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Pharm Chap 21 Neuromuscular Drugs

Total questions: 19

Worksheet time: 11mins

Name
Class
Date
1.

The nurse teaches a class about muscle movement to a group of patients who have neuromuscular disorders. What will the best plan of the nurse include? Select all that apply.

a)

Body movement depends on an intact spinal cord

b)

Body movement depends on proper functioning of muscles

c)

Body movement depends on intact nerves

d)

Body movement depends on proper endocrine functioning

e)

Body movement depends on the level of consciousness

2.

The nurse teaches the patient with a neuromuscular disorder about nonpharmacological treatment of muscle spasms. What will the best information include? Select all that apply.

a)

Application of heat or cold

b)

Ultrasound

c)

Massage

d)

Relaxation techniques

e)

Guided imagery

3.

The patient is started on a medication to treat a neuromuscular disorder. What does the nurse teach as the primary therapeutic goal of the medication?

a)

To stop the patient's muscle spasms

b)

To improve the patient's appearance

c)

To promote exercise in the patient

d)

To allow the patient increased independence

4.

The patient receives dantrolene (Dantrium) for muscle spasticity. Which lab result is a priority for the nurse to assess?

a)

Creatinine clearance

b)

Serum amylase

c)

Hemoglobin and hematocrit

d)

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT)

5.

The physician has ordered dantrolene (Dantrium) for a patient. What is a priority assessment by the nurse prior to administering this medication?

a)

Does the patient have gastric ulcer disease?

b)

Does the patient have psoriasis?

c)

Does the patient have gallbladder disease?

d)

Is the patient pregnant or lactating?

6.

The physician prescribes cyclobenzaprine (Flexeril) for the patient. When doing medication education, what will the best information of the nurse include?

a)

Increase the intake of fiber while taking this medication

b)

Restrict the intake of sodium while taking this medication

c)

Increase the intake of protein while taking this medication

d)

Do not drink any caffeine while taking this medication

7.

The patient is treated for muscle spasms following a spinal cord injury. What is the best outcome for this patient?

a)

Patient will have stabilized vital signs

b)

Patient will have an improved self-concept

c)

Patient will sleep without pain

d)

Patient will have increased bladder tone

8.

The patient tells the nurse that she awakens frequently during the night because of leg and foot cramps. What is the best response by the nurse?

a)

"Ask your physician for a muscle relaxant."

b)

"Increase your intake of vitamin B6."

c)

"Take a warm bath before going to bed."

d)

"Apply heat to relieve the cramping."

9.

The patient receives dantrolene (Dantrium). Which medication would the nurse evaluate as being contraindicated with dantrolene (Dantrium)?

a)

Verapamil (Calan)

b)

Insulin

c)

Clarithromycin (Biaxin)

d)

Methylphenidate (Concerta)

10.

Which list of treatment options would be considered optimal for treating a muscle spasm with an unknown cause?

a)

Anti-inflammatory agents, casting, and ultrasound

b)

Analgesics, antibiotics, and heat application

c)

Analgesics, muscle relaxants, and massage

d)

Anti-inflammatory agents, immobilization, and fluid and electrolyte replacement

11.

Which statement about skeletal muscle relaxants is correct?

a)

The inhibit upper motor neuron activity within the central nervous system

b)

They work primarily by stimulating the peripheral nervous sytem

c)

The increase the amount of neurotransmitter within the muscles

d)

They stimulate motor activity within the brainstem

12.

Which change is a common adverse effect of cyclobenzaprine (Flexeril)?

a)

Alopecia

b)

Tongue swelling

c)

Drowsiness

d)

Hypotension

13.

Which statement describes the primary difference between centrally acting muscle relaxants and direct-acting antispasmodics?

a)

Centrally acting agents inhibit neurons of the central nervous system, while direct-acting agents stimulate neurons of the central nervous system.

b)

Centrally acting agents stimulate neurons of the central nervous system, while direct-acting agents stimulate neurons of the peripheral nervous system.

c)

Centrally acting agents inhibit neurons of the central nervous system, while direct-acting agents work at the level of the neuromuscular junction and skeletal muscles.

d)

Centrally acting agents stimulate the central nervous system, while direct-acting agents inhibit neuronal conduction of the central nervous system.

14.

Spasticity is most commonly caused by damage to what area of the body?

a)

Cerebral cortex

b)

Peripheral nerves

c)

Brainstem

d)

Spinal cord

15.

The parents of a 2-year-old who has cerebral palsy are only now beginning to accept that their child will have a permanent disability. The nurse has been instructing the parents about the treatment for the spasticity their child is experiencing. Which statements by the parents indicate that the nurse should plan additional teaching sessions? Select all that apply.

a)

"At some point, our child may require surgery to correct this spasticity."

b)

"As long as we continue our child's medications, the spasticity can be controlled."

c)

"Our physical therapy sessions should focus on flexing our child's muscles."

d)

"We should repeat the exercises several times with each muscle group."

e)

"It is best to give our child a rest from physical therapy by skipping 1 week a month."

16.

The patient's health care provider prescribed cyclobenzaprine (Flexeril) for the treatment of neck spasms. The patient reports that the medication is "not working," even though it has been a week since the medication was started. What changes in this patient's plan of care would the nurse anticipate? Select all that apply.

a)

Increase in the dosage frequency

b)

Discontinuation of the medication

c)

Waiting a few more days for full medication effect

d)

Change to a different medication

17.

The nurse is discharging a 72-year-old man who was hospitalized after a muscle strain injury to his back. One of the discharge prescriptions for this patient is cyclobenzaprine (Flexeril) 10 mg three times per day with food. The prescription is written for 90 tablets and there are three refills available. Which information from this situation would alert the nurse for the need to collaborate with the patient's health care provider? Select all that apply.

a)

The dosage amount is too low for the type of injury this patient sustained

b)

Cyclobenzaprine should be used with great caution in those over 65

c)

If taken as directed, the patient would be able to take the medication for 120 days

d)

Cyclobenzaprine is not effective for back pain

e)

Cyclobenzaprine should not be taken with food

18.

A nurse is talking with a patient who has just been prescribed cyclobenzaprine (Flexeril). The nurse would provide additional information if the patient made which statements? Select all that apply.

a)

“My wife and I are driving our motor home to the beach tomorrow.”

b)

“I am going home to mow my lawn.”

c)

“I take a nap every afternoon.”

d)

“I just checked out a new book from the library.”

e)

“I am taking my grandchildren to the zoo tomorrow.”

19.

A patient calls the clinic and asks for a refill for a prescription for cyclobenzaprine (Flexeril) that was written a year ago. Which information from the medical record would the nurse draw to the prescriber’s attention? Select all that apply.

a)

The patient reported drinking wine each day with dinner

b)

The patient has been using nasal saline spray for allergies

c)

The patient was prescribed a MAO inhibitor last month

d)

The patient's blood glucose was elevated at the last visit

e)

The patient had an ulnar fracture repaired a year ago