Font size
WorksheetsPharm 2 Exam 1 Review
Total questions: 82
Worksheet time: 41mins
Buspirone (Buspar) differs from benzodiazepines in that it:
Does not cause sedation or muscle relaxation
Is used for alcohol withdrawal
Is recommended for PRN use
Acts as a GABA agonist
A nurse is teaching a patient about antidepressant therapy with SSRIs. Which statements are appropriate?
Take the medication in the morning to avoid insomnia.
Report any signs of serotonin syndrome such as agitation, hallucinations, or hyperreflexia.
Use caution when engaging in hazardous activities if experiencing dizziness.
Avoid alcohol to prevent increased bleeding risk.
Expect immediate relief of symptoms within 48 hours.
Which medication class is most likely to cause anticholinergic effects such as dry mouth, blurred vision, and urinary retention?
MAOIs
TCAs
SSRIs
SNRIs
A critical safety measure after starting an antidepressant is:
Monitoring for suicidal ideation
Increasing the dose rapidly
Stopping the medication abruptly
Avoiding all physical activity
Which of the following is the most appropriate nursing action for a patient with depression who is prescribed an antidepressant?
Advise the patient to ignore any thoughts of suicide.
Tell the patient to stop the medication if they feel worse.
Only monitor the patient if they are feeling anxious.
Ensure the patient understands to contact their provider immediately if they have thoughts of harming themselves.
A client with depression is prescribed amitriptyline (TCA). Which assessment finding requires immediate intervention?
Dry mouth and blurred vision
Urinary retention
Irregular heartbeat on ECG
Drowsiness during daytime
A nurse is providing education to a patient starting phenelzine (MAOI). Which instructions should be included?
Increase intake of caffeine to counteract potential hypotension.
Avoid foods high in tyramine, such as aged cheese and cured meats.
Take the medication with meals to reduce gastrointestinal upset.
Report sudden headache or palpitations immediately.
Avoid sudden changes in position to prevent orthostatic hypotension.
Which of the following substances can increase the effects of Buspirone?
Valerian
Kava
St. John’s wort
Ashwagandha
Which of the following are precautions for using benzodiazepines? Select all that apply.
A. Patients with hypertension
B. Patients with a history of substance abuse
C. Patients with organic brain disease
D. Patients with sleep apnea
E. Patients with respiratory depression
A patient is prescribed zolpidem for insomnia. Which instruction should the nurse include?
“Take the medication with a high-fat meal to improve absorption.”
“Allow at least 8 hours of sleep after taking this medication.”
“Take the medication only when you feel anxious.”
“Avoid activities requiring alertness for 2 hours after taking the medication.”
Melatonin receptor agonists like ramelteon are effective for maintaining sleep throughout the night.
True
False
A patient with a history of sleep apnea is prescribed a benzodiazepine. What should the nurse do?
Administer the medication as prescribed, monitoring for effectiveness
Give the medication with food to minimize respiratory effects
Advise the patient to take an extra dose for better sleep
Question the prescription and notify the healthcare provider
A patient reports daytime drowsiness after taking ramelteon. What is the most appropriate nursing intervention?
Instruct the patient to take the medication earlier in the evening
Discontinue the medication immediately
Educate the patient to avoid activities requiring alertness if sleepiness occurs
Advise the patient to take the medication with high-fat meals
Which herbs or supplements may be used to promote sleep?
Lemon balm
Valerian
Melatonin
Chamomile
Ashwagandha
A patient has been prescribed ramelteon for sleep. Which statement suggests the patient needs further education?
I can take this medication with a high-fat meal to improve absorption.
I will take this medication 30 minutes before bedtime on an empty stomach.
I should avoid activities requiring alertness if I feel sleepy.
This medication does not help with staying asleep once I wake up during the night.
A patient reports hallucinations and confusion after starting a new insomnia medication. What is the priority nursing intervention?
Document the adverse effects and continue medication as prescribed
Advise the patient to rest and monitor symptoms at home
Discontinue the medication immediately and notify the healthcare provider
Increase the dose to overcome tolerance
A patient using herbal supplements for insomnia asks about safety. Which statement by the nurse is most appropriate?
You should stop herbal supplements once your sleep improves.
Herbal supplements are safe for everyone.
Herbs like valerian and chamomile are not effective for sleep.
Always discuss herbal supplement use with your healthcare provider.
A nurse is educating a client newly prescribed pramipexole. Which of the following should the nurse include?
Take this medication on an empty stomach to increase absorption.
