125 Questions
What is a potential side effect of administering albuterol to a patient with asthma?
Increased heart rate
Which side effect is NOT generally associated with adrenergic agonists?
Increased drowsiness
Which beta blocker would be the safest choice for a patient with asthma and cardiovascular disease?
Metoprolol (Lopressor)
What is the main benefit of Metoprolol over other beta blockers in patients with both asthma and cardiovascular disease?
Reduced bronchoconstriction risk
Which receptor do selective beta2 agonists like albuterol preferentially act on?
Beta2
What side effect is commonly associated with beta1 receptor activation by adrenergic agonists?
Increased heart rate
What is the expected outcome when a nurse administers epinephrine to a patient experiencing an anaphylactic reaction?
Decreased urine output
Why might a nurse suspect that a patient experiencing asthma exacerbation has overused albuterol?
High doses of albuterol may affect beta1 receptors, causing an increase in heart rate.
What action should a nurse take upon noting erythema and swelling at the IV insertion site of a patient receiving intravenous dopamine (Intropin)?
Notify the provider of a need for phentolamine mesylate (Regitine).
What instruction should a nurse give to a patient using phenylephrine HCl (Neo-Synephrine) nasal spray to treat congestion from a viral upper respiratory infection?
Use this product for a maximum of 3 days.
When teaching a patient about taking atenolol (Tenormin) for hypertension, what information should the nurse include?
The patient should rise slowly from a chair or bed.
A patient taking atenolol (Tenormin) reports dizziness, nausea, vomiting, and decreased libido. What should the nurse do?
Hold the next dose until notifying the provider of these side effects.
What is the primary purpose of benztropine (Cogentin) in patients with Parkinson's disease?
To suppress tremors and lessen muscle rigidity
Which side effect would prompt the nurse to notify the provider in a patient who received atropine sulfate preoperatively?
Absent bowel sounds
What type of drug would a patient with irritable bowel syndrome most likely receive for treatment?
An anticholinergic
Which statement is true about phentermine?
It is indicated for short-term use in treating obesity.
When taking an anticholinergic medication, what should patients do to counter the side effect of dry mouth?
Use gum or lozenges
What diagnostic test may be ordered to assist with a diagnosis of ADHD in a child with symptoms of inattention and hyperactivity?
EEG
Which statement by a patient indicates a need for further teaching about bethanechol (Urecholine)?
'Excessive sweating is a normal reaction to this medication.'
Why should methylphenidate be taken before breakfast and lunch?
It can cause insomnia, and taking it before meals can help with this side effect.
What would be a concerning health history that the nurse should investigate before administering neostigmine to a male patient with myasthenia gravis?
Benign prostatic hypertrophy
What should a parent understand about giving methylphenidate to their child for ADHD?
The child should avoid caffeine-containing products.
What would be a crucial monitoring parameter when a patient is prescribed bethanechol (Urecholine)?
Heart rate variations
What advice should a nurse give to a parent of a child on amphetamine for ADHD who asks about over-the-counter cold medications?
Avoid products with pseudoephedrine or caffeine.
Why are anticholinergic drugs like benztropine used in Parkinson's disease?
To decrease tremors and muscle rigidity
For a child taking methylphenidate, which assessments are particularly important during clinic visits?
Height, weight, and blood pressure
During which stage of sleep do vivid dreams occur?
Rapid eye movement (REM) sleep
When do nightmares commonly occur in children?
Nonrapid eye movement (NREM) sleep
What non-pharmacologic measure may help with sleep difficulties according to the text?
"Get out of bed at the same time each morning."
Which stage of sleep is related to nightmares in children?
Nonrapid eye movement (NREM) sleep
What is the recommended approach for promoting sleep without medication?
"Exercise in the evening to promote bedtime fatigue."
Which statement best describes the action of an indirect-acting cholinergic agonist?
Inhibits cholinesterase
Why are direct-acting cholinergic agonist drugs selective to muscarinic receptors sometimes considered non-specific?
Muscarinic receptors are present in many different tissues
If a patient has a blood pressure of 90/60 mm Hg, what is the appropriate action before administering bethanechol (Urecholine) for urinary retention?
Hold the medication and notify the provider of decreased blood pressure
After voiding 800 mL of urine, a patient taking bethanechol reports a loose stool but no cramping. Blood pressure is 110/70 mm Hg. What should the nurse do?
Record urine output and blood pressure and continue monitoring
What does it mean when a nurse is advised to use sympathomimetic drugs with caution in diabetic patients?
The drugs may cause hyperglycemia
What is the appropriate action if a nurse learns a patient with diabetes mellitus has been ordered to receive pseudoephedrine for nasal congestion?
Hold the medication and contact the provider
What action should be taken if a nursing student asks why a direct-acting cholinergic agonist selective to muscarinic receptors is described as non-specific?
Muscarinic receptors are present in many different tissues
What should a nurse do if preparing to administer an indirect-acting cholinergic agonist drug?
Hold the medication and contact the provider.
When preparing to give bethanechol (Urecholine) for urinary retention, what should the nurse do if the patient has a blood pressure of 120/80 mm Hg?
Administer the drug and monitor urine output.
What is the appropriate action for the nurse to take when a parent expresses concern about their child experiencing nausea, vomiting, and headaches after taking methylphenidate for ADHD?
Ask the child whether the drug is being taken as prescribed.
What does a parent's statement about consulting a pharmacist when giving OTC medications with methylphenidate indicate?
Awareness of potential interactions between OTC medications and methylphenidate.
What is an appropriate response by the nurse when asked about weight loss medications for an obese 10-year-old child?
Children under 12 years of age should not use weight loss drugs.
Which drug is indicated for treating neonatal apnea in infants experiencing bradycardia and apnea?
Caffeine citrate
What potential adverse effects should a nurse anticipate when a patient presents after consuming caffeine tablets, coffee, and energy drinks?
Arrhythmias and convulsions may occur.
What medication would a nurse expect a provider to order for a patient diagnosed with narcolepsy and reporting difficulty staying awake during the daytime?
Modafinil
What is a common side effect of beta-adrenergic blockers?
Increased heart rate
What should a patient do if experiencing side effects from beta-blockers?
Discuss them with the healthcare provider
What are high dosages of albuterol (Proventil) inhaler known to potentially cause?
Increase in heart rate
How do alpha-adrenergic blockers help in treating Raynaud’s disease?
Vasodilation
What is a crucial skill for a patient's family to learn when the patient is on beta blockers?
Monitoring heart rate and blood pressure
What category does Reserpine fall under?
Adrenergic neuron antagonist
What is neostigmine used for?
Myasthenia gravis
Where should a patient apply the transdermal scopolamine patch?
Behind the ear
Why should a patient change the transdermal scopolamine patch every three days?
To maintain effectiveness
What condition would cause a nurse to hold benztropine medication for a patient with Parkinson's disease?
Glaucoma
What action should the nurse take if a patient reports a dry mouth after receiving atropine?
Palpate the patient’s bladder
When should a patient with myasthenia gravis use benztropine with caution?
Myasthenia gravis
Which medication is used to treat sinus bradycardia?
Atropine sulfate
Why should a nurse hold the administration of tolterodine tartrate in a patient with incontinence?
Absent bowel sounds
What is donepezil commonly used to treat?
Alzheimer's disease
What is a common side effect that patients can experience with the use of phentermine?
Headaches
Which diagnostic test is NOT helpful in diagnosing attention-deficit/hyperactivity disorder (ADHD)?
Electrocardiogram (ECG)
A patient with ADHD taking methylphenidate is experiencing insomnia. What advice should the nurse give regarding the timing of medication administration?
Take the medication before breakfast and lunch
What is a significant benefit of using phentermine for obesity treatment?
Short-term weight loss support
What class of drug is phentermine based on its Schedule IV classification as a controlled substance?
Stimulant
Why is an Electroencephalogram (EEG) ordered for a child suspected of having ADHD?
To evaluate brain wave patterns
Which stage of sleep is associated with vivid dreams?
Rapid eye movement (REM) sleep
During which stage of sleep do nightmares occur in children?
Nonrapid eye movement (NREM) sleep
What non-pharmacologic measure can help promote sleep?
Get out of bed at the same time each morning
Which barbiturate is an intermediate-acting agent helpful in sustaining sleep?
Butabarbital
What is indicated for use in newborns with respiratory distress?
Caffeine citrate
What can cause cardiac arrhythmias and seizures when consumed excessively?
Psychological dependence on caffeine
What medication is given to treat narcolepsy?
Modafinil
'Anorexiants should not be given to children under what age?'
'12 years'
What drug could induce arrhythmias and convulsions when taken excessively?
Caffeine
What is the maximum recommended dose of benzodiazepine for sleep aid?
10 mg
Why should a patient taper the dose gradually when stopping benzodiazepine used as a sleep aid?
Withdrawal
What is the purpose of administering a hypnotic medication the night before surgery?
To decrease the amount of general anesthesia needed
What is the recommended timing for taking methylphenidate twice daily?
30-45 minutes before breakfast and lunch
Which type of medication is given during surgery in balanced anesthesia?
Inhaled anesthetic
What is a crucial reason for avoiding products containing caffeine when a child is taking methylphenidate for ADHD?
Caffeine can worsen the side effects of methylphenidate
Why is it essential to ask about drug and alcohol use during a preoperative assessment?
