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NSG 6005 WEEK 9 QUIZ SOUTH UNIVERSITY 2023-2024 GRADED A+ 100% CORRECT, Exams of Nursing

NSG 6005 WEEK 9 QUIZ SOUTH UNIVERSITY 2023-2024 GRADED A+ 100% CORRECT

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NSG6005 Advanced Pharmacology @ SOUTH UNIVERSITY
NSG 6005 WEEK 9 QUIZ SOUTH UNIVERSITY 2023-2024
GRADED A+ 100% CORRECT
Chapter 15. Drugs Affecting the Central Nervous System
1. Sarah, a 42-year-old female, requests a prescription for an anorexiant to treat her obesity. A trial of
phentermine is prescribed. Prescribing precautions include:
1. Understanding that obesity is a contraindication to prescribing phentermine
2. Anorexiants may cause tolerance and should only be prescribed for 6 months
3. Patients should be monitored for postural hypotension
4. Renal function should be monitored closely while on anorexiants
2. Before prescribing phentermine to Sarah, a thorough drug history should be taken including
assessing for the use of serotonergic agents such as selective serotonin reuptake inhibitors (SSRIs)
and St John’s wort due to:
1. Additive respiratory depression risk
2. Additive effects affecting liver function
3. The risk of serotonin syndrome
4. The risk of altered cognitive functioning
3. Antonia is a 3-year-old child who has a history of status epilepticus. Along with her routine
antiseizure medication, she should also have a home prescription for to be used for an
episode of status epilepticus.
1. IV phenobarbital
2. Rectal diazepam (Diastat)
3. IV phenytoin (Dilantin)
4. Oral carbamazepine (Tegretol)
4. Rabi is being prescribed phenytoin for seizures. Monitoring includes assessing:
1. For phenytoin hypersensitivity syndrome 3 to 8 weeks after starting treatment
2. For pedal edema throughout therapy
3. Heart rate at each visit and consider altering therapy if heart rate is less than 60
bpm
4. For vision changes, such as red-green blindness, at least annually
5. Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note
that while his carbamazepine levels had been in the therapeutic range, they are now low. The
possible cause for the low carbamazepine levels include:
1. Dwayne hasn’t been taking his carbamazepine because it causes insomnia.
2. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good
compliance.
3. Dwayne was not originally prescribed the correct amount of carbamazepine.
4. Carbamazepine is probably not the right antiseizure medication for Dwayne.
6. Carbamazepine has a Black Box Warning due to life-threatening:
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NSG 6005 WEEK 9 QUIZ SOUTH UNIVERSITY 2023- 2024

