Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 21

Question 1 Type: MCMA The nurse teaches a class about muscle movement to a group of patients who have neuromuscular disorders. What will the best plan of the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: elect all that apply. 1. !ody movement depends on an intact spinal cord. 2. !ody movement depends on proper functioning of muscles. 3. !ody movement depends on intact nerves. 4. !ody movement depends on proper endocrine functioning. 5. !ody movement depends on the level of consciousness. Corre t Ans!er: "#$ "ationa#e 1: !ody movement depends on intact nerves and on proper functioning of muscles. !ody movement does not depend on the level of consciousness. !ody movement does not depend on an intact spinal cord. !ody movement does not depend on proper endocrine functioning. "ationa#e 2: !ody movement depends on intact nerves and on proper functioning of muscles. !ody movement does not depend on the level of consciousness. !ody movement does not depend on an intact spinal cord. !ody movement does not depend on proper endocrine functioning. "ationa#e 3: !ody movement depends on intact nerves and on proper functioning of muscles. !ody movement does not depend on the level of consciousness. !ody movement does not depend on an intact spinal cord. !ody movement does not depend on proper endocrine functioning. "ationa#e 4: !ody movement depends on intact nerves and on proper functioning of muscles. !ody movement does not depend on the level of consciousness. !ody movement does not depend on an intact spinal cord. !ody movement does not depend on proper endocrine functioning. "ationa#e 5: !ody movement depends on intact nerves and on proper functioning of muscles. !ody movement does not depend on the level of consciousness. !ody movement does not depend on an intact spinal cord. !ody movement does not depend on proper endocrine functioning. $#o%a# "ationa#e:
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %&' Copyright "()% by *earson 'ducation# +nc.

Co&niti'e (e'e#: Applying C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: Nursing *rocess: *lanning (earnin& +ut ome: "),) Question 2 Type: MCMA The nurse teaches the patient with a neuromuscular disorder about nonpharmacological treatment of muscle spasms. What will the best information include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: elect all that apply. 1. Application of heat or cold 2. -ltrasound 3. Massage 4. .ela/ation techni0ues 5. 1uided imagery Corre t Ans!er: )#"#$ "ationa#e 1: Nonpharmacological treatment of muscle spasms includes application of heat or cold# ultrasound# and massage. 1uided imagery is not a nonpharmacological treatment for muscle spasms. .ela/ation techni0ues are not a type of nonpharmacological treatment for muscle spasms. "ationa#e 2: Nonpharmacological treatment of muscle spasms includes application of heat or cold# ultrasound# and massage. 1uided imagery is not a nonpharmacological treatment for muscle spasms. .ela/ation techni0ues are not a type of nonpharmacological treatment for muscle spasms. "ationa#e 3: Nonpharmacological treatment of muscle spasms includes application of heat or cold# ultrasound# and massage. 1uided imagery is not a nonpharmacological treatment for muscle spasms. .ela/ation techni0ues are not a type of nonpharmacological treatment for muscle spasms. "ationa#e 4: Nonpharmacological treatment of muscle spasms includes application of heat or cold# ultrasound# and massage. 1uided imagery is not a nonpharmacological treatment for muscle spasms. .ela/ation techni0ues are not a type of nonpharmacological treatment for muscle spasms. "ationa#e 5: Nonpharmacological treatment of muscle spasms includes application of heat or cold# ultrasound# and massage. 1uided imagery is not a nonpharmacological treatment for muscle spasms. .ela/ation techni0ues are not a type of nonpharmacological treatment for muscle spasms.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %&' Copyright "()% by *earson 'ducation# +nc.

$#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: Nursing *rocess: +mplementation (earnin& +ut ome: ")," Question 3 Type: MC A The patient is started on a medication to treat a neuromuscular disorder. What does the nurse teach as the primary therapeutic goal of the medication? 1. To stop the patient2s muscle spasms 2. To improve the patient2s appearance 3. To promote e/ercise in the patient 4. To allow the patient increased independence Corre t Ans!er: % "ationa#e 1: The therapeutic goals of pharmacotherapy include minimi3ing pain and discomfort# increasing range of motion# and improving the patient2s ability to function independently. topping muscle spasms can be achieved# but this is not the primary goal. *romoting e/ercise is not a goal. +mproving the patient2s appearance is not a goal. "ationa#e 2: The therapeutic goals of pharmacotherapy include minimi3ing pain and discomfort# increasing range of motion# and improving the patient2s ability to function independently. topping muscle spasms can be achieved# but this is not the primary goal. *romoting e/ercise is not a goal. +mproving the patient2s appearance is not a goal. "ationa#e 3: The therapeutic goals of pharmacotherapy include minimi3ing pain and discomfort# increasing range of motion# and improving the patient2s ability to function independently. topping muscle spasms can be achieved# but this is not the primary goal. *romoting e/ercise is not a goal. +mproving the patient2s appearance is not a goal. "ationa#e 4: The therapeutic goals of pharmacotherapy include minimi3ing pain and discomfort# increasing range of motion# and improving the patient2s ability to function independently. topping muscle spasms can be achieved# but this is not the primary goal. *romoting e/ercise is not a goal. +mproving the patient2s appearance is not a goal. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %&' Copyright "()% by *earson 'ducation# +nc.

