NSG 3100 Exam 6, Units 12 and 13 Questions With Correct Answers

When caring for a patient who is experiencing status epilepticus which of the following medications would the nurse expect to administer? a. lorazepam (ativan) b. propofol (diprivan) c. morphine sulfate (astramorph) d. meperidine (demerol) - Answer a. Lorazepam (Ativan) True or False: Family members should be instructed on how to administer medication to a patient on a PCA pump if they appear to be in pain? - Answer False Which of the following is the analgesic of choice for management of most types of acute and severe chronic pain including pain from an MI? a. Morphine sulfate (Astramorph) b. Diazepam (Valium) c. Fentanyl (Sublimaze) d. Flumazenil (Romazicon) - Answer a. Morphine sulfate (Astramorph) A patient arrives to the ER for treatment of benzodiazepine overdose. Which medication would the nurse expect to administer? a. Naloxone (Narcan) b. Dexrazoxane (Zinecard) c. Flumazenil (Romazicon) d. Filgrastim (Neupogen) - Answer c. Flumazenil (Romazicon) The patient's medication reconciliation reveals he has been on morphine sulfate (Roxanol) long term for chronic pain. With this in mind, which medication would the nurse expect the surgeon to order for post-op pain control? a. Phenytoin (Dilantin) b. Naloxone (Narcan) c. Propofol (Diprivan) d. Fentanyl (Sublimaze) - Answer d. Fentanyl (Sublimaze) True or False: Meperidine (Demerol) is a first line choice for management of chronic pain. - Answer False The nurse administers naloxone to a post-op patient who is having respiratory depression after a dose of morphine. Respiratory rate returns to normal. What other effects from naloxone (Narcan) would the nurse expect to see? a. Increased sedation b. Urinary frequency c. Return of post op pain d. Nausea and vomiting - Answer c. Return of post op pain When providing teaching to a patient who is to receive midazolam (versed) for a procedure, which statement should the nurse include? a. We are giving you this medicine to control your pain b. This medication is so safe we don't need to monitor you during surgery. c. This medication helps you relax, and you will not remember anything for a couple of hours. d. You will not feel any pain, but you will be able to remember what happens during your surgery. - Answer c. This medicine helps you relax, and you will not remember anything for a couple of hours. What medication is second-line for pain control due to toxicity from metabolite? - Answer Meperidine (Demerol) What medication is the most widely used IV anesthetic? - Answer Propofol (Diprivan) What medication occupies mu and kappa receptors in the brain and spinal cord, altering the perception of and response to pain? - Answer Morphine sulfate (Astramorph) What medication is a GABA receptor agonist used primarily with anesthesia or procedures? - Answer Midazolam (Versed) Morphine sulfate (astramorph), hydromorphone (dilaudid), fentanyl (sublimaze), and meperidine (demerol) are all what type of drugs - Answer Analgesics/opioid agonists Naloxone (narcan) is what type of drug - Answer Opioid antagonist Flumazenil (Romazicon) is what type of drug - Answer Benzodiazepine reversal Diazepam (valium), lorazepam (ativan), and phenytoin (dilantin) are what type of drugs - Answer Antiepileptics Midazolam (versed), and propofol (diprivan) are what kind of drugs - Answer Anesthetics Imipramine (tofranil), and Amitriptyline (elavil) are what kind of drugs - Answer Tricyclic antidepressants (TCAs) - Fluoxetine (prozac) - Citalopram (celexa) - Escitalopram (lexapro) - Paroxetine (Paxil) - Sertraline (zoloft) are what kind of drugs - Answer Selective serotonin reuptake inhibitors (SSRIs) What category of drugs are atypical antidepressants? - Answer - serotonin-norepinephrine reuptake inhibitor (SNRI) - Norepinephrine and dopamine reuptake inhibitor (NDRI) - Venlafaxine (effexor) - Duloxetine (cymbalta) - Desvenlafaxine (pristiq) are what kind of drugs - Answer Serotonin-norepinephrine reuptake inhibitors (SNRIs) - atypical antidepressants Buproprion (wellbutrin) is what kind of drug - Answer Norepinephrine and dopamine reuptake inhibitors (NDRI) Lithium carbonate (eskalith, lithobid) is what kind of drug - Answer Alkali metal ion salt Haloperidol (haldol) is what kind of drug - Answer Nonphenothiazine, dopamine antagonist Risperidone (risperdal) and Quetiapine (Seroquel) are what kind of drugs - Answer Dopamine antagonists Aripiprazole (abilify) is what kind of drug - Answer Dopamine system stabilizer How do we treat opioid addiction? - Answer Methadone and Buprenorphine with or without naloxone Name the mood disorder: sad or despondent mood out of proportion to actual life events - Answer major depressive disorder (depression) Name the mood disorder: mild chronic depression that persists for at least 2 years - Answer Dysthymic disorder Name the mood disorder: alternates between intense excitement and major depressive disorder - Answer Bipolar disorder Name the mood disorder: mania symptoms that last for at least 1 week and significantly impact social functioning. Hypomania is less intense and lasts only 4 days - Answer Manic and hypomanic episodes Name the mood disorder: Mild form of bipolar disorder in which patient alternates between hypomania and mild depression - Answer cyclothymic disorder what neurotransmitters, at what level, are involved in major depressive disorder (depression) - Answer low norepinephrine, serotonin, and dopamine What is the black box warning for antidepressants? - Answer Can increase the risk of suicidal thinking and behavior in children, adolescents, and young adults. patients of all ages should be monitored closely during therapy What are the antidepressant classes? - Answer - Monoamine oxidase inhibitors (MAOIs) - Tricyclic antidepressants (TCAs) - Selective serotonin reuptake inhibitors (SSRIs) - Atypical antidepressants = (SNRIs and NDRIs) Briefly describe monoamine oxidase inhibitors (MAOIs) {antidepressants} - Answer - Have serious adverse effects and a low safety margin - Rarely used unless other antidepressants are unsuccessful - Most serious a/e is HTN crisis when combined with foods with high tyramine. What are the adverse effects of tricyclic antidepressants (TCAs)? - Answer - Life threatening dysrhythmias - Sedation, confusion, and dizziness - Seizures - Orthostatic hypotension - Anticholinergic effects What is the overwhelming craving to take the drug and you cannot stop it? - Answer dependence