GRADED A+ 100% CORRECT

Chapter 15. Drugs Affecting the Central Nervous System

  1. Sarah, a 42-year-old female, requests a prescription for an anorexiant to treat her obesity. A trial of phentermine is prescribed. Prescribing precautions include:
  2. (^) Understanding that obesity is a contraindication to prescribing phentermine
  3. (^) Anorexiants may cause tolerance and should only be prescribed for 6 months
  4. (^) Patients should be monitored for postural hypotension
  5. (^) Renal function should be monitored closely while on anorexiants
  6. Before prescribing phentermine to Sarah, a thorough drug history should be taken including assessing for the use of serotonergic agents such as selective serotonin reuptake inhibitors (SSRIs) and St John’s wort due to:
  7. (^) Additive respiratory depression risk
  8. (^) Additive effects affecting liver function
  9. (^) The risk of serotonin syndrome
  10. (^) The risk of altered cognitive functioning
  11. Antonia is a 3-year-old child who has a history of status epilepticus. Along with her routine antiseizure medication, she should also have a home prescription for to be used for an episode of status epilepticus.
  12. (^) IV phenobarbital
  13. (^) Rectal diazepam (Diastat)
  14. (^) IV phenytoin (Dilantin)
  15. (^) Oral carbamazepine (Tegretol)
  16. Rabi is being prescribed phenytoin for seizures. Monitoring includes assessing:
    1. (^) For phenytoin hypersensitivity syndrome 3 to 8 weeks after starting treatment
    2. (^) For pedal edema throughout therapy
    3. (^) Heart rate at each visit and consider altering therapy if heart rate is less than 60 bpm
    4. (^) For vision changes, such as red-green blindness, at least annually
  17. Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels include:
    1. (^) Dwayne hasn’t been taking his carbamazepine because it causes insomnia.
    2. (^) Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance.
    3. (^) Dwayne was not originally prescribed the correct amount of carbamazepine.
    4. (^) Carbamazepine is probably not the right antiseizure medication for Dwayne.
  18. Carbamazepine has a Black Box Warning due to life-threatening:
  1. (^) Renal toxicity, leading to renal failure
  2. (^) Hepatotoxicity, leading to liver failure
  3. (^) Dermatologic reaction, including Steven’s Johnson and toxic epidermal necrolysis
  1. (^) To wear sunscreen due to photosensitivity from levetiracetam
  2. (^) To get an annual eye exam while on levetiracetam
  3. (^) To report weight loss if it occurs
  4. Levetiracetam has known drug interactions with:
  5. (^) Combined oral contraceptives
  6. (^) Carbamazepine
  7. (^) Warfarin
  8. (^) Few, if any, drugs
  9. Zainab is taking lamotrigine (Lamictal) and presents to the clinic with fever and lymphadenopathy. Initial evaluation and treatment includes:
  10. (^) Reassuring her she has a viral infection and to call if she isn’t better in 4 or 5 days
  11. (^) Ruling out a hypersensitivity reaction that may lead to multi-organ failure
  12. (^) Rapid strep test and symptomatic care if strep test is negative
  13. (^) Observation only, with further assessment if she worsens
  14. Samantha is taking lamotrigine (Lamictal) for her seizures and requests a prescription for combined oral contraceptives (COCs), which interact with lamotrigine and may cause:
  15. (^) Contraceptive failure
  16. (^) Excessive weight gain
  17. Reduced lamotrigine levels, requiring doubling the dose of lamotrigine
  18. (^) Induction of estrogen metabolism, requiring higher estrogen content OCs be prescribed
  19. The tricyclic antidepressants should be prescribed cautiously in patients with:
  20. (^) Eczema
  21. (^) Asthma
  22. (^) Diabetes
  23. (^) Heart disease
  24. A 66-year-old male was prescribed phenelzine (Nardil) while in an acute psychiatric unit for recalcitrant depression. The NP managing his primary health care needs to understand the following regarding phenelzine and other monoamine oxidase inhibitors (MAOIs):
  25. (^) He should not be prescribed any serotonergic drug such as sumatriptan (Imitrex)
  26. (^) MAOIs interact with many common foods, including yogurt, sour cream, and soy sauce
  27. (^) Symptoms of hypertensive crisis (headache, tachycardia, sweating) require immediate treatment
  28. (^) All of the above
  29. Taylor is a 10 - year-old child diagnosed with major depression. The appropriate first-line antidepressant for children is:
  30. (^) Fluoxetine
  31. (^) Fluvoxamine
  32. Sertraline
  1. (^) Escitalopram
  2. Suzanne is started on paroxetine (Paxil), a selective serotonin reuptake inhibitor (SSRI), for depression. Education regarding her antidepressant includes:
  3. (^) SSRIs may take 2 to 6 weeks before she will have maximum drug effects.
  4. (^) Red-green color blindness may occur and should be reported.
  5. (^) If she experiences dry mouth or heart rates greater than 80, she should stop taking the drug immediately.
  6. (^) She should eat lots of food high in fiber to prevent constipation.
  7. Cecilia presents with depression associated with complaints of fatigue, sleeping all the time, and lack of motivation. An appropriate initial antidepressant for her would be:
  8. (^) Fluoxetine (Prozac)
  9. (^) Paroxetine (Paxil)
  10. (^) Amitriptyline (Elavil)
  11. (^) Duloxetine (Cymbalta)
  12. Jake, a 45-year-old patient with schizophrenia, was recently hospitalized for acute psychosis due to medication noncompliance. He was treated with IM long-acting haloperidol. Besides monitoring his schizophrenia symptoms, the patient should be assessed by his primary care provider:
  13. (^) For excessive weight loss
  14. With the Abnormal Involuntary Movement Scale (AIMS) for extrapyramidal symptoms (EPS)
  15. (^) Monthly for tolerance to the haloperidol
  16. (^) Only by the mental health provider, as most NPs in primary care do not care for mentally ill patients
  17. Anticholinergic agents, such as benztropine (Cogentin), may be given with a phenothiazine to:
  18. (^) Reduce the chance of tardive dyskinesia
  19. (^) Potentiate the effects of the drug
  20. (^) Reduce the tolerance that tends to occur
  21. (^) Increase central nervous system (CNS) depression
  22. Patients who are prescribed olanzapine (Zyprexa) should be monitored for:
  23. (^) Insomnia
  24. (^) Weight gain
  25. (^) Hypertension
  26. (^) Galactorrhea
  27. A 19 - year-old male was started on risperidone. Monitoring for risperidone includes observing for common side effects, including:
  28. (^) Bradykinesia, akathisia, and agitation
  29. (^) Excessive weight gain
  30. (^) Hypertension
  31. (^) Potentially fatal agranulocytosis
  1. (^) Valproate is not safe at any time during pregnancy.
  2. (^) Valproate is a known teratogen, but may be taken after the first trimester if necessary.
  3. When prescribing an opioid analgesic such as acetaminophen and codeine (Tylenol #3), instructions to the patient should include:
  4. (^) The medication may cause sedation and they should not drive.
  5. (^) Constipation is a common side effect and they should increase fluids and fiber.
  6. (^) Patients should not take any other acetaminophen-containing medications at the same time.
  7. (^) All of the above
  8. Kirk sprained his ankle and is asking for pain medication for his mild-to-moderate pain. The appropriate first-line medication would be:
  9. (^) Ibuprofen (Advil)
  10. (^) Acetaminophen with hydrocodone (Vicodin)
  11. (^) Oxycodone (Oxycontin)
  12. (^) Oral morphine (Roxanol)
  13. Kasey fractured his ankle in two places and is asking for medication for his pain. The appropriate first-line medication would be:
  14. Ibuprofen (Advil)
  15. (^) Acetaminophen with hydrocodone (Vicodin)
  16. (^) Oxycodone (Oxycontin)
  17. (^) Oral morphine (Roxanol)
  18. Jack, age 8, has attention deficit disorder (ADD) and is prescribed methylphenidate (Ritalin). He and his parents should be educated about the side effects of methylphenidate, which are:
  19. (^) Slurred speech and insomnia
  20. (^) Bradycardia and confusion
  21. (^) Dizziness and orthostatic hypotension
  22. Insomnia and decreased appetite
  23. Monitoring for a child on methylphenidate for attention deficit hyperactivity disorder (ADHD) includes:
  24. (^) ADHD symptoms
  25. (^) Routine height and weight checks
  26. (^) Amount of methylphenidate being used
  27. (^) All of the above
  28. When prescribing Adderall (amphetamine and dextroamphetamine) to adults with ADHD the nurse practitioner will need to monitor:
  29. (^) Blood pressure
  30. (^) Blood glucose levels
  31. (^) Urine ketone levels
  32. Liver function

