Pharm Test

Which of the following is stimulated during the body’s fight-or-flight response to a stressful condition?
Sympathetic nervous system

Another name for adrenergic drugs is
Sympathomimetic drugs.

Which of the following types of shock occur as the result of significantly diminished blood volume?
Hypovolemic shock

Which of the following represent the two types of receptors that are found in the adrenergic nervous system?
• Beta receptors
• Alpha receptors

A priority nursing assessment for a patient who is to receive an alpha- or beta-adrenergic antagonist would be to
assess heart rate.

A patient is administered epinephrine in conjunction with a local anesthetic. What effect will epinephrine produce?
Increased vasoconstrictive effects

An 80-year-old patient has been brought to the Emergency Department in shock. The patient is receiving dopamine (Intropin). What potentially serious adverse effect will the nurse monitor for?
Cardiac arrhythmia

Adrenergic drugs produce which of the following effects?`
Increased heart rate

A nurse in the intensive care unit is caring for a patient in shock and has started IV administration of dopamine (Intropin). For a patient in shock, dopamine helps to
increase blood pressure.

Drugs that produce activity similar to the neurotransmitter norepinephrine are known as which of the following?

A nurse is caring for an elderly patient who is to be administered isoproterenol. Which of the following changes monitored in the patient should the nurse report immediately to the primary healthcare provider?
Changes in pulse rate

Which of the following is the primary neurotransmitter of the sympathetic nervous system?

Stimulation of beta1 adrenergic receptors in the heart results in:
Increased heart rate.

Which of following adrenergic receptors is responsible for vasodilation of peripheral vessels and bronchodilation
β2 receptors

You are caring for a patient who is in hypovolemic shock. The patient’s condition is increasing in severity. What features will present clinically?
• Decreased urinary output
• Tachycardia
• Cool extremities

Drugs that block or inhibit the sympathetic nervous system are known as which of the following?
• Adrenergic blocking drugs
• Sympatholytics
• Antiadrenergic drugs

The nurse is administering an adrenergic agonist to a patient and realizes that this medication will cause stimulation of the sympathetic nervous system. Which effects will it produce
• Bronchodilation
• Decreased bladder tone

The nursing students are discussing beta-specific adrenergic agonists in their pharmacology class. What drug is a beta-specific adrenergic agonist and is used to prevent bronchospasm during anesthesia?
Isoproterenol (Isuprel)

The autonomic nervous system controls which of the following body functions?
• Heart rate
• Blood pressure
• Glandular secretions
• GI activity

When administered to a client isoproterenol (Isuprel) will most likely cause which of the following to occur?
• Increased use of glucose
• Decreased gastric motility
• Wakefulness

A nurse may be asked to administer adrenergic drugs to clients with which of the following conditions?
• Hypovolemic shock
• Respiratory distress
• Allergic reactions
• Cardiac arrest

The nurse should not administer isoproterenol (Isuprel) to which of the following clients?
• Clients with digoxin toxicity
• Clients with angina pectoris
• Clients with ventricular arrhythmias

A patient has been prescribed dopamine. Which of the following interventions should the nurse perform during the drug regimen?
Administer dopamine only via IV route

Which of the following are examples of sympathomimetic drugs?
• Epinephrine (EpiPen)
• Midodrine (ProAmatine)
• Isoproterenol (Isuprel)

Which of the following needs to be part of the nurse’s preadministration assessment for dobutamine?
• Blood pressure
• Respiratory rate
• Pulse
• Level of consciousness

While educating a client on the use of midodrine (ProAmatine) the nurse should tell the client to report which of the following changes?
• Vision changes
• Bradycardia
• Difficulty urinating

Adrenergic drugs may be used to treat which of the following?
• Asthma
• Glaucoma
• Nausea and vomiting
• Sinus congestion

What assessment should the nurse make before administering beta-adrenergic blocking agents?
Pulse and blood pressure

A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessments?
Heart rate and blood pressure

A nurse is required to administer propranolol to a patient for the treatment of cardiac arrhythmias. The nurse checks the patient’s apical pulse rate and blood pressure before administration of the drug and observes that the pulse rate is below 60 bpm. What nursing intervention should the nurse perform in this case?
Withhold the drug administration and contact PHCP.

A patient has recently been prescribed a drug that treats his hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of
an adrenergic antagonist.

