CNS/PNS PRACTICE QUESTIONS AND ANSWERS & RATIONALE
1. A nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle
... [Show More] spasms. The nurse should instruct the client to report which of the following adverse effects?
a. Slow heart rate
b. Cough
c. Diarrhea
d. Hearing loss
2. A nurse is providing teaching for a client who has a new prescription for valproic acid to treat a seizure disorder. The nurse should instruct the client to monitor for which of the following adverse effects?
a. Hirsutism
b. Depression
c. Jaundice
d. Gum irritation
3. A nurse is teaching a client who is taking levodopa/carbidopa to treat Parkinson’s disease. Which of the following instructions should the nurse include?
a. Change position slowly to prevent orthostatic hypotension.
b. Eat a high-protein snack to increase absorption.
c. Take the drug at bedtime to avoid daytime drowsiness.
d. Expect eye twitching to develop with long-term therapy.
4. A nurse in an acute care facility is preparing to admit a client who has myasthenia gravis. Which of the following supplies should the nurse place at the client's bedside?
A. Metered-dose inhaler
B. Continuous passive motion machine
C. External defibrillator pads
D. Oral-nasal suction equipment
5. A patient is taking selegiline (Eldepryl) to treat Parkinson's Disease. The provider is considering the use of analgesics for the patient but should be aware that a drug interaction between selegiline and meperidine (Demerol) can result in which of the following?
A.Frequent urination
B.Jaundice
C.Cellulitis
D.Muscle rigidity
6. A HCP is caring for a patient who is about to begin taking dantrolene for skeletal muscle spasms. The HCP should recognize that which of the following lab tests requires monitoring
A.Serum potassium
B.Liver function
C.Serum sodium
D.Thyroid function
7. The reduction of what chemical within the central nervous system causes Parkinson's Disease?
A. Substantia nigra
B. Acetylcholine
C. Dopamine
D. Serotonin
8. At what point are cholinesterase inhibitors no longer effective in the treatment of Alzheimer disease?
A. When the brain size shrinks and can no longer produce acetylcholinesterase
B. When the number of neurotransmitters sufficiently decreases
C. When the patient's ability to swallow is impaired
D. When there are fewer intact neurons available to make acetylcholine
9. A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity due to overdose. Which of the following actions is the nurse's priority?
a. administer flumazenil
b. Identify the clients LOC
c. Infuse IV fluids
d. Prepare the client for gastric lavage
10. A nurse is providing teaching to a client who has a new prescription for buspirone to treat anxiety. Which of the following information should the nurse include?
a. "Take this medication on empty stomach"
b. "Expect optimal therapeutic effects within 24 hrs"
c. "Take this medication when needed for anxiety"
d. "This medication has a low risk for dependency"
11. A nurse is caring for a client who is experiencing a seizure while in bed. Which of the following actions should the nurse take?
A) Raise the head of the client's bed
B) Restrain the client’s arms and legs
C) Turn the client’s head to the side
D) Insert a tongue blade into the client’s mouth
12. A nurse is reinforcing teaching with a client who has major depressive disorder and a new prescription for amitriptyline. Which of the following information should the nurse include? (Select All That Apply)
A. Expect therapeutic effects in 24 to 48 hours.
B. Discontinue the medication after a week of improved mood.
C. Change positions slowly to minimize dizziness.
D. Decrease dietary fiber intake to control diarrhea.
E. Chew sugarless gum to prevent dry mouth.
13. A nurse is teaching the family of a client who has a new diagnosis of Alzheimer's disease about donepezil. Which of the following should the nurse included?
A. Monitor for constipation.
B. The dosage will be increased weekly to provide optimum therapeutic effect.
C. Administering the drug first thing in the morning promotes effectiveness.
D. Avoid the use of NSAIDs for pain.
14. A patient who is taking LAMOTRIGINE reports the appearance of a new rash. What is your best action?
a. repot the rash to the hcp immediately
b. Add the reaction to the patients list of allergies in his/ her record
c. instruct the patient to take the drug with a substantial meal or snack
d. Suggest that the pt apply a cortisone containing cream to the area
15. Which drug for MULTIPLE SCLEROSISS is specifically prescribed to improve walking?
a. Beta Interferon
b. Daclizumab
c. Dalfampridine
d. Tecfidera
16. A nurse is reinforcing teaching with a client who has hypertension and a new prescription for oral clonidine. Which of the following instructions should the nurse include in the teaching?
a) Discontinue the medication if a rash develops
b) Expect increased salivation during the first few weeks of therapy
c) Minimize fiber intake to prevent diarrhea
d) Avoid driving until the client's reaction to the medication is known
17. A nurse is caring for an adolescent who has cystic fibrosis (CF) and has a prescription for high-dose ibuprofen daily. The nurse should identify which of the following is an expected outcome for the client receiving this medication?
a) Thinned pulmonary secretions that are retained in the airways
b) Slowed progression of pulmonary damage
c) Potentiated action of bronchodilator therapy
d) Decreased risk of fevers associated with CF
18. While talking with a patient and his family about taking memantine (Namenda) for Alzheimer's disease, the healthcare professional should include which of the following instructions?
