Exam Review
- A nurse is administering morphine sulfate to a postoperative patient. Which are appropriate nursing actions when giving this drug? (Select all that apply)(SATA)A)Encouraging physical activity and offering increased fluidsB)Monitoring the patient's blood pressure closely for hypertensionC)Requesting an order for methylnaltrexone (Relistor) to prevent constipationD)Palpating the patient's lower abdomen every 4 to 6 hoursE)Counting respirations before and after giving the medication
- Janie is 20 years old with severe, prolonged 2 to 3 day migraines twice per month. She also has mild chronic tension headache (CDH). She has difficulty sleeping and is mildly anxious. She occasionally utilizes an inhaler for asthma. With only two migraines per month and mild CDH, a case could be made against prevention medication. However, with the severity and length of julie's migraines (4 to 6 total days of severe migraine per month), prophylactic medications are indicated. What medication would you expect the provider to prescribe?A)ButorphanolB)IbuprofenC)Amitriptyline (Elavil)D)Ergotamine
- The most common type of headache is:A)Cluster headacheB)Migraine with auraC)Migraine without auraD)Tension-type headache
- Endogenous opioid peptides are found in the central nervous system (CNS) and in peripheral tissue. Which of the following is an endogenous opioid peptide that is a neurotransmitter that is released by the brain to alleviate pain and promote pleasure?A)EndorphinsB)DynorphinsC)EnkephalinsD)Nalbuphines
Exam Review
- All of the following generic medications are Selective Serotonin reuptake Inhibitors (SSRIs) except: (Select all that apply, may be one, some or all).A)CitalopramB)ParoxetineC)LorazepamD)Sertraline
- Which tricyclic antidepressant, used to treat depression, but is also used to treat pain (nerve pain and back pain) at lower doses, should be taken before bed, can cause extra side effects if you stop taking suddenly.A)SelegilineB)BupropionC)CitalopramD)Amitriptyline
- Schedule I drugs are considered to have:A)No medical benefit and a high potential for abuseB)High medical benefit but also a high potential for abuseC)Limited medical benefit and high potential for abuseD)Limited medical benefit with average potential for abuse
- The nurse would question the administration of morphine in the patient with a history of which condition?A)DiabetesB)AnorexiaC)AsthmaD)Cancer
Exam Review
- A young adult patient has been taking an antidepressant medication for several weeks and reports having increased thoughts of suicide. The nurse questions further and learns that the patient has attempted suicide more than once in the past. The patient identifies a concrete plan for committing suicide. The nurse will contact the provider to discuss:A)Changing the medication to another drug classB)Discontinuing the medication immediatelyC)Requiring more frequent clinic visits for this patientD)Hospitalizing the patient for closer monitoring
- Which of the following medications is a second generation antipsychotic and is also used to treat bipolar disorder and Tourettes syndrome?A)Quetiapine (Seroquel)B)Risperidone (Resperdal)C)Olanzapine (Zyprexa)D)Aripiprazole (Ability)
- All antidepressant drug carry the increased risk of suicide. With what group(s) carry this induced risk?A)The elderly, children and adolescentsB)Children, adolescents and adults younger than 25 years of ageC)The elderly and children and adults younger than 25 years of ageD)The elderly, adolescents and adults younger than 25 years of age
- Which side effects of opioid analgesics can have therapeutic benefits? (Select all that apply)A)Urinary retentionB)Suppression of bowel motilityC)Billary colicD)VasodilationE)Cough suppression
Exam Review
- A patient with bipolar disorder who wants to minimize the need for drug therapy asks the nurse what else can be done to treat the disorder. The nurse will recommend which measure? (Select all that apply)A)Using a chart to monitor mood changesB)Moderate use of alcohol to reduce stressC)Regular sleep and exerciseD)Electroconvulsive therapy (ECT)E)Psychotherapy
