WorksheetsPharm Exam 2 Part 1
Total questions: 58
Worksheet time: 29mins
What are the normal parameters for temperature, pulse, respirations, BP, and pulse ox for an adult patient?
- Pulse: 2+, 60-100 bpm - RR: 12-20 - SBP: 130-90 - DBP: 90-50 - SpO2: 90-100% - Temp: 36.1-37.7 C (97-99.9 F)
- Pulse: 1+, 40-60 bpm - RR: 8-16 - SBP: 100-60 - DBP: 60-30 - SpO2: 80-90% - Temp: 35.0-36.0 C (95-96.8 F)
- Pulse: 3+, 100-120 bpm - RR: 20-30 - SBP: 150-110 - DBP: 100-70 - SpO2: 95-98% - Temp: 38.0-39.0 C (100.4-102.2 F)
- Pulse: 2+, 50-70 bpm - RR: 10-18 - SBP: 120-80 - DBP: 80-40 - SpO2: 85-95% - Temp: 36.5-38.0 C (97.7-100.4 F)
What is the problem in the body that causes Parkinson’s disease?
Dopamine deficiency (death of neurons that produce dopamine) and imbalance of dopamine and Ach in basal ganglia.
Excess production of serotonin in the cerebellum.
Overactivity of the thyroid gland leading to increased metabolism.
Deficiency of insulin causing high blood sugar levels.
How many percent of neurons are lost before Parkinson's signs and symptoms are obvious?
70-80%
10-20%
30-40%
50-60%
Which of the following is the 2nd most common neurodegenerative disorder?
Alzheimer's disease
Parkinson's disease
Huntington's disease
Multiple sclerosis
Is there a cure for Parkinson’s disease?
True
False
What type of meds are used to treat Parkinson’s and how do these meds work in the body to treat this condition?
Dopaminergics (increase dopamine) and Anticholinergics (decrease Ach) are used to restore balance of dopamine and Ach.
Beta-blockers (reduce heart rate) and ACE inhibitors (lower blood pressure) are used to manage symptoms.
Antibiotics (kill bacteria) and Antivirals (inhibit viruses) are used to treat infections.
Insulin (regulates blood sugar) and Statins (lower cholesterol) are used to control metabolic conditions.
Which of the following medications is a combination used to increase the effectiveness of L-dopa and crosses the blood-brain barrier more easily?
Levodopa
Carbidopa
Sinemet (levodopa+carbidopa)
Amantadine
Which of the following is NOT a dopamine agonist used in the treatment of Parkinson’s disease?
Pramipexole
Ropinirole
Amantadine
Bromocriptine
Which of the following drugs increases the half-life of dopamine by inhibiting metabolism of l-dopa in the periphery?
Selegiline
Entacapone
Trihexyphenidyl
Benztropine
Which of the following are MAO-B inhibitors?
Selegiline and Rasagiline
Entacapone and Benztropine
Trihexyphenidyl and Artane
Carbidopa and L-dopa
MAO-B inhibitors may reduce the ______ phenomenon in Parkinson's disease.
OFF
ON
Wearing-off
Peak-dose
Anticholinergics block the effects of ______ in the brain, decreasing symptoms and evening out imbalance of Ach and dopamine.
Ach
Serotonin
GABA
Glutamate
Which of the following is NOT an example of an anticholinergic used in Parkinson's disease?
Trihexyphenidyl
Benztropine
Entacapone
Artane
Anticholinergics are used more for drug-induced parkinsonism.
True
False
Select any two side effects (SE) of anticholinergics used in Parkinson's disease.
Dry mouth and blurred vision
Increased appetite and weight gain
Improved memory and alertness
Muscle growth and increased strength
What medications are prescribed when a patient on carbidopa/levodopa starts experiencing 'off' periods?
L dopa inhalation prn for off periods, Amantadine
Aspirin and Metformin
Ibuprofen and Atorvastatin
Omeprazole and Lisinopril
Are there any food interactions that might cause the 'off' periods?
High protein foods can reduce therapeutic response, reduces amount of levodopa absorbed and transported into brain, may be the cause of the OFF phenomenon.
Low fiber foods increase levodopa absorption and prevent OFF periods.
Spicy foods enhance the effectiveness of levodopa and reduce OFF periods.
Sugary foods have no impact on levodopa absorption or OFF periods.
If a patient is taking levodopa for Parkinson’s, the patient might experience 'off' periods during treatment. What should the nurse teach the patient regarding these foods?
You still need to eat protein! You should spread protein consumption evenly throughout the day.
