Drugs for CNS
1. Which neurotransmitter has an inhibitory action within the CNS?
a. Epinephrine
b. Acetylcholine
c. Norepinephrine
d. Gamma-aminobutyric acid
d. Gamma-aminobutyric acid
What electrolyte would you expect to be monitored for a patient taking a SSRI?
a. Magnesium
b. Calcium
c. Sodium
D. Potassium
c. Sodium
If a patient is taking an opioid agonists such as morphine, and is having a strong adverse reaction or an overdose, how can the effects be reversed?
a. induce vomiting by giving an emetic
b. give naloxone
c. inject fentanyl IM or SQ
d. keep the patient awake and help the patient move as much as possible
b. give naloxone
Which of the following are considered chronic pain? (select all that apply)
a. Osteoarthritis of the knee
b. Pain from UTI
c. Pain from broken bone
d. Chemo induced peripheral neuropathy
e. Diabetic neuropathy
a. Osteoarthritis of the knee
d. Chemo induced peripheral neuropathy
e. Diabetic neuropathy
A 73-year-old male patient newly diagnosed with Parkinson's disease (PD) is prescribed a dopamine agonist. The patient's wife asks you to explain how this class of drugs will work to help her husband. What is your best response?
a. "Dopamine agonists reduce levels of acetylcholine to restore gait and balance."
b. "Dopamine agonists use an enzyme to break down dopamine to improve PD symptoms."
c. "Dopamine agonists prevent the buildup of beta amyloid plaques to improve coordination." d. "Dopamine agonists reduce muscle rigidity and tremors by increasing dopamine levels."
d. "Dopamine agonists reduce muscle rigidity and tremors by increasing dopamine levels."
If a patient is taking an SNRI, what herbal supplement would be of concern to you if you found in their med list?
a. Kava Kava
b. St. Johns Wort
c. Cannabis
d. Flaxseed
b. St. Johns Wort
How do non-opioid centrally acting analgesics, such as clonidine and tramadol help manage pain?
a. interacting with opioid receptors
b. stimulating the endorphines
c. blocking activity in the CNS
d. enhancing a feeling of euphoria
c. blocking activity in the CNS
When assessing a patient before starting the first dose of a newly prescribed antiepileptic drug, what is the most important nursing action to perform?
a. Determine the type of aura a patient usually has before a seizure.
b. Obtain an accurate weight because most drug dosages are based on weight.
c. Ask the patient about all other prescribed or over-the-counter drugs he or she takes daily.
d. Ensure that oxygen and suction equipment are in the patient's room and in good working order.
c. Ask the patient about all other prescribed or over-the-counter drugs he or she takes daily.
What is/are side effects of TCAs (Select all that apply)
a.Orthostatic hypotension
b. weight gain
c. sedation
d. seizures
e. high WBC count
f. High platelet count
a.Orthostatic hypotension
b. weight gain
c. sedation
d. seizures
Why are carbidopa and levodopa usually given together?
a. Carbidopa is a dopamine agonist and levodopa is a dopamine antagonist.
b. Levodopa is a dopamine agonist and carbidopa is a dopamine antagonist.
c. Carbidopa enhances the action of levodopa, and less drug is needed.
d. Levodopa reverses or prevents the side effects of carbidopa.
c. Carbidopa enhances the action of levodopa, and less drug is needed.
Tardive Dyskinesia (TD) can be characterized by (Select all that apply)
a. protrusion and rolling of the tongue
b. Seizures
c. sucking and smacking movements of the lips
d. involuntary movements of the body and extremities
e. vocal outbursts
a. protrusion and rolling of the tongue
c. sucking and smacking movements of the lips
d. involuntary movements of the body and extremities
Which of the following drugs is used to reduce pain from muscular contractions or spasms?
a. cyclobenzaprine
b. prednisone
c. acetaminophen
d. nabumetone
a. cyclobenzaprine
A patient you are caring for is scheduled for elective surgery. When reviewing the preoperative laboratory results of a patient taking oxcarbazepine for seizure control, you note all of the following values below. For which one will you notify the surgeon immediately?
a. White blood cell count 8700/mm3
b. Serum sodium level of 128 mEq/L
c. International normalized ratio (INR) 0.9
d. Serum chloride level of 100 mEq/L
b. Serum sodium level of 128 mEq/L
The LPN/LVN is taking care of a patient with Parkinson's disease who is taking levodopa. The LPN/LVN knows that there are certain symptoms to watch out for that an indicate that the drug is "wearing off?" (Select all that apply.)
