ATI-P ATI Pharmacology - Set 1 - Part 2

Correct Answer: A benzodiazepine

Benzodiazepines are first-line for alcohol withdrawal because they ease symptoms, lower the seizure risk, and provide substitution therapy. The nurse should expect a benzodiazepine to be ordered to help keep the client's vital signs stable during withdrawal. Option a is incorrect because naloxone reverses opioid effects and has no role in alcohol withdrawal. It would not relieve the tremors, agitation, or seizure risk that benzodiazepines address, so it is not the medication the nurse should anticipate here. Option b is incorrect because disulfiram is used for abstinence maintenance after withdrawal and causes an unpleasant reaction if alcohol is consumed. It is not given to treat the acute withdrawal manifestations that this client is currently experiencing during alcohol withdrawal. Option d is incorrect because methadone is used for opioid withdrawal and maintenance, not alcohol withdrawal. It does not target the seizure risk and the autonomic symptoms that occur during alcohol

Correct Answer: Naloxone

Naloxone is the specific opioid antagonist used to reverse respiratory depression, coma, and other signs of opioid toxicity. The nurse should anticipate giving naloxone to restore adequate breathing and reverse the opioid effects in this client. Option a is incorrect because flumazenil reverses benzodiazepine toxicity, not opioid toxicity. It would not counteract the respiratory depression caused by an opioid, so it is the wrong antidote for a client experiencing opioid toxicity with slowed breathing. Option c is incorrect because atropine is used to treat cholinergic excess and a slow heart rate. It does not reverse opioid effects, so atropine would not help a client whose breathing is depressed because of opioid toxicity in this situation. Option d is incorrect because dantrolene relieves malignant hyperthermia and muscle spasticity. It has no action against opioids, which makes it an inappropriate choice for reversing opioid toxicity and the respiratory depression that this client i

Correct Answer: Mouthwash containing alcohol

Disulfiram causes a severe reaction when combined with any alcohol, including hidden sources. Alcohol-containing mouthwash can trigger nausea, flushing, and palpitations, so the client must avoid it along with other products that contain alcohol. Option a is incorrect because caffeinated coffee does not contain alcohol and does not provoke a disulfiram reaction. The concern with disulfiram is exposure to alcohol, so coffee is not the product the client must avoid while taking this medication. Option b is incorrect because aged cheeses are a concern with monoamine oxidase inhibitors because of tyramine, not with disulfiram. Disulfiram reacts specifically with alcohol, so aged cheese is not the relevant restriction for a client taking this drug. Option c is incorrect because dairy products do not contain alcohol and are not linked to a disulfiram reaction. The teaching for this client focuses on avoiding all sources of alcohol, which ordinary dairy products are not in this case.

Correct Answer: Avoid alcohol while taking this medication.

Benzodiazepines depress the central nervous system, and alcohol intensifies this effect, which raises the risk of severe respiratory depression. The nurse should instruct the client to avoid alcohol completely while taking the medication for insomnia. Option b is incorrect because high-fat meals can slow the absorption of some benzodiazepines, but taking the drug with fatty food is not the key teaching point. The critical instruction is to avoid alcohol, not to pair the dose with a fatty meal. Option c is incorrect because doubling the dose can cause dangerous oversedation and respiratory depression in the client. Clients should take only the prescribed amount, so increasing the dose on their own when sleep is slow to come is unsafe guidance. Option d is incorrect because benzodiazepines can cause lingering drowsiness and impaired coordination into the next day. The client should avoid driving until the sedating effects fully wear off, so driving as usual the next morning could be haza

Correct Answer: Reduced bradykinesia and improved movement

Levodopa and carbidopa restore dopamine activity in the brain, which relieves bradykinesia, tremor, and rigidity. Improved movement and greater ease with daily activities are the expected therapeutic effects of this combination medication for the client. Option a is incorrect because increased rigidity and tremor would indicate that the medication is not working. The goal of levodopa and carbidopa is to lessen these motor symptoms, so worsening them is the opposite of the expected therapeutic effect. Option b is incorrect because a worsening shuffling gait reflects uncontrolled Parkinson's disease rather than effective treatment. The therapy is intended to improve gait and mobility, so this finding would not be expected when the medication is working well. Option d is incorrect because the medication relieves manifestations even though it does not halt disease progression. A faster decline in motor function is not the intended outcome and would suggest that the drug is failing to

Correct Answer: "My sweat and urine may harmlessly darken."

Levodopa can cause a harmless darkening of sweat and urine in the client. Recognizing this as an expected, benign effect reassures the client and reflects correct understanding of the known and harmless effects of the medication. Option a is incorrect because high-protein meals can delay levodopa absorption and reduce its effect on symptoms. The client should avoid pairing doses with high-protein foods, so this statement reflects a misunderstanding of the teaching about this medication. Option b is incorrect because stopping the medication when feeling better can cause symptoms to return and should be avoided. Therapy is continued under provider guidance over the long term, so this statement is incorrect and shows a knowledge gap. Option c is incorrect because levodopa and carbidopa relieve symptoms but do not cure Parkinson's disease or stop its progression over time. Believing that the drug is curative shows that the teaching about its purpose was not understood by the client.

Correct Answer: Cholinergic crisis from excess medication

Muscle weakness combined with heavy cholinergic signs such as drooling, tearing, and cramping indicates a cholinergic crisis from too much neostigmine. The nurse should withhold the next dose and notify the provider promptly about these findings. Option b is incorrect because a myasthenic crisis from too little drug also causes weakness, but it would not flood the client with saliva, tears, and abdominal cramps. Those extra secretions are what distinguish a cholinergic overdose from undertreatment here. Option c is incorrect because an allergic reaction would more likely bring rash, swelling, or breathing difficulty rather than heavy secretions. A picture dominated by drooling, tearing, and abdominal cramping points to cholinergic excess instead of a hypersensitivity reaction. Option d is incorrect because poor absorption would simply let the client's weakness return without any added secretions. The drooling and abdominal cramping show that the drug is very much active in the bod

Correct Answer: Overgrowth of the gums

Phenytoin commonly causes gingival hyperplasia, an overgrowth of gum tissue, with long-term use. The nurse should monitor for this effect and teach the client to maintain good oral hygiene in order to help reduce the gum overgrowth. Option a is incorrect because yellowing of the sclera suggests liver problems and jaundice, which is not the classic phenytoin effect. Gum overgrowth, rather than scleral yellowing, is the hallmark long-term finding the nurse should watch for with this medication. Option b is incorrect because a persistent dry cough is associated with certain blood pressure medications, not with phenytoin. It is not a recognized adverse effect of this antiseizure drug, so it is not the finding the nurse should monitor for here. Option d is incorrect because hair loss is not a typical phenytoin effect; the drug is more often linked to coarse facial features and excess hair growth. Gingival hyperplasia, an overgrowth of gum tissue, is the expected oral change with extended th

Correct Answer: Take the medication exactly as prescribed.

Antiepileptic medications must be taken consistently to maintain steady blood levels and prevent seizures. Teaching the client to take the drug exactly as prescribed supports seizure control and helps avoid breakthrough seizure activity over time. Option a is incorrect because stopping the medication when seizures stop can trigger their return, sometimes severely. The drug controls but does not cure the disorder, so discontinuing it abruptly once seizures cease is unsafe for the client. Option c is incorrect because skipping doses lowers blood levels and increases the chance of a seizure occurring. Consistent daily dosing is essential for seizure control, so missing doses on days when the client feels well undermines the therapy. Option d is incorrect because clients should avoid driving until seizures are well controlled and the effects of the drug are known. Driving right after starting the medication could be dangerous if a seizure or excessive drowsiness occurs unexpectedly.

Correct Answer: Apply pressure to the inner eye corner.

Applying gentle pressure over the nasolacrimal duct at the inner corner of the eye reduces drainage of the drug into the systemic circulation. This limits systemic beta-blocker effects such as a slow heart rate or bronchospasm. Option a is incorrect because rapid blinking pushes medication out of the eye and does not limit systemic absorption. Pressure on the inner corner of the eye, rather than blinking, is the technique that actually reduces systemic uptake of the drops. Option b is incorrect because placing drops directly on the cornea causes discomfort and is improper technique. It does nothing to reduce systemic absorption, which instead requires pressing on the tear duct beside the nose after the drops are instilled. Option c is incorrect because holding the eyes wide open does not prevent drainage of the medication into the nasolacrimal duct. Gentle closure of the eye with inner-corner pressure is what limits the drug from entering the bloodstream after instillation.

Correct Answer: Pull the auricle up and back.

For an adult, the nurse pulls the auricle up and back to straighten the ear canal so the drops reach their target. This positioning promotes proper distribution of the medication throughout the ear canal during instillation. Option b is incorrect because pulling the auricle down and back is the technique used for a young child, not an adult. Using it on an adult would not straighten the canal correctly, so it is the wrong approach for this client. Option c is incorrect because pressing on the tragus is done gently after instillation, not before, to help the drops move inward. It does not straighten the ear canal, so it is not the action used for positioning the ear before instilling drops. Option d is incorrect because inserting a cotton ball deep into the canal can damage the ear and is not recommended. If used at all, it is placed loosely at the outer portion, not pushed deep before the drops are instilled into the ear.

Correct Answer: Continuous respiratory support must be maintained.

Neuromuscular blockers paralyze the respiratory muscles, so the client cannot breathe independently during therapy. Maintaining continuous mechanical ventilation and respiratory support is the priority in order to keep the client safe throughout the period of paralysis. Option a is incorrect because neuromuscular blockers do not affect pain perception, so the client may still feel pain and needs separate analgesia. This makes pain management a real concern rather than a reassuring feature of the drug for the client. Option b is incorrect because these agents have no effect on consciousness or thinking at all. They paralyze the muscles without sedating the client, so they do not improve the level of consciousness as this option incorrectly states. Option d is incorrect. Because these agents act only on muscle, they cannot relieve anxiety in the client. Separate sedation is required for comfort, so anxiety relief is not something this medication provides during the period of paralysis.

Correct Answer: Drowsiness

Centrally acting muscle relaxants depress the central nervous system, so drowsiness and sedation are common adverse effects. The nurse should monitor the client for these effects and caution against activities that require full alertness while taking the drug. Option a is incorrect because a fast heart rate is not a typical effect of centrally acting muscle relaxants. Their main concern is central nervous system depression with drowsiness, rather than stimulation of the heart, so a fast pulse is not expected. Option b is incorrect because increased urine output is not associated with these muscle relaxants. Sedation and drowsiness, rather than a change in urination, are the expected adverse effects the nurse should watch for with cyclobenzaprine in this client. Option c is incorrect because these medications tend to cause sedation and possibly low blood pressure, not hypertension. Elevated blood pressure is not an expected effect of cyclobenzaprine, so it is not the adverse effect the

Correct Answer: Dry mouth and constipation

Muscarinic antagonists block cholinergic activity, which produces anticholinergic effects such as dry mouth and constipation. The nurse should teach the client about these effects and suggest fluids, fiber, and sugarless candy to relieve the discomfort. Option a is incorrect because excess salivation reflects cholinergic stimulation, which is the opposite of this drug's action. Oxybutynin dries secretions through its anticholinergic effect, so increased saliva is not an effect the client should expect from this medication. Option c is incorrect because a slow heart rate is a cholinergic effect, whereas muscarinic blockade tends to increase the heart rate instead. A slow pulse is therefore not an expected adverse effect of oxybutynin for a client with overactive bladder. Option d is incorrect because anticholinergic drugs reduce sweating and can cause overheating, rather than increasing perspiration. Telling the client to expect more sweating would misrepresent this medication, sin

Correct Answer: Take the medication just before bedtime.

Zolpidem acts quickly to induce sleep, so it should be taken just before bedtime when the client can allow adequate time for rest. Taking it at any other time of day risks daytime sedation and possible injury. Option b is incorrect because taking zolpidem in the early morning would cause sedation during the client's waking hours. The drug is meant to promote nighttime sleep, so a morning dose is inappropriate and could leave the client unsafe during the day. Option c is incorrect because the client should go to bed right after taking zolpidem because the drug works quickly. Staying awake afterward risks drowsiness, dizziness, and complex sleep behaviors, so this instruction is unsafe for a client taking zolpidem. Option d is incorrect because zolpidem is intended for short-term management of insomnia, not for indefinite nightly use. Recommending long-term use does not reflect appropriate teaching, since the drug is meant to be used only for a short period.

