PHARM - Neurological Medications Test
Questions with Verified Answers
The client with myasthenia gravis is suspected of having cholinergic crisis. Which
sign/symptom indicates this crisis is taking place? - Ans -Hypertension
Rationale:Cholinergic crisis occurs as a result of an overdose of medication. Indications of
cholinergic crisis include gastrointestinal disturbances, nausea, vomiting, diarrhea,
abdominal cramps, increased salivation and tearing, miosis, hypertension, sweating, and
increased bronchial secretions.
The client is receiving meperidine hydrochloride for pain. Which signs/symptoms are side
and adverse effects of this medication? Select all that apply. - Ans -Tremors
Drowsiness
Hypotension
Rationale:Meperidine hydrochloride is an opioid analgesic. Side and adverse effects
include respiratory depression, drowsiness, hypotension, constipation, urinary retention,
nausea, vomiting, and tremors.
The client with myasthenia gravis becomes increasingly weak. The primary health care
provider (PHCP) prepares to identify whether the client is reacting to an overdose of the
medication (cholinergic crisis) or increasing severity of the disease (myasthenic crisis). An
injection of edrophonium is administered. Which change in condition indicates that the
client is in cholinergic crisis? - Ans -A temporary worsening of the condition
Rationale:An edrophonium injection makes the client experiencing cholinergic crisis
temporarily worse. This is known as a negative test. An improvement of weakness would
occur if the client were experiencing myasthenia gravis.
1
Page
,Carbidopa-levodopa is prescribed for a client with Parkinson's disease, and the nurse
monitors the client for adverse effects of the medication. Which sign/symptom indicates
the client is experiencing an adverse effect? - Ans -Impaired voluntary movements
Rationale:Dyskinesia and impaired voluntary movement may occur with high levodopa
dosages. Nausea, anorexia, dizziness, orthostatic hypotension, bradycardia, and akinesia
(the temporary muscle weakness that lasts 1 minute to 1 hour, also known as the "on-off
phenomenon") are frequent side effects of the medication.
Phenytoin, 100 mg orally three times daily, has been prescribed for a client for seizure
control. The nurse reinforces instructions regarding the medication to the client. Which
statement by the client indicates an understanding of the instructions? - Ans -"I will
use a soft toothbrush to brush my teeth."
Rationale:Phenytoin is an anticonvulsant. Gingival hyperplasia, bleeding, swelling, and
tenderness of the gums can occur with the use of this medication. The client needs to be
taught good oral hygiene, gum massage, and the need for regular dentist visits. The client
should not skip medication doses because this could precipitate a seizure. Capsules
should not be chewed or broken, and they must be swallowed. The client needs to be
instructed to report a sore throat, fever, glandular swelling, or any skin reaction because
this indicates hematological toxicity.
The client is taking phenytoin for seizure control, and a blood sample for a serum drug level
is drawn. Which laboratory finding indicates a therapeutic serum drug result? - Ans -
15 mcg/mL (59.52 mcmol/L)
Rationale:The therapeutic serum drug level range for phenytoin is 10 to 20 mcg/mL (39.68
to 79.36 mcmol/L).
Ibuprofen is prescribed for a client. Which instruction should the nurse give the client
2
about taking this medication? - Ans -Take with 8 oz of milk.
Page
, Rationale:Ibuprofen is a nonsteroidal antiinflammatory drug (NSAID). NSAIDs should be
given with milk or food to prevent gastrointestinal irritation.
The nurse is caring for a client who is taking phenytoin for control of seizures. During data
collection, the nurse notes that the client is taking birth control pills. Which information
should the nurse provide to the client? - Ans -The potential for decreased
effectiveness of the birth control pills exists while taking phenytoin.
Rationale:Phenytoin enhances the rate of estrogen metabolism, which can decrease the
effectiveness of some birth control pills.
The client with trigeminal neuralgia is being treated with carbamazepine. Which laboratory
result indicates that the client is experiencing an adverse effect of the medication? -
Ans -White blood cell count, 3000 mm3 (3 × 109/L)
Rationale:Adverse effects of carbamazepine appear as blood dyscrasias, including
aplastic anemia, agranulocytosis, thrombocytopenia, leukopenia, cardiovascular
disturbance, thrombophlebitis, dysrhythmia, and dermatological effects.
The client with myasthenia gravis is receiving pyridostigmine. The nurse monitors for signs
and symptoms of cholinergic crisis caused by overdose of the medication. The nurse
checks the medication supply to ensure that which medication is available for
administration if a cholinergic crisis occurs? - Ans -Atropine sulfate
Rationale:The antidote for cholinergic crisis is atropine sulfate. Acetylcysteine is the
antidote for acetaminophen. Vitamin K is the antidote for warfarin and protamine sulfate is
the antidote for heparin.