Chapter 29. Anxiety and Depression

  1. Common mistakes practitioners make in treating anxiety disorders include:
    1. (^) Switching medications after an 8 - to 12 - week trial
    2. (^) Maximizing dosing of antianxiety medications
    3. (^) Encouraging exercise and relaxation therapy before starting medication
    4. (^) Thinking a partial response to medication is acceptable
  2. An appropriate first-line drug to try for mild to moderate generalized anxiety disorder would be:
    1. (^) Alprazolam (Xanax)
    2. (^) Diazepam (Valium)
    3. (^) Buspirone (Buspar)
    4. (^) Amitriptyline (Elavil)
  3. An appropriate drug to initially treat panic disorder is:
    1. (^) Alprazolam (Xanax)
    2. (^) Diazepam (Valium)
    3. (^) Buspirone (Buspar)
    4. (^) Amitriptyline (Elavil)
  4. Prior to starting antidepressants, patients should have laboratory testing to rule out:
    1. (^) Hypothyroidism
    2. (^) Anemia
    3. (^) Diabetes mellitus
    4. (^) Low estrogen levels
  5. David is a 34 - year-old patient who is starting on paroxetine (Paxil) for depression. David’s education regarding his medication would include:
    1. (^) Paroxetine may cause intermittent diarrhea.
    2. (^) He may experience sexual dysfunction beginning a month after he starts therapy.
    3. (^) He may have constipation and he should increase fluids and fiber.
    4. (^) Paroxetine has a long half-life so he may occasionally skip a dose.
  6. Jamison has been prescribed citalopram (Celexa) to treat his depression. Education regarding how quickly selective serotonin reuptake inhibitor (SSRI) antidepressants work would be:
    1. (^) Appetite and concentration improve in the first 1 to 2 weeks.
    2. (^) Sleep should improve almost immediately upon starting citalopram.
    3. (^) Full response to the SSRI may take 2 to 4 months after he reaches the full therapeutic dose.
    4. (^) His dysphoric mood will improve in 1 to 2 weeks.
  7. An appropriate drug for the treatment of depression with anxiety would be:
    1. (^) Alprazolam (Xanax)
    2. (^) Escitalopram (Lexapro)
    3. (^) Buspirone (Buspar)
    4. (^) Amitriptyline (Elavil)
  1. (^) It is quasi-addictive in the dopaminergic reward system.
  2. (^) It is the most activating of SSRI medications and will cause the person to have sudden deep sadness.
  3. The patient shares with the provider that he is taking his Prozac at night before going to bed. What is the best response?
  4. (^) This is a good idea because this class of medications generally makes people sleepy.
  5. (^) Have you noticed that you are having more sleep issues since you started that?
  6. (^) This a good way to remember to take your daily medications because it is near your toothbrush.
  7. (^) This is a good plan because you can eat grapefruit if there is 8 – 12 hours difference in the time each are ingested.

