TAKE HOME QUIZ #3

Please answer the followin" rel="nofollow">ing questions: 1. Which adjustment in" rel="nofollow">in pain" rel="nofollow">in medication may be needed for an elderly person with elevated liver enzymes due to anticonvulsant therapy? A. A higher dose should be used with the same time schedule due to excessive enzyme counts. B. The time between doses should be expanded to allow for metabolism in" rel="nofollow">in hepatic dysfunction. C. The medication should be crushed to facilitate more rapid metabolism D. The time between doses should be shortened. Elevated enzyme counts will speed metabolism 2. The nurse reads that the half-life or morphin" rel="nofollow">ine is roughly 3 hours. How would the nurse use this in" rel="nofollow">information to decide if it is safe to give Morphin" rel="nofollow">ine every 3 hours as needed for pain" rel="nofollow">in? A. The half-life of Morphin" rel="nofollow">ine shouldn’t be an issue here. Pain" rel="nofollow">in should determin" rel="nofollow">ine the in" rel="nofollow">interval” B. The half-life for Morphin" rel="nofollow">ine shortens in" rel="nofollow">in states of dependence. It will be needed more often.” C. The half-life of Morphin" rel="nofollow">ine shortens over time as the liver becomes familiar with the drug. D. The half-life of Morphin" rel="nofollow">ine would be longer in" rel="nofollow">in hepatic in" rel="nofollow">insufficiency. The drug would accumulate. 3. A client with persistent pain" rel="nofollow">in due to cancer is brought to the emergency department by his spouse. Upon assessment, the nurse notes pin" rel="nofollow">inpoin" rel="nofollow">int pupils and a respiratory rate of 6 breaths per min" rel="nofollow">inute. The nurse should immediately prepare for admin" rel="nofollow">inistration of which medication? A. Naloxone (Narcan) B. Flumazenil (Romazicon) C. Methamphetamin" rel="nofollow">ine hydrochloride (Desoxyn) D. Acetylcystein" rel="nofollow">ine (Mucomyst) 4. A nurse is providin" rel="nofollow">ing client education about the use of a fentanyl transdermal delivery system. Which of these statements would in" rel="nofollow">indicate accurate understandin" rel="nofollow">ing of self-care expectations? A. Massage the patch whenever pain" rel="nofollow">in occurs B. Always apply the patch to the same spot on your skin" rel="nofollow">in C. Change the patch every 72 hours D. Drivin" rel="nofollow">ing is safe when usin" rel="nofollow">ing this form of narcotic 5. What should the nurse do after givin" rel="nofollow">ing a young man Dilaudid (hydromorphone) for migrain" rel="nofollow">ine? A. Awaken him to assess his pain" rel="nofollow">in level. B. Explain" rel="nofollow">in the risks of the medication. C. Offer him somethin" rel="nofollow">ing to eat. D. Provide a restful, dimly lit environment. 6. Sumatriptan (Imitrex) has been ordered for an elderly client experiencin" rel="nofollow">ing a migrain" rel="nofollow">ine. The nurse understands that Triptan medications are contrain" rel="nofollow">indicated in" rel="nofollow">in which condition? A. Cerebrovascular in" rel="nofollow">insufficiency B. Chronic Lung disease C. Narcotic dependency D. Irritable bowel syndrome 7. A client is returnin" rel="nofollow">ing to the clin" rel="nofollow">inic for follow-up related to elevated liver enzymes. Which of the followin" rel="nofollow">ing medications on the client’s medication list would concern the nurse the most? A. Antacids routin" rel="nofollow">inely B. Daily antihistamin" rel="nofollow">ines C. Acetamin" rel="nofollow">inophen as needed for pain" rel="nofollow">in D. Daily multivitamin" rel="nofollow">ins with min" rel="nofollow">inerals 8. A client takin" rel="nofollow">ing paroxetin" rel="nofollow">ine (Paxil), a serotonin" rel="nofollow">in reuptake in" rel="nofollow">inhibitor for posttraumatic stress disorder, calls the clin" rel="nofollow">inic complain" rel="nofollow">inin" rel="nofollow">ing of confusion, restlessness and fever. What should the nurse reply? A. Tell him to seek a haloperidol (Haldol) prescription from an urgent care doctor. B. Have him talk to his doctor before takin" rel="nofollow">ing any more Paxil. These are signs of serotonin" rel="nofollow">in toxicity. C. Have him submit a urin" rel="nofollow">ine specimen. He is at risk for drug in" rel="nofollow">induced urin" rel="nofollow">ine retention, and UTI. D. Explain" rel="nofollow">in to the client that these are expected antidepressant side effects that will subside with time. 9. A client takin" rel="nofollow">ing amitriptylin" rel="nofollow">ine (Elavil) complain" rel="nofollow">ins of havin" rel="nofollow">ing blurred vision and dry mouth, and he states that he hasn’t had a bowel movement in" rel="nofollow">in 3 days, whereas he normally has one daily. His vital signs are temperature 97.6° F, pulse 90/min" rel="nofollow">inute, blood pressure 130/79 mm Hg, and respirations 20/min" rel="nofollow">inute. Based on this assessment, the nurse should suspect which of the followin" rel="nofollow">ing causes? A. Medication in" rel="nofollow">incompatibilities B. Sympatholytic effects C. Dehydration D. Anticholin" rel="nofollow">inergic effects 10. A client experiencin" rel="nofollow">ing loss of libido wants to know why he was started on citalopram, an SSRI, rather than one of the other types of antidepressants." Which response would be most appropriate? A. "Probably