A. Increase fluids to improve renal excretion
B. Report memory loss or confusion
C. Watch for signs of liver impairment, such as jaundice and abdominal pain
D. Notify the healthcare professional before taking over-the-counter antacids
19. A healthcare professional is talking to a patient who is newly diagnosed with Parkinson's disease about how levodopa/carbidopa (Sinemet) will help control her symptoms.With which of the following mechanisms is the drug effective in treating the disorder?
A. Increases available acetylcholine in the brain
B. Inhibits norepinephrine metabolism in the brain
C. Inhibits serotonin metabolism in the brain
D. Increases available dopamine in the brain
20. A nurse is preparing to administer benztropine 8 mg PO daily in 2 divided doses to a client who has Parkinson's disease. The amount available is benztropine 2 mg tablets. How many tablets should the nurse administer with each dose? (Fill in the blank with the numeric value only. Round the answer to the nearest whole number. Use a leading zero if applicable but do not use a trailing zero.)
_________
Answer: 2 tablets
Step 1: What is the unit of measurement the nurse should calculate? tablet
Step 2: What is the dose the nurse should administer? 8 mg/2 doses daily = 4 mg
Step 3: What is the dose available? 2 mg
Step 4: Should the nurse convert the units of measurement? No
Step 5: What is the quantity of the dose available? 1 tablet
Step 6: Set up an equation and solve for X.
Have/Quantity = Desired/X
2 mg/1 tablet = 4 mg/X tablet
X = 2
Step 7: Round if necessary.
Step 8: Reassess to determine whether the amount to administer makes sense.
If there are 2 mg/tablet and the amount prescribed is 4 mg, the nurse should administer benztropine 2 tablets PO 2 times daily.
21A nurse is caring for a client with Alzheimer's disease who has a new prescription for memantine. Which of the following laboratory results should the nurse identify as increasing the client's risk for decreased clearance of the medication?
a) Alanine aminotransferase (ALT) 30 units/L
b) Creatinine clearance 35 mL/min
c) HbA1c 5%
d) BMI 31
22. A nurse is reviewing the laboratory data for a client who is receiving clozapine for schizophrenia. The nurse should identify which of the following findings as a potential adverse effect of the medication?
a) Fasting blood glucose 95 mg/dL
b) Triglycerides 135 mg/dL
c) Total cholesterol 175 mg/dL
d) Absolute neutrophil count 1,200 mm^3
-threatening conditioning in which WBCs (including neutrophils) are severely decreased.
23. Which of the following information should a healthcare professional include when talking to a patient about taking baclofen (Lioresal) ?
A. Avoid driving until drug effects are evident
B. Stop taking the drug immediately if headache occurs
C. Take the drugs PRN for spasticity
D. Take the drugs with antacids to reduce gastric effects
.
24. Anesthetists often administer Midazolam (Versed) during induction of anesthesia because of which pharmacological actions?
A. Produces analgesia
B. Induces muscle paralysis
C. Dries secretions
D. Causes amnesia
25.A healthcare professional is caring for a patient who is taking venlafaxine to treat major depression. The healthcare professional should recognize which of the following drugs can cause serotonin syndrome when patients take it concurrently with venlafaxine?
A) Pilocarpine (IsoptoCarpine)
B) Phenelzine (Nardil)
C) Alprazolam (Xanax)
D) Phenytoin (Dilantin)
26. A nurse in an acute mental health facility is reviewing the medication records for a group of clients. The nurse should expect a prescription for memantine for a client who has which of the following diagnoses?
a. Depression
b. Schizophrenia
c. Obesity
d. Alzheimer’s disease
27. A nurse is collecting data from a client who takes an MAOI for the treatment of depression. Which of the following findings is the priority for the nurse to report to the provider?
a. Elevated blood pressure
b. Weight gain
c. Muscle twitching
d. 2+ peripheral
28. A nurse is reviewing the medication of a client who has bipolar disorder and a new prescription for lithium. The nurse should identify that it is safe to administer which of the following medications while the client is taking lithium?
a. Ibuprofen
b. Haloperidol
c. Valproic Acid
d. Hydrochlorothiazide
29. A nurse is reinforcing teaching with a newly licensed nurse about metoclopramide. The nurse should include in the teaching that which of the following conditions is a contraindication to this medication?