Correct Answer: Monitor respiratory status continuously.

Propofol causes respiratory and cardiovascular depression, so continuous monitoring of respiratory status is the priority during the procedure. The nurse must be ready to support ventilation and keep resuscitation equipment available throughout the sedation for this client. Option a is incorrect because a client receiving sedation should not be eating, as this raises the risk of aspiration. Encouraging a snack is unsafe during propofol administration, so it is not a priority action and could endanger the sedated client. Option b is incorrect because opened propofol vials must be used within a short window because the lipid emulsion supports bacterial growth. Saving an opened vial for the next day risks infection for the client and is incorrect practice with this medication. Option d is incorrect because resuscitation equipment must be readily available, not withheld, because of the depressant effects of propofol. Removing or withholding this equipment would endanger the client if respi

Correct Answer: Take the final daily dose before late afternoon.

Central nervous system stimulants can cause insomnia, so the final daily dose should be taken before late afternoon to limit sleep disturbance. Timing the last dose earlier helps the client rest while still benefiting from the therapy. Option a is incorrect because taking the last dose late in the evening would worsen insomnia caused by central nervous system stimulation. The dosing schedule aims to avoid bedtime stimulation, so a late evening dose is counterproductive for the client's sleep. Option b is incorrect because caffeine adds to central nervous system stimulation and can heighten side effects such as restlessness and a fast heart rate. The client should limit caffeine, not increase it, while taking a stimulant for this disorder. Option c is incorrect because stimulants help manage attention-deficit hyperactivity disorder but do not cure it, and behavioral approaches are also needed. Expecting a cure from the medication reflects a misunderstanding of the overall treatment

Correct Answer: Taper the medication gradually as directed.

Abruptly stopping a centrally acting alpha-adrenergic agonist can cause rebound hypertension in the client. The nurse should teach the client to taper the medication gradually under provider guidance in order to avoid a dangerous rise in blood pressure. Option b is incorrect because stopping abruptly can trigger rebound hypertension rather than avoiding side effects for the client. A gradual taper guided by the provider is required, so sudden discontinuation of this medication is unsafe and should not be taught. Option c is incorrect because doubling the dose before stopping does not prevent rebound effects and could cause excessive sedation or low blood pressure. The correct approach for this client is a gradual taper, not an increase in the dose. Option d is incorrect because randomly skipping doses produces unstable blood levels and does not safely wean the client from the drug. A structured, slowly stepped-down dose under medical supervision is the appropriate way to discontinue th

Correct Answer: Use the bronchodilator before the glucocorticoid.

When both inhalers are prescribed, the beta-adrenergic agonist is used first to open the airways, which enhances the delivery and absorption of the glucocorticoid that follows. This sequence improves the overall effectiveness of the inhaled steroid. Option a is incorrect because using the glucocorticoid first means the airways are still narrowed, which reduces how well the steroid is delivered to the lungs. The bronchodilator should come first to open the airways, so this order is incorrect. Option b is incorrect because both inhalers are prescribed for a reason and should be used as ordered each day. Limiting therapy to a single inhaler daily would leave the client undertreated, so this is not appropriate teaching for the regimen. Option d is incorrect because the client should rinse the mouth after an inhaled glucocorticoid to prevent oral fungal infection. Telling the client not to rinse would increase the risk of candidiasis, so this instruction is incorrect for the inhaled steroid

Correct Answer: Peanut allergy

Ipratropium preparations may contain soy lecithin, so a peanut allergy is a contraindication because of cross-sensitivity. The nurse should recognize this allergy and verify the concern with the provider before the inhaled medication is administered to the client. Option a is incorrect because hypertension is not a contraindication to ipratropium, which acts locally in the airways with limited systemic effect. The peanut allergy, rather than high blood pressure, is the key concern the nurse must recognize for this client. Option c is incorrect because diabetes mellitus does not contraindicate the use of ipratropium. The cross-sensitivity associated with a peanut allergy is the specific contraindication the nurse must recognize before this inhaled medication is given to the client. Option d is incorrect because seasonal allergies are not a contraindication, and the drug may even help relieve allergen-induced bronchospasm. It is the peanut allergy, not seasonal allergies, that requires c