Prior to the administration of a sympatholytic drug, the nurse should check a patient’s blood pressure and which of the following?
Apical pulse

A priority nursing assessment for a patient who is to receive an alpha- or beta- adrenergic blocking agent would be what?
Assess heart rate

A patient is experiencing urinary retention. He has been prescribed terazosin (Hytrin). What condition contributes to the urinary retention?
Benign prostatic hypertrophy

Your patient is a 72-year-old Asian male, status post-MI, with a 10-year history of cardiovascular disorder. During your pre-discharge patient teaching on his new medications, you discuss his prescribed clonidine and its major clinical effect. Because the drug is an alpha2-adrenergic agonist, the expected effect is:
Decreased blood pressure.

In which organ are the majority of beta-adrenergic receptors found?

A patient is receiving tamsulosin. The nurse understands that this drug is most likely being given for which reason?
To relax prostatic smooth muscles

Propranolol (Inderal) is used extensively as treatment for what condition?

The student nurses are learning about drugs that act on the ANS. The students should learn that adrenergic blocking agents prevent which of the following neurotransmitters from being released and causing SNS effects to be blocked?

A patient has been diagnosed with benign prostatic hypertrophy and has been prescribed prazosin (Minipress) to assist in the treatment of the symptoms. How does this alpha1-blocking agent decrease urinary retention?
The medication inhibits urinary bladder contraction.

Which of the following are classified as sympatholytic drugs?
• Beta-adrenergic blockers
• Alpha-adrenergic blockers

The nurse is assessing the patient for adverse CNS effects after administering a nonselective adrenergic blocker based on the understanding that these effects occur due to which of the following?
Blockage of norepinephrine’s effect

After teaching a group of students about beta-1 selective blockers, the instructor determines that the teaching was successful when the students identify which of the following as a contraindication for using this group of drugs?
Sinus bradycardia

Which of following is an example of an alpha/beta-adrenergic blocking drug?
Carvedilol (Coreg)

A 35-year-old female has been recently diagnosed with hyperthyroidism. Her doctor has prescribed propranolol (Inderal) for what effect?
To decrease heart rate

The physician has prescribed alpha/beta blockers for a patient suffering from hypertension. In which of the following cases would alpha/beta blocker medications be contraindicated?
• Patient has severe bradycardia
• Patient has bronchial asthma
• Patient has decompensated heart failure

In which of the following situations would a nurse caring for a hospitalized client hold the dose of propranolol (Inderal)?
• Pulse less than 60 bpm
• Irregular pulse
• Systolic pressure less than 90 mmHg

A nurse administers atenolol (Tenormin) to a client suffering an acute MI. The atenolol will result in which of the following changes in the client?
• Decrease the heart’s workload
• Decreases heart rate

A nurse must recognize which class of medication a drug is part of in order to help in planning ongoing assessment and patient education. Which of the following is an example of a drug in the class of beta-adrenergic blockers?
• Atenolol (Tenormin)
• Metoprolol (Lopressor)
• Propranolol (Inderal)

A nurse completing discharge counseling with a client being discharged with clonidine (Catapres) should be told about which of the following adverse events that may occur?
• Dry mouth
• Sedation
• Anorexia

Which of the following agents would be indicated for the treatment of benign prostatic hypertrophy?
• Terazosin
• Alfuzosin

While most beta-adrenergic receptors are found in the heart, they are also commonly found in which other organs?
• Eyes
• Lungs

A nurse should observe which of the following clients more carefully during the use of propranolol (Inderal) due to the increase likelihood of adverse reactions?
• Clients with asthma
• Clients with diabetes
• Clients with peptic ulcer disease

A nurse caring for a client with benign prostatic hypertrophy (BPH) may be taking which of the following antiadrenergic drugs to treat their BPH?
• Doxazosin (Cardura)
• Alfuzosin (Uroxatral)
• Tamsulosin (Flomax)

A nurse is assigned to care for a patient who has to be administered alpha adrenergic blocking drug. Which category of patients requires a cautious use of this drug which the nurse should be aware of?
• Patients with renal failure
• Patients with Raynaud’s disease
• Patients with a recent myocardial infarction

A patient has been admitted to the emergency department with complaints of sudden nausea, diaphoresis, and shortness of breath. A thorough history has revealed that the patient’s signs and symptoms are attributable to an accidental overdose of neostigmine (Prostigmin). The nurse who is providing care for the patient should anticipate that the patient is likely to require what drug?

A nurse is writing a plan of care for a patient who is taking bethanechol (Urecholine). What would be an appropriate outcome for this patient?
Improved bladder function

Which of the following is the substance responsible for transmission of nerve impulses across the parasympathetic nervous system?

What condition is the cholinergic drug bethanechol (Duvoid) used to treat?
Urinary retention

Which of the following is the enzyme responsible for activating acetylcholine the primary neurotransmitter in the parasympathetic nervous system?

