Anxiety and Depression Drugs
Adrenergic Drugs
Cholinergic Drugs
Seizure Drugs
Surgery Drugs
100

The nurse in the emergency department is caring for a patient with a suspected overdose of diazepam [Valium]. Which agent is most likely to be administered to reverse the effects of diazepam?

A. Naloxone [Narcan]
B. Flumazenil [Romazicon]
C. Acetylcysteine [Mucomyst]
D. Vitamin K

B. Flumazenil [Romazicon]

Flumazenil [Romazicon], a benzodiazepine receptor antagonist, is the treatment of choice for overdose of the benzodiazepine diazepam [Valium]. Naloxone [Narcan] is used to reverse opioid overdose. Acetylcysteine [Mucomyst] is used to reverse acetaminophen [Tylenol]
overdose. Vitamin K is used to reverse warfarin toxicity.

100

A patient is admitted with a dysrhythmia. The physician prescribes Propranolol. Which statement by the patient requires the nurse to hold the ordered dose and notify the physician for further orders?*
A. "I use an inhaler at home for asthma."
B. "My heart feels like it is racing, and I feel very weak."
C. "I had caffeine this morning with breakfast."
D. "I smoke 2 packs of cigarettes per day."

A. "I use an inhaler at home for asthma."

100

Cholinergic (parasympathomimetic) drugs have which therapeutic effect?

A. Increased gastrointestinal (GI) motility

B. Blood vessel vasoconstriction

C. Urinary retention

D. Pupil dilation

A. Increased gastrointestinal (GI) motility

100

Which information should be given to the client taking phenytoin (Dilantin)?

A. Taking the medication with meals will increase its effectiveness.

B. The medication can cause sleep disturbances

C. More frequent dental appointments will be needed for special gum care.

D. The medication decreases the effects of oral contraceptives.

C. More frequent dental appointments will be needed for special gum care.

Gingival hyperplasia is a side effect of phenytoin. The client will need more frequent dental visits.

100

A lidocaine oral anesthetic mouthwash has been administered to a patient whose mouth ulcerations have worsened during cancer treatment. The nurse should withhold food and drink after administration of the anesthetic to prevent
A. gastroesophageal reflux.
B. dysphagia.
C. aspiration.
D. gastritis.

C. aspiration.

Patients should not drink fluids or eat after gargling with oral anesthetics due to risk of aspiration. This intervention doesn't prevent gastritis, reflux, or dysphagia.

200

A patient diagnosed with depression begins selective serotonin reuptake inhibitor (SSRI) antidepressant therapy. The nurse should provide information to the patient and family about:
a. restricting sodium intake to 1 gram daily.
b. minimizing exposure to bright sunlight.
c. reporting increased suicidal thoughts.
d. maintaining a tyramine-free diet.

c. reporting increased suicidal thoughts.

200

When performing discharge instructions to a patient prescribed metoprolol (Lopressor), which statement by the nurse is correct?

A. "If you take your pulse and it is less than 60 beats/min, hold your medicine and call your health care provider for instructions."
B. "If you become dizzy, do not take your medication for 2 days and then restart on the third day."
C. "This medication may make you fatigued; increasing caffeine in your diet may help alleviate this problem."
D. "Increase your intake of green leafy vegetables to prevent bleeding problems that can be caused by this medication."

A. "If you take your pulse and it is less than 60 beats/min, hold your medicine and call your health care provider for instructions."

**Beta blockers have a negative chronotropic effect and could cause symptomatic bradycardia or heart block. The health care provider should be consulted before administering to a patient with bradycardia (heart rate

200

The nurse is performing postoperative teaching for a patient prescribed bethanechol (Urecholine). The patient is prescribed this drug for the treatment of which condition?

A. Ischemic colitis

B. Orthostatic hypotension

C. Urinary atony

D. Respiratory atelectasis

C. Urinary atony

200

The nurse is teaching a patient who is newly diagnosed with epilepsy about her disease. Which statement made by the nurse best describes the goals of
antiepilepsy medication therapy?

A) "With proper treatment we can completely eliminate your seizures."

B) "Our goal is to reduce your seizures to an extent that helps you live a normal life."

C) "Epilepsy medication does not reduce seizures in most patients."

D) "These drugs will help control your seizures until you have surgery."

B) "Our goal is to reduce your seizures to an extent that helps you live a normal life."

Epilepsy is treated successfully with medication in a majority of patients. However, the dosages needed to completely eliminate seizures may cause intolerable side effects. Neurosurgery is indicated only for patients in whom medication therapy is unsuccessful.

200

A diabetic patient's great toe amputation will take place under spinal anesthesia. How will the local anesthetic be administered?
A. Into the patient's cerebrospinal fluid
B. Into the patient's epidural space
C. Into the cranial nerve
D. Into the patient's spinal cord

A. Into the patient's cerebrospinal fluid

300

A nurse taught a patient about a tyramine-restricted diet. Which menu selection would the nurse approve?
a. Macaroni and cheese, hot dogs, banana bread, caffeinated coffee
b. Mashed potatoes, ground beef patty, corn, green beans, apple pie
c. Avocado salad, ham, creamed potatoes, asparagus, chocolate cake
d. Noodles with cheddar cheese sauce, smoked sausage, lettuce salad, yeast rolls

b. Mashed potatoes, ground beef patty, corn, green beans, apple pie

300

Which of the following medications is commonly used to treat BPH?

A. Atenolol

B. Sertraline

C. Tamsulosin

D. Pilocarpine

C. Tamsulosin

Tamsulosin is an Alpha 1 Blocker commonly used to treat urinary retention secondary to BPH

300

The nurse administering donepezil (Aricept) to a patient with Alzheimer's disease understands this drug has which expected therapeutic action?

