Pharm II Final Exam Review
A nurse is discussing the use of alprazolam (Xanax) with a 68-year-old patient. What statement indicates
that the patient has an understanding of the drug?
- This drug will calm me down in about 30 minutes after I take it.
What anxiolytic drugs would be given to a premenopausal patient who is a registered nurse planning to
return to work at the hospital after anxiety is controlled?
- buspirone
A patient is brought to the emergency department in the midst of an active clonic-tonic seizure. What is
the most appropriate antiseizure drug for the nurse to administer intravenously to terminate acute
convulsive seizures?
- Diazepam (Valium)
A psychotic patient is admitted through the emergency department. The physician has ordered
chlorpromazine (Thorazine) 25 mg intramuscularly. After administration of the medication, what is the
nurse’s priority to evaluate?
- A decrease in psychotic symptoms
A nurse is caring for a patient who is taking lithium for mania. The nurse’s assessment includes a
notation of a lithium serum level of 2.4 mEq/L. The nurse anticipates seeing what?
- Clonic movements
A patient arrives at the emergency room after attempting suicide by taking an entire bottle of diazepam.
What antidote will the nurse most likely administer?
- Flumazenil (Romazicon)
The patient reports pain caused by muscle spasms in his back. The nurse assesses the patient as being
very anxious and notes how the anxiety results in tensing of muscles. What medication would be most
effective in treating this patient?
- Diazepam (Valium)
A psychotic patient is admitted through the emergency department. The physician has ordered
chlorpromazine (Thorazine) 25 mg intramuscularly. After administration of the medication, what is the
nurse’s priority to evaluate?
- A decrease in psychotic symptoms
,A patient on chlorpromazine is feeling better and decides they no longer need their medication. The
nurse teaches the patient that abrupt withdrawal of a typical antipsychotic medication can result in
what?
- Insomnia
The pharmacology instructor is explaining to their class the difference between the typical and the
atypical groups of antipsychotic drugs. What medication would the instructor explain to the students
has fewer extrapyramidal effects and greater effectiveness than older antipsychotic drugs in relieving
negative symptoms of schizophrenia?
- Clozapine (Clozaril)
A patient develops intractable hiccoughs after surgery. The nurse anticipates that the physician will
order which drug?
- Chlorpromazine (Thorazine)
A patient comes to the mental health clinic for a regular appointment. The patient tells the nurse he has
been taking oral fluoxetine (Prozac) 20 mg daily for the past 3 weeks and that he has lost 3 pounds2
during that time due to a loss of appetite. What action should the nurse take?
- Reassuring the patient that a decrease in weight is a common adverse effect with this
medication
A patient has been taking Prozac (fluoxetine) for the past 3 years for depression. She is seeing her
gynecologist for premenopausal symptoms and during the interview with the nurse she says that she
would like to try Sarafem because her friend is taking it and she says it works great. The nurse’s best
response is what?
- Sarafem and Prozac are different brand names for the same generic medication.
The nurse is working on the telemetry unit and has noted that many postmyocardial-infarction (MI)
patients experience depression. What medication would the nurse question if ordered for one of these
patients?
- Amitriptyline
The pharmacology instructor is discussing drugs used for the treatment of partial seizures. What
accurately describes the physiological action of carbamazepine?
- Increases gamma-aminobutyric acid (GABA) activity and blocks sodium and calcium channels to
stop action potentials
The drug of choice for the treatment of partial seizures is what?
- Carbamazepine (Tegretol)
A patient has a new order for carbamazepine (Tegretol). What does the nurse know is a contraindication
to administration of carbamazepine?
- Bone marrow depression
, A patient is brought in to the emergency department by ambulance in status epilepticus. What drug may
be used for this patient?
