Exam (elaborations)
_6521 Advanced Pharmacology.
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_6521 Advanced Pharmacology.
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6521 Advanced PharmacologyA nurse is caring for an infant after a surgical procedure. After ensuring that the ordered
dose is appropriate for the infant's age and weight, the nurse administers a narcotic
analgesic intravenously. When assessing the infant 15 minutes later, the nurse notes
respirations of 22 breaths/minute and a heart rate of 110 beats/minute. The infant is
asleep in the parent's arms and does not awaken when vital signs are assessed. The
nurse understands that these findings are the result of: - ANS-immaturity of the
blood-brain barrier in the infant.
A child will receive 750 mg of an antibiotic for 10 days. The child attends day care. The
drug may be dosed in several ways and is available in two concentrations. Which
dosing regimen will the nurse discuss with the child's provider? - ANS-500 mg/5 mL to
375 mg PO twice daily
Parents ask the nurse why an over-the-counter cough suppressant with sedative side
effects is not recommended for infants. Which response by the nurse is correct? -
ANS-"Infants are more susceptible to central nervous system effects than are adults."
A nurse caring for a 5-year-old child notes that the child has discoloration of several
teeth. When taking a medication history, the nurse will ask about which group of
medications? - ANS-Tetracyclines
An infant has allergies and often develops a pruritic rash when exposed to allergens.
The infant's parents ask the nurse about using a topical antihistamine. What should the
nurse tell them? - ANS-Applying an antihistamine to the skin can cause toxicity in this
age group.
An infant is receiving a medication that has a narrow therapeutic range. The nurse
reviews the medication information and learns that the drug is excreted by the kidneys.
When giving the medication, the nurse will assess the infant for: - ANS-signs of drug
toxicity.
A pediatric nurse is teaching nursing students to calculate medication doses for children
using a formula based on body surface area. Which statement by a nursing student
indicates understanding of the teaching? - ANS-"This formula helps approximate the
first dose; other doses should be based on clinical observations."
A pediatric nurse is teaching nursing students about medication administration in
,children. Which statement by a student indicates an understanding of the teaching? -
ANS-"Drugs effective in adults may not work in children, even if the dose is proportional
for weight and size."
A nurse is teaching nursing students about pediatric medication administration. What
will the nurse include when discussing pediatric drug research? - ANS-Studies showed
a significant percentage of unanticipated and potentially lethal side effects in children.
A prescriber has ordered medication for a newborn. The medication is eliminated
primarily by hepatic metabolism. The nurse expects the prescriber to: - ANS-order a
dose that is lower than an adult dose.
The parents of a child with asthma ask the nurse why their child can not use oral
corticosteroids more often, because they are so effective. The nurse will offer which
information that is true for children? - ANS-Chronic steroid use can inhibit growth.
A patient with schizophrenia receives a dose of risperidone [Risperdal Consta] IM. The
nurse teaching this patient about this medication will make which statement? -
ANS-"You will need to take an oral antipsychotic drug for 3 weeks."
A patient with schizophrenia shows suicidal behaviors, and the provider orders
clozapine [Clozaril]. The nurse teaches the family about the medication and its side
effects. Which statement by a family member indicates a need for further teaching about
this drug? - ANS-"If the ANC is less than 3000, the drug will be discontinued
permanently."
A patient in whom drug therapy has failed several times in the past is readmitted to a
hospital to begin therapy for schizophrenia. What will the nurse do to help improve
adherence? - ANS-Teach the patient about drug side effects and how to manage them.
A nurse provides teaching for a patient about to begin taking an FGA drug for
schizophrenia. Which statement by the patient indicates a need for further teaching
about side effects of these drugs? - ANS-"Dry mouth and constipation are uncommon
with this medication."
A patient taking an FGA medication develops severe parkinsonism and is treated with
amantadine [Symmetrel]. The amantadine is withdrawn 2 months later, and the
parkinsonism returns. The nurse will expect the provider to: - ANS-try a
second-generation antipsychotic (SGA).
,What are negative symptoms of schizophrenia? Select all that apply. - ANS-Poor
judgment
Poor self-care
Poverty of speech
A patient is taking an FGA for schizophrenia. The nurse notes that the patient has
trouble speaking and chewing and observes slow, wormlike-movements of the patient's
tongue. The nurse recognizes which adverse effect in this patient? - ANS-Tardive
dyskinesia
A nurse and a nursing student are discussing the plan of care for a patient with
schizophrenia. The patient, who has been taking a high-potency FGA for 2 months, has
become restless and constantly needs to be in motion. Which statement by the student
indicates a need for further education? - ANS-"Because this may be an exacerbation of
psychosis, the provider may increase the dose of the FGA."
A patient who is taking a first-generation antipsychotic (FGA) drug for schizophrenia
comes to the clinic for evaluation. The nurse observes that the patient has a shuffling
gait and mild tremors. The nurse will ask the patient's provider about which course of
action? - ANS-Giving an anticholinergic medication
A patient with schizophrenia has been taking an oral FGA for 1 week. The patient has
been taking the drug daily in two divided doses. The individual complains of daytime
drowsiness. The patient's family reports a decrease in the person's hostility and anxiety
but states that the patient remains antisocial with disordered thinking. What will the
nurse tell the patient and the family? - ANS-Some symptoms take months to improve.
A patient with schizophrenia has been taking an antipsychotic drug for several days.
The nurse enters the patient's room to administer a dose of haloperidol [Haldol] and
finds the patient having facial spasms. The patient's head is thrust back, and the patient
is unable to speak. What will the nurse do? - ANS-Request an order to give
diphenhydramine.
A parent reports being afraid that a child may have schizophrenia because of
disorganized speech and asocial behaviors. The nurse will tell this parent that which of
the following must also be present to make a diagnosis? Select all that apply. - ANS-A
decrease in self-care, job, or school function
A 1-month duration of active phase symptoms
, Continuous signs of disturbance for longer than 6 months
Which side effects are more common in second-generation antipsychotic medications
than in first-generation antipsychotic medications? Select all that apply. -
ANS-Agranulocytosis
Anticholinergic effects
Metabolism by CYP3A4
A nurse in a mental health hospital finds a patient with schizophrenia who takes
haloperidol [Haldol] lying rigid in bed with a temperature of 41.3°C. A cardiac monitor
shows cardiac dysrhythmias. What will be included in the treatment of this patient?
Select all that apply. - ANS-Dantrolene
Intravenous fluids
Withdrawal of haloperidol
A patient who has diabetes mellitus is diagnosed with schizophrenia and the provider
orders thioridazine. The patient asks the nurse why the provider has not ordered
olanzapine [Zyprexa], which the patient has seen advertised on television. Which
response by the nurse is the most important reason that this patient is not receiving
olanzapine? - ANS-"Olanzapine causes more metabolic side effects than thioridazine."
A patient who has been taking a monoamine oxidase inhibitor (MAOI) for depression for
several months tells the provider that the medication has not helped with symptoms.
The provider plans to switch the patient to an SSRI. The nurse will teach this patient to:
- ANS-stop taking the MAOI 2 weeks before starting the SSRI.
A young adult patient has been taking an antidepressant medication for several weeks
and reports having increased thoughts of suicide. The nurse questions further and
learns that the patient has attempted suicide more than once in the past. The patient
identifies a concrete plan for committing suicide. The nurse will contact the provider to
discuss: - ANS-hospitalizing the patient for closer monitoring.
An older adult patient who is to begin taking imipramine [Tofranil] asks the nurse when
the drug should be taken. The nurse will instruct the patient to: - ANS-divide the daily
dose into two equal doses 12 hours apart.
A patient has been taking an SSRI antidepressant for major depression and reports
having headaches and jaw pain. What will the nurse tell the patient? - ANS-Discuss
these symptoms with a dentist.
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