Chapter 20: Central Nervous System Stimulants Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 20: Central Nervous System Stimulants

Test Bank

MULTIPLE CHOICE

1. A nurse is teaching a group of clients about narcolepsy. The most important concept that the nurse should relay to the client is that narcolepsy is characterized by:

a.

falling asleep during early morning hours.

b.

falling asleep during normal waking hours.

c.

waking up during sleep.

d.

inability to fall asleep.

ANS: B

Narcolepsy is characterized by the client falling asleep during normal waking hours.

DIF: Cognitive Level: Application REF: p. 288

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pathophysiology

2. A client with narcolepsy is being treated with modafinil (Provigil). The nurse anticipates which expected response from the drug?

a.

An increase in the amount of time the client feels awake

b.

Increased effectiveness when given primarily after the evening meal

c.

Sleep induction

d.

Sleep paralysis if taken at bedtime

ANS: A

This is the function of this medication.

DIF: Cognitive Level: Application REF: p. 288

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

3. What is the best time to administer amphetamines for maximum effectiveness?

a.

At bedtime

b.

1 to 2 hours before sleep

c.

3 to 4 hours before sleep

d.

6 to 8 hours before sleep

ANS: D

Amphetamines should be given as far from normal sleep time as possible in order to avoid wakefulness.

DIF: Cognitive Level: Comprehension REF: p. 291

TOP: Nursing Process: Intervention/Implementation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

4. A client discloses to a nurse that he has taken amphetamines for 5 years for weight control. The nurse teaches the client that long-term use of amphetamines lead to:

a.

diarrhea.

b.

cardiac dysrhythmias.

c.

urinary retention.

d.

rash.

ANS: B

Long-term use of amphetamines can result in cardiac dysrhythmias.

DIF: Cognitive Level: Application REF: p. 288

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

5. A pediatric nurse admits a child who has a history of ADHD. The nurse is aware that ADHD may display as:

a.

poor coordination and abnormal electroencephalogram (EEG).

b.

abnormal EEG and decrease in intelligence.

c.

minimal brain dysfunction and marked decrease in intelligence.

d.

developmental delay and poor coordination.

ANS: A

Diagnostic manifestations of ADHD include poor coordination and an abnormal electroencephalogram.

DIF: Cognitive Level: Application REF: p. 288

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Psychosocial Integrity

6. The parents of a 6-year-old child diagnosed with ADHD will most typically describe their childs behavior as:

a.

a learning disorder and muscle paralysis.

b.

nervousness and sleeplessness.

c.

hyperactivity and decreased attention span.

d.

hyperactivity and nervousness.

ANS: C

Hyperactivity and decreased attention span are behaviors consistent with ADHD.

DIF: Cognitive Level: Comprehension REF: p. 288

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Psychosocial Integrity: Pharmacological and Parenteral Therapies

7. The nurse is deciding on a dosage schedule for methylphenidate (Ritalin). The nurse recognizes that which time is the most appropriate to administer this drug for maximum effectiveness?

a.

Before breakfast or lunch

b.

With meals

c.

After dinner

d.

At bedtime

ANS: A

This represents the correct time for administration of this drug. The drug should be taken 30 to 45 minutes before meals to enhance absorption and early in the day to avoid wakefulness at bedtime.

DIF: Cognitive Level: Application REF: p. 289

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

8. A client with ADHD is prescribed methylphenidate (Ritalin). Based on the half-life of the drug, how often should the nurse administer the drug?

a.

Daily

b.

Twice a day

c.

Every 8 hours

d.

Every 12 hours

ANS: B

Methylphenidate should not be given more than 6 hours before bedtime, because it may cause insomnia.

DIF: Cognitive Level: Application REF: p. 289

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

9. A client states that he is taking an over-the-counter (OTC) appetite suppressant. Clinical teaching should include that:

a.

OTC appetite suppressants are safe for daily use.

b.

appetite suppressants should be taken for no more than 4 to 6 months.

c.

an OTC amphetamine group frequently does not cause tolerance or dependence.

d.

appetite suppressants should be taken only with medical approval.

ANS: D

Appetite suppressants should be taken for only 4 to 12 weeks. Their administration should be monitored, and long-term use may lead to dependence.

DIF: Cognitive Level: Application REF: p. 289

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

10. A college student expresses to the health center nurse that he has been taking appetite suppressants for 8 years. The nurse recognizes that long-term use of anorexiants may result in which severe side effect?

a.

Heart palpitations

b.

Hypotension

c.

Drowsiness

d.

Abdominal cramps

ANS: A

Use of appetite suppressants will result in heart palpitations.

DIF: Cognitive Level: Comprehension REF: p. 289

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

11. A client enters the emergency department with a suspected drug overdose. The nurse anticipates that which CNS respiratory stimulant will be used to treat the client?

a.

Doxapram (Dopram)

b.

Sumatriptan (Imitrex)

c.

Methamphetamine (Desoxyn)

d.

Pemoline (Cylert)

ANS: A

Dopram is the drug of choice for suspected drug overdose.

DIF: Cognitive Level: Application REF: p. 291

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

12. A client complains of a mild migraine headache. What treatment may the healthcare provider suggest?

a.

Opioid analgesics (e.g., meperidine [Demerol])

b.

Analgesics (e.g., acetaminophen, ibuprofen)

c.