C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: Nursing *rocess: +mplementation (earnin& +ut ome: "),$ Question 4 Type: MC A The patient receives dantrolene 45antrium6 for muscle spasticity. Which lab result is a priority for the nurse to assess? 1. Creatinine clearance 2. erum amylase 3. 7emoglobin and hematocrit 4. Aspartate aminotransferase 4A T6 and alanine aminotransferase 4A8T6 Corre t Ans!er: % "ationa#e 1: 5antrolene 45antrium6 can cause hepatitis9 the aspartate aminotransferase 4A T6 and alanine aminotransferase 4A8T6 are the priority laboratory tests for the nurse to assess. 5antrolene 45antrium6 does not affect hemoglobin or hematocrit9 these laboratory tests are not a priority to assess. 5antrolene 45antrium6 does not significantly affect renal function9 the creatinine clearance test isn2t a priority laboratory test to assess. 5antrolene 45antrium6 does not affect pancreatic function9 the serum amylase isn2t a priority laboratory test to assess. "ationa#e 2: 5antrolene 45antrium6 can cause hepatitis9 the aspartate aminotransferase 4A T6 and alanine aminotransferase 4A8T6 are the priority laboratory tests for the nurse to assess. 5antrolene 45antrium6 does not affect hemoglobin or hematocrit9 these laboratory tests are not a priority to assess. 5antrolene 45antrium6 does not significantly affect renal function9 the creatinine clearance test isn2t a priority laboratory test to assess. 5antrolene 45antrium6 does not affect pancreatic function9 the serum amylase isn2t a priority laboratory test to assess. "ationa#e 3: 5antrolene 45antrium6 can cause hepatitis9 the aspartate aminotransferase 4A T6 and alanine aminotransferase 4A8T6 are the priority laboratory tests for the nurse to assess. 5antrolene 45antrium6 does not affect hemoglobin or hematocrit9 these laboratory tests are not a priority to assess. 5antrolene 45antrium6 does not significantly affect renal function9 the creatinine clearance test isn2t a priority laboratory test to assess. 5antrolene 45antrium6 does not affect pancreatic function9 the serum amylase isn2t a priority laboratory test to assess. "ationa#e 4: 5antrolene 45antrium6 can cause hepatitis9 the aspartate aminotransferase 4A T6 and alanine aminotransferase 4A8T6 are the priority laboratory tests for the nurse to assess. 5antrolene 45antrium6 does not affect hemoglobin or hematocrit9 these laboratory tests are not a priority to assess. 5antrolene 45antrium6 does not significantly affect renal function9 the creatinine clearance test isn2t a priority laboratory test to assess. 5antrolene 45antrium6 does not affect pancreatic function9 the serum amylase isn2t a priority laboratory test to assess.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %&' Copyright "()% by *earson 'ducation# +nc.

$#o%a# "ationa#e: Co&niti'e (e'e#: Analy3ing C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: Nursing *rocess: Assessment (earnin& +ut ome: "),% Question 5 Type: MC A The patient receives dantrolene 45antrium6. A consulting physician orders hydro/y3ine 4:istaril6 for the patient and he begins ta;ing it. What will the best assessment by the nurse reveal? 1. Confusion 2. 7ypertension 3. .espiratory depression 4. 5elirium Corre t Ans!er: $ "ationa#e 1: 5antrolene 45antrium6 and hydro/y3ine 4:istaril6 are both central nervous system 4CN 6 depressants# and the patient needs to be assessed for respiratory depression. 7ypertension would not result from the use of these two medications. Confusion would not result from the use of these two medications. 5elirium would not result from the use of these two medications. "ationa#e 2: 5antrolene 45antrium6 and hydro/y3ine 4:istaril6 are both central nervous system 4CN 6 depressants# and the patient needs to be assessed for respiratory depression. 7ypertension would not result from the use of these two medications. Confusion would not result from the use of these two medications. 5elirium would not result from the use of these two medications. "ationa#e 3: 5antrolene 45antrium6 and hydro/y3ine 4:istaril6 are both central nervous system 4CN 6 depressants# and the patient needs to be assessed for respiratory depression. 7ypertension would not result from the use of these two medications. Confusion would not result from the use of these two medications. 5elirium would not result from the use of these two medications. "ationa#e 4: 5antrolene 45antrium6 and hydro/y3ine 4:istaril6 are both central nervous system 4CN 6 depressants# and the patient needs to be assessed for respiratory depression. 7ypertension would not result from the use of these two medications. Confusion would not result from the use of these two medications. 5elirium would not result from the use of these two medications. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy3ing
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, %&' Copyright "()% by *earson 'ducation# +nc.

