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1. Mr. C., who suffered a head injury this morning, is having difficulty breathing. This is a result of swelling around his:
A) Thalamus
B) Cerebrum
C) Pituitary
D) Medulla oblongata |
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2. This neurotransmitter stimulates the brain to increase activity:
A) Dopamine
B) Acetylcholine
C) Gamma-aminobutyric acid
D) Norepinephrine |
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3. The major inhibitory neurotransmitter in the CNS is:
A) Acetylcholine
B) Dopamine
C) GABA
D) Serotonin |
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4. Your client has been taking morphine q2h for chronic pain associated with cancer. It is important to assess for:
A) Diarrhea
B) Respiratory depression
C) Cough
D) Urinary frequency |
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5. The following drug is used to reverse the effects of opioids:
A) Naloxone hydrochloride (Narcan) tartrate
B) Butorphanol
C) Buprenorphine (Buprenex)
D) Nalbuphine hydrochloride (Nubain) |
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6. A client with terminal cancer has been receiving morphine sulfate 5 mg IV q4h for the past 3 weeks. She states that the pain is not relieved. You recognize that the reason for this is the client:
A) Has developed a dependency on the morphine
B) Is imagining the pain
C) Resents that the nurse is healthy
D) Has developed tolerance to the morphine |
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7. The best way to evaluate pain response after administering analgesia is to:
A) Observe the client when he or she is not aware you are watching.
B) Use a pain assessment tool before and 30 minutes after medication administration.
C) Ask the nonlicensed personnel (aide) to find out if the medication worked.
D) If a family member is present, ask him or her if the medication worked. |
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8. Which drug is likely to be ordered for a client experiencing withdrawal symptoms from a narcotic?
A) Fentanyl
B) Clonidine
C) Tylenol
D) Naloxone |
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9. A potentially serious side effect that a person using ibuprofen (Motrin) should be aware of is:
A) Agranulocytosis
B) GI bleed
C) Elevated serum potassium levels
D) Dysrhythmias |
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10. Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used in the treatment of minor aches and pains. It is important for the nurse to remind the client to
A) Take antacids to decrease gastric irritation.
B) Take NSAIDs with food.
C) Limit fluids to improve absorption.
D) Take NSAIDs at least three times a day. |
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11. The following medication treats gout by increasing urinary excretion of uric acid:
A) Allopurinol (Zyloprim)
B) Probenecid (Benemid)
C) Colchicine
D) Salicylic acid (ASA) |
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12. A client has diabetes mellitus, angina, peptic ulcer disease, and asthma. For which of these problems would you alert the physician before commencing treatment with sumatriptin for moderate to severe migraine headaches?
A) Angina
B) Asthma
C) Peptic ulcer disease
D) Diabetes mellitus |
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13. The antidote for acetaminophen (Tylenol) poisoning is:
A) Acetylcysteine (Mucomyst)
B) Allopurinol (Zyloprim)
C) Ascorbic acid (Vitamin C)
D) Amphojel |
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14. A client enters the emergency room with complaints of visual changes, drowsiness, and tinnitus. The client is confused and hyperventilating. These symptoms may be attributable to which of the following?
A) Acute acetaminophen poisoning
B) Salicylate intoxication
C) Ibuprofen overdose
D) Caffeine abuse |
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15. Buspirone (BuSpar) is unique from other antianxiety drugs in that it has:
A) Muscle relaxant effects
B) Anticonvulsant effects
C) No propensity to cause physical dependence
D) Sedative effects |
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16. An antihistamine used as a hypnotic is:
A) Zolpidem (Ambien)
B) Diphenhydramine (Benadryl)
C) Flurazepam (Dalmane)
D) Chloral hydrate |
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17. Prior to the administration of hypnotics, the nurse should assess the client for:
A) Agitation
B) Drug dependence and abuse
C) Anorexia
D) Heart disease |
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18. You know that your teaching has been effective if a client who is taking a benzodiazepine states:
A) “I can only take the medication with meals.”
