N316A Autonomic Nervous Quiz [2]

The following are steps in norepinephrine release. Put them in the proper sequence as they would occur. Action potential arrives at the axon terminal Axon membrane depolarizes Calcium moves into the nerve Storage vesicles fuse with cell membrane Membrane contracts Norepinephrine travels across synapse to effector cells

1. Action potential arrives at the axon terminal. 2. Axon membrane depolarizes. 3. Calcium moves into the nerve. 4. Membrane contracts. 5. Storage vesicles fuse with cell membrane. 6. Norepinephrine travels across synapse to effector cell

A pt is experiencing sympathetic stimulation in response to a stressful event. Which substance will most affect the pt sodium and water retention? A) Aldosterone B) Cortisol C) Glucose D) Thyroid hormone

A) Aldosterone

The nurse is assessing a pt who has urinary hesitation & occasional overflow incontinence. What adrenergic receptors may be overstimulated in this pt? A) Alpha 1 B) Alpha 2 C) Beta 1 D) Beta 2

A) Alpha 1 is found in blood vessels, iris, and bladder Alpha 2 - nerve membranes; Beta 1 - cardiac tissue; Beta 2 - smooth muscles of blood vessels, bronchi, uterine muscle

A pt with progressive muscle weakness is undergoing diagnostic testing for myasthenia gravis. Neostigmine 0.022 mg/kg has been prescribed and the pt weighs 144.8 lb. How much Neostigmine should the nurse administer? Provide answer to two decimal places.

1.45 mg

The nurse receives a prescription to infuse Dopamine 5 mcg/kg/min IV. The drug is supplied as 1 mg/mL solution, and the pt weighs 70 kg. How many milliliters per hour will the nurse set the pump to deliver?

21 mL/hr

A pt with HTN has been prescribed Sotalol 200 mg b.i.d. How many 80 mg tablets will the pt receive each day?

5 tablets

A pt receives a dose of phenylephrine intravenously. The nurse would expect the drug to last for how long? A) 15-20 min B) 25-30 min C) 35-40 min D) 5-10 min

A) 15-20 min

The nurse has entered a pt's room and found the pt unresponsive, in respiratory and cardiac arrest. The nurse has initiated a code blue and the resuscitation team has come to the bedside. The nurse should anticipate an order for what intervention? A) Administration of norepinephrine IV B) STAT administration of Midodrine C) Administration of Phenylephrine IM D) Administration of Dobutamine IV

A) Administration of norepinephrine IV

The nurse is assessing a pt who is experiencing significant CNS effects after receiving an alpha-specific adrenergic agonist. What finding is most likely? A) Anxiety B) Tinnitus C) Respiratory depression D) Disorientation

A) Anxiety

A pt has been administered a beta 1 receptor agonist. What assessment should the nurse prioritize in order to identify the desired therapeutic effect? A) Assess the pts heart rate B) measure the pts blood glucose C) Assess the pts level of consciousness D) Auscultate the pts lungs

A) Assess the pts heart rate

A pt has been prescribed a beta 2 receptor agonist by the care provider. What diagnosis may indicate the need for beta 2 receptor stimulation? A) Asthma B) Cirrhosis C) Chronic heart failure D) Type 2 diabetes

A) Asthma

Select all that apply: The nurse, transcribing an order for a direct acting cholinergic agent, would consider what conditions to be a contraindication to its use? A) Asthma B) Pregnancy C) Peptic ulcer disease D) Blader obstruction E) Bradycardia

A) Asthma C) Peptic ulcer disease D) Blader obstruction E) Bradycardia

Which agent would the nurse administer to counteract a severe reaction occurring with the use of Neostigmine? A) Atropine B) Phentolamine C) Naloxone D) Edrophonium

A) Atropine

Select all that apply: A nurse would question an order for a beta-adrenergic blocker if the pt was also receiving what other drugs? A) Clonidine B) Ergot alkaloids C) Aspirin D) NSAIDs E) Triptans F) Epinephrine

