pharm 29-31

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pharm 29-31
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  1. Anorectic agents are drugs that reduce the appetite
    True
  2. Anorectic agents are suitable for long-term therapy.
    False
  3. Anorectic agents are available as both short- and sustained-acting products.
    True
  4. Analeptic agents are sometimes used to stimulate respiration.
    True
  5. Caffeine is the most commonly used CNS stimulant in the United States.
    True
  6. The use of anorectic drugs is contraindicated in clients:

    a.
    with hypotension.
    b.
    with bradycardia.
    c.
    who take monoamine oxidase (MAO) inhibitors.
    d.
    who are overweight.
    c. who take monoamine oxidase (MAO) inhibitors
  7. A child is prescribed atomoxetine HCl. The nurse instructs the mother to monitor her child for:

    a.
    increased hunger.
    b.
    increased thirst
    c.
    polyuria.
    d.
    increased attention span.
    d. increased attention span.
  8. The nurse identifies Nutrition altered, more than body requirements related to obesity as the nursing diagnosis for a client taking an anorexiant. A successful outcome of this diagnosis would be that the client:

    a.
    loses two to four pounds per month until desired weight is obtained.
    b.
    joins an exercise group.
    c.
    verbalizes a 1500-calorie-per-day diet plan.
    d.
    weighs self daily.
    a. loses two to four pounds per month until desired weight is obtained.
  9. While teaching the mother of a child receiving atomoxetine HCl about the drug, the mother asks the nurse what norepinephrine is. The nurse’s best response would be:

    a.
    “It’s a neurotransmitter in the brain that decreases excitability.”
    b.
    “It is a chemical that regulates what a person thinks and how he or she reacts.”
    c.
    “It is a chemical in the brain that helps focus attention and organize thoughts.”
    d.
    “It is the opposite of dopamine, the chemical that causes Parkinson’s disease.”
    c. “It is a chemical in the brain that helps focus attention and organize thoughts.”
  10. After client teaching about methylphenidate HCL, which statement by the client would indicate further teaching is necessary?

    a.
    “I should take this medication early in the day.”
    b.
    “I should ask my doctor about my anticoagulant medication.”
    c.
    “This medication may cause physical dependence.”
    d.
    “This medication is safe to take with my MAO inhibitor.”
    d. “This medication is safe to take with my MAO inhibitor.”
  11. The child prescribed atomoxetine HCl asks if she can still play school soccer once she starts her medication. The most appropriate nursing response would be:

    a.
    “This medication can cause dizziness, so you’ll need to let your coach know.”
    b.
    “Certainly you can, and this medication will probably help you play better.”
    c.
    “It would be better for you to not play soccer this season.”
    d.
    “Soccer is a rather demanding sport, don’t you think?”
    a. “This medication can cause dizziness, so you’ll need to let your coach know.”
  12. An adult prescribed atomoxetine HCl should be monitored for which of the following adverse effects of this medication?

    a.
    vomiting
    b.
    insomnia
    c.
    abdominal pain
    d.
    dyspepsia
    b. insomnia
  13. The client asks the nurse which of the following has the least amount of caffeine. The nurse should respond:

    a.
    coffee.
    b.
    cola soda.
    c.
    hot tea.
    d.
    chocolate milk.
    d. chocolate milk.
  14. A child receiving atomoxetine should be monitored for which of the following adverse effects in children?

    a.
    dry mouth
    b.
    upset stomach
    c.
    constipation
    d.
    decreased libido
    b. upset stomach
  15. The daughter of a client with Alzheimer’s disease asks what has caused her father’s disease. The nurse’s best response is:

    a.
    “We don’t know the exact cause.”
    b.
    “His brain lacks norepinephrine.”
    c.
    “His brain is deficient in dopamine.”
    d.
    “His brain is experiencing accelerating aging changes.”
    a. “We don’t know the exact cause.
  16. Some CNS stimulants are used in the treatment of narcolepsy. Narcolepsy is best described as a condition characterized by:

    a.
    the inability to fall asleep at night.
    b.
    attacks of sleep occurring throughout the day.
    c.
    the inability to remain asleep throughout the night.
    d.
    lack of REM sleep.
    b. attacks of sleep occurring throughout the day.
  17. The nurse understands that most medications used to treat Alzheimer’s disease exert their effects to:

    a.
    increase anticholinergic activity.
    b.
    increase norepinephrine
    c.
    increase acetylcholine levels.
    d.
    increase dopamine receptor activity.
    c. increase acetylcholine levels
  18. The wife of a client recently diagnosed with Alzheimer’s disease asks the nurse if the medication he is prescribed will cure his disease. The nurse’s best response would be:

    a.
    “The medication is designed to restore his memory, but it isn’t a cure.”
    b.
    “Currently there is no cure for his disease, but this medication will make him behave better.”
    c.
    “I’m not sure. We are still learning about his illness. Maybe it will cure him.”
    d.
    “His medication will help him act more like himself longer, but it won’t cure him.”
    d. “His medication will help him act more like himself longer, but it won’t cure him.”
  19. After beginning Alzheimer’s treatment with donepezil, the client’s wife states that her husband “has been so irritable since he started his medication.” The nurse’s response is based on knowledge that this reaction is:

    a.
    a normal response to this drug.
    b.
    a manifestation of toxicity.
    c.
    rare and indicates a problem.
    d.
    one that occurs initially and then subsides.
    d. one that occurs initially and then subsides
  20. The nurse understands how Alzheimer’s medications work. Which of the following is accurate?

    a.
    rivastigmine-increases anticholinergic effect
    b.
    galantamine HBr-increases acetylcholinesterase
    c.
    tacrine HCl decreases acetylcholine levels
    d.
    memantine controls levels of glutamate
    d. memantine controls levels of glutamate
  21. Clients receiving donepezil, rivastigmine, galantamine HBr, or tacrine HCl should be monitored for:

    a.
    hypertensive crisis.
    b.
    cholinergic crisis.
    c.
    suicidal tendencies.
    d.
    tachycardia.
    b. cholinergic crisis
  22. A client being treated for Alzheimer’s disease is experiencing diaphoresis, tachycardia, “severe” vomiting, and hypotension. The nurse anticipates the client will need to be treated with:

    a.
    IV atropine sulfate.
    b.
    an increase in the dose of Alzheimer medication.
    c.
    digoxin by mouth.
    d.
    ondansetron IV.
    a. IV atropine sulfate.
  23. The nurse is teaching the client with Alzheimer’s disease and his wife about rivastigmine. The wife asks the nurse when her husband’s dose can be increased. The nurse responds:

    a.
    no more often than every week.
    b.
    no more often than every two weeks
    c.
    it should not need to be increased.
    d.
    no more often than every four weeks.
    b. no more often than every two weeks
  24. Clients receiving Alzheimer’s medications should be instructed to take their medication:

    a.
    on an empty stomach.
    b.
    in divided doses
    c.
    with food.
    d.
    daily at bedtime.
    c. with food
  25. The definitive diagnosis of Alzheimer’s disease is made:

    a.
    with the results of a brain scan.
    b.
    with the results of acetylcholine levels.
    c.
    with the results from the autopsy.
    d.
    with clinical manifestations.
    c. with the results from the autopsy
  26. Competitive neuromuscular blocking agents mimic the action of acetylcholine.
    False
  27. Methocarbamol (Robaxin) may turn urine brown, black, or green.
    True
  28. Antidotal drugs such as neostigmine can only reverse the actions of competitive neuromuscular blocking agents.
    True
  29. Centrally acting skeletal muscle relaxants are useful in treating chronic disorders characterized by involuntary motor activity.
    True
  30. Neuromuscular blockade, the intentional paralysis of a client using medications that paralyze skeletal muscle groups, also causes paralysis of cardiac muscle
    False
  31. A client is admitted to the hospital with acute severe burns to his upper torso from an explosion. He is prescribed a neuromuscular blocking agent for which of the following reasons?