You may experience increased urination while on this drug.
This medication may make you sleepy during the day.
Discontinue the medication immediately if you feel nauseated.
A nurse is caring for a patient prescribed selegiline. Which food choice by the client indicates a need for further teaching?
Bananas
Aged cheddar cheese
Yogurt
Grilled chicken breast
What is the mechanism of action of amantadine in treating Parkinson’s disease?
Inhibits dopamine synthesis
Prevents dopamine breakdown
Prevents dopamine reuptake and promotes its release
Blocks cholinergic receptors only
What is a visible side effect of carbidopa/levodopa?
Skin rash
Bruising
Discoloration of sweat and urine
Alopecia
A client taking levodopa/carbidopa reports brown discoloration in urine. What should the nurse do next?
Notify the provider immediately
Instruct the client to stop taking the drug
Document the finding as expected
Recommend a high-protein diet
A nurse is providing education to a client prescribed carbidopa/levodopa. Which of the following should be included?
Avoid foods high in vitamin B6
You may experience discoloration of your urine
This medication works immediately after the first dose
Take the medication with food to avoid nausea
Report any muscle twitching or facial grimacing to your provider
Which of the following are side effects of dopamine agonists like ropinirole?
Daytime sleepiness
Psychosis
Hypotension
Liver failure
Impulse control disorder
A client is taking entacapone. The nurse should monitor for which complications?
Yellow-orange urine
Constipation
Rhabdomyolysis
Dry mouth
Liver failure
Patient education for benztropine should include which of the following?
Chew sugarless gum to reduce dry mouth
Stop medication if sedation occurs
Increase fluid intake to 2–3 L/day
Avoid alertness-requiring activities
Schedule regular eye exams
Which medications are contraindicated in patients with urinary retention or benign prostatic hyperplasia (BPH)?
Amantadine
Bromocriptine
Benztropine
Trihexyphenidyl
Rasagiline
What statement by the patient indicates a need for further teaching about the signs/symptoms of beta-2 agonists?
Vasodilation
Bronchodilation
Mydriasis
Increased glyconeogenesis
A patient has a new prescription for tamsulosin, an alpha 1 adrenergic blocker, when would you administer the medication?
Before they go to sleep
In the morning with food
Only as needed
In the morning before meals
Which statement by the patient indicates that they have an understanding on how to use a metered-dose inhaler?
I do not need to shake the inhaler before inhaling the medication
I should hold the inhaler about 1-2 cm away from the mouth
I should tilt my head forward before pressing the inhaler
I should hold my breath for 10 seconds to allow the medication to deposit
Which complication would you expect from adrenergic agonists?
Hypotension
Bradycardia
Hypertensive Crisis
Miosis
A patient recently started taking labetalol, what pre-existing condition would be less likely to put them at risk for a complication?
Diabetes
Hypotension
Pregnancy
Hypothyroidism
Which of the following is an expected finding of a centrally acting alpha 2 agonist such as clonidine?
Increased inhibition of norepinephrine release
Increased sympathetic outflow
Increased cardiac output
Rise in blood pressure
What would happen if we antagonize an alpha-1 receptor?
Mydriasis
Increased bladder closure
Increased blood pressure
Constricted pupils
A nurse is caring for a client who has been prescribed lithium for the treatment of bipolar disorder. Which of the following findings should the nurse report immediately?
Fine hand tremors
Mild thirst
Nausea and abdominal pain
Coarse tremors and mental confusion
A nurse is reinforcing education to a client starting lamotrigine. Which instruction is most important to include?
Take it with milk to reduce nausea.
Report any rash to your provider immediately.
Avoid grapefruit juice while on this medication.
Use a soft toothbrush and report gum bleeding.
Which of the following medication combinations requires the nurse to question the order due to a risk for lithium toxicity?
Lithium and sertraline
Lithium and acetaminophen
Lithium and hydrochlorothiazide
Lithium and lamotrigine
A nurse is teaching a female client about carbamazepine. Which of the following statements by the client indicates the need for further teaching?
I will use another form of birth control while on this medication.
I'll take the medication at bedtime to avoid drowsiness.
If I develop a rash, I’ll keep taking the medication and see if it goes away.
I won’t drink grapefruit juice while taking this medication.
A client taking valproic acid reports nausea, vomiting, and right upper quadrant pain. Which of the following is the nurse’s priority action?