B) “I know this drug needs to be gradually tapered before discontinuation.”
C) “I cannot take this medication if I am using aspirin.”
D) “I will take this medication for the rest of my life.” |
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19. Which of the following drug reactions can occur from combining alcohol and a benzodiazepine, such as diazepam (Valium)?
A) Excitability
B) Insomnia
C) Drug dependency
D) Respiratory depression |
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20. Which neurohormone is released when a client experiences anxiety?
A) Norepinephrine
B) Serotonin
C) GABA
D) All of the above are correct |
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21. Phenothiazines can cause:
A) Bradycardia
B) Bradypnea
C) Extrapyramidal effects
D) Hypoglycemia |
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22. A patient who is taking chlorpromazine (phenothiazide: antipsychotic) for several months for schizophrenia wants to attend a picnic on the 4th of July. The nurse would be most concerned about which of the medication's side effects?
A) Photosensitivity
B) Hypotension
C) Constipation
D) Increased appetite |
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23. Mr. Davidson is experiencing hallucinations. He is often belligerent, loud, and abusive when you enter his room. The best response by the nurse during future interactions would be to:
A) Respond in a loud, belligerent manner to get his attention.
B) Use a calm, soft voice when talking to him.
C) Respond only over the intercom and delegate all care to the nurse's aide.
D) Request a transfer to a different floor. |
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24. What is the most likely outcome of abrupt withdrawal of a typical antipsychotic medication?
A) Insomnia
B) Tardive dyskinesia
C) Somnolence
D) Constipation |
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25. The family of your patient with schizophrenia is worried because the patient continues to have delusional thoughts despite the fact that he was started on thorazine (Phenothiazine: antipsychotic) 24 hours ago. Your BEST response is:
A) "Don't worry, we don't expect it to be working yet."
B) "It may take up to 6 weeks for all psychological symptoms to subside."
C) "If the medicaine is not working yet, it may not work at all."
D) "You can expect the medicine to start working in the next 48-72 hours." |
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26. The following is an anticholinergic response associated with antipsychotic drugs:
A) Blood dyscrasias
B) Lowered seizure threshold
C) Weight gain
D) Urinary retention |
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27. Clients taking an MAO inhibitor should be monitored frequently for:
A) Hypertension
B) Respiratory congestion
C) Decreased urinary output
D) Anemia |
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28. A client taking amitriptyline (Elavil) should be monitored for which side effect?
A) Hypertension
B) Sodium retention
C) Hyperglycemia
D) Dysrhythmia |
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29. The patient is in the clinical for a follow-up visit for depression. She began taking fluoxetine (Prozac), an SSRI, 2 weeks ago. She tells you, "This medication is not working. I don't feel any better at all." The BEST response is
A) "You should try doubling the dose."
B) "I'll talk to your doctor about increasing your dosage."
C) "This drug may take up to 4 weeks to take effect. Please discuss this with your doctor."
D) "You may just be one of those people who don't get any better with this drug." |
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30. Abrupt withdrawal of antiseizure agents may precipitate:
A) Hypertensive crisis
B) Cardiac dysrhythmias
C) Respiratory arrest
D) Status epilepticus |
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31. The antiseizure drug used intravenously to terminate acute convulsive seizures is:
A) Lorazepam (Ativan)
B) Phenytoin (Dilantin)
C) Ethosuximide (Zarontin)
D) Gabapentin (Neurontin) |
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32. R. F. is to be sent home on phenytoin 100 mg bid. Which of the following statements by R. F. leads you to believe he has understood your teaching?
A) “I will take the medication on an empty stomach.”
B) “I will discontinue the drug immediately if any side effects occur.”
C) “I will make routine visits to the dentist.”