A. Hyperthyroidism
B. Intestinal Obstruction
C. Glaucoma
D. Low blood pressure
30. A healthcare professional is reviewing the medical record of a patient who has a newly diagnosed seizure disorder. The patient is to begin taking both valproic acid (Depakote) and phenytoin (Dilantin). The healthcare professional should recognize which of the following can occur as a result of a drug interaction between valproic acid and phenytoin?
a. Hyperammonemia
b. Phenytoin toxicity
c. Hypertension
d. Peptic ulcer disease
31. A nurse is teaching a pt who received a Rx for interferon beta-1a for the tx of multiple sclerosis. Which of the following information should the nurse include?
a.) “Have kidney function tests done every month for a year.”
b.) “Take an extra dose if muscle aches occur.”
c.) “Store the drug at room temperature after mixing it.”
d.) “Administer the drug in your thigh or upper arm.”
32. A nurse is reinforcing teaching with the partner of a client who has moderate Alzheimer's disease about a new prescription for a rivastigmine transdermal patch. Which of the following information should the nurse provide?
A.) The patch should be changed every 72 hours.
B.) The patch provides higher drug levels than oral medications.
C.) The old patch should be removed before a new patch is applied.
D.) Allowing the patch to get wet will deactivate it.
33. A nurse is caring for a client who has multiple sclerosis and is receiving interferon beta-1a. The nurse should identify which of the following client statements indicates a potential adverse effect of the medication?
A. "My body aches all over."
B. "I have abdominal cramping."
C. "My hair seems to be thinning."
D. "It hurts when I urinate."
34. A nurse in a provider's office is reinforcing teaching with a female client who has a new diagnosis of seizures and a prescription for valproic acid. Which of the following pieces of information should the nurse provide?
A "This medication can cause changes in your mood and behavior."
B. "Valproic acid is one of the few seizure medications that can be taken during pregnancy."
C. "You can expect this medication to cause you to lose weight."
D. Valproic acid should be taken every morning on an empty stomach>"
35. A nurse is collecting data on a client who is postoperative and received a dose of morphine 15 minutes ago. The client now has a respiratory rate of 8/min and is unresponsive. Which of the following medications should the nurse prepare to administer?
a. Naproxen
b. Nifedipine
c. Naloxone
d. Nebivolol
36. A nurse is collecting data from a client who is receiving clozapine to treat schizophrenia. The nurse should identify that an increase in which of the following parameters is an early indication of agranulocytosis?
a. Urine specific gravity
b. Urine output
c. Blood pressure
d. Temperature
37. A nurse is reinforcing teaching with a client who has a seizure disorder and a new prescription for carbamazepine. Which of the following statements should the nurse include in the teaching?
a. “This medication will decrease the effectiveness of oral contraceptives.”
b. “Once you are seizure-free for a month, you will be able to stop taking the medication”
c. “You can cut the dose in half if GI upset occurs”
d. “This medication might initially increase the frequency of your seizures”
38. A nurse is caring for a client who takes warfarin to treat chronic atrial fibrillation and has early manifestations of Alzheimers disease. The client's partner asks the nurse if the client would benefit from taking ginkgo biloba. Which of the following responses should the nurse provide?
a. “Ginkgo biloba will probably interfere with the effectiveness of his other medications”
b. “You should ask his provider if ginkgo biloba is safe”
c. “Ginkgo biloba is most effective in the later stages of Alzheimer's disease”
d. “People who have Alzheimer's disease should adhere to the medication regimen their provider prescribes”
39. A nurse is caring for a child who has epilepsy and is scheduled to receive a dose of phenytoin. The nurse notes the child’s serum phenytoin level is 14 mcg/mL. Which of the following actions should the nurse take?
a. Administer the dose
b. Administer half the dose
c. Do not administer the dose
d. Clarify the dose with the provider
40. A nurse is caring for a patient who overdosed on benzodiazepines. What is the antidote to reverse the effects of benzodiazepines?
a. Flumazenil
b. Zolpidem
c. Valium
d. Pregalbalin
41. A nurse in a primary care clinic is assessing a client who takes lithium carbonate (Lithotabs.) for the treatment of bipolar disorder. The nurse should recognize which of the following findings as a possible indication of toxicity to this medication?
