6521 Advanced Pharmacology Final Exam 2022 Answered correct

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A nurse is caring for an infant after a surgical procedure. After ensuring that the ordered dose is appropriate for the infant's age and weight, the nurse administers a narcotic analgesic intravenousl... y. When assessing the infant 15 minutes later, the nurse notes respirations of 22 breaths/minute and a heart rate of 110 beats/minute. The infant is asleep in the parent's arms and does not awaken when vital signs are assessed. The nurse understands that these findings are the result of: - ANSWER immaturity of the blood-brain barrier in the infant. A child will receive 750 mg of an antibiotic for 10 days. The child attends day care. The drug may be dosed in several ways and is available in two concentrations. Which dosing regimen will the nurse discuss with the child's provider? - ANSWER 500 mg/5 mL to 375 mg PO twice daily Parents ask the nurse why an over-the-counter cough suppressant with sedative side effects is not recommended for infants. Which response by the nurse is correct? - ANSWER "Infants are more susceptible to central nervous system effects than are adults." A nurse caring for a 5-year-old child notes that the child has discoloration of several teeth. When taking a medication history, the nurse will ask about which group of medications? - ANSWER Tetracyclines An infant has allergies and often develops a pruritic rash when exposed to allergens. The infant's parents ask the nurse about using a topical antihistamine. What should the nurse tell them? - ANSWER Applying an antihistamine to the skin can cause toxicity in this age group. An infant is receiving a medication that has a narrow therapeutic range. The nurse reviews the medication information and learns that the drug is excreted by the kidneys. When giving the medication, the nurse will assess the infant for: - ANSWER signs of drug toxicity. A pediatric nurse is teaching nursing students to calculate medication doses for children using a formula based on body surface area. Which statement by a nursing student indicates understanding of the teaching? - ANSWER "This formula helps approximate the first dose; other doses should be based on clinical observations." A pediatric nurse is teaching nursing students about medication administration in children. Which statement by a student indicates an understanding of the teaching? - ANSWER "Drugs effective in adults may not work in children, even if the dose is proportional for weight and size." A nurse is teaching nursing students about pediatric medication administration. What will the nurse include when discussing pediatric drug research? - ANSWER Studies showed a significant percentage of unanticipated and potentially lethal side effects in children. A prescriber has ordered medication for a newborn. The medication is eliminated primarily by hepatic metabolism. The nurse expects the prescriber to: - ANSWER order a dose that is lower than an adult dose. The parents of a child with asthma ask the nurse why their child can not use oral corticosteroids more often, because they are so effective. The nurse will offer which information that is true for children? - ANSWER Chronic steroid use can inhibit growth. A patient with schizophrenia receives a dose of risperidone [Risperdal Consta] IM. The nurse teaching this patient about this medication will make which statement? - ANSWER "You will need to take an oral antipsychotic drug for 3 weeks." A patient with schizophrenia shows suicidal behaviors, and the provider orders clozapine [Clozaril]. The nurse teaches the family about the medication and its side effects. Which statement by a family member indicates a need for further teaching about this drug? - ANSWER "If the ANC is less than 3000, the drug will be discontinued permanently." A patient in whom drug therapy has failed several times in the past is readmitted to a hospital to begin therapy for schizophrenia. What will the nurse do to help improve adherence? - ANSWER Teach the patient about drug side effects and how to manage them. A nurse provides teaching for a patient about to begin taking an FGA drug for schizophrenia. Which statement by the patient indicates a need for further teaching about side effects of these drugs? - ANSWER "Dry mouth and constipation are uncommon with this medication." A patient taking an FGA medication develops severe parkinsonism and is treated with amantadine [Symmetrel]. The amantadine is withdrawn 2 months later, and the parkinsonism returns. The nurse will expect the provider to: - ANSWER try a second-generation antipsychotic (SGA). What are negative symptoms of schizophrenia? Select all that apply. - ANSWER Poor judgment Poor self-care Poverty of speech A patient is taking an FGA for schizophrenia. The nurse notes that the patient has trouble speaking and chewing and