Lehne's Pharmacology for Nursing Care 9th Edition by Jacqueline Burchum
Lehne's Pharmacology for Nursing Care 9th Edition by Jacqueline Burchum
$2.99
Chapter 20: Introduction to Central Nervous System Pharmacology
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | changes in the brain as a result of prolonged drug exposure. |
| b. | direct actions of the drug on specific synaptic functions in the brain. |
| c. | slowed drug absorption across the blood-brain barrier. |
| d. | tolerance to exposure to the drug over time. |
ANS: A
It is thought that beneficial responses to central nervous system (CNS) drugs are delayed because they result from adaptive changes as the CNS modifies itself in response to prolonged drug exposure, and that the responses are not the result of the direct effects of the drugs on synaptic functions. The blood-brain barrier prevents protein-bound and highly ionized drugs from crossing into the CNS, but it does not slow the effects of drugs that can cross the barrier. Tolerance is a decreased response to a drug after prolonged use.
PTS: 1 DIF: Cognitive Level: Application REF: p. 173
TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
| a. | “Adaptation can lead to tolerance of these drugs with prolonged use.” |
| b. | “Adaptation helps explain how physical dependence occurs.” |
| c. | “Adaptation often must occur before therapeutic effects develop.” |
| d. | “Adaptation results in an increased sensitivity to side effects over time.” |
ANS: D
With adaptation of the central nervous system to prolonged exposure to CNS drugs, many adverse effects diminish and therapeutic effects remain. Adaptation helps explain how tolerance and physical dependence occur, as the brain adapts to the presence of the drug. Therapeutic effects can take several weeks to manifest, because they appear to work by initiating adaptive changes in the brain.
PTS: 1 DIF: Cognitive Level: Analysis REF: p. 174
TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
| a. | prevents some potentially toxic substances from crossing into the central nervous system. |
| b. | causes infants to be less sensitive to CNS drugs and thus require larger doses. |
| c. | allows only ionized or protein-bound drugs to cross into the central nervous system. |
| d. | prevents lipid-soluble drugs from entering the central nervous system. |
ANS: A
The blood-brain barrier can prevent some drugs and some toxic substances from entering the CNS. The blood-brain barrier in infants is not fully developed, so infants are more sensitive to CNS drugs and often require lower doses. The blood-brain barrier prevents highly ionized and protein-bound drugs from crossing into the CNS and allows lipid-soluble drugs and those that can cross via specific transport systems to enter.
PTS: 1 DIF: Cognitive Level: Analysis REF: p. 173
TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
| a. | “Central nervous system drug development relies on observations of their effects on human behavior.” |
| b. | “Studies of new central nervous system drugs in healthy subjects can produce paradoxical effects.” |
| c. | “Our knowledge of the neurochemical and physiologic changes that underlie mental illness is incomplete.” |
| d. | “These drugs are developed based on scientific knowledge of CNS transmitters and receptors.” |
ANS: D
The deficiencies in knowledge about how CNS transmitters and receptors work make systematic development of CNS drugs difficult. Testing in healthy subjects often leads either to no effect or to paradoxical effects. Medical knowledge of the neurochemical and physiologic changes underlying mental illness is incomplete. The development of CNS drugs depends less on knowledge of how the CNS functions and how these drugs affect that process and more on how administering one of these agents leads to changes in behavior.
PTS: 1 DIF: Cognitive Level: Analysis REF: p. 174
TOP: Nursing Process: Assessment
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
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