You should avoid all protein-rich foods completely while on levodopa.
You can eat as much protein as you want at dinner only.
You should only eat carbohydrates and avoid proteins entirely.
What is the problem in the body that causes Alzheimer’s?
Neurodegeneration in the brain, often associated with amyloid plaques and neurofibrillary tangles.
Deficiency of insulin in the pancreas.
Blockage of arteries in the heart.
Mutation in the hemoglobin gene.
What is the goal of treatment (tx) for Alzheimer's Disease?
To slow down memory and cognition loss, prolong independent function and QOL (quality of life), but it is incurable.
To completely cure the disease and restore all lost memory.
To prevent the onset of Alzheimer's Disease in all patients.
To treat only the physical symptoms without addressing cognition.
Which type of neurons are associated with cerebral atrophy and degeneration in Alzheimer's Disease?
Cholinergic neurons
Dopaminergic neurons
GABAergic neurons
Glutamatergic neurons
Name two types of medications used for the treatment of Alzheimer's Disease.
Cholinesterase inhibitors and NMDA receptor antagonists
Beta blockers and ACE inhibitors
Insulin and sulfonylureas
SSRIs and benzodiazepines
In advanced Alzheimer's Disease, acetylcholine (Ach) is what percentage below normal levels?
90%
30%
60%
75%
The plan of care for a patient taking donepezil (Aricept) for Alzheimer’s Disease, who is still able to perform simple ADLs, should include which of the following?
Encouraging independence in daily activities
Restricting all physical activity
Providing total assistance with all ADLs
Discontinuing donepezil immediately
What is the primary purpose of OT and PT for patients?
To help patients do as much on their own as possible and maintain independence.
To provide entertainment during hospital stays.
To administer medication to patients.
To diagnose diseases and prescribe treatments.
Which of the following is important when caring for a patient with a seizure disorder?
Let patient do as much on their own as possible
Restrict all activities
Avoid reorientation
Isolate from loved ones
Which of the following are important points to teach a patient prescribed an antiseizure medication?
Take the medication at the same time every day, do not stop abruptly, and report any side effects to your healthcare provider.
Take the medication only when you feel a seizure coming on, and stop if you feel better.
Double the dose if you miss a dose, and avoid all physical activity.
Antiseizure medications do not interact with other drugs, so no precautions are needed.
Antiseizure medications treat the underlying cause of seizures.
True
False
How will you know the antiseizure meds are working?
Reduction in seizure activity and serum plasma levels
Increased drowsiness and confusion
Development of a rash and itching
Sudden increase in appetite
To help us know if the seizure medications are working, the patient should be taught to:
Keep a record of seizure activity
Increase the medication dose if a seizure occurs
Stop taking the medication if no seizures happen for a week
Only take the medication when feeling unwell
Phenytoin has which type of therapeutic index?
Wide therapeutic index
Narrow therapeutic index
No therapeutic index
Variable therapeutic index
A reason for increasing the dose of carbamazepine in a patient newly diagnosed with a seizure disorder is:
breakthrough seizures despite therapy
improvement in seizure control
development of a rash
resolution of all symptoms
A patient with hypertension on a diuretic that alters electrolytes and a seizure disorder on oxcarbazepine should have which labs monitored?
Serum sodium and electrolytes
Liver function tests only
Blood glucose only
Thyroid function tests
The basic considerations that would apply to ALL antidepressants include:
Potential for side effects and drug interactions
Specific action on dopamine only
Guaranteed immediate effect
No need for monitoring during use
Recognize the side effects if a patient ABRUPTLY STOPS taking their antidepressant. Which of the following is a possible withdrawal symptom?
Flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances, hyperarousal
Sudden weight gain and increased appetite
Improved concentration and energy
Permanent memory loss
Tricyclic antidepressants, i.e. amitriptyline, nortriptyline, also antagonize muscarinic receptor sites, which means they can cause anticholinergic symptoms such as:
dry mouth
muscle rigidity
increased salivation
bradycardia
Select the medication that is an SSRI.
Fluoxetine
Amitriptyline
Bupropion
Lithium
Which of the following is an SSRI medication?
Fluoxetine/Prozac
Sertraline/Zoloft
Paroxetine/Paxil
All of the above
How do SSRI meds work in the body?
Blocks the reuptake of serotonin. Does not affect dopamine or NE.
Increases the breakdown of serotonin in the synaptic cleft.
Blocks the release of serotonin from neurons.
Enhances the reuptake of dopamine and norepinephrine.
Which neurotransmitter's reuptake is blocked by SSRIs?
