NURS 6521 Advanced Pharmacology – Week 5 – Quiz
NURS 6521 Advanced Pharmacology – Week 5 – Quiz
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Completed
Attempt Score
30 out of 30 points
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46 minutes out of 1 hour and 15 minutes
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Please answer each question below and click Submit when you have completed the Quiz.
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Question 1
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1 out of 1 points
A middle-aged patient was diagnosed with major depression after a suicide attempt several months ago and has failed to respond appreciably to treatment with SSRIs. As a result, his psychiatrist has prescribed phenelzine. When planning this patient’s subsequent care, what nursing diagnosis should the nurse prioritize?
Response Feedback:
MAOIs such as phenelzine carry a significant risk of injury that results from the multiple interactions associated with these drugs. Infection, impaired tissue perfusion, and constipation are less common, and less serious, adverse effects. NURS 6521 Advanced Pharmacology – Week 5 – Quiz
Question 2
1 out of 1 points
A male patient has been brought to the emergency department during an episode of status epilepticus. Diazepam is to be administered intravenously. The nurse will be sure to
Response Feedback:
When diazepam is administered intravenously during status epilepticus, the small veins in the dorsum of the hand or the wrist should be avoided. It should be injected slowly, no faster than 5 mg in 1 minute. Diazepam should not be mixed or diluted with other solutions or drugs, either in the syringe or in intravenous solutions.
Question 3
1 out of 1 points
A nurse who works at an outpatient mental health clinic follows numerous clients who have schizophrenia, many of whom are being treated with olanzapine (Zyprexa). Which of the following clients likely has the highest susceptibility to the adverse effects of olanzapine?
Response Feedback:
The use of olanzapine creates a significant risk of hyperglycemia. This is of particular concern in patients and clients who have diabetes mellitus. Smoking affects the pharmacodynamics of olanzapine, but this is less likely to result in serious adverse effects. Obesity, low BMI, and recent antibiotic use are not associated with a significantly increased risk of adverse effects. NURS 6521 Advanced Pharmacology – Week 5 – Quiz
Question 4
1 out of 1 points
A 4-year-old child is brought to the emergency department by her mother. The mother reports that the child has been vomiting, and the nurse notes that the child’s face is flushed and she is diaphoretic. The mother thinks that the child may have swallowed carbachol drops. A diagnosis of cholinergic poisoning is made. Which of the following drugs would be administered?
Response Feedback:
Acetylcholine and cevimeline are both cholinergic agonists, and, like carbachol, would be contraindicated in this patient. Administration of either of these drugs could be fatal. Nicotine is a direct-acting nicotinic agonist and is not indicated in cholinergic poisoning. Atropine is considered the antidote for cholinergic poisoning. The actions of atropine are a reduction in salivary, bronchial, and sweat gland secretions; mydriasis; cycloplegia; changes in heart rate; contraction of the bladder detrusor muscle and of the gastrointestinal smooth muscle; decreased gastric secretion; and decreased gastrointestinal motility.
Question 5
1 out of 1 points
A trauma patient has been receiving frequent doses of morphine in the 6 days since his accident. This pattern of analgesic administration should prompt the nurse to carefully monitor the patient’s
Response Feedback:
Morphine, like most opioid analgesics, creates a risk for constipation. The drug is unlikely to influence the patient’s temperature, skin integrity, or urine specific gravity. NURS 6521 Advanced Pharmacology – Week 5 – Quiz
Question 6
1 out of 1 points
A patient has been prescribed zolpidem (Ambien) for short-term treatment of insomnia. Which of the following will the nurse include in a teaching plan for this patient? (Select all that apply.)
Response Feedback:
Zolpidem generally is not used for more than 7 to 10 days at a time. It induces sleep rapidly and should be taken immediately before going to bed. It is true that the drug does not seem to produce residual effects the next morning or cause prolonged rebound effects when it is discontinued. It is available in both quick-onset and continuous-release oral forms, and common adverse effects of the drug are headache, prolonged drowsiness, and dizziness.
Question 7
1 out of 1 points
NURS 6521 Advanced Pharmacology – Week 5 – Quiz
A nurse is caring for a patient who is in severe pain and is receiving an opioid analgesic. Which of the following would be the nurse’s priority assessments?
