Professional Documents
Culture Documents
sulfate (Adderall).The health care professional should monitor the patient for which of the
following adverse effects?
Tachycardia
Rationale
Amphetamine sulfate is an amphetamine stimulant. It can cause tachycardia and
dysrhythmias. Patients should notify the health care professional if they develop
palpitations or chest pain.
A health care professional is talking to a patient and her family about how
methylphenidate (Ritalin) will help manage attention-deficit hyperactivity disorder
(ADHD). Which of the following therapeutic effects should they expect?
Increased focus
Rationale:
Stimulants, such as methylphenidate, regulate levels of dopamine and
norepinephrine in the brain to produce calmness, reduce hyperactivity, and increase
focus for patients who have ADHD.
A health care professional is talking to a patient about beginning sumatriptan
(Imitrex) therapy to treat migraine headaches. The health care professional should
advise the patient to watch for which of the following adverse effects?
Chest pain
Rationale
Sumatriptan, a serotonin agonist, can cause coronary vasospasm and chest pain.
Patients should report any pressure, pain, or tightness in the jaw, chest, or back.
Sumatriptan is not an appropriate choice for patients who have a history of coronary
artery disease.
A health care professional is reviewing the medical record of a patient who has a
newly diagnosed seizure disorder. The patient is to begin taking both valproic acid
(Depakote) and phenytoin (Dilantin). The health care professional should recognize
that which of the following can occur as a result of a drug interaction between
valproic acid and phenytoin?
Phenytoin toxicity
Rationale:
Valproic acid can cause an increase in phenytoin blood levels, causing phenytoin
toxicity. The primary care provider should monitor serum phenytoin levels and
reduce the dosage if levels begin to exceed the therapeutic range.
A health care professional is caring for a patient who is about to begin taking
dantrolene (Dantrium) for skeletal muscle spasms. The health care professional
should recognize that which of the following laboratory tests requires monitoring?
Liver function
Rationale:
Liver toxicity is a serious adverse effect of dantrolene. The health care professional
should monitor liver function prior to treatment and at regular intervals, and advise
patients to report jaundice or abdominal pain.
Because of the potential for adverse effects, which of the following should a health
care professional recommend for patients who begin taking carbamazepine
(Tegretol)?
Begin taking the drug at a low dosage.
Rationale:
Visual disturbances, vertigo, and ataxia can result from taking carbamazepine, an
iminostilbene that treats seizure disorders. Dosages should be low to minimize or
prevent these adverse effects.
For which of the following should a health care professional monitor a patient who is
taking donepezil (Aricept) for Alzheimer's disease?
Nausea
Rationale:
The most common adverse effects of donepezil, a cholinesterase inhibitor, are
nausea, vomiting, and diarrhea. Taking the drug with food can help minimize
adverse effects.
Which of the following information should a health care professional include when
talking to a patient about taking baclofen (Lioresal)?
Avoid driving until the drug's effects are evident.
Rationale:
Baclofen, a centrally-acting muscle relaxant, causes CNS depression. Patients taking
the drug should avoid alcohol and other CNS depressants and should not drive a
vehicle until they know how the drug will affect them.
A patient is taking selegiline (Eldepryl) to treat Parkinson's disease. The provider is
considering the use of analgesics for the patient but should be aware that a drug
interaction between selegiline and meperidine (Demerol) can result in which of the
following?
Muscle rigidity
Rationale:
A drug interaction between selegiline and opioids, especially meperidine, can result
in a serious reaction resulting in rigidity, stupor, agitation, hypertension, and fever.
A health care professional is caring for a patient who is about to begin taking
pramipexole (Mirapex) to treat Parkinson's disease. The health care professional
should recognize that which of the following laboratory tests require monitoring?
Creatine phosphokinase (CPK)
Rationale:
CPK is an enzyme found in the heart, brain, and skeletal muscles. Patients taking
pramipexole can develop muscle weakness with a lack of energy, creating a
situation that can be more problematic for patients than their original muscle
dysfunction. Monitoring CPK can alert health care professionals to the possibility of
skeletal muscle damage from the drug.
Which of the following findings should alert a health care professional that a patient
is developing a potentially serious adverse reaction to interferon beta-1b
(Betaseron)?
Fatigue
Rationale:
Because of the potential for bone marrow suppression and decreased platelet count,
patients should report unexplained bruising, bleeding, or fatigue.
A health care professional is caring for a patient who is about to begin taking
dantrolene (Dantrium) for skeletal muscle spasms. The health care professional
should tell the patient to report which of the following adverse effects?
