Review Nursing interventions and care

Controlled Substances and Prescription Drugs > Pharmacology

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Nursing interventions and care

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Total Questions : 7

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Question 1:

A nurse is reviewing the medication record of a client who has a history of substance use disorder and is prescribed methadone for opioid withdrawal. Which of the following actions should the nurse take to ensure the safe administration of this controlled substance? (Select all that apply.)

A. Verify the client's identity using two identifiers. B. Document the dose and time of administration in the controlled substance log. C. Count the remaining methadone tablets with another nurse before and after administration. D. Dispose of any unused or expired methadone tablets in a sharps container. E. Assess the client for signs of sedation and respiratory depression after administration.

Answer and Explanation

Choice A:

Rationale: Methadone is a Schedule II controlled substance that requires strict regulation and documentation. The nurse should verify the client's identity, document the dose and time of administration, count the remaining tablets with another nurse, and assess the client for adverse effects. Disposing of unused or expired methadone tablets in a sharps container is not appropriate as it poses a risk of needlestick injury and environmental contamination.

Choice B:

Choice C:

Choice D:

This is incorrect as it poses a risk of needlestick injury and environmental contamination.

Choice E:

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Question 2:

A client who is receiving morphine sulfate for severe pain reports feeling nauseated and vomits. The nurse should recognize that this is an adverse effect of which of the following classifications of controlled substances?

A. Opioids B. Stimulants C. Depressants D. Hallucinogens

Answer and Explanation

Choice A:

Rationale: Opioids are controlled substances that act on opioid receptors to produce analgesia, euphoria, sedation, and respiratory depression. Nausea and vomiting are common adverse effects of opioids due to stimulation of the chemoreceptor trigger zone in the brain.

Choice B:

Stimulants are controlled substances that increase alertness, energy, mood, and heart rate. Nausea and vomiting are not typical adverse effects of stimulants.

Choice C:

Depressants are controlled substances that reduce anxiety, agitation, and insomnia. Nausea and vomiting are not typical adverse effects of depressants.

Choice D:

Hallucinogens are controlled substances that alter perception, cognition, mood, and behavior. Nausea and vomiting are not typical adverse effects of hallucinogens.

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Question 3:

A nurse is preparing to administer diazepam to a client who has an anxiety disorder. The nurse should identify that diazepam belongs to which of the following schedules of controlled substances?

A. Schedule I B. Schedule II C. Schedule III D. Schedule IV

Answer and Explanation

Choice A:

Schedule I substances have no accepted medical use and a high potential for abuse and dependence. Examples include heroin, LSD, and ecstasy.

Choice B:

Schedule II substances have a high potential for abuse and dependence but have some accepted medical uses with severe restrictions. Examples include morphine, oxycodone, and cocaine.

Choice C:

Schedule III substances have a moderate potential for abuse and dependence but have accepted medical uses. Examples include codeine, ketamine, and anabolic steroids.

Choice D:

Rationale: Diazepam is a benzodiazepine that acts as a central nervous system depressant. It belongs to Schedule IV of controlled substances, which have a low potential for abuse and dependence compared to Schedule I, II, or III substances.

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Question 4:

A nurse is caring for a client who is receiving phenobarbital for a seizure disorder. The nurse should monitor the client for which of the following adverse effects of this controlled substance?

A. Hypertension B. Tachycardia C. Insomnia D. Drowsiness

Answer and Explanation

Choice A:

Hypertension is not a typical adverse effect of phenobarbital or other barbiturates. Phenobarbital can cause hypotension due to vasodilation.

Choice B:

Tachycardia is not a typical adverse effect of phenobarbital or other barbiturates. Phenobarbital can cause bradycardia due to decreased cardiac output.

Choice C:

Insomnia is not a typical adverse effect of phenobarbital or other barbiturates. Phenobarbital can cause sedation and sleepiness.