D) “I will weigh myself daily.” |
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33. AEDs may alter seizure activity by:
A) Decreasing GABA effects
B) Increasing GABA effects
C) Increasing sodium ions
D) Decreasing sodium ions |
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34. Parkinsonism, which may occur with long-term use of antipsychotics, can be treated with:
A) Anticholinergic agents
B) MAO inhibitors
C) Synthetic antiviral agents
D) Dopaminergic drugs |
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35. Mr. French complains of diarrhea and nausea when he takes levodopa/carbidopa (Sinemet). One way to reduce his adverse effects is to:
A) Decrease the dosage while increasing the frequency of administration.
B) Increase the dosage while decreasing the frequency of administration.
C) Crush the tablet prior to administration.
D) Add more levodopa and decrease the amount of carbidopa. |
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36. A patient taking carisoprodol (Soma) should be told to:
A) Taper drug before stopping.
B) Take first thing in the AM.
C) Take with food.
D) Take on an empty stomach. |
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37. People using skeletal muscle relaxants should avoid:
A) Alcohol
B) High-protein foods
C) Caffeine
D) Nicotine |
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38. You are planning care for your patient who is started on carisoprodol (Soma: Skeletal muscle relaxant) after a back injury. Which of the following OUTCOME CRITERIA is appropriate for the nursing diagnosis, "Impaired physical mobility related to muscle spasm and pain"?
A) Will rate pain as < 3 within 1 hour.
B) Able to walk from bed to bathroom with minimal discomfort by day 3.
C) Verbalizes understanding of medication and side effects.
D) Absence of muscle spasms within 3 hours. |
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39. People receiving flumazenil (Romazicon) for benzodiazepine overdose must be closely observed because the drug may:
A) Cause sedation and respiratory depression
B) Induce acute tubular necrosis
C) Precipitate acute withdrawal symptoms
D) Cause severe nausea and vomiting |
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40. Before Mrs. Johnson stops smoking, you should inform her about the signs and symptoms of withdrawal, which include:
A) Anxiety, irritability, and difficulty concentrating
B) Muscle cramping and palpitations
C) Chronic fatigue and food intolerance
D) Diarrhea, dehydration, and electrolyte imbalance |
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41. Inhaled substances containing gasoline, benzene, or carbon tetrachloride can cause serious damage to the:
A) Lungs, pancreas, and brain
B) Immune system and lymphatic system
C) Liver, kidneys, and bone marrow
D) Mucous membranes, eyes, and thyroid gland |
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42. All of the following are appropriate for a client undergoing drug withdrawal; which one takes priority?
A) Ineffective coping related to reliance on alcohol or other drugs
B) Risk for injury: adverse drug effects
C) Imbalanced nutrition: less than body requirements due to drug effects and drug-seeking behavior
D) Disturbed thought processes related to the use of psychoactive drugs |
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43. An 18-year-old male is brought to the emergency room due to an overdose of the benzodiazepine, diazepam (Valium). The client should be watched cautiously for:
A) Respiratory depression
B) Agitation
C) Electrolyte imbalance
D) Bone marrow depression |
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44. The expected response from drinking alcohol while taking the drug disulfiram (Anatabuse) is:
A) Hypertension
B) Nausea and vomiting
C) CNS stimulation
D) Blood anticoagulation |
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45. The following statement by the parents of a child receiving methylphenidate (Ritalin) indicates that they understand how the drug is to be used:
A) “We know that our child can develop a tolerance to the medication, so we will monitor him.”
B) “We will monitor our child's height and weight.”
C) “Self-image and learning ability may diminish with the use of this drug.”
D) “Stimulants used for ADHD always produce a therapeutic effect.” |
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46. Methylphenidate (Ritalin) is a schedule II drug because it:
A) Causes anorexia
B) Is costly
C) Is only available illegally
D) Has a high risk of abuse and dependence |
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47. Which of the following medications may be given to increase the excretion of an amphetamine after accidental overdose?
A) Haloperidol
B) Mannitol
C) Activated charcoal
D) Calcium carbonate |
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