The nursing instructor is discussing cholinergic drugs with his clinical group. What system would the instructor tell his students is stimulated by cholinergic drugs?
Parasympathetic nervous system

Which agent would be used to counteract a severe reaction occurring with the use of neostigmine?

A patient is brought to the Emergency Department (ED) and is found to have cholinergic toxicity. What is the drug of choice to treat this condition?

A nurse is caring for a patient with urinary retention. Which of the following conditions should the nurse notify the primary healthcare provider as part of the ongoing assessment?
Failure to void after drug administration

The nurse administered neostigmine to a patient with myasthenia gravis. The nurse is doubling the dose that the patient was taking at home. Three hours later, the nurse is assessing the patient and notes the following symptoms: nausea with vomiting, diarrhea, and sweating. What does she interpret these symptoms to be?
This is cholinergic crisis, and the physician needs to be notified immediately.

A patient is brought to the Emergency Department after a motor vehicle accident. The patient is diagnosed with multiple injuries including a bladder injury. The patient is taken to surgery and develops a nonobstructive postoperative urinary retention. What drug would the nurse expect to be ordered for this patient?

A nurse observing a patient receiving treatment with edrophonium (Tensilon) for myasthenia gravis notices the patient clenching his/her jaw, salivating excessively, experiencing and muscle weakness, rigidity, and spasm. These are all symptoms of which of the following?
Cholinergic crisis

A patient has atony of the smooth muscle of the gastrointestinal tract. Which type of medication will be administered to increase smooth muscle strength?
Cholinergic drugs

A patient has been prescribed edrophonium for myasthenia gravis. Which of the following can the nurse monitor as a general adverse reaction in the patient?
Cardiac arrhythmias

A nurse is caring for a patient with urinary retention. The patient has been prescribed Urecholine. For which category of patients should the nurse take precautions when administrating Urecholine?
Patients with bradycardia

Prior to administering ambenonium (Mytelase) to a client, the nurse’s preadministration assessment should include which of the following?
• Signs of muscle weakness
• Signs of difficulty breathing
• Drooping eyelids

Which of the following drugs would be used to diagnose myasthenia gravis in a child?
Edrophonium (Tensilon)

When administering anticholinesterase drugs, what assessment finding would indicate the patient is experiencing a toxic effect of the medication?
Muscle weakness

A nurse should notify the physician immediately if a client taking a cholinergic drug develops which of the following cholinergic crisis symptoms??
• Muscle spasms
• Excessive salivation
• Muscle rigidity
• Severe abdominal cramping

A nurse is caring for a patient with myasthenia gravis at a healthcare facility. The patient has been administered ambenonium. Which of the following symptoms of drug under dosage should the nurse monitor in the client?
Difficulty in breathing

Prior to administering bethanechol (Urecholine) to a client, the nurse’s preadministration assessment should include which of the following?
• Blood pressure
• Pulse rate
• Palpation of the bladder

Which of the following medical conditions can be treated with cholinergic drugs?
• Urinary retention
• Myasthenia gravis

A nurse should review a client’s medical conditions prior to administering a cholinergic drug as their use is contraindicated in clients with which of the following medical conditions?
• Hyperthyroidism
• Asthma
• Peptic ulcer disease

A nurse is caring for a patient with urinary retention who is undergoing cholinergic drug therapy. What ongoing assessment should the nurse perform while caring for the patient?
• Monitor voiding after drug administration
• Measure and record the fluid intake and output
• Palpate the bladder to determine its size

Which of the following medication when administered with a cholinergic drug will result in increased adverse effects of the cholinergic drug?
• Prednisone
• Dexamethasone

Which of the following are true about the enzyme acetylcholinesterase?
• Acetylcholinesterase makes the parasympathetic nervous system function differently.
• Acetylcholinesterase activity results in the prevention of nerve synapses to continue nerve impulses.

The nurse should be cautious and closely monitor clients receiving ambenonium (Mytelase) with which of the following medical conditions?
• Hypertension
• Epilepsy

A 27-year-old male patient is taking an anticholinergic drug as adjunctive therapy to treat his peptic ulcer disease. The patient comes to the clinic and tells the nurse that he “feels his heart beating.” What adverse effect is the patient experiencing from the anticholoinergic medication?