C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: Nursing *rocess: Assessment (earnin& +ut ome: "),< Question , Type: MC A The physician has ordered dantrolene 45antrium6 for a patient. What is a priority assessment by the nurse prior to administering this medication? 1. 5oes the patient have gastric ulcer disease? 2. 5oes the patient have cardiovascular disease? 3. 5oes the patient have gallbladder disease? 4. +s the patient pregnant or lactating? Corre t Ans!er: % "ationa#e 1: 5antrolene 45antrium6 is a *regnancy Category C drug# so pregnancy should be assessed prior to administration. 1astric ulcer disease is not a contraindication to receiving dantrolene 45antrium6. 1allbladder disease is not a contraindication to receiving dantrolene 45antrium6. Cardiovascular disease is not a contraindication to receiving dantrolene 45antrium6. "ationa#e 2: 5antrolene 45antrium6 is a *regnancy Category C drug# so pregnancy should be assessed prior to administration. 1astric ulcer disease is not a contraindication to receiving dantrolene 45antrium6. 1allbladder disease is not a contraindication to receiving dantrolene 45antrium6. Cardiovascular disease is not a contraindication to receiving dantrolene 45antrium6. "ationa#e 3: 5antrolene 45antrium6 is a *regnancy Category C drug# so pregnancy should be assessed prior to administration. 1astric ulcer disease is not a contraindication to receiving dantrolene 45antrium6. 1allbladder disease is not a contraindication to receiving dantrolene 45antrium6. Cardiovascular disease is not a contraindication to receiving dantrolene 45antrium6. "ationa#e 4: 5antrolene 45antrium6 is a *regnancy Category C drug# so pregnancy should be assessed prior to administration. 1astric ulcer disease is not a contraindication to receiving dantrolene 45antrium6. 1allbladder disease is not a contraindication to receiving dantrolene 45antrium6. Cardiovascular disease is not a contraindication to receiving dantrolene 45antrium6. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy3ing C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: Nursing *rocess: Assessment
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(earnin& +ut ome: "),% Question Type: MC A The physician prescribes cycloben3aprine 4=le/eril6 for the patient. When doing medication education# what will the best information of the nurse include? 1. +ncrease the inta;e of fiber while ta;ing this medication. 2. .estrict the inta;e of sodium while ta;ing this medication. 3. +ncrease the inta;e of protein while ta;ing this medication. 4. 5o not drin; any caffeine while ta;ing this medication. Corre t Ans!er: ) "ationa#e 1: Cycloben3aprine 4=le/eril6 has anticholinergic properties and can cause constipation# so the patient should increase the inta;e of fiber while ta;ing this medication. There is no need to limit sodium. There is no need to limit caffeine. There is no need to increase protein. "ationa#e 2: Cycloben3aprine 4=le/eril6 has anticholinergic properties and can cause constipation# so the patient should increase the inta;e of fiber while ta;ing this medication. There is no need to limit sodium. There is no need to limit caffeine. There is no need to increase protein. "ationa#e 3: Cycloben3aprine 4=le/eril6 has anticholinergic properties and can cause constipation# so the patient should increase the inta;e of fiber while ta;ing this medication. There is no need to limit sodium. There is no need to limit caffeine. There is no need to increase protein. "ationa#e 4: Cycloben3aprine 4=le/eril6 has anticholinergic properties and can cause constipation# so the patient should increase the inta;e of fiber while ta;ing this medication. There is no need to limit sodium. There is no need to limit caffeine. There is no need to increase protein. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy3ing C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: Nursing *rocess: +mplementation (earnin& +ut ome: "),> Question . Type: MC A The patient receives dantrolene 45antrium6 for treatment of muscle spasms following a spinal cord in?ury. What is the best outcome for this patient?
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1. *atient will have stabili3ed vital signs. 2. *atient will have and improved self,concept. 3. *atient will sleep without pain. 4. *atient will have increased bladder tone. Corre t Ans!er: $ "ationa#e 1: 5ecreasing muscle spasms will help prevent pain that can interfere with sleep. This medication rela/es muscles# but it will not increase bladder tone. tabili3ation of vital signs is not an e/pected effect of this medication. .elief of muscle spasms may help with self,concept# but this is not a direct effect of the drug. "ationa#e 2: 5ecreasing muscle spasms will help prevent pain that can interfere with sleep. This medication rela/es muscles# but it will not increase bladder tone. tabili3ation of vital signs is not an e/pected effect of this medication. .elief of muscle spasms may help with self,concept# but this is not a direct effect of the drug. "ationa#e 3: 5ecreasing muscle spasms will help prevent pain that can interfere with sleep. This medication rela/es muscles# but it will not increase bladder tone. tabili3ation of vital signs is not an e/pected effect of this medication. .elief of muscle spasms may help with self,concept# but this is not a direct effect of the drug. "ationa#e 4: 5ecreasing muscle spasms will help prevent pain that can interfere with sleep. This medication rela/es muscles# but it will not increase bladder tone. tabili3ation of vital signs is not an e/pected effect of this medication. .elief of muscle spasms may help with self,concept# but this is not a direct effect of the drug. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy3ing C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: Nursing *rocess: *lanning (earnin& +ut ome: "),@ Question / Type: MC A The patient tells the nurse that she awa;ens fre0uently during the night because of leg and foot cramps. What is the best response by the nurse? 1. AAs; your physician for a muscle rela/ant.A 2. A+ncrease your inta;e of calcium.A 3. ATa;e a warm bath before going to bed.A 4. AApply heat to relieve the cramping.A
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Corre t Ans!er: " "ationa#e 1: A lac; of calcium is a ma?or cause of muscle cramps. +t is premature to as; the physician for a muscle rela/ant. Applying heat will rela/ the muscles# but will not prevent cramping. Ta;ing a warm bath will rela/ the muscles# but will not prevent cramping. "ationa#e 2: A lac; of calcium is a ma?or cause of muscle cramps. +t is premature to as; the physician for a muscle rela/ant. Applying heat will rela/ the muscles# but will not prevent cramping. Ta;ing a warm bath will rela/ the muscles# but will not prevent cramping. "ationa#e 3: A lac; of calcium is a ma?or cause of muscle cramps. +t is premature to as; the physician for a muscle rela/ant. Applying heat will rela/ the muscles# but will not prevent cramping. Ta;ing a warm bath will rela/ the muscles# but will not prevent cramping. "ationa#e 4: A lac; of calcium is a ma?or cause of muscle cramps. +t is premature to as; the physician for a muscle rela/ant. Applying heat will rela/ the muscles# but will not prevent cramping. Ta;ing a warm bath will rela/ the muscles# but will not prevent cramping. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy3ing C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: Nursing *rocess: +mplementation (earnin& +ut ome: "),< Question 10 Type: MC A The patient receives dantrolene 45antrium6. Which medication would the nurse evaluate as being contraindicated with dantrolene 45antrium6? 1. :erapamil 4Calan6 2. +nsulin 3. Clarithromycin 4!ia/in6 4. Methylphenidate 4Concerta6 Corre t Ans!er: ) "ationa#e 1: :erapamil 4Calan6 is a calcium channel bloc;er9 combining this with dantrolene 45antrium6 could lead to cardiovascular collapse. There isn2t any contraindication to the use of dantrolene 45antrium6 and insulin. There isn2t any contraindication to the use of dantrolene 45antrium6 and methylphenidate 4Concerta6. There isn2t any contraindication to the use of dantrolene 45antrium6 and clarithromycin 4!ia/in6.
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"ationa#e 2: :erapamil 4Calan6 is a calcium channel bloc;er9 combining this with dantrolene 45antrium6 could lead to cardiovascular collapse. There isn2t any contraindication to the use of dantrolene 45antrium6 and insulin. There isn2t any contraindication to the use of dantrolene 45antrium6 and methylphenidate 4Concerta6. There isn2t any contraindication to the use of dantrolene 45antrium6 and clarithromycin 4!ia/in6. "ationa#e 3: :erapamil 4Calan6 is a calcium channel bloc;er9 combining this with dantrolene 45antrium6 could lead to cardiovascular collapse. There isn2t any contraindication to the use of dantrolene 45antrium6 and insulin. There isn2t any contraindication to the use of dantrolene 45antrium6 and methylphenidate 4Concerta6. There isn2t any contraindication to the use of dantrolene 45antrium6 and clarithromycin 4!ia/in6. "ationa#e 4: :erapamil 4Calan6 is a calcium channel bloc;er9 combining this with dantrolene 45antrium6 could lead to cardiovascular collapse. There isn2t any contraindication to the use of dantrolene 45antrium6 and insulin. There isn2t any contraindication to the use of dantrolene 45antrium6 and methylphenidate 4Concerta6. There isn2t any contraindication to the use of dantrolene 45antrium6 and clarithromycin 4!ia/in6. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy3ing C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: (earnin& +ut ome: "),> Question 11 Type: MC A The patient receives dantrolene 45antrium6 intravenously 4+:6. What will a priority assessment by the nurse include? 1. Assessing the patient2s urinary output 2. Assessing the patient2s blood glucose 3. Assessing the patient2s breath sounds 4. Assessing the patient2s intravenous 4+:6 site Corre t Ans!er: % "ationa#e 1: 5antrolene 45antrium6 intravenous 4+:6 solution has a high p7 and is very irritating to tissue. The nurse should assess for infiltration of the intravenous 4+:6 site. 5antrolene 45antrium6 does not affect the patient2s blood glucose. 5antrolene 45antrium6 does not affect the patient2s breath sounds. 5antrolene 45antrium6 does not affect the patient2s urinary output. "ationa#e 2: 5antrolene 45antrium6 intravenous 4+:6 solution has a high p7 and is very irritating to tissue. The nurse should assess for infiltration of the intravenous 4+:6 site. 5antrolene 45antrium6 does not affect the patient2s blood glucose. 5antrolene 45antrium6 does not affect the patient2s breath sounds. 5antrolene 45antrium6 does not affect the patient2s urinary output.
