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Pharmacology quizzes
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Pharmacology
04/24/2012

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Term

The home health nurse visits the client. The client gives the nurse a bottle of clomipramine hydrochloride (Anafranil). The nurse notes that the medication has not been taken by the client in 2 months. What behaviors observed in the client would validate noncompliance with this medication?


Frequent handwashing with hot, soapy water.    
Complaints of hunger and fatigue    
A pulse rate fewer than 60 beats per minute    
Complaints of insomnia

Definition
A
Term

Drug to avoid during therapy with MAOIs are:


A. Valium, aspirin, and steroids

Lasix, Valium, and lidocaine    
Prostigmin, Prozac, and Pamelor    
  Levodopa, meperidine, and antihistamines
Definition
D
Term

Today your client begins a new drug regimen of escitalopram (Lexapro) for depression. Before administering this medication, you should assess for which of the following?

history of seizure disorders    
history of cigarette use.    
Prior diet high in tyramine-containing foods.    
  Prior recent use of monoamine oxidase inhibitor antidepressant (MAOI)s.    
Definition
D
Term

A client taking lithium is having problems with coordination and unstabel gait. the patient's lithium level is 2.3 mEq/L. The nurse should do which of the following?

 

Administer an extra dose of lithium    
Continue to administer the lithium three times per day.    
Skip a dose of lithium and then resume the regular medication schedule.    
  Withhold the lithium and notify the physician of the lithium level.
Definition
D
Term
A client receiving lithium carbonate (Lithobid) complains of loose, watery stools, and difficulty walking. The nurse would expect the serum lithium level to be which of the following?
0.7 mEq/L    
1 mEq/L    
1.3 mEq/L    
  1.8 mEq/L
Definition
D
Term

Which of the following are MAOI's?

Thorazine, Mellaril, and Haldol    
Elavil, Prozac, and Tofranil    
Cogentin, Artane, and levodopa    
  Marplan, Nardil, and Parnate
Definition
D
Term

A nurse is teaching the importance of proper diet to a patient taking tranylcypromine (Parnate) for depression. Which of the following food selection by the patient indicates that further teaching is needed?

  A sandwich with salami and Swiss cheese.
 
a tossed salad and a bowl of vegetable soup.    
a cold plate with cottage cheese, chicken salad and grapes.    
a hamburger and french fries.
Definition
A
Term
Lithium(Lithobid)
Definition
Mood-Stailizing Agent
Term
Imipramine(Tofranil)
Definition
Tricyclic Antidepressant(TCA)
Term
Phenelzine (Nardil)
Definition
Monoamine Oxidase Inhibitor (MAOI)
Term
Floxetine (Prozac)
Definition
Selective Serotonin reuptake Inhibitors
Term

The nurse is preforming a follow-up teaching session with a client discharged 1 month ago. The client is taking fluoxetine (Prozac). What information would be important for the nurse to obtain during this client visit regarding the side effects related to the medication?

Problems with excessive sweating    
  Gastrointestinal dysfunctions    
Cardiovascular symptoms    
Problems with mouth dryness
Definition
B
Term
Side effects of fluoxetine (Prozac) are:
Leukopenia, GI bleeding, and nausea    
  Insomnia, drowsiness, and nervousness    
Pruritus, nausea, and vomiting    
Diarrhea, hypertension, and nausea
Definition
B
Term

Which of the following are tricylcic antidepressants?

Elavil, Tofranil, and Pamelor    
Marplan, Nardil, and Parnate    
Lithium, Cogentin, and Artane    
Haldol, Mellaril, and Navane
Definition
A
Term

A patient who started on tricyclic antidepressant therapy should be told:

That a tyramine-free diet is necessary.    
To avoid exposure to sunlight    
  That mood improvement may take 7 to 28 days
 
That only 1 gram of sodium is allowed
Definition
C
Term

Your client has been taking imiparmine (Tofranil) for 1 week for depression. He tells you he is going to stop taking this medication because it isn't working. Your best response is which of the following?