A. Severe hypertension
B. Coarse tremors
C. Constipation
D. Urinary retention
42. A nurse is caring for a client who has a new prescription for valproic acid (Depakote). The nurse should instruct the client that while taking this medication he will need to have which of the following laboratory tests completed periodically? (Select all that apply.)
A. Thrombocyte count
B. Hematocrit
C. Amylase
D. Liver function tests
E. Potassium
44. A nurse is caring for a client who has schizophrenia and a prescription for chlorpromazine. For which of the following adverse effects should the nurse monitor?
a. Orthostatic hypotension
b. Diarrhea
c. Urinary frequency
d. Bradycardia
45. A nurse is reinforcing teaching with a client who has a new prescription for phenytoin. Which of the following adverse effects can occur with the abrupt withdrawal of phenytoin?
a. Status epilepticus
b. Bleeding gums
c. Disorientation
d. Severe nausea
46. A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to obtain prior to administering the medication?
a. Hearing examination
b. Glucose tolerance test
c. Electrocardiogram
d. Pulmonary function tests
47. A HCP is caring for a patient who is about to begin taking pramipexole (mirapex) to treat Parkinson’s disease. The HCP should recognize that which of the following labatory test requires monitoring?
A. C-reactive protein
B. Creatine Phosphokinase (CPK)
C. Thyroid function
D. CBC
48. A nurse is caring for a client who has been taking sertraline for the past 2 days. Which of the following findings should alert the nurse to the possibility that the client is developing serotonin syndrome?
A. Bruising
B. Fever
C. Tinnitus
D. Rash
49. A nurse is planning to reinforce with a female client who has bipolar disorder and a new prescription for carbamazepine. Which of the following statements should the nurse include? (Select all that apply)
A. “This medication can safely be taken during pregnancy”
B. “Eliminate grapefruit juice from your diet”
C. “You will need to have your blood count monitored periodically”
D. “Notify your provider if you develop a rash”
E. “Avoid driving for the first few days after starting this medication”
50. A nurse is collecting data from a client who is suspected of having benzodiazepine toxicity. Which of the following findings should the nurse identify as the priority to report to the provider?
A. Drowsiness
B. Confusion
C. Ataxia
D. Hypotension
51. A nurse is reinforcing teaching with a client who has a new prescription for escitalopram for treatment of generalized anxiety disorder. Which of the following statements indicates that their client understands the teaching?
A. “I should take the medication on an empty stomach.”
B. “I will follow a low-sodium diet while taking this medication.”
C. “I need to discontinue this medication slowly.”
D. “I should stop taking the medication if it causes me to have nausea.”
52. A nurse is reinforcing teaching with a client who has early Parkinson’s disease and new prescription for pramipexole. The nurse should instruct the client to monitor for which of the following adverse effects of this medications?
A. Hallucinations
B. Increased salivation
C. Diarrhea
D. Discoloration of urine
53. A nurse is reviewing a new prescription for oxcarbazepine with a female client who has partial seizures. Which of the following instructions should the nurse include? (Select all that apply)
A. “Use caution if the doctor prescribes a diuretic medication.”
B. “Consider using another form of birth control if you are taking oral contraceptives.”
C. “Chew gum to increase saliva production.”
D. “Avoid driving until you see how the medication affects you.”
E. Notify the doctor if you develop a skin rash.”
54. A nurse is collecting data from a client who recently began taking haloperidol. Which of the following findings should the nurse identify as the highest priority to report to the provider?
a. Shuffling gait
b. Neck spasms
c. Drowsiness
d. Sexual dysfunction
55. A nurse is reinforcing teaching with a male client who has schizophrenia and is taking risperidone. Which of the following statements should the nurse include?
a. “Add extra snacks to your diet to prevent weight loss.”
b. “Notify the provider if you develop breast enlargement.”
c. “You may begin to have mild seizures while taking this medication.”
d. “This medication is likely to increase your libido.”
56. A healthcare professional is caring for a patient who is taking zolpidem (Ambien).The patient has a history of benzodiazepine abuse and reports insomnia. The healthcare professional should caution the patient that the drug can cause
a. Hearing loss
b. Memory impairment
c. Joint pain
d. constipation
57. A nurse is reinforcing teaching with a client who has schizophrenia about strategies to cope with anticholinergic effects of fluphenazine. Which of the following strategies should the nurse include?