Serotonin
Dopamine
Norepinephrine
GABA
Which neurotransmitters are NOT affected by SSRIs?
Dopamine and norepinephrine (NE)
Serotonin
Acetylcholine
Gamma-aminobutyric acid (GABA)
What are some common side effects of SSRIs?
Sexual dysfunction, insomnia, nausea, increased risk of suicide in early treatment.
Hair loss, blurred vision, constipation, weight loss.
Joint pain, cough, fever, rash.
Hearing loss, dry mouth, increased appetite, muscle cramps.
Which SSRI causes the most weight gain?
Paroxetine/Paxil
Sertraline/Zoloft
Fluoxetine/Prozac
Escitalopram/Lexapro
What are the signs and symptoms of serotonin syndrome?
Confusion, anxiety, restlessness, hypertension (HTN), tremors
Bradycardia, hypothermia, dry skin, constipation
Jaundice, pruritus, dark urine, clay-colored stools
Polyuria, polydipsia, weight loss, blurred vision
What combination of medications increase the risk of serotonin syndrome?
SNRIs, migraine meds, opioids, illicit drugs (LSD, molly, coke, meth), OTC cough and cold meds, nutmeg, ginseng
Beta blockers, ACE inhibitors, statins, calcium channel blockers
Antacids, proton pump inhibitors, H2 blockers, sucralfate
NSAIDs, acetaminophen, corticosteroids, bisphosphonates
How does this type of med work in the body?
It affects specific processes or targets in the body to treat a condition.
It only provides energy to the body without any therapeutic effect.
It replaces all natural hormones in the body.
It works by increasing the body's temperature.
A serious drug-food interaction for MAOI meds is:
Tyramine-containing foods
High-fiber foods
Low-fat foods
Gluten-free foods
What specific foods should a patient avoid when taking MAOI medications?
Aged cheese, cream, yogurt, bananas, raisins, coffee, chocolate, Italian green beans, liver, sausage, soy sauce, beer, red wine.
Fresh fruits, grilled chicken, steamed vegetables, white rice, herbal tea.
Whole grain bread, baked potatoes, apples, orange juice, water.
Lean fish, lettuce, carrots, oatmeal, green tea.
If the patient would ingest these foods (high in tyramine) while on MAOIs, what will happen in the body and what would be a priority for the nurse to assess?
The patient may experience a hypertensive crisis, and the nurse should assess blood pressure.
The patient may develop hypoglycemia, and the nurse should assess blood sugar levels.
The patient may have respiratory depression, and the nurse should assess oxygen saturation.
The patient may develop dehydration, and the nurse should assess fluid intake.
What conditions do antianxiety meds treat?
anxiety and insomnia
anxiety and hypertension
anxiety and allergies
anxiety and osteoporosis
What are the common side effects for the 1st generation antipsychotics?
Sedation, seizures, sexual dysfunction, hypotension, anticholinergic effects
Weight gain, hyperglycemia, increased risk of diabetes, agranulocytosis
Insomnia, tachycardia, blurred vision, rash
Bradycardia, cough, diarrhea, alopecia
The primary adverse effects a patient may experience while taking Olanzapine (Zyprexa) for schizophrenia include:
Weight gain and metabolic syndrome
Hair loss and blurred vision
Hearing loss and skin rash
Insomnia and increased appetite
Clozapine (Clozaril) is another antipsychotic used for schizophrenia and has some very serious side effects that could kill the patient. If a patient is taking this medication, the provider would frequently monitor the WBCs because:
it can cause agranulocytosis, a dangerous drop in white blood cells.
it can cause severe liver damage.
it can lead to high blood pressure.
it can cause kidney failure.
Neuroleptic malignant syndrome (NMS) is a potentially life-threatening reaction to antipsychotic drugs. Which of the following signs and symptoms would indicate that a patient may have NMS?
Muscle rigidity, high fever, altered mental status, and autonomic dysfunction
Bradycardia, hypotension, and dry skin
Mild headache, nausea, and blurred vision
Increased appetite, weight gain, and insomnia
Fill in the blank: One of the symptoms of NMS is ______ and muscle breakdown.
Rigidity
Dizziness
Nausea
Fever
Fill in the blank: Immobility and ______ (going mute) is a symptom listed.
mutism
mania
delirium
euphoria
Fill in the blank: ______ and tachycardia are symptoms mentioned in the list of NMS symptoms.
Fever
Cough
Rash
Headache
Fill in the blank: Diaphoresis means ______.
sweating
dizziness
vomiting
coughing