"Contact your physician about taking a different antidepressant medication."    
  'It may take up to 4 weeks before this medication makes you feel better."
 
"You should slowly taper rather than suddenly discontinue this medication."    
"You should take an extra dose today to build up your blood level and get faster results."
Definition
B
Term

For better effectiveness, tricyclic antidepressants should be taken in the morning.

True    
  False
Definition
False
Term

Foods and drugs to avoid while taking a MAOI are: aged cheese, wine, bananas, chocolate, soy sauce, caffeine, yogurt, amphetamines, antiallergy and antiasthmatic medications.

A.True

B.False

Definition
True
Term

The hospitalized client has begun taking bupropion (Wellbutrin) as an antidepressant agent. The nurse monitors this client for which adverse effect that indicates that the client is taking an excessive amount of medication?

Dizziness when getting upright    
  Seizure activity
 
Increased weight    
Constipation
Definition
B
Term

The client's medication sheet contains an order for sertraline hydrochloride (Zoloft). To ensure safe administration of the medication, the nurse would administer the dose:

evenly spaced around the clock    
  at the same time each evening
 
on an empty stomach    
as needed when the client complains of depression
Definition
B
Term

 

Generalized Anxiety Disorder (GAD)

 

Definition
Worry about two or more circumstances and multiple symtpoms for 6 months or longer and elimination of disease processes or drugs as possible causes.
Term
Post traumatic stress Disorder (PTSD)
Definition

Develops after seeing or being involved in highly stressful events that involve actual or threatened death or serious injury.

 
Term
Obsessive Compulsive disorder (OCD)
Definition
Involves an uncontrollable desire to dwell on a thought or a feeling
Term
Social Phobia
Definition
Involves excessive concern about scrutiny by others
Term

When administering benzodiazepines to clients with malnutrition or liver disease, the nurse should monitor carefully for:

toxicity    
seizures    
withdrawal    
pradoxical exitation
Definition
A
Term
Drug tolerance
Definition
when larger amounts of the drug are need to get the same effect.
Term
Drug dependence
Definition
a physical or emotional need for the drug.
Term
Sedative
Definition
Promotes relaxation
Term
Hypnotic
Definition
Produces sleep
Term
Definition
Term

Which statement about benzodiazepines would indicate to the nurse the need for further patient teaching?

"I only use my medication when I really need it."    
  "My sister often has a sleep problem similar to mine."
 
"I avoid smoking after taking my sleeping pill."    
"I skip my evening glass of wine when I take my sleeping pill."
Definition
B
Term
Valerian
Definition
increases the amount of GABA in the brain, probably by inhibiting the transaminase enzyme that normally metabolizes GABA. Action results in calming, sedative effects
Term
Kava
Definition
Supresses emotional excitability and may produce a mild euphoria. Effects include analgesia, sedation, diminished reflexes, impaired gait, and pupil dilation
Term
Meltonin
Definition

Influences sleep-wake cycles; it is released during sleep, and serum levels are very low

during waking hours

Term

When assessing a patient before giving an antianxiety benzodiazepine, what assessment data would cause the nurse to omit the dose?

Restlessness    
tachycardia    
  respriatory depression    
irritability
Definition
C
Term
When using flumazenil (Romazicon) as an antidote for benzodiazepine overdose, the nurse should:
Administer the antidote IM into a large mucle    
Inject the antidote IV push over 5 seconds    
Administer the antidote one time only    
  Observe for re-sedation after administration of the antidote
Definition
D
Term

A patient is brought to the emergency department with ongoing tonic-clonic seizure activity. The health care provider orders lorazepam (Ativan) 4 mg IV. Lorazepam is the drug of choice for which of the following seizures?

partial seizures    
  status epilepticus    
tonic-clonic seizures    
absence seizures
Definition
B
Term

A patient is started on phenytoin (Dilantin). A teaching plan for the patient should include strategies to minimize which of the following common side effects?

hypoglycemia    
  gingival hyperplasia
 
photosensitivity    
hyponatremia
Definition
B
Term

The home health nurse visits a client who is taking phenytoin (Dilantin) for control of seizures. During the assessment, the nurse notes that the client is taking birth control pills. Which of the following information should the nurse include in the teaching plan?

