Holland/Adams/Brice, Core Concepts in Pharmacology 5th Edition Test Bank
Chapter 13

Question 1

Type: MCMA

Which are the most common, debilitating, and progressive neurologic disorders? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Parkinson disease
2. Alzheimer disease
3. Psychosis
4. Multiple sclerosis
5. Bipolar disorder

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Page Number: 179

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 13-1 Identify the most common degenerative diseases of the CNS.

Question 2

Type: MCSA

Which disorder is characterized by the progressive loss of brain function with memory loss, confusion, and dementia?

1. Psychosis
2. Multiple sclerosis
3. Parkinson disease
4. Alzheimer disease

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Number: 185

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 13-4 Describe the symptoms of Alzheimer disease and dementia.

Question 3

Type: MCSA

The nurse is assessing a client with progressive weakness and wasting of muscles caused by destruction of motor neurons. The nurse anticipates that this client is diagnosed with what disorder?

1. Parkinson disease
2. Multiple sclerosis (MS)
3. Amyotrophic lateral sclerosis (ALS)
4. Alzheimer disease

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Page Number: 180

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 13-1 Identify the most common degenerative diseases of the CNS.

Question 4

Type: MCSA

A client has been diagnosed with Parkinson disease. Based on this diagnosis, the nurse knows that there is lack of which neurotransmitter in the brain?

1. Norepinephrine
2. Sodium
3. Dopamine
4. Potassium

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 181

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 13-2 Describe progressive symptoms of Parkinson disease, and explain its neurological basis.

Question 5

Type: MCSA

What instruction should the nurse provide to a client who is taking medications for dementia?

1. Take any OTC medication needed
2. Report any changes in urine color immediately
3. Be careful about getting up quickly from a seated position
4. Never take with high-fat foods

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 186

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-4 Describe the symptoms of Alzheimer disease and dementia.

Question 6

Type: MCSA

Which type of medication does the nurse anticipate for a client who has been diagnosed with Alzheimer disease?

1. Beta blockers
2. Acetylcholinesterase inhibitors
3. Cholinergic blockers
4. Dopaminergic agents

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 186

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-5 Explain the goals of pharmacotherapy for Alzheimer disease and categorize drugs used in its treatment based on drug classes, actions, and important adverse effects.

Question 7

Type: MCSA

A client diagnosed with Parkinson disease has been prescribed levodopa–carbidopa (Sinemet). Which data indicates the medication has been effective?

1. The client has muscle rigidity.
2. The client has bradykinesia.
3. The client is able to walk without stumbling.
4. The client has tremors.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 183

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 13-3 Explain the goals of pharmacotherapy for Parkinson disease, and categorize drugs used in its treatment based on drug classes, actions, and important adverse effects.

Question 8

Type: MCSA

Which medication used to treat multiple sclerosis causes flu-like symptoms?

1. Mitoxantrone (Novantrone)
2. Modafinil (Provigil)
3. Interferon beta-1b (Betaseron)
4. Apomorphine

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 189

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 13-7 Describe the pharmacologic management of multiple sclerosis.

Question 9

Type: MCMA

The client receives levodopa. Which foods can the nurse include in the dietary teaching for this client?

(Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Banana
2. Green, leafy vegetables
3. Citrus fruit
4. Chocolate
5. Fish

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 184

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 13-3 Explain the goals of pharmacotherapy for Parkinson disease and categorize drugs used in its treatment based on drug classes, actions, and important adverse effects.

Question 10

Type: MCSA

An adult client, diagnosed with Parkinson disease, has been prescribed levodopa. What nursing observations would indicate that the medication is working?

1. Increased strength on affected side
2. Blood pressure changes from 180/90 to 140/80 mmHg.
3. Urine output increases to 60 mL per hour.
4. Decrease in tremors in upper extremities

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 181

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 13-5 Explain the goals of pharmacotherapy for Alzheimer disease and categorize drugs used in its treatment based on drug classes, actions, and important adverse effects.

Question 11

Type: MCSA

The client has been diagnosed with Parkinson disease and wants to know the goal of pharmacotherapy. Which is the nurse’s best response?