Anticholinergic drugs are used to treat a variety of disease processes. What should the patient newly prescribed anticholinergic drugs by taught by the nurse?
Do not drive or operate machinery until you know how it affects you

A patient taking anticholinergic drugs should be taught to minimize the risks of heat exhaustion and heat stroke. What would be one way to meet this goal?
Avoid extremes of temperature

While preparing your client for an eye examination, you explain that the eye drops, an ophthalmic anticholinergic preparation, will cause the pupil to:

A 50-year-old female patient received atropine and meperidine (Demerol) preoperatively. After surgery, the patient complains of mouth dryness. What would the best response be to the patient?
“This is caused by your preoperative medication, which decreased your saliva. It is only temporary and will improve.”

A student asks the pharmacology instructor to explain the action of anticholinergic agents. What would be the instructor’s best response?
They act to block the effects of the parasympathetic nervous system

Anticholinergic agents are also called parasympatholytic agents. True or False?

A patient who is going on a cruise is concerned about motion sickness and sees his physician, who prescribes scopolamine. The nurse informs the patient that using scopolamine may cause him to experience

The nurse is preparing Mr. Hahn for pacemaker surgery. The physician orders atropine to be given 30 minutes before the patient leaves for the operating room. The nurse knows that the physician ordered this medication for what reason?
To dry up respiratory secretions to prevent aspiration during surgery

Anticholinergics do not block the effects of acetylcholine in the central nervous system. True or False?

Unwanted anticholinergic effects include:
Constipation and dry mouth.

Which of the following symptoms will warrant the administration of atropine?

A patient has been given atropine to cause mydriasis and cycloplegia. What is the expected outcome for this patient?
Dilated pupils and blurred vision

Clients with the following disorder should not be given anticholinergic drugs:

The cholinergic blocking drug glycopyrrolate (Robinul) is used in conjunction with anesthesia for which of the following reasons?
Reduction of oral secretions

The nurse must be aware the some of the cholinergic blocking drugs are available over the counter without a prescription. Which of the following cholinergic blocking drugs are available without a prescription?

Which of the following would be important for a patient who has received an anticholinergic agent?
• Auscultating bowel sounds
• Monitoring urine output
• Monitoring heart rate

A nurse is administering a cholinergic-blocking drug preoperatively to a patient. What intervention should the nurse perform after administering the drug to the patient?
Raise the side rails of the bed.

A patient is scheduled for an exploratory laparoscopy. She has been prescribed an anticholinergic agent. Why is it important to administer the anticholinergic agent in the preoperative phase?
It will decrease respiratory secretions.

A patient with an overactive bladder has been prescribed solifenacin by the physician. The patient is also taking digoxin for the treatment of a cardiac dysrhythmia. The nurse should monitor for which of the following effects occurring due to the interaction of these two drugs?
Increased serum levels of digoxin

Because of the systemic effects of anticholinergic drugs older adults using these drugs are susceptible to what?
Heat stroke related to decreased perspiration

Which of the following is a cholinergic blocking drug which is available in an inhaler form for the treatment of COPD?
Ipratropium (Atrovent)

Which of the following cholinergic-blocking drug are used in the treatment of chronic obstructive pulmonary disease (COPD)?
• Tiotropium (Spiriva)
• Ipratropium (Atrovent)

A nurse is caring for a 60-year-old patient with a peptic ulcer. The patient is administered belladonna alkaloids by the nurse. Which of the following conditions should the nurse monitor for when caring for this patient?
Blurred vision

Anticholinergics have varied effects on the body. What is one of those effects?
Preventing vagal stimulation

Dry mouth is a common adverse event that occurs with the daily administration of cholinergic-blocking drugs. Dry mouth can lead to which of the following for which the nurse should monitor a client?
• Dysphagia
• Impeded speech

A nurse administering a cholinergic-blocking medication to a client should monitor the client for which of the following visual adverse reactions?
• Mydriasis
• Photophobia
• Cycloplegia

If a cholinergic-blocking drug is administered prior to surgery, the nurse instructs the client of which of the following?
• Remain in bed after drug administration.
• Dry mouth is to be expected.

What should the nurse monitor for when an elderly patient is receiving cholinergic blocking drugs?
• Urinary retention
• Drowsiness
• Mental confusion

The nurse should be cautious and closely monitor clients receiving benztropine (Congentin) with which of the following medical conditions?
• Hepatic disease
• Renal disease
• Hypertension
• Hyperthyroidism

A nurse administering glycopyrrolate (Robinul) to a client with a peptic ulcer should monitor the client for which of the following gastrointestinal adverse reactions?
• Nausea
• Dysphagia
• Dry mouth

Which of the following represents an idiosyncratic reaction to scopolamine (Transderm Scop)?
• Restlessness
• Insomnia

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