Controlled Substances and Prescription Drugs > Pharmacology
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Introduction
Total Questions : 9
Showing 9 questions, Sign in for moreA client is prescribed morphine sulfate, a Schedule II medication, for severe postoperative pain. The nurse knows that this medication has which of the following characteristics?
Explanation
Correct answer: b)It can be prescribed by telephone or fax in an emergency.
Rationale: Schedule II medications are those with a high potential for abuse and dependence, but have accepted medical uses. They require a written prescription from a licensed prescriber, except in an emergency situation when a telephone or fax order is allowed. However, the written prescription must follow within 72 hours. Schedule II medications cannot be refilled; a new prescription is required for each dispensing.
Incorrect choices:
a) It can be refilled up to five times within six months.: This is true for Schedule III and IV medications, not Schedule II.
c) It can be obtained without a prescription for medical use.: This is true for Schedule V medications, not Schedule II.
d) It can be dispensed by any healthcare provider.: Only licensed prescribers with a DEA number can prescribe controlled substances.
A nurse is teaching a client who has insomnia about zolpidem, a Schedule IV medication. The nurse should include which of the following information in the teaching?
Explanation
Correct answer: c) The medication should be tapered off gradually to avoid withdrawal symptoms.
Rationale: Zolpidem is a sedative-hypnotic medication that acts on the central nervous system to induce sleep. It has a low potential for abuse and dependence, but it can still cause withdrawal symptoms such as anxiety, insomnia, and seizures if discontinued abruptly. Therefore, the medication should be tapered off gradually under the supervision of a prescriber.
Incorrect choices:
a) The medication should be taken only as needed for sleep.: Zolpidem should be taken regularly as prescribed for short-term treatment of insomnia, not on an as-needed basis.
b) The medication should be taken with food to enhance absorption.: Zolpidem should be taken on an empty stomach to facilitate its onset of action, which is within 15 to 30 minutes.
d) The medication should be avoided if the client has a history of substance abuse.: Although zolpidem has a low potential for abuse and dependence, it can still interact with other substances such as alcohol, opioids, and benzodiazepines, which can increase the risk of respiratory depression and overdose. Therefore, the client should inform the prescriber of any history of substance abuse and use Zolpidem with caution.
A client is admitted to the emergency department with signs of opioid overdose, such as pinpoint pupils, respiratory depression, and altered mental status. The nurse anticipates that the prescriber will order which of the following medications to reverse the effects of the opioid?
Explanation
Correct answer: a) Naloxone
Rationale: Naloxone is an opioid antagonist that binds to opioid receptors and displaces opioids from them, thereby reversing their effects. It is used as an antidote for opioid overdose and can rapidly restore respiration and consciousness.
Incorrect choices:
b) Flumazenil: This is a benzodiazepine antagonist that reverses the effects of benzodiazepines, not opioids.
c) Acetylcysteine: This is an antidote for acetaminophen overdose, not opioid overdose.
d) Physostigmine: This is an antidote for anticholinergic overdose, not opioid overdose.
A nurse is reviewing the medication list of a client who has chronic pain and takes oxycodone, a Schedule II medication, on a regular basis. The nurse should monitor the client for which of the following adverse effects of oxycodone?
Explanation
Correct answer: a) Constipation
Rationale: Oxycodone is an opioid analgesic that acts on the central nervous system to relieve pain. It also has peripheral effects, such as decreasing gastrointestinal motility and secretion, which can cause constipation. The nurse should advise the client to increase fluid and fiber intake, exercise regularly, and use stool softeners or laxatives as needed to prevent or treat constipation.
Incorrect choices:
b) Hypertension: Oxycodone can cause hypotension, not hypertension, due to its vasodilatory effect.
c) Tachycardia: Oxycodone can cause bradycardia, not tachycardia, due to its vagal stimulation effect.
d) Diarrhea: Oxycodone can cause constipation, not diarrhea, due to its decreased gastrointestinal motility and secretion effect.
A client is prescribed diazepam, a Schedule IV medication, for anxiety. The nurse should instruct the client to avoid which of the following substances while taking this medication?
Explanation
Correct answer: a) Grapefruit juice
Rationale: Grapefruit juice can inhibit the metabolism of diazepam, a benzodiazepine that acts on the central nervous system to reduce anxiety and induce sedation. This can increase the blood levels and effects of diazepam, which can lead to excessive sedation, respiratory depression, and overdose. The client should avoid grapefruit juice and other citrus fruits while taking this medication.
Incorrect choices:
b) Milk: Milk does not interact with diazepam and can be consumed safely while taking this medication.
c) Coffee: Coffee does not interact with diazepam and can be consumed safely while taking this medication. However, caffeine can have a stimulant effect that may counteract the sedative effect of diazepam.
d) Water: Water does not interact with diazepam and can be consumed safely while taking this medication. In fact, the client should drink plenty of water to prevent dehydration and maintain renal function.
