CNS Stimulants Flashcards
A patient is receiving instructions regarding the use of caffeine. The nurse shares that caffeine should be used with caution if which of these conditions is present?
a. A history of peptic ulcers
b. Migraine headaches
c. Asthma
d. A history of kidney stones
ANS: A
Caffeine should be used with caution by patients who have histories of peptic ulcers or cardiac dysrhythmias or who have recently had myocardial infarctions. The other conditions are not contraindications to the use of caffeine
A patient who started taking orlistat 1 month ago calls the clinic to report some
―embarrassing‖ adverse effects. She tells the nurse that she has had episodes of ―not being able to control my bowel movements.‖ Which statement is true about this situation?
a. These are expected adverse effects that will eventually diminish.
b. The patient will need to stop this drug immediately if these adverse effects are occurring.
c. The patient will need to increase her fat intake to prevent these adverse effects.
d. The patient will need to restrict fat intake to less than 30% of total calories to help reduce these adverse effects.
ANS: D
Restricting dietary intake of fat to less than 30% of total calories can help reduce some of the GI adverse effects, which include oily spotting, flatulence, and fecal incontinence. The other options are incorrect.
A 6-year-old boy has been started on an extended-release form of methylphenidate hydrochloride for the treatment of attention deficit hyperactivity disorder (ADHD). During a follow-up visit, his mother tells the nurse that she has been giving the medication at bedtime so that it will be ―in his system‖ when he goes to school the next morning. What is the nurse‘s appropriate evaluation of the mother‘s actions?
a. She is giving him the medication dosage appropriately.
b. The medication should not be taken until he is at school.
c. The medication should be taken with meals for optimal absorption.
d. The medication should be given 4 to 6 hours before bedtime to diminish insomnia.
ANS: D
Central nervous system stimulants should be taken 4 to 6 hours before bedtime to decreaseinsomnia. Generally speaking, once-a-day dosing is used with extended-release or long-acting preparations. These formulations eliminate the need to take this medication at school.
A 22-year-old nursing student has been taking caffeine tablets for the past few weeks to
―make it through‖ the end of the semester and exam week. She is in the university clinic today because she is ―exhausted.‖ What human needs statement may be appropriate for her?
a. Altered oxygenation need
b. Altered physical activity
c. Altered need for sleep
d. Altered food intake
ANS: C
Caffeine, is a central nervous system stimulant that can be used to increase mental alertness. It is available in OTC forms such as NoDoz. Restlessness, anxiety, and insomnia are common adverse effects. Thus, altered need for sleep is the most appropriate human needs statement of those listed.
A 10-year-old patient will be started on methylphenidate hydrochloride therapy. The nurse will perform which essential baseline assessment before this drug is started?
a. Eye examination
b. Height and weight
c. Liver function studies
d. Hearing test
ANS: B
Assessment of baseline height and weight is important before beginning methylphenidate therapy because it may cause a temporary slowing of growth in prepubertal children. The other studies are not as essential at this time.
When evaluating a patient who is taking orlistat, which is an intended therapeutic effect?
a. Increased wakefulness
b. Increased appetite
c. Decreased weight
d. Decreased hyperactivity
ANS: C
Orlistat is a nonstimulant drug that is used as part of a weight loss program. The other options are incorrect.
The nurse is teaching a patient how to self-administer triptan injections for migraineheadaches. Which statement by the patient indicates that he needs further teaching?
a. ―I will take this medication regularly to prevent a migraine headache from occurring.‖
b. ―I will take this medication when I feel a migraine headache starting.‖
c. ―This medication will not reduce the number of migraines I will have.‖
d. ―I will keep a journal to record the headaches I have and how the injections are working.‖
ANS: A
Although they may be taken during aura symptoms by patients who have auras with their headaches, these drugs are not indicated for preventive migraine therapy. The medication is intended to relieve the migraine and not to prevent it or to reduce the number of attacks. The triptans do not reduce the number of migraines a person will have. Journal recordings of headaches and the patient‘s responses to the medication are helpful.
The nurse is reviewing the use of central nervous system stimulants. Which of these are indications for this class of drugs? (Select all that apply.)
a. Narcolepsy
b. Depression
c. Panic attacks
d. Neonatal apnea
e. Attention deficit hyperactivity disorder (ADHD)
f. Appetite suppression
g. Migraine headaches
ANS: A, D, E, F, G
Central nervous system stimulants can be used for narcolepsy, neonatal apnea, ADHD, migraine headaches, and appetite suppression in the treatment of obesity. They are not used for depression and panic attacks.
A patient has a new prescription for phentermine as part of the treatment for weight loss. Which information will the nurse include when teaching this patient about a stimulant such as phentermine? (Select all that apply.)
a. Take this medication after meals.
b. Take this medication in the morning.
c. This drug is taken along with supervised exercise and suitable diet.
d. Use mouth rinses, sugarless gum, or hard candies to minimize dry mouth.
e. Avoid foods that contain caffeine, such as coffee, tea, and colas.
ANS: B, C, D, E
This drug should be taken in the morning to avoid interference with sleep, and the patient should also be on a supervised exercise and dietary regime. Caffeine-containing productsshould be avoided because of possible additional stimulation. Dry mouth can be minimized by the use of mouth rinses, sugarless gum, or hard candy. The other option is incorrect.
A patient has just received an injection of onabotulinumtoxin A. The nurse will monitor for which adverse effects? (Select all that apply.)
a. Insomnia
b. Dysphagia
c. Weight gain
d. GI upset
e. Difficulty breathing
ANS: B, E
Onabotulinumtoxin A (Botox) is given by injection (by a healthcare provider) 12 weeks. Botox has a Black Box Warning regarding spread of the toxin beyond the site of injection which can result in dysphagia and breathing difficulties. The other answers are not correct
