Ati pharm exam 2 Questions & Answers

Ati pharm exam 2 Questions & Answers A nurse is providing teaching for a client who is withdrawing from alcohol and has a prescription for propranolol . Which of the following information should the nurse to include in the teaching? increases the risk for seizure activity provides a form of aversion therapy decreases cravings results in minor hypertension decreases cravings A charge nurse is planning a staff education session to discuss medications used during the care of a client experiencing alcohol withdrawal. Which of the following medications should the charge nurse include in the discussion? (select all that apply) Lorazepam Diazepam Disulfiram Naltrexone Acamprosate Lorazepam Diazepam A nurse is teaching a client who has Graves' disease about her prescribed medications. Which of the following statements by the client indicted an understanding of the use of propranolol in the treatment of Graves' disease. "propranolol helps increase blood flow to my thyroid gland" "propranolol is used to prevent excess glucose in my blood" "propranolol will decrease my tremors and fast heart rate" "propranolol promotes a decrease of thyroid hormone in my body" "propranolol will decrease my tremors and fast heart rate" A nurse working in an emergency dept. is caring for a client who has benzodiazepine toxicity due to an overdose. Which of the following actions is the nurse's priority? Administer flumazenil Identify the client's level of orientation Infuse IV fluids Prepare the client for gastric lavage Identify the client's level of orientation A nurse is caring for a client who takes paroxetine to treat PTSD and reports that he grinds his teeth during the night. The nurse should identify which of the following interventions to manage bruxism? (select all that apply) Concurrent administration of buspirone Administration of a different SSRI Use of a mouth guard Changing to a different class of antidepressant medication Increasing the dose of paroxetine Concurrent administration of buspirone Use of a mouth guard Changing to a different class of antidepressant medication A nurse is providing teaching to a client who has a new prescription for amitriptyline for treatment of depression. Which of the following should the nurse include her teaching?(select all that apply) Expect therapeutic effects in 24-48 hours Discontinue the medication after a week of improved mood Change positions slowly to minimize dizziness Decrease dietary fiber intake to control diarrhea Chew sugarless gum to prevent dry mouth Change positions slowly to minimize dizziness Chew sugarless gum to prevent dry mouth A nurse is providing discharge teaching to a client who has a new prescription for fluoxetine for PTSD. Which of the following statements should the nurse include in her teaching? "You may have a decreased desire for intimacy while taking this medication" "You should take this medication at bedtime to help promote sleep" "You will have fewer urinary adverse effects if you urinate just before taking the medication" "You'll need to wear sunglasses when outdoors due to the light sensitivity caused by this medication" "You may have a decreased desire for intimacy while taking this medication" A nurse is caring for a client who has depression and a new prescription for venlafaxine. For which of the following adverse effects should the nurse monitor this client? (select all that apply) Cough Dizziness Decreased libido Alopecia Hypotension Dizziness Decreased libido A nurse is caring for a client who has been taking sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing serotonin syndrome? Bruising Fever Abdominal pain Rash Fever For best results when treating severe pain associated with pathologic spinal fractures related to metastatic bone cancer, the nurse should remember that the best type of dosage schedule is to administer the pain medication is which of these? a. As needed b. Around the clock c. On schedule during waking hours only d. Around the clock, with additional doses as needed for breakthrough pain d. Around the clock, with additional doses as needed for breakthrough pain A patient is receiving an opioid via a PCA pump as part of his postoperative pain management program. During rounds, the nurse finds him unresponsive, with respirations of 8 breaths/min and blood pressure of 102/58 mm Hg. After stopping the opioid infusion, what should the nurse do next? a. Notify the charge nurse. b. Draw arterial blood gases. c. Administer an opiate antagonist per standing orders. d. Perform a thorough assessment, including mental status examination. c. Administer an opiate antagonist per standing orders. A patient with bone pain caused by metastatic cancer will be receiving transdermal fentanyl patches. The patient asks the nurse what benefits these patches have. The nurse's best response includes which of these features? a. More constant drug levels for analgesia b. Less constipation and minimal dry mouth c. Less drowsiness than with oral opioids d. Lower dependency potential and no major adverse effects a. More constant drug levels for analgesia Intravenous morphine is prescribed for a patient who has had surgery. The nurse informs the patient that which common adverse effects can occur with this medication? (Select all that apply.) a. Diarrhea b. Constipation c. Pruritus d. Urinary frequency e. Nausea b. Constipation c. Pruritus e. Nausea Several patients have standard orders for acetaminophen as needed for pain. While reviewing their histories and assess-ments, the nurse discovers that one of the patients has a contraindication to acetaminophen therapy. Which patient should receive an alternate medication? a. A patient with a fever of 103.4°F (39.7°C) b. A patient admitted with deep vein thrombosis c. A patient admitted with severe hepatitis d. A patient who had abdominal surgery 1 week earlier c. A patient admitted with severe hepatitis An opioid analgesic is prescribed for a patient. The nurse checks the patient's medical history knowing this medication is contraindicated in which disorder? (Select all that apply.) a. Renal insufficiency b. Severe asthma c. Sleep apnea d. Severe head injury e. Liver disease b. Severe asthma c. Sleep apnea d. Severe head injury A patient with renal cancer needs an opiate for pain control. Which opioid medication would be the safest choice for this patient? a. fentanyl b. hydromorphone (Dilaudid) c. morphine sulfate d. methadone (Dolophine) d. methadone (Dolophine) The surgical nurse is reviewing operative cases scheduled for the day. Which of these patients is more prone to complications from general anesthesia? (Select all that apply.) a. A 79-year-old woman who is about to have hip replacement surgery b. A 49-year-old male athlete who quit heavy smoking 12 years ago c. A 19-year-old male who has a history of substance and alcohol abuse d. A 30-year-old woman who is in perfect health but has never had anesthesia e. A 50-year-old woman scheduled for outpatient laser surgery for vision correction a. A 79-year-old woman who is about to have hip replacement surgery c. A 19-year-old male who has a history of substance and alcohol abuse The physician has requested "lidocaine with epinephrine." The nurse recognizes that the most important reason for adding epinephrine is which of these factors? a. It helps to calm the patient before the procedure. b. It minimizes the risk for an allergic reaction. c. It enhances the effect of the local lidocaine. d. It reduces bleeding in the surgical area d. It reduces bleeding in the surgical area Which human need statement is appropriate for a patient who is now recovering after having been under general anesthesia for 3 to 4 hours during surgery? a. Altered urinary elimination, decreased, related to the use of vasopressors as anesthetics b. Decreased self control related to the effects of general anesthesia c. Altered safety with risk for falls related to decreased sensorium for 2 to 4 days postoperatively d. Altered oxygenation, decreased, due to the CNS depressant effect of general anesthesia d. Altered oxygenation, decreased, due to the CNS depressant effect of general anesthesia The nurse is administering an NMBD to a patient during a surgical procedure. Number the following phases of muscle paralysis in the order in which the patient will experience them. (Number 1 is the first step.) a. Paralysis of intercostals and diaphragm muscles b. Muscle weakness c. Paralysis of muscles of the limbs, neck, and trunk d. Paralysis of small rapidly moving muscles (fingers, eye) a=4 b=1 c=3 d=2 A patient has been admitted to the emergency department because of an overdose of an oral benzodiazepine. He is very drowsy but still responsive. The nurse will prepare for which immediate intervention? a. Hemodialysis to remove the medication b. Administration of flumazenil c. Administration of naloxone d. Intubation and mechanical ventilation b. Administration of flumazenil A patient is recovering from general anesthesia. What is the nurse's main concern during the immediate postoperative period? a. Airway b. Pupillary reflexes c. Return of sensations d. Level of consciousness a. Airway An older adult has been given a benzodiazepine for sleep induction, but the night nurse noted that the patient was awake most of the night, watching television and reading in bed. The nurse documents that the patient has had which type of reaction to the medication? a. Allergic b. Teratogenic c. Paradoxical d. Idiopathic c. Paradoxical A patient is about to undergo cardioversion, and the nurse is reviewing the procedure and explaining moder-ate sedation with propofol. The patient asks, "I am afraid of feeling it when they shock me." What is the nurse's best response? a. "You won't receive enough of a shock to feel anything." b. "You will feel the shock but you won't remember any of the pain." c. "These medications will help ease any pain during the procedure, and many patients often report having no recollection of the procedure." d. "They will give you enough pain medication to prevent you from feeling it." c. "These medications will help ease any pain during the procedure, and many patients often report having no recollection of the procedure." The nurse will monitor the patient who is taking a muscle relaxant for which adverse effect? a. CNS depression b. Hypertension c. Peripheral edema d. Blurred vision a. CNS depression During a patient's recovery from a lengthy surgery, the nurse monitors for signs of malignant hyperthermia. In addition to a rapid rise in body temperature, which assessment findings would indicate the possible presence of this condition? (Select all that apply.) a. Respiratory depression b. Tachypnea c. Tachycardia d. Seizure activity e. Muscle rigidity b. Tachypnea c. Tachycardia e. Muscle rigidity A hospitalized patient is complaining of having difficulty sleeping. Which action will the nurse take first to address this problem? a. Administer a sedative-hypnotic drug if ordered. b. Offer tea made with the herbal preparation valerian. c. Encourage the patient to exercise by walking up and down the halls a few times if tolerated. d. Provide an environment that is restful, and reduce loud noises. d. Provide an environment that is restful, and reduce loud noises. A patient with narcolepsy will begin treatment with a CNS stimulant. The nurse expects to see which adverse effects? (Select all that apply.) a. Bradycardia b. Anxiety c. Increased blood pressure d. Tremors e. Drowsiness at night b. Anxiety c. Increased blood pressure d. Tremors The nurse is preparing to give medications. Which is an appropriate nursing action for intravenous (IV) phenytoin (Dilantin)? (Select all that apply) a. Give IV doses via rapid IV push. b. Administer in normal saline solutions. c. Administer in dextrose solutions. d. Use a filter for IV infusions. e. Ensure continuous infusion of the drug. b. Administer in normal saline solutions. d. Use a filter for IV infusions. Which considerations are important for the nurse to remember when administering a benzodiazepine as a sedative-hypnotic drug? (Select all that apply.) a. These drugs are intended for long-term management of insomnia. b. The drugs can be administered safely with other central nervous system depressants for insomnia. c. The dose needs to be given approximately 1 hour before the patient's bedtime. d. The drug is used as a first choice for treatment of sleeplessness. e. The patient needs to be evaluated for the drowsiness that may occur the morning after a benzodiazepine is taken. c. The dose needs to be given approximately 1 hour before the patient's bedtime. e. The patient needs to be evaluated for the drowsiness that may occur the morning after a benzodiazepine is taken. The nurse is reviewing the drugs currently taken by a patient who will be starting drug therapy with carbamazepine (Tegretol). Which drug may raise a concern for interactions? a. digoxin (Lanoxin) b. acetaminophen (Tylenol) c. diazepam (Valium) d. warfarin (Coumadin) b. acetaminophen (Tylenol) The nurse is reviewing the prescriptions for a patient who will be discharged to home after being hospitalized for a hysterectomy. The patient asked for a sleeping pill, and the surgeon wrote a prescription for Ambien, 10 mg at bedtime as needed for sleep. What is the nurse's priority action at this time? a. Review the potential adverse effects with the patient. b. Suggest that the patient try drinking a glass of wine at bedtime. c. Contact the prescriber to question the dose of the Ambien. d. Assist the patient to find a pharmacy to fill the prescription on her way home. c. Contact the prescriber to question the dose of the Ambien.