- Lithium is considered a second-line prophylactic treatment for which type of headache?A)Stress headacheB)TensionC)Migraine headacheD)Cluster headache
- Which drugs are used to prevent migraine headaches? (Select all that apply).A)Divalproex (Depakote)B)ErgotamineC)TimololD)AcebutololE)Amitriptyline (Elavil)
- Your patient has been taking fluoxetine (Prozac) for 2 years and reports feeling cured of depression. You learn that the patient is sleeping well, participates in his usual activities, and feels upbeat and energetic most of the time. His weight has returned to normal. He reports last having symptoms of depression at least 9 months ago. What will you tell this patient?A)Stop the drug while remaining alert for the return of symptomsB)Take a drug holiday to see whether symptoms recurC)Discuss gradual withdrawal of the medication with the providerD)Indefinite drug therapy is necessary to maintain remission
Exam Review
- Bipolar disorder is what type of disorder?A)SchizophrenicB)DepressiveC)MoodD)Manic
- Margo who started a low-potency antipsychotic for 2 weeks has shown minimal response. The most probable explanation is:A)It is too early to see a full therapeutic responseB)The client probably has refractory illnessC)The client is definitely not taking the medicationD)The client needs a stronger medication
- A patient is admitted to a hospital for treatment for first-time symptoms of mania and is exhibiting euphoric mania. Which medication will the provider order?A)Lithium (Lithobid)B)Risperidone (Risperdal)C)Divalproex sodium (Valproate)D)Olanzapine (Zyprexa)
- You are working the night shift in the Emergency Department. A patient arrives accompanied by a friend. The patient has had a drastic change in mental status, has become very agitated and seems to be having some hallucinations and is very disorientated. She is sweating profusely and has a slight tremor along with some scary muscle spasms. Upon further questioning you discover she has just started on fluoxetine (Prozac). She denies any alcohol intake or any other medications, recreationally or prescribed. She has had nothing different in her diet and has not traveled anywhere except to work, shopping and home. Her friend says she was with her when she took her first dose which was about 24 hours ago. What are your thoughts about what is happening and what is the appropriate action to be taken?A)Patient is most likely experiencing Serotonin Syndrome. Add an MAOI and monitor patientB)Patient most likely experiencing Serotonin Syndrome. Decrease the dose of the ProzacC)Patient is experiencing an allergic reaction. Treat with epinephrine and diphenhydramine.D)Patient is experiencing Serotonin Syndrome. Stop the medication immediately
Exam Review
- A patient with bipolar disorder has frequent manic episodes alternating with depressive episodes. The prescriber orders risperidone (Risperdal) In addition to the lithium (Lithobid) that the patient is already taking. The patient asks the nurse why another drug is needed. The nurse will tell the patient that the risperidone is used to:A)Elevate mood during depressive episodesB)Prevent recurrence of depressive episodesC)Manage tremors associated with lithium useD)Help control symptoms during manic episodes
- Differentiate between a migraine headache and cluster headaches. Manifestations and/or risk factors for a patient with cluster headaches include what? (Select all that apply)A)Female genderB)Male genderC)Throbbing, sometimes piercing painD)Auras before the onset of headache painE)complaints of nausea and vomitingF)Short duration (15 minutes to 2 hours)
- Which of the following medications is indicated for long-term maintenance therapy of bipolar disorder (BPD)?A)Divalproex sodium (Valproate)B)Olanzapine (Zyprexa)C)Lamotrigine (Lamictal)D)Carbamazepine (Tegretol Equetro)
- A provider has indicated that a serotonin/norepinephrine reuptake inhibitor (SNRI) will be prescribed for a patient who is experiencing major depression. When conducting a pretreatment health history, the nurse learns that the patient has a recent history of alcohol abuse. Which SNRI would be contraindicated for this patient?A)Venlafaxine (Effexor SR)B)Desvenlafaxine (Pristiq)C)Escitalopram (Lexapro)D)Duloxetine (Cymbalta)