observes slow, wormlike-movements of the patient's tongue. The nurse recognizes which adverse effect in this patient? - ANSWER Tardive dyskinesia A nurse and a nursing student are discussing the plan of care for a patient with schizophrenia. The patient, who has been taking a high-potency FGA for 2 months, has become restless and constantly needs to be in motion. Which statement by the student indicates a need for further education? - ANSWER "Because this may be an exacerbation of psychosis, the provider may increase the dose of the FGA." A patient who is taking a first-generation antipsychotic (FGA) drug for schizophrenia comes to the clinic for evaluation. The nurse observes that the patient has a shuffling gait and mild tremors. The nurse will ask the patient's provider about which course of action? - ANSWER Giving an anticholinergic medication A patient with schizophrenia has been taking an oral FGA for 1 week. The patient has been taking the drug daily in two divided doses. The individual complains of daytime drowsiness. The patient's family reports a decrease in the person's hostility and anxiety but states that the patient remains antisocial with disordered thinking. What will the nurse tell the patient and the family? - ANSWER Some symptoms take months to improve. A patient with schizophrenia has been taking an antipsychotic drug for several days. The nurse enters the patient's room to administer a dose of haloperidol [Haldol] and finds the patient having facial spasms. The patient's head is thrust back, and the patient is unable to speak. What will the nurse do? - ANSWER Request an order to give diphenhydramine. A parent reports being afraid that a child may have schizophrenia because of disorganized speech and asocial behaviors. The nurse will tell this parent that which of the following must also be present to make a diagnosis? Select all that apply. - ANSWER A decrease in self-care, job, or school function A 1-month duration of active phase symptoms Continuous signs of disturbance for longer than 6 months Which side effects are more common in second-generation antipsychotic medications than in first-generation antipsychotic medications? Select all that apply. - ANSWER Agranulocytosis Anticholinergic effects Metabolism by CYP3A4 A nurse in a mental health hospital finds a patient with schizophrenia who takes haloperidol [Haldol] lying rigid in bed with a temperature of 41.3°C. A cardiac monitor shows cardiac dysrhythmias. What will be included in the treatment of this patient? Select all that apply. - ANSWER Dantrolene Intravenous fluids Withdrawal of haloperidol A patient who has diabetes mellitus is diagnosed with schizophrenia and the provider orders thioridazine. The patient asks the nurse why the provider has not ordered olanzapine [Zyprexa], which the patient has seen advertised on television. Which response by the nurse is the most important reason that this patient is not receiving olanzapine? - ANSWER "Olanzapine causes more metabolic side effects than thioridazine." A patient who has been taking a monoamine oxidase inhibitor (MAOI) for depression for several months tells the provider that the medication has not helped with symptoms. The provider plans to switch the patient to an SSRI. The nurse will teach this patient to: - ANSWER stop taking the MAOI 2 weeks before starting the SSRI. 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: - ANSWER hospitalizing the patient for closer monitoring. An older adult patient who is to begin taking imipramine [Tofranil] asks the nurse when the drug should be taken. The nurse will instruct the patient to: - ANSWER divide the daily dose into two equal doses 12 hours apart. A patient has been taking an SSRI antidepressant for major depression and reports having headaches and jaw pain. What will the nurse tell the patient? - ANSWER Discuss these symptoms with a dentist. A neonate is born to a patient who reports taking venlafaxine [Effexor XR]. The nurse caring for the infant will observe the infant for: - ANSWER irritability, tremor, and respiratory distress. A patient is brought to the emergency department after taking a handful of TCA pills. The nurse will expect to provide what when caring for this patient? Select all that apply. - ANSWER Cardiac monitoring Cholinesterase inhibitors Gastric lavage and activated charcoal A patient is diagnosed with major depression with severe symptoms and begins taking an antidepressant medication. Three weeks after beginning therapy, the patient tells the nurse that the drug is not working. The nurse will counsel this patient to ask the provider about: - ANSWER using nondrug therapies to augment the medication. Which patients are candidates for MAOIs? Select all that apply. - ANSWER Patients who have not responded to SSRIs and TCAs Patients with atypical depression [Show More]

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