Drugs: CNS Questions

1. Which adverse effect would the nurse NOT expect to observe in a client receiving a narcotic analgesic?
a. Urine retention
b. Constipation
c. Hypoglycemia
d. Hypotension

Ans: An A/E of narcotic analgesics is hyperglycemia. The nurse would not expect to see hypoglycemia.

2. Which assessment by the nurse is most important before administering meperidine (Demerol) to a patient?
a. Apical pulse rate
b. Respiratory rate
c. Blood pressure
d. Level of consciousness

Ans: Respiratory rate needs to be assessed before giving the client a narcotic as it can have a life-threatening effect.

3. Which client should have cautious use of naloxone hydrochloride (Narcan)?
a. Meperidine (Demerol)
b. Brittle diabetic
c. Asthmatic
d. Post-op radical neck

Ans: The client will experience withdrawal syndrome if naloxone is given to a client who is addicted to narcotics. Thus, narcotic addicts should use this drug cautiously.

4. What other drug is added to local anesthetics?
a. Epinephrine
b. Demerol
c. Atropine
d. Quinidine

Ans: Epinephrine is added to prolong anesthetic action, while shortening the onset of action and reducing blood flow to injection site.

5. Which of the following is a common complaint in a patient who is taking prescribed viscous lidocaine (Xylocaine) after a tooth extraction?
a. mouth sore
b. dryness of lips
c. sore throat
d. numbness of the tongue

Ans: Sore throat is a common complaint in patients taking viscous lidocaine because it can interfere with swallowing reflex and clients should at least wait 60 minutes after use before eating.

6. What A/E of pentobarbital (Nembutol) should you NOT include during a client education of the drug?
a. Respiratory depression
b. Anxiety and hand tremors
c. Hypotension and bradycardia
d. Dry mouth and urinary retention

Ans: A/E of pentobarbital do not include dry mouth and urinary retention. These effects are more typical of an anticholinergic drug.

7. Which group should not receive barbiturates?
a. Children <5>
b. Pregnant women
c. Nursing mothers
d. Adults with bleeding ulcers

Ans: Barbiturates are teratogenic and are contraindicated for pregnant women.

8. What should the nurse teach a child patient and her family to watch for a common adverse effect of phenytoin (Dilantin)?
a. Alopecia
b. Edema
c. Gingival hyperplasia
d. Hallucinations

Ans: Gingival hyperplasia is a common A/E of this drug, seen mostly in children and adolescents.

9. What is the drug of choice for status epilepticus?
a. Phenytoin (Dilantin)
b. Carbamazepine (Tegretol)
c. Phenobarbital (Luminal)
d. Diazepam (Valium)

Ans: Diazepam (Valium) is the DOC for status epilepticus

10. Which statement by a client indicates a need for more teaching about baclofen (Lioresal) by the nurse?
a. "I'll take my pills with my meals"
b. "I'll drive myself to work each day"
c. "I won't have wine with dinner anymore"
d. "I'll use sunscreen when I go outside"

Ans: Due to the depressant effects of this drug, the client should not engage in any potentially dangerous activities (driving or operate machinery) until the client response to the drug is known.

11. The nurse should handle carefully chlorpromazine (Thorazine) to be given to a patient IM to prevent:
a. Skin discoloration
b. Skin irritation
c. Headache
d. Dizziness

Ans: Handling the parenteral or liquid forms of chlorpromazine may cause contact dermatitis.

12. Which of the following interventions should be included in a patient's care plan concerning chlorpromazine (Thorazine) therapy?
a. Supervise ambulation
b. Take a hot bath to reduce agitation
c. Restrict fluid intake to prevent edema
d. Discontinue drug if sedation occurs

Ans: This drug can initially cause orthostatic hypotension; ambulation should be supervised to prevent falls until tolerance develops.

13. Which phenothiazine is used specifically as an antiemetic and rarely causes EPS?
a. Thioridazine (Mellaril)
b. Fluphenazine (Prolixin)
c. Promethazine (Phenergan)
d. Chlorpromazine (Thorazine)

Ans: Promethazine (Phenergan) is used as an antiemetic and rarely causes EPS.

14. Which antipsychotic agent is also used to treat Tourette's syndrome and causes less sedation than other phenothiazines?
a. Haloperidol (Haldol)
b. Thioridazine (Mellaril)
c. Fluphenazine (Prolixin)
d. Chlorpromazine (Thorazine)

Ans: Haloperidol is also used to treat Tourette's syndrome and causes less sedation.

15. Which of the following should be included in a client's teaching taking imipramine (Tofranil)?
a. Expect to see improvement of depression in 2-3 days
b. Stop taking drug if dizziness occurs
c. Do not drive or operate machinery
d. Take drug on an empty stomach

Ans: Imipramine can cause drowsiness; therefore the client should avoid driving and operating machinery.

16. When should a client expect to see improvement of depression while on impramine (Tofranil)?
a. 1-2 days
b. 1 week
c. Several weeks
d. Immediately after first dose

Ans: It takes several weeks (2-4 weeks) before seeing improvement of depression.

17. Which food/beverages should a client avoid while taking phenelzine (Nardil)?
a. Cheese
b. Apples
c. Pasta
d. Cereal

Ans: Foods such as cheese that contain tyramine or tryptophan should be avoided while taking MAO inhibitors to prevent hypertensive crisis.

18. Which statement by a client indicates a need for more teaching by the nurse concerning flouxetine (Prozac) therapy?
a. "I will take this medication in the morning"
b. "I will use calamine lotion if I get a skin rash"
c. "It will take a month before I feel better"
d. "I will check with my doctor before I take any other medications"

Ans: A skin rash resulting from use of flouxetine indicates an allergic reaction and should be reported to the provider immediately.