Administer an antiemetic as prescribed
Evaluate for possible pancreatitis
Monitor the client's intake and output
Notify the provider and prepare for liver function tests
A nurse is caring for a client on valproic acid who develops bruising and bleeding gums. Which lab value should the nurse assess first?
Hemoglobin
INR
Platelet count
White blood cell count
Which of the following instructions is most important for the nurse to include when educating a client beginning valproic acid?
If you miss a dose, double up next time.
Avoid dairy products while on this medication.
Report symptoms such as vomiting or unusual tiredness to your provider.
You can stop the medication once your mood is stable.
What is the primary mechanism of action of tricyclic antidepressants (TCAs)?
Increase dopamine release in the CNS
Block reuptake of serotonin and norepinephrine
Inhibit MAO enzyme activity
Stimulate alpha-2 adrenergic receptors
Which of the following are common side effects of tricyclic antidepressants (TCAs)?
Dry mouth
Bradycardia
Blurred vision
Urinary retentino
Sedation
A patient prescribed nortriptyline reports increased sweating and confusion after also taking St. John’s Wort. What is the most likely concern?
Anticholinergic toxicity
Serotonin syndrome
Neuroleptic malignant syndrome
Rebound hypertension
It is safe for patients with recent myocardial infarction (MI) to take imipramine for ADHD.
True
False
Which patient education point is most appropriate for someone starting a TCA like amitriptyline?
Expect to see effects within 2–3 days
Stop taking the drug immediately if dry mouth occurs
Increase fluid intake to 2–3 L/day
Avoid all fiber-rich foods
Which of the following should the nurse include when educating a patient starting Clonidine for ADHD?
Take the larger dose in the morning to stay alert
Do not stop taking abruptly
Chew sugarless gum for dry mouth
Use caution with activities requiring mental alertness
Expect weight gain as a common side effect
Which condition is a contraindication for centrally acting alpha-2 agonists like guanfacine?
Hyperthyroidism
COPD
Seasonal allergies
Type 2 diabetes mellitus
The transdermal patch form of Clonidine should be removed immediately and replaced if it falls off.
True
False
Which interaction should the nurse be most concerned about in a patient taking amoxapine and MAOIs concurrently?
Increased CNS depression
Decreased heart rate
Hypertensive crisis
Rebound hypertension
Which of the following medications may increase CNS depression when taken with TCAs?
Alcohol
Benzodiazepines
Pseudoephedrine
Opioids
Antihistamines
Which of the following conditions would cause you to question the administration of a skeletal muscle relaxant?
Liver Disease
Hypertension
Diabetes Mellitus
Pulmonary Embolism
What are muscle spasms?
Involuntary muscle contractions with constant pain
Permanent contracture of muscles located at the joints
Involuntary muscle contractions with intermittent pain
Shaking of extremities with movement
What education would you give to patients taking skeletal muscle relaxants?
Do not suddenly stop taking medication
Take medication with a full glass of water
Take in the morning to prevent insomnia
Avoid activities that require alertness
Which of these medication classes would a skeletal muscle relaxant interact with? (Select all that apply)
Opioid analgesic
Benzodiazepine
Pseudoephedrine
Sumatriptan
Which of these muscle relaxants could cause a patient to develop a physical dependence?
Baclofen
Cyclobenzaprine
Tizanadine
Methocarbamol
What is the mechanism of action of a skeletal muscle relaxant?
Blocks GABA receptors in the brain and spinal cord
Stimulates GABA receptors in the brain and spinal cord
Stimulates dopamine receptors in the brain and spinal cord
Decreases intracellular calcium concentration
Which antiepileptic medication is indicated for absence seizures?
Carbamazepine
Phenytoin
Ethosuximide
Phenobarbital
Which antiepileptic drug is associated with weight gain and peripheral edema?
Lamotrigine
Pregabalin
Topiramate
Ethosuximide
Which of the following are complications of phenytoin?
Carbamazepine
Phenytoin
Ethosuximide
Phenobarbital
A nurse is providing instructions to a client prescribed carbamazepine. Which statement by the client indicates understanding?
I should avoid grapefruit juice.
I can safely take this medication with other antiepileptics.
This medication is safe for pregnancy.
I should expect increased bruising or bleeding.
Which antiepileptic medication may cause Stevens-Johnson syndrome and requires the client to report any skin rash?
Phenobarbital
Phenytoin
Lamotrigine
Gabapentin
Which antiepileptic drugs are indicated for simple partial seizures?
Phenobarbital
Phenytoin
Carbamazepine
Gabapentin
Ethosuximide
Which antiepileptic drugs can decrease the effectiveness of oral contraceptives?