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"ationa#e 3: 5antrolene 45antrium6 intravenous 4+:6 solution has a high p7 and is very irritating to tissue. The nurse should assess for infiltration of the intravenous 4+:6 site. 5antrolene 45antrium6 does not affect the patient2s blood glucose. 5antrolene 45antrium6 does not affect the patient2s breath sounds. 5antrolene 45antrium6 does not affect the patient2s urinary output. "ationa#e 4: 5antrolene 45antrium6 intravenous 4+:6 solution has a high p7 and is very irritating to tissue. The nurse should assess for infiltration of the intravenous 4+:6 site. 5antrolene 45antrium6 does not affect the patient2s blood glucose. 5antrolene 45antrium6 does not affect the patient2s breath sounds. 5antrolene 45antrium6 does not affect the patient2s urinary output. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy3ing C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: Nursing *rocess: Assessment (earnin& +ut ome: "),< Question 12 Type: MC A Which of the following lists of treatment options would be considered optimal for treating a muscle spasm with an un;nown cause? 1. Anti,inflammatory agents# casting# and ultrasound 2. Analgesics# antibiotics# and heat application 3. Analgesics# muscle rela/ants# and massage 4. Anti,inflammatory agents# immobili3ation# and fluid and electrolyte replacement Corre t Ans!er: $ "ationa#e 1: Muscle spasms can be treated with a variety of pharmacologic and non,pharmacologic methods. When the cause is un;nown# a more general approach is indicated# such as analgesics# muscle rela/ants# and massage. Antibiotics and casting are not indicated for muscle spasms. =luid and electrolyte replacement can be indicated# if determined to be the cause. "ationa#e 2: Muscle spasms can be treated with a variety of pharmacologic and non,pharmacologic methods. When the cause is un;nown# a more general approach is indicated# such as analgesics# muscle rela/ants# and massage. Antibiotics and casting are not indicated for muscle spasms. =luid and electrolyte replacement can be indicated# if determined to be the cause. "ationa#e 3: Muscle spasms can be treated with a variety of pharmacologic and non,pharmacologic methods. When the cause is un;nown# a more general approach is indicated# such as analgesics# muscle rela/ants# and massage. Antibiotics and casting are not indicated for muscle spasms. =luid and electrolyte replacement can be indicated# if determined to be the cause.
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"ationa#e 4: Muscle spasms can be treated with a variety of pharmacologic and non,pharmacologic methods. When the cause is un;nown# a more general approach is indicated# such as analgesics# muscle rela/ants# and massage. Antibiotics and casting are not indicated for muscle spasms. =luid and electrolyte replacement can be indicated# if determined to be the cause. $#o%a# "ationa#e: Co&niti'e (e'e#: -nderstanding C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: Nursing *rocess: *lanning (earnin& +ut ome: ")," Question 13 Type: MC A Which statement about s;eletal muscle rela/ants is correct? 1. They inhibit upper motor neuron activity within the central nervous system. 2. They wor; primarily by stimulating the peripheral nervous system. 3. They increase the amount of neurotransmitter within the muscles. 4. They stimulate motor activity within the brainstem. Corre t Ans!er: ) "ationa#e 1: The e/act mechanism by which s;eletal muscle rela/ants wor; is not fully understood. +t is believed that they inhibit upper motor neuron activity# causing CN depression. "ationa#e 2: The e/act mechanism by which s;eletal muscle rela/ants wor; is not fully understood. +t is believed that they inhibit upper motor neuron activity# causing CN depression. "ationa#e 3: The e/act mechanism by which s;eletal muscle rela/ants wor; is not fully understood. +t is believed that they inhibit upper motor neuron activity# causing CN depression. "ationa#e 4: The e/act mechanism by which s;eletal muscle rela/ants wor; is not fully understood. +t is believed that they inhibit upper motor neuron activity# causing CN depression. $#o%a# "ationa#e: Co&niti'e (e'e#: .emembering C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: Nursing *rocess: 'valuation (earnin& +ut ome: "),>
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Question 14 Type: MC A The nurse identifies a patient with a repeating pattern of muscle contraction of the leg for @ seconds followed by " seconds of rela/ation as e/periencing 1. a clonic spasm. 2. a tonic spasm. 3. spasticity. 4. dystonia. Corre t Ans!er: ) "ationa#e 1: Clonic muscle spasms involve multiple# rapidly repeated contractions. Tonic spasms involve a single prolonged contraction. pasticity involves a continuous state of contraction# and dystonia is a chronic neurological disorder that can cause spasticity. "ationa#e 2: Clonic muscle spasms involve multiple# rapidly repeated contractions. Tonic spasms involve a single prolonged contraction. pasticity involves a continuous state of contraction# and dystonia is a chronic neurological disorder that can cause spasticity. "ationa#e 3: Clonic muscle spasms involve multiple# rapidly repeated contractions. Tonic spasms involve a single prolonged contraction. pasticity involves a continuous state of contraction# and dystonia is a chronic neurological disorder that can cause spasticity. "ationa#e 4: Clonic muscle spasms involve multiple# rapidly repeated contractions. Tonic spasms involve a single prolonged contraction. pasticity involves a continuous state of contraction# and dystonia is a chronic neurological disorder that can cause spasticity. $#o%a# "ationa#e: Co&niti'e (e'e#: .emembering C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: Nursing *rocess: Assessment (earnin& +ut ome: "),< Question 15 Type: MC A Which of the following is a common adverse effect of cycloben3aprine 4=le/eril6? 1. Alopecia
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2. Tongue swelling 3. 5rowsiness 4. 7ypotension Corre t Ans!er: $ "ationa#e 1: All centrally acting agents have the potential to cause sedation. Tongue swelling is serious# but rare. Tachycardia is possible# but would li;ely lead to hypertension# not hypotension. Alopecia is not an associated adverse effect. "ationa#e 2: All centrally acting agents have the potential to cause sedation. Tongue swelling is serious# but rare. Tachycardia is possible# but would li;ely lead to hypertension# not hypotension. Alopecia is not an associated adverse effect. "ationa#e 3: All centrally acting agents have the potential to cause sedation. Tongue swelling is serious# but rare. Tachycardia is possible# but would li;ely lead to hypertension# not hypotension. Alopecia is not an associated adverse effect. "ationa#e 4: All centrally acting agents have the potential to cause sedation. Tongue swelling is serious# but rare. Tachycardia is possible# but would li;ely lead to hypertension# not hypotension. Alopecia is not an associated adverse effect. $#o%a# "ationa#e: Co&niti'e (e'e#: .emembering C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: Nursing *rocess: *lanning (earnin& +ut ome: "),> Question 1, Type: MC A Which statement describes the primary difference between centrally acting muscle rela/ants and direct,acting antispasmodics? 1. Centrally acting agents inhibit neurons of the central nervous system# while direct,acting agents stimulate neurons of central nervous system. 2. Centrally acting agents stimulate neurons of the central nervous system# while direct,acting agents stimulate neurons of the peripheral nervous system. 3. Centrally acting agents inhibit neurons of the central nervous system# while direct,acting agents wor; at the level of the neuromuscular ?unction and s;eletal muscles.
