Neuro CH11,13,14,15,16,17,19,20,21 Pharm for Nurses Book and ATI CH7-16
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NURS 215
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NURS 215
Neuro CH11,13,14,15,16,17,19,20,21 Pharm for Nurses Book and ATI CH7-16
1.Following a surgical procedure, the client states that he does not want to take narcotic analgesicsfor pain because he is afraid he will become addicted to the drug. What is the best response bythe nurse to the client's conce...
Neuro CH 11,13,14,15,16,17,19,20,21 Pharm for Nurses Book and ATI CH 7-16
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pathophysiological-approach-4th-edition-michael-adams-1.pdf
CH 11 Pharm for Nurses Book
1. Following a surgical procedure, the client states that he does not want to take narcotic
analgesics for pain because he is afraid he will become addicted to the drug. What is the best
response by the nurse to the client’s concerns?
a. 1. Dependence on narcotics is common among postoperative clients but can be
managed successfully.
b. 2. Addiction to prescription drugs is rare when used as prescribed and according
to medical protocol such as for pain control.
c. 3. Female patients are more likely to become addicted.
d. 4. Addiction is rare if the patient has a high pain threshold.
Rationale: Prescription drugs rarely cause addiction when used according to accepted
medical protocols. Options 1, 3, and 4 are incorrect. Postoperative clients or females
are not more likely to become addicted than other clients. A client’s pain threshold
does not determine the potential for addiction. The risk of addiction for prescription
medications is primarily a function of the dose and the length of therapy..
2. The client states that she has been increasing the amount and frequency of the antianxiety
drug she is using because “it just isn’t working like it did before.” What effect does this
indicate?
a. 1. Immunity
b. 2. Resistance
c. 3. Tolerance
d. 4. Addiction
Rationale: Tolerance is a biologic condition that occurs when the body adapts to a
substance after repeated administration. Over time, higher doses of the drug are required
to produce the same initial effect. Options 1, 2, and 4 are incorrect. Immunity is related to
the response of the body’s immune system and not to drug response. Resistance is a
concept most often applied to antibiotic drugs, and the term addiction is used to describe
an overwhelming compulsion that drives someone to take drugs repetitively, despite
serious health and social consequences.
3. A 17-year-old confides to the nurse that he smokes marijuana but that “it isn’t as bad as
tobacco cigarettes; it’s not addicting like nicotine!” Which statement would be an appropriate
response by the nurse?
a. 1. While marijuana may not be addicting in the same way that nicotine is, it damages
lung tissue and may cause breathing problems and cancer.
b. 2. Marijuana is not approved for any use except under highly regulated conditions.
c. 3. Marijuana is four times as addicting as nicotine.
d. 4. The effects of marijuana are much more prolonged than nicotine because it stays
in the body longer.
, Rationale: Marijuana does not appear to cause physical dependence or tolerance but
because it is inhaled deeper and held in the lungs for a longer length of time, it may
damage lung tissue and promote cancer. Options 2, 3, and 4 are incorrect. Marijuana is a
controlled substance; however, because this teen is using the drug, stating this fact may
have little influence on his use. Marijuana has not been shown to be more addicting than
nicotine. And while metabolites of marijuana remain in the body for prolonged periods,
the effects may not remain. This statement may be considered a desirable reason to
continue using the drug.
4. The client with a history of alcohol abuse is admitted to the hospital. The nursing care
plan includes assessment for symptoms of alcohol withdrawal. What symptoms will the
nurse observe for? (Select all that apply.)
a. 1. Confusion
b. 2. Violent yawning
c. 3. Tremors
d. 4. Constricted pupils
e. Hallucinations
Rationale: Clients who are experiencing alcohol withdrawal typically experience
tremors, fatigue, anxiety, abdominal cramping, hallucinations, confusion, seizures,
and delirium. Options 2 and 4 are incorrect. Violent yawning is a symptom of heroin
withdrawal and constricted pupils is a sign of opioid toxicity
5. The client states that she is going to quit smoking “cold turkey.” The nurse teaches the client to
expect which of the following symptoms during withdrawal from nicotine? (Select all that
apply.)
a. 1. Headaches and insomnia
b. 2. Increased appetite
c. 3. Tremors
d. 4. Insomnia
e. 5. Increased heart rate and blood pressure
Rationale: Symptoms of nicotine withdrawal include irritability, anxiety, restlessness,
headaches, increased appetite, insomnia, inability to concentrate, and a decrease in
heart rate and blood pressure. Options 3 and 5 are incorrect. Nicotine withdrawal is
not known to cause tremors or an increase in heart rate or blood pressure. If these
occur, the nurse should evaluate for another possible causative factor.
6. What is the difference between physical and psychological dependence?
a. 1. Physical dependence is the adaptation of the body to a substance over time such
that when the substance is withdrawn, withdrawal symptoms will result. Psychological
dependence is the overwhelming desire to continue using a substance after it is
stopped or withdrawn but without physical withdrawal symptoms occurring.
b. 2. Physical and psychological dependence are terms that are used interchangeably. In
both cases, physical withdrawal symptoms will result if the substance is withdrawn
from use.
