A nurse is caring for a client being treated with an alpha blocker. What counseling should the client receive?
A nurse is caring for a client being treated with an alpha blocker. What counseling should the client receive?
Rise slowly from lying to standing to avoid dizziness and a possible fall.
Void before taking the medication to avoid urine retention.
Take a daily laxative to avoid constipation.
Avoid drinking more than 600 mls of fluid per day while taking this medication.
Question 2When reviewing the client’s list of medications, the nurse notes that two anticholinergics have been prescribed. Which of the client’s recent symptoms could be caused by excessive anticholinergic therapy? (Select all that apply.)
Hyperacidity and gastric reflux
Tachycardia
Dry mouth
Frequent loose stools
Light sensitivity due to dilated pupils
Question 3What lab value will best reflect renal function in a client taking multiple medicines?
Creatinine clearance
Serum potassium
Serum sodium
Urinalysis
Question 4Which teaching point is correct about the concept of “tolerance”?
Tolerance is a state where people become used to pain, and therefore need less pain medicine.
In tolerance, larger drug doses are needed to achieve prior effects because the body develops a reduced responsiveness to the drug.
Tolerance occurs in slow metabolizers. Slow metabolism leads to prolonged sedation.
In tolerance, smaller drug doses are needed to achieve prior effects because the body develops an increased responsiveness to the drug.
Question 5A client with Alzheimer’s disease has been taking a cholinesterase inhibitor for a week. What anticipated side effects of this cholinergic medication would the nurse anticipate?
Numbness and tingling in the extremities
Hypertension
Diarrhea, urgency, and possible bradycardia
Tinnitus and hearing loss
Question 6The most common adverse effect associated with antiepileptic medications is central nervous system (CNS) depression. Knowing this, which signs and symptoms would the nurse watch for when assessing an epileptic client? (Select all that apply.)
Drooling
Insomnia
Confusion
Hyperventilation
Unsteady gait
Question 7The client diagnosed with a general anxiety disorder is prescribed alprazolam. Which information should the clinic nurse discuss with the client?
Explain to the client that this medication is intended for short-term use only.
Tell the client to expect rigidty as a side effect.
Tell the client to avoid foods that are high in vitamin K.
Instruct the client to take the medication before driving to avoid transit anxiety.
Question 8How would a nurse explain the way a cholinergic would resolve related dry mouth?
It stimulates salivation by blocking nicotinic receptors
It stimulates salivation by stimulating muscarinic receptors
It stimulates salivation by stimulating alpha receptors in the brain
It stimulates salivation by redirecting fluid from the optic nerve
Question 9A client who has been taking an antiepileptic medication with a narrow therapeutic window for 2 weeks seems confused and forgetful. What should be the priority action of the nurse?
Call the prescriber and have them change the seizure medication.
Give an antihistamine under protocol to stop the allergic response.
Seek a plasma drug level order from the client’s prescriber.
Set up oxygen and obtain an order for activated charcoal.
Question 10A client is using a scopolamine patch for motion sickness. Since the medication has anticholinergic properties, which side effects should the client expect? (Select all that apply.)
Urine retention
Blurred vision
Dry mouth
Diarrhea
Wheezes
Question 11For which client would a beta adrenergic blocker be prescribed?
A client with urinary retention
A client who suffers from diarrhea
A hypertensive client with a heart rate of 104 beats/minute
A client who suffers from asthma
Question 12A nurse is taking a history from a client admitted for medication related syncope. Which of these comments from the client needs to be reported to the provider? (Select all that apply.)
“I just gave you my medication list the last time I was here!. Nothing has changed. Look it up!”
“I’m taking over the counter substitutes for the medicines I can’t affort.”
“I get my medicines from an online supplier, so I never run out of them, and refills are cheaper that way.”
“I don’t like to bother the doctor every time I need a medication refill, so sometimes I don’t.”
“My cardiologist never orders anything. He just tells my regular doctor what to order.”
Question 13The provider is considering starting a diabetic client on valproic acid for nerve pain this week. During the health history, the client tells the nurse, “I drink a six pack of beer daily and two to three six packs on weekends.” What is the priority nursing action?
Obtain a lab order to assess the current level of valproic acid.
Tell the client his alcoholism is causing his nerve pain, so medicine won’t help.
Seek an order for liver function labs to see if valproic acid would be safe for the client.
Reassure the client that beer and valproic acid are compatible.
Question 14The nurse recognizes that which of the following are actions of benzodiazepines? (Select all that apply.)
Sleep facilitation
Relief from anxiety
Suppression of seizures
Relief from tardive dyskinesia
Improvement of muscle coordination
Question 15A 68 year old male has a history of seizures and has been taking phenytoin for years. His last seizure occurred 2 years ago, so he has decided that he no longer needs the mediation. What would be the nurse’s best response? (Select all that apply.)
Recommend that he start cutting his pills in half, then see how it goes.
Affirm his plan to stop taking it, but tell him to restart the medication if tremors occur.
Recommend that he develop a withdrawal plan with his prescriber, as it is his right to negotiate his medicines.
Educate the client that suddenly stopping the medication could precipitate seizures.
Tell the client that once a medication for seizures is started, it can never be stopped.
Question 16What advice should the parents of a child needing methylphenidate receive? (Select all that apply.)
Insomnia is a risk, so the medication should be given in the morning.
It should always be given before the meal.
It is smart to order the medication from an online provider, because it it cheaper that way.
It is a C2 substance, so automatic refills are not allowed.
It is a gateway drug to other stimulants, and teens seek it to lose weight, so it it best for parents to keep control of it.
There is no need to worry about addiction in these medications in well-adjusted children.
Question 17A nurse in the emergency department is caring for a client whose family reports that she had taken an overdose of diazepam. Which of the following medications should the nurse have available to reverse the central nervous system (CNS) depression caused by this drug?
Ondasteron
Magnesium sulfate
Flumazanil
Protamine sulfate
Question 18The nurse is assessing a client who has requested an adrenergic drug for dyspnea. Which sign would make the nurse hesitate to give the medication?
Pulse oximetry saturation of 88%
Blood pressure of 130/86 mm Hg
Respiratory rate of 28 breaths/minute
Irregular heart rate of 122 beats/minute
Question 19Which statement regarding the blood-brain barrier demonstrates a need for further teaching?
“It can protect the brain from potentially toxic substance injuries.”
“It can be a significant obstacle to entry of therapeutic agents.”
“It is not fully developed at birth.”
“It lets in therapeutic agents in but filters out everything else.”
Question 20A nurse is caring for a client who has been taking phenytoin for 6 weeks. Upon review of the laboratory results, the nurse notes that the client’s phenytoin level is 18 mcg/mL. What is the nurse’s best action?
The nurse should contact the prescriber to suggest a dose increase.
This drug level is in the therapeutic range, so the nurse can give the medicine as ordered.
Suspect that another drug is preventing phenytoin metabolism, and hold the causative medication.
This drug level is too high; the nurse should contact the prescriber about reducing the dose
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