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4. Centrally acting agents stimulate the central nervous system# while direct,acting agents inhibit neuronal conduction of the central nervous system. Corre t Ans!er: $ "ationa#e 1: Centrally acting agents inhibit neurons of the central nervous system# while direct,acting agents wor; at the level of the neuromuscular ?unction and s;eletal muscles. "ationa#e 2: Centrally acting agents inhibit neurons of the central nervous system# while direct,acting agents wor; at the level of the neuromuscular ?unction and s;eletal muscles. "ationa#e 3: Centrally acting agents inhibit neurons of the central nervous system# while direct,acting agents wor; at the level of the neuromuscular ?unction and s;eletal muscles. "ationa#e 4: Centrally acting agents inhibit neurons of the central nervous system# while direct,acting agents wor; at the level of the neuromuscular ?unction and s;eletal muscles. $#o%a# "ationa#e: Co&niti'e (e'e#: .emembering C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: Nursing *rocess: Assessment (earnin& +ut ome: "),@ Question 1Type: MC A Which of the following patients suffering from muscle spasms should not receive the direct,acting antispasmodic medication dantrolene sodium 45antrium6? 1. "(,year,old suffering from a spinal cord in?ury 2. @<,year,old suffering from congestive heart failure 3. %(,year,old suffering from multiple sclerosis 4. >@,year,old suffering from a cerebral vascular accident Corre t Ans!er: " "ationa#e 1: 5antrolene sodium 45antrium6 is contraindicated in patients with cardiac# pulmonary# and hepatic problems. +t is indicated for spinal cord in?ury# stro;es# and multiple sclerosis. "ationa#e 2: 5antrolene sodium 45antrium6 is contraindicated in patients with cardiac# pulmonary# and hepatic problems. +t is indicated for spinal cord in?ury# stro;es# and multiple sclerosis.
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"ationa#e 3: 5antrolene sodium 45antrium6 is contraindicated in patients with cardiac# pulmonary# and hepatic problems. +t is indicated for spinal cord in?ury# stro;es# and multiple sclerosis. "ationa#e 4: 5antrolene sodium 45antrium6 is contraindicated in patients with cardiac# pulmonary# and hepatic problems. +t is indicated for spinal cord in?ury# stro;es# and multiple sclerosis. $#o%a# "ationa#e: Co&niti'e (e'e#: -nderstanding C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: Nursing *rocess: *lanning (earnin& +ut ome: "),> Question 1. Type: MC A pasticity is most commonly caused by damage to what area of the body? 1. Cerebral corte/ 2. *eripheral nerves 3. !rainstem 4. pinal cord Corre t Ans!er: ) "ationa#e 1: pasticity usually results from damage to the motor area of the cerebral corte/. "ationa#e 2: pasticity usually results from damage to the motor area of the cerebral corte/. "ationa#e 3: pasticity usually results from damage to the motor area of the cerebral corte/. "ationa#e 4: pasticity usually results from damage to the motor area of the cerebral corte/. $#o%a# "ationa#e: Co&niti'e (e'e#: .emembering C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: Nursing *rocess: Assessment (earnin& +ut ome: "),) Question 1/ Type: MC A
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Which statement is correct in regard to the muscle rela/ant botulinum to/in type ! 4Myobloc6? 1. +t can be classified as a cholinergic agonist. 2. +ncreased muscle strength is often seen within a couple of wee;s. 3. +t can ta;e > months for the effects to be seen. 4. +n high doses# it is poisonous# causing the same symptoms food poisoning does. Corre t Ans!er: % "ationa#e 1: !otulinum to/in type ! 4Myobloc6 is to/ic in high doses. Clostridium botulinum is the bacteria responsible for food poisoning. The drug wor;s by bloc;ing the release of acetylcholine from cholinergic nerve terminals. +t generally ta;es > wee;s to see the effects# and they only last for $B> months. *atients ta;ing this drug generally e/perience muscle wea;ness# not strength. "ationa#e 2: !otulinum to/in type ! 4Myobloc6 is to/ic in high doses. Clostridium botulinum is the bacteria responsible for food poisoning. The drug wor;s by bloc;ing the release of acetylcholine from cholinergic nerve terminals. +t generally ta;es > wee;s to see the effects# and they only last for $B> months. *atients ta;ing this drug generally e/perience muscle wea;ness# not strength. "ationa#e 3: !otulinum to/in type ! 4Myobloc6 is to/ic in high doses. Clostridium botulinum is the bacteria responsible for food poisoning. The drug wor;s by bloc;ing the release of acetylcholine from cholinergic nerve terminals. +t generally ta;es > wee;s to see the effects# and they only last for $B> months. *atients ta;ing this drug generally e/perience muscle wea;ness# not strength. "ationa#e 4: !otulinum to/in type ! 4Myobloc6 is to/ic in high doses. Clostridium botulinum is the bacteria responsible for food poisoning. The drug wor;s by bloc;ing the release of acetylcholine from cholinergic nerve terminals. +t generally ta;es > wee;s to see the effects# and they only last for $B> months. *atients ta;ing this drug generally e/perience muscle wea;ness# not strength. $#o%a# "ationa#e: Co&niti'e (e'e#: -nderstanding C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: Nursing *rocess: 'valuation (earnin& +ut ome: "),> Question 20 Type: MCMA A patient tells the nurse# A+ have been reading about using castor oil as a treatment for muscle cramping. 5o you ;now anything about that?A 7ow should the nurse respond to this 0uestion? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
