NURS 601 Pharm Neurological Meds Questions and Answers- University of San Francisco
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Nursing
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Nursing
NURS 601 Pharm Neurological Meds Questions and Answers- University of San Francisco/NURS 601 Pharm Neurological Meds Questions and Answers- University of San Francisco/NURS 601 Pharm Neurological Meds Questions and Answers- University of San Francisco/NURS 601 Pharm Neurological Meds Questions and ...
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KEY:
All un-highlighted questions are required for Patho-Pharm 1
Red Text = Should Understand
Green Text = Absolutely Should Know
Yellow Highlight = Patho-Pharm 2 Material (Skip in Patho-Pharm 1)
Blue Highlight = Skip (In both Patho-Pharm 1 & 2)
Neurological Medications
1. Carbidopa-levodopa is prescribed for a client with Parkinson's disease. The nurse monitors
the client for side and adverse effects of the medication. Which finding indicates that the client
is experiencing an adverse effect?
Rationale: Dyskinesia and impaired voluntary movements may occur with high carbidopa-
levodopa dosages. Nausea, anorexia, dizziness, orthostatic hypotension, bradycardia, and
akinesia are frequent side effects of the medication.
2. The home health nurse visits a client who is taking phenytoin for control of seizures. During
the assessment, the nurse notes that the client is taking birth control pills. Which information
should the nurse include in the teaching plan?
1. Pregnancy must be avoided while taking phenytoin.
2. The client may stop the medication if it is causing severe gastrointestinal effects.
3. There is the potential of decreased effectiveness of birth control pills while taking
phenytoin.
4. There is the increased risk of thrombophlebitis while taking phenytoin and birth control
pills together.
Correct answer: 3
Rationale: Phenytoin enhances the rate of estrogen metabolism, which can decrease the
effectiveness of some birth control pills. Options 1, 2, and 4 are inappropriate instructions.
Pregnancy does not need to be "avoided" while taking phenytoin; however, because phenytoin
,may cause some risk to the fetus (Pregnancy Category D medication), consultation with the
health care provider should be done if pregnancy is considered. Telling a client that there is an
increased risk of thrombophlebitis is incorrect and inappropriate and could cause anxiety in the
client. A client should not be instructed to stop antiseizure medication.
3. The nurse is caring for a client in the emergency department who has been diagnosed with
Bell's palsy. The client has been taking acetaminophen, and acetaminophen overdose is
suspected. Which antidote should the nurse prepare for administration if prescribed?
Rationale: The antidote for acetaminophen is acetylcysteine. The normal therapeutic serum
level of acetaminophen is 10 to 20 mcg/mL (40 to 79 mcmol/L). A toxic level is higher than 50
mcg/mL (200 mcmol/L), and levels higher than 100 mcg/mL (400 mcmol/L) could indicate
hepatotoxicity. Auranofin is a gold preparation that may be used to treat rheumatoid arthritis.
Pentostatin and fludarabine are antineoplastic agents.
4. Meperidine has been prescribed for a client to treat pain. Which side and adverse effects
should the nurse monitor for? Select all that apply.
Rationale: Meperidine is an opioid analgesic. Side and adverse effects include respiratory
depression, drowsiness, hypotension, constipation, urinary retention, nausea, vomiting, and
tremors.
5. A client is taking the prescribed dose of phenytoin to control seizures. Results of a phenytoin
blood level study reveal a level of 35 mcg/mL (140 mcmol/L). Which finding would be expected
as a result of this laboratory result?
1. Hypotension
2. Tachycardia
,3. Slurred speech
4. No abnormal finding
Correct answer: 3
Rationale: The therapeutic phenytoin level is 10 to 20 mcg/mL (40 to 79 mcmol/L). At a level
higher than 20 mcg/mL, involuntary movements of the eyeballs (nystagmus) occur. At a level
higher than 30 mcg/mL (120 mcmol/L), ataxia and slurred speech occur.
6. The client arrives at the emergency department complaining of back spasms. The client
states, "I have been taking 2 to 3 aspirin every 4 hours for the last week, and it hasn't helped my
back." Since acetylsalicylic acid intoxication is suspected, the nurse should assess the client for
which manifestation?
Rationale: Mild intoxication with acetylsalicylic acid is called salicylism and is experienced
commonly when the daily dosage is higher than 4 g. Tinnitus (ringing in the ears) is the most
frequent effect noted with intoxication. Hyperventilation may occur because salicylate
stimulates the respiratory center. Fever may result because salicylate interferes with the
metabolic pathways coupling oxygen consumption and heat production. Options 2, 3, and 4 are
not associated specifically with toxicity.
7. A client with trigeminal neuralgia is being treated with carbamazepine, 400 mg orally daily.
Which value indicates that the client is experiencing an adverse effect to the medication?
Rationale: Adverse effects of carbamazepine {= Tegretol, an antiepileptic drug} appear as
blood dyscrasias, including aplastic anemia, agranulocytosis, thrombocytopenia, and
leukopenia; cardiovascular disturbances, including thrombophlebitis and dysrhythmias; and
dermatological effects. The low white blood cell count reflects agranulocytosis. The laboratory
values in options 1, 2, and 4 are normal values.
, 8. The nurse is caring for a client with chronic back pain. Codeine has been prescribed for the
client. Specific to this medication, which intervention should the nurse include in the plan of
care while the client is taking this medication?
Rationale: While the client is taking codeine, the nurse would monitor vital signs and assess for
hypotension. The nurse also should increase fluid intake, palpate the bladder for urinary
retention, auscultate bowel sounds, and monitor the pattern of daily bowel activity and stool
consistency because the medication causes constipation. The nurse should monitor respiratory
status and initiate deep-breathing and coughing exercises. In addition, the nurse monitors the
effectiveness of the pain medication.
9. The nurse has given medication instructions to a client receiving phenytoin. Which statement
indicates that the client has an adequate understanding of the instructions?
1. "Alcohol is not contraindicated while taking this medication."
2. "Good oral hygiene is needed, including brushing and flossing."
3. "The medication dose may be self-adjusted, depending on side effects."
4. "The morning dose of the medication should be taken before a serum medication level is
drawn."
Correct answer: 2
Rationale: Typical antiseizure medication instructions include taking the prescribed daily dosage
to keep the blood level of the medication constant and having a sample drawn for serum
medication level determination before taking the morning dose. The client is taught not to stop
the medication abruptly, to avoid alcohol, to check with a health care provider before taking
over-the-counter medications, to avoid activities in which alertness and coordination are
required until medication effects are known, to provide good oral hygiene, and to obtain regular
dental care. The client should also wear a MedicAlert bracelet.
10. A client with myasthenia gravis has become increasingly weaker. The health care provider
prepares to identify whether the client is reacting to an overdose of the medication (cholinergic
crisis) or an increasing severity of the disease (myasthenic crisis). An injection of edrophonium is
administered. Which finding would indicate that the client is in cholinergic crisis?
1. No change in the condition
2. Complaints of muscle spasms
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