- Fosphenytoin (Rationale: Carbamazepine is used to treat seizure disorders as well as trigeminal
neuralgia and bipolar disorder but it is not indicated for status epilepticus)
The nurse is caring for a child receiving a central nervous system (CNS) stimulant who was admitted to
the pediatric intensive care unit following repeated seizures after a closed head injury. The physician
orders phenytoin to control seizures and lorazepam to be administered every time the child has a
seizure. What is the nurse’s priority action?
- Call the doctor and question the administration of phenytoin (Rationale: The combination of
CNS stimulants with phenytoin leads to a risk of increased drug levels. Patients who receive such
a combination should be monitored for toxicity)
A patient is admitted to the emergency department with severe recurrent convulsive seizures. What
drug would the nurse expect to be ordered for use in emergency control of status epilepticus?
- Phenobarbital (Luminal)
The nurse evaluates the patient’s serum phenytoin (Dilantin) level and determines the level is
therapeutic when it is within what range?
- Between 10 and 20 mcg/mL
A nurse is teaching a patient about his or her newly prescribed drug, phenytoin (Dilantin) for a seizure
disorder. What will the nurse alert the patient to as a serious adverse effect of this drug?
- Rash
An 8-year-old child has been diagnosed with a seizure disorder and phenytoin (Dilantin) has been
prescribed for him or her. What nursing diagnosis would be appropriate if the child demonstrated
adverse effects to the drug?
- Impaired skin integrity related to dermatological effects (Rationale: phenytoin can cause
potentially serious dermatological effects as well as gum disease and stained teeth)
Richard, 15 years old, has been diagnosed with epilepsy. He is to be sent home on oral phenytoin 100
mg b.i.d. What statement by Richard’s mother leads the nurse to believe she has understood drug
teaching?
- I will make sure he has routine visits to the dentist. (Rationale: Gingival hyperplasia is common
in patients, especially children, who take phenytoin, which makes regular dentist visits
important to oral health)
The patient’s serum drug level is elevated and indicates a toxic level. What will the nurse assess for in
this patient? (Select all that apply.)
- Liver Toxicity
- Bone Marrow Suppression
- Serious dermatological Reactions
A nurse is discussing the use of alprazolam (Xanax) with a 68-year-old patient. What statement indicates
that the patient has an understanding of the drug?
- This drug will calm me down in about 30 minutes after I take it.
What anxiolytic drugs would be given to a premenopausal patient who is a registered nurse planning to
return to work at the hospital after anxiety is controlled?
- buspirone
A patient is brought to the emergency department in the midst of an active clonic-tonic seizure. What is
the most appropriate antiseizure drug for the nurse to administer intravenously to terminate acute
convulsive seizures?
- Diazepam (Valium)
A psychotic patient is admitted through the emergency department. The physician has ordered
chlorpromazine (Thorazine) 25 mg intramuscularly. After administration of the medication, what is the
nurse’s priority to evaluate?
- A decrease in psychotic symptoms
A nurse is caring for a patient who is taking lithium for mania. The nurse’s assessment includes a
notation of a lithium serum level of 2.4 mEq/L. The nurse anticipates seeing what?
- Clonic movements
A patient arrives at the emergency room after attempting suicide by taking an entire bottle of diazepam.
What antidote will the nurse most likely administer?
- Flumazenil (Romazicon)
The patient reports pain caused by muscle spasms in his back. The nurse assesses the patient as being
very anxious and notes how the anxiety results in tensing of muscles. What medication would be most
effective in treating this patient?
- Diazepam (Valium)
A psychotic patient is admitted through the emergency department. The physician has ordered
chlorpromazine (Thorazine) 25 mg intramuscularly. After administration of the medication, what is the
nurse’s priority to evaluate?
- A decrease in psychotic symptoms
,A patient on chlorpromazine is feeling better and decides they no longer need their medication. The
nurse teaches the patient that abrupt withdrawal of a typical antipsychotic medication can result in
what?
- Insomnia
The pharmacology instructor is explaining to their class the difference between the typical and the
atypical groups of antipsychotic drugs. What medication would the instructor explain to the students
has fewer extrapyramidal effects and greater effectiveness than older antipsychotic drugs in relieving
negative symptoms of schizophrenia?