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Standard Text: elect all that apply. 1. AWhy don2t you as; the doctor about whether it wor;s or not?A 2. A+ thin; you ta;e a tablespoon twice a day.A 3. AThe castor oil should be warmed before use.A 4. A oa; a flannel cloth with the castor oil and apply it to your muscle.A 5. ACou must wear gloves when handling castor oil.A Corre t Ans!er: $#% "ationa#e 1: The nurse should be prepared to discuss pharmaceutical and nonpharmaceutical methods of symptom management# including complementary and alternative therapies. There is no reason to defer to the health care provider. "ationa#e 2: Castor oil is used as a topical application when it is used for muscle cramping. "ationa#e 3: Warming the castor oil has the added benefit of warming the muscle tissue# which helps to relieve discomfort. "ationa#e 4: The flannel cloth absorbs the castor oil and holds it on the s;in. The flannel also holds in the warmth of the oil. "ationa#e 5: There is no indication that contact between castor oil and the hands is detrimental. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: *harmacological and *arenteral Therapies )ursin&/*nte&rated Con epts: Nursing *rocess: +mplementation (earnin& +ut ome: ")," Question 21 Type: MCMA A patient who has cerebral palsy is beginning to e/perience spasticity of the muscles in the upper arm. Which medications would the nurse 0uestion if prescribed for this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: elect all that apply. 1. Meta/alone 4 ;ela/in6 dosed three times a day
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2. Chlor3o/a3one 4*arafon =orte6 dosed four times a day 3. Carisoprodol 4 oma6 dosed three times a day 4. +ntrathecal baclofen 48ioresal6 5. Ti3anidine 4Danafle/6 dosed twice a day Corre t Ans!er: )#"#@ "ationa#e 1: Meta/alone 4 ;ela/in6 is ineffective in the treatment of spasticity,related neurologic disorders. "ationa#e 2: Chlor3o/a3one 4*arafon =orte6 is ineffective in the treatment of spasticity related to neurodegenerative disorders. "ationa#e 3: Carisoprodol 4 oma6 is effective in relieving the pain# muscle spasms# and spasticity associated with cerebral palsy and is dosed three times a day. "ationa#e 4: !aclofen 48ioresal6 is effective in reducing muscle spasticity and can be delivered intrathecally. "ationa#e 5: Ti3anidine 4Danafle/6 is used for muscle spasticity but has a short half,life and must be dosed every >E?F hours. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy3ing C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: *harmacological and *arenteral Therapies )ursin&/*nte&rated Con epts: Nursing *rocess: +mplementation (earnin& +ut ome: "),$ Question 22 Type: MCMA The parents of a ",year,old who has cerebral palsy are only now beginning to accept that their child will have a permanent disability. The nurse has been instructing the parents about the treatment for the spasticity their child is e/periencing. Which statements by the parents indicate that the nurse should plan additional teaching sessions? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: elect all that apply. 1. AAt some point# our child may re0uire surgery to correct this spasticity.A 2. AAs long as we continue our child2s medications# the spasticity can be controlled.A 3. AGur physical therapy sessions should focus on fle/ing our child2s muscles.A
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4. AWe should repeat the e/ercises several times with each muscle group.A 5. A+t is best to give our child a rest from physical therapy by s;ipping ) wee; a month.A Corre t Ans!er: "#$#@ "ationa#e 1: urgery is sometimes necessary in these cases# so this statement reflects accurate ;nowledge. "ationa#e 2: Medication alone is generally not enough to control spasticity in these children. The parents need additional teaching. "ationa#e 3: The physical therapy sessions for spasticity focus on muscle stretching# not fle/ion. The parents need additional teaching. "ationa#e 4: .epetitive motion e/ercises are beneficial in reducing and controlling spasticity. The parents have e/pressed accurate ;nowledge. "ationa#e 5: *hysical therapy should be routine and consistent in order to reduce or control spasticity. These parents need additional teaching. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: *hysiological Adaptation )ursin&/*nte&rated Con epts: Nursing *rocess: 'valuation (earnin& +ut ome: ")," Question 23 Type: MCMA The patient2s health care provider prescribed dantrolene sodium 45antrium6 "@ mg daily for the treatment of nec; spasms secondary to spinal cord in?ury. The patient reports that the medication is Anot wor;ing#A even though it has been %@ days since the medication was started. What changes in this patient2s plan of care would the nurse anticipate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: elect all that apply. 1. +ncrease in the dosage fre0uency to twice a day 2. 5iscontinuation of the medication 3. +ncrease in the fre0uency of hepatic function tests 4. Change to a different medication