Diarrhea
Rationale:
Prolonged diarrhea can cause dehydration and other serious effects. Diarrhea is an
adverse effect of dantrolene, as are nausea and vomiting. Patients should report
these effects so the health care professional can monitor fluid balance and
intervene accordingly.
A health care professional is caring for a patient who is receiving thiopental
(Pentothal). For which of the following should the health care professional monitor?
Respiratory depression
Rationale:
Thiopental, a short-acting barbiturate, causes respiratory depression. Mechanical
ventilation and continuous monitoring are essential for patients receiving the drug.
Anesthetists often administer midazolam (Versed) during induction of anesthesia
because of which of the following pharmacological actions?
Causes amnesia
Rationale:
Midazolam, a benzodiazepine, is appropriate during induction because of its
antianxiety and amnesiac properties.
A health care professional is caring for a patient who is taking zolpidem (Ambien).
The patient has a history of benzodiazepine abuse and reports insomnia. The health
care professional should caution the patient that the drug can cause
memory impairment.
Rationale:
Zolpidem, a non-benzodiazepine, can cause anterograde amnesia, or memory
impairment, particularly an inability to recall activities patients carry out just before
or during sleep.
While talking with a patient and his family about taking memantine (Namenda) for
Alzheimer's disease, the health care professional should include which of the
following instructions?
Notify the health care professional before taking over-the-counter antacids.
Rationale:
Antacids that contain sodium bicarbonate increase urine alkalinity and can decrease
drug excretion, ultimately leading to toxicity.
An anesthetist is about to administer lidocaine (Xylocaine) as part of the protocol for
spinal anesthesia for a patient who is undergoing a surgical procedure. The health
care professional should be aware that the patient could develop which of the
following potentially serious effects?
Hypotension
Rationale:
When systemically absorbed in sufficient amounts, lidocaine, a local anesthetic, can
cause hypotension, particularly when used as spinal anesthesia.
When talking with a patient about taking temazepam (Restoril), which of the
following instructions should the health care professional include? (Select all that
apply.)
Avoid alcohol and other depressants.
Take the drug 30 min before bedtime.
Taper the drug slowly to prevent withdrawal symptoms.
Avoid alcohol and other depressants is correct. Temazepam can cause CNS
depression. Combined use with alcohol or other depressants can cause severe
respiratory depression.
Take the drug 30 min before bedtime is correct. Patients should take
temazepam 30 min before bedtime to improve sleep and to prevent daytime
drowsiness.
Taper the drug slowly to prevent withdrawal symptoms is correct. Abrupt
discontinuation of temazepam can cause withdrawal symptoms. Patients should
taper the drug slowly to prevent or minimize withdrawal.
A health care professional is talking to a patient about the adverse effects of
interferon beta-1a (Avonex). To help minimize these effects, she should tell the
patient to
premedicate with acetaminophen (Tylenol).
Rationale:
Interferon beta drugs can cause fever, chills, headaches, and muscle aches.
Acetaminophen or a nonsteroidal anti-inflammatory drug can help minimize these
symptoms.
When talking to a patient about taking modafinil (Provigil) to treat narcolepsy, which
of the following instructions should the health care professional include?
Which of the following instructions should a health care professional include when
advising a patient about instilling pilocarpine (Isopto Carpine) for managing openangle glaucoma? (Select all that apply.)
Apply gentle pressure to the nasolacrimal duct for 1 min after instilling the drops.
Applying gentle pressure to the nasolacrimal duct for 1 to 2 min after
instillation helps keep the drug from entering the systemic circulation.
Do not touch the tip of the dropper.
The tip of the dropper should remain sterile. It is important that patients
avoid touching the dropper's tip or touching it to the eye area.
Remove contact lenses prior to instilling the drops.
Patients should remove contact lenses before instilling eye drops because
they can cause further irritation if left in place.
When caring for a patient who is taking risperidone (Risperdal) for schizophrenia,
the health care professional should monitor for which of the following adverse
effects of the drug?
Polyuria
Rationale:
Risperidone, an atypical antipsychotic, can cause new-onset diabetes mellitus. It is
essential to monitor patients taking the drug for signs of hyperglycemia, and check
their glucose levels regularly.
Soon after beginning fluoxetine (Prozac), a patient is admitted to the emergency
department with agitation and confusion. The health care professional should
suspect which of the following?
Serotonin syndrome
Rationale:
Serotonin syndrome can begin 2 to 72 hr after beginning to take fluoxetine, a
selective serotonin reuptake inhibitor. Manifestations include mental confusion,
difficulty concentrating, and agitation.
