N368 Pharmacology Exam 2

Front 1

Bethanechol

Back 1

therapeutic class: Non Obstructive Urinary Retention
TX: Smooth muscle of GI & Uro following Anesthesia, NON OBSTRUCTIVE URINARY RETENTION
AE: GI disorder exacerbation
CI: Asthma, COPD, parkinsons
OD: Atropine

Front 2

AchE Inhibitors

Back 2

nonselective
affect Ach sites throughout body therefore not widely used
Tx: Glaucoma

Front 3

Prazosin

Back 3

Tx: Anti-HTN or BPH
Receptor: Blocks Alpha 1
AE: Orthostatic Hypotension
CI: Pregnancy
OD: dopamine or dobutamine

Front 4

Isoproterenol is nonselective agonist for?

Back 4

Beta 1+2
Tx: Asthma
AE: Can cause tachycardia leading to DYSRHYTHMIAS

Front 5

Pseudoephedrine is nonselective agonist for?

Back 5

Alpha1 & Beta2
Tx: decongestant
Routes: PO or TOP (rebound congestion)
AE:

Front 6

drugs that imitate acetylcholine are known as

Back 6

parasympathomimetic or cholinergic drugs

Front 7

drugs that block or inhibit acetylcholine are known as

Back 7

parasympatholytic or anticholinergic drugs

Front 8

drugs that imitate norepinephrine (NE) are known as

Back 8

sympathomimetic or adrenergic drugs

Front 9

drugs that inhibit or block NE are known as

Back 9

sympatholytic or antiadrenergic drugs

Front 10

Beta Receptors

Back 10

beta-1 : primarily in the heart, increase HR & force of Contractility & release renin, treat: cardiac arrest, heart failure, Shock
beta-2 : in the lungs vasodilate and inhibit smooth muscle tissue, e.g., treat premature labor

Front 11

only therapeutic use of nicotinic blockers currently?

Back 11

muscle relaxants during surgery

Front 12

A 32-year-old female patient has been taking lorazepam (Ativan) for her anxiety and is brought into the emergency department after taking 30 days' worth at one time. The antagonist used in some cases of benzodiazepine overdosage is:
Question options:
1) Epinephrine
2) Atropine
3) Flumazenil
4) Naloxone

Back 12

3) Flumazenil

Front 13

Choose the CNS center responsible for awakefulness and anxiety?
1) Hippocampus
2) Limbic area and Reticular Activating System
3) Basal ganglia
4) Cerebral cortex

Back 13

2) Limbic area and RAS

Front 14

Which of the following drug types used to treat anxiety or depression by selectively preventing reuptake of serotonin at postsynaptic receptor sites located within the CNS?
Question options:
1) Monoamine oxidase inhibitors (MAOIs)
2) Tricyclic antidepressants (TCAs)
3) Selective serotonin reuptake inhibitors (SSRIs)
4) Beta-adrenergic blockers

Back 14

3) Selective serotonin reuptake inhibitors (SSRIs)

Front 15

A patient is seeking for treatment for insomnia. Which is the best approach for this patient?
Question options:
1) Assess the causes and pattern of insomnia and whether she/her tried non-pharmacological approach before.
2) Most of times depression is related to insomnia. Start to put her on anti-depressant medication.
3) Barbiturate is the best drug of choice to start to treat insomnia.
4) TCA is the better drug of choice over SSRI due to less adverse effect.

Back 15

1) Assess the causes and pattern of insomnia and whether she/her tried non-pharmacological approach before.

Front 16

A female, age 39, has been on haloperidol (Haldol) for 5 months for severe psychosis. The nurse is monitoring the patient for the development of mental changes, hyperthermia with muscle rigidity, profuse diaphoresis, and tremor with haloperidol. The patient is experiencing
Question options:
1) Cholinergic crisis
2) Neuroleptic malignant syndrome
3) Serotonin syndrome
4) Hypertensive crisis

Back 16

2) Neuroleptic malignant syndrome

Front 17

The following statements are about the advantages atypical antipsychotic drugs over traditional antipsychotic drugs (Phenothiazines). Please select the incorrect statement.

1) Treat both positive and negative symptoms
2) Has less extrapyramidal side effect
3) Less likely to cause weight gain or sexual dysfunction
4) Has more effective with poor responders

Back 17

3) Less likely to cause weight gain or sexual dysfunction

Front 18

The following statements describe several extrapyramidal symptoms due to the use of antipsychotic drug. "constant pacing, agitation, restlessness or compulsive behaviors" are the typical symptom of

Question options:
1) Akathisia
2) Acute dystonia
3) Tardive dyskinesia
4) Parkinsonism symptoms

Back 18

1) Akathisia

Front 19

Clinical use of bupropion (Wellbutrin) include
Question options:
1) Treatment of depression
2) Bipolar disorder
3) Smoking cessation
4) All statements are true

Back 19

4) All statements are true

Front 20

Adverse effects of TCAs include all EXCEPT
Question options:
1) Liver toxicity
2) Cardiac arrhythmias
3) Sedation
4) Dry mouth, urine retention, and blurred vision

Back 20

1) Liver toxicity

Front 21

Which of the following are not restrictions for patient taking MAOIs?

Question options:
1) Liver
2) Cheese
3) Beer
4) Tuna

Back 21

4) Tuna

Front 22

The following describes the side effect for each drug classification of lipid lowering therapy. Please select correct match.

Question options:
1) Abdominal obstruction : statin (HMGCoA reductase inhibitor)
2) Muscle or joint pain: bile acid resin
3) Hemorrhoids: fibric acid
4) Flushing or "hot flash": Niacin

Back 22

4) Flushing or "hot flash": Niacin

Front 23

What is the goal of lipid lowering therapy?
Question options:
1) Increased total cholesterol, LDL, VLDL, and HDL levels
2) Increased LDL levels and VLDL, and decreased HDL levels
3) Decreased total cholesterol and LDL levels, and increased HDL levels
4) Maintenance of cholesterol, HDL, and LDL levels

Back 23

3) Decreased total cholesterol and LDL levels, and increased HDL levels

Front 24

Among the following lipoproteins, which one assists in transport of cholesterol from body tissue and back to liver for cholesterol destruction?
Question options:
1) LDL
2) VLDL
3) HDL
4) Cholesterol

Back 24

3) HDL

Front 25

The client with essential hypertension is prescribed the beta blocker metoprolol (Lopressor). Which assessment data would make the nurse question administering this medication?
Question options:
1) The client' blood pressure is 112/90
2) The client's apical pulse is 56
3) The client has an occipital headache
4) The client is complaining of a yellow haze

Back 25

2) The client's apical pulse is 56

Front 26

The class of antihypertensives that decreases blood pressure due to vasodilatation by inhibiting calcium influx into smooth muscle cells is :
Question options:
1) Calcium channel blockers
2) Alpha 1 Adrenergic blockers
3) ACE inhibitors
4) Direct-acting vasodilators

Back 26

1) Calcium channel blockers

Front 27

The nurse is preparing to administer the following medications. Which medication would the nurse question administering?
Question options:
1) The vasodilator hydralazine (Apresoline) to the client with a blood pressure of 168/94
2) The alpha blocker prazosin (Minipress) to the client with a serum sodium level of 137mEq/L
3) The calcium channel blocker diltiazem (Cardizem) to the client with a glucose level of 280mg/dl
4) The loop diuretic furosemide (Lasix) to the client with a serum potassium level of 3.1mEq/L.

Back 27

4) The loop diuretic furosemide (Lasix) to the client with a serum potassium level of 3.1mEq/L.

Front 28

A patient is diagnosed with Congestive Heart Failure. The patient complains that "I am easily getting short of breath even when I walk next door." Which classification of CHF is indicated according to New York Heart Failure Classification:
Question options:
1) Class I
2) Class II
3) Class III
4) Class IV

Back 28

3) Class III

Front 29

The nurse reviews lab studies of a patient receiving digoxin (Lanoxin). Intervention by the nurse is required if the results include a:
Question options:
1) Serum digoxin level of 1.2 ng/dL (normal therapeutic range: 0.5-1.8ng/dL)
2) Serum potassium level of 3.0 mEq/L (normal range: 3.5-5.0mEq/L)
3) Serum sodium level of 140 mEq/L (normal range: 135-145mEq/L)
4) Hemoglobin of 14.4 g/dL (normal range: 12-16g/dL)