, c. 3. They occur together: psychological dependence is the first type of dependence
to occur with a substance, followed by physical dependence.
d. 4. Psychological dependence develops when the brain adapts over time to the use of
the substance. Physical dependence is the active seeking of a substance associated
with a desire to continue using the substance.
Rationale: Physical dependence and psychological dependence may occur together and
result in drug-seeking behavior. But physical dependence occurs as the body adapts to
the substance such that withdrawal symptoms will occur if the substance is stopped.
Physical withdrawal symptoms do not occur with psychological dependence although
an intense craving for the substance may be felt. Options 2, 3, and 4 are incorrect.
Physical and psychological dependence are not interchangeable terms and one
does not always lead to the other. Psychological dependence is a term associated
with the desire to continue using the drug, not the term physical dependence.
CH 13 Pharm for Nurses Book
1. Following administration of phenylephrine (NeoSynephrine), the nurse would assess for which
of the following adverse drug effects?
a. 1. Insomnia, nervousness, and hypertension
b. 2. Nausea, vomiting, and hypotension
c. 3. Dry mouth, drowsiness, and dyspnea
d. 4. Increased bronchial secretions, hypotension, and bradycardia
Rationale: Adrenergic agonists such as phenylephrine (NeoSynephrine) stimulate the
sympathetic nervous system and produce symptoms including insomnia, nervousness,
and hypertension. Options 2, 3, and 4 are incorrect. Nausea, vomiting, and drowsiness
are common adverse effects to many drugs and are not adverse effects known to occur
with adrenergic agonists. Hypotension and bradycardia are potential adverse reactions
related to the use of adrenergic antagonists. Dry mouth may occur from
anticholinergics and increased bronchial secretions are an effect of cholinergic agents.
Dyspnea is not an adverse reaction related to adrenergic agonists and adrenergics may
be ordered for bronchodilation properties.
2. 2. Anticholinergics may be ordered for which of the following conditions? (Select all that apply.)
a. 1. Peptic ulcer disease
b. 2. Bradycardia
c. 3. Decreased sexual function
d. 4. Irritable bowel syndrome
e. 5. Urine retention
Rationale: Anticholinergics are used in the treatment of peptic ulcer disease,
irritable bowel syndrome, and bradycardia because they suppress the effects of
acetylcholine and stimulate the sympathetic nervous system. Options 3 and 5 are
incorrect.
Anticholinergics may cause decreased sexual function because the parasympathetic
impulses are blocked. Urine retention is a potential adverse effect of
anticholinergics.
, 3. 3. Propranolol (Inderal) has been ordered for a client with hypertension. Because of
adverse effects related to this drug, the nurse would carefully monitor for which adverse
effect?
a. 1. Bronchodilation
b. 2. Tachycardia
c. 3. Edema
d. 4. Bradycardia
Rationale: Because beta-adrenergic blockers such as propranolol (Inderal) slow
electrical conduction through the cardiac conduction system, they may cause
bradycardia. Options 1, 2, and 3 are incorrect. Bronchodilation, tachycardia, and edema
are not adverse effects associated with betaadrenergic blockers.
4. 4. Older adult clients taking bethanechol (Urecholine) need to be assessed more
frequently because of which of the following adverse effects?
a. 1. Tachycardia
b. 2. Hypertension
c. 3. Dizziness
d. 4. Urinary retention
Rationale: The nurse should monitor older adult clients for episodes of dizziness
caused by CNS stimulation from the parasympathomimetic system. Options 1, 2, and 4
are incorrect. Bethanechol does not cause tachycardia or hypertension and is used to
treat nonobstructive urinary retention.
5. 5. The client taking benztropine (Cogentin) should be provided education on methods to
manage which common adverse effect?
a. 1. Heartburn
b. 2. Constipation
c. 3. Hypothermia
d. 4. Increased gastric motility
Rationale: Anticholinergic medications such as benztropine (Cogentin) slow intestinal
motility; therefore, constipation is a potential side effect. Clients should be taught
methods to manage constipation such as increasing fluids and fiber in the diet. Options
1, 3, and 4 are incorrect. Heartburn and hypothermia are not associated with the use
of benztropine.
6. 6. The client or family of a client taking tacrine (Cognex) should be taught to be observant
for which of the following adverse effects that may signal that a possible overdose has
occurred?
a. 1. Excessive sweating, salivation, and drooling
b. 2. Extreme constipation
c. 3. Hypertension and tachycardia
d. 4. Excessively dry eyes and reddened sclera
Rationale: Overdosage of parasympathomimetics (cholinesterase-inhibitors) such as
tacrine (Cognex) may produce excessive sweating, drooling, dyspnea, or excessive
fatigue. These symptoms should be promptly reported. Options 2, 3, and 4 are
incorrect.
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