NCLEX Pharmacology Quiz 26 Neurologic And Psychiatric Drugs

1. As a knowledgeable nurse. you know that you should never give amphetamines in combination with:

Oral hypoglycemics

Insulin

MAO inhibitors

Antihypertensives

MAO inhibitors must never be given with drugs affecting the CNS because hypertension can occur. Amphetamines can be given with oral hypoglycemics and insulin as long as blood sugar levels are monitored because these can decrease antidiabetic requirements.

Explanation

MAO inhibitors must never be given with drugs affecting the CNS because hypertension can occur. Amphetamines can be given with oral hypoglycemics and insulin as long as blood sugar levels are monitored because these can decrease antidiabetic requirements.

2. The nurse evaluates that carbidopa and levodopa (Sinemet) is therapeutically effective if the client has:

Decreased GI responses

Increased tolerance to pyridoxine

Decreased tremors at rest

Increased urinary output

Carbidopa and levodopa help restore the balance between dopamine and acetylcholine. thereby controlling the responses of Parkinson’s disease.

Explanation

Carbidopa and levodopa help restore the balance between dopamine and acetylcholine. thereby controlling the responses of Parkinson’s disease.

3. Amphetamines and amphetamine-like compounds are most commonly used for:

Narcolepsy

Attention deficit disorder

Exogenous obesity

All of the above

The most common uses of amphetamines and amphetamine-like compounds are narcolepsy. exogenous obesity. and attention deficit disorder.

Explanation

The most common uses of amphetamines and amphetamine-like compounds are narcolepsy. exogenous obesity. and attention deficit disorder.

4. The client asks the nurse why he is taking bromocriptine (Parlodel). The nurse's reply is based in the understanding that bromocriptine mimics the effects of dopamine by:

Decreasing dopamine levels in the brain

Decreasing the storage of dopamine peripherally

Activating dopamine receptors in the brain

Inhibiting monoamine oxidase type B

Bromocriptine is a dopaminergic agent. and this response refers to its action. Choice A refers to the action of levodopa. Choice B refers to the action of carbidopa and levodopa. Choice D refers to the action of selegiline.

Explanation

Bromocriptine is a dopaminergic agent. and this response refers to its action. Choice A refers to the action of levodopa. Choice B refers to the action of carbidopa and levodopa. Choice D refers to the action of selegiline.

5. Use of methylphenidate for attention deficit disorders in children can result in:

Tourette’s syndrome

Growth suppression

Growth spurt

A and B

Use of Ritalin does not cause a growth spurt. Instead. it can cause Tourette’s syndrome and growth suppression in children.

Explanation

Use of Ritalin does not cause a growth spurt. Instead. it can cause Tourette’s syndrome and growth suppression in children.

6. When administering IV phenytoin (Dilantin). the nurse should:

Administer it at a rate 100 mg/min.

Protect the drug from light exposure.

Mix the drug in dextrose solution.

Mix the drug in saline solution.

Phenytoin must be mixed in saline solution only. Phenytoin should be administered at a rate of 50 mg/min. There is no need to protect phenytoin from light because it does not destabilize with light exposure. Phenytoin will precipitate when mixed with a dextrose solution.

Explanation

Phenytoin must be mixed in saline solution only. Phenytoin should be administered at a rate of 50 mg/min. There is no need to protect phenytoin from light because it does not destabilize with light exposure. Phenytoin will precipitate when mixed with a dextrose solution.

7. The priority nursing intervention for a client receiving amantadine is to teach the client to:

Monitor the pulse for rate and regularity.

Take the last dose of medication at bedtime.

Inspect the skin for erythematous rash.

Stop taking the drug if the mouth becomes dry.

Dopaminergic agents can cause heart rate changes and cardiac arrhythmias. Choice B is incorrect because amantadine can cause insomnia. Choice C is incorrect because an adverse effect of amantadine is a mottled discoloration of the skin. Choice D is incorrect because dry mouth is an expected side effect and not an indication to discontinue amantadine.

Explanation

Dopaminergic agents can cause heart rate changes and cardiac arrhythmias. Choice B is incorrect because amantadine can cause insomnia. Choice C is incorrect because an adverse effect of amantadine is a mottled discoloration of the skin. Choice D is incorrect because dry mouth is an expected side effect and not an indication to discontinue amantadine.

8. When caring for a client who is receiving phenytoin and warfarin (Coumadin). the nurse would expect which of the following drug-drug interactions?

Decreased effectiveness of warfarin

Increased effectiveness of phenytoin

Increased effectiveness of warfarin

Decreased effectiveness of phenytoin

The interaction will reduce the effectiveness of warfarin.

Explanation

The interaction will reduce the effectiveness of warfarin.

9. Before administering amantadine (Symadine). the nurse should investigate which of the following client statements?

“My hands are always shaking.”

“I had to take Dilantin 6 months ago.”

“I take low-dose enteric aspirin each day.”

“Simple tasks seem to take so long to perform.”

Amantadine is used cautiously in clients with a history of seizures. A and D are clinical manifestations of Parkinson’s disease. Amantadine does not interact negatively with aspirin.

Explanation

Amantadine is used cautiously in clients with a history of seizures. A and D are clinical manifestations of Parkinson’s disease. Amantadine does not interact negatively with aspirin.

10. Which of the following assessment is most essential before beginning a drug regimen of an antimuscarinic agent?

Date of birth

Ethnic background

History of diabetes

Activity intolerance

Antimuscarinic agents are contraindicated in elderly patients.

Explanation

Antimuscarinic agents are contraindicated in elderly patients.