Back 29

2) Serum potassium level of 3.0 mEq/L (normal range: 3.5-5.0mEq/L)

Front 30

The followings are the possible treatment options for heart failure and its rationale for their use. Please select an inappropriate treatment option or incorrect rationales for heart failure treatment/management.
Question options:
1) Loop Diuretics: reduce heart failure symptoms by reducing preload by decreasing blood volume
2) Verapamil (Calan), Calcium channel blockers: reduce heart failure symptoms by reducing cardiac workload by relaxing cardiac muscle and reducing the cardiac contraction
3) Digoxin: reduce heart failure symptoms by increasing cardiac contractility
4) Hydralazine with isosorbide dinitrate (BiDil), Vasodilators: reduce heart failure symptoms by reducing afterload by producing vasodilatation

Back 30

2) Verapamil (Calan), Calcium channel blockers: reduce heart failure symptoms by reducing cardiac workload by relaxing cardiac muscle and reducing the cardiac contraction

Front 31

The following are signs of?
SALIVATION
LACRIMATION (tearing)
URINATION
DEFECATION
GASTRIC UPSET
EMESIS

Back 31

Cholinergic Crises - SLUDGE (mneumonic)
common with myasthenia gravis PTs bc OD

Usually due to AchE Inhibitor

Front 32

The nurse recognizes that several chemicals inhibit neurotransmitter function in the brain, rather than excite its neurotransmitter function. The primary inhibitory neurotransmitter in the brain which benzodiazepine or barbiturate affects to treat anxiety disorder is:
1) Sodium
2) Dopamine
3) Acetylcholine
4) Serotonin
5) GABA

Back 32

5) GABA

Front 33

A patient has been taking prazosin (Minipress) for high blood pressure control for 2 weeks. Which symptom of a patient should a nurse report to a physician as the possible side effect?
Question options:
1) Urinary retention
2) Constipation
3) Orthostatic hypotension
4) Photophobia

Back 33

3) Orthostatic hypotension

Front 34

The physician orders metoprolol (Toprol-XL) for several clients. However, the nurse will hold the medication and contact the physician for which client? Who is the contraindication for metoprolol administration?
Question options:
1) The client with a history of migraines
2) The client with chronic bronchitis
3) The client with compensated heart failure
4) The client with an apical pulse rate of 100

Back 34

2) The client with chronic bronchitis

Front 35

A 43- year old female is taking OTC drug, pseudoephedrine (Sudafed) for her nasal congestion symptom. The followings are the symptom of adverse drug effects caused by pseudoephedrine (Sudafed) use except:
Question options:
1) Bradycardia
2) Headache
3) Rebound congestion
4) Nervousness

Back 35

1) Bradycardia

Front 36

The patient is taking benztropine (Cogentin) for the Parkinson disease treatment. Which symptoms should be assessed for:
Question options:
1) Heartburn
2) Urinary Retention
3) Dizziness
4) Increased gastric motility
5) Hypothermia

Back 36

2) Urinary Rentention

Front 37

Elderly patients taking bethanechol (Urecholine) need to be assessed more frequently because of which of the following side effects?
Question options:
1) Diaphoresis
2) Tachycardia
3) Hypotension
4) Constipation
5) Urinary retention

Back 37

3) Hypotension

Front 38

The nurse recognizes that mixed agonist/antagonis have benefit over pure opioid agonist analgesics. Please select a correct answer.
Question options:
1) Have more analgesic effect
2) Block both kappa and blocking mu receptors
3) Cause less physical and psychological dependency
4) Have better safety

Back 38

3) Cause less physical and psychological dependency

Front 39

Choose the primary neurotransmitter which control and deliver the pain signal to brain.
Question options:
1) Substance P
2) GABA
3) Opioids
4) Serotonin

Back 39

1) Substance P

Front 40

What is the good drug of choice for acute phase of migraine?
Question options:
1) Topamax (Sulfamate)
2) metoprolol
3) amitryptline (Elavil)
4) Sumatriptan (Imitrex)

Back 40

4) Sumatriptan (Imitrex)

