ATI Modules Case Study & Quiz Questions_ Pharmacology Made Easy 4.0_ 2023.

Tutorial:Pharmacology Made Easy 4.0 Module:The Neurological System (Part 1) Case Study Questions #1: 1. Which of the following assessments of this client is most important immediately following the administration of intravenous diazepam? A. ECG B. Seizure Activity C. Blood Pressure D. Respiratory Rate 2. The healthcare professional is about to administer a loading dose of phenytoin IV. Which of the following is essential for the health care professional to do before administering phenytoin IV? A. Protect the phenytoin solution from light. B. Make sure the phenytoin solution is cloudy. C. Mix phenytoin with a dextrose solution. D. Infuse phenytoin slowly. 3. The health care professional is now assessing the client. Which of the following findings can be an early indication of phenytoin toxicity? A. Nystagmus B. Tachycardia C. Tachypnea D. Jaundice 4. The healthcare professional is talking with the client, who is soon to be discharged to home, about the adverse effects of phenytoin. Which of the following instructions may help minimize the adverse effects of phenytoin? A. Use good oral hygiene. B. Take the drug on an empty stomach. C. Use sunblock when outdoors. D. Decrease dietary fiber. 5. The client is taking oral contraceptives for birth control. Which of the following instructions should the health care professional include? A. It is safe to discontinue birth control while taking phenytoin. B. Additional birth control methods may be needed. C. Oral contraceptives may increase the risk for phenytoin toxicity. D. Oral contraceptives may reduce the effectiveness of phenytoin. Case Study Questions #2: 1. Which laboratory tests should you monitor for a client who is taking interferon beta-1b to treat multiple sclerosis? (Select all that apply.) A. Serum osmolality B. Blood glucose C. Thyroid hormones D. Liver function E. CBC ● Interferon beta-1b, an immunosuppressant, may cause hepatotoxicity and myelosuppression. Minot liver studies and CBC. The client should undergo thyroid function testing every 6 months 2. While obtaining a client's medical history, you find that the client is taking levodopa/carbidopa for Parkinson's disease. Which information in the client's health history alerts you to take further action? A. BradycardiaB. Pancreatic disease C. Glaucoma D. Impaired hearing ● The combination of levodopa and carbidopa, both dopamine-replacement drugs, can cause changes in intraocular pressure. 3. At a visit to the provider's office, an older adult client's partner reports that the client has nausea, diarrhea, and a loss of appetite. He has a history of Alzheimer's disease and is taking donepezil. Which information should be provided by the nurse? A. Take the drug with food. B. Stop taking the drug right away. C. Take a reduced dosage of the drug. D. Undergo liver function tests right away. 4. You are instructing a client who has multiple sclerosis about how dantrolene will help control spasticity. With which mechanism is this drug effective in treating this manifestation? A. Blocks acetylcholine at the neuromuscular junction B. Interrupts nerve signals from the spinal cord to the muscles C. Inhibits destruction of acetylcholine by acetylcholinesterase D. Alters intracellular calcium exchange at the muscles 5. You are caring for a client who is preoperative and is NPO. Theclient takes carbamazepine, 200 mg PO BID for a seizure disorder. Which action should the nurse take? A. Give the oral dose of carbamazepine with a sip of water. B. Give carbamazepine IV. C. Withhold the carbamazepine. D. Administer half the usual morning dose of carbamazepine 6. You are instructing a school-age child and his parent about the use of amphetamine-dextroamphetamine to manage the child's attention-deficit/hyperactivity disorder. Which clinical manifestations should the nurse instruct the parent to report? (Select all that apply.) A. Weight loss B. Insomnia C. Hallucinations D. Orthostatic hypotension E. Flu-like symptoms 7. Drag the drug classification in the left column to match it with its therapeutic use in the right column. ● Hydantoin: Controls seizures ● Immunomodulator: Reduces symptoms of multiple sclerosis ● Dopamine receptor agonist: Reduces the effects of Parkinson's disease ● Cholinesterase inhibitor: Helps minimize symptoms of Alzheimer's disease 8. A primary care provider prescribes sumatriptan to treat a client's migraine headaches. Which instructions should the nurse include when telling the client how to take sumatriptan? (Select all that apply.) A. Take the drug after onset of the migraine. B. Administer one nasal spray into each nostril. C. Take it once per day to prevent migraine. D. Repeat the dose once if the headache returns. E. Allow the tablet to dissolve under the tongue. 9. A client receives spinal anesthesia with lidocaine and epinephrine. You explain that epinephrine is used with lidocaine for which of the following reasons?A. Decreases the risk for a spinal headache B. Reduces the risk for infection C. Prolongs the anesthetic effects D. Prevents respiratory depression 10. Drag the drug in the left column to match it with its therapeutic use in the right column. ● Fentanyl: Anesthesia or cancer pain management ● Amphetamine/dextroamphetamine sulfate: Attention-deficit/hyperactivity disorder ● Dantrolene: Malignant hyperthermia ● Baclofen: Muscle spasms Pharmacology Made Easy 4.0 The Neurological System (Part 1) Quiz: 1. A nurse is caring for a client who has a new prescription for amphetamine sulfate. The nurse should monitor the client for which of the following adverse effects? A. Hypotension B. Tinnitus C. Tachycardia D. Bronchospasm ● Amphetamine sulfate is an amphetamine stimulant. It can cause tachycardia and dysrhythmias. The client should notify the nurse if they develop palpitations or chest pain. 2. A nurse is caring for a client who has been taking selegiline to treat Parkinson's disease. The provider is considering the use of analgesics for the client but should be aware that a drug interaction between selegiline and meperidine can result in which of the following? A. Frequent urination B. Jaundice C. Cellulitis D. Muscle rigidity ● A drug interaction between selegiline and opioids, especially meperidine, can result in rigidity, stupor, agitation, hypertension, and fever. 3. A nurse is preparing to administer sumatriptan to a client for the first time. The nurse should instruct the client that sumatriptan is indicated for which of the following conditions? A. Tonic-clonic seizures B. Presence of a migraine headache C. Exacerbation of multiple sclerosis D. Alzheimer's disease ● Sumatriptan is used in the treatment of migraine headaches. 4. A nurse is teaching the family of a client who has a new diagnosis of Alzheimer's disease about donepezil. Which of the following information should the nurse include? 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. ● Combining NSAIDs with donepezil can cause gastrointestinal bleeding. Therefore, the nurse should instruct the client's family to avoid the use of NSAIDs. 5. A nurse is teaching a client who has a prescription for baclofen. Which of the following instructions should the nurse include? A. Avoid driving until the drug's effects are evident. B. Stop taking the drug immediately if headache occurs. C. Take the drug as needed for spasticity. D. Take the drug with antacids to reduce gastric effects.● Baclofen, a centrally-acting muscle relaxant, causes CNS depression. Clients taking the drug should avoid alcohol and other CNS depressants, and should not drive a vehicle until they know how the drug will affect them. 6. A nurse is teaching a client who has a prescription for modafinil to treat narcolepsy. Which of the following instructions should the nurse include? A. Take the drug in the morning. B. Take the drug 30 min before bedtime. C. Anticipate daytime drowsiness. D. Expect urinary frequency. ● Modafinil is a nonamphetamine stimulant. Taking it in the morning helps improve wakefulness for clients who have narcolepsy. Clients taking the drug for shift-work sleepiness should take it 1 hr before work. 7. A nurse is teaching a client about interferon beta-1a. Which of the following instructions should the nurse give to help the client avoid the adverse effects of this drug? A. "Premedicate with acetaminophen." B. "Take the drug with food." C. "Increase your fluid intake." D. "Take the drug in the morning." ● Interferon beta drugs can cause fever, chills, headaches, and muscle aches. Acetaminophen can help minimize these symptoms. 8. A nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle 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 ● Prolonged diarrhea can cause dehydration and other serious effects. Diarrhea, nausea, and vomiting are adverse effects of dantrolene. The client should report these effects so the nurse can monitor fluid balance and intervene accordingly. 9. A nurse is teaching a client who has a prescription for carbamazepine. Which of the following instructions should the nurse include to help the client avoid adverse effects of this drug? A. Begin taking the drug at a low dosage. B. Discontinue the drug immediately if diarrhea occurs. C. Have serum glucose levels checked regularly. D. Take the drug on an empty stomach. ● Visual disturbances, vertigo, and ataxia can result from taking carbamazepine, a drug that treats seizure disorders. Dosages should be low to minimize or prevent these adverse effects. 10. A nurse is caring for a client who is receiving methohexital sodium. The nurse should monitor the client for which of the following adverse effects? A. Cardiac excitability B. Respiratory depression C. Hyperthermia D. Hypertension ● Methohexital, a short-acting barbiturate, causes respiratory depression. Mechanical ventilation and continuous monitoring are essential for clients receiving the drug. 11. A nurse is teaching a client who has Alzheimer's disease and their caregiver about memantine. Which of the following instructions should the nurse include? A. Increase fluid intake to improve renal excretion.B. Report memory loss or confusion. C. Watch for signs of liver impairment, such as jaundice and abdominal pain. D. Avoid taking over-the-counter antacids. ● Antacids that contain sodium bicarbonate increase urine alkalinity and can decrease drug excretion, ultimately leading to toxicity. 12. A nurse is caring for a client who is taking donepezil to treat Alzheimer's disease. For which of the following adverse effects should the nurse monitor? A. Confusion B. Dry mouth C. Nausea D. Double vision ● The most common adverse effects of donepezil, a cholinesterase inhibitor, are nausea, vomiting, and diarrhea. Taking donepezil with food can help minimize adverse effects. 13. 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 ● Valproic acid can cause hepatic toxicity, characterized by jaundice, abdominal pain, and nausea. Clients taking the drug should report these manifestations, and the nurse should monitor liver function studies prior to treatment and periodically during therapy. 14. A nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle spasms. The nurse should identify that which of the following laboratory tests requires monitoring? A. Serum potassium B. Liver function C. Serum sodium D. Thyroid function ● Liver toxicity is a serious adverse effect of dantrolene. The nurse should monitor the client's liver function prior to treatment and at regular intervals and advise the client to report jaundice or abdominal pain. 15. 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. ● Levodopa/carbidopa can cause orthostatic hypotension. 16. A nurse is teaching 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. (Select all that apply.) A. Hirsutism B. Drowsiness C. Headache D. Ataxia E. Rash ● Drowsiness is correct. Clients taking valproic acid should report CNS depressant effects, such as sedation or drowsiness, because these adverse effects can indicate the need for a reduction in dose.● Headache is correct. Valproic acid can cause headache, along with other CNS adverse effects, such as sleep disturbances. ● Rash is correct. Skin rash is an adverse effect of valproic acid and other antiepileptic drugs. 17. A nurse is caring for a client who has been taking amphetamine/dextroamphetamine sulfate for the treatment of attention deficit hyperactivity disorder (ADHD) for 2 weeks. The nurse should report which of the following findings to the provider? A. Weight loss of 2.3 kg (5 lb) B. BP 110/70 mm Hg C. Apical pulse 80/min D. Respiratory rate 16/min ● Amphetamine/dextroamphetamine sulfate can cause a decreased appetite and weight loss. The nurse should instruct the client to weigh themself twice weekly and report unintended weight loss. 18. A nurse is reviewing the medical record of a client who has a newly diagnosed seizure disorder and a new prescription for valproic acid and phenytoin. The nurse should identify that which of the following can occur as a result of an interaction between these drugs? A. Hyperammonemia B. Phenytoin toxicity C. Hypertension D. Peptic ulcer disease ● Valproic acid can cause an increase in phenytoin blood levels, resulting in phenytoin toxicity. The nurse should monitor serum phenytoin levels and notify the provider if levels begin to exceed the therapeutic range. 19. A nurse is teaching a client who is about to begin sumatriptan therapy to treat migraine headaches. The nurse should instruct the client to monitor for which of the following adverse effects? A. Chest pain B. Polyuria C. Joint pain D. Insomnia ● Sumatriptan, a serotonin agonist, can cause coronary vasospasm and chest pain. Clients should report any pressure, pain, or tightness in the jaw, chest, or back. Sumatriptan is not an appropriate choice for clients who have a history of coronary artery disease. 20. A nurse is teaching a client who has a new diagnosis of Parkinson's disease about how levodopa/carbidopa can help control symptoms. The nurse should identify that the drug has which of the following pharmacologic effects? 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 ● Levodopa/carbidopa, a dopaminergic agent, can increase dopamine in the extrapyramidal center of the brain, reducing involuntary motion, or tremors, associated with Parkinson's disease. 21. A nurse is caring for a client who has a new prescription for pramipexole to treat Parkinson's disease. The nurse should recognize that which of the following laboratory tests requires monitoring? A. C-reactive protein B. Creatinine clearance C. Thyroid function D. CBC ● Pramipexole, a direct-acting dopamine receptor agonist, should be used with caution for clients who have renal disease. Therefore, the nurse should monitor the client's renal function.22. A nurse is preparing to administer memantine to a client who has Alzheimer's disease. Which of the following findings in the client's medical history indicates a need to withhold the drug and notify the provider? A. Pancreatic cancer B. Hypotension C. Cirrhosis D. Osteoporosis ● Memantine should be used cautiously in clients who have severe hepatic impairment. The nurse should contact the provider about the client's history of cirrhosis to see if laboratory testing is required before starting the drug or if the dosage needs to be adjusted.Memantine should be used cautiously in clients who have severe hepatic impairment. The nurse should contact the provider about the client's history of cirrhosis to see if laboratory testing is required before starting the drug or if the dosage needs to be adjusted. 23. A nurse is caring for a client who is taking interferon beta-1b. The nurse should identify that which of the following findings indicates a potential serious adverse effect of this drug? A. Tinnitus B. Twitching eyelids C. Blue-green skin discoloration D. Fatigue ● The nurse should identify that potential serious adverse effects of interferon beta-1b include unexplained bruising, bleeding, and fatigue. Clients should report these adverse effects to their provider immediately because they can indicate bone marrow suppression and decreased platelet count. 24. A nurse is administering fentanyl to a client to reduce pain. Which of the following drugs should the nurse have available to reverse the effects of fentanyl? A. Neostigmine B. Succinylcholine C. Naloxone D. Dantrolene ● Naloxone is an opioid antagonist that reverses the effects of opioids. Fentanyl, an opioid agonist, can cause severe respiratory depression. The nurse should also have resuscitation equipment available when administering fentanyl to a client. 25. A nurse is teaching a client who received a prescription for interferon beta-1a for the treatment 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." ● Interferon beta-1a is administered via the subcutaneous route. Therefore, the nurse should instruct the client how to perform subcutaneous injections for self-administration. Tutorial:Pharmacology Made Easy 4.0 Module:The Neurological System (Part 2) Case Study Questions #1: 1. Which of the following drug classifications is the first line of therapy for treating open-angle glaucoma? A. Glucocorticoids B. Beta blockers C. Anticholinergic agents D. Mast cell stabilizers2. Which of the following drugs, used to treat open-angle glaucoma, should primary care providers use with caution for a client who is taking propranolol? A. Betaxolol B. Latanoprost C. Pilocarpine D. Echothiophate 3. The primary care provider prescribes pilocarpine for the client. Which of the following information should he include when instructing the client about instilling pilocarpine eye drops? A. Apply gentle pressure to the nasolacrimal duct after instillation. B. Massage the eyelid after instillation. C. Cover the eye with a patch after instillation. D. Blink rapidly to disperse the eye drops after instillation. 4. The primary care provider continues to instruct the client about using pilocarpine. He tells the client to watch for and report which of the following adverse effects of this drug? (Select all that apply.) A. Blurred vision B. Headache C. Visual floaters D. Dilated pupils E. Tachycardia 5. The client returns to the primary care provider after 1 week. He is sweating and reports urinary urgency. He suspects systemic effects from the pilocarpine. Which of the following drugs can reverse systemic toxicity from pilocarpine? A. Flumazenil B. Protamine sulfate C. Naloxone D. Atropine sulfate Case Study #2 Questions: 1. A client is to start taking amitriptyline. For which of the following should you instruct the client to watch for and report? (Select all that apply.) A. Blurred vision B. Urinary hesitancy C. Diarrhea D. Joint pain E. Tachycardia 2. Early clinical manifestations of lithium toxicity include which of the following? (Select all that apply.) A. Seizures B. Nausea C. Hypotension D. Ataxia E. Muscle weakness 3. During an assessment of a client taking chlorpromazine, you note a slow shuffling gait, rigid facial expression, and fine tremors. These manifestations indicate which of the following? A. Acute dystonia B. Tardive dyskinesia C. Parkinsonism D. Akathisia4. Which of the following drugs blocks beta-adrenergic receptors and thereby decreases intraocular pressure (IP) by reducing the amount of aqueous humor produced? A. Betaxolol B. Pilocarpine C. Latanoprost D. Acetazolamide 5. Match the drug classification in the left column with its therapeutic use in the right column. ● Benzodiazepines: Anxiety disorders ● Cholinergic agonists: ● Glaucoma Antipsychotics: Schizophrenia ● Monoamine oxidase inhibitors: Depression 6. You are instructing a client about taking phenelzine to treat depression. Which of the following foods should you tell the client to avoid? A. Aged cheese B. Milk C. Potato chips D. Candy 7. A client is taking risperidone for schizophrenia. Recognizing the adverse effects of risperidone, you advise the client to watch for and report which of the following? A. Tremor B. Weight loss C. Oral ulcers D. Bronchospasm 8. A client is taking venlafaxine to treat major depression. Which of the following instructions should you include when advising the client and family about the use of venlafaxine? (Select all that apply.) A. Discontinue it immediately for increased depression. B. Take it with food to reduce gastric disturbances. C. Monitor and report insomnia. D. Have blood pressure checked regularly. E. Check with the primary care provider before taking any herbal supplements. 9. Match the drug classification in the left column with its therapeutic use in the right column. ● Lithium carbonate: Controls manic episodes ● Venlafaxine: Reduces depression ● Betaxolol: Reduces intraocular pressure ● Risperidone: Treats schizophrenia 10. When instructing a client about taking buspirone, you tell the client to watch for and report a paradoxical reaction to buspirone. Which of the following is a paradoxical effect of buspirone? A. Chest pain B. Insomnia C. Diaphoresis D. Fever Pharmacology Made Easy 4.0 The Neurological System (Part 2) Quiz: 1. A nurse is providing teaching to a client who has a new prescription for fluoxetine. Which of the following instructions should the nurse include? A. "Weigh yourself twice a month."B. "If you have persistent headaches, let the provider know." C. "Reduce your daily sodium intake." D. "If your symptoms don't improve in 10 days, you will need a higher dosage." ● The client should report persistent headache, anxiety, or insomnia to the provider as an adverse drug reaction. 2. When reviewing the indications for various antidepressants, a nurse should identify that bupropion hydrochloride is an appropriate choice for clients who have which of the following? (Select all that apply.) A. Motion sickness B. Seasonal affective disorder C. Insomnia D. Nicotine addiction E. Depression ● Seasonal affective disorder is correct. Bupropion, an atypical antidepressant, helps prevent and treat seasonal affective disorder, a type of depression associated with the reduction of natural light during winter months. ● Nicotine addiction is correct. Bupropion, an atypical antidepressant, is an appropriate adjunct for clients who are trying to quit smoking. ● Depression is correct. Bupropion, an atypical antidepressant, can help treat depression. 3. A nurse is caring for a client who has a prescription for alprazolam. For which of the following adverse effects should the nurse monitor? (Select all that apply.) A. Tolerance B. Anxiety C. Sedation D. Respiratory depression E. Constipation ● Tolerance is correct. Tolerance and dependence can develop with benzodiazepines, such as alprazolam. Clients should use these drugs only as needed and for short periods of time. ● Anxiety is correct. Paradoxical reactions, such as anxiety and insomnia, can develop when taking alprazolam, especially in older adults. Clients should report these findings. ● Sedation is correct. CNS depression, manifested as sedation and drowsiness, is an adverse effect of benzodiazepines, such as alprazolam. Clients should take a benzodiazepine 30 min prior to bedtime. ● Respiratory depression is correct. Benzodiazepines, such as alprazolam, can cause CNS depression when taken with other CNS depressants, especially for older adult clients. It is important to monitor for respiratory depression and recommend the lowest effective dose. Clients should avoid alcohol and other CNS depressants while taking a benzodiazepine. 4. A nurse is caring for a client who has been taking alprazolam for an extended period of time to treat anxiety. The nurse should identify that abruptly stopping alprazolam therapy can result in which of the following adverse effects? A. Anterograde amnesia B. Respiratory depression C. Paradoxical reaction D. Withdrawal symptoms ● Physical dependence can develop with extended use of alprazolam, a benzodiazepine. To prevent withdrawal symptoms, clients should taper the dose slowly over several weeks. 5. A nurse is providing teaching for a client who has a prescription for phenelzine. The nurse should instruct the client to avoid tyramine-enriched foods because of an increased risk for which of the following adverse reactions? A. Respiratory depression B. Hypertensive crisisC. Neuroleptic malignant syndrome D. Serotonin syndrome ● Tyramine-enriched foods, such as aged cheese and processed meat, can trigger severe hypertension in clients who are taking phenelzine. Manifestations include hypertension, headache, and nausea. 6. A nurse is caring for a client who was admitted to the emergency department with a head injury. The nurse notes that the client has an existing prescription for bupropion hydrochloride to treat depression. For which of the following adverse effects is the client at increased risk? A. Ischemic stroke B. Drowsiness C. Respiratory depression D. Seizure activity ● Bupropion, an atypical antidepressant, can cause seizure activity when clients take high doses or have a seizure disorder, a CNS tumor, or a history of head trauma. 7. A nurse is caring for a client who is about to begin taking lithium carbonate to treat bipolar disorder. The nurse should instruct the client to monitor for which of the following findings as indications of lithium toxicity? (Select all that apply.) A. Tremors B. Confusion C. Bronchospasm D. Nausea E. Muscle weakness ● Tremors is correct. A fine hand tremor is an early indication of lithium toxicity. A coarse tremor indicates advanced toxicity that can lead to seizure activity. ● Confusion is correct. Confusion, slurred speech, and ataxia are indications of lithium toxicity that develop because of the drug's narrow therapeutic range. ● Nausea is correct. Nausea, vomiting, and diarrhea are early indications of lithium toxicity that develop because of the drug's narrow therapeutic range. Clients should report any of these adverse effects. ● Muscle weakness is correct. Muscle weakness is an early indication of lithium toxicity that develops because of the drug's narrow therapeutic range. The nurse should monitor lithium levels periodically. 8. A nurse is reviewing the medical history of a client who has a new prescription for a reduced dosage of alprazolam for anxiety. Which of the following findings should indicate to the nurse the reason for the prescription modification? A. Renal function impairment B. Cataracts C. Recent weight loss D. Smoking ● Alprazolam dosage should be decreased for clients who have renal or hepatic impairment. 9. A nurse is providing teaching to a client who is about to begin amitriptyline therapy to treat major depressive disorder. Which of the following instructions should the nurse include? (Select all that apply.) A. Change positions slowly from sitting or lying to standing. B. Do not stop taking the drug abruptly. C. Avoid crushing the tablet. D. Take the drug at bedtime to prevent daytime drowsiness. E. Increase fiber and fluid intake. ● Change positions slowly from sitting or lying to standing is correct. Amitriptyline, a tricyclic antidepressant, can cause orthostatic hypotension. Clients should move slowly from sitting or lying to standing.● Do not stop taking the drug abruptly is correct. Relapse and withdrawal symptoms can occur with abrupt discontinuation of amitriptyline. When discontinuing the drug, it is important to reduce the dosage over a 2-week period to prevent or minimize withdrawal symptoms. ● Take the drug at bedtime to prevent daytime drowsiness is correct. Amitriptyline, a tricyclic antidepressant, can cause drowsiness. Clients should take the drug at bedtime and avoid activities that require alertness until they know how the drug will affect them. ● Increase fiber and fluid intake is correct. Amitriptyline, a tricyclic antidepressant, causes anticholinergic effects, such as dry mouth, constipation, and urinary retention. Clients should increase fiber and fluid intake during drug therapy and urinate before taking the drug. 10. A nurse is caring for a client who recently began taking chlorpromazine to treat schizophrenia and who was admitted to the emergency room with spasms of their face and back. Which of the following adverse reactions should the nurse suspect? A. Cholinergic crisis B. Serotonin syndrome C. Stevens-Johnson syndrome D. Acute dystonia ● Acute dystonia can develop during the first few days of treatment with chlorpromazine. Manifestations include muscle spasms of the back, neck, face, and tongue. Treatment includes immediate administration of an anticholinergic drug, such as diphenhydramine. 11. A nurse is providing teaching to a client who has a prescription for chlorpromazine. Which of the following instructions should the nurse include? A. Stop taking the drug immediately with the first sign of a sore throat. B. Wear sunscreen when exposed to sunlight. C. Take the drug with food to reduce gastrointestinal distress. D. Take the drug in the morning to prevent nocturia. ● Chlorpromazine, a conventional antipsychotic, can cause photosensitivity, or increased susceptibility to sunburn, when exposed to sunlight. Clients should limit their exposure to sunlight and wear sunscreen and protective clothing while outdoors. 12. A nurse is reviewing the drug history of a client who is taking lithium carbonate for bipolar disorder. Which of the following findings should indicate to the nurse to monitor for lithium toxicity? A. Furosemide for hypertension B. Acetaminophen for headaches C. Ciprofloxacin for a urinary tract infection D. Montelukast for asthma ● Furosemide, a high-ceiling loop diuretic, increases sodium loss and can cause lithium reabsorption. The nurse should evaluate the client for lithium toxicity. 13. A nurse is providing teaching to a client about instilling pilocarpine for managing open-angle glaucoma. Which of the following instructions should the nurse include in the teaching? (Select all that apply.) A. Apply gentle pressure to the nasolacrimal duct for 1 min after instilling the drops. B. Do not touch the tip of the dropper. C. Wash hands after instilling the drops. D. Rub eyes gently after instilling the drops. E. Remove contact lenses prior to instilling the drops. ● Apply gentle pressure to the nasolacrimal duct for 1 min after instilling the drops is correct. ● Applying gentle pressure to the nasolacrimal duct for 1 to 2 min after instillation helps keep the drug from entering the systemic circulation. ● Remove contact lenses prior to instilling the drops is correct. Clients should remove contact lenses before instilling eye drops because they can cause further irritation if left in place.14. A nurse is providing teaching to a client who has a prescription for buspirone. Which of the following instructions should the nurse include? A. Take the drug with grapefruit juice to increase absorption. B. Use the drug as needed for anxiety. C. Allow 2 to 4 weeks for full therapeutic effects. D. Take the drug on an empty stomach. ● It can take up to 4 weeks for a client to feel the drug's full therapeutic effects. 15. A nurse is providing teaching to a client who has a prescription for lithium carbonate about reducing the risk for lithium toxicity. Which of the following instructions should the nurse include? A. Consume a low-sodium diet. B. Reduce fluid intake. C. Avoid taking NSAIDs. D. Take the drug with food. ● NSAIDs increase renal reabsorption of lithium and sodium. Clients who take lithium should not take NSAIDs. 16. A nurse is providing teaching for a client who has a new prescription for betaxolol eye drops. Which of the following adverse effects should the nurse include in the teaching? A. Constricted pupils B. Discoloration of the iris C. Hypertension D. Bradycardia ● Betaxolol and timolol can cause bradycardia because of the blockade of cardiac beta1 receptors. Clients should check their pulse rate regularly and report any sustained decreases. 17. A nurse is caring for a client who is taking venlafaxine to treat major depressive disorder. The nurse should identify that which of the following drugs can cause serotonin syndrome when taken concurrently with venlafaxine? A. Alprazolam B. Phenytoin C. Phenelzine D. Pilocarpine ● Clients should not take venlafaxine, a serotonin norepinephrine reuptake inhibitor, within 14 days of taking phenelzine, other MAOIs, or serotonergic drugs. Serotonin syndrome is a life-threatening complication characterized by anxiety, confusion, hallucinations, and fever. 18. A nurse is providing teaching to a client who has a new prescription for diazepam for anxiety disorders. Which of the following client statements indicates an understanding of the teaching? A. "It is not a big deal if I forget my pills for a couple of days." B. "I should limit alcohol intake to one drink daily while taking this medication." C. "I will avoid salt because this medication can increase my blood pressure." D. "If I become pregnant, it is important to let my health care provider know." ● Diazepam can increase the risk of congenital malformations and is contraindicated for clients who are pregnant. 19. A nurse is caring for a client who has a prescription for fluoxetine and who reports self-administering St. John's wort daily for the past 2 weeks. Which of the following findings should the nurse report to the provider as an indication of serotonin syndrome? A. Hallucinations B. Decreased temperature C. Hypersexual behavior D. Constipation● Hallucinations are an expected finding of serotonin syndrome. SSRIs are contraindicated with St. John's wort because the combination can increase the risk of developing serotonin syndrome. 20. A nurse is caring for a client who has schizoaffective disorder and who has been prescribed chlorpromazine IV. Which of the following client findings should the nurse monitor after administering the medication? A. BUN level B. Blood pressure C. Urine specific gravity D. Pedal pulse strength ● Clients who receive chlorpromazine are at risk for hypotension during and immediately after IV administration. The client should remain supine for 30 min while the nurse monitors their blood pressure. The nurse should instruct the client to change positions slowly as a safety precaution to prevent client injury. This medication can also cause orthostatic hypotension. 21. A nurse is providing teaching to a client who has a prescription for buspirone to treat anxiety. Which of the following instructions should the nurse include? A. "Take a missed dose as soon as you remember." B. "Take the drug as needed at the first sign of anxious feelings." C. "Take the drug in the morning with a glass of grapefruit juice." D. "Drink a cup of chamomile tea at night with the drug." ● Buspirone should be taken on a regular scheduled basis to be therapeutic. If a client misses a dose, then they should take one as soon as they remember, as long as it is not close to time for the next scheduled dose. 22. A nurse is caring for a client who is taking lithium carbonate to treat bipolar disorder. Which of the following diagnostic tests should the nurse recommend that the client undergo periodically? A. Chest x-ray B. Tonometry C. Thyroid function tests D. Endoscopic retrograde cholangiopancreatography (ERCP) ● Hypothyroidism is an adverse effect of lithium carbonate. Clients should report neck enlargement, weight gain, lethargy, and constipation. They should also have their thyroid function checked before they begin taking lithium and annually thereafter. 23. 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 ● Timolol, a beta-adrenergic antagonist, can cause bronchospasm and difficulty breathing. Clients who have asthma or any disorder that compromises respiratory function should not use the drug. 24. A nurse is providing teaching to a client about the adverse effects of drug therapy. The nurse should include that orthostatic hypotension is a common adverse reaction of which of the following drugs? A. Venlafaxine B. Bupropion C. Imipramine D. Valproic acid ● Imipramine, a tricyclic antidepressant, can result in orthostatic (postural) hypotension. Clients who take this drug should change positions slowly from sitting or lying to standing. 25. A nurse is assessing a client who has been taking alprazolam for several days. Which of the following findings should the nurse identify as an adverse drug reaction caused by alprazolam? A. AnxietyB. Ringing in the ears C. Increased appetite D. Muscle spasms ● The client can experience a paradoxical effect when taking benzodiazepines or buspirone, indicated by increased anxiety rather than relief of anxiety. The nurse should report this to the provider, who might consider a different medication. Tutorial:Pharmacology Made Easy 4.0 Module:The Musculoskeletal System Case Study Questions #1: 1. Which of the following information in the client's history causes the health care provider to suspect the client has osteoporosis? (Select all that apply.) A. Menopause B. Calcium supplements C. Long-term corticosteroid use D. Weight E. Loss of height 2. The health care provider explains to the client that there may be a drug interaction between the glucocorticoid and the calcium supplement. Which of the following may occur? A. The glucocorticoid may cause reduced absorption of the calcium supplement. B. The glucocorticoid may potentate the effects of the calcium supplement. C. The oral calcium supplement used with the glucocorticoid may cause bradycardia. D. The calcium supplement may increase the risk for peptic ulcer disease. 3. The health care provider instructs the client about the importance of taking the prescribed 1,500 mg/day dosage of calcium carbonate (Tums). Which of the following instructions should the health care provider recommend? A. Set up a simple reminder system. B. Take the three tablets at the same time. C. Reduce fluid intake to increase effectiveness. D. Take the drug with meals to reduce gastric irritation. 4. The health care provider prescribes alendronate (Fosamax) to reduce bone resorption and instructs the client to monitor for which of the following indications of a serious adverse effect of this drug? A. Calf inflammation B. Chest pain C. Dizziness D. Dysphagia 5. When instructing the client about alendronate, which of the following information should the health care provider include? (Select all that apply.) A. Take the drug on an empty stomach. B. Take the drug before bedtime. C. Take the drug with an antacid. D. Sit upright for 30 minutes following dosage. E. Take with a full glass of water. Case Study Questions #2: 1. A client is about to start therapy with methotrexate for rheumatoid arthritis. Knowing the adverse effects of methotrexate, you advise the client to watch for which of the following? A. Dysphagia B. Sore throatC. Edema D. Paresthesia 2. A primary care provider prescribes etanercept to treat a client's rheumatoid arthritis. Prior to beginning the treatment, the client requires testing for which of the following? A. Pancreatitis B. Hepatitis C. Tuberculosis D. Gastritis 3. A client who is menopausal is taking a calcium supplement to prevent osteoporosis. You instruct the client to watch for which of the following indications of hypercalcemia? A. Eye twitching B. Bleeding gums C. Tinnitus D. Nausea 4. Drag the drug used to treat osteoporosis in the left column to match it with its expected pharmacologic action in the right column. ● Calcium supplements: Raises calcium levels ● Bisphosphonates: Reduces the number of osteoclasts ● Calcitonin: Increases the excretion of calcium ● Selective estrogen receptor modulators: Mimics the effects of estrogen on the bones 5. A client is about to start taking raloxifene to treat osteoporosis. You advise the client to watch for which of the following adverse effects? A. Hot flashes B. Breast cancer C. Blurred vision D. Jaw pain 6. A nurse is caring for a client taking etanercept. Which of the following adverse effects is most important to mention when educating this client? A. Injection site reaction can occur. B. Elevation of liver enzvmes can occur. C. Gastric perforation can occur. D. Vision changes can occur. 7. Which of the following drugs are effective in disease prevention as well as treatment of osteoporosis? (Select all that apply.) A. Raloxifene B. Calcitonin-salmon C. Alendronate D. NSAIDs 8. A primary care provider prescribes calcitonin salmon for a post-menopausal client. Knowing the adverse effects of calcitonin, you instruct the client to: A. increase fluid intake. B. Brise slowly from a reclining position. C. increase calcium and vitamin D intake. D. rest painful joints after exercise. 9. Prior to starting alendronate, the nurse should assess which of the following in the client? (Select all that apply.)A. Ability to swallow B. Baseline vision C. The client's ability to lay flat D. Absence of nasal dryness 10. A client who has rheumatoid arthritis is taking methotrexate. Which of the following reduces toxicity from this drug? A. Folic acid B. Magnesium sultate C. Ferrous sulfate D. Niacin Pharmacology Made Easy 4.0 The Musculoskeletal System Quiz: 1. A nurse is caring for a client who has a prescription for etanercept. The nurse should identify that etanercept treats rheumatoid arthritis by which of the following actions? A. Inactivation of tumor necrosis factor B. Inhibition of osteoclast activity C. Decreasing the reuptake of serotonin D. Interference with the production of lymphocytes ● Etanercept directly binds to the tumor necrosis factor (TNF), preventing the attachment of TNF onto the cell's surface. This prevents the autoimmune response and subsequent inflammation of the joints. 2. A nurse should instruct a client who is taking alendronate to monitor for which of the following adverse effects? (Select all that apply.) A. Jaw pain B. Drowsiness C. Blurred vision D. Tinnitus E. Muscle pain ● Jaw pain is correct. Alendronate can cause osteonecrosis of the jaw, and clients who develop it should report it to the provider. ● Blurred vision is correct. Alendronate can cause ocular inflammation. The client should report any eye pain or blurred vision to the provider. ● Muscle pain is correct. Alendronate can cause musculoskeletal pain. If analgesics do not help, the client might have to stop taking alendronate. 3. A nurse is planning care for a client who has a new prescription for methotrexate. The nurse should plan to monitor the client for which of the following adverse effects? A. Bone marrow depression B. Thrombocythemia C. Double vision D. Constipation ● The nurse should monitor the client for bone marrow depression, which is an adverse effect of folic acid analogs such as methotrexate. 4. A nurse is caring for a client who is currently taking methotrexate for rheumatoid arthritis. The nurse should identify that which of the following is an adverse effect of this medication? A. Hypertension B. Thrombocytopenia C. Glaucoma D. Edema ● Methotrexate has many adverse effects that affect the central nervous, respiratory, dermatologic, and hematology systems, such as anemia, leukopenia, and thrombocytopenia.5. A nurse should identify that a client who has diabetes mellitus and is taking etanercept is at an increased risk for which of the following adverse effects? A. Kidney toxicity B. Infection C. Gout D. Deep-vein thrombosis ● Etanercept increases the risk of developing a serious infection. Providers should not prescribe etanercept for clients who have an existing infection and should use it cautiously with clients who have diabetes mellitus because the disease itself already causes an increased risk for infection. 6. A nurse is teaching a client about raloxifene. Which of the following information should the nurse include? (Select all that apply.) A. Perform a breast self-examination twice per month. B. Increase physical activity by taking walks. C. Use a contraceptive if there is any possibility of pregnancy. D. Take the drug on an empty stomach. E. Increase intake of calcium and vitamin D. ● Increase physical activity by taking walks is correct. Clients who take raloxifene should avoid long periods of inactivity to prevent deep-vein thrombosis. Furthermore, walking, and other weight-bearing exercises, can help increase bone density. ● Use a contraceptive if there is any possibility of pregnancy is correct. Raloxifene is a pregnancy category X drug and can cause severe fetal harm. Women who are pregnant, breastfeeding, or might become pregnant should not take the drug. ● Increase intake of calcium and vitamin D is correct. An increased intake of calcium and vitamin D helps improve the effectiveness of raloxifene and increases bone mass. 7. Alendronate is contraindicated for administration to clients who have which of the following conditions? A. Heart failure B. Fish protein allergy C. Inability to sit upright D. Tuberculosis ● Alendronate is contraindicated for administration to a client who cannot sit upright or stand for 30 min. Clients should drink 240 mL (8 oz) of water after taking the drug and sit upright or stand for at least 30 min to prevent esophagitis. 8. A nurse is teaching a client about calcitonin-salmon intranasal spray to treat osteoporosis. Which of the following information should the nurse include? (Select all that apply.) A. Report rash or itching. B. Deliver two sprays to each nostril. C. Prime the pump before the first dose. D. Report nasal irritation. E. Hold the pump horizontally. ● Report rash or itching is correct. The nurse should tell the client to stop using the drug and seek medical attention if any swelling or rash develops. ● Prime the pump before the first dose is correct. The client should prime the pump before using the spray for the first time to ensure proper dosage. ● Report nasal irritation is correct. The client should report any nasal irritation or bleeding. The client might require parenteral administration if there is severe nasal irritation. 9. A nurse is teaching about self-administering methotrexate to a client who has rheumatoid arthritis. Which of the following statements should the nurse make? A. "Use a nonsteroidal anti-inflammatory drug to reduce toxicity." B. "If you miss a dose, go ahead and take it with the next scheduled dose."C. "Drink a minimum of 2 liters of water per day to promote the drug's excretion." D. "Take it in the morning to prevent insomnia." ● Methotrexate can cause kidney damage. Adequate hydration optimizes drug excretion and helps prevent kidney damage. Clients can also take sodium bicarbonate tablets to increase urine alkalinity and reduce the drug precipitation that can lead to kidney damage. 10. Which of the following is a therapeutic action of raloxifene? A. Blocks the effects of estrogen on endometrial tissue B. Mimics the effects of estrogen on bone tissue C. Stimulates secretion of parathyroid hormone D. Stimulates menstruation ● Raloxifene mimics the effects of estrogen on bone tissue, minimizing or stopping bone loss. 11. A nurse is teaching a client about adverse effects of etanercept. Which of the following statements by the client indicates understanding of the teaching? A. "I will need to get my blood drawn periodically while on this medication." B. "I may lose part or all of my hair." C. "I may wake up with a very dry mouth." D. "I will leave the needle cap off during the time the medication comes to room temperature." ● Etanercept places the client at risk for systemic fungal infections and other opportunistic infections. Therefore, the client will need to have their CBC monitored periodically while on this medication. 12. A nurse is caring for a client who has a new prescription for etanercept. Which of the following actions should the nurse take? A. Administer a tuberculin skin test prior to starting the medication. B. Teach the client that fevers are common while taking this medication. C. Determine if the client has chronic hypertension. D. Mix the medication with methotrexate prior to administration. ● Etanercept is contraindicated for administration to clients who have a history of exposure to tuberculosis. Therefore, the nurse should administer a tuberculin skin test prior to starting the medication. 13. A nurse is caring for a client who is taking etanercept for rheumatoid arthritis. The nurse should monitor the client for which of the following indications of a serious adverse reaction to the drug? A. Excessive salivation B. Increased thirst C. Blood in the urine D. Shortness of breath ● Etanercept can cause heart failure, manifesting as shortness of breath, cough, elevated blood pressure and heart rate, and pink-tinged sputum. 14. A nurse is teaching a client about methotrexate therapy for rheumatoid arthritis. Which of the following information should the nurse include? (Select all that apply.) A. Avoid being near people who are sick with a communicable illness. B. Periodic laboratory tests are required. C. The drug's effects are immediate. D. Report bruising or petechiae. E. Avoid drinking alcohol. ● Avoid being near people who are sick with a communicable illness is correct. Methotrexate causes bone marrow suppression and increases the risk for infection. Clients taking the drug should avoid contact with large crowds or people who are sick with a communicable illness. ● Periodic laboratory tests are required is correct. Periodic laboratory tests help the provider monitor for kidney and liver damage. It is important to assess for jaundice and abdominal pain because these findings can indicate liver damage.● Report bruising or petechiae is correct. Methotrexate can cause thrombocytopenia. Clients should report bruising or petechiae, because these findings indicate a low platelet count. The nurse should monitor the client's laboratory values for a decrease in platelets and red and white blood cells. ● Avoid drinking alcohol is correct. Alcohol ingestion can increase the risk of liver damage. Clients who are taking methotrexate should avoid drinking alcohol. 15. A nurse is caring for a client who was diagnosed with postmenopausal osteoporosis. Which of the following actions should the nurse take prior to administering calcitonin-salmon to the client for the first time? A. Check the client's urine for sedimentation. B. Assess the client's liver function. C. Use skin testing to check the client for allergies. D. Evaluate the client's breath sounds. ● Calcitonin-salmon is developed using salmon. The nurse should perform skin testing to check for an allergy to salmon or fish protein, and have epinephrine, antihistamines, and resuscitation equipment available. 16. A nurse is teaching a client about methotrexate. The nurse should inform the client to monitor for which of the following as an adverse effect of this drug? A. Muscle pain B. Peripheral edema C. Black, tarry stools D. Redness in the calf ● Methotrexate can cause gastric intestinal ulceration, which can lead to perforation and bleeding. The client should monitor for blood in stools or emesis and report either to the provider immediately. 17. A nurse is caring for a client who is taking alendronate to treat postmenopausal osteoporosis. The nurse should explain to the client that alendronate increases bone mass by which of the following actions? A. Decreases activity of osteoclasts B. Increases calcium excretion C. Promotes intestinal absorption of calcium and phosphorus D. Reduces action of osteoblasts ● Osteoclasts are cells that cause bone resorption or bone loss. Alendronate reduces the activity of osteoclasts, reducing bone loss and increasing bone mass. 18. A nurse is teaching a client who has a prescription for calcium citrate about manifestations of hypercalcemia. Which of the following manifestations should the nurse include in the teaching? A. Muscle twitching B. Laryngospasm C. Paresthesia D. Vomiting ● The nurse should teach the client that hypercalcemia can occur when taking this drug. Manifestations of hypercalcemia include nausea, vomiting, flank pain, lethargy, and deep bone pain. 19. A nurse is teaching a client about methotrexate therapy for rheumatoid arthritis. Which of the following statements by the client indicates understanding of the teaching? A. "I will take a birth control pill every day." B. "Methotrexate decreases my chances of developing an infection." C. "I take methotrexate every day with breakfast." D. "I will aim to drink five 8-ounce glasses of water per day." ● Methotrexate is teratogenic to a fetus and is contraindicated during pregnancy. Therefore, a client of childbearing age should use birth control while on this medication.20. A nurse is teaching a client who has a prescription for prednisone and takes 1,500 mg/day of calcium carbonate to reduce the risk of osteoporosis. Which of the following information should the nurse include? (Select all that apply.) A. Take the calcium tablets with food. B. Drink 240 mL (8 oz) of water with the calcium tablets. C. Chew calcium tablets before swallowing them. D. Take the drugs 1 hr apart. E. Divide the daily dosage of calcium into three 500-mg doses. ● Drink 240 mL (8 oz) of water with the calcium tablets is correct. Clients should drink 240 mL (8 oz) of water after taking the calcium carbonate to ensure complete passage of the drug and to maintain hydration. ● Chew calcium tablets before swallowing them is correct. Clients should chew the tablets before swallowing them to increase bioavailability. Clients should not swallow chewable tablets whole. ● Take the drugs 1 hr apart is correct. Glucocorticoids, such as prednisone, reduce the absorption of calcium carbonate. Clients should allow 1 hr in between the two to ensure optimal absorption. ● Divide the daily dosage of calcium into three 500-mg doses is correct. Clients should not take more than 600 mg of calcium carbonate at one time. Clients should divide the daily dosage into three doses to increase absorption of the calcium carbonate. 21. A nurse is teaching a client who has a new prescription for etanercept. Which of the following statements should the nurse make? A. "You will inject this medication once a week in your thigh muscle." B. "You should report signs of infection to your provider immediately." C. "You will need to avoid taking ibuprofen while on this medication." D. "You will need to receive a MMR vaccine 1 month after starting this medication." ● The nurse should teach the client that they are susceptible to infections when taking DMARD II medications such as etanercept. The client should report symptoms of infection, such as fever, cough, malaise, weight loss, and dyspnea, to the provider immediately to prevent further complications. 22. A nurse is caring for a client who has a prescription for methotrexate. Which of the following drugs would likely be prescribed in conjunction during the initial treatment for rheumatoid arthritis? A. Aspirin B. Salicylates C. Sulfonylureas D. Ibuprofen ● NSAID analgesics, such as ibuprofen, are often prescribed along with methotrexate during the initial course of treatment for rheumatoid arthritis. It can take weeks for DMARDs to reach therapeutic levels and begin relieving joint inflammation and pain, so ibuprofen can be administered concurrently to help make the client more comfortable while waiting for methotrexate's therapeutic effects. 23. A nurse is teaching a client who is taking etanercept for rheumatoid arthritis. The nurse should instruct the client to monitor for which of the following indications of an adverse reaction to this drug? A. Skin rash B. Tinnitus C. Diarrhea D. Dysphagia ● Etanercept can cause serious skin infections. Clients should immediately report any skin rashes or blisters, because an infection can cause a serious reaction, such as Stevens-Johnson syndrome or toxic epidermal necrolysis. 24. A nurse is teaching a client about raloxifene therapy to prevent osteoporosis. The nurse should instruct the client to monitor for which of the following indications of an adverse reaction to this drug?A. Loss of hair B. Numbness of the fingertips C. Calf pain D. Blisters on mucous membranes ● Raloxifene can increase the risk of deep-vein thrombosis, which can lead to a pulmonary embolism or cerebrovascular accident. Clients should avoid long periods of inactivity and report any pain, redness, or swelling in the calf. 25. A nurse is preparing to administer alendronate to a client who has osteoporosis. The nurse should recognize which of the following as an adverse effect of alendronate? A. Venous thromboemboli B. Ventricular dysrhythmias C. Breast cancer D. Joint pain ● Alendronate can cause joint and muscle pain. Clients can treat joint pain with analgesics. Other adverse effects of this drug include nausea, visual disturbances, and esophagitis. Tutorial:Pharmacology Made Easy 4.0 Module:The Reproductive and Genitourinary Systems Case Study Questions #1: 1. The provider talks with the client about clomiphene therapy. Which of the following instructions should the provider include? A. Take it once a day until they can confirm pregnancy. B. Begin taking it on the first day and stop on the last day of menstruation. C. Begin 5 days after menstruation begins and take it every day for next 5 days. D. Take it once, 17 to 19 days after the onset of menstruation. 2. One month later, the client tells the provider that she has developed some adverse effects. Which of the following effects does clomiphene cause? (Select all that apply.) A. Blurred vision B. Hot flashes C. Breast engorgement D. Muscle pain E. Nausea 3. The provider should instruct the client to do which of the following? A. Take half the usual dosage. B. Continue the usual dosage. C. Take a pregnancy test. D. Double the previous dosage. 4. Recognizing the adverse effects of terbutaline, the nurse should monitor the client for which of the following? A. Hypoglycemia B. Tachycardia C. Hyperkalemia D. Wheezing 5. Which of the following drugs should the nurse have available to reverse the adverse effects of terbutaline? A. Naloxone B. Neostigmine (Prostigmin) C. Propranolol (Inderal) D. AtropineCase Study Questions #2: 1. A client is given conjugated estrogen and medroxyprogesterone acetate to treat postmenopausal vasomotor symptoms. The health care provider instructs the client to monitor for which of the following, which may indicate a serious adverse effect of the conjugated estrogen and medroxyprogesterone acetate? A. Ringing in ears B. Insomnia C. Swelling or pain in calf D. Difficulty swallowing 2. Match the pharmacologic term in the left column with a therapeutic use in the right column. ● Sildenafil: Erectile dysfunction ● Finasteride: Benign prostatic hypertrophy ● Oxybutynin chloride: Urinary incontinence ● Testosterone: Male puberty induction 3. Combination oral contraceptives, such as ethinyl estradiol and drospirenone, should be used with caution in clients with which of the following disorders? A. Diabetes B. Hypothyroidism C. Thrombocytopenia D. Osteoporosis 4. A client is prescribed testosterone to treat testicular failure. The nurse instructs the client to monitor and report which of the following? A. Dizziness B. Paresthesia C. Weight gain D. Shortness of breath 5. A client is prescribed finasteride to treat benign prostatic hypertrophy. When providing instructions about the finasteride, the nurse should include which of the following information? A. Avoid high-fat foods. B. Allow 6 to 12 months to see improvement. C. Wear protective clothing and sunscreen. D. Avoid activities that require alertness until drug effects are known. 6. For which of the following clients should a health care provider question the use of sildenafil to treat erectile dysfunction. A client who is taking: A. Oxybutynin chloride for urinary incontinence B. Phenytoin for a seizure disorder C. Thyroid for hypothyroid D. Nitroglycerin as needed for chest pain 7. Match the pharmacologic term in the left column with a therapeutic use in the right column. ● Medroxyprogesterone: Treats endometriosis ● Terbutaline: Stops uterine contractions ● Human chorionic gonadotropin): Stimulates ovulation ● Dinoprostone: Induces uterine contractions 8. A client is prescribed clomiphene for infertility. The health care provider instructs the client on clomiphene to monitor for which of the following? A. Shortness of breath B. Pelvic painC. Diarrhea D. Fever 9. For rapid relief of urinary obstruction due to prostatic enlargement, the health care provider should choose which of the following drugs? A. Sildenafil B. Tamsulosin C. Finasteride D. Oxybutynin 10. The health care provider administers oxytocin for induction of labor. The health care provider should monitor which of the following in order to assess for an adverse reaction to oxytocin? (Select all that apply) A. Urine output B. Blood pressure C. Level of consciousness D. Duration of contractions E. Fetal heart rate Pharmacology Made Easy 4.0 The Reproductive and Genitourinary System Quiz: 1. A nurse is providing teaching to a client about sildenafil to treat erectile dysfunction. Which of the following instructions should the nurse include? A. Take the drug with a glass of grapefruit juice. B. Do not take the drug with high-fat foods. C. Increase intake of foods rich in vitamin K. D. Avoid aged cheeses and red wine. ● High-fat foods delay absorption and reduce peak effects of sildenafil. Clients who take the drug should not take it with high-fat foods. 2. A nurse is caring for a client who has a new prescription for transdermal conjugated estrogen and medroxyprogesterone to treat postmenopausal symptoms. The nurse should explain to the client that this drug combination includes which of the following therapeutic effects? (Select all that apply.) A. Reduces the risk of ovarian cancer B. Relieves hot flashes C. Prevents osteoporosis D. Reduces the risk of breast cancer E. Reduces the risk of thromboembolism ● Reduces the risk of ovarian cancer is correct. Drug therapy with an estrogen and progesterone combination reduces the risk of ovarian cancer. However, the use of estrogen alone without progesterone can increase the risks of endometrial and ovarian cancer. ● Relieves hot flashes is correct. Drug therapy with an estrogen and progesterone combination or