Headaches and clots
Your patient has hyperlipidemia, hypertension, and diabetes. Which medication do you expect the HCP to place them on?
Lantus
Clopidogrel
Dexamethasone
Cholinesterase Inhibitors
2. Clopidogrel because the patient is at risk for arthlesclerotic plaque development.
What education is important to provide to patients taking antiseizure medications? (select all that apply)
Don’t stop medication suddenly
Use another form of birth control
Avoid alcohol and sedatives
Wear sunscreen
1,2,3,4: all of these are important
An elderly patient sways and is unsteady with ambulation. After reviewing the chart, what does the nurse identify as a potential cause?
Right knee arthroplasty
Left hip replacement
Memantine
Docusate sodium
3. A side effect mematine is dizziness. Donepezil can also cause dizziness
The nurse is concerned about a patient’s new prescription of pramipexole when the patient makes which statement?
a. “I should be able to walk much better.”
b. “I guess I will have to take this with food.”
c. “I work full-time as an over-the-road truck driver.”
d. “I guess since it might make me dizzy I won’t have to mow the lawn.”
C. patients taking this medication can get sleepy and should not operate heavy machinery.
A patient on selegiline reports increasing insomnia. Which assessment information will be of most importance to the nurse in assisting this patient?
a. The consumption of caffeine.
b. The time the patient wakes up in the morning.
c. The time of day the patient takes the selegiline.
d. The type of activity the patient does during waking hours.
c. The time of day the patient takes the selegiline.
Which statement is most concerning for a patient on sumatriptan?
My headache isn’t better.
My chest is heavy and hurts.
I am not sure I can afford this medication.
I can stop this medication since it seem sto be working.
2. Sumatriptan causes vasoconstriction. Therefore any chest pain and heaviness must be investigated.
A patient has been prescribed phenytoin. What does the nurse recommend? Select all that apply
Use a soft toothbrush
Follow up with lab draws
Hold if one week seizure free
Monitor for skin rash
1,2,4: using a soft toothbrush for gingival hyperplasia, making sure med is therapeutic and monitoring for skin rashes is important.
The nurse decides to hold donepezil due to which contraindication?
Heart rate of 58
Diminished lung sounds
Confusion
Diminished pedal pulses
1. Bradycardia which can increase the risk of syncopal episodes
The nurse is assessing a patient and sees the following are listed in the patient’s medication administration record: carbamazepine, omeprazole, and acetaminophen? Which assessment findings are most concerning?
a. Sun burned cheeks.
b. Nonpitting edema to feet.
c. White blood cell count 5,500.
d. Dark colored urine and shortness of breath with exertion.
D. Carbamazepine can cause fluid retention resulting in dark urine and sob with exertion
It is important to educate patients taking levodopa/carbidopa to avoid taking the medication with foods high in what?
Sodium
Potassium
Sugar
Protein
4. Protein inhibits absorption of the medication
After having received tpa, what would the nurse monitor in a patient? (select all that apply)
Loc
Vital signs
Coagulation values
Neuro assessment changes
1,2,3,4: each of these would need to be monitored to ensure the patient is stable due to the risk of bleeding after receiving TPA
A nurse is preparing to give phenytoin IVP but calls the healthcare provider to request what order?
Heart monitor
neurology consult
Acetaminophen prn for headache
CT scan and MRI asap
Heart monitor
Due to the risk of arrhythmia with IVP phenytoin
The nurse notices dark, tarry stools in a patient taking donepezil and identifies it is most likely due to what?
Eating black licorice
Hemmorhoids
Taking NSAIDS
Drinking coffee
3. concurrent use of nsaids can cause black tarry stools in patients taking donepezil.
A patient takes carbamazepine 200mg by mouth twice a day but is currently experiencing dysphagia. What is the next best action by the nurse?
a. Discontinue the dose.
b. Give half of the dose intravenous.
c. Crush it and mix it in plain applesauce.
d. Hold the medication and notify the health care provider.
D. hold the medication and contact the provider
Patients taking levodopa/carbidopa may have which of the following? (select all that apply)
Dark urine
Orthostatic hypotension
Dyskinesias
psychosis
1,2,3,4
Which patient population is at increased risk for stroke?
a. A 40-year-old obese Caucasian female.
b. A 60-year-old Caucasian male with a history of diabetes mellitus.
c. A 30 year-old-African American female taking oral contraceptives.
d. A 70-year-old African American male with hypertension and diabetes mellitus.
d. A 70-year-old African American male with a history of hypertension and diabetes mellitus due to increase risk factor with age, race, and comorbidities of hypertension and diabetes. The other candidates don’t reach the age or the history factor
Which assessment findings are most concerning in a patient taking carbamezepine?
Drowsiness and headache
Edema and wbc count of 2,500
HR of 101 and b/p of 102/75
Nausea and heartburn
3. carbamezepine can cause fluid retention so sob, edema, and decreased urine output need reported. It also causes immunosuppresion so bruising, bleeding and low wbc counts need reported.
What is the best way a nurse can describe how donepezil works to treat Alzheimer’s
Meds reverse Alzheimer’s by increasing dopamine.
Meds increase the amount of acetylcholine in the brain.
Meds decrease the amount of acetylcholine in the brain.
Meds work with neurotransmitters to slow degenerative changes.
2. Meds increase the amount of acetylcholine available in the brain.
A patient is scheduled to have an elective knee replacement in ten days and is on clopidogrel. What does the nurse recommend to the health care provider?
a. Give vitamin K 5mg by mouth x1 now.
b. Give protamine 10mg intravenous x1 now.
c. Hold clopidogrel for five to seven days before surgery.
d. Type and cross for two units of red blood cells and platelets STAT.
c. Hold clopidogrel for five to seven days before surgery.
The plan of care for a patient taking pramipexole will be to educate the patient on which side effect?
Sleep attacks
Dry mouth
Insomnia
Watery eyes
Sleep attacks
Which assessment finding is contraindicated in the administration of Tpa?
PT 33, INR 2.9
Blood pressure 172/84
Total knee replacement 40 days ago
Head injury after a fall 2 months ago
1. TPA is contraindicated in patients with elevated bleeding times.
Which patient taking valproic acid needs seen first
Patient ℅ hematuria
Patient ℅ fatigue
Patient ℅ pain
Patient with new onset confusion
4. Pt. with new onset confusion as this may be indicative of hyperammonemia.
A patient with taking donepezil is experiencing GI upset. What can the nurse include in the plan of care to assist this patient? Select all that apply.
Give at night.
Give with food.
Give with ibuprofen.
Give with mannitol.
1,2. giving this medication at night and with food can decrease GI upset.
Education for a patient receiving valproic acid should include which of the following? (Select all that apply):
a. Report improvement of migraine symptoms.
b. Report if you notice a new rash or yellowing of the skin or eyes.
c. Report any new bruising or any bleeding when you brush your teeth.
b. Report if you notice a new rash or yellowing of the skin or eyes.
c. Report any new bruising or any bleeding when you brush your teeth.
Which assessment finding in a patient taking selegiline is most alarming?
℅ insomnia
b/p 198/99
Tongue redness
℅ indigestion
2. While all of these are s/e of selegiline, the most concerning is the b/p