Chapter 56 Drug Therapy to Stimulate the Central Nervous System


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Chapter 56  Drug Therapy to Stimulate the Central Nervous System



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Sample Questions



1. A 4-year-old child is brought to the pediatric clinic by his mother. She states, “I don’t know what to do with him. He is in constant motion. He won’t sit for more than a few seconds and he is doing something else. He often throws his toys and yells loudly, even compared with other kids his age.” The child is diagnosed with attention deficit hyperactivity disorder. Which of the following medications will most likely be administered in conjunction with treatment?

  1. A)  ACE inhibitors
  2. B)  SSRIs
  3. C)  Central nervous system stimulants
  4. D)  MAO inhibitors

Ans: C
ADHD is characterized by persistent hyperactivity, short attention span, difficulty completing tasks, restlessness, and impulsivity. The diagnosis has increased in recent years, with a concomitant increase in the use of prescribed CNS stimulants for its treatment. SSRIs, ACE inhibitors, and MAOIs are not typically used.

2. A patient visits the occupational health office of the factory in which he works. He has fallen asleep on the line and has a history of muscle weakness. This instance is not the first time he has fallen asleep on the line. From what disease process does the occupational health nurse suspect the patient is suffering?

  1. A)  Sleep apnea
  2. B)  Insomnia
  3. C)  Narcolepsy
  4. D)  Substance abuse

Ans: C


Narcolepsy is characterized by daytime sleep attacks in which the person goes to sleep at any place or at any time. Sleep apnea is episodes of apnea during sleep. Insomnia is the inability to sleep. This patient is not exhibiting signs and symptoms of substance abuse.

3. A patient suffers from narcolepsy. Which of the following aspects of patient teaching should be provided?

  1. A)  Take 250 mg of caffeine daily.
  2. B)  Avoid working shifts.
  3. C)  Take a lengthy nap every afternoon.
  4. D)  Increase the Ritalin dose as needed.

Ans: B Feedback:

The patient who is diagnosed with sleep apnea should avoid shift work. Caffeine use may or may not be indicated. The patient should ideally not take naps. The patient should not increase the Ritalin dose without the input of the primary health provider.

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4. A child is prescribed an amphetamine for attention deficit hyperactivity disorder. Which of the following effects provide evidence that the medications are working?

  1. A)  Improved grades
  2. B)  Increased sleep quality
  3. C)  Lethargy
  4. D)  Polyphagia

Ans: A
Amphetamines used with ADHD improve academic performance. Amphetamines often decrease sleep. Amphetamines will not result in lethargy. Amphetamines decrease appetite and do not cause polyphagia.

5. A patient is taking dextroamphetamine for ADHD. He has developed constipation since beginning therapy. Which of the following should the patient be taught?

  1. A)  Take an OTC laxative daily.
  2. B)  Increase fiber intake.
  3. C)  Take diphenoxylate hydrochloride (Lomotil).
  4. D)  Take metronidazole (Flagyl).

Ans: B Feedback:

A patient who is experiencing constipation should be instructed to increase fiber in his diet. The patient should not take a laxative. The patient should not be instructed to take diphenoxylate hydrochloride (Lomotil) because it is an antidiarrheal agent. The patient should not be given metronidazole (Flagyl).

6. A neonate is suffering from apnea. Which of the following medications may be administered as a respiratory stimulant?

  1. A)  Caffeine and methylphenidate
  2. B)  Caffeine and Mefoxitin
  3. C)  Caffeine and sodium benzoate
  4. D)  Caffeine and sodium bicarbonate

Ans: C
The combination of caffeine and sodium benzoate is occasionally used as a respiratory stimulant in neonates. Caffeine is not mixed with methylphenidate. Caffeine is not mixed with Mefoxitin. Caffeine is not mixed with sodium bicarbonate for this indication.

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