Response Feedback:
The nurse must assess the patient’s pain intensity before and after administering an opioid analgesic. The respiratory rate and level of consciousness need to be assessed because respiratory depression and sedation are two adverse effects of opioid analgesics. Seizure activity, electrolytes, liver function, blood glucose level, and mental status may need to be assessed during opioid analgesic therapy related to adverse effects, but they would not be the priority assessments.
Question 8
1 out of 1 points
A nurse is caring for a patient who has been admitted with acute cocaine intoxication. Which of the following vital signs would the nurse expect to find initially when assessing the patient?
Response Feedback:
CNS stimulants like cocaine initially increase heart rate and blood pressure. Cocaine impairs the uptake of norepinephrine and epinephrine by presynaptic nerve endings, thus activating the adrenergic systems and causing hypertension, tachycardia, and vasoconstriction.
Question 9
1 out of 1 points
A 39-year-old patient who is having trouble sleeping is beginning drug treatment with zaleplon (Sonata). The nurse will be sure to ask the patient if she is taking
Response Feedback:
The nurse will assess for cimetidine use. Cimetidine greatly increases the level of circulating zaleplon and could cause toxic effects in the patient. Secobarbital is a barbiturate, and oxycodone and meperidine are narcotics that would not be used with lorazepam because the combinations may depress respiratory drive, create severe hypotension or bradycardia, and substantially alter level of consciousness. NURS 6521 Advanced Pharmacology – Week 5 – Quiz
Question 10
1 out of 1 points
A patient has been admitted to the ICU because of multiple traumas due to a motor vehicle accident. The physician has ordered propofol (Diprivan) to be used for maintenance of sedation. Before administration of propofol, a priority assessment by the nurse would be to check for a history of
Response Feedback:
Propofol is relatively contraindicated in patients with a history of seizure disorders because they are at risk of developing convulsions during the recovery phase. This drug should be used with caution in patients with low blood pressure because it can aggravate this condition. Also, it should be used with caution in patients with increased intraocular pressure because it can cause a substantial reduction in cerebral perfusion. Because disorders of lipid metabolism can be aggravated by the emulsion vehicle in which propofol is delivered, it should be used with caution in patients with diabetic hyperlipidemia.
Question 11
1 out of 1 points
A nurse who provides care on an acute medicine unit has frequently recommended the use of nicotine replacement gum for patients who express a willingness to quit smoking during their admission or following their discharge. For which of the following patients would nicotine gum be contraindicated?
Response Feedback:
Nicotine in any dosage form should not be used in patients immediately after myocardial infarction, or in those with life-threatening arrhythmias or severe or worsening angina pectoris. Antibiotics, anticoagulants, and renal failure are not contraindications for the use of nicotine as an aid to smoking cessation.
Question 12
1 out of 1 points
A patient who is experiencing acute alcohol withdrawal is being treated with intravenous lorazepam (Ativan). This drug achieves a therapeutic effect by
Response Feedback:
Like all benzodiazepines, lorazepam increases the effects of GABA, which has an inhibitory effect on the CNS. However, none of the benzodiazepines act like GABA or increase the amount of GABA present. MAOIs inhibit monoamine oxidase and tricyclic antidepressants primarily affect serotonin and norepinephrine levels. SSRIs increase the availability of serotonin in the synapses. NURS 6521 Advanced Pharmacology – Week 5 – Quiz
Question 13
1 out of 1 points
An elderly woman is slated for a hemiarthroplasty (hip replacement surgery) after falling and breaking her hip on the stairs outside her home. The woman’s pain in the time since her injury has been severe, and her care team has been treating it with morphine. Which of the following administration schedules is most likely to control the patient’s pain?
Response Feedback:
The use of long-acting analgesia combined with short-acting opioids for breakthrough pain is a proactive pain management technique that maximizes therapeutic benefit while minimizing the risks of adverse effects.
Question 14
1 out of 1 points
A nurse will be prepared to administer naloxone (Narcan) to a patient who has had an overdose of morphine. Repeated doses of Narcan will be necessary because Narcan
Response Feedback:
The duration of the morphine may be longer than the duration of naloxone. Therefore, naloxone has a shorter half-life than morphine. Repeated doses may be necessary to maintain reversal of the opiate’s effects. Naloxone does not increase the action of morphine, and it causes the respiratory rate to increase, not decrease. Dosage strength is not associated with drug duration.
Question 15
1 out of 1 points
A nurse is talking to an 18-year-old patient who has had a seizure disorder since she was 10 years old and is taking phenytoin (Dilantin). The nurse should suggest that she take which of the following?
Response Feedback:
Long-term phenytoin therapy is associated with folate deficiency. Folic acid and phenytoin are structurally similar and thought to compete with each other for the same receptors. A deficiency in folic acid in a pregnant woman can cause birth defects. Potassium, iron, and vitamin C do not compete with phenytoin nor are they directly affected by phenytoin.
Question 16
1 out of 1 points
A nurse works in a sleep disorder clinic and is responsible for administering medications to the patients. Which of the following patients would be most likely to receive zaleplon (Sonata)?
Response Feedback:
The nurse will most likely administer the zaleplon to the 35-year-old man who is having difficulty falling asleep, but once asleep can stay asleep. Zolpidem would most likely be administered to the 20-year-old who will take a sleep aid only once a week. Eszopiclone (Lunesta) will be given to the 52-year-old woman who needs to fall asleep quickly and has trouble staying asleep. The 46-year-old man will likely receive trazodone (Desyrel). This drug is given as a sleep aid for a patient who is taking an antidepressant.
Question 17
1 out of 1 points
A 64-year-old-patient has been prescribed lorazepam (Ativan) because of increasing periods of anxiety. The nurse should be careful to assess for
Response Feedback:
The patient who has history of alcohol or substance abuse may be a poor candidate for lorazepam because the patient is more likely to develop dependence on the drug. Alcohol will also have an additive effect with lorazepam. A diet high in fat and carbohydrates or nicotine use should not affect the use of lorazepam.
Question 18
1 out of 1 points
A patient who has been taking buspirone (BuSpar) for 1 week calls the clinic and reports to the nurse that the drug is not working. The patient informs the nurse that she is still having symptoms of anxiety. The nurse will tell the patient that
Response Feedback:
The nurse will inform the patient that it will likely take 3 to 4 weeks of treatment before she notices consistent relief of her anxiety. However, some improvement is often seen within 7 to 10 days of starting therapy. Since the patient had only been taking the drug 1 week, there is no need to inform the physician. The nurse would not make the assumption that the medication is not going to work for the patient nor would she tell her that it would take up to 6 months to see therapeutic results.
Question 19
1 out of 1 points
A patient has been hospitalized for treatment of substance abuse after being arrested and jailed for the past 24 hours. The patient is experiencing severe muscle and abdominal cramps, seizures, and acute psychosis due to abrupt withdrawal. Which of the following drug classes is the most likely cause of these severe and potentially fatal withdrawal symptoms?
Response Feedback:
Abrupt withdrawal from long-term use of sedative–hypnotic drugs should never be attempted because withdrawal symptoms are serious and potentially fatal. Withdrawal symptoms include agitation, dysphoria, insomnia, vomiting, diarrhea, ataxia, hallucinations, acute psychosis, muscle and abdominal cramps, anorexia, and seizures. These symptoms may occur 12 to 72 hours after the last use of the drug and may last up to 14 days. The abrupt withdrawal of benzodiazepines, opioids, and amphetamines does not cause such severe and potentially fatal withdrawal symptoms. NURS 6521 Advanced Pharmacology – Week 5 – Quiz
Question 20
1 out of 1 points
A nurse is assigned to a patient who is taking lithium. Which of the following drug serum levels would indicate that the patient is at risk for adverse effects of the drug?
Response Feedback:
The therapeutic range for lithium is 0.6 to 1.2 mEq/L. A level of 0.3 mEq/L would not be in the therapeutic range and would therefore not produce a therapeutic response. Levels of 0.6 and 1.2 mEq/L would be within the therapeutic range and would not be expected to produce adverse effects. A level of 1.7 mEq/L would be a high level and place the patient at risk for adverse effects or overdose.
Question 21
1 out of 1 points
Which of the following would be an expected outcome in a patient who has been given atropine during a medical emergency?
Response Feedback:
Atropine is used to help restore normal sinus rhythm in emergency situations, such as symptomatic bradycardia, pulseless electrical activity, ventricular asystole, or cardiopulmonary resuscitation. It does not resolve acid-based imbalances or decreased level of consciousness and atropine increases, rather than decreases, blood pressure.