The increased risk of thrombophlebitis while taking phenytoin and birth control pills together.  
  The potential decreased effectiveness of the birth control pills while taking phenytoin.
 
That the client may stop the medication if it is causing severe gastrointestinal effects.    
That pregnancy should be avoided while taking phenytoin.
Definition
B
Term

The client is taking phenytoin (Dilantin) for seizure control. A seizure drug level is drawn, and the nurse reviews the results. Which of the following would indicate a therapeutic serum drug range?

5 to 10 mcg/mL    
  10 to 20 mcg/mL
 
20 to 30 mcg/mL    
30 to 40 mcg/mL
Definition
B
Term
clonazepam and clorazepate
Definition
Used for long-term treatment of seizures disorders, alone or with other AED's
Term

Diazepam and lorazepam

Definition

Used to terminate acute convulsive seizures,

especially life-threatening seizures of status

epilepticus

Term
IV lorazepam
Definition
Drug of choice for rapid control of tonic-clonic seizures
Term

The client with epilepsy is taking the prescribed dose of pheytoin (Dilantin) to control seizures. Results of a phenytoin blood level study reveal a level of 35 mcg/mL Which of the following symptoms would be expeted as a result of this laboratory result?

No symptoms because this is a normal therapeutic level.    
  Slurred speech
 
Tachycardia    
Nystagmus
Definition
B
Term

Phenytoin (Dilantin) 100 mg PO 3 times a day, has been prescribed for the client for seizure control. The home health nurse visits the client and provides teaching regarding the medication. Which of the following statements, if made by the client, would indicate effective teaching?

"It's okay to break the capsules to make it easier for me to swallow them."    
  "I will use a soft toothbrush to brush my teeth."
 
"If I forget to take my medication, I can wait until the next dose and eliminate that dose."    
"If my throat becomes sore, it's a normal effect of the medication, and it's nothing to be concerned with."
Definition
B
Term

Periodic assessment of a client with parkinsonism should include which of the following?

Blood tests of liver function    
Blood tests of kidney function    
evaluation of mental status    
  evaluation of responses to drug therapy
Definition

 

D

Term

Carbidopa is usually given along with levodopa because it:

crosses the blood-brain barrier and acts centrally    
  inhibits peripheral breakdown of levodopa
 
directly stimulates dopamine receptors in the brain    
decreases adverse effects of anticholinergic antiparkinson drugs
Definition
B
Term
Definition
Term
Definition
Term
Definition
Term

The main purpose of combination drug therapy for parkinsonism is to:

stop disease progression    
relieve adverse effect of other drugs    
  reduce dosage of levodopa
 
delay the need for drug therapy
Definition
C
Term

Parkinson's disease is attributed to an imbalance of neurotransmitters in which of the following structures?

Basal ganglia
 
Cerebral cortex    
limbic system    
reticular activating system
Definition
A
Term

The main pathophysiology of Parkinson's disease is a decrease in brain content of which of the following substances?

acetylcholine    
serotonin    
glutamate    
  dopamine
Definition
D
Term

For a client with MS receiving baclofen (Lioresal), the main therapeutic effect is

increased drowsiness    
improved appetite    
  decreased muscle spasticity    
improved renal function
Definition
C
Term

Adverse effects of centrally active skeletal muscle relaxants include which of the following?

muscle spasms    
insomnia    
nervousness    
  hypotension
Definition
D
Term

Which of the following muscle relaxants is the only one that acts peripherally on muscles?

