NCLEX Pharmacology Quiz 41 Neurological Medications

1. A pediatric client went to the emergency room complaining of right upper quadrant abdominal pain. nausea. and vomiting. Upon the interview of the nurse to the mother. the client has been taking a long-term use of acetaminophen. An overdosage of the medication is suspected. Which of the following medication should be readily available?

Naltrexone (ReVia).

Urea (Ureaphil).

Acetylcysteine (Mucomyst).

Valproic acid (Depakene).

Acetylcysteine (Mucomyst) is the antidote for acetaminophen toxicity.Option A is an opioid antagonist.Option B is an osmotic diuretic.Option C is a valproate.

Explanation

Acetylcysteine (Mucomyst) is the antidote for acetaminophen toxicity.Option A is an opioid antagonist.Option B is an osmotic diuretic.Option C is a valproate.

2. Codeine sulfate is prescribed to a client with a severe back pain. Which of the following side effect is associated with this medication?

Hypertension.

Urinary frequency.

Constipation.

Hyperactivity.

Codeine Sulfate is an opioid analgesic indicated for the relief of mild to moderately severe pain. Side effects include drowsiness. lightheadedness. dizziness. sedation. shortness of breath. nausea. vomiting. sweating. and constipation.

Explanation

Codeine Sulfate is an opioid analgesic indicated for the relief of mild to moderately severe pain. Side effects include drowsiness. lightheadedness. dizziness. sedation. shortness of breath. nausea. vomiting. sweating. and constipation.

3. A nurse is caring for a client with a history of overdosage of aspirin. The nurse suspects which of the following can be an early sign of aspirin toxicity?

Unsteady gait.

Drowsiness.

Confusion.

Tinnitus.

The earliest symptoms of acute aspirin poisoning may include ringing in the ears (tinnitus) and impaired hearing.Options A. B. and C are the late signs of aspirin poisoning.

Explanation

The earliest symptoms of acute aspirin poisoning may include ringing in the ears (tinnitus) and impaired hearing.Options A. B. and C are the late signs of aspirin poisoning.

4. Phenobarbital (luminal) is given to a client for a short treatment of anxiety. Which of the following results would indicate a therapeutic serum range of the medication?

5-10 mcg/ml.

15-40 mcg/ml.

45-65 mcg/ml.

50-90 mcg/ml.

The therapeutic serum range of phenobarbital is 15-40 ng/ml.

Explanation

The therapeutic serum range of phenobarbital is 15-40 ng/ml.

5. A client with bell's palsy tells the nurse that acetaminophen (Tylenol) is taken daily as prescribed by the physician. Which laboratory value would indicate a toxicity of the medication?

Blood urea nitrogen of 60 mg/dl.

Total bilirubin of 1.5 mg/dl.

Alkaline phosphatase of 120 IU/L.

Direct bilirubin of 0.3 mg/dl.

Acetaminophen is hepatotoxic. Among the choices. the blood urea nitrogen is elevated. The normal value of BUA is between 7 to 20 mg/dL (2.5 to 7.1 mmol/L).Options B. C. and D all have normal values.

Explanation

Acetaminophen is hepatotoxic. Among the choices. the blood urea nitrogen is elevated. The normal value of BUA is between 7 to 20 mg/dL (2.5 to 7.1 mmol/L).Options B. C. and D all have normal values.

6. Meperidine hydrochloride (Demerol) is given to a client who is experiencing post-operative pain. Which of the following are the side effects of the medication. except?

Tremors.

Diarrhea.

Urinary retention.

Hypotension.

Meperidine hydrochloride is an opioid analgesic. Side effects of this medication are as follows: nausea. vomiting. tremors. hypotension. urinary retention. confusion and respiratory depression

Explanation

Meperidine hydrochloride is an opioid analgesic. Side effects of this medication are as follows: nausea. vomiting. tremors. hypotension. urinary retention. confusion and respiratory depression

7. A nurse is providing instructions to a client is taking Doxapram (Dopram). Which of the following statements made by the client needs further instructions?

“I need to take the medication before meals”.

“I need to take the medication at bedtime”.

“I need to avoid drinking coffee”.

“I will not chew or crush long acting form of the medications”.

Doxapram (Dopram) is a central nervous system stimulant. One of the side effects is insomnia so instruct the client to take it at least 6 hours before bedtime to prevent it.

Explanation

Doxapram (Dopram) is a central nervous system stimulant. One of the side effects is insomnia so instruct the client to take it at least 6 hours before bedtime to prevent it.

8. A client with tonic-clonic seizure is receiving Phenobarbital (Luminal) and Valproic acid (Depakene). The nurse tells the client that:

Valproic acid decreases phenobarbital metabolism.

Valproic acid increases phenobarbital metabolism.

There is no interaction between the two.

Increase the dosage of the two medications.

Valproic acid appear to decrease phenobarbital metabolism. thus there is increase levels of phenobarbital in the body. Therefore. phenobarbital blood levels should be monitored and appropriate dosage adjustments made as indicated.

Explanation

Valproic acid appear to decrease phenobarbital metabolism. thus there is increase levels of phenobarbital in the body. Therefore. phenobarbital blood levels should be monitored and appropriate dosage adjustments made as indicated.

9. Diazepam (Valium) is prescribed to a client with alcohol withdrawal. Which of the following statements made by the client indicates an understanding of the treatment regimen?

“This medication causes a blurring of vision”.

“This medication will cause a decrease platelet and white blood cell count in my blood”.

“I’ll have my physician to lower my dosage once I started to feel okay”.

“Drinking grapefruit can decrease the side effects with this medication”.

Diazepam (Valium) can cause side effects such as sleepiness and drowsiness. Meanwhile. grapefruit can reduce the metabolism of this drug. This can result in increased pharmacologic effect of Valium as well as its side effects.

Explanation

Diazepam (Valium) can cause side effects such as sleepiness and drowsiness. Meanwhile. grapefruit can reduce the metabolism of this drug. This can result in increased pharmacologic effect of Valium as well as its side effects.

10. Mannitol (Osmitrol) an osmotic diuretic which is contraindicated to which conditions? Select all that apply

Pulmonary edema.

Narrow-angle glaucoma.

Heart failure.

Chemotherapy.

Too rapid infusion of large amounts of mannitol injection will cause a shift of intracellular water into the extracellular compartment resulting in cellular dehydration and overexpansion of the intravascular space with hyponatremia. congestive heart failure. and pulmonary edema.Option B: Mannitol is used to decrease ICP in clients with narrow-angle glaucoma.Option D: Mannitol is used with chemotherapy to induce diuresis.

Explanation

Too rapid infusion of large amounts of mannitol injection will cause a shift of intracellular water into the extracellular compartment resulting in cellular dehydration and overexpansion of the intravascular space with hyponatremia. congestive heart failure. and pulmonary edema.Option B: Mannitol is used to decrease ICP in clients with narrow-angle glaucoma.Option D: Mannitol is used with chemotherapy to induce diuresis.