CNS Depressants/Stimulants
A patient has received an overdose of the benzodiazepine, midazolam [Versed]. The appropriate antidote is:
Flumazenil (Romazicon)
Which of the following possible side effects of neuroleptic medication (e.g. haloperidol [Haldol]) may become irreversible?
Tardive Dyskinesia
Which of the following statements about the antidepressants is FALSE?
Many of these drugs have relatively potent anticholinergic effects.
Fluoxetine [Prozac] metabolite has a half-life measured in days.
Fluoxetine has been reported to increase the toxicity of a number of drugs (e.g., tricyclics)
Fatal hyperpyrexia has been reported when meperidine [Demerol] has been administered to patients on MAO inhibitor drugs (e.g., tranylcypromine [Parnate])
Controlled studies show the selective serotonin reuptake inhibitors (SSRIs) produce markedly superior results over the older tricyclic antidepressants
E. Controlled studies show the selective serotonin reuptake inhibitors (SSRIs) produce markedly superior results over the older tricyclic antidepressants
Which statement, if made by the client, would alert the nurse that the antiparkinson medication is effective?
A. I’m sleeping a lot more, especially during the day
B. My appetite has improved
C. I’m able to shower by myself
D. My skin doesn’t itch anymore.
C. I’m able to shower by myself
Of the following, the drug of choice for treating generalized tonic-clonic seizures in adults is
C. phenytoin [Dilantin]
Mike, an 8 year old with undifferentiated ADHD, is to receive methylphenidate [Ritalin] daily. He must be assessed for adverse effects of methylphenidate which include:
D. altered growth & development
The antipsychotic drugs (e.g., phenothiazines, thioxanthines, butyrophenones) may cause Parkinson-like symptoms (extrapyramidal symptoms) by blockade of dopamine receptors in the
striatum (basal ganglia)
A health care provider has ordered imipramine (Tofranil) for each of these clients. A nurse should question the order for the client with:
A. Seizure disorders
B. Depression
C. Enuresis
D. Neuropathic pain
C. Enuresis
The nurse, who is monitoring a client taking phenytoin (Dilantin) has noted symptoms of nystagmus, confusion and ataxia. Considering these findings, the nurse would expect that the dose of the drug should be:
A. Reduced
B. Increased
C. Maintained
D. Discontinued
A. Reduced
D. Discontinued
Early signs of toxicity in a patient with epilepsy receiving phenytoin [Dilantin] include:
nystagmus and ataxia
. Which of the following outcomes would the nurse consider most significant in evaluating a client who started atomoxetine (Strattera) 6 months ago?
A. Decrease in attention
B. Decrease in hyperactivity
D. Development of mydriasis
D. Elevated liver enzymes
B. Decrease in hyperactivity
The nurse expects that the client experiencing extrapyramidal symptoms during therapy with phenothiazines will be prescribed:
A. Benztropine [Cogentin]
B. Diazepam [Valium]
C. Haloperidol {Haldol]
D. Lorazepam [Ativan]
D. Lorazepam [Ativan]
Of the following, the drug of choice to treat the manic-depressive (bipolar) disorder patient is:
A. diazepam [Valium].
B. methylphenidate [Ritalin].
C. terbutaline [Ventolin]
D. lithium [LithoBid]
D. lithium [LithoBid]
The nurse is counseling the caregivers of a client with Alzheimer’s disease. Which of the following statements, if made by a caregiver, would indicate that the session had been effective?
A. I should give this medication as symptoms of AD become noticeable.
B. If constipation occurs, I will notify the health care provider immediately
C. The medication may improve symptoms but will not cure the disease.
D. I will take the client’s vital signs before every dose of the medication.
B. If constipation occurs, I will notify the health care provider immediately
When your patient was started on carbamazepine [Tegretol] therapy the total drug regimen should have been carefully reviewed because carbamazepine is a potent
hepatic enzyme inhibitor
The nurse is caring for a client receiving a sedative-hypnotic. Which of the following adverse effects associated with this drug therapy is the highest priority for the nurse?
A. Urinary incontinence
B. Activity intolerance
C. Risk for falls
D. Poor nutritional intake
C. Risk for falls
The development of which symptom(s) in a client taking an antipsychotic must be reported immediately?
A. Fever, tachycardia, stupor, and incontinence.
B. Suddenly occurring muscle spasms, especially in the neck and back
D. Sexual dysfunction
D. Leg pains, pacing, an inability to sit still
A. Fever, tachycardia, stupor, and incontinence.
The client who has been taking imipramine (Tofranil) for 3 weeks calls the nurse to report that there is no improvement in the depression. The nurse’s best response is:
A. Call your health care provider and see if he or she will change the order to a different medication.
B. re you sure that you are taking it as it is ordered? Perhaps you should consider increasing the dosage gradually.
C. The medication may take up to 8 weeks to be effective. Continue taking the medication as ordered.
D. Add an over-the-counter antianxiety agent to your daily medications.
C. The medication may take up to 8 weeks to be effective. Continue taking the medication as ordered.
Ethosuximide [Zarontin] is prescribed for each of the following clients. A nurse should question the order for the client with: (Select all that apply.)
A. Absence seizures
B. Simple partial seizures
C. Tonic-clonic seizures
D. Simple complex seizure
E. Febrile seizure
B. Simple partial seizures
C. Tonic-clonic seizures
D. Simple complex seizure
The drug generally considered by many as "first line" in the emergency treatment of seizures and status epilepticus is the IV use of
lorazepam [Ativan]
6. A client is being treated for painful muscle spasms with cyclobenzaprine (Flexeril). The client should be instructed on which of the following? Select all that apply.
A. Void before administration
B. Increase foods rich in calcium
C. Do not operate machinery
D. Utilize hard candy to decrease dry mouth
E. Consume a diet low in fiber.
A. Void before administration
C. Do not operate machinery
D. Utilize hard candy to decrease dry mouth
. The nurse is monitoring the client for early lithium carbonate (Eskalith) toxicity. Which of the following symptoms, if manifested by the client, would indicate that toxicity may be developing? Select all that apply.
A. Persistent GI upset
B. Confusion
C. Polyuria
D. Convulsions
E. Ataxia
A. Persistent GI upset
B. Confusion
A client who is a body builder has been administered a general anesthetic to allow for the repair of a radial fracture. Following the administration of the anesthesia the client begins to spike a high fever of 104 degrees F. The circulating nurse is alerted to obtain which medication?
A. Botulinum toxin type A
B. Carisoprodol (Soma)
C. Dantrolene sodium (Dantrium)
D. Phenytoin (Dilantin.
C. Dantrolene sodium (Dantrium)
Your friend has had back pain due to muscle spasms after lifting some heavy objects. His physician has ordered rest and physical therapy and prescribed the muscle relaxant Flexeril [cyclobenzaprine]. You should warn him that this drug
may make him drowsy