danrolene (Dantrium)
 
baclofen (Lioresal)    
methocarbamol (Robaxin)    
diazepam (Valium)
Definition
A
Term

When administering atypical antipsychotics, the nurse should be alert to possible:

renal failure    
liver failure    
hypertension    
  diabetes mellitus
Definition
D
Term

For patients taking clozapine, the nurse should assess which of the following laboratory values weekly?

liver enzyme studies    
blood urea nitrogen and creatinine    
hemaglobin and hematocrit    
  complete blood count
Definition
D
Term
Akathisia
Definition
Compulsive involuntary restlessness and body movements
Term
Dyskinesia
Definition
Involuntary, rhythmic body movements
Term
Dystonia
Definition

Uncoordinated, bizarre movements of the neck,

face, eyes, tongue, trunk, or extremities

Term
Tardive dyskinesia
Definition

Hyperkinetic movements of the face such as

smacking lips, sucking, tongue protrusion, and

facial grimacing)

Term

Parkinsonism (sometimes called

Pseudoparkinsonism)

Definition

Loss of muscle movement (akinesia), muscular

rigidity and tremors, shuffling gait, postrual abnormalities, mask-like facial expressions, hypersalivation, and drooling

Term

The nurse should administer long-acting injections of antipsychotic drugs in which of the following ways?

intramuscular into the deltoid muscle    
  intramuscularly into the ventrogluteal muscle
 
subcutaneously into the abdomen    
Intraveneously into a large vein
Definition
B
Term

An adverse effect of long-term use of phenothiazine antipsychotics is the development of which of the following?

Glaucoma    
  tardive dyskinesia
 
Hypertension    
diabetes
Definition
B
Term

A patient is receiving fluphenazine hydrochloride (Prolixin) daily. The nurse would teach the patient to do which of the following to minimize common side effects of this medication?

Have the blood pressure checked one a week.    
Monitor the temperature daily.    
Eat snacks at midmorning and at bedtime.    
  Use hard sour candy or sugarless gum.
Definition
D
Term
clozapine (Clozaril)
Definition
Atypical antipyschotic agents
Term
chlorpromazine (Thorazine)
Definition
Phenothiazines
Term
haolperidol (Haldol)
Definition
First-generation "typical" drugs
Term

A 26-year-old female patient with schizophrenia has been prescribed chlorpromazine (Thorazine). The patient calls the mental health clinic and tells the nurse that her urine has become dark. The patient has no other urinary symptoms. The nurse tells the client

  That this is an expected side effect of the medication.    
To increase intake of acid-ash foods and liquids.    
To seek treatment for urinary tract infection.    
that his indicateds medication toxicity
Definition
A
Term

A client recently started on methylphenidate (Ritalin) for treatment of ADHD complains that he is unable to go to sleep at night. Which of the following is the best response of the nurse? (Select all that apply.)

  Assess for time of day that Ritalin is taken.
 
Assess for caffeine intake, especially late in the afternoon or evening hours.    
Inform the health care provider that the client is unable to fall asleep while taking Ritalin.    
Suggest taking melatonin to assist in nighttime drowsiness.    
Assess for non-pharmacological measures taken to induce sleep.
Definition
1.
Term

An elderly client with Parkinson's disease is being seen because the daughter states the client cannot stay awake in the daytime. The client is sleeping most of the day, and is having trouble sleeping at night. The client has no history of cardiac events, and liver and renal test results are within normal limits. The client has no other psychiatric history. VS and electrolytes are within normal limits. The client is slightly underweight for height. The nurse would anticipate a prescription for which of the following medications? 

Sodium oxybate    
Selegiline (Eldepryl)    
  Modafinil (Provigil, Alertec)

 
Methylphenidate (Ritalin)
Definition
C
Term

Atomoxetine (Strattera) has been prescribed for an 8-year-old patient newly diagnosed with ADHD. Which of the following comments by the mother would indicate that the nurse needs to perform more teaching?