During and immediately following IV administration of chlorpromazine to a patient
who has schizoaffective disorder, the health care professional should monitor which
of the following?
Blood pressure
Patients receiving chlorpromazine are at risk for hypotension during and
immediately after IV administration. They should remain supine for 30 min while the
health care professional monitors their blood pressure. It is essential to infuse the
chlorpromazine solution slowly and not to mix it with other drugs.
A health care professional is caring for a patient who has been taking alprazolam
(Xanax) for an extended period of time to treat anxiety. The health care professional
should recognize that stopping alprazolam therapy suddenly can result in which of
the following?
Withdrawal symptoms
A health care professional is caring for a patient who is taking lithium carbonate
(Lithobid) to treat bipolar disorder. Which of the following diagnostic tests should
the health care professional recommend periodically for the patient?
Thyroid function tests
Rationale:
Hypothyroidism is an adverse effect of lithium carbonate. Patients should report
neck enlargement, weight gain, lethargy, and constipation. They should also have
their thyroid function checked before they begin taking lithium and annually
thereafter.
A health care professional is caring for a patient who is about to begin taking lithium
carbonate (Lithobid) to treat bipolar disorder. The health care professional should
caution the patient to watch for which of the following indications of lithium toxicity?
(Select all that apply.)
Tremors is correct. A fine hand tremor is an early indication of lithium toxicity. A
coarse tremor indicates advanced toxicity that can lead to seizure activity.
Confusion is correct. Confusion, slurred speech, and ataxia are indications of
lithium toxicity that develop because of the drug's narrow therapeutic range.
Nausea is correct. Nausea, vomiting, and diarrhea are early indications of lithium
toxicity that develop because of the drug's narrow therapeutic range. Patients
should report any signs of these adverse effects.
Muscle weakness is correct. Muscle weakness is an early indication of lithium
toxicity that develops because of the drug's narrow therapeutic range. The health
care professional should monitor lithium levels periodically.
A health care professional is caring for a young adult patient who is taking
fluoxetine (Prozac) to treat depression. The health care professional should tell the
patient and the patient's family to report which of the following?
Suicidal thoughts
Rationale:
Young adults taking fluoxetine, a selective serotonin reuptake inhibitor, have an
increased risk for suicide, especially in the early stages of treatment. Patients who
are severely depressed can have, with drug therapy, the energy for self-harm. With
awareness of this risk, family members and patients can watch for indications of
worsening depression.
When reviewing the adverse effects of drug therapy with a patient, a health care
professional should explain that orthostatic hypotension is a common adverse
reaction of which of the following drugs?
Imipramine (Tofranil)
Rationale:
Imipramine, a tricyclic antidepressant, can result in orthostatic (postural)
hypotension. Patients taking this drug should change positions slowly from sitting or
lying to standing.
A health care professional is collecting data from a patient who is taking bupropion
hydrochloride (Wellbutrin) to treat depression. The health care professional notes
that the patient has a recent history of a head injury. She should recognize that the
drug is inappropriate for the patient because of the increased risk for which of the
following?
Seizure activity
Bupropion, an atypical antidepressant, can cause seizure activity when patients
take high doses or have a seizure disorder, a CNS tumor, or a history of head
trauma.
A health care professional should monitor an older adult patient who is taking
alprazolam (Xanax) for which of the following adverse effects? (Select all that
apply.)
Tolerance is correct. Tolerance and dependence can develop with
benzodiazepines, such as alprazolam. Patients should use these drugs only as
needed and for short periods of time.
Anxiety is correct. Paradoxical reactions, such as anxiety and insomnia, can
develop, especially in older adults. Patients should report these findings.
Sedation is correct. CNS depression, manifested as sedation and drowsiness, is
an adverse effect of benzodiazepines, such as alprazolam. Patients should take a
benzodiazepine 30 min prior to bedtime.
Respiratory depression is correct. Benzodiazepines, such as alprazolam, can
cause CNS depression when patients, especially older adults, take them with other
CNS depressants. It is important to monitor for respiratory depression and
recommend the lowest effective dose. Patients should avoid alcohol and other CNS
depressants while taking a benzodiazepine.
A health care professional is talking to a patient who is taking lithium carbonate
(Lithobid). Which of the following instructions should be included to reduce the risk
of lithium toxicity?
Avoid taking NSAIDs.
NSAIDs increase renal reabsorption of lithium and sodium. Patients taking lithium
should not take NSAIDs.