A) Clonidine B) Ergot alkaloids D) NSAIDs F) Epinephrine

Select all that apply: What adverse effects might a nurse assess in a pt receiving bethanechol? A) Dehydration B) Diarrhea C) Pallor D) Tachycardia E) Diaphoresis

A) Dehydration B) Diarrhea E) Diaphoresis

Select all that apply: The sympathetic system uses catecholamines at the postganglionic receptors. Which of the following are considered to be catecholamines? A) Dopamine B) Norepinephrine C) ACh D) Epinephrine E) MAO F) Serotonin

A) Dopamine B) Norepinephrine D) Epinephrine F) Serotonin

Select all that apply: The neurologic nurse is reviewing the roles of catecholamines. Which neurotransmitters would the nurse review? A) Dopamine B) Serotonin C) Calcium D) Acetylcholine E) Norepinephrine

A) Dopamine B) Serotonin E) Norepinephrine

An instructor is preparing a teaching plan about adrenergic agonists for a group of students. What drug would the nurse include as an alpha and beta adrenergic agonist? A) Epinephrine B) Phenylephrine C) Albuterol D) Terbutaline

A) Epinephrine

A pt in shock has been prescribed isoproterenol. When preparing to administer this the nurse should: A) Establish reliable IV access B) Ensure the pt is capable of using an inhaler C) Educate the pt about expected adverse effects D) Check the pt blood glucose level

A) Establish reliable IV access

The nurse is reviewing the history of a pt who is to receive Midodrine. What would alert the nurse to contraindication for the drug? A) Glaucoma B) Vasomotor spasm C) Thyrotoxicosis D) Diabetes

A) Glaucoma

Select all that apply: The nurse is teaching the pt about phenylephrine who is in preparation for discharge. What are the priority teaching points the nurse will include? A) Importance of notifying the provider if sudden weight gain occurs B) Potential for feelings of fear, anxiety, and restlessness C) Procedure for injecting the med subcutaneously D) Symptoms of hypotension to report to provider E) Importance of avoiding OTC cough and cold meds

A) Importance of notifying the provider if sudden weight gain occurs B) Potential for feelings of fear, anxiety, and restlessness E) Importance of avoiding OTC cough and cold meds

Select all that apply: The nurse administers a drug that stimulates the alpha 1 receptors. What manifestations would indicate to the nurse that the drug is working? A) Increased BP B) Pallor C) Thickened salivary secretions D) Vasodilation E) Contracted piloerection muscles

A) Increased BP C) Thickened salivary secretions E) Contracted piloerection muscles

Stimulation of the nicotinic receptors will create what type of response in a pt? A) Increased heart rate and BP B) A "rest and digest" reaction C) Increased bowel motility D) Decreased level of consciousness

A) Increased heart rate and BP

Select all that apply: The SNS: A) Is called the thoracolumbar system B) Is called the fight-or-flight system C) Is called the craniosacral system D) Uses ACh as its sole neurotransmitter E) Uses epinephrine as its sole neurotransmitter F) Is active during stress reaction

A) Is called the thoracolumbar system B) Is called the fight-or-flight system F) Is active during stress reaction

SATA. Why would the nurse expect to see Dobutamine ordered for the pt in end-stage heart failure? A) It increased myocardial contractility, thus increasing cardiac output without much change in heart rate B) It is a naturally occurring catecholamine that the body normally produces in small amounts C) It does not increase the oxygen demand of the cardiac muscle the way other drugs in this class do D) It has a slight preference for alpha-receptor sites E) The drug is absorbed rapidly after injection and achieves a rapid onset of action

A) It increased myocardial contractility, thus increasing cardiac output without much change in heart rate C) It does not increase the oxygen demand of the cardiac muscle the way other drugs in this class do E) The drug is absorbed rapidly after injection and achieves a rapid onset of action