  "I will keep this medication in a secure place, because it is popular as a recreationally abused drug."
 
"I will monitor my child's appetite and watch for excessive weight loss."    
"I must look for signs of suicidal ideation."    
"I will monitor my child for a persistent cough that does not go away."
Definition
A
Term

A friend of the nurse expresses concern that her husband might have narcolepsy. She states that he falls asleep whenever he sits quietly for more than five minutes. He even falls asleep during his favorite team's football games. Which of the following would indicate to the nurse that he needs further workup by his health care provider?

The husband has difficulty staying awake about 1—2 hours after having lunch each day.    
  The husband has to put the vehicle in park every time he comes to a stoplight, because he often falls asleep for several minutes whenever parked and waiting for the light to turn green.
 
The husband falls asleep as soon as he lies down at night.    
The husband sometimes nods off, and has difficulty staying alert at home Bible study gatherings.
Definition
B
Term
Definition
Term

A mother expresses concern over her daughter's use of an inhaler for asthmatic episodes. The daughter is taking Adderall XR for ADHD. The mother states that since beginning the Adderall, every time the daughter uses her inhaler, she gets very agitated, jittery, and anxious. What would be an appropriate response?

"Inhalers used for asthma tend to cause central nervous system stimulation, just as medications for ADHD do. Her symptoms are likely due to the additive effect of having both medications."
 
"The daughter needs to see her primary care provider to have her asthmatic medication changed to another medication."    
"The Adderall should be discontinued during times of asthma exacerbation."    
"The daughter will need to discontinue her treatment for ADHD, as it is contraindicated with medications use to treat asthma."
Definition
A
Term

When a CNS stimulant is used to treat a child with ADHD, which of the following outcomes is expected?

increased behavioral problems.    
  improved performance in schoolwork
 
decreased ability to complete a task    
increased hyperactivity
Definition
B
Term

Caffeine and other CNS stimulants may cause which of the following adverse effects?

increased appetite    
respiratory depression    
sedation    
  cardiac dysthythmias
Definition
D
Term

A child receiving a CNS stimulant for ADHD should be monitored for which of the following?

abnormal liver function    
  weight loss    
fever    
seizure activity
Definition
B
Term

A 35-year-old client with a history of migraine headaches tells the nurse at her provider's office that in the past six months, she has needed to use her medication to abort her headaches on the average of 5—6 times a month, despite avoiding her migraine triggers. The nurse discusses with the client that the next step in her therapy might be to:

Take a drug holiday to clear out her system.    
Try a different drug to abort the headaches.    
  Try a drug to prevent the headaches.
 
Review her migraine triggers and look for new ones.
Definition
C
Term

The nurse is teaching a client who is starting sumatriptan therapy for treatment of migraine headaches. The nurse instructors the client to take the drug:

First thing in the morning if expecting a headache.    
When the client can lie down for one hour after taking the drug.    
About 30 minutes after the start of the headache.    
  At the first sign of aura or headache
Definition
D
Term

A 52-year-old client with a history of obesity, asthma, peripheral vascular disease, and migraine headaches tells the nurse she saw an advertisement in a magazine for a drug for migraine headaches. "The drug was Imitrex; it looked very effective, and I wonder why my provider hasn't talked to me about using it for my headaches." What is the nurse's best response?

"You have asthma, so you cannot use the drug."    
"I think it will be good for you, bring in the ad."    
  "Your peripheral vascular disease is a contraindication for the drug."
 
"Once you lose some weight, the drug will be perfect for you."
Definition
C
Term

A client is experiencing neuropathy of the lower extremities, and has been receiving an opioid analgesic for pain. The client continues to experience pain, and the provider has added a tricyclic antidepressant medication (TCA) for pain management. The client asks the nurse, "Why am I getting this new drug? I am not depressed, my feet just burn." What is the best response from the nurse?