A. Helps control associated urinary and fecal incontinence

B. Blocks the effect of norepinephrine at the presynaptic cell membrane

C. Increases levels of acetylcholine in the brain by blocking its breakdown

D. Relief of anxiety and restless behavior of the patient

C. Increases levels of acetylcholine in the brain by blocking its breakdown

300

The nurse is preparing to give ethosuximide (Zarontin). The nurse understands that this drug is only indicated for which seizure type?

A) Tonic-clonic
B) Absence
C) Simple partial
D) Complex partial

B) Absence

Absence seizures are the only indication for ethosuximide. The drug effectively eliminates absence seizures in approximately 60% of patients and effectively controls 80% to 90% of cases.

300

The patient is scheduled to receive a dose of pancuronium bromide prior to undergoing tracheal intubation. The nurse recognizes that this is an appropriate choice for the patient because pancuronium is which type of drug?

A. Central acting muscle relaxant
B. Nondepolarizing muscle relaxant
C. Anxiolytic
D. Antispasticity drug

B. Nondepolarizing muscle relaxant

400

A patient being treated with paroxetine (Paxil) 50 mg po daily for depression reports to the clinic nurse, "I took a few extra tablets earlier today and now I feel bad." Which assessments are most critical? Select all that apply.
a. Vital signs
b. Urinary frequency
c. Psychomotor retardation
d. Presence of abdominal pain and diarrhea
e. Hyperactivity or feelings of restlessness

a. Vital signs
d. Presence of abdominal pain and diarrhea
e. Hyperactivity or feelings of restlessness

400

A patient with asthma asks the nurse how his albuterol inhaler will work to help him breathe better. What is the best response for the nurse to explain the action of the medication?
A) "Albuterol will increase your heart rate so you will feel like you are able to breathe better."
B) "Albuterol causes bronchodilation in the lungs, improving function."
C) "Albuterol will cause an increase in urinary output to remove extra fluid from the lungs."
D) Albuterol causes bronchial smooth muscle contraction that forces air into the lungs."

B) "Albuterol causes bronchodilation in the lungs, improving function."

400

A client being treated for glaucoma with eye drops complains of photophobia. What instructions should the nurse include in the client teaching?
1. Discontinue use of the medication.
2. Wipe eyes with a tissue after instilling eye drops.
3. Wear dark glasses when outside, or, when around bright lights.
4. Special glasses are necessary while being treated for glaucoma.

3. Wear dark glasses when outside, or, when around bright lights.

400

The nurse is reviewing the drugs currently taken by a patient who will be starting drug therapy with carbamazepine (Tegretol). Which substance may raise a concern for interactions?

a. Grapefruit juice
b. Green, leafy vegetables
c. Diazepam (Valium)
d. Warfarin (Coumadin)

a. Grapefruit juice

400

The nurse anticipates an increased risk of malignant hyperthermia when inhalation anesthetics are combined with what?

A. Epinephrine
B. Acetylcholine
C. Norepinephrine
D. Succinylcholine

D. Succinylcholine

Malignant hyperthermia is a potentially fatal reaction that can occur with all inhalation anesthetics. Predisposition to the reaction is genetic. Malignant hyperthermia is characterized by muscle rigidity and a profound increase of temperature. Left untreated, the reaction can rapidly prove fatal. The risk of malignant hyperthermia is greatest when an inhalation anesthetic is combined with succinylcholine, a neuromuscular blocker that also can trigger the reaction.

500

The physician determines a patient needs to be started on a selective serotonin reuptake inhibitor (SSRI). As the nurse you know which medication below is NOT an SSRI?

 A. Citalopram

 B. Paroxetine

 C. Fluoxetine

D. Rasagiline

D. Rasagiline


The answer is D. Rasagiline is a MAOI (monoamine oxidase inhibitor) and is used to treat Parkinson’s Disease.

500

The nurse has reinforced instructions to the client regarding the use of a clonidine patch. Which client statement indicates a need for further teaching?

1 “I intend to change the patch every 7 days.”

2 “I need to trim the patch if an edge becomes loose.”

3 “It’s important to put the patch on a hairless site on my torso.”

4 “It’s all right to leave the patch in place during bathing or showering.”

2 “I need to trim the patch if an edge becomes loose.”

Rationale: The clonidine patch should not be trimmed because it will alter the medication dose. If it becomes slightly loose, it should be covered with an adhesive overlay from the medication package. If it becomes very loose or falls off, it should be replaced. It is changed every 7 days, and it is left in place when bathing or showering. The clonidine patch should be applied to a hairless site on the torso or the upper arm. The patch is discarded by folding it in half with the adhesive sides together.

500

Which statement by the client indicates to the nurse that the client has an understanding regarding pilocarpine (Isopto Carpine)?
1. "I will see better at night."
2."I may have trouble adjusting to darkness."
3. "I will adjust quickly to changes from light to dark."
4. "I will not use this medication if I plan to drive."

2."I may have trouble adjusting to darkness."

500

A patient is taking pregabalin (Lyrica) but does not have a history of seizures. The nurse recognizes that this drug is also indicated for

a. postherpetic neuralgia.
b. viral infections.
c. Parkinson's disease.
d. depression.

a. postherpetic neuralgia.

500

What preanesthetic medication does the nurse recognize as being administered primarily to reduce anxiety?

A. Morphine
B. Nitrous oxide
C. Midazolam
D. Demerol

C. Midazolam

Benzodiazepines are given before surgery to reduce anxiety and promote analgesia. They cause little or no respiratory depression. Intravenous midazolam (Versed) is used most often.