Changes in anesthesia type and dose may be required
Why should a child taking amphetamine for ADHD avoid products with pseudoephedrine or caffeine?
To avoid additional stimulation
When does a patient who received isoflurane to induce anesthesia generally recover consciousness?
In 1 hour
What should be closely monitored in a child taking methylphenidate due to potential medication side effects?
Height, weight, and blood pressure
What is the appropriate initial action if a child on methylphenidate shows signs of nausea, vomiting, and hyperactivity?
Ask about medication adherence
Why should a parent consult a pharmacist before giving their child OTC medications while on methylphenidate?
To prevent interactions with stimulants in OTC products
What should a nurse do when assessing a child taking methylphenidate who reports recent nausea, vomiting, and headaches?
Ask the child about medication adherence
Why is it significant for a parent to understand that behavioral therapy may still be necessary alongside medication therapy for ADHD?
"Behavioral therapy can complement medication effects"
Why should patients taking benzodiazepines like alprazolam avoid alcohol?
Alcohol can enhance the sedative effects of the medication.
Which medication is recommended for older adults experiencing difficulty falling asleep?
Temazepam
What is the primary ingredient in over-the-counter sleep aids?
Antihistamine
Which drug is classified as a melatonin receptor agonist?
Ramelteon
What effect might a patient experience after taking Zolpidem (Ambien) for several weeks?
Hangover
When should a patient take Zolpidem tartrate (Ambien) for sleep according to the teaching?
At bedtime
'Why might a bed alarm be used for older patients receiving flurazepam?'
To prevent falls
What is the most common cause of epilepsy according to the text?
Of unknown origin
Why are anticonvulsants usually taken throughout a patient's lifetime?
Stopping the medication can lead to seizure recurrence
What age-related factor influences phenytoin dosage in children?
Children with rapid metabolism may need higher doses
What is the cause of reddened gums that bleed easily in patients on phenytoin?
Adverse effect of phenytoin
What should a nurse do if a patient's random serum phenytoin level is 18 mcg/mL?
Administer the dose as prescribed
Why is it important for children on phenytoin to have their dosage adjusted?
Due to their decreased drug metabolism rate
What action should a nurse take when administering phenytoin to an 80-year-old patient?
Administer the dose as ordered
What is a common adverse effect of phenytoin experienced by patients?
Drowsiness and fatigue
What serum drug level range is considered therapeutic for phenytoin?
10-20 mcg/mL
What is a common age-related consideration for phenytoin dosing in pediatric patients?
Children usually require higher doses than adults due to rapid metabolism.
How does ethosuximide (Zarontin) work as an antiepileptic drug?
Suppressing calcium influx
What is the most appropriate next step when a patient has a serum carbamazepine level of 18 mcg/mL?
Ask the patient about usual dietary preferences
What aspect of a patient's medical history would be concerning when starting therapy with valproic acid (Depakote) for epilepsy?
Liver disease
Why should a pregnant woman taking anticonvulsants receive vitamin K toward the end of her pregnancy?
Vitamin K inhibitor neutralization
What percentage of children who experience febrile seizures are likely to develop epilepsy?
A large percentage develop epilepsy
For a 25-year-old female starting phenytoin for epilepsy while on oral contraceptives, what advice would the nurse give?
Use backup contraception with oral contraceptives
What should a parent understand about a child with a history of febrile seizures and the likelihood of developing epilepsy?
'A small percentage develop epilepsy'
'A 5-year-old child who had a febrile seizure is at high risk of developing epilepsy.' - Is this statement true or false?
'False'
What is the recommended route for administering phenytoin to older patients?
Directly into a large vein via a central line or PICC
What is the reason for avoiding intramuscular injection of phenytoin?
Very irritating to tissues
What blood test should the nurse discuss with the provider for a patient taking phenytoin for several years?
Blood glucose
What action is appropriate if a patient presents with reddish-brown urine while taking phenytoin?
Reassure the patient that it is a harmless side effect
What action is necessary if a female patient taking phenytoin becomes pregnant?
Discontinue phenytoin and discuss alternative options
Which antiepileptic medication is specifically used to treat absence seizures?
Ethosuximide (Zarontin)
What drug should the nurse anticipate administering first to an intubated child having a seizure for 20 minutes in the emergency department?
Diazepam (Valium)
What might the nurse expect regarding serum phenytoin levels in a patient taking antacids for dyspepsia?
5 to 10 mcg/mL
In a patient with new-onset dyspepsia after taking antacids, what action should the nurse take?
Obtain a serum phenytoin level.
Which patient symptom indicates a potential side effect of phenytoin?
Reddish-brown urine.
Test your knowledge on pediatric nursing by answering a scenario involving an adolescent with ADHD symptoms who is taking methylphenidate. Choose the best course of action for the nurse to take next based on the situation presented.
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