NR566 Final Exam Study Guide: Questions and Answers for a Guaranteed Pass, Exams of Nursing

Download NR566 Final Exam Study Guide: Questions and Answers for a Guaranteed Pass and more Exams Nursing in PDF only on Docsity! NR566 FINAL EXAM STUDY GUIDE| QUESTIONS AND ANSWERS FOR A GUARANTEED PASS| EXPERT VERIFIED| ALREADY GRADED A| LATEST UPDATE How long does it take to see effects of Dutasteride (Avodart)? May take months. Patient should continue to take it even if improvement is not seen right away. What are side effects of Dutasteride (Avodart)? May lower ejaculatory volume. May lower libido. How do you know that Terazosin (Hytrin) is working? Symptoms of dysuria, urgency, UTI, and hesitancy improve. When is it not safe to prescribe progesterone? If a patient is pregnant or has had a hysterectomy. Breast cancer. Arterial disease. Previous diagnosis of depression. What are side effects of progestin oral contraceptives? irregular bleeding Patient teaching about progestin oral contraceptives. Must take at the same time every day to be effective. May cause inconsistent bleeding. Benefits of using medroxyprogesterone acetate? (Depo-Provera) Does not cause thrombolytic disorders, headache, nausea, or other adverse effects associated with combo OC's. Testosterone replacement therapy routes. Pill, injection, patch. What are teaching points about testosterone patch? Wash hands after applying Cover site after dried Wash application site before skin to skin contact May cause rash at application site When is androgen therapy appropriate for short term use? Pressure of delayed sexual maturation causes significant distress. When is androgen therapy appropriate for long term use? Delayed puberty related to hypogonadism. Side effects of testosterone replacement therapy. hot flashes, bone fractures, decreased libido, insulin resistance, erectile dysfunction, acne, hypertension, sterility, aggression, mood swings. What is alprostadil used for? erectile dysfunction Routes of administration for alprostadil. Intracavernosal (Immediate erection) Intraurethral pellet (Erection 5-10 mintutes) How does carbamazepine impact OC's? Accelerate the metabolism reducing the effect. How would an OC be prescribed with carbamazepine? Increase the estrogen dose, combine with a second form of birth control, or switch to an alternate birth control. What is carbamazepine used to treat? Dopamine receptor agonist Best when used in the early stages of PD What are adverse effects of pramipexole (mirapex)? nausea, dizziness, daytime sleep attacks(extreme/irresistible urge), insomnia, constipation, weakness, hallucinations, impulse control When to prescribe COMT inhibitors When levodopa is not working long enough and starts to wear off between doses. This medication extends the half-life of levodopa. What seizure medications reduce oral contraceptive efficacy? Carbamazepine Eslicarbazephine Lamotrigine Oxcarbazepine Phenytoin Phenobarbital Rufinamide Topiramate What can patients do to minimize adverse effects of bromocriptine (dopamine agonist)? Take medication with food to decrease GI upset or decrease dose What is levodopa/carbidopa used for? Treatment and replacement of dopamine for PD. Helps improve ADL function. What are adverse effects of levodopa/carbidopa? orthostatic hypotension, psychosis, dyskinesia Phenytoin (Dilantin) common side effects CNS side effects, gingival hyperplasia, leathery skin, GI upset, blurred vision, suicidal behavior, cognitive decline. Ways to prevent gingival hyperplasia when taking phenytoin Good oral hygiene How long should a patient wait before they start driving after being diagnosed with a seizure disorder? 1 year What vitamin should a patient take when on phenytoin besides folic acid? Vitamin D. Phenytoin and contraceptive interaction Makes OC's less effective, should have backup or increase dose. How is phenytoin effectiveness monitored? Serum drug level. Absence of seizures during trial drug period. What anticonvulsant would be given for adjunctive therapy for partial seizures with or without secondary generalization? Lamotrigine What medication (with example) can be used preventatively for migraines? Beta blockers such as metoprolol/propranolol What is abortive therapy? Abortive therapy is aimed at alleviating pain during the aura phase (if present) or soon after the headache has started. What are examples of abortive therapy for migraines? NSAIDS, opioids, triptans, ergot alkaloids What is the first line treatment for acute mid/moderate migraines without vomiting? NSAIDs such as naproxen or ASA When is it appropriate to prescribe a patient preventative therapy for migraines? Frequent attacks 3 or more a month, or attacks that do not respond to abortive therapy, severe migraines. What are examples of opioid analgesics for severe migraines? Butorphanol nasal spray. Spray each nostril Q60 min PRN What is the mechanism of action for sumatriptan? Suppresses release of CGRP from trigeminal neurons. This leads to vasoconstriction and decreased perivascular inflammation to relieve migraine pain. The first dose of triptan should be under medical supervision for what reason? In the case of any unknown underlying cardiac condition. What are contraindications to triptans? Ischemic heart disease HTN CV disease Pregnancy Basilar or hemiplegic migraine can cause cerebral vasoconstriction Use of an ergot alkaline within 24 hours cause prolonged cerebral vasospasm What is rivastigmine (Exelon) used for? Combat symptoms of Alzheimer's disease. Slows progression of disease-not a cure What should the provider consider if a treatment for depression is not working? Switch to a drug of the same class Switch to a drug of another class Add a drug like an atypical antidepressant When are initial and maximal results seen when a patient is on antidepressants? Initial: 1-3 weeks Maximal: 12 weeks What is a black box warning for all antidepressants? Increased suicide risk What populations are at higher risk for increased suicide risk when starting on antidepressants? Children, adolescents, adults younger than 25 What medication can help a patient fall asleep but does not effect staying asleep? Melatonin What is the first line treatment for sleep disturbances? Benzodiazepine (Triazolam) Benzodiazepine-Like Drugs (Zolpidem ,Zaleplon, eszopiclone) Barbiturate (Secobarbital) Melatonin Receptor Agonist (Ramelteon , melatonin) Orexin Receptor Agonist (Suvorexant) What is the therapeutic range of lithium? 0.6-0.8 mEq/L is ideal level Can be anywhere from 0.4-1.0mEq/L What medications interact with lithium? Diuretics NSAIDs Anticholinergics What is a side effects of first generation antipsychotics? Severe movement disorders known as extrapyramidal symptoms and tardive dyskinesia. What should a patient be educated on when taking a first generation antipsychotic? Hypotension signs and management What drugs interact with SSRIs? MAOIs Antiplatelet (ASA) Anticoagulant (Eliquis, Xeralto) What baseline data is needed in older adults and those on diuretics before starting therapy with an SSRI or SNRI? Sodium levels What is a strategy to minimize adverse effects of SSRIs? Report thoughts of suicide or self harm. Do not abruptly discontinue. What are common adverse effects of SSRIs? Sexual dysfunction weight gain serotonin syndrome What baseline data is needed before starting tricyclic antidepressants? ECG, especially if they are known to have a dysrhythmia or are above the age of 40 What side effect of tricyclic antidepressants should patients be educated on? Hypotension What baseline data is needed before starting an MAOI? BP What can happen to patients when taking MAOIs and what are the symptoms? Hypertensive crisis - headache, tachycardia, palpitations, N/V, sweating. What is the dietary restriction with MAOIs? Tyramine What kinds of foods contain tyramine? Fermented, aged, bean curd, cured meats, protein supplements, chocolate, caffeine, avocado, banana. What are examples of benzodiazepine-like drugs? Zolpidem Zaleplon Eszopicolone (Lunesta) Triazolam is an example of what drug class? Benzodiazepines What are examples of melatonin receptor agonists? Ramelteon (Rozerem) Melatonin What are symptoms of serotonin syndrome?