A. Take medication in the morning to prevent insomnia .
B. Chew sugarless gum to moisten the mouth .
C. Use cooling measures to decrease fever.
D. Take an antacid to relieve nausea.
58. A nurse is collecting data from a client who has schizophrenia and is taking chlorpromazine. In which of the following manifestations should the nurse expect the most improvement? (Select all that apply)
A. Disorganized speech
B. Bizarre behavior
C. Impaired social interactions
D. Hallucinations
E. Decreased motivation
59. For which of the following should a healthcare professional monitor a patient who is donepezil (Aricept) for Alzheimer’s?
A. Confusion
B. Dry mouth
C. Nausea
D. Double vision
60. During and immediately following IV administration of chlorpromazine to a patient who has schizoaffective disorder, the health-care professional should monitor which of the following?
A. Cardiac output
B. Blood pressure
C. Urine specific gravity
D. Oxygen saturation
61. Soon after taking fluoxetine (Prozac), a patient is admitted to the emergency department with agitation and confusion. The health-care professional should suspect which of the following?
A. Neuroleptic malignant syndrome
B. Stevens-Johnson syndrome
C. Extrapyramidal symptoms
D. Serotonin syndrome
62. A nurse is reinforcing teaching with a client who has a new diagnosis of multiple sclerosis (MS). The client asks the nurse about the usual course of MS. Which of the following responses should the nurse provide?
a. “Each client is different. We cannot predict what will happen."
b. “I can see that you are worried, but it's too soon to predict what will happen.”
c. Acute episodes are usually followed by remissions, which can last varying lengths of time."
d. It’s too early to think about the future. Let’s focus on the present and take each day at a time."
63. A nurse is collecting data from a client who has increased intracranial pressure and has received intravenous mannitol. The nurse should identify which of the following findings indicates a therapeutic effect of this medication?
A. Decreased blood glucose
B. Decreased bronchospasms
C. Increased urine output
D. Increased temperature
64. A nurse is caring for a client who has a major depressive disorder and a new prescription for phenelzine. Which of the following findings should the nurse identify as an adverse effect of this medication?
A. Orthostatic hypotension
B. Hearing loss
C. Gastrointestinal bleeding
D. Weight loss
65. A HCP is caring for a patient who is receiving thiopental (Pentothal). For which of the following should the healthcare professional monitor?
A) cardiac excitability
B) respiratory depression
C) hyperthermia
D) Hypotension
66. A nurse is reinforcing discharge teaching with a client who has a new prescription for clozapine. Which of the following statements should the nurse include?
A. you should have a high- carbohydrate snack between meals and at bedtime
B. you are likely to develop hand tremors if you take this medication for a long period of time.
C. You may experience temporary numbness of your mouth after each dose
D. You should have your white blood cell count monitored every week
67. A nurse is reinforcing teaching with a client who has obsessive-compulsive disorder and a new prescription of paroxetine.Which of the following instructions should the nurse include?
A. " It can take several weeks before you feel like medication is helping."
B. " Take the medication just before time to promote sleep."
C ."You should take the medication when needed for obsessive urges."
D. "Monitor for weight gain while taking this medication."
68. A nurse is reinforcing teaching with the client who has a new prescription for levodopa/carbidopa for Parkinson's disease. Which of the following instructions should the nurse include?
A- increase intake of protein rich foods
B- Expect muscle twitching to occur
C- take this medication with food
D- Anticipate relief of manifestations in 24 hrs.
69. A nurse is reviewing the medical history of a client who has spasticity due to MS and a new prescription for tizanidine. Which of the following comorbidities should the nurse identify as increasing the client’s risk for adverse effects while taking this medication?
a. Pneumonia
b. BPH (Benign prostatic hypertrophy)
c. Hepatitis
d. Diabetes Mellitus
A nurse is caring for a client who took an overdose of acetaminophen. Which of the following medications should the nurse plan to administer?
a. Acetylcysteine
b. Celecoxib
c. Finasteride
d. meclizine
A nurse is reinforcing medication teaching to a client who has a new diagnosis of rheumatoid arthritis. Which of the following medications in the therapy regimen will take weeks to months to be effective?
a. Ibuprofen
b. Methotrexate
c. Prednisone
d. Celecoxib
A nurse should identify that timolol is contraindicated for a client who has which of the following disorders?
A)Asthma
B)Seizure Disorder
C)Diabetes Mellitus
D)Rheumatoid Arthritis [Show Less]