- Clozapine (Clozaril)
A patient develops intractable hiccoughs after surgery. The nurse anticipates that the physician will
order which drug?
- Chlorpromazine (Thorazine)
A patient comes to the mental health clinic for a regular appointment. The patient tells the nurse he has
been taking oral fluoxetine (Prozac) 20 mg daily for the past 3 weeks and that he has lost 3 pounds2
during that time due to a loss of appetite. What action should the nurse take?
- Reassuring the patient that a decrease in weight is a common adverse effect with this
medication
A patient has been taking Prozac (fluoxetine) for the past 3 years for depression. She is seeing her
gynecologist for premenopausal symptoms and during the interview with the nurse she says that she
would like to try Sarafem because her friend is taking it and she says it works great. The nurse’s best
response is what?
- Sarafem and Prozac are different brand names for the same generic medication.
The nurse is working on the telemetry unit and has noted that many postmyocardial-infarction (MI)
patients experience depression. What medication would the nurse question if ordered for one of these
patients?
- Amitriptyline
The pharmacology instructor is discussing drugs used for the treatment of partial seizures. What
accurately describes the physiological action of carbamazepine?
- Increases gamma-aminobutyric acid (GABA) activity and blocks sodium and calcium channels to
stop action potentials
The drug of choice for the treatment of partial seizures is what?
- Carbamazepine (Tegretol)
A patient has a new order for carbamazepine (Tegretol). What does the nurse know is a contraindication
to administration of carbamazepine?
- Bone marrow depression
, A patient is brought in to the emergency department by ambulance in status epilepticus. What drug may
be used for this patient?
- Fosphenytoin (Rationale: Carbamazepine is used to treat seizure disorders as well as trigeminal
neuralgia and bipolar disorder but it is not indicated for status epilepticus)
The nurse is caring for a child receiving a central nervous system (CNS) stimulant who was admitted to
the pediatric intensive care unit following repeated seizures after a closed head injury. The physician
orders phenytoin to control seizures and lorazepam to be administered every time the child has a
seizure. What is the nurse’s priority action?
- Call the doctor and question the administration of phenytoin (Rationale: The combination of
CNS stimulants with phenytoin leads to a risk of increased drug levels. Patients who receive such
a combination should be monitored for toxicity)
A patient is admitted to the emergency department with severe recurrent convulsive seizures. What
drug would the nurse expect to be ordered for use in emergency control of status epilepticus?
- Phenobarbital (Luminal)
The nurse evaluates the patient’s serum phenytoin (Dilantin) level and determines the level is
therapeutic when it is within what range?
- Between 10 and 20 mcg/mL
A nurse is teaching a patient about his or her newly prescribed drug, phenytoin (Dilantin) for a seizure
disorder. What will the nurse alert the patient to as a serious adverse effect of this drug?
- Rash
An 8-year-old child has been diagnosed with a seizure disorder and phenytoin (Dilantin) has been
prescribed for him or her. What nursing diagnosis would be appropriate if the child demonstrated
adverse effects to the drug?
- Impaired skin integrity related to dermatological effects (Rationale: phenytoin can cause
potentially serious dermatological effects as well as gum disease and stained teeth)
Richard, 15 years old, has been diagnosed with epilepsy. He is to be sent home on oral phenytoin 100
mg b.i.d. What statement by Richard’s mother leads the nurse to believe she has understood drug
teaching?
- I will make sure he has routine visits to the dentist. (Rationale: Gingival hyperplasia is common
in patients, especially children, who take phenytoin, which makes regular dentist visits
important to oral health)
The patient’s serum drug level is elevated and indicates a toxic level. What will the nurse assess for in
this patient? (Select all that apply.)
- Liver Toxicity
- Bone Marrow Suppression
- Serious dermatological Reactions