Choice D:

Rationale: Phenobarbital is a barbiturate that acts as a central nervous system depressant. It belongs to Schedule IV of controlled substances, which have a low potential for abuse and dependence compared to Schedule I, II, or III substances. Drowsiness is a common adverse effect of phenobarbital and other barbiturates.

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Question 5:

A nurse is teaching a client who has attention deficit hyperactivity disorder (ADHD) and is prescribed methylphenidate. The nurse should inform the client that methylphenidate belongs to which of the following classifications of controlled substances?

A. Opioids B. Stimulants C. Depressants D. Hallucinogens

Answer and Explanation

Choice A:

Opioids are controlled substances that act on opioid receptors to produce analgesia, euphoria, sedation, and respiratory depression. They belong to Schedule II or III of controlled substances depending on their potency and formulation.

Choice B:

Rationale: Methylphenidate is a stimulant that acts on the central nervous system to increase alertness, attention, and focus. It belongs to Schedule II of controlled substances, which have a high potential for abuse and dependence but have some accepted medical uses with severe restrictions.

Choice C:

Depressants are controlled substances that reduce anxiety, agitation, and insomnia. They belong to Schedule IV or V of controlled substances depending on their potential for abuse and dependence.

Choice D:

Hallucinogens are controlled substances that alter perception, cognition, mood, and behavior. They belong to Schedule I of controlled substances, which have no accepted medical use and a high potential for abuse and dependence.

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Question 6:

A nurse is reviewing the medication administration record of a client who has bipolar disorder and is prescribed lithium carbonate. The nurse should recognize that lithium carbonate belongs to which of the following categories of prescription drugs?

A. Controlled substances B. Legend drug C. Over-the-counter drug D. Herbal supplement

Answer and Explanation

Choice A:

Controlled substances are drugs that have a potential for abuse or dependence and are regulated by the Drug Enforcement Administration (DEA). They are classified into five schedules based on their medical use and abuse potential.

Choice B:

Rationale: Lithium carbonate is a legend drug, which means that it requires a prescription from a licensed provider and has a label that states "Caution: Federal law prohibits dispensing without prescription." Legend drugs are not classified as controlled substances unless they have a potential for abuse or dependence.

Choice C:

Over-the-counter drugs are drugs that do not require a prescription and can be purchased by consumers without supervision from a health care provider. They have labels that state "Drug Facts" and provide information about their ingredients, uses, warnings, directions, and other information.

Choice D:

Herbal supplements are products that contain plant extracts or other natural ingredients that are intended to supplement the diet or promote health. They are not regulated by the Food and Drug Administration (FDA) as drugs but as dietary supplements. They have labels that state "Supplement Facts" and provide information about their ingredients, serving size, amount per serving, and other information

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Question 7:

A client who has chronic pain due to cancer is prescribed fentanyl patches for pain management. The nurse should instruct the client to follow which of the following guidelines when using this controlled substance? (Select all that apply.)

A. Apply the patch to a dry, hairless area of intact skin. B. Change the patch every 24 hours or as needed for pain relief. C. Dispose of the used patch by flushing it down the toilet. D. Avoid exposing the patch to heat sources such as heating pads or hot tubs. E. Report any signs of confusion, drowsiness, or difficulty breathing.

Answer and Explanation

Choice A:

Rationale: Fentanyl patches are transdermal delivery systems that provide continuous opioid analgesia for up to 72 hours. The nurse should instruct the client to apply the patch to a dry, hairless area of intact skin; avoid exposing the patch to heat sources that can increase absorption and cause overdose; and report any signs of opioid toxicity such as confusion, drowsiness, or difficulty breathing.

Choice B:

This is incorrect as changing the patch more frequently than every 72 hours can cause overdose and dependence.

Choice C:

This is incorrect as flushing the patch down the toilet can contaminate the water supply and pose a risk of accidental ingestion by children or pets. The nurse should instruct the client to fold the patch in half with the sticky sides together and dispose of it in a secure trash container.

Choice D:

Choice E:

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Total Questions : 7

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Nursing interventions and care

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