Front 41

Select the adverse effects of opioid analgesics.
Question options:
1) Polyuria
2) Convulsions
3) Constipation
4) Bradycardia

Back 41

3) Constipation

Front 42

Parkinson's symptoms

Back 42

SMART:
Shuffling gait
Mask-like face
Akinesia
Rigidity
Tremor

Front 43

Akinesia

Back 43

Absence or loss of the power of voluntary movement, due to an extrapyramidal disorder

Front 44

Cholinergic Blockers Indication

Back 44

Parkinson's Disease, Extra-Pyramidal Manifestations with antipsychotics

Front 45

Cholinergic Blockers Action

Back 45

Parasympatholytic

Front 46

Cholinergic Blockers Examples

Back 46

benztropine mesylate (Cogentin), procyclidine hydrochloride (Kemadrin)

Front 47

Cholinergic Blockers Adverse Effects

Back 47

Anticholinergic, Blurred vision, dry mouth, constipation, urinary retention, Orthostatic Hypotension, Drowsiness

Front 48

Cholinergic Blockers Nursing Interventions

Back 48

Provide Fluids, Increase Dietary fiber, Monitor I&O, Monitor BP

Front 49

Dopaminergic Therapy Indication

Back 49

Parkinson's Disease

Front 50

Dopaminergic Therapy Action

Back 50

Increase Dopamine

Front 51

Dopaminergic Therapy Examples

Back 51

levodopa (Sinemet), bromocriptine (Parlodel), amantadine (Symmetrel)

Front 52

Dopaminergic Therapy Adverse Effects

Back 52

Impaired Concentration, Hypotension, GI upsets

Front 53

Dopaminergic Therapy Nursing Interventions

Back 53

Change Positions slowly, Minimize Vitamin B6 foods (meat, eggs, poultry, sweet potatoes)

Front 54

For the client taking epinephrine, the nurse realizes there is a possible drug interaction with which drug?
a. albuterol (Proventil)
b. bethanechol (Urecholine)
c. bethanechol (Detrol)
d. tolterodine tartrate (Detrol)

Back 54

metoprolol (Lopressor)

Front 55

The nurse will monitor the client taking albuterol (Proventil) for which condiiton?
a. Palpitations
b. Hypoglycemia
c. Bronchospasm
d. Uterine contractions

Back 55

Palpitaitons

Front 56

A client is prescribed metoprolol (Lopressor) to reat hypertension. It is important for the nurse to monitor the client for which condition?
a. Bradycardia
b. Hypertension
c. Ankle edema
d. Decreased respirations

Back 56

Bradycardia

Front 57

Atenolol (Tenormin) is prescribed fro a client. The nurse realizes that this drug is a beta-adrenergic blocker and that this drug classification is contraindicated for clients with which condiiton?
a. Hypothyroidism
b. Angia pectoris
c. Cardiogenic shock
d. Liver dysfunction

Back 57

Cardiogenic shock

Front 58

The nurse realizes that beta 1 receptor stimulation is differentiated from beta 2 stimulation in that stimulation of beta 1 receptors leads tto which condition?
a. Increased broncholdilation
b. Decreased uterine contractility
c. Increased myocardial contractility
d. Decreased blood flow to skeletal muscles

Back 58

Increased myocardial contractility

Front 59

A client is given epinephrine (Adrenalin), and adrenergic agonist (sympathomimetic). The nurse should monitor the client for which condiiton?
a. Decreased pulse
b. Pupil constriction
c. Bronchial constriction
d. Increased blood pressure

Back 59

Increased blood pressure

Front 60

The nurse is administering atenolol (Tenormin) to a client. Which concurrent drug does the nurse expect to most likely cause an interaction?
a. ginseng herb
b. An NSAID, such as aspirin
c. methyldopa (Aldomet)
d. heloperidol (Haldol)

Back 60

An NSAID, such as aspirin

Front 61

A client is receiving bethanechol (Urecholine). The nurse realizes that the action of this drug is to treat:
a. Glaucoma
b. Urinary retention
c. Delayed gastric emptying
d. Gastroesphageal reflux disease

Back 61

urinarry retention

Front 62

The nurse teaches the client receiving atropine to expect which side effect?
a. Diarrhea
b. Braydcardia
c. Blurred vision
d. Frequent urination

