Chapter 28-CNS stimulants

Question 1

The use of anorectic drugs is contraindicated in clients:

Answer 1

who take monoamine oxidase (MAO) inhibitors.

Question 2

A child is prescribed atomoxetine HCl. The nurse instructs the mother to monitor her child for:

Answer 2

increased attention span.

This agent is used to treat ADHD, and this observation would indicate its effectiveness.

Question 3

The nurse identifies “Nutrition altered, more than body requirements related to obesity” as the nursing diagnosis for a client taking an anorexiant. A successful outcome of this diagnosis would be that the client:

Answer 3

loses 2 to 4 pounds per month until desired weight is obtained.

Question 4

While teaching the mother of a child receiving atomoxetine HCl about the drug, the mother asks the nurse what norepinephrine is. The nurse’s best response would be:

Answer 4

“It is a chemical in the brain that helps focus attention and organize thoughts.” This explains norepinephrine in client-friendly terms.

Question 5

After client teaching about methylphenidate HCl, which statement by the client would indicate further teaching is necessary?

Answer 5

“This medication is safe to take with my MAO inhibitor.”

This drug can result in serious drug-drug interactions with MAO inhibitor therapy. So this response indicates the client needs more teaching.

Question 6

The child prescribed atomoxetine HCl asks if she can still play school soccer once she starts her medication. The most appropriate nursing response would be:

Answer 6

“This medication can cause dizziness, so you’ll need to let your coach know.”

Question 7

An adult prescribed atomoxetine HCl should be monitored for which of the following adverse effects of this medication?

Answer 7

insomnia

Question 8

The client asks the nurse which of the following has the least amount of caffeine. The nurse should respond:

Answer 8

chocolate milk. Chocolate milk contains less than 10 mg/serving.

Question 9

A child receiving atomoxetine should be monitored for which of the following adverse effects in children?

Answer 9

upset stomach

Nausea, vomiting, and dyspepsia are adverse effects in children.

Question 10

Some CNS stimulants are used in the treatment of narcolepsy. Narcolepsy is best described as a condition characterized by:

Answer 10

attacks of sleep occurring throughout the day.

Question 11

The nurse understands that most medications used to treat Alzheimer’s disease exert their effects to:

Answer 11

increase acetylcholine levels.

Question 12

The wife of a client recently diagnosed with Alzheimer’s disease asks the nurse if the medication he is prescribed will cure his disease. The nurse’s best response would be

Answer 12

“His medication will help him act more like himself longer, but it will not cure him.”

Question 13

After a client begins Alzheimer’s treatment with donepezil, the client’s wife states that her husband “has been so irritable since he started his medication.” The nurse’s response is based on knowledge that this reaction is:

Answer 13

one that occurs initially and then subsides.

Question 14

Which of the following statements does the nurse understand is accurate concerning the action of Alzheimer’s medications?

Answer 14

Memantine controls levels of glutamate.-acts differently from the other Alzheimer’s agents by controlling levels of glutamate.

Question 15

Clients receiving donepezil, rivastigmine, galantamine HBr, or tacrine HCl should be monitored for:

Answer 15

cholinergic crisis- This is the most critical effect of an overdose of these medications.

Question 16

A client being treated for Alzheimer’s disease is experiencing diaphoresis, tachycardia, severe vomiting, and hypotension. The nurse anticipates the client will need to be treated with:

Answer 16

IV atropine sulfate. These are manifestations of a cholinergic crisis, which is treated with IV atropine sulfate.

Question 17

The nurse is teaching the client with Alzheimer’s disease and his wife about rivastigmine. The wife asks the nurse when her husband’s dose can be increased. The nurse responds:

Answer 17

no more often than every 2 weeks

Question 18

Clients receiving Alzheimer’s medications should be instructed to take their medication:

Answer 18

with food.-These medications should be taken with food to decrease the risk of nausea.

Question 19

The definitive diagnosis of Alzheimer’s disease is made:

Answer 19

with the results from the autopsy.
When the brain can be completely examined during biopsy is when the definitive diagnosis of Alzheimer’s disease can be made.

Question 20

A 7-year-old child is prescribed atomoxetine HCl 12 mg by mouth daily. The pharmacy sends 0.006 gram capsules. The child should receive how many

Answer 20

2 capsules-0.006 grams = 6 mg; 12 mg divided by 6 mg = 2 capsules.

Question 21

The nurse recruit exhibits a need for further instructions concerning orlistat when she makes which of the following statements?

Answer 21

“It inhibits the absorption of dietary carbohydrates.”

Orlistat inhibits the absorption of dietary fats.

Question 22

The client is to receive the analeptic doxapram HCl. The nurse would expect an onset of action within:

Answer 22

20 to 40 seconds.

Question 23

The client has received a prescription for an anorectic. Which of the following statements exhibits a need for further client teaching?

Answer 23

“If I have difficulty swallowing the tablet, I can crush it and mix it with food.”

This statement exhibits need for further instruction. Sustained-release products should not be crushed or chewed.

Question 24

When discussing anorectic agents, the nurse recruit is correct when she states:

Answer 24

“The medication should be taken 1 hour before meals.”

Question 25

Which of the following is NOT true concerning Adipex-P?

Answer 25

“It is for long-term treatment, with diet, for weight loss.

Question 26

The nurse would instruct which of the following clients to avoid caffeine?

Answer 26

the client with a peptic ulcer

Question 27

The priority nursing diagnosis for the significant other of a client with Alzheimer’s disease is which of the following? Select all that apply.

Answer 27

b. Deficient knowledge R/T disease process and medication regimen
d. Risk for caregiver role strain R/T stress of caring for client
f. Deficit knowledge R/T medication regimen

Question 28

The nurse is asked about the characteristics of Alzheimer’s disease. Which of the following is the nurse’s best response? Select all that apply.

Answer 28

a. It usually occurs after the age of 65.
b. It is classified according to mild, moderate, or severe memory loss.
c. There is no cure at this time.
e. It is a progressive, degenerative disease of the brain tissue.
f. It is the leading cause of dementia in older adults.

Question 29

The nurse recruit is to give instructions to a client who is to receive stratterra. Which of the following statements contain the correct information for this client? Select all that apply.

Answer 29

b. “It may be discontinued without being tapered.”
d. “It can be administered without regard to food.”
e. “Dyspepsia may be an adverse effect.”

Question 30

Which of the following statements could be included in client teaching for the client who has received a prescription for Exelon?
a. “The oral preparation is administered once daily.”

Answer 30

b. “We will need to monitor your weight.”
c. “The patch should be applied once daily after removal of the previous patch.”
d. “UTI may be an adverse effect.”
e. “Accidental injury may occur, so safety measures should be implemented.”
f. “Do not continue to take your NSAIDs, due to the increased risk of GI bleeding.”