Physiology and pharmacology N215 Exam IV MCQS

Physiology and pharmacology N215 Exam IV MCQS

Total Questions : 21

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Question 1: View

A client is being prescribed dextroamphetamine for the treatment of attention deficit hyperactivity disorder (ADHD). During health education, the nurse should make the client aware of the black box warning relating to what potential risk issue?

Explanation

Dextroamphetamine is a central nervous system (CNS) stimulant that is used to treat ADHD and narcolepsy. The drug has a high potential for abuse and dependence, and therefore it carries a black box warning from the FDA. The black box warning is the strongest warning that the FDA requires, and it indicates that a drug has a significant risk of serious or life-threatening adverse effects.

The black box warning for dextroamphetamine relates to its potential for abuse, addiction, and misuse. The drug should only be used as directed by a healthcare provider, and clients should be advised not to share their medication with others or to take more than the prescribed dose. Excessive doses of dextroamphetamine can lead to serious adverse effects, including stroke and heart attack. Clients should also be advised to store their medication securely and to dispose of any unused medication properly.


Question 2: View

A client with a history of heroin use has begun addiction treatment. The nurse had administered the client's daily dose of methadone. How does methadone therapy affect opioid addiction?

Explanation

Methadone is a synthetic opioid medication that is used to treat opioid addiction. Methadone acts as an agonist at opioid receptors in the brain and central nervous system, which helps to prevent withdrawal symptoms and reduce cravings for opioids.

Methadone is a long-acting opioid, which means that it has a slower onset and longer duration of action compared to other opioids like heroin or morphine. This allows methadone to stabilize the client's opioid receptors and prevent withdrawal symptoms for up to 24 hours or more.

Methadone is often used as a part of medication-assisted treatment (MAT) for opioid addiction. MAT combines medication, such as methadone, with counseling and behavioral therapies to provide a comprehensive approach to addiction treatment.


Question 3: View

A client is diagnosed with overdose of diazepam. What drug does the nurse anticipate being administered?

Explanation

Flumazenil is a medication that is used as an antidote for benzodiazepine overdose, including diazepam. Benzodiazepines are a class of drugs that are used to treat anxiety, insomnia, seizures, and other conditions. However, they can also be abused or taken in excessive doses, leading to overdose.

Flumazenil works by binding to the same receptors in the brain that benzodiazepines bind to, but it has the opposite effect. Flumazenil blocks the activity of benzodiazepines and can rapidly reverse the effects of an overdose, including respiratory depression, sedation, and coma.

It is important to note that flumazenil should only be used in cases of benzodiazepine overdose and should be administered under close medical supervision. Flumazenil may cause seizures in clients who are physically dependent on benzodiazepines, and it should not be used as a substitute for appropriate medical care and monitoring.


Question 4: View

A client is being prescribed a central nervous system stimulant. Which will haw lowest risk of abuse and dependence?

Explanation

Atomoxetine is a non-stimulant medication that is used to treat attentiondeficit/hyperactivity disorder (ADHD). Unlike central nervous system (CNS) stimulants such as dextroamphetamine, dexmethylphenidate, and dextroamphetamine/amphetamine, atomoxetine does not have a high risk of abuse or dependence.

CNS stimulants like dextroamphetamine, dexmethylphenidate, and dextroamphetamine/amphetamine can be effective in treating ADHD symptoms, but they can also be abused and lead to dependence. These medications work by increasing levels of dopamine and norepinephrine in the brain, which can improve focus and attention. However, they also have the potential to be misused, particularly by individuals seeking a "high" or increased alertness.

In contrast, atomoxetine works by selectively inhibiting the reuptake of norepinephrine in the brain. This mechanism of action does not produce the same effects on dopamine levels as CNS stimulants, and it is not associated with a high risk of abuse or dependence. However, it may take several weeks for the full therapeutic effects of atomoxetine to be seen, and it may not be as effective as CNS stimulants for some individuals with ADHD.


Question 5: View

A client is prescribed disulfiram. How does this medication assist the client in refraining from ingestion of alcohol?

Explanation

Disulfiram is a medication used to treat alcohol use disorder (AUD). It works by inhibiting the enzyme acetaldehyde dehydrogenase, which is responsible for breaking down acetaldehyde, a toxic metabolite of alcohol. When alcohol is consumed while taking disulfiram, the accumulation of acetaldehyde in the body leads to unpleasant symptoms such as flushing, sweating, nausea, and vomiting. This creates an aversive reaction to alcohol consumption, which can help the client refrain from drinking.

The aversive effects of disulfiram can last for several hours to several days after alcohol consumption, depending on the dose of disulfiram and the amount of alcohol consumed. Therefore, it is important for clients taking disulfiram to avoid all sources of alcohol, including alcoholic beverages, mouthwash, and other products containing alcohol.

It is important to note that disulfiram is not a cure for AUD, and it works best when used as part of a comprehensive treatment plan that includes counseling and support. Disulfiram should only be used under the close supervision of a healthcare provider, as it can have serious side effects if used improperly.


