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WorksheetsCh 12-14, 18 Neurologic Med
Total questions: 74
Worksheet time: 41mins
Which condition would alert the nurse of the need to use beta-adrenergic blockers cautiously?
Hypertension
Raynaud’s phenomenon
Emphysema
Cardiac dysrhythmias
Which explanation by the nurse is most accurate when a patient with chronic obstructive pulmonary disease (COPD) reports having insomnia and a racing heart after starting terbutaline therapy?
The symptoms are typical and indicate that the medication is at a therapeutic level
The symptoms will tend to resolve with continued therapy
The symptoms are unusual and need to be reported to the healthcare provider immediately
The symptoms are indicative of toxicity
Which response is the primary response to alpha-1–receptor stimulation?
Bronchodilation
Tachycardia
Vasoconstriction
Uterine relaxation
Which category of medications is used for peripheral vascular diseases characterized by excessive vasoconstriction, such as Raynaud‘s disease?
Adrenergic agents
Alpha-adrenergic blocking agents
Beta-adrenergic blocking agents
Cholinergic agents
Which explanation provides rationale for why beta blockers are used cautiously in patients with respiratory conditions?
Mask the signs and symptoms of acute hypoglycemia.
Cause extensive vasodilation and cardiac overload.
May produce severe bronchoconstriction.
Increase hypertensive episodes.
Which response by the nurse is most accurate when a patient with the diagnosis of Parkinson's disease asks the nurse why anticholinergics are used in the treatment?
These drugs help you urinate.
These drugs will decrease your eye pressure.
These drugs inhibit the action of acetylcholine.
These drugs will assist in lowering your heart rate.
Which condition is important to screen a patient for before the initiation of anticholinergic medications?
Hypertension
Infectious diseases
Diabetes
Closed-angle glaucoma
Which nerve endings liberate norepinephrine?
Cholinergic
Adrenergic
Anticholinergic
Muscarinic
Which types of adrenergic receptors subdivide the autonomic nervous system?
Nicotinic and muscarinic
Afferent and efferent
Alpha and beta
Agonists and antagonists
Which is most important for the nurse to assess prior to the administration of metoprolol, a beta-adrenergic blocking agent?
Blood pressure
Lung sounds
Mental status
Urine output
Which statement by the patient indicates a need for further teaching when a patient with a history of type 1 diabetes after myocardial infarction has been placed on a beta-adrenergic blocking agent?
This medication should not be discontinued suddenly.
This medication lowers my blood pressure by helping me get rid of fluid.
I may not have my usual symptoms of a hypoglycemic reaction while on this drug.
This medication may take a few weeks to work.
An older adult patient is to receive atenolol, a beta-adrenergic blocking agent. Prior to administration of the drug, the nurse assesses an apical pulse rate of 58 and notes ankle edema. Which action will the nurse take first?
Determine the therapeutic blood level.
Encourage the patient to decrease water intake.
Elevate the patient‘s legs.
Withhold the medication.
Which action is the most appropriate to take when a patient hospitalized in an acute care setting reports to the nurse that since starting on an adrenergic medication, he has been feeling dizzy and weak?
Immediately notify the physician.
Teach the patient to move slowly from standing to sitting.
Discontinue the adrenergic blocker.
Monitor blood pressure in both the supine and standing positions.
Which priority nursing action needs to be implemented when a long-term care resident taking an anticholinergic agent is observed to be disoriented and hallucinating?
Report development of alterations to the charge nurse.
Assess blood glucose.
Provide for resident’s safety.
Medicate with antianxiety medication.
Which is the best action for the nurse to take when auscultating inspiratory and expiratory wheezing bilaterally on a patient taking a cholinergic agent?
Provide the next dose of the cholinergic agent immediately.
Assess heart rate and blood pressure.
Reposition the patient.
Withhold the next dose and notify the physician.
Which adverse effect(s) is/are common when a patient is receiving a cholinergic agent? (Select all that apply.)
Nausea
Hypertension
Dizziness
Bradycardia
Constipation
Which statement(s) is/are true about efferent nerves? (Select all that apply.)
Transmit signals to the spinal cord and brain.
Leave the CNS to carry impulses to other body parts.
Are part of the peripheral nervous system.
Transmit signals that control contractions of smooth and skeletal muscles.
Transmit signals that control contractions of some glandular secretions.
Which instruction(s) given by the nurse will assist a patient to cope with the common adverse effects of anticholinergic medications? (Select all that apply.)