Question 22
1 out of 1 points
A patient who is experiencing withdrawal from heavy alcohol use have developed psychosis and been treated with haloperidol. Which of the following assessment findings should prompt the care team to assess the patient for neuroleptic malignant syndrome?
Response Feedback:
Neuroleptic malignant syndrome is characterized by fever, sweating, tachycardia, muscle rigidity, tremor, incontinence, stupor, leukocytosis, elevated creatinine phosphokinase levels, and renal failure. Agitation, pruritis, thirst, and increased urine output are not indicative of neuroleptic malignant syndrome.
Question 23
1 out of 1 points
A 20-year-old man has begun treatment of the psychotic symptoms of schizophrenia using olanzapine (Zyprexa). Which of the following symptoms would be categorized as a negative symptom of schizophrenia?
Response Feedback:
The negative symptoms of schizophrenia include flat or blunted emotions, lack of pleasure or interest in things (anhedonia), and limited speech. The positive symptoms of schizophrenia, and the most recognizable symptoms, include delusions (e.g., paranoia or distorted perceptions of other people’s intentions) and hallucinations.
Question 24
1 out of 1 points
The wife of a patient who is taking haloperidol calls the clinic and reports that her husband has taken the first dose of the drug and it is not having a therapeutic effect. An appropriate response by the nurse would be
Response Feedback:
The nurse should instruct the wife to continue offering her husband the drug and that it will probably take several days to reach its full therapeutic effect. The dosage would not be increased, decreased, or discontinued.
Question 25
1 out of 1 points
A 62-year-old woman has been prescribed a fentanyl transdermal patch for chronic cancer pain. The patient asks the nurse how long it will take for her to experience pain relief. The nurse will instruct the patient that she should feel pain relief in approximately
Response Feedback:
The nurse will instruct the patient that it will take approximately 24 hours for the full pain-relieving effect of a fentanyl transdermal patch to occur. NURS 6521 Advanced Pharmacology – Week 5 – Quiz
Question 26
1 out of 1 points
A patient has been prescribed lithium therapy. Which of the following signs and symptoms will the nurse tell the patient to report immediately?
Response Feedback:
Muscle twitching is an early symptom of lithium toxicity and should be reported immediately. Muscle twitching indicates that a dosage change may be needed. Increased thirst and urination are acute effects of lithium, whereas hair loss is a chronic adverse effect.
Question 27
1 out of 1 points
A patient with mild low back pain has been advised to take acetaminophen. The nurse will inform him that excessive intake of acetaminophen may result in
Response Feedback:
A patient taking acetaminophen should be taught the common adverse effects of the drug, which include rash, urticaria, and nausea. Nausea, not gastrointestinal distress, is a common adverse effect of acetaminophen. Flushing, dizziness, and feelings of tingling, heat, and fatigue are the most common adverse effects of sumatriptan, not acetaminophen.
Question 28
1 out of 1 points
A postsurgical patient has been provided with a morphine patient-controlled analgesic (PCA) but has expressed her reluctance to use it for fear of becoming addicted. How can the nurse best respond to this patient’s concerns?
Response Feedback:
Addiction to opioids is a rare occurrence among hospital patients who do not have a history of drug abuse. It would be inappropriate to downplay the patient’s concerns, however. A more appropriate response would be to explain the phenomenon of dependence and to differentiate it from addiction. NURS 6521 Advanced Pharmacology – Week 5 – Quiz
Question 29
1 out of 1 points
Which of the following drugs used to treat anxiety would be appropriate for a patient who is a school teacher and is concerned about feeling sedated at work?
Response Feedback:
Buspirone does not cause as much sedation and functional impairment as lorazepam, alprazolam, and diazepam. However, it can cause dizziness, nausea, headache, nervousness, lightheadedness, or excitement.
Question 30
1 out of 1 points
A 30-year-old woman is taking phenelzine (Nardil) 30mg PO tid. The nurse knows that at that dosage, the patient will need to be carefully monitored for
Response Feedback:
The nurse will closely monitor for the adverse effects of phenelzine related to the anticholinergic effect of the drug, such as dizziness that tends to be more pronounced at dosages above 45 mg/day. Dizziness is also a sign of a phenelzine drug overdose. Constipation and dry mouth are also adverse effects, not diarrhea and increased secretions. Facial flushing is not an identified adverse effect of phenelzine.
Question 31
0 out of 0 points
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