Ergotamine tartrate

d.

Serotonin1-receptor agonists (e.g., sumatriptan succinate [Imitrex])

ANS: B

For mild migraines, OTC analgesics are recommended.

DIF: Cognitive Level: Application REF: pp. 287-288

TOP: Nursing Process: Intervention/Implementation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

13. The client complains of a severe migraine headache. The nurse anticipates that the physician will order:

a.

opioid analgesics.

b.

nonnarcotic analgesics.

c.

ergotamine tartrate.

d.

serotonin1-receptor agonists (triptans).

ANS: D

More severe migraine headaches are treated with triptans.

DIF: Cognitive Level: Application REF: pp. 287-288

TOP: Nursing Process: Intervention/Implementation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

14. A client is 4 months pregnant and is sharing with the nurse her frustrations with regard to weight gain. The client asks about anorexiants. The nurses response is based on which information?

a.

Low-dose appetite suppressants are safe during pregnancy.

b.

Appetite suppressants can be taken while nursing, but not while pregnant.

c.

Appetite suppressants are not safe during pregnancy or while nursing.

d.

Research is inconclusive about the safety of appetite suppressants during pregnancy.

ANS: C

Appetite suppressants are contraindicated both during pregnancy and while breast-feeding.

DIF: Cognitive Level: Application REF: p. 292

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

15. A school nurse is caring for an adolescent diagnosed with migraine headaches. Which nursing intervention is most appropriate during an acute migraine?

a.

Maintain bright lights in the room.

b.

Administer sumatriptan succinate (Imitrex).

c.

Obtain a complete headache history.

d.

Provide ordered opioid analgesic.

ANS: B

The client will require treatment with Imitrex for relief.

DIF: Cognitive Level: Application REF: p. 288

TOP: Nursing Process: Intervention/Implementation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

16. A newborn with apnea of prematurity is treated with caffeine. Which condition would indicate to the nurse that the treatment was effective?

a.

Respiratory rate of 32 to 40 breaths/minute

b.

Heart rate of 80 to 100 beats/minute

c.

Respiratory rate of 20 to 30 breaths/minute

d.

Heart rate of 110 to 130 beats/minute

ANS: A

Caffeine is ordered to stimulate respiratory activity. The first option indicates a respiratory rate in the correct range.

DIF: Cognitive Level: Analysis REF: p. 292

TOP: Nursing Process: Evaluation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

17. A nurse is teaching the family of a child with ADHD about her diet and medications. The child is prescribed methylphenidate (Ritalin) every day. In teaching about the clients diet, it is most important that the nurse encourage the child to avoid which foods and/or drinks?

a.

High-sodium foods

b.

High-sugar foods and drinks

c.

High-fat foods

d.

Caffeinated foods and drinks

ANS: D

Caffeine is contraindicated with methylphenidate. There is no evidence of the other foods interacting with methylphenidate.

DIF: Cognitive Level: Application REF: p. 289

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

18. A client suffers from migraine headaches and is ordered to receive sumatriptan succinate (Imitrex). The client asks why the medication works. The nurse explains that this medication:

a.

dilates cerebral vessels to increase cerebral blood flow.

b.

causes vasoconstriction to relieve migraine attacks.

c.

increases blood flow and oxygen to the brain.

d.

decreases blood pressure in order to decrease oxygen to the brain.

ANS: B

Migraines are caused by vasodilation and increased blood flow to the cerebral tissues. These medications decrease the blood flow and the symptoms of migraines.

DIF: Cognitive Level: Application REF: pp. 287-288

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

19. The client has been placed on Ritalin. He is already being treated with Coumadin. The nurse anticipates that the combination of the two drugs will have a(n) _____ in the effect of the _____.

a.

increase; Coumadin

b.

decrease; Coumadin

c.

increase; Ritalin

d.

decrease; Ritalin

ANS: A

When Ritalin is combined with Coumadin, the result will be an increase in the effect of the Coumadin.

DIF: Cognitive Level: Application REF: p. 289

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Psychosocial Integrity

20. The nurse is caring for a 5-year-old child who has been placed on Ritalin. What is the highest priority action on the part of the nurse?

a.

Administer the medication as ordered by the physician.

b.

Monitor the client closely during administration.

c.

Hold the medication and call the physician.

d.

Call the pharmacist to verify the dosage of the drug.

ANS: C

Ritalin should not be given to a client younger than 6 years.

DIF: Cognitive Level: Application REF: p. 289

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

21. The client is an older adult who has been started on Provigil. The nurse anticipates that the dosage of the drug will need to be:

a.

doubled.

b.

cut in half.

c.

decreased.

d.

increased.

ANS: C

When Provigil is administered to an older adult, the dosage must be decreased.

DIF: Cognitive Level: Application REF: p. 291

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

ESSAY

1. A newborn is ordered to receive caffeine to stimulate respiratory activity. The medication order reads caffeine 0.5 mg/kg. The infant weighs 8.8 pounds. The medication is available in a 20 mg/mL elixir. How much should the infant receive?

ANS:

0.1 mL

8.8 lb = 4 kg. 0.5 mg/kg 4 kg = 2 mg. 20 mg = 1 mL; then 2 mg = 0.1 mL.

DIF: Cognitive Level: Application REF: p. 292

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

Copyright 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

Leave a Reply