WGU D116 ADVANCED PHARMACOLOGY FINAL

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WGU D116 ADVANCED PHARMACOLOGY FINAL

EXAM OBJECTIVE ASSEMENT & PRE-ASSESMENT

700 QUESTIONS AND ANSWERS LATEST UPDATE

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WGU D116 ADVANCED PHARMACOLOGY EXAM OBJECTIVE ASSEMENT

• A nurse is teaching a group of nurses about Parkinson's medications. The nurse is correct in

stating that one side effect associated with pramipexole that is less likely to occur with other dopamine agonists is which of the following?

• Dizziness
• Dyskinesias
• Hallucinations
• Sleep attacks

Sleep attacks

Few patients taking pramipexole have experienced sleep attacks or an overwhelming and irresistible sleepiness that comes on without warning. Dizziness, hallucinations, and dyskinesias are listed as side effects of pramipexole and other dopamine agonists.

• A nursing student wants to know why a patient who has been taking levodopa for years

will now receive carbidopa. As the provider, you explain the reasons that levodopa as a single agent is no longer available.

• Which statement by the student indicates a need for further education? 1 / 4

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• "Carbidopa increases the availability of levodopa in the central nervous system."
• "Combination products reduce peripheral cardiovascular side effects."
• "Carbidopa reduces the incidence of nausea and vomiting."
• "Combination products cause fewer dyskinesias and decrease psychosis."

"Combination products cause fewer dyskinesias and decrease psychosis."

Adding carbidopa to levodopa does not reduce the incidence of dyskinesias or psychosis.Carbidopa can increase the intensity and the speed of onset of these effects. Carbidopa inhibits decarboxylation of levodopa in the intestine and peripheral tissues, leading to more levodopa in the CNS. Carbidopa cannot cross the blood-brain barrier, so it does not have action in the central nervous system (CNS). Peripheral side effects are reduced, including nausea, vomiting, and cardiovascular effects.

• A patient with Parkinson disease is taking carbidopa. The prescriber orders bromocriptine

to treat dyskinesias. The nurse notes that the patient is agitated, and the patient reports having frequent nightmares.The nurse should contact the provider to discuss which of the following?

• Adding an antipsychotic medication
• Reducing the dose of carbidopa
• Reducing the dose of bromocriptine
• Changing from bromocriptine to cabergoline

Reducing the dose of bromocriptine

Bromocriptine is used to treat levodopa-induced dyskinesias and has dose-dependent psychologic side effects. The nurse should suggest reducing the dose of this drug to minimize 2 / 4

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3 these side effects. Adding an antipsychotic medication is not indicated. Cabergoline is not approved for this use. Reducing the dose of carbidopa is not indicated.

• A hospitalized patient with Parkinson disease who is receiving apomorphine to treat

episodes develops nausea and vomiting. As the patient's provider, the nurse should discuss the use of which medication with you?

• Prochlorperazine
• Trimethobenzamide
• Ondansetron
• Levodopa

Trimethobenzamide can be used as an antiemetic in patients treated with apomorphine.Serotonin receptor agonists (e.g., ondansetron) and dopamine receptor antagonists (e.g., prochlorperazine) cannot be used because they increase the risk of serious postural hypotension. Levodopa only increases nausea and vomiting.

• A patient will begin taking a cholinesterase inhibitor for early Alzheimer disease. The

provider is teaching the patient's spouse about the medication. Which statement by the spouse indicates a need for further teaching?

• "This drug significantly slows the progression of the disease."
• "Gastrointestinal symptoms are common with this medication."
• "This drug helps neurons that are not already damaged to function better."
• "People taking this drug should not take antihistamines."

"This drug significantly slows the progression of the disease."

• A nurse is preparing to administer memantine to a patient and notes a slight elevation in

the patient's creatinine clearance level. What should the nurse order for this patient?

• Reducing the dose of memantine 3 / 4

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• Adding sodium bicarbonate to the patient's drug regimen
• Discontinuing the memantine
• Continuing the memantine as ordered

Reducing the dose of memantine

• A nurse is caring for an older adult patient who has Alzheimer disease. The patient is taking

a cholinesterase inhibitor drug. Which side effects should concern the nurse?

• Confusion and memory impairment
• Slowed heart rate and lightheadedness
• Dizziness and headache
• Nausea, vomiting, and diarrhea

Slowed heart rate and lightheadedness

• A nurse is teaching a group of nursing students about the use of memantine for Alzheimer

disease (AD). Which statement by a student indicates an understanding of the teaching?

• "Memantine is indicated for patients with mild to moderate Alzheimer disease."
• "Memantine and donepezil combined may stop the progression of Alzheimer disease."
• "Memantine prevents calcium from leaving neurons, which improves their function."
• "Memantine modulates the effects of glutamate to alter calcium influx into neurons."

"Memantine modulates the effects of glutamate to alter calcium influx into neurons."

Memantine modulates the effects of glutamate, which is involved in calcium influx into neuronal cells. Memantine is used for patients with moderate to severe AD. Memantine does not prevent calcium from leaving cells; it only affects the calcium influx. In studies, although the effects of memantine and donepezil appear to be synergistic or may confer independent

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