Take the medication with meals
Increase fluids daily
Decrease fiber in the diet
Suck on candy or ice chips
Monitor blood glucose
Which body function(s) is/are controlled by the autonomic nervous system? (Select all that apply.)
Blood pressure
Skeletal muscle contraction
GI secretion
Body temperature
Urination
Which common adverse effect(s) will the nurse include in discharge teaching for a patient on an adrenergic bronchodilator? (Select all that apply.)
Palpitations
Dizziness
Orthostatic hypotension
Hypoglycemia
Tremors
Which terms identify neurotransmitter(s)? (Select all that apply.)
Gamma aminobutyric acid
Acetylcholine
Serotonin
Histamine
Epinephrine
Which disorder(s) would indicate the use of anticholinergic agents? (Select all that apply.)
Glaucoma
Benign prostatic hypertrophy
Bradycardia
Parkinson‘s disease
Preparation for surgery
Which initial action should the nurse take when finding a patient extremely agitated, yelling frequently, and attempting to get out of bed without assistance?
Administer zolpidem after taking the patient’s vital signs.
Close the patient’s door for privacy after administering Tylenol.
Administer benzodiazepine before calling the healthcare provider.
Spend uninterrupted time listening to the patient.
An older adult patient received a hypnotic agent at 9:00 PM. At 2:00 AM, the nurse discovers that the patient has removed her gown and is attempting to get out of bed without assistance. Which type of medication effect is the patient exhibiting?
Allergic
Hypersensitivity
Paradoxical
Therapeutic
Which condition indicates the need for benzodiazepines to be prescribed?
Chronic amnesia
Chronic insomnia
Preoperative sedation
Psychotic episode
Which type of blood work will be performed when a patient receiving diazepam (Valium) is complaining of nausea and vomiting and is becoming jaundice?
Renal function tests
Liver function tests
Clotting times
Electrolyte panels
Which benefit applies to the use of sedatives?
Increased pain control postoperatively
Reduced bronchial secretions
Decreased patient anxiety
Increased patient alertness
Which two phases make up normal sleep?
Hypnagogic and hypnopompic
Rapid eye movement (REM) and non REM
Alpha and beta
Delta and theta
Which sleep pattern stage diminishes as an effect of aging?
Stage I
Stage II
Stage III
Stage IV
Which action will the nurse take when a patient has been prescribed lorazepam (Ativan)?
Advise the patient to take the medication with food.
Assess the patient’s blood pressure in sitting and lying positions.
Inform the patient to discontinue the medication once sleep improves.
Instruct the patient to lie down before taking the medication.
Which disease is associated with insufficient sleep?
Cancer
Glaucoma
Myocardial infarction
Renal failure
The nurse is caring for an older patient recently admitted to an assisted living center who is experiencing insomnia associated with the recent relocation. Which nursing action will assist the patient to sleep?
Offering the patient hot tea
Encouraging the patient to ambulate in the hallway
Performing back massage
Administering an analgesic
Which statement about sedatives is true?
A sedative will produce sleep.
Sedatives increase the total time in REM sleep.
Increased relaxation occurs with sedatives.
Sedatives are more potent than hypnotics.
The nurse is assessing a patient who is being evaluated in an outpatient clinic for complaints of back pain. The patient reports taking diphenhydramine for insomnia related to job stress. Which statement by the nurse is accurate regarding this medication?
This medication should only be taken for 1 week.
This medication can cause nausea.
The medication should not be taken after eating a high-fat meal.
This is an herbal medication that has been used for hundreds of years.
When reviewing a patient's history and physical information, the nurse notes that the patient has physician's orders for older hydralazine and warfarin. During assessment of this patient, the nurse observes areas of petechiae and ecchymosis on the upper and lower extremities. Which lab work is most appropriate for the nurse to assess next?
Liver function studies
C-reactive protein
Sedimentation rate
Prothrombin time
Which information should be included when providing patient education on ramelteon (Rozerem)?
Thoroughly chew.
Do not take with a high fat meal.
Take on an empty stomach.
Take only before bedtime.
Which explanation is correct in identifying why benzodiazepines are often preferred over barbiturates?
They have selective action at specific receptor sites.
There is a wider range of safety between therapeutic and lethal levels.
REM sleep is decreased to a lesser extent.
Accidental overdoses are well tolerated.
There are no hypotensive episodes when rising to a sitting position.
Which common adverse effect(s) apply(ies) to barbiturates? (Select all that apply.)