it is the only medication that your in" rel="nofollow">insurance will pay for" B. "I can’t begin" rel="nofollow">in to guess what your doctor was thin" rel="nofollow">inkin" rel="nofollow">ing. You need to ask him." C. “Serotonin" rel="nofollow">in reuptake in" rel="nofollow">inhibitors have fewer side effects than other antidepressants" D. "Medications like Celexa work much faster than the other medications" 11. A depressed client is bein" rel="nofollow">ing started on phenelzin" rel="nofollow">ine (Nardil), a monoamin" rel="nofollow">ine oxidase (MAO) in" rel="nofollow">inhibitor. Which statement shows he knows the needed self-care precautions? A. "Nardil causes memory problems, but I can take Gin" rel="nofollow">inseng to help with that." B. "I can’t drin" rel="nofollow">ink alcohol, but caffein" rel="nofollow">inated drin" rel="nofollow">inks and hot chocolate are fin" rel="nofollow">ine." C. "I can have pizza as long as there is no sausage on it." D. "When I go to cookouts this summer I should eat chicken in" rel="nofollow">instead of hotdogs." 12. A client who started an antidepressant 1 week ago tells his nurse, "I really don't thin" rel="nofollow">ink this medication is helpin" rel="nofollow">ing me." Which response by the nurse would be most appropriate? A. "Why do you thin" rel="nofollow">ink the medication is not helpin" rel="nofollow">ing you?" B. "What were you hopin" rel="nofollow">ing would happen?" C. "You need to come to the clin" rel="nofollow">inic so we can discuss this." D. "Did you know that it typically takes 3 weeks for antidepressants to work?" 13. A friend of a nurse who is bein" rel="nofollow">ing treated for anxiety with a selective serotonin" rel="nofollow">in reuptake in" rel="nofollow">inhibitor wants to know why Zoloft (sertralin" rel="nofollow">ine) is better for controllin" rel="nofollow">ing anxiety than a benzodiazepin" rel="nofollow">ine. Which of the followin" rel="nofollow">ing is the nurse’s best response? A. “Zoloft is better for the control of physical symptoms of anxiety than benzodiazepin" rel="nofollow">ines.” B. “Zoloft provide a more rapid and durable response to the uncomfortable anxiety symptoms.” C. “Benzodiazepin" rel="nofollow">ines currently have no role in" rel="nofollow">in the treatment of anxiety.” D. “Zoloft is better for reducin" rel="nofollow">ing cognitive symptoms of anxiety than benzodiazepin" rel="nofollow">ines.” 14. The client has been prescribed clozapin" rel="nofollow">ine (Clozaril), an atypical antipsychotic. Which laboratory fin" rel="nofollow">indin" rel="nofollow">ing should the nurse pay close attention to (sin" rel="nofollow">ince it may be altered by this medication)? A. The client's thyroid level B. The client's white blood cell count C. The client's albumin" rel="nofollow">in level D. The client's arterial blood gases 15. A client who has been takin" rel="nofollow">ing haloperidol (Haldol), a traditional antipsychotic, is now to complain" rel="nofollow">inin" rel="nofollow">ing of severe muscle spasms of the eyes, neck and back. Based on these manifestations, which of these prn prescriptions could the nurse offer to help stop the symptoms? A. Benadryl (diphenhydramin" rel="nofollow">ine) B. Motrin" rel="nofollow">in (ibuprofen) C. Ativan (lorazepam) D. APAP (acetamin" rel="nofollow">inophen) 16. A client who was in" rel="nofollow">involved in" rel="nofollow">in a motor vehicle accident comes in" rel="nofollow">into the ER distraught and complain" rel="nofollow">inin" rel="nofollow">ing of leg pain" rel="nofollow">in. Knowin" rel="nofollow">ing that the client is experiencin" rel="nofollow">ing a stress response to trauma, what signs or symptoms would the nurse expect to see? A. A decrease in" rel="nofollow">in serum glucose B. Pupil constriction C. Elevated pulse and respirations D. Hyperactive bowel sounds 17. An elderly person is bein" rel="nofollow">ing assessed for repeated falls. Which of their medicin" rel="nofollow">ines in" rel="nofollow">increases that risk? (SELECT ALL THAT APPLY.) A. Halcion (triazolam), a benzodiazepin" rel="nofollow">ine for sleep B. Acetamin" rel="nofollow">inophen (APAP), a peripheral analgesic for back pain" rel="nofollow">in C. OxyContin" rel="nofollow">in (oxycodone), an opiate for back pain" rel="nofollow">in D. Lyrica (pregabalin" rel="nofollow">in), a GABA sustain" rel="nofollow">iner for nerve pain" rel="nofollow">in E. Lidoderm (lidocain" rel="nofollow">ine) patch for local control of back pain" rel="nofollow">in 18. The nurse is preparin" rel="nofollow">ing to admin" rel="nofollow">inister lithium (Eskalith), to a client with bipolar disorder whose lithium level is 2.0 mEq/L. What symptoms might the nurse expect to see? (SELECT ALL THAT APPLY.) A. Irregular heart rate B. Hunger C. Slurred speech D. Unsteady gate E. Pacin" rel="nofollow">ing F. Droolin" rel="nofollow">ing 19. Which of these effects of opiate analgesics should be considered when formulatin" rel="nofollow">ing a client care plan? (SELECT ALL THAT APPLY.) A. Constipation B. Cough suppression C. Inflammation reduction D. Fall risk E. Fever reduction 20. Aspirin" rel="nofollow">in would be detrimental in" rel="nofollow">in which of these situations? (SELECT ALL THAT APPLY.) A. Client also takes anticoagulants B. Client is also pregnant C. Client also has rheumatoid arthritis D. Client also has a peptic ulcer E. Client is a child with a fever