Carbamazepine
Oxcarbazepine
Phenobarbital
Lamotrigine
A 16 month old toddler is being admitted for a minor surgical procedure that requires a local anesthetic. The anesthesiologist orders a topical benzocaine for the procedure. What is the child at risk for?
Necrosis
Respiratory depression
Methemoglobinemia
Peripheral edema
Which of the following is a potential adverse effect of nitroprusside therapy?
Hyperkalemia
Hypercalcemia
Methemoglobinemia
Peripheral edema
A patient is being admitted for a brain surgery that requires them to remain conscious without feeling discomfort. What medication is likely to be ordered for this procedure?
Ketamine
Dantrolene
Procaine
Midazolam
Neostigmine is the reversal agent for which type of drugs?
Conscious Sedatives
Neuromuscular Blockers
Antispasmodics
Local Anesthesia
During a procedure, a patient is given Succinylcholine, but begins to display adverse reactions of muscle rigidity, increase heart rate, high body temperature, a drop in O2 saturation, and mottled skin. What type of adverse reaction is occurring?
Malignant Hyperthermia
Anaphylaxis
Sjogren’s Syndrome
Overdose of Succinylcholine
What is the mechanism of action for Dantrolene?
Inhibition of muscle contraction by preventing release of calcium
Loss of consciousness and elimination of response to painful stimuli
Allows the patient to stay awake without feeling discomfort
Decreases pain by blocking conduction of pain impulses in a specific area
Local Anesthetics have interactions with…. (SATA)
Echinacea
St. John's Wart
Gingo, Garlic, Ginseng
Vitamin E
Antihypertensives
A 17 year old patient was brought into the emergency department by his mother. She states that he is extremely confused, believes he is hallucinating, and found a syringe on his dresser. What drug did he likely inject himself with?
Ketamine
Isoflurane
Lidocaine
Which of these medications are used to treat Alzheimer's? SATA
Ketorolac
Donepezil
Galantamine
Rivastigmine
What medication is used for anticholinergic toxicity?
Neostigmine
Pyridostigmine
Physostigmine
Rivastigmine
A 65 year old man who is taking a cholinesterase inhibitor and is experiencing excessive drool, eyes are watery, peeing frequently, complains of sweating all the time, has GI cramping, and is experiencing vomiting and diarrhea. What is he most likely experiencing?
Hemolytic reaction
Anaphylaxis Reaction
Cholinergic Crisis
Complications from myasthenia gravis
Anticholinergic effects
A 25 year old woman just gave birth to a baby boy that weighs 7lbs 9oz. The pregnancy was uncomplicated. This is her first pregnancy. She is currently in her room feeding her baby. The nurse comes in to check on her and asks her if she has voided yet. The patient says no. Bladder scan shows 100ml of urine. Ultrasound shows no obstruction What medication is the nurse anticipating the provider to prescribe?
Bethanechol
Pilocarpine
Cevimeline
Carbachol
Why do we question administering muscarinic agonists in a patient with asthma?
Muscarinic agonists cause bronchospasms therefore making it more difficult to breathe.
We don’t question it. It will not be an issue.
They cause a release of epinephrine causing an increase in respiration rate.
Contraction of skeletal muscles making it more difficult for the diaphragm to work.
Because they decrease heart rate.
How does cholinesterase inhibitors work (MOA)?
The enzyme cholinesterase breaks down acetylcholine making it inactive.
Prevents the enzyme cholinesterase from breaking down acetylcholine therefore increases the amount of Ach available at the receptor sites.
Block the action of Ach, inhibiting nerve impulses responsible for involuntary muscle movements and various bodily functions.
Stimulate muscarinic receptors therefore increasing heart rate.
Which anticholinergic medications are used to treat asthma? SATA
Oxybutynin
Scopolamine
Tiotropium
Ipratropium
Benztropine
A nurse has just finished giving education to her patient about muscarinic antagonists. Which statement indicates a need for further education?
“I should increase my fluids and fiber to prevent constipation.”
“I will use sunglasses when going outside”
“I should put my scopolamine patch on different limbs each time I apply it”
“I will avoid driving or other hazardous activities if I am experiencing drowsiness”
True/False: When administering eye drops you should hold the dropper 3-4 cm above the conjunctival sac.
True
False
What counteracts the effects of cholinesterase inhibitors?
Atropine
Scopolamine
Benztropine
Dicyclomine