1. “To alleviate the depression associated with the illness.”
2. “To prevent progressive memory loss and confusion.”
3. “To cure the illness.”
4. “To increase the ability to perform normal daily activities.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 181

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 13-5 Explain the goals of pharmacotherapy for Alzheimer disease and categorize drugs used in its treatment based on drug classes, actions, and important adverse effects.

Question 12

Type: MCSA

The client takes ginkgo biloba at home for memory impairment. Which statement by the client indicates that teaching by the nurse has been effective?

1. “I can’t take any other medication with ginkgo biloba.”
2. “I need to be on a low-fat diet while I am taking ginkgo biloba.”
3. “Ginkgo biloba will keep me from developing Alzheimer disease.”
4. “I can have increased bleeding if I have to take an anticoagulant drug.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 188

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 13-5 Explain the goals of pharmacotherapy for Alzheimer disease and categorize drugs used in its treatment based on drug classes, actions, and important adverse effects.

Question 13

Type: MCSA

The client has a medical diagnosis of multiple sclerosis and receives modafinil (Provigil). Which evaluation by the nurse would most likely indicate a therapeutic response to this drug?

1. Improved appetite and ability to eat
2. Reduction of pain and anxiety
3. Decreased myelin swelling and inflammation
4. Increased alertness and energy

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 189

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 13-7 Describe the pharmacologic management of multiple sclerosis.

Question 14

Type: MCSA

A client is receiving tizanidine (Zanaflex) for treatment of muscle spasms. What should the nurse include in the medication teaching for this client?

1. This is a seizure medication.
2. This is used for diseases of the central nervous system.
3. To take the medication on a scheduled basis
4. To exercise caution when operating machinery

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 191

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 13-9 Discuss pharmacologic and nonpharmacologic strategies used to treat muscle spasms and spasticity.

Question 15

Type: MCMA

The nurse is caring for several clients who have undergone back surgeries. Which medications for the list are considered antispasmodic drugs? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Tizanidine (Zanaflex)
2. Mitoxantrone (Novantrone)
3. Cyclobenzaprine (Flexeril)
4. Baclofen (Lioresal)
5. Ibuprofen (Advil)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 193

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 13-10 Explain the roles of centrally acting skeletal muscle relaxants in treating muscle spasms.

Question 16

Type: MCSA

A client with a spinal cord injury is left with spasticity and dystonia. The nurse anticipates what treatment as most beneficial for this condition?

1. Physical therapy and medications
2. Hydrotherapy and massage
3. Occupational therapy and surgery
4. Surgery and medications

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 194

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 13-11 Discuss the approaches for spasticity treatment, including regular and consistent physical therapy.

Question 17

Type: MCMA

Which nonpharmacologic interventions would the nurse utilize in helping a client with muscle spasms? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Application of heat or cold
2. Hydrotherapy
3. Massage
4. Manipulation
5. Liniments

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 191

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 13-9 Discuss pharmacologic and nonpharmacologic strategies used to treat muscle spasms and spasticity.

Question 18

Type: MCMA

Which nondepolarizing blocking agents are used to relax the muscles of clients being prepared for longer surgical procedures? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Vecuronium (Norcuron)
2. Atracurium (Tracrium)
3. Cisatracurium (Nimbex)
4. Succinylcholine (Anectine)
5. Diazepam (Valium)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 198

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 13-13 Discuss the pharmacology of neuromuscular blocking drugs.

Question 19

Type: MCSA

What type of drugs are onabotulinumtoxin A (Botox) and rimabotulinumtoxin B (Myobloc)?

1. Peripherally acting antispasmodic
2. Indirect-acting antispasmodic
3. Centrally acting antispasmodic
4. Direct-acting antispasmodic

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 195

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 13-12 Explain the roles of direct-acting antispasmodics in treating muscle spasticity.

Question 20

Type: MCMA

A client taking a muscle relaxant is experiencing side effects from the medication. Which client symptoms are side effects of muscle relaxants? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Epistaxis
2. Drowsiness
3. Constipation
4. Sleepiness
5. Diarrhea

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Page number: 192

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 13-10 Explain the roles of centrally acting skeletal muscle relaxants in treating muscle spasms.