Back 62

Blurred vision

Front 63

When benztropine (Cogentin) is ordered for a client, the nurse acknowledges that this drug is an effective treatment for which condition?
a. Parkinsonism
b. Paralytic ileus
c. Motion sickness
d. urinary retention

Back 63

Parkinsonism

Front 64

Dicyclomine (Bentyl) is an anticholinergic, which the nurse realizes is given to treat which condition?
a. Mydriasis
b. Constipation
c. Urinary retention
c. Irritable bowel syndrome

Back 64

Irritable bowel syndrome

Front 65

The nurse realizes that cholinergic agonists mimic which parasympathetic neurotransmitter?
a. dopamine
b. acetylcholine
c. cholinesterase
d. monnoamine oxidase

Back 65

acetylcholine

Front 66

The nurse is administering a cholinergic agonist and should know that the expected cholinergic effects include which of the following?
a. Increased heart rate
b. Decreased peristalsis
c. Decreased salivation
d. Increased pupil constriction

Back 66

Increased pupil constriction

Front 67

When the client has a cholinergic overdose, the nurse anticipated administration of which drug as the antidote?
a. atropine
b. bethanechol
c. ambenonium
d. metoclopramide

Back 67

atropine

Front 68

The nurse, caring for a client receiving a cholinergic drug, should observe for increased symptoms of which of the following processes?

Back 68

Heart failure

Cholinergic drugs decrease heart rate and force of contraction which may result in increased symptoms of HF.

Front 69

The client is receiving metoprolol (Lopressor) for treatment of hypertension. Considering the client's history of prostatic hypertrophy, the nursing care plan should include assessment for

Back 69

urinary retention

Lopressor is an alpha adrenergic antagonist. Side effects of this drug include urinary retention.

Front 70

The nurse administers dopamine (Inotropin) to a client. What data collected by the nurse demonstrates that the drug is effective?

Back 70

Increased heart rate and blood pressure

Dopamine is a sympathomimetic drug that causes increased heart rate and blood pressure.

Front 71

Doxazosin (Cardura) is prescribed for a client diagnosed with hypertension. Which of the following should the nurse include in the teaching plan?

Back 71

Change from lying to sitting position slowly

The most common side effect of alpha blockers is orthostatic hypotension.

Front 72

During the nursing history, the client states he has had a stuffy nose for the past 6 weeks. He is using phenylephrine (Neosynephrine) nasal spray several times per day with no relief. The nurse recognizes this phenomenon as

Back 72

rebound congestion

When used for prolonged periods, intranasal use can cause burning of the mucosa and rebound congestion.

Front 73

The client is prescribed oxymetazoline (Afrin) for treatment of nasal congestion. The patient is also taking a MAO Inhibitor. A primary nursing intervention is to

Back 73

monitor blood pressure.

Alpha-adrenergic antagonists may interact with MAOIs and cause hypertensive crisis.

Front 74

Pyridogotigmine (Mestinon) is prescribed for a client diagnosed with myasthenia gravis. Priority nursing assessment includes assessing the

Back 74

client's ability to chew and swallow.

Front 75

The nurse provides preoperative teaching for a client. The teaching plan includes instructions on the side effects of Atropine given as a preoperative medication. The client informs the patient to expect

Back 75

xerostomia - dry mouth.

Front 76

The client reports use of Valerian tea prior to bedtime. The nurse recognizes this herbal remedy is most effective to

Back 76

promote rest and relaxation.

Valerian is used to decrease nervous tension and anxiety, to promote rest without affecting REM sleep, and to reduce side effects such as "hangover".

Front 77

The client, prescribed furosemide (Lasix) as an adjunct to treatment of hypertension, returns for follow-up. Which of the following is the most objective data to determine the effectiveness of the drug therapy?

1)Absence of edema in lower extremities
2)Weight loss of six pounds
3)Blood pressure log notes blood pressure 120/70 to 134/88 since discharge
4)Frequency of voiding of at least six times per day

Back 77

Blood pressure log notes blood pressure 120/70 to 134/88 since discharge

Maintenance of blood pressure within normal limits indicates treatment goals are achieved

Front 78

A client, receiving HCTZ 25 mg qd and Digoxin 0.125 mg qd, complains of nausea and vomiting and of seeing halos around lights. The client's serum digoxin level is 2.5 ng. The appropriate nursing intervention is to

Back 78

hold the digoxin and HCTZ.