Residual daytime sedation
Headache
Hyperactivity
Blurred vision
Impaired coordination
Which effect(s) can occur as a result of rapid withdrawal from long-term use of benzodiazepine therapy? (Select all that apply.)
Anxiety
Delirium
Weakness
Grand mal seizures
Severe pain
Which information will the nurse include when assessing the patient‘s central nervous system (CNS) function following sedative-hypnotic therapy? (Select all that apply.)
Level of alertness
Orientation
Ability to perform motor functions
Blood pressure
Usual pattern of sleep
Which adverse effects associated with levodopa therapy would support adding a nursing diagnosis that relates to being at risk for injury to the patient's plan of care?
Nausea and vomiting
Orthostatic hypotension
Anorexia and depression
Tachycardia and palpitations
Which vitamin will reduce the therapeutic effects of levodopa?
A
B6
C
D
Which cholinergic symptoms of Parkinson’s disease are reduced with anticholinergic drugs?
Cognitive impairments
Rigidity
Tremors and drooling
Postural abnormalities
Which pharmacologic action applies to entacapone?
Slows the deterioration of dopaminergic nerve cells.
Inhibits the relative excess of dopaminergic activity.
Reduces the destruction of dopamine in peripheral tissues.
Enhances the cholinergic symptoms of Parkinson’s disease.
Which statement is by accurate regarding the administration of levodopa?
Take this medication in between meals.
Take this medication at bedtime to prevent dizziness.
Take this medication when your tremors get worse.
Take this medication with food or antacids to reduce GI upset.
Which adverse effects in patients with Parkinson’s disease have been linked to dopamine agonists?
Oculogyric crisis
Tardive dyskinesia
Sudden sleep events
Akathisia
Which rationale applies to administering levodopa instead of dopamine for treatment of Parkinson’s disease?
Dopamine does not cross the blood-brain barrier when administered orally.
Levodopa is much less expensive.
The half-life of dopamine is too short.
Dopamine has too many reactions with other medications.
Which statement by the patient recently placed on selegiline disintegrating tablets indicates a need for further teaching?
This medication will help slow the development of symptoms.
I will place the tablet on my tongue before breakfast.
I may need to use a stool softener for constipation.
I should not push the tablet through the foil.
Which statement about entacapone is correct?
This medication is not to be taken with carbidopa levodopa.
Dosage is adjusted according to the patient’s response.
There will be fewer incidences of dopaminergic effects, such as confusion.
This medication increases the production of dopamine in the brain.
The nurse is assessing an older patient with Parkinson’s disease who was started on entacapone 1 week ago. The patient has a history of coronary artery disease and takes an antihypertensive and aspirin. Which information would support the need for a reduction in medication dosage by the healthcare provider?
Constipation
Brownish orange urine
Drowsiness
Dizziness
Which item should be removed from the meal tray of a patient taking a monoamine oxidase B inhibitor?
Cheese
Eggs
Bread
Coffee
Which medication should be held when a patient taking rasagiline is assessed by the nurse to have a lasting significant increase in blood pressure?
Dextromethorphan
Levodopa
Ciprofloxacin
Valium
Which characteristic symptom(s) apply(ies) to a patient’s diagnosis of Parkinson’s disease?
Muscle tremors
Posture alterations
Muscle flaccidity
Tachycardia
Slow body movement
Which point(s) should be included when teaching a patient about the use of apomorphine for treatment of Parkinson‘s disease? (Select all that apply.)
The restoration of function resulting from stimulation of dopamine receptors is permanent
Apomorphine does not have any opioid activity
A multidose injector pen is commonly used to administer apomorphine
You may experience nausea and vomiting, which can be treated with trimethobenzamide (Tigan)
You may experience sleep attacks or episodes of daytime sleepiness
. Which baseline assessment(s) will be performed prior to administering apomorphine to a patient? (Select all that apply.)
Mobility
Orientation
Intellectual ability
Alertness
Vital signs
Which condition is associated with hydantoin therapy?
Postictal state
Atonia
Seizure threshold reduction
Gingival hyperplasia
Which symptom is most likely to be assessed in a patient prescribed hydantoin therapy with a history of diabetes who has just been diagnosed with seizure disorder?
Hunger
Hyperglycemia
Diarrhea
Pupil dilation
Which guideline should be followed when administering phenytoin (Dilantin) intravenously?
Deliver rapidly.
Monitor for signs of tachycardia.
Assess for hypertensive crisis.
Administer without mixing with other medications.
Which condition may the patient have carbamazepine (Tegretol) prescribed to treat symptoms?
