Controlled Substances and Prescription Drugs > Pharmacology
Exam Review
Causes and risk factors
Total Questions : 6
Showing 6 questions, Sign in for moreA nurse is assessing a client who has a history of prescription drug abuse. Which of the following findings is a possible indicator of opioid misuse?
Explanation
Correct answer: a) Constricted pupils
Rationale: Opioids are central nervous system depressants that can cause miosis (constricted pupils), respiratory depression, bradycardia, hypotension, and sedation.
Incorrect choices:
b) Tachycardia: This is a sign of sympathetic stimulation, which can be caused by stimulants, withdrawal, or anxiety.
c) Hypertension: This is also a sign of sympathetic stimulation, which can be caused by stimulants, withdrawal, or anxiety.
d) Agitation: This is a sign of psychological distress, which can be caused by stimulants, withdrawal, or anxiety.
A client is prescribed methylphenidate for attention-deficit/hyperactivity disorder (ADHD). The client tells the nurse that they sometimes take more than the prescribed dose to study for exams. What is the nurse's best response?
Explanation
Correct answer: a) "You should not take more than the prescribed dose because it can cause serious side effects."
Rationale: Methylphenidate is a stimulant that can increase alertness, attention, and energy. However, taking more than the prescribed dose can cause adverse effects such as insomnia, anxiety, palpitations, hypertension, psychosis, and seizures.
Incorrect choices:
b) "You should talk to your doctor about adjusting your dose if you feel that it is not effective.": This may encourage the client to continue misusing the medication and may not address the underlying causes of their academic difficulties.
c) "You should stop taking this medication because it is addictive and can lead to dependence.": This may discourage the client from adhering to their treatment plan and may not acknowledge the benefits of the medication for their condition.
d) "You should use other strategies to improve your concentration and memory, such as exercise and meditation.": This may imply that the medication is unnecessary or ineffective and may not address the risks of misusing the medication.
A nurse is caring for a client who has chronic pain and is prescribed oxycodone. The client reports that they have been taking more than the prescribed dose because their pain is not well controlled. Which of the following actions should the nurse take first?
Explanation
Correct answer: a) Assess the client's pain level and quality
Rationale: The first action the nurse should take when using the nursing process is to assess the client's condition. By assessing the client's pain level and quality, the nurse can determine the possible causes of their inadequate pain relief and plan appropriate interventions.
Incorrect choices:
b) Educate the client about the dangers of opioid overdose: This is an important action, but not the first one. The nurse should first assess the client's pain before providing education.
c) Refer the client to a pain management specialist: This may be a helpful action, but not the first one. The nurse should first assess the client's pain and collaborate with the prescriber before making referrals.
d) Notify the prescriber about the client's medication misuse: This is an essential action, but not the first one. The nurse should first assess the client's pain and communicate their findings to the prescriber.
A nurse is reviewing the medication history of a client who has insomnia. The client reports that they have been taking Zolpidem for several months and that they sometimes take an extra pill if they wake up during the night. Which of the following statements by the nurse is appropriate?
Explanation
Correct answer: a) "You should not take more than one pill per night because it can impair your memory and coordination."
Rationale: Zolpidem is a hypnotic that can help with falling asleep and staying asleep. However, taking more than the recommended dose can cause adverse effects such as anterograde amnesia, impaired motor skills, and increased risk of falls and injuries.
Incorrect choices:
b) "You should switch to a different medication because zolpidem is not effective for long-term use.": This may not be necessary or appropriate for the client, as zolpidem may still be beneficial for their condition. The nurse should not suggest changing the medication without consulting the prescriber.
c) "You should try to avoid taking zolpidem because it can cause dependence and withdrawal symptoms.": This may not be realistic or helpful for the client, as zolpidem may be prescribed for a legitimate reason and may not cause dependence or withdrawal if used as directed.
d) "You should consult your doctor about reducing your dose because zolpidem can cause rebound insomnia.": This may not be relevant or accurate for the client, as rebound insomnia is more likely to occur with abrupt discontinuation of zolpidem rather than gradual dose reduction.
A nurse is teaching a group of clients about the safe use of prescription drugs. Which of the following information should the nurse include in the teaching? (Select all that apply.)
Explanation
Correct answers:
a) Store prescription drugs in a secure place away from children and pets;
d) Follow the directions on the prescription label and do not adjust the dose without
consulting the prescriber;
e) Inform the prescriber and pharmacist about any allergies or other medications being
taken
Rationale: These are examples of safe practices that can prevent prescription drug misuse, abuse, diversion, and adverse reactions.
Incorrect choices:
b) Dispose of unused or expired prescription drugs in the trash or toilet: This is not a safe practice, as it can pose environmental and health hazards. The nurse should advise the clients to follow the FDA guidelines for proper disposal of prescription drugs, such as using drug take-back programs or mixing them with unpalatable substances before throwing them away in a sealed container.
c) Share prescription drugs with family or friends who have similar symptoms: This is not a safe practice, as it can lead to inappropriate use, overdose, interactions, or allergic reactions. The nurse should emphasize that prescription drugs are intended for individual use only and that self-medication or medication borrowing is dangerous.
A client is admitted to the emergency department with signs of benzodiazepine overdose, such as slurred speech, confusion, and respiratory depression. The client's family reports that the client has been taking alprazolam for anxiety and has recently increased their dose due to stress. Which of the following medications should the nurse anticipate administering to reverse the effects of benzodiazepine overdose?
Explanation
Correct answer: b) Flumazenil
Rationale: Flumazenil is an antidote that can reverse the central nervous system depression caused by benzodiazepines by antagonizing their binding to GABA receptors.
Incorrect choices:
a) Naloxone: This is an antidote that can reverse the respiratory depression caused by opioids by antagonizing their binding to opioid receptors.
c) Acetylcysteine: This is an antidote that can prevent liver damage caused by acetaminophen overdose by replenishing glutathione levels.
d) Physostigmine: This is an antidote that can reverse the anticholinergic effects caused by atropine overdose by inhibiting acetylcholinesterase activity.
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