Controlled Substances and Prescription Drugs > Pharmacology
Exam Review
Signs and symptoms
Total Questions : 9
Showing 9 questions, Sign in for moreA nurse is assessing a client who has a history of opioid abuse and is experiencing withdrawal symptoms. Which of the following findings should the nurse expect?
Explanation
Correct answer: a) Hypertension, tachycardia, and diaphoresis
Rationale: Opioid withdrawal symptoms are similar to those of sympathetic nervous system activation and include hypertension, tachycardia, diaphoresis, restlessness, anxiety, muscle aches, nausea, vomiting, and diarrhea.
Incorrect choices:
b) Hypotension, bradycardia, and constipation: These are signs of opioid intoxication or overdose, not withdrawal.
c) Hypothermia, lethargy, and miosis: These are also signs of opioid intoxication or overdose, not withdrawal.
d) Hyperthermia, agitation, and mydriasis: These are signs of stimulant abuse or withdrawal, not opioid withdrawal.
A client is prescribed alprazolam (Xanax) for anxiety disorder. 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 increase the blood levels of alprazolam and other benzodiazepines by inhibiting their metabolism in the liver. This can result in increased sedation, drowsiness, and risk of adverse effects.
Incorrect choices:
b) Green tea: Green tea does not interact with alprazolam or other benzodiazepines.
c) Vitamin C: Vitamin C does not interact with alprazolam or other benzodiazepines.
d) Calcium supplements: Calcium supplements do not interact with alprazolam or other benzodiazepines.
A nurse is caring for a client who has been taking amphetamine (Adderall) for attention-deficit/hyperactivity disorder (ADHD). The client reports insomnia, weight loss, and palpitations. Which of the following actions should the nurse take?
Explanation
Correct answer: d) Notify the provider of the client's symptoms
Rationale: Insomnia, weight loss, and palpitations are common adverse effects of amphetamine and other stimulants. The nurse should notify the provider of these symptoms as they may indicate a need for dosage adjustment or discontinuation of the medication.
Incorrect choices:
a) Advise the client to stop taking the medication immediately: The nurse should not advise the client to stop taking a prescribed medication without consulting with the provider. Abrupt cessation of amphetamine can cause withdrawal symptoms such as fatigue, depression, and irritability.
b) Assess the client for signs of substance abuse: While amphetamine has a high potential for abuse and dependence, these symptoms do not necessarily indicate that the client is abusing the medication. The nurse should assess the client for other signs of substance abuse such as increased tolerance, craving, loss of control, and impaired functioning.
c) Encourage the client to increase fluid and food intake: While increasing fluid and food intake may help with dehydration and malnutrition caused by amphetamine use, this does not address the underlying problem of adverse effects from the medication.
A nurse is reviewing the medication history of a client who is prescribed lithium carbonate (Lithobid) for bipolar disorder. Which of the following medications should alert the nurse to a potential drug interaction?
Explanation
Correct answer: a) Ibuprofen (Advil)
Rationale: Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) can increase the blood levels of lithium by reducing its renal excretion. This can result in lithium toxicity, which can cause nausea, vomiting, tremors, confusion, and seizures.
Incorrect choices:
b) Levothyroxine (Synthroid): Levothyroxine and other thyroid hormones do not interact with lithium.
c) Omeprazole (Prilosec): Omeprazole and other proton pump inhibitors (PPIs) do not interact with lithium.
d) Metformin (Glucophage): Metformin and other antidiabetic drugs do not interact with lithium.
A nurse is teaching a client who is prescribed disulfiram (Antabuse) for alcohol use disorder. Which of the following statements by the client indicates an understanding of the teaching?
Explanation
Correct answer: b) "I should avoid using mouthwash that contains alcohol."
Rationale: Disulfiram works by inhibiting the enzyme that metabolizes alcohol, causing a buildup of acetaldehyde in the body. This produces a severe reaction when alcohol is consumed, which includes flushing, headache, nausea, vomiting, chest pain, and hypotension. The reaction can occur even with small amounts of alcohol found in mouthwash, cough syrup, perfume, or food.