Question 6: View

A client is to be started on amphetamine therapy for attention deficit hyperactivity disorder. Which medication has less physical dependence and abuse than other amphetamines?

Explanation

Lisdexamfetamine is a prodrug of dextroamphetamine, which means that it is converted into dextroamphetamine in the body. It is a central nervous system (CNS) stimulant medication used to treat attention deficit hyperactivity disorder (ADHD). Lisdexamfetamine has a lower risk of abuse and dependence compared to other amphetamines, such as methamphetamine, dextroamphetamine, and dextroamphetamine and amphetamine combination products.

Lisdexamfetamine is a long-acting medication that is taken once daily, and it has a slower onset of action compared to other amphetamines. This slower onset of action may make it less attractive for abuse or misuse, as individuals seeking immediate effects may be less likely to use lisdexamfetamine.

However, it is important to note that all amphetamines have the potential for abuse and dependence, and they should only be used under the close supervision of a healthcare provider. Individuals taking amphetamines for ADHD should be closely monitored for signs of misuse, and the medication should be discontinued if misuse or abuse is suspected.


Question 7: View

A client is started on levothyroxine for the treatment of hypothyroidism. During client teaching, the nurse indicates that the dosage may be increased how often until symptoms are relieved?

Explanation

A. Weekly – This frequency is too frequent for dosage adjustments of levothyroxine. Adjustments are generally made less frequently to allow for the medication to reach therapeutic levels.

B. Monthly – While some adjustments may be made on a monthly basis, this is not the typical recommendation.

C. Every 3 to 5 days – This is also too frequent for dosage adjustments as it may not allow enough time to assess the effects of the current dose.

D. Every 4 to 6 weeks – This is the correct recommendation for adjusting levothyroxine dosages. After starting therapy or adjusting the dose, it is advised to wait 4 to 6 weeks before evaluating thyroid function tests and making any further adjustments to the dosage, as it takes time for the medication to take effect.


Question 8: View

A client will be using an insulin pump to deliver a consistent amount of insulin to meet the client's needs. Where should the nurse insert the pump for the maximum amount of absorption?

Explanation

When using an insulin pump, the best site for inserting the infusion set is in the abdomen. This is because the abdomen has a higher amount of subcutaneous fat and a larger surface area, which allows for better absorption of the insulin. In addition, the abdomen is more accessible and easier to reach for self-insertion, and it also allows for better flexibility and comfort for the patient during daily activities.

It is important to rotate the infusion set insertion sites within the abdomen to avoid tissue damage and to ensure consistent absorption. Other sites, such as the hip, thigh, or deltoid, may be used but are generally not recommended due to the potential for slower absorption, tissue damage, and discomfort for the patient


Question 9: View

A client will soon begin long-term treatment with hydrocortisone after being diagnosed with Addison's disease. In order to mitigate the potential adverse effect of this treatment regimen, the nurse should encourage the client to increase the intake of what nutrient?

Explanation

Hydrocortisone is a synthetic form of the hormone cortisol, which is produced by the adrenal glands. Addison's disease is a condition in which the adrenal glands do not produce enough cortisol and other hormones. Treatment with hydrocortisone is a lifelong therapy that replaces the missing hormones.

One of the potential adverse effects of long-term treatment with hydrocortisone is the development of sodium depletion or hyponatremia. This occurs because hydrocortisone can increase the excretion of sodium in the urine, leading to low levels of sodium in the blood.

To mitigate this potential adverse effect, the nurse should encourage the client to increase their intake of sodium. This can be done through dietary sources such as adding more salt to their food or drinking sports drinks that contain electrolytes. The client should also be monitored closely for signs of sodium depletion, such as weakness, fatigue, and confusion.

It is also important to note that long-term treatment with hydrocortisone can increase the risk of other adverse effects, such as osteoporosis, hyperglycemia, and infection. The nurse should educate the client on these potential adverse effects and encourage them to follow their healthcare provider's instructions for monitoring and management.


Question 10: View

A client who regularly takes metformin has developed a severe infection. How will the infection change the established diabetic regimen?

Explanation

Metformin is an oral medication used to lower blood sugar levels in clients with type 2 diabetes. It works by decreasing the production and absorption of glucose in the liver and intestines, respectively. However, metformin is contraindicated in clients with severe infections, as the drug can increase the risk of developing lactic acidosis, a rare but serious complication characterized by the buildup of lactic acid in the bloodstream.

During a severe infection, the body may experience a state of inflammation and stress, which can cause metabolic changes that increase the risk of developing lactic acidosis. Therefore, metformin should be temporarily discontinued in clients with severe infections and resumed only after the infection has been successfully treated and resolved.

In the meantime, the client's diabetic regimen may need to be adjusted to maintain appropriate blood sugar levels. This may include the use of alternative medications such as insulin, which can be used to control blood sugar levels during times of illness or infection. The healthcare provider will determine the appropriate management plan based on the individual client's needs and medical history.


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