drug that treats hypertension by blocking the sympathetic receptors in the sympathetic nervous system. This action is characteristic of which? an adrenergic agonist. a cardiotonic. a neurotransmitter. an adrenergic antagonist.an adrenergic antagonist.Another name for adrenergic drugs is: steroids. central nervous system drugs. sympathomimetic drugs. parasympathetic drugs.sympathomimetic drugs.A client has been using NSAIDs daily over an extended period. Which of the following effects should the nurse carefully monitor for in this client? Urinary tract infection Hypothyroidism Gastrointestinal bleeding Cardiac disordersGastrointestinal bleedingA female client is diagnosed with renal insufficiency. The nurse develops a teaching plan based on the diagnosis and antipsychotic drug usage. The client asks the nurse why it is so important to have renal function tests routinely. The nurse replies that if renal function test results become abnormal, what may be a consequence? The drug may need to be lowered in dosage or discontinued. The drug will be discontinued immediately. The drug dosages will be increased to increase absorption. The drug will be continued with caution.The drug may need to be lowered in dosage or discontinued.A client is prescribed phenytoin and reports gastrointestinal (GI) upset. The nurse should tell the client to: take the medication at bedtime. take the medication two hours after ingesting dairy products. take the medication with meals. ask the health care provider to change the route from oral to injection.take the medication with meals.A client has been admitted to the cardiac unit for heart failure and has been ordered carvedilol (Coreg). The client's blood pressure is 80/50. What should the nurse do? Give the medication so that the blood pressure will increase. Call the provider and advise them of the client's blood pressure prior to administering the medication. Call the provider after giving the medication, informing the provider of client's blood pressure when the medication was administered. Continue to take the client's blood pressure using different BP machines until a better blood pressure is obtained.Call the provider and advise them of the client's blood pressure prior to administering the medication.The client has been taking a sleep medication for the last 6 months. The client informs the primary care provider that she sleeps great now and wants to discontinue the drug. The provider informs the client that this is not a good idea. What is the best rationale for the providers advice? The provider believes that stopping the drug abruptly may cause serious consequences for the client. The provider wants to keep the client happy. The provider thinks the client will feel better if she takes it. The provider does not want the client to waste the remainder of the prescription.The provider believes that stopping the drug abruptly may cause serious consequences for the client.While reviewing the medication history of an older adult client, the nurse learns that the client is taking amitriptyline 25 mg three times per day. What adverse effect should the nurse prioritize when incorporating safety measures into the care plan? Orthostatic hypotension Dry mouth Incontinence Urinary retentionOrthostatic hypotensionA client has been achieving an acceptable reduction in the positive and negative signs of schizophrenia after several weeks of treatment with clozapine. The client has asked the nurse if it is acceptable to have "a few drinks from time to time." How should the nurse best respond to the client's enquiry? "When you're taking clozapine, it's best to avoid drinking alcohol altogether." "If you notice that your symptoms are worsening when you drink, you should stop doing it." "That shouldn't present a problem, provided you make sure that you're safe when you do it." "That's okay in most cases, but it's advisable to limit it to beer and wine and to avoid spirits.""When you're taking clozapine, it's best to avoid drinking alcohol altogether."Stopping an Anxiolytic abruptly will cause:Irritability, increased heart rate, increased blood pressure, restlessness, headache, dizziness, insomnia, nausea, flu like symptomswhich client is diazepam most appropriate for? select all that apply Pre op pt who expresses fear of surgery PTSD sufferer who drinks 3-4 drinks per week nursing mother with anxiety grieving widow who expresses anxietyPre op patient who expresses fear of surgery (best answer) Grieving widow who expresses anxiety (very vague, may not need it)in the first several weeks of starting an antidepressant he client is at higher risk for? restlessness insomnia suicidal ideation increased blood pressureSuicidal ideationWhich assessment for a client n lithium is subjective Blood urea nitrogen creatinine clearance liver function test ask the patient how they feel respiratory assessmentask the patient how they feelwhat medication would you give a client with status epilepticus?IV lorazepam or rectal diazepamWhat are the safety concerns for someone taking benzodiazepines?Drinking, taking other CNS depressants, breast feeding mothers, possible accidents, addictionA slow shuffling gait in a client taking antipsychotic medications is a possible sign of? Ataxia Extrapyramidal effect Tardive dyskinesia Parkinsonism reactionExtrapyramidal effect Parkinsonism reactionwhy should a pateint take carbidopa levodopa in the am?Take prior to food because protein in food interferes with medication absorptionWhat medical conditions would make taking an antipsychotic contraindicated?Cardiac issues, Kidney issues, Liver issues, Glaucoma, Bone marrow depressionWhat do you teach a client new to anti seizure medication?take the medication consistently, dont drive while being stabilized on the medication, no drinking alcohol, avoid pregnancy while on theseWhat is the most important safety assessment for a client on an opioid analgesic?Respiratory AssessmentWhat medication is administered when an opioid overdose is suspected?Narcan or NaloxoneWhat would vital signs be or a client who has overdosed on opioids?BP will be low, pulse less than 60, RR super low, low O2 satThe nurse administered oral opioid ain medication t 1900. When should she return to the bedside for reassessment? 2000 1915 1930 19451930What assessment indicators are present when pain medication as been effective?Patient reports relief, HR/BP/RR will decreaseThe client needs more medication to get the same pain relief. What is the most likely reason? Allergy Addiction Tolerance DependenceToleranceMAOI's can interact with chemicals in foods calledTyraminesAdronergic Agonists will cause?Fight or Flight. Increased heart rate, blood pressure, pupil size, RR, and glucose metabolism. Decreased GI/GU activityScopolamine is used for motion sickness. It will dry up secretions decreasing N/V. Is it an adrenergic or cholinergic agonist or antagonist?Cholinergic AntagonistAdronergic medications work at hat receptor sites?Alpha and BetaCholinergic drugs work at which receptor sites?Muscarinic and NicotinicThe rest and digest drug(s):Cholinergic agonistAgainst fight or Flight drugsAdrenergic AntagonistAgonistEncourages activityAntagonistDiscourages activityFluoxetineAntidepressant, SSRICitalopramTreats depression and anxiety, SSRILithiumMood stabilizer, mania, depression, BPDCarbidopa-levodopaTreats Parkinson's, disorders of the CNSCyclobenzaprineMuscle RelaxantNaloxoneTreats narcotic overdoseSumatriptanTreats migraines and cluster headachesScopolaminePrevents n/v post: anesthesia, narcotic pain meds, surgery