BSN 315 Hesi study set Which medication is contraindicated in a patient receiving selegiline for Parkinson's disease? Aspirin Lisinopril Ranitidine Meperidine - correct answer Meperidine Rationale: Concomitant admisitration of a monoamine oxidase -B (MAO -B) inhibitor such as selegikine with meperidine is contraindicated because it can cause serotonin syndrome as a result of enhanced serotonin activity in the brain. Which drug is used as an adjunct therapy with levodopa/carbidopa to treat Parkinson's disease? Selegiline Entacapone Benztropine Amantadine - correct answer Selegiline Rationale: Selegiline is a selective type B monoamine oxidase inhibitor that is useful as an adjunct therapy with levodopa/carbidopa to decrease fluctuating symptoms. Which class of drugs is administered to treat on -off phenomenon in a patient with Parkinson's? Dopamine Modulators Anticholinergic drugs Catechol O -methyltransferase (COMT) Indirect -acting dopamine receptor agonists - correct answer COMT Rationale: COMT drugs are useful for treating the on -off phenomenon in Parkinson's, which is caused by fluctuations in dopamine concentrations. These drugs inhibit the enzyme catalyzing the breakdown of catecholamines, thereby maintaining uniform concentra tions of dopamine. Which symptoms are associated with parkinson's? Rigidity Tremors Seizures Tachycardia Bradykinesia - correct answer Rigidity, tremors, bradykinesia What is the main anatomic area of the brain that is affected in a patient with Parkinson's disease? Thalamus Cerebellum Globus Pallidus Substantia nigra - correct answer Substantia nigra Rationale: The substantia nigra is a part of the extrapyramidal system, which is involved in motor function, including posture, muscle tone, and smooth muscle activity. Dopamine depletion in this area causes PD What is the goal of pharmacological therapy in the treatment of Parkinson's? - correct answer Balance cholinergic and dopaminergic activity in the brain. Rationale: PD results from a decrease in dopaminergic (Inhibitory) activity leaving an imbalance with too much cholinergic (excitatory) activity. The healthcare provider orders entacapone 400 mg by mouth (PO) every 6 hours. The nurse notes that the total dose given in a 24 -hour period would be what amount? - correct answer 1600mg A patient is in status epilepticus. What is an appropriate nursing action? Apply restraints Hold the patient's limbs steady Administer intravenous pain medicine Administer intravenous antiepileptic drug therapy. - correct answer Administer intravenous antiepileptic drug therapy Rationale: During status epilepticus, the patient is unable to swallow medications, and the appropriate treatment is to administer intravenous drug therapy to stop the seizure. The nurse is administering phenytoin intravenously. What intervention is essential? Push the medications quickly through a central line Mix the medication in 5% dextrose with 0.9% saline Administer the medication no faster than 50 mg/min Administer the medication in a 22 -gauge or smaller catheter - correct answer Administer the medication no faster than 50 mg/min. The nurse is administering morning medications. which administration technique is an error? The nurse administers intravenous Dilantin with a filter. The nurse administers phenobarbital elixir with fruit juice The nurse administers carbamazepine with grapefruit juice The nurse administers gabapentin without determining when the patient ate. - correct answer The nurse administers carbamazepine with grapefruit juice. Rationale: Carbamazepine is not to be given with grapefruit juice, as this can lead to increased toxicity of the drug. The nurse is caring for a patient whose seizures are characterized by a 10 to 30 second loss of conciousness and mild, symmetric eye blinking. which seizure type does this most closely illustrate? Atonic Absence Myoclonic Tonic -clonic - correct answer Absence Rationale: Tonic -clonic seizures present with convulsions and muscle rigidity followed by muscle jerks. Atonic seizures cause sudden loss of muscle tone. Myoclonic seizures present with sudden muscle contractions that last but a second. A parent calls the clinic to state that a child who has a history of a seizure disorder has a rash all over the torso. What is the most appropriate assessment question for the nurse to ask? Ask the parent is the child has sesonal allergies Ask the parent if the child is on any new medication ask the parent to hold all medications and come into the clinic - correct answer Ask the parent if the child is on any new medication
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