Incorrect choices:
a) "I can drink alcohol as long as I skip the dose of disulfiram.": This is incorrect as the effects of disulfiram can last for up to two weeks after the last dose. The client should abstain from alcohol completely while taking disulfiram and for at least 14 days after stopping the medication.
c) "I will experience euphoria if I drink alcohol while taking disulfiram.": This is incorrect as the reaction caused by disulfiram and alcohol is unpleasant and aversive, not euphoric. The purpose of disulfiram is to deter the client from drinking alcohol by creating a negative association.
d) "I can stop taking disulfiram once I have been sober for a month.": This is incorrect as disulfiram is not a cure for alcohol use disorder, but a tool to help the client maintain sobriety. The client should continue taking disulfiram as prescribed by the provider and participate in other forms of treatment such as counseling, support groups, and relapse prevention.
A nurse is planning care for a client who has a benzodiazepine overdose. Which of the following interventions should the nurse include in the plan?
Explanation
Correct answer: b) Administer flumazenil (Romazicon)
Rationale: Flumazenil is an antidote for benzodiazepine overdose that works by blocking the benzodiazepine receptors in the brain. It can reverse the effects of benzodiazepines such as sedation, respiratory depression, and coma.
Incorrect choices:
a) Administer naloxone (Narcan): Naloxone is an antidote for opioid overdose that works by displacing opioids from their receptors in the brain. It has no effect on benzodiazepines or their receptors.
c) Administer activated charcoal: Activated charcoal is a substance that binds to drugs or toxins in the gastrointestinal tract and prevents their absorption into the bloodstream. It may be useful for some cases of drug overdose, but it is not effective for benzodiazepines as they are rapidly absorbed and distributed in the body.
d) Administer acetylcysteine (Mucomyst): Acetylcysteine is an antidote for acetaminophen overdose that works by replenishing glutathione, a substance that helps detoxify acetaminophen in the liver. It has no effect on benzodiazepines or their metabolism.
A nurse is assessing a client who has been prescribed oxycodone for chronic pain. Which of the following signs and symptoms should alert the nurse to possible prescription drug abuse?
Explanation
Correct answer: b) Drowsiness and respiratory depression
Rationale: Drowsiness and respiratory depression are signs of opioid overdose and indicate that the client is taking more than the prescribed dose or combining oxycodone with other depressants. The nurse should monitor the client's vital signs, administer naloxone if indicated, and report the situation to the prescriber.
Incorrect choices:
a) Constipation and dry mouth: These are common side effects of opioids and do not necessarily indicate abuse.
c) Nausea and vomiting: These are also common side effects of opioids and can be managed with antiemetics.
d) Pupillary constriction and itching: These are also common side effects of opioids and do not necessarily indicate abuse.
A client is admitted to the emergency department with signs of stimulant intoxication. The client reports taking amphetamines prescribed by a friend for weight loss. Which of the following findings should the nurse expect?
Explanation
Correct answer: b) Agitation and paranoia
Rationale: Agitation and paranoia are signs of stimulant intoxication and indicate that the client is experiencing a psychotic reaction to amphetamines. The nurse should provide a calm and safe environment, administer antipsychotics if ordered, and monitor the client for violence or self-harm.
Incorrect choices:
a) Hypotension and bradycardia: These are signs of depressant intoxication and indicate that the client is taking sedatives, opioids, or alcohol.
c) Slurred speech and ataxia: These are signs of depressant intoxication and indicate that the client is taking sedatives, opioids, or alcohol.
d) Sedation and respiratory depression: These are signs of depressant intoxication and indicate that the client is taking sedatives, opioids, or alcohol.
A nurse is caring for a client who has been prescribed benzodiazepines for anxiety disorder. The client tells the nurse that they have been taking more than the prescribed dose because they feel more anxious lately. Which of the following actions should the nurse take?
Explanation
Correct answer: c) Educate the client about the risks of benzodiazepine dependence and withdrawal
Rationale: Taking more than the prescribed dose of benzodiazepines can lead to physical and psychological dependence, tolerance, and withdrawal symptoms. The nurse should educate the client about these risks and advise them to consult with their prescriber before making any changes to their medication regimen.
Incorrect choices:
a) Encourage the client to continue taking benzodiazepines as needed: This can worsen the client's dependence, tolerance, and withdrawal symptoms.
b) Advise the client to stop taking benzodiazepines abruptly: This can cause severe withdrawal symptoms such as seizures, delirium, or death.
d) Suggest alternative therapies for anxiety such as meditation or exercise: While these therapies can be helpful for anxiety management, they are not a substitute for medication therapy for clients who have been prescribed benzodiazepines.
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