"Maybe this is a mistake, if you are not depressed."    
"Sometimes people get depressed with chronic pain."    
  "These drugs also help with the nerve pain you are having in your feet."
 
"It is to help you sleep at night instead of using the opioid."
Definition
C
Term

When administrating opioid drugs, an opioid antagonist should be readily available in case of which of the following?

The client experiences hyperventilation.    
The client has hypovolemia.    
The client has nausea and vomiting.    
  The client experiences hypoventilation.
Definition
D
Term

Clients and health care providers' beliefs can often interfere with successful pain management. A commonly held myth is:

Clients cannot sleep when experiencing pain.    
Clients will not become addicted to their medication.    
Vital signs are unreliable indicators of pain.    
  Clients must look and act like they are in pain.
Definition
D
Term

Somatic pain is a type of nociceptor pain that is usually experienced in:

Cancer or tumors    
Internal organs    
The nerves    
  Muscles and joints
Definition
D
Term

The client is a 10-year-old child admitted to the Emergency Department after "huffing" gasoline. The physician suspects mild brain damage. What signs will the nurse teach the parents to observe for after they take the child home?

Irregular pulse, fainting, and anger    
Nausea, vomiting, and dizziness    
Depression, cold extremities, and dyspnea    
  Slurred speech, memory loss, and personality changes
Definition
D
Term

The client is withdrawing from opioids. Which symptoms best describe the results of the nurse's assessment? (Select all that apply.)

  Dilated pupils
 
Hypotension    
Diaphoresis    
Abdominal cramping and pain    
Pinpoint pupils
Definition
1.
Term

The adolescent client is in a drug rehabilitation program. The mother of this client says to the nurse, "The doctor said my son has a physical addiction to alcohol. What does this mean?" What is the best response by the nurse?

"His body is used to alcohol; he will have specific withdrawal symptoms when it is stopped."
 
"He will have feelings of depression when stopping alcohol; we need to monitor him for suicide."    
"His brain remembers the euphoria he had with alcohol, and he has a craving to return to it."    
"He will have an intense craving for alcohol; this is best managed in group therapy."
Definition
A
Term

The client is postop, day 1 after an abdominal hysterectomy, and is requesting morphine sulfate intravenous (IV), which is prescribed. The client rates her pain as 8 out of 10, with 10 being the most intense. The nurse caring for this client says to another nurse, "She really doesn't look like she is in pain. Maybe she is an addict." What is the best response by the other nurse?

"You could call the doctor and get an order for an oral medication."    
"Maybe you could tell her to do some distraction techniques first."    
"I would hold the medication until she looks like she is in pain."    
  "I would give the morphine; pain is subjective, and we don't know her history."
Definition
D
Term

Prior to administering sumatriptan for migraine headaches, the nurse should assess for:

Use of ergot preparations in past 24 hours.    
bradycardia    
elevated blood glucose level    
adequate urine output
Definition
A
Term

The nurse would question the pain medication order for which of the following patients?

acetaminophen for OA in a 60-year-old man with peptic ulcer disease    
celecoxib for RA in a 48-year-old woman taking warfarin    
acetaminophen for a headache in a 55-year-old man scheduled for surgery in the morning.    
  aspirin for a feverish 12-year-old child with influenza
Definition
D
Term
Analgesia
Definition
inactivates cyclooxygenase, the enzyme that initiates the formation of prstaglandins from arachidonic acid, preventing the formation of prostaglandins and their effect on tissues
Term
Antipyresia
Definition
acts on the hypothalamus to reduce fever and reset the thermostat.
Term
Anti-inflammatory
Definition
prevents prostaglandins from increasing pain and edema.
Term
Antiplatelet
Definition
ASA dissociates the acetyl portion that binds irreversibly with cyclooxygenase, preventing the synthesis of thromboxane A2 and inhibiting platelet aggregation.