a. Decreased muscle tone b. Dry mouth
c. Slower gait
d. Difficulty swallowing
e. Increased appetite
f. Increased tremors
c. Slower gait
d. Difficulty swallowing
f. Increased tremors
When assessing a patient with Parkinson's disease who takes a carbidopa/levodopa combination drug, you find that he now has almost constant muscle movements that look like uncoordinated dancing. What is your best action?
a. Document the finding as the only action.
b. Hold the next drug dose and report the finding to the healthcare provider.
c. Give the next dose earlier than scheduled because the drugs are wearing off.
d. Request that the healthcare provider prescribe a one-time dose of a muscle relaxant.
b. Hold the next drug dose and report the finding to the healthcare provider.
You are preparing to teach a patient with anxiety disorder about the actions the benzodiazepine agonist buspirone. What would you inform the patient about how this drug works?
a. Buspirone acts by inhibiting GABA pathways to decrease anxiety
b. Buspirone acts by affecting the serotonin and dopamine neurotransmitters
c. Buspirone acts by inhibiting the dopamine receptors
d. Buspirone acts by affecting the monoamine oxidase pathway
b. Buspirone acts by affecting the serotonin and dopamine neurotransmitters
A patient continues to have pain even after morphine administration. Which of the following drugs would you expect the MD to order next?
a. Codeine
b. Oxycodone
c. Dilaudid
d. Hydrocodone
c. Dilaudid
A new RN nurse is about to insert a nasogastric tube into a client with Guillain-Barre Syndrome. To determine the accurate measurement of the length of the tube to be inserted, the nurse should:
B. Place the tube at the tip of the nose and measure by extending the tube to the earlobe and then down to the xiphoid process.
2. Which changes are most important to assess for in a patient who is taking topiramate for seizure control? (Select all that apply.)
a. Weight loss
b. Decreased seizure activity
c. Warm flushed skin
d. Insomnia
e. Pain at the IV site
f. Decreased heart rate
b. Decreased seizure activity
c. Warm flushed skin
f. Decreased heart rate
You are assessing the drug list of a patient who has been started on a dopamine agonist. You discover the patient is also taking an oral antihypertensive drug. Which of the following statements should you make to this patient?
a. "Taking an antihypertensive and a dopamine antagonist will increase your blood pressure." b. "Taking an antihypertensive and a dopamine antagonist will decrease your blood pressure." c. "Taking an antihypertensive and a dopamine antagonist will have no adverse effects."
d. "Taking an antihypertensive and a dopamine antagonist will reduce your dopamine levels."
b. "Taking an antihypertensive and a dopamine antagonist will decrease your blood pressure."
When teaching Mario with a typical depression about foods to avoid while taking phenelzine(Nardil), which of the following would the nurse in charge include? (Select all that apply)
a. Hamburger
b. Salami
c. fresh fish
d. liver
e. Turkey
f. raisins
b. Salami
d. liver
e. Turkey
f. raisins
A patient receiving what drug is at risk for hypotension through dilation of blood vessels?
a. tramadol
b. Clonidine
c. Oxycontin
d. Butorphanol
b. Clonidine
The physician prescribes penicillin potassium oral suspension 56 mg/kg/day in four divided doses for a client with anorexia nervosa who weighs 25 kg. The medication dispensed by the pharmacy contains a dosage strength of 125 mg/5 ml. How many milliliters of solution should the nurse administer with each dose?
Correct Answer: 14
RATIONALES: To determine the total daily dosage, set up the following proportion:
25 kg/X = 1 kg/56 mg
X = 1,400 mg.
Next, divide the daily dosage by four doses to determine the dose to administer every 6 hours:
X = 1,400 mg/4 doses
X = 350 mg/dose.
The adolescent should receive 350 mg every 6 hours.
Lastly, calculate the volume to give for each dose by setting up this proportion:
X/350 mg = 5 ml/125 mg
X = 14 ml.
You are teaching a patient about common and possible side effects for anti anxiety drugs. What would you include in your teaching? Select all that apply
a. drowsiness
b. dizziness
c. headache
d. hypotension
e. seizures
f. confusion
g. apnea
h. all of the above
a. drowsiness
b. dizziness
c. headache
d. hypotension