Chapter 43. Smoking Cessation

  1. Nicotine withdrawal symptoms include:
    1. (^) Nervousness
    2. (^) Increased appetite
    3. (^) Difficulty concentrating
    4. (^) All of the above
  2. If a patient wants to quit smoking, nicotine replacement therapy is recommended if the patient:
    1. (^) Smokes more than 10 cigarettes a day
    2. (^) Smokes within 30 minutes of awakening in the morning
    3. (^) Smokes when drinking alcohol
    4. (^) All of the above
  3. Instructions for a patient who is starting nicotine replacement therapy include:
    1. (^) Smoke less than 10 cigarettes a day when starting nicotine replacement.
    2. (^) Nicotine replacement will help with the withdrawal cravings associated with quitting tobacco.
    3. (^) Nicotine replacement can be used indefinitely.
    4. (^) Nicotine replacement therapy is generally safe for all patients.
  4. Nicotine replacement therapy should not be used in which patients?
    1. (^) Pregnant women
    2. (^) Patients with worsening angina pectoris
    3. (^) Patients who have just suffered an acute myocardial infarction
    4. (^) All of the above
  5. Instructions for the use of nicotine gum include:
    1. (^) Chew the gum quickly to get a peak effect.
    2. (^) The gum should be “parked” in the buccal space between chewing.
    3. (^) Acidic drinks such as coffee help with the absorption of the nicotine.
    4. (^) The highest abstinence rates occur if the patient chews the gum when he or she is

having cravings.

  1. Patients who choose the nicotine lozenge to assist in quitting tobacco should be instructed:
    1. (^) Chew the lozenge well.
    2. (^) Drink at least 8 ounces of water after the lozenge dissolves.
    3. (^) Use one lozenge every 1 to 2 hours (at least nine per day with a maximum of 20 per day).
    4. (^) A tingling sensation in the mouth should be reported to the provider.
  2. Transdermal nicotine replacement (the patch) is an effective choice in tobacco cessation because:
    1. (^) The patch provides a steady level of nicotine without reinforcing oral aspects of smoking.
    2. (^) There is the ability to “fine tune” the amount of nicotine that is delivered to the patient at any one time.
    3. (^) There is less of a problem with nicotine toxicity than other forms of nicotine replacement.
    4. (^) Transdermal nicotine is safer in pregnancy.
  3. The most common adverse effect of the transdermal nicotine replacement patch is:
    1. (^) Nicotine toxicity
    2. (^) Tingling at the site of patch application
    3. (^) Skin irritation under the patch site
    4. (^) Life-threatening dysrhythmias
  4. If a patient is exhibiting signs of nicotine toxicity when using transdermal nicotine, they should remove the patch and:
    1. (^) Wash the area thoroughly with soap and water.
    2. (^) Flush the area with clear water.
    3. (^) Reapply a new patch in 8 hours.
    4. (^) Take acetaminophen for the headache associated with toxicity.
  5. When a patient is prescribed nicotine nasal spray for tobacco cessation, instructions include:
  6. (^) Inhale deeply with each dose to ensure deposition in the lungs.
  7. (^) The dose is one to two sprays in each nostril per hour, not to exceed 40 sprays per day.
  8. (^) If they have a sensation of “head rush” this indicates the medication is working well.
  9. (^) Nicotine spray may be used for up to 12 continuous months.
  10. If prescribing bupropion (Zyban) for tobacco cessation, the instructions to the patient include:
  11. (^) Bupropion (Zyban) is started 1 to 2 weeks before the quit date.
  12. (^) Nicotine replacement products should not be used with bupropion.
  13. (^) If they smoke when taking bupropion they may have increased anxiety and insomnia.
  14. (^) Because they are not using bupropion as an antidepressant, they do not need to worry about increased suicide ideation when starting therapy.