    a.
    to facilitate surgery by reducing muscle movement
    b.
    to aid in the treatment of a condition resulting in severe muscle spasms
    c.
    to facilitate electroconvulsive therapy by reducing muscle movement
    d.
    to prevent muscle spasm of the larynx in clients who require endotracheal intubation
    d. to prevent muscle spasm of the larynx in clients who require endotracheal intubation
  32. When preparing a client for the administration of atrocurium, the nurse should:

    a.
    prepare emergency equipment to support the client’s respiratory system.
    b.
    administer neostigmine intravenously.
    c.
    prepare the atrocurium for intramuscular administration.
    d.
    prepare the client for paralysis of smooth muscles.
    a. prepare emergency equipment to support the client’s respiratory system
  33. The nurse should monitor clients receiving dantrolene for hepatic adverse effects:

    a.
    within days of initiating therapy.
    b.
    3-4 weeks after initiating therapy.
    c.
    3-12 months after initiating therapy.
    d.
    after therapy has been discontinued.
    c. 3-12 months after initiating therapy
  34. The nurse understands that the most common use of neuromuscular blockade is to:

    a.
    sedate clients with a head injury.
    b.
    treat the client with multiple sclerosis.
    c.
    facilitate intubation and mechanical ventilation.
    d.
    decrease spasticity and muscular rigidity.
    c. facilitate intubation and mechanical ventilation
  35. Nursing care of the client receiving a neuromuscular blocking agent while on a mechanical ventilator includes to:

    a.
    avoid using mechanical ventilators, as these may startle the client.
    b.
    be sure to leave the call button within the client’s reach.
    c.
    provide frequent mouth care to the client.
    d.
    communicate to the client what the nurse is going to do before touching the client.
    d. communicate to the client what the nurse is going to do before touching the client.
  36. The nurse questions the use of which of the following agents in a client who has recently received a neuromuscular blocking agent?

    a.
    gentamicin
    b.
    levodopa
    c.
    diazepam
    d.
    aspirin
    a. gentamicin
  37. A client with cerebral palsy is prescribed diazepam for involuntary muscle movement because of its action as a/an:

    a.
    anxiolytic.
    b.
    centrally acting skeletal muscle relaxant.
    c.
    neuromuscular blocking agent.
    d.
    direct-acting skeletal muscle relaxant.
    b. centrally acting skeletal muscle relaxant
  38. The nurse understands that methocarbamol is contraindicated:

    a.
    in clients with acute muscle spasms.
    b.
    as a centrally acting muscle relaxant
    c.
    for use as a pediatric muscle relaxant.
    d.
    for oral administration.
    c. for use as a pediatric muscle relaxant
  39. For the client prescribed baclofen, the nurse should:

    a.
    closely monitor the client for hypersensitivity reaction.
    b.
    monitor the client for worsening of urinary retention.
    c.
    instruct the client that this drug may discolor the urine purple-red.
    d.
    instruct the client that this drug causes drowsiness.
    d. instruct the client that this drug causes drowsiness.
  40. Dantrolene is prescribed intravenously for a client to:

    a.
    facilitate mechanical ventilation.
    b.
    prevent development of malignant hyperthermia.
    c.
    facilitate induction of anesthesia.
    d.
    clients with history of myasthenia gravis.
    b. prevent development of malignant hyperthermia
  41. The nurse knows that when caring for clients being treated with neuromuscular blocking agents, what drug should be available?

    a.
    naxolone
    b.
    neostigmine
    c.
    succinylcholine
    d.
    carisoprodol
    b. neostigmine
  42. When instructing a client about dantrolene, the nurse should:

    a.
    inform client to avoid direct sunlight.
    b.
    caution client about the risk of drowsiness.
    c.
    instruct client to drink plenty of fluids to prevent constipation.
    d.
    tell client to inform the health care provider immediately if the drug causes insomnia.
    a. inform client to avoid direct sunlight
  43. A 40-year-old woman is prescribed dantrolene. The nurse should monitor the client for:

    a.
    gastrointestinal upset.
    b.
    increased risk of urinary tract infection
    c.
    hepatotoxicity.
    d.
    nephrotoxicity.
    c. hepatotoxicity.
  44. A client with myasthenia gravis is prescribed pyridostigmine bromide (Mestinon) to:

    a.
    decrease concentration of dopamine.
    b.
    increase concentration of acetylcholine.
    c.
    decrease activity at the internuncial neurons.
    d.
    increase calcium use in the skeletal muscles.
    b. increase concentration of acetylcholine.
  45. A client is scheduled for a diagnostic test to see if the client has myasthenia gravis. The nurse prepares what medication for this test?

