Nokea
The nurse is reviewing the use of central nervous system stimulants. Which of these are indications for this class of drugs? (Select all that apply.)
- A. Narcolepsy
- B. Depression
- C. Panic attacks
- D. Neonatal apnea
- E. Attention deficit hyperactivity disorder (ADHD)
- F. Appetite suppression
- G. Migraine headaches
Correct Answer: A,D,E,F,G
Rationale: CNS stimulants are indicated for narcolepsy, neonatal apnea, ADHD, appetite suppression in obesity treatment, and migraine headaches (via triptans). They are not used for depression or panic attacks, as they may worsen these conditions.
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A patient is receiving instructions regarding the use of caffeine. The nurse shares that caffeine should be used with caution if which of these conditions is present?
- A. A history of peptic ulcers
- B. Migraine headaches
- C. Asthma
- D. A history of kidney stones
Correct Answer: A
Rationale: Caffeine can exacerbate peptic ulcers by increasing gastric acid secretion, which may worsen the condition. It is not contraindicated in migraine headaches, asthma, or kidney stones, though it may have varying effects on these conditions.
A patient has a new prescription for phentermine as part of the treatment for weight loss. Which information will the nurse include when teaching this patient about a stimulant such as phentermine? (Select all that apply.)
- A. Take this medication after meals.
- B. Take this medication in the morning.
- C. This drug is taken along with supervised exercise and suitable diet.
- D. Use mouth rinses, sugarless gum, or hard candies to minimize dry mouth.
- E. Avoid foods that contain caffeine, such as coffee, tea, and colas.
Correct Answer: B,C,D,E
Rationale: Phentermine should be taken in the morning to avoid insomnia, alongside supervised exercise and diet for weight loss, and with measures like mouth rinses to manage dry mouth. Avoiding caffeine prevents additive stimulant effects. Taking it after meals is not necessary, as timing is not meal-dependent.
When evaluating a patient who is taking orlistat, which is an intended therapeutic effect?
- A. Increased wakefulness
- B. Increased appetite
- C. Decreased weight
- D. Decreased hyperactivity
Correct Answer: C
Rationale: Orlistat is a nonstimulant drug used for weight loss by inhibiting fat absorption, making decreased weight the intended therapeutic effect. It does not affect wakefulness, appetite, or hyperactivity.
A 22-year-old nursing student has been taking caffeine tablets for the past few weeks to 'make it through' the end of the semester and exam week. She is in the university clinic today because she is 'exhausted.' What human needs statement may be appropriate for her?
- A. Altered oxygenation need
- B. Altered physical activity
- C. Altered need for sleep
- D. Altered food intake
Correct Answer: C
Rationale: Caffeine, a CNS stimulant, can cause restlessness, anxiety, and insomnia, leading to an altered need for sleep. This is the most relevant human needs statement given her exhaustion from overuse. The other options are not directly related to caffeine's effects.
A patient who started taking orlistat 1 month ago calls the clinic to report some 'embarrassing' adverse effects. She tells the nurse that she has had episodes of 'not being able to control my bowel movements.' Which statement is true about this situation?
- A. These are expected adverse effects that will eventually diminish.
- B. The patient will need to stop this drug immediately if these adverse effects are occurring.
- C. The patient will need to increase her fat intake to prevent these adverse effects.
- D. The patient will need to restrict fat intake to less than 30% of total calories to help reduce these adverse effects.
Correct Answer: D
Rationale: Orlistat's gastrointestinal side effects, such as fecal incontinence, are related to its mechanism of inhibiting fat absorption. Restricting dietary fat to less than 30% of total calories can reduce these effects. They are not expected to diminish entirely without dietary changes, stopping the drug is not necessary, and increasing fat intake would worsen the effects.