3
Page
Questions with Verified Answers
The client with myasthenia gravis is suspected of having cholinergic crisis. Which
sign/symptom indicates this crisis is taking place? - Ans -Hypertension
Rationale:Cholinergic crisis occurs as a result of an overdose of medication. Indications of
cholinergic crisis include gastrointestinal disturbances, nausea, vomiting, diarrhea,
abdominal cramps, increased salivation and tearing, miosis, hypertension, sweating, and
increased bronchial secretions.
The client is receiving meperidine hydrochloride for pain. Which signs/symptoms are side
and adverse effects of this medication? Select all that apply. - Ans -Tremors
Drowsiness
Hypotension
Rationale:Meperidine hydrochloride is an opioid analgesic. Side and adverse effects
include respiratory depression, drowsiness, hypotension, constipation, urinary retention,
nausea, vomiting, and tremors.
The client with myasthenia gravis becomes increasingly weak. The primary health care
provider (PHCP) prepares to identify whether the client is reacting to an overdose of the
medication (cholinergic crisis) or increasing severity of the disease (myasthenic crisis). An
injection of edrophonium is administered. Which change in condition indicates that the
client is in cholinergic crisis? - Ans -A temporary worsening of the condition
Rationale:An edrophonium injection makes the client experiencing cholinergic crisis
temporarily worse. This is known as a negative test. An improvement of weakness would
occur if the client were experiencing myasthenia gravis.
1
Page
,Carbidopa-levodopa is prescribed for a client with Parkinson's disease, and the nurse
monitors the client for adverse effects of the medication. Which sign/symptom indicates
the client is experiencing an adverse effect? - Ans -Impaired voluntary movements
Rationale:Dyskinesia and impaired voluntary movement may occur with high levodopa
dosages. Nausea, anorexia, dizziness, orthostatic hypotension, bradycardia, and akinesia
(the temporary muscle weakness that lasts 1 minute to 1 hour, also known as the "on-off
phenomenon") are frequent side effects of the medication.
Phenytoin, 100 mg orally three times daily, has been prescribed for a client for seizure
control. The nurse reinforces instructions regarding the medication to the client. Which
statement by the client indicates an understanding of the instructions? - Ans -"I will
use a soft toothbrush to brush my teeth."
Rationale:Phenytoin is an anticonvulsant. Gingival hyperplasia, bleeding, swelling, and
tenderness of the gums can occur with the use of this medication. The client needs to be
taught good oral hygiene, gum massage, and the need for regular dentist visits. The client
should not skip medication doses because this could precipitate a seizure. Capsules
should not be chewed or broken, and they must be swallowed. The client needs to be
instructed to report a sore throat, fever, glandular swelling, or any skin reaction because
this indicates hematological toxicity.
The client is taking phenytoin for seizure control, and a blood sample for a serum drug level
is drawn. Which laboratory finding indicates a therapeutic serum drug result? - Ans -
15 mcg/mL (59.52 mcmol/L)
Rationale:The therapeutic serum drug level range for phenytoin is 10 to 20 mcg/mL (39.68
to 79.36 mcmol/L).
Ibuprofen is prescribed for a client. Which instruction should the nurse give the client
2
about taking this medication? - Ans -Take with 8 oz of milk.
Page
, Rationale:Ibuprofen is a nonsteroidal antiinflammatory drug (NSAID). NSAIDs should be
given with milk or food to prevent gastrointestinal irritation.
The nurse is caring for a client who is taking phenytoin for control of seizures. During data
collection, the nurse notes that the client is taking birth control pills. Which information
should the nurse provide to the client? - Ans -The potential for decreased
effectiveness of the birth control pills exists while taking phenytoin.
Rationale:Phenytoin enhances the rate of estrogen metabolism, which can decrease the
effectiveness of some birth control pills.
The client with trigeminal neuralgia is being treated with carbamazepine. Which laboratory
result indicates that the client is experiencing an adverse effect of the medication? -
Ans -White blood cell count, 3000 mm3 (3 × 109/L)
Rationale:Adverse effects of carbamazepine appear as blood dyscrasias, including
aplastic anemia, agranulocytosis, thrombocytopenia, leukopenia, cardiovascular
disturbance, thrombophlebitis, dysrhythmia, and dermatological effects.
The client with myasthenia gravis is receiving pyridostigmine. The nurse monitors for signs
and symptoms of cholinergic crisis caused by overdose of the medication. The nurse
checks the medication supply to ensure that which medication is available for
administration if a cholinergic crisis occurs? - Ans -Atropine sulfate
Rationale:The antidote for cholinergic crisis is atropine sulfate. Acetylcysteine is the
antidote for acetaminophen. Vitamin K is the antidote for warfarin and protamine sulfate is
the antidote for heparin.
3
Page