Select all that apply: A nurse is explaining myasthenia gravis to a family. Which of the following points would be included in the explanation? A) It is thought to be an autoimmune disease B) It is associated w/ destruction of acetylcholine receptor sites C) It is best treated with potent antibiotics D) It is a chronic and progressive muscular disease E) It is caused by demyelination of the nerve fibers F) Once diagnosed, it has a 5 year survival rate

A) It is thought to be an autoimmune disease B) It is associated w/ destruction of acetylcholine receptor sites D) It is a chronic and progressive muscular disease

Myasthenia graves is treated with indirect-acting cholinergic agents that: A) Lead to accumulation of acetylcholine in the synaptic cleft B) Block the GI effects of the disease, allowing for absorption C) Directly stimulate the remaining acetylcholine receptors D) Can be given only by injection because of problems associated with swallowing

A) Lead to accumulation of acetylcholine in the synaptic cleft

Select all that apply: The beta adrenergic blocker Propranolol is approved for a wide variety of uses. Which of the following are approved indications? A) Migraine HA B) Stage fright C) Bronchospasm D) Reinfarction after an MI E) Erectile dysfunction F) HTN

A) Migraine HA B) Stage fright D) Reinfarction after an MI F) HTN

Select all that apply: What component would be included when describing the parasympathetic nervous system structure and function? A) Muscarinic and nicotinic receptors are fond in the PNS B) The preganglionic fibers are short C) Ganglia are located close to or within the effector tissue D) Adrenergic receptors are found in the PNS E) The system is primarily involved in responding to stress

A) Muscarinic and nicotinic receptors are fond in the PNS C) Ganglia are located close to or within the effector tissue

The beta-blocker of choice for a pt is hypertensive and has angina is: A) Nadolol B) Propranolol C) Timolol D) Carteolol

A) Nadolol

SATA. The instructor is preparing a teaching plan for a group of students that describes nonselective beta-adrenergic blockers. What would the instructor address? A) Nebivolol B) Atenolol C) Betaxolol D) Pindolol E) Timolol

A) Nebivolol D) Pindolol E) Timolol

A pt with myasthenia gravis takes Pyridostigmine on a regular basis. The nurse should anticipate administering this drug by which route? A) Oral B) Intramuscular C) Intravenous D) Subcutaneous

A) Oral

Select all that apply: The nurse is conducting a comprehensive assessment of a new pt. the nurse would confirm that the pt is having a sympathetic response when noting what manifestations? A) Pupils dilated B) Need to urinate frequently C) Increased bowel sounds D) Increased respiratory rate E) Increased heart rate

A) Pupils dilated D) Increased respiratory rate E) Increased heart rate

A pt receives a beta-specific agonist. What assessment findings would indicate to the nurse that the drug is effective? A) Relief from shortness of breath B) Resolution of glaucoma C) Relief of pain D) Increased level of consciousness

A) Relief from shortness of breath

What drug would the nurse expect to be administered to a pt requiring treatment for Alzheimer's disease? A) Revastigmine B) Pyridostigmine C) Cevimeline D) Edrophonium

A) Revastigmine

Stimulation of the PNS would cause: A) Slower heart rate and increased GI secretions B) Faster heart rate and urinary retention C) Vasoconstriction and bronchial dilation D) Pupil dilation and muscle paralysis

A) Slower heart rate and increased GI secretions

The nurse is reviewing the medication regimen of an older adult who has just admitted to a long-term care facility. The nurse reads that the pt takes Droxidopa. What should the nurse include in the pt's care plan? A) Supervise the pt during transfers B) Spread out activities every throughout the day C) Ensure the pt's diet does not include grapefruit juice D) Monitor the pt's respiratory status closely

A) Supervise the pt during transfers

Select all that apply: When working with a pt who is experiencing a stress response the nurse should anticipate what effects? A) Tachycardia B) Diaphoresis C) Pupil dilation D) Increased bowel sounds E) Hypotension

A) Tachycardia B) Diaphoresis C) Pupil dilation

Select all that apply: A nurse would question an order for a cholinergic drug if the pt was also taking which of the following? A) Theophylline B) NSAIDs C) Cephalosporin D) Atropine E) Propranolol F) Memantine