Thiazide diuretics increase serum digitalis level. A digitalis level above 2.0 ng is toxic.

Front 79

Nitroprusside (Nitropress) is prescribed for a client admitted with a blood pressure of 220/110. What action by a graduate nurse (G.N.) would require intervention by the charge nurse?

Back 79

The G.N. uses electronic monitoring of blood pressure every hour

Nitroprusside decreases blood pressure instantaneously. Vital signs must be monitored very closely, e.g. every 5-15 minutes.

Front 80

The client is receiving Nitroprusside (Nitropress) I.V. for severe hypertension. Which of the following actions by the nurse is appropriate administration of this drug?

Back 80

Administers in 250 ml D5W with opaque cover to solution and tubing

Nitropress is only compatible with D5W. Never mix with other drugs or diluents. The drug is light sensitive and must be covered with an opaque substance.

Front 81

The client presents to the medical office with history of blood pressure 140/90 to 154/92 for the past month. There is no history of other medical conditions. The nurse recognizes the most likely initial treatment to include is

Back 81

Diuril 25 mg b.i.d.

Blood pressure of 140-159/90-99 is Stage I hypertension. Initial treatment includes use of a Thiazide diuretic in the absence of other symptoms.

Front 82

The nurse prepares to administer HCTZ (hydrodiuril) 25 mg to a client with hypertension. The potassium lab result is 2.8 mEq. The appropriate action is to

Back 82

hold the medication and notify the health care provider.

The normal serum potassium level is 3.5-5.0. HCTZ is a potassium-depleting drug. The drug should be held until a consultation with the health care provider.

Front 83

The nurse reviews the teaching plan with a client receiving nifedipine (Procardia). Which of the following indicates understanding?

Client monitors blood pressure every week
Client consumes 3 servings of alcohol daily
Client breaks enteric coated tablet for ease of swallowing
Client avoids use of grapefruit juice with drug

Back 83

Client avoids use of grapefruit juice with drug

Grapefruit juice increases absorption of nifedipine resulting in increased serum level.

Front 84

A diuretic is added to the treatment regimen for a client with hypertension. The nurse explains that diuretics help reduce blood pressure by

Back 84

decreasing blood volume resulting in decreased workload of the heart.

Diuretics decrease the workload of the heart by decreasing blood volume.

Front 85

Atenolol (Tenormin) is prescribed for a client with hypertension. Which of the following represents safe dose range?

Atenolol (Tenormin) 50 mg. b.i.d.
Atenolol (Tenormin) 150 mg. qd
Atenolol (Tenormin) 100mg. b.i.d.
Atenolol (Tenormin) 75 mg. b.i.d.

Back 85

Atenolol (Tenormin) 50 mg. b.i.d.

The maximum dosage range for Atenolol (Tenormin) is 100 mg/day.

Front 86

Nifedipine (Procardia) 30 mg p.o. is prescribed for a client. The nurse teaches the side effects and instructs the client to immediately report
1)dizziness when changing positions.
2)blood pressure 110-114/70-78 for 2 successive readings.
3)weight loss of two pounds per week.
4)severe shortness of breath or frothy sputum.

Back 86

severe shortness of breath or frothy sputum.

Nifedipine (Procardia) is a calcium channel blocker. Calcium channel blockers decrease myocardial contractility increasing the risk of heart failure.

Front 87

Nifedipine is what class of drug?

Back 87

Nifedipine

Front 88

The client informs the nurse he has experienced pain in the lower extremities for the past 8 months. This pain is classified as

Back 88

chronic pain

Chronic pain persists longer than six months. It can interfere with daily activities and is associated with feelings of helplessness or hopelessness.

Front 89

The client describes his pain as "burning and shooting." This pain may be classified as

Back 89

neuropathic pain.

Neuropathic pain is caused by injury to nerves and is typically described as burning, shooting, or numbing pain. Injury to tissues produces norciceptor pain.