Tardive dyskinesia
Psychotic episodes
Trigeminal neuralgia pain
Sedation
Which drug of choice is prescribed for treating a generalized tonic-clonic seizure?
Diazepam (Valium)
Haloperidol (Haldol)
Valproic acid (Depakene)
Risperidone (Risperdal)
Which response by the nurse is accurate when a patient who has been on lamotrigine (Lamictal) for seizure control reports a skin rash and urticaria?
Reassure the patient that this is a common adverse effect of the medication and not to worry.
Instruct the patient to discontinue use of the drug immediately.
Instruct the patient to decrease the dosage of the medication until the rash disappears.
Advise the patient that this adverse effect usually resolves but should be reported to the healthcare provider.
Which medication is used to control seizures or prevent migraine headaches?
Topiramate (Topamax)
Zonisamide (Zonegran)
Valproic acid (Depakene)
Tiagabine (Gabitril)
Which condition would indicate to the nurse that a patient has phenytoin (Dilantin) toxicity?
Oculogyric crisis
Nystagmus
Strabismus
Amblyopia
Which information would be most important for the nurse to provide to a patient when teaching about the adverse effects of succinimide therapy?
Nausea, vomiting, and indigestion are common during initiation of therapy.
Avoid taking the medication with food or milk to minimize adverse effects.
Sedation, drowsiness, and dizziness tend to worsen with continued therapy.
Reducing the dosage of medication will relieve symptoms of nausea.
Which dose is within the acceptable range for administering IV phenytoin (Dilantin) to a patient with a seizure disorder?
5 mg/min
30 mg/min
60 mg/min
100 mg/min
Which patient statement indicates a need for further teaching about phenytoin (Dilantin) prescribed to manage a seizure disorder?
I need to avoid or limit caffeine intake.
I will check with the pharmacist before taking over-the-counter medication.
If I develop enlarged gums, I will stop taking the medication.
It is important for me to take my medicine at the same time daily.
Which premedication assessment by the nurse is most important prior to the initiation of carbamazepine (Tegretol) therapy?
Determine patient’s ancestry.
Monitor blood pressure (BP) lying, sitting, and standing.
Auscultate lung sounds.
Obtain smoking history.
Which statement by the patient recently prescribed pregabalin (Lyrica) indicates a need for further instruction?
I may feel tired at first, but this should improve with continued use.
Once my pain improves, I will stop taking this medication.
Taking sleeping aids will increase the sedative effect of this medication.
This drug may affect my mental alertness, so I need to be careful around machinery.
Which food should be removed from the tray of a pediatric patient on a ketogenic diet for refractory seizure control?
Fat
Salt
Carbohydrates
Vitamin K
Which action(s) is/are appropriate in the nursing management of a patient with generalized tonic-clonic seizure activity? (Select all that apply.)
Restraining the patient‘s arms to avoid further injury
Placing padding around or under the patient‘s head
Attempting to insert a tongue depressor into the patient‘s mouth
Positioning the patient on the side once the relaxation stage is entered to allow oral secretions to drain
Requesting additional assistance and/or necessary equipment in case the patient does not begin breathing spontaneously when the seizure is over
Which important nursing interventions(s) is/are associated with administration of diazepam (Valium) 10 mg IV stat for a patient admitted with status epilepticus? (Select all that apply.)
Apply a cardiac monitor to the patient to assess for continuous heart rate, if not already done.
Administer the prescribed dosage over 1 minute.
Mix diazepam in a primary IV solution to avoid overdosing.
Continuously assess the patient‘s airway.
Obtain the correct dose (10 mg) and administer over slow IV push.
Which adverse effect(s) should patients taking phenytoin (Dilantin) for control of seizures be aware can occur? (Select all that apply.)
Blood dyscrasias
Hyperglycemia
Gingival hyperplasia
Sedation
Urinary retention
The nurse is preparing to administer zonisamide (Zonegran) to a newly admitted patient with the diagnosis of adult partial seizures. Which sign(s) or symptom(s) would cause the nurse to hold this medication? (Select all that apply.)
Skin rash
Urinary frequency
Drowsiness
Allergy to Bactrim
Pruritus
A patient on anticonvulsant therapy confides to the nurse at an outpatient clinic that she suspects she may be pregnant. Which action(s) should the nurse encourage the patient to take? (Select all that apply.)
Consult an obstetrician.
Discontinue medications.
Carry an identification card.
Provide a list of seizure medications.
Consider oral contraception.