A nurse is caring for a client who has schizophrenia and takes clozapine, a Schedule V medication. The nurse should monitor the client for which of the following serious adverse effects of clozapine?
Explanation
Correct answer: a) Agranulocytosis
Rationale: Clozapine is an atypical antipsychotic that acts on the central nervous system to reduce psychotic symptoms such as hallucinations, delusions, and paranoia. It also has a low potential for abuse and dependence, which is why it is classified as a Schedule V medication. However, it can cause agranulocytosis, a life-threatening condition characterized by a severe decrease in white blood cells that increases the risk of infection. The nurse should monitor the client's complete blood count (CBC) regularly and report any signs of infection such as fever, sore throat, or mouth ulcers.
Incorrect choices:
b) Stevens-Johnson syndrome: This is a rare but serious skin reaction that can be caused by some medications such as sulfonamides, anticonvulsants, and allopurinol, not clozapine.
c) Torsades de pointes: This is a rare but serious cardiac arrhythmia that can be caused by some medications such as antiarrhythmics, antibiotics, and antidepressants that prolong the QT interval, not clozapine.
d) Rhabdomyolysis: This is a rare but serious condition characterized by muscle breakdown and renal failure that can be caused by some medications such as statins, antipsychotics, and corticosteroids, not clozapine.
A nurse is reviewing the medication list of a client who has chronic pain and is prescribed oxycodone, a controlled substance. Which of the following actions should the nurse take?
Explanation
Correct answer: d) All of the above.
Rationale: The nurse should follow all of these actions to ensure the safe and legal administration of controlled substances. These actions help prevent medication errors, diversion, and misuse of controlled substances.
Incorrect choices:
a) Verify the client's identity using two identifiers before administering the medication.: This is correct but not comprehensive as it does not include other actions that are required for controlled substances.
b) Document the administration of the medication on a separate controlled substance record.: This is correct but not comprehensive as it does not include other actions that are required for controlled substances.
c) Count the remaining tablets of oxycodone with another nurse at the end of each shift.: This is correct but not comprehensive as it does not include other actions that are required for controlled substances.
A client who has insomnia is prescribed zolpidem, a controlled substance, by their primary care provider. The client tells the nurse that they have been taking more than the prescribed dose because they still have trouble falling asleep. Which of the following responses should the nurse make?
Explanation
Correct answer: d) All of the above.
Rationale: The nurse should provide all of these responses to educate the client about the risks and alternatives of taking zolpidem, a controlled substance. Taking more than the prescribed dose can lead to physical and psychological dependence, tolerance, and withdrawal symptoms, which can be dangerous and unpleasant. Changing the medication may be necessary if zolpidem is not effective for the client's insomnia, as there may be other underlying causes or better options for treatment. Trying some nonpharmacological methods can also help improve sleep quality and reduce reliance on medications.
Incorrect choices:
a) "You should not take more than the prescribed dose because it can cause dependence and withdrawal symptoms.": This is correct but not comprehensive as it does not include other responses that are helpful for the client.
b) "You should talk to your provider about changing your medication because zolpidem is not effective for you.": This is correct but not comprehensive as it does not include other responses that are helpful for the client.
c) "You should try some nonpharmacological methods to improve your sleep quality, such as relaxation techniques and avoiding caffeine.": This is correct but not comprehensive as it does not include other responses that are helpful for the client.
A client who has attention-deficit/hyperactivity disorder (ADHD) is prescribed methylphenidate, a controlled substance, by their psychiatrist. The client tells the nurse that they sometimes share their medication with their friends who also have ADHD but do not have a prescription. Which of the following statements should the nurse make?
Explanation
Correct answer: d) All of the above.
Rationale: The nurse should make all of these statements to discourage
the client from sharing their medication with others. Sharing controlled substances with others is illegal and can result in criminal charges, fines, or imprisonment for both parties. It can also cause harm to others who may have different medical conditions, allergies, or interactions with other medications. Methylphenidate is a stimulant that can cause adverse effects such as increased blood pressure, heart rate, anxiety, insomnia, and appetite suppression. It can also be addictive and abused by some people. Therefore, it should only be taken by a person who has a valid prescription and under the supervision of a psychiatrist who can monitor the dosage, effectiveness, and side effects.
Incorrect choices:
a) "Sharing your medication with others is illegal and can result in serious consequences for you and your friends.": This is correct but not comprehensive as it does not include other statements that are important for the client.
b) "Your medication is specifically tailored to your needs and may not be appropriate or safe for others.": This is correct but not comprehensive as it does not include other statements that are important for the client.
c) "Your friends should see a psychiatrist if they have ADHD and need medication treatment.": This is correct but not comprehensive as it does not include other statements that are important for the client.
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