Front 90

The nurse teaches the client relaxation techniques and guided imagery as an adjunct to medication for treatment of pain. The nurse explains the major benefit of these techniques is that they:

Back 90

allow lower doses of drugs with fewer side effects.

When used concurrently with medication, non-pharmacologic techniques may allow for lower doses, and possibly fewer drug related adverse effects.

Front 91

The nurse recognizes that opioid analgesics exert their action by interacting with a variety of opioid receptors. Drugs, such as morphine, act by

Back 91

activating mu and kappa receptors.

Some opioid agonists, such as morphine, activate both mu and kappa receptors, therefore, most effective but most addictive

Front 92

The client, admitted with Hepatitis B, is prescribed Vicodin tabs 2 for treatment of pain. The appropriate nursing action is to

Back 92

Vicodin is a combination drug of hydrocodone and acetaminophen. Acetaminophen can be nephrotoxic.

Front 93

The nurse administers morphine sulfate 4 mg I.V. to a client for treatment of severe pain. Which of the following assessments require immediate nursing interventions?

Back 93

Respiratory rate 10/min

Opioids activate mu and kappa receptors that may cause profound respiratory depression. Respiratory rate should remain above 12.

Front 94

Nursing intervention for a client receiving opioid analgesics over an extended period of time should include

Back 94

encouraging increased fluids and fiber in the diet.

Opioids suppress intestinal contractility, increase anal sphincter tone, and inhibit fluids into the intestines, which can lead to constipation.

Front 95

Naloxone (Narcan) is administered to a client with severe respiratory depression and suspected drug overdose. After 20 minutes the client remains unresponsive. The most likely explanation for this is

Back 95

the client did not use an opioid drug.

If opioid antagonists (Naloxone) fail to quickly reverse symptoms of respiratory depression, the overdose was likely due to a non-opioid substance.

Front 96

The client is prescribed ketorolac tromenthamine (Toradol) for treatment of pain following a surgical procedure. The nurse should question which of the following drug orders?
Toradol 10 mg p.o b.i.d.
Toradol 20 mg p.o. b.i.d
Toradol 5mg p.o t.i.d
Toradol 20 mg p.o q.i.d.

Back 96

Toradol 20 mg p.o q.i.d.

The maximum daily dose of Toradol is 40 mg.

Front 97

Celecoxib (Celebrex) is added to the treatment regimen of a client with arthritis. The nurse explains the major advantage of this drug is

Back 97

the drug has anti-inflammatory properties.

Celecoxib (Celebrex) has anti-inflammatory properties.

Front 98

receptors located on target tissues affected by postganglionic neurons in parasympathetic nervous system

Back 98

muscarinic

Front 99

receptors are located at the ganglionic synapse in both the sympathetic and parasympathetic nervous systems, i.e., the sub divisions of the autonomic nervous system

Back 99

nicotinic

Front 100

Beta2 receptors are responsible for what?

Back 100

inhibiting smooth muscle

Front 101

what destroys NE at the synaptic cleft?

Back 101

Catecholamine-O-Methyl Transferase (COMT)

Front 102

Beta1 receptors do what in the body?

Back 102

Increase HR & Force of Contractility

Front 103

What destroys NE once it is reuptaken into the presynaptic terminal?

Back 103

Monoamine Oxidase (MAO)

Front 104

Anticholinergic or aka ______________ produce actions opposite to?

Back 104

parasympatholytics: produce effects that inhibit PNS, which is the opposite of cholinergics

Front 105

cholinergic agents aka _______________ produce SX of rest-and-digest

Back 105

parasympathomimetics stimulate the PNS response.

Front 106

Drugs that inhibit the SNS are called?

Back 106

Adrenergic inhibiting agents or sympatholytics

Front 108

Direct Acting Cholinergic General Effects

Back 108

Decreased heart rate, vasodilation, variable BP effects
Increased tone and contractility in GI smooth muscle, relaxation of sphincters, increased salivary gland and GI secretions
Increased tone and contractility of smooth muscle in urinary bladder and relaxation of the sphincter
Increased tone and contractility of bronchial smooth muscle
Increased respiratory secretions
Constriction of pupils (miosis) and contraction of ciliary muscle