A) Theophylline B) NSAIDs D) Atropine

SATA. The nurse is caring for an older adult pt who has been prescribed Donepezil to treat Alzheimer's disease. The nurse should question the pt's concurrent use of what medications? A) Theophylline B) Propranolol C) Furosemide D) Acetaminophen E) Ibuprofen

A) Theophylline E) Ibuprofen

A pt has elected to take an OTC cold preparation that contains phenylephrine. The nurse would advise the pt not to take that drug if the pt has: A) Thyroid or CV disease B) A cough and runny nose C) COPD D) Hypotension

A) Thyroid or CV disease

Phentolamine, an alpha-adrenergic blocker, is most frequently used: A) To prevent cell death after extravasation of intravenous Dopamine or Norepinephrine B) To treat COPD in pt's with HTN or arrhythmias C) To treat HTN and BPH in male pts D) To block bronchoconstriction during acute asthma attacks

A) To prevent cell death after extravasation of intravenous Dopamine or Norepinephrine

SATA. A pt is receiving Doxazosin. The nurse would assess the pt for development of potential adverse effects? A) Weakness B) Edema C) Hypotension D) Constipation E) Pallor

A) Weakness B) Edema C) Hypotension

Why are indirect acting cholinergic agonists used for treatment of myasthenia gravis but direct acting agents are ineffective? A) Indirect acting cholinergic agents reduce production of acetylcholinesterase B) Direct acting cholinergic agents allow acetylcholine to accumulate C) Indirect acting cholinergic agents can cross the BBB D) Direct acting cholinergic agents have very short durations of action

B) Direct acting cholinergic agents allow acetylcholine to accumulate

What drug would the nurse be expected to give to a pt who is experiencing acute bronchospasm? A) Norepinephrine B) Epinephrine C) Ephedrine D) Dopamine

B) Epinephrine

The nurse is assessing the pt for adverse CNS effects after administering a nonselective adrenergic blocker based on the understanding that these effects occur due to what action? A) Vasodilation of the mucous membrane vessels B) Blockage of norepinephrine's effect C) Loss of vascular tone D) Increased parasympathetic dominance

B

What suffix is common to all the beta adrenergic blocking agents, whether selective or nonselective, as well as many of the adrenergic blocking antagonists? A) -Azole B) -Lol C) -Aine D) -Mab

B -Lol

A pt receives IV Labetalol. The nurse would expect this drug to exert its maximum effectiveness within what time frame? A) 1 min B) 5 min C) 10 min D) 15 min

B) 5 min

The nurse is preparing to administer Carvedilol to a pt with HTN and recognizes the dosage as safe as long as it falls within what range? A) 200-400 mg B) 6.25-12.5 mg C) 800-1,600 mg D) 1.25-2.75 mg

B) 6.25-12.5 mg

The ANS differs from other systems in the CNS in that it: A) Uses only peripheral pathways B) Affects organs and muscles via a two-neuron system C) Uses a unique one-neuron system D) Bypasses the CNS in all of its actions

B) Affects organs and muscles via a two-neuron system

What pt would be most likely to benefit form the administration of Amiodarone? A) A morbidly obese pt whose HTN has not responded to Propranolol B) An unresponsive pt who is in ventricular tachycardia C) An older adult pt whose urinary hesitancy has been attributed to benign prostatic hyperplasia D) A pt with asthma who requires ongoing treatment for HTN

B) An unresponsive pt who is in ventricular tachycardia

A pt has been prescribed Midodrine 10 mg PO t.i.d. How should the nurse best assess for therapeutic effects? A) Auscultate the pt's apical heart rate for 1 minute B) Assess the pt's lying, sitting, and standing BP C) Assess the patency of the pt's nasal passages D) Assess the pt for SOB on exertion

B) Assess the pt's lying, sitting, and standing BP

A pt has been taking Indacaterol once per day, as prescribed. What assessment would the nurse perform when monitoring for therapeutic effects? A) Assessing BP B) Assessