Pharm Module 2 Exam With 100% Correct Questions &
Answers Top Verified Solution (A+ SCORED)
A patient who has a seizure disorder is admitted to the hospital after an increase in seizure
frequency, and the prescriber orders carbamazepine [Tegretol] 100 mg twice daily to be added
to the patient's medication regimen. The nurse reviewing the patient's medical history notes that
the patient is already taking lamotrigine [Lamictal] 375 mg twice daily. The nurse will contact the
provider to discuss which action?
A. Reduce the carbamazepine dose to 50 mg twice daily.
B. Reduce the lamotrigine dose to 225 mg twice daily.
C. Increase the carbamazepine dose to 200 mg twice daily.
D. Increase the lamotrigine dose to 500 mg twice daily. - ANSWER ✔ - D. Increasing the
lamotrigine dose to 500 mg twice daily.
Carbamazepine induces hepatic drug-metabolizing enzymes and can increase the rate at which
lamotrigine and other drugs are metabolized; therefore, patients taking any of these drugs would
need an increased dose.
The patient who is on memantine therapy has a slight elevation in the creatinine clearance. What
action will the provider take in response to this laboratory result?
a. Add sodium bicarbonate to the patient's drug regimen.
b. Order a serum creatinine level to validate the creatinine clearance
c. Discontinue the memantine.
d. Reduce the dose of memantine. - ANSWER ✔ - D. Reduce the dose of mematine
,Patients with severe renal impairment may require discontinuation, but with a slight elevation, a
dosage reduction is indicated.
A patient who takes phenytoin for seizures asks the provider for a prescription for oral
contraceptives. What recommendation will the provider make to help assure the effectiveness
of the contraception method?
A. She may need to increase her dose of phenytoin while taking oral contraceptives.
B. She should consider a different form of birth control while taking phenytoin.
C. She should adhere strictly to oral contraceptive schedules because phenytoin causes birth
defects.
D. She should not take oral contraceptives, because they reduce the effectiveness of phenytoin.
- ANSWER ✔ - B. She should consider a different form of birth control while taking phenytoin.
She should consider a different form of birth control while taking phenytoin. Because phenytoin
reduces the efficacy of oral contraception.
A patient who has been taking an antiepileptic drug for several weeks reports little change in
seizure frequency, what action will the provider take to provide effective care?
A. Ask the patient to complete a seizure frequency chart for the past few weeks.
B. Write an order for serum drug levels.
C. Reinforce to the patient the need to take the medications as prescribed.
D. increase the dose of the antiepileptic drug. - ANSWER ✔ - B. Write an order for serum drug
levels.
If medication therapy is not effective, it is important to measure serum drug levels of the
medication to determine whether therapeutic levels have been reached. Patients should be
asked at the beginning of therapy to keep a seizure frequency chart to help deepen their
involvement in therapy; asking for historical information is not helpful. Until it is determined that
, the patient is not complying, the nurse should not reinforce the need to take the medication.
Until the drug level is known, increasing the dose is not indicated.
A patient with cerebral palsy has severe muscle spasticity and muscle weakness which makes it
difficult to take anything by mouth. The provider will prescribe and educate the patient on which
medication for home therapy?
A. Baclofen
B. Dantrolene
C. Diazepam
D. Metaxalone - ANSWER ✔ - A. Baclofen.
Baclofen is used to treat muscle spasticity associated with multiple sclerosis, spinal cord injury,
and cerebral palsy. It does not reduce muscle strength, so it will not exacerbate this patient's
muscle weakness. It can be given intrathecally, via an implantable pump, and therefore is a good
choice for patients who cannot take medications by mouth. Dantrolene causes muscle weakness
and must be given by mouth or intravenously, so it would not be a good option for this patient.
Diazepam is not the first-line drug of choice. Metaxalone is used to treat localized muscle spasms
caused by injury and is not used for cerebral palsy.
A provider has prescribed dantrolene for the following patients. Which patient will the provider
monitor most closely for risk of injury?
A. A 20-year-old woman with a spinal cord injury
B. A 45-year-old man with a history of malignant hyperthermia
C. A 55-year-old woman with multiple sclerosis
D. An 8-year-old child with cerebral palsy - ANSWER ✔ - C. A 55-year old woman with multiple
sclerosis
Dose-related liver damage is the most serious adverse effect of dantrolene and is most common
in women older than 35 years.
Answers Top Verified Solution (A+ SCORED)
A patient who has a seizure disorder is admitted to the hospital after an increase in seizure
frequency, and the prescriber orders carbamazepine [Tegretol] 100 mg twice daily to be added
to the patient's medication regimen. The nurse reviewing the patient's medical history notes that
the patient is already taking lamotrigine [Lamictal] 375 mg twice daily. The nurse will contact the
provider to discuss which action?
A. Reduce the carbamazepine dose to 50 mg twice daily.
B. Reduce the lamotrigine dose to 225 mg twice daily.
C. Increase the carbamazepine dose to 200 mg twice daily.
D. Increase the lamotrigine dose to 500 mg twice daily. - ANSWER ✔ - D. Increasing the
lamotrigine dose to 500 mg twice daily.
Carbamazepine induces hepatic drug-metabolizing enzymes and can increase the rate at which
lamotrigine and other drugs are metabolized; therefore, patients taking any of these drugs would
need an increased dose.
The patient who is on memantine therapy has a slight elevation in the creatinine clearance. What
action will the provider take in response to this laboratory result?
a. Add sodium bicarbonate to the patient's drug regimen.
b. Order a serum creatinine level to validate the creatinine clearance
c. Discontinue the memantine.
d. Reduce the dose of memantine. - ANSWER ✔ - D. Reduce the dose of mematine
,Patients with severe renal impairment may require discontinuation, but with a slight elevation, a
dosage reduction is indicated.
A patient who takes phenytoin for seizures asks the provider for a prescription for oral
contraceptives. What recommendation will the provider make to help assure the effectiveness
of the contraception method?
A. She may need to increase her dose of phenytoin while taking oral contraceptives.
B. She should consider a different form of birth control while taking phenytoin.
C. She should adhere strictly to oral contraceptive schedules because phenytoin causes birth
defects.
D. She should not take oral contraceptives, because they reduce the effectiveness of phenytoin.
- ANSWER ✔ - B. She should consider a different form of birth control while taking phenytoin.
She should consider a different form of birth control while taking phenytoin. Because phenytoin
reduces the efficacy of oral contraception.
A patient who has been taking an antiepileptic drug for several weeks reports little change in
seizure frequency, what action will the provider take to provide effective care?
A. Ask the patient to complete a seizure frequency chart for the past few weeks.
B. Write an order for serum drug levels.
C. Reinforce to the patient the need to take the medications as prescribed.
D. increase the dose of the antiepileptic drug. - ANSWER ✔ - B. Write an order for serum drug
levels.
If medication therapy is not effective, it is important to measure serum drug levels of the
medication to determine whether therapeutic levels have been reached. Patients should be
asked at the beginning of therapy to keep a seizure frequency chart to help deepen their
involvement in therapy; asking for historical information is not helpful. Until it is determined that
, the patient is not complying, the nurse should not reinforce the need to take the medication.
Until the drug level is known, increasing the dose is not indicated.
A patient with cerebral palsy has severe muscle spasticity and muscle weakness which makes it
difficult to take anything by mouth. The provider will prescribe and educate the patient on which
medication for home therapy?
A. Baclofen
B. Dantrolene
C. Diazepam
D. Metaxalone - ANSWER ✔ - A. Baclofen.
Baclofen is used to treat muscle spasticity associated with multiple sclerosis, spinal cord injury,
and cerebral palsy. It does not reduce muscle strength, so it will not exacerbate this patient's
muscle weakness. It can be given intrathecally, via an implantable pump, and therefore is a good
choice for patients who cannot take medications by mouth. Dantrolene causes muscle weakness
and must be given by mouth or intravenously, so it would not be a good option for this patient.
Diazepam is not the first-line drug of choice. Metaxalone is used to treat localized muscle spasms
caused by injury and is not used for cerebral palsy.
A provider has prescribed dantrolene for the following patients. Which patient will the provider
monitor most closely for risk of injury?
A. A 20-year-old woman with a spinal cord injury
B. A 45-year-old man with a history of malignant hyperthermia
C. A 55-year-old woman with multiple sclerosis
D. An 8-year-old child with cerebral palsy - ANSWER ✔ - C. A 55-year old woman with multiple
sclerosis
Dose-related liver damage is the most serious adverse effect of dantrolene and is most common
in women older than 35 years.