    a.
    edrophonium
    b.
    orphenadrine
    c.
    succinylcholine Cl
    d.
    methocarbamol
    a. edrophonium
  46. When caring for a client receiving pyridostigmine bromide (Mestinon), the nurse should:

    a.
    monitor for cholinergic crisis.
    b.
    administer the medication SC.
    c.
    limit the client’s fluid intake.
    d.
    monitor for an autoimmune response.
    a. monitor for cholinergic crisis.
  47. A client receiving pyridostigmine bromide (Mestinon) develops muscle weakness, difficulty breathing, and difficulty swallowing. The nurse should:

    a.
    prepare to administer atropine sulfate.
    b.
    notify the health care provider for an increase in the dose of pyridostigmine bromide.
    c.
    prepare the client for intubation.
    d.
    position the client in a supine position.
    a. prepare to administer atropine sulfate
  48. When instructing a client receiving pyridostigmine about self-administration at home, which client comment indicates that the client understands the teaching?

    a.
    “If I miss a dose of my medicine I should double-up for the next dose.”
    b.
    “I must take my medication exactly on time.”
    c.
    “I will need to have routine pyridostigmine blood levels drawn.”
    d.
    “If I develop a skin rash, I will immediately stop taking the drug.”
    b. “I must take my medication exactly on time.”
  49. A client is diagnosed with RLS (restless legs syndrome). The nurse anticipates which of the following agents specifically approved for the treatment of RLS to be prescribed for this client?

    a.
    methocarbamol
    b.
    carbidopa
    c.
    ropinirole
    d.
    metaxalone
    c. ropinirole
  50. When obtaining the history from a client with primary RLS, the nurse expects complaints that symptoms are:

    a.
    worse in the morning on waking up.
    b.
    primarily noticeable after exercising.
    c.
    worse in the evening and at bedtime.
    d.
    associated with pregnancy.
    c. worse in the evening and at bedtime
  51. A client from the nursing unit in radiology for a chest radiograph is scheduled to receive pyridostigmine bromide at 1700. At 1645,the client has not returned to the nursing unit from X-ray. The nurse should:

    a.
    call radiology to see if the client will be returning to the unit within the next 30 minutes.
    b.
    plan to administer the medication as soon as the client returns.
    c.
    take the medication to the client in radiology, so it can be administered at 1700.
    d.
    delegate and send the nursing assistant to radiology to give the client the medication.
    c. take the medication to the client in radiology, so it can be administered at 1700
  52. During drug therapy for Parkinson’s disease often the disease continues to progress, necessitating adjustments in drugs used.
    True
  53. Clients with Parkinson’s disease have excessive amounts of acetylcholine and deficiency of dopamine
    True
  54. Tolcapone, the newest of the drugs used for Parkinson’s disease, is the treatment of choice for most clients.
    False
  55. Amantadine was originally developed and used for the treatment of viral disorders.
    True
  56. The most common adverse side effect of amantadine is the risk of liver failure.
    False
  57. When assessing a client’s knowledge about Parkinson’s disease, the nurse recognizes more teaching is needed when the client comments,

    a.
    “The main symptoms of the disease come from not having enough dopamine.”
    b.
    “I inherited Parkinson’s from my parents.”
    c.
    “Having this disease means my lack of coordination may cause me to drop things.”
    d.
    “Usually Parkinson’s disease begins slowly with symptoms developing over a period of months to years.”
    b. “I inherited Parkinson’s from my parents.”
  58. Home care/client teaching for clients receiving levodopa should include which of the following?

    a.
    Take the medication with a high protein food to avoid GI distress.
    b.
    Drinking plenty of fluids will help decrease the dry mouth response.
    c.
    Use caution and rise slowly from a bed or chair.
    d.
    Levodopa should be taken once daily at night.
    c. Use caution and rise slowly from a bed or chair
  59. When developing a care plan for a client with Parkinson’s disease, the nurse would identify which of the following nursing diagnoses as the highest priority:

    a.
    Altered nutrition, more than body requirements related to increased appetite.
    b.
    Deficient knowledge related to disease process and treatment regime.
    c.
    Impaired physical mobility related to hand tremors.
    d.
    Risk for injury, falls related to lack of coordination in movements.
    d. Risk for injury, falls related to lack of coordination in movements
  60. The most common adverse effects experienced by clients taking levodopa include:

    a.
    nausea, vomiting, orthostatic hypotension.
    b.
    facial droop, drooling, psychiatric disturbances.
    c.
    shuffling gait, muscle rigidity, anxiety.
    d.
    lack of coordination, disturbed equilibrium, hypertension.
    a. nausea, vomiting, orthostatic hypotension
  61. The nurse understands that apomorphine is sometimes used for clients with Parkinson’s disease:

    a.
    to facilitate restfulness.
    b.
    as a rapid “rescue” from a “frozen” state.
    c.
    to reverse the depressive effects of acetylcholine.
    d.
    as an analgesic for painful muscle spasms.
    b. as a rapid “rescue” from a “frozen” state.
  62. When teaching a client prescribed tolcapone, the nurse should instruct the client that the client:

    a.
    should not take the tolcapone at the same time during the day as other MAO inhibitors.
    b.
    will need to have liver function tests monitored every two weeks for the first year of therapy.
    c.
    may need to increase his levodopa increased when tolcapone is started.
    d.
    when taken over a period of years, tolcapone (Tasmar) will cure Parkinson’s disease.
    b. will need to have liver function tests monitored every two weeks for the first year of therapy
  63. The client with Parkinson’s disease prescribed carbidopa to be used in combination with levodopa asks the nurse why this has been prescribed. The nurse’s best response would be:

    a.
    “The carbidopa prevents levodopa breakdown, so you’ll need less levodopa.”
    b.
    “With an increase in your levodopa, the carbidopa will give you better relief of your symptoms.”
    c.
    “The carbidopa increases the speed at which levodopa transforms into dopamine.”
    d.
    “The carbidopa decreases the adverse effects of levodopa.”
    a. “The carbidopa prevents levodopa breakdown, so you’ll need less levodopa
  64. Carbidopa can best be classified as a(n):

    a.
    neuromuscular blocking agent.
    b.
    anticholinergic agent.
    c.
    neurotransmitter.
    d.
    decarboxylase inhibitor.
    d. decarboxylase inhibitor.
  65. After being diagnosed with Parkinson’s disease, which of the following responses made to the nurse by the client would indicate a basic understanding of Parkinson’s disease?

    a.
    “I have too much dopamine in my brain.”
    b.
    “I need to increase the amount of calcium in my diet.”
    c.
    “I don’t have enough levodopa in my brain.”
    d.
    “I have too much acetylcholine in my brain.”
    d. “I have too much acetylcholine in my brain.”
  66. When teaching clients taking levodopa alone, the nurse should instruct them not to take vitamin supplements containing:

    a.
    pyridoxine (B6).
    b.
    thiamine (B1).
    c.
    riboflavin (B2).
    d.
    cyanocobalamin (B12).
    a. pyridoxine (B6).
  67. In administering oral medications to a client with Parkinson’s disease the nurse:

    a.
    gives a large quantity of water.
    b.
    is careful not to rush the client.
    c.
    speaks in a loud voice.
    d.
    selects liquid preparations whenever possible.
    b. is careful not to rush the client.
  68. The therapeutic effectiveness of anti-Parkinson drugs can be assessed through observations regarding:

    a.
    the frequency of gastrointestinal upset.
    b.
    an absence of psychological changes.
    c.
    the ability to ambulate, speak, and provide self-care.
    d.
    the number of hours per night the client sleeps.
    c. the ability to ambulate, speak, and provide self-care.
  69. When a client is to begin taking carbidopa/levodopa after having been on levodopa alone, the nurse should advise the client to:

    a.
    stop taking levodopa at least one week before starting carbidopa/levodopa.
    b.
    continue using the levodopa for at least one week after starting carbidopa/levodopa.
    c.
    discontinue levodopa at least eight hours before carbidopa/levodopa therapy begins.
    d.
    administer the first dose of carbidopa/levodopa simultaneously with the last dose of levodopa.
    c. discontinue levodopa at least eight hours before carbidopa/levodopa therapy begins.
  70. A client asks the nurse if his medications for Parkinson’s disease will cure his disease. The nurse’s best response would be:

    a.
    “Yes, but this will not occur until after years of therapy.”
    b.
    “Yes, if you take the medications as they are prescribed.”
    c.
    “No, although the medications are designed to reverse the damage done by the disease.”
    d.
    “No, at this time there is not cure for the disease, but these medications can manage the symptoms.”
    d. “No, at this time there is not cure for the disease, but these medications can manage the symptoms.”
  71. A client is prescribed carbidopa/levodopa in the form of Sinemet 10/100. The nurse explains to the client that this indicates what dosage of this medication?

    a.
    10 mg of carbidopa and 100 mg of levodopa.
    b.
    10 mg of levodopa and 100 mg of carbidopa.
    c.
    equal amounts of levodopa and carbidopa.
    d.
    10 times the dose of carbidopa than of levodopa.
    a. 10 mg of carbidopa and 100 mg of levodopa.
  72. A client is prescribed a monoamine oxidase inhibitor for the treatment of his Parkinson’s disease. The nurse anticipates that this drug is:

    a.
    amantadine.
    b.
    selegiline.
    c.
    benztropine mesylate.
    d.
    bromocriptine mesylate.
    b. selegiline.
  73. A client is prescribed benztropine mesylate for treatment of her Parkinson’s symptoms. The nurse understands this agent is:

    a.
    an antidopaminergic agent.
    b.
    an acetylcholinergic stimulant
    c.
    an anticholinergic agent.
    d.
    a dopamine receptor stimulant.
    c. an anticholinergic agent.
  74. The nurse should offer the client taking benztropine mesylate which suggestion to cope with the adverse effects of this agent:

    a.
    “Exercising daily and remaining active will help decrease the fatigue associated with this drug.”
    b.
    “Eating foods high in dark green leafy vegetables and other carbohydrates will increase your energy level from lack of B vitamins.”
    c.
    “Drinking at least 10 glasses of water a day will decrease the darkening of your urine associated with this drug.”
    d.
    “Sucking on sugar-free hard candy and increasing your fluid intake with help decrease the dry mouth associated with this drug.”
    d. “Sucking on sugar-free hard candy and increasing your fluid intake with help decrease the dry mouth associated with this drug.”
  75. Newer treatments for Parkinson’s disease include the use of antioxidants such as:

    a.
    vitamin C.
    b.
    vitamin E.
    c.
    vitamin D.
    d.
    calcium.
    b. vitamin E.
  76. The nurse understands that most adverse effects associated with levodopa are related to:

    a.
    the chemical make-up of the drug.
    b.
    the large doses required for therapy.
    c.
    the frequent drug-drug interactions.
    d.
    the route of administration.
    b. the large doses required for therapy
  77. When assessing a client diagnosed with Parkinson’s disease for evidence of inadequate drug management of the disease, the nurse anticipates the client will exhibit which of the following manifestations?
    a.
    shuffling unsteady gait
    b.
    nausea and vomiting
    c.
    urinary retention
    d.
    orthostatic hypotension
    a. shuffling unsteady gait
  78. A client is prescribed apomorphine. The nurse prepares to administer this medication via what route?

    a.
    oral
    b.
    subcutaneous
    c.
    intramuscular
    d.
    intravenous
    b. subcutaneous
  79. When caring for the client with Parkinson’s disease, the nurse’s assessment of the client is influenced by an understanding that these clients:

    a.
    frequently demonstrate noncompliance with drug therapy.
    b.
    frequently demonstrate psychiatric health problems.
    c.
    often have a family history of cognitive impairment.
    d.
    usually develop additional health problems.
    d. usually develop additional health problems
  80. Many clients with Parkinson’s disease experience negative feelings about how they appear, because of the manifestations of this disease. An appropriate goal for these clients would be:

    a.
    Client will experience decreasing tremors and spasms.
    b.
    Client will verbalize positive feelings about body image.
    c.
    Client will verbalize understanding of disease process and treatment plan.
    d.
    Client will maintain weight within defined limits.
    b. Client will verbalize positive feelings about body image.

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