Question 21

Type: MCSA

The nurse is caring for a client who is prescribed baclofen (Lioresal). The client asks the nurse if there are any adverse effects for the medication. Which list of adverse effects is most appropriate for the nurse to share with this client?

1. Drowsiness, dizziness, weakness, and fatigue
2. Sleepiness, increased appetite, renal failure, and constipation
3. Dizziness, mental awakeness, decreased appetite, and diarrhea
4. Insomnia, decreased energy, diarrhea, and headaches

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 192

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 13-9 Discuss pharmacologic and nonpharmacologic strategies used to treat muscle spasms and spasticity.

Question 22

Type: MCSA

Which statement is true about incobotulinumtoxin A (Xeomin)?

1. It can be also taken orally.
2. At lower doses, it is a safe and effective muscle relaxant.
3. There are no side effects.
4. It can only be injected into large muscle groups.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 195

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 13-12 Explain the roles of direct-acting antispasmotics in treating muscle spasticity.

Question 23

Type: MCMA

Which medications are used to treat muscle spasms? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Centrally acting skeletal muscle relaxants
2. Analgesics
3. Anti-inflammatory agents
4. Immune system modulating drugs
5. Antipyretic drugs

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 192

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 13-9 Discuss pharmacologic and nonpharmacologic strategies used to treat muscle spasms and spasticity.

Question 24

Type: MCSA

An adult client, diagnosed with Parkinson disease (PD), is asking about progression of the disease. Which are characteristics of the progression of Parkinson disease?

1. Anxiety and depression

2. Constipation and forgetfulness

3. Muscle rigidity and increased blood pressure.

4. Negative symptoms and interruption of sleeping patterns

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 181

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 13-2 Describe progressive symptoms of Parkinson disease, and explain its neurological basis.

Question 25

Type: MCSA

An adult client presents to the primary care provider with symptoms of fatigue, disruption of balance and coordination, and dizziness. The nurse identifies these as which of the following?

1. Alzheimer disease

2. Parkinson disease

3. Muscle spasm

4. Multiple sclerosis

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Numbers: 180 and 189

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 13-6 Describe symptoms of multiple sclerosis.

Question 26

Type: MCMA

Which are true regarding drugs for multiple sclerosis? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Drugs can cure the symptoms of MS.

2. Drugs can reverse the progressive nature of MS.

3. Drugs can reduce the inflammation of the MS attacks.

4. Drugs can prevent MS attacks on the immune system.

5. Drugs can repair the damaged axons.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Numbers: 189–190

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 13-6 Describe symptoms of multiple sclerosis.

Question 27

Type: MCSA

A client is admitted to the emergency room for neck pain. The client describes the pain in the neck started one day ago and feels like it is “frozen”. They also complain of inability to turn their head. What does the nurse suspect?

1. Multiple sclerosis

2. Muscle spasm

3. Spasticity

4. Alzheimer disease

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 191

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 13-8 Describe muscle spasms and how these injuries occur.

Question 28

Type: MCMA

Which are causes of muscle spasms? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. They occur from overuse of a skeletal muscle.

2. Overmedication with antipsychotic drugs can be a cause of muscle spasms.

3. Pain can be a cause of muscle spasms.

4. Those clients hospitalized have muscle spasms.

5. Epilepsy can be a cause for muscle spasms.

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 191

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 13-8 Describe muscle spasms and how these injuries occur.

Question 29

Type: MCSA

A client is talking to the nurse about physical therapy (PT) and their diagnosis of spasticity from epilepsy. The client asks if they can do anything else besides attending therapy three times a week. Which statement is the best response to the client’s question?

1. PT three times a week is plenty.

2. Muscle stretching can be added to the physical therapy regimen.

3. Using an exercise bike each day for 10 minutes should be added.

4. Walking at a fast pace on days when you do not attend PT has been shown to decrease the spasticity.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 194

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 13-11 Discuss the approaches for spasticity treatment, including regular and consistent physical therapy.

Question 30

Type: MCMA

In what types of clients would neuromuscular blocking drugs be used? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. A client who returned from an electrocardiogram

2. A client who is going to receive electroconvulsive therapy

3. A client who is preparing for a surgical removal of the left toe

4. A client who is complaining of pain

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 198

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 13-13 Discuss the pharmacology of neuromuscular blocking drugs.