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5. Addition of succinylcholine 4Anectine6 to the patient2s medications Corre t Ans!er: "#% "ationa#e 1: +f no therapeutic effect of the medication is noted after %@ days of treatment# increasing the dosage in not indicated. "ationa#e 2: +f there has been no therapeutic effect from the dantrolene after %@ days of therapy# the medication should be discontinued. "ationa#e 3: imply increasing the fre0uency of liver tests will not prevent damage to the liver. "ationa#e 4: ince there have been no therapeutic effects from this medication# a different medication is indicated. "ationa#e 5: uccinylcholine 4Anectine6 is a drug used during surgery# not on an outpatient basis. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy3ing C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: *harmacological and *arenteral Therapies )ursin&/*nte&rated Con epts: Nursing *rocess: *lanning (earnin& +ut ome: "),> Question 24 Type: MCMA The patient tells the nurse# AThe doctor is going to start me on !oto/ for the muscle spasms in my nec;. +2ve always wanted to try that. +t will ma;e me loo; younger.A What information should the nurse provide to this patient regarding onabotulinumto/inA 4!oto/6? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: elect all that apply. 1. AGnce you start on the medication# it may ta;e a wee; or so before you notice a change in your s;in.A 2. A!e certain you ta;e the medication with a full glass of water because it can be hard on your ;idneys.A 3. AThere are many different uses for that drug# depending on how it is administered.A 4. ACou may have to have additional treatments with the medication in a few months.A 5. ACou should be aware that side effects of the medication can occur hours or wee;s after your treatment.A Corre t Ans!er: $#%#@
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"ationa#e 1: Gnabotulinumto/inA 4!oto/6 in this patient2s case will not change the s;in. "ationa#e 2: Gnabotulinumto/inA 4!oto/6 is administered by in?ection into the muscle. "ationa#e 3: Gnabotulinumto/inA 4!oto/6 has many clinical indications. Action depends on the area where the medication is administered. "ationa#e 4: The effects of onabotulinumto/inA 4!oto/6 generally last from $ to > months. "ationa#e 5: ide effects of onabotulinumto/inA 4!oto/6 may not occur immediately upon administration# and the patient should watch for their development for several hours to wee;s later. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: *harmacological and *arenteral Therapies )ursin&/*nte&rated Con epts: Nursing *rocess: +mplementation (earnin& +ut ome: "),> Question 25 Type: MCMA The nurse is discharging a <",year,old man who was hospitali3ed after a muscle strain in?ury to his bac;. Gne of the discharge prescriptions for this patient is cycloben3aprine 4=le/eril6 )( mg three times per day with food. The prescription is written for H( tablets and there are three refills available. Which information from this situation would alert the nurse for the need to collaborate with the patient2s health care provider? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: elect all that apply. 1. The dosage amount is too low for the type of in?ury this patient sustained. 2. Cycloben3aprine should be used with great caution in those over >@. 3. +f ta;en as directed# the patient would be able to ta;e the medication for )"( days. 4. Cycloben3aprine is not effective for bac; pain. 5. Cycloben3aprine should not be ta;en with food. Corre t Ans!er: "#$ "ationa#e 1: The dosage of )( mg three times daily is standard.

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"ationa#e 2: The adverse reactions from cycloben3aprine include confusion# hallucinations# and cardiac events# which are more common in patients over >@. "ationa#e 3: The manufacturer recommends that treatment not e/tend beyond $ wee;s or ") days. "ationa#e 4: Cycloben3aprine is not effective for muscle spasm due to spinal cord in?ury# but is useful in the treatment of bac; pain from muscle strain. "ationa#e 5: The drug may be ta;en with food or mil; if gastric upset occurs. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy3ing C#ient )eed: *hysiological +ntegrity C#ient )eed Su%: *harmacological and *arenteral Therapies )ursin&/*nte&rated Con epts: Nursing *rocess: +mplementation (earnin& +ut ome: "),>

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