HES005_11-13

A client with chronic pain is prescribed morphine. The nurse understands that morphine exerts its analgesic effect primarily by:

• Blocking sodium channels in nerve membranes

• Binding to mu-receptors in the CNS

• Inhibiting prostaglandin synthesis

• Enhancing GABA neurotransmission

Which assessment finding would be most concerning in a client taking oxycodone?

• Constipation

• Mild sedation

• Respiratory rate of 8 breaths per minute

• Pinpoint pupils

A client with myasthenia gravis is scheduled for a Tensilon test. The nurse explains that improvement in muscle strength after the injection indicates:

• Cholinergic crisis (medication overdose)

• Myasthenic crisis (under-medication)

• Normal drug response

• Development of drug resistance

The antidote for narcotic overdose that should be readily available when administering opioid analgesics is:

• Flumazenil

• Naloxone

• Atropine

• Phentolamine

A client with epilepsy is prescribed phenytoin (Dilantin). Which side effect requires immediate nursing intervention?

• Gingival hyperplasia

• Drowsiness

• Stevens-Johnson syndrome

• Nystagmus

Which type of seizure is characterized by brief 3-5 second periods of loss of consciousness without muscle contractions?

• Tonic-clonic (grand mal)

• Absence (petit mal)

• Myoclonic

• Complex partial

A construction worker is prescribed anticholinergic medications for Parkinson's disease. The nurse should:

• Refuse to administer the medication

• Administer with increased caution due to heat exposure risk

• Double the prescribed dose

• Administer only during cooler months

The mainstay treatment for Parkinson's disease that crosses the blood-brain barrier is:

• Dopamine

• Carbidopa

• Levodopa

• Benztropine

A client with Alzheimer's disease is prescribed donepezil. The primary mechanism of action is:

• Increasing dopamine levels

• Blocking acetylcholine receptors

• Inhibiting acetylcholinesterase

• Enhancing NMDA receptor activity

Which muscle relaxant is associated with potentially fatal hepatocellular damage?

• Baclofen

• Dantrolene

• Cyclobenzaprine

• Carisoprodol