Test 5 CH 10 Flashcards
Which neurotransmitter has an inhibitory action within the CNS?
a. Epinephrine
b. Acetylcholine
c. Norepinephrine
d. Gamma-aminobutyric acid
ANS: D
A 73-year-old male patient newly diagnosed with Parkinson’s disease (PD) is prescribed a dopamine agonist. The patient’s wife asks you to explain how this class of drugs will work to help her husband. What is your best response?
a. “Dopamine agonists reduce levels of acetylcholine to restore gait and balance.”
b. “Dopamine agonists use an enzyme to break down dopamine to improve PD symptoms.”
c. “Dopamine agonists prevent the buildup of beta amyloid plaques to improve coordination.”
d. “Dopamine agonists reduce muscle rigidity and tremors by increasing dopamine levels.”
ANS: D
A patient placed on the drug tolcapone (Tasmar) for the relief of symptoms of Parkinson’s disease asks you how this drug works for the disease. What is your best response?
a. “Tolcapone acts as a dopamine agonist, replacing the activity of dopamine.”
b. “Tolcapone forces the substantia nigra to increase production of natural dopamine.”
c. “Tolcapone suppresses the enzyme that breaks down naturally occurring dopamine.”
d. “Tolcapone increases the number of dopamine receptors sites.”
ANS: C
Why are carbidopa and levodopa usually given together?
a. Carbidopa is a dopamine agonist and levodopa is a dopamine antagonist.
b. Levodopa is a dopamine agonist and carbidopa is a dopamine antagonist.
c. Carbidopa enhances the action of levodopa, and less drug is needed.
d. Levodopa reverses or prevents the side effects of carbidopa.
ANS: C
When assessing a patient with Parkinson’s disease who takes a carbidopa/levodopa combination drug, you find that he now has almost constant muscle movements that look like uncoordinated dancing. What is your best action?
a. Document the finding as the only action.
b. Hold the next drug dose and report the finding to the healthcare provider.
c. Give the next dose earlier than scheduled because the drugs are wearing off.
d. Request that the healthcare provider prescribe a one-time dose of a muscle relaxant.
ANS: B
A patient newly diagnosed with Parkinson’s disease is prescribed an oral dopamine agonist. Which precaution is most important to teach the patient and family about the timing for taking this drug?
a. “Take the drug 30 to 60 minutes before meals on an empty stomach.”
b. “Take the drug 30 to 60 minutes after eating a high protein meal.”
c. “Take the drug first thing in the morning before getting out of bed.”
d. “Take the drug when your symptoms are at their worst.”
ANS: A
You are assessing the drug list of a patient who has been started on a dopamine agonist. You discover the patient is also taking an oral antihypertensive drug. Which of the following statements should you make to this patient?
a. “Taking an antihypertensive and a dopamine antagonist will increase your blood pressure.”
b. “Taking an antihypertensive and a dopamine antagonist will decrease your blood pressure.”
c. “Taking an antihypertensive and a dopamine antagonist will have no adverse effects.”
d. “Taking an antihypertensive and a dopamine antagonist will reduce your dopamine levels.”
ANS: B
A patient with diagnosed Parkinson’s disease is prescribed a monoamine oxidase type B inhibitor reports not adhering to a tyramine-restricted diet. What signs/symptoms would you expect this patient to present with?
a. Hypertension
b. Severe bradycardia
c. Bone marrow failure
d. Edema of the lower extremities
ANS: A
When asking the family of a patient with Alzheimer’s disease who takes the drug donepezil (Aricept) what other prescribed or over-the-counter drugs the patient takes, they list all the following drugs. Which one will you tell them to stop giving the patient?
a. Aspirin
b. Buspirone
c. Vitamin C
d. Dextromethorphan
ANS: D
When admitting a new patient with Alzheimer’s to a memory unit of a long-term care facility, you note that she is prescribed both memantine and rivastigmine. What is your best action?
a. Give both drugs as prescribed.
b. Ask the patient when she usually takes these drugs.
c. Notify the prescriber that both drugs are for Alzheimer’s disease.
d. Give the memantine one odd-numbered days and rivastigmine on even-numbered days.
ANS: A
A family member of a patient using the rivastigmine patches reports that the patient keeps taking the patches off his chest. Where will you suggest the family member apply the patches to avoid this problem?
a. On the forehead
b. On the buttocks
c. On the upper or lower back
d. On the outer aspect of the thigh
ANS: C
A patient is prescribed to receive memantine extended release (XR) 14 mg orally once daily. You have on hand memantine XR 7-mg capsule and memantine 28-mg capsule. What is the best way to ensure the patient gets a 14-mg dose?
a. Give the patient two 7-mg capsules every day.
b. Give the patient one 28-mg capsule every other day.
c. Cut the 28-mg capsule in half and give the patient one of the halves.
d. Open a 28-mg capsule, empty it into a drug cup, divide the contents in half, and give one half to the patient.
ANS: A
When assessing a patient before starting the first dose of a newly prescribed antiepileptic drug, what is the most important nursing action to perform?
a. Determine the type of aura a patient usually has before a seizure.
b. Obtain an accurate weight because most drug dosages are based on weight.
c. Ask the patient about all other prescribed or over-the-counter drugs he or she takes daily.
d. Ensure that oxygen and suction equipment are in the patient’s room and in good working order.
ANS: C
You are about to give a patient hospitalized for seizures a dose of intravenous (IV) phenytoin. The patient asks why this drug is given by IV instead of by intramuscular (IM) injection. What is your best response?
a. “The rapid IM absorption can cause tachycardia.”
b. “Giving phenytoin IM is very irritating to tissue”.
c. “Seizure activity is worsened by giving phenytoin by IM injection.”
d. “When phenytoin is given by IM route, drug elimination is impaired.”
ANS: B
A patient you are caring for is scheduled for elective surgery. When reviewing the preoperative laboratory results of a patient taking oxcarbazepine for seizure control, you note all of the following values below. For which one will you notify the surgeon immediately?
a. White blood cell count 8700/mm3
b. Serum sodium level of 128 mEq/L
c. International normalized ratio (INR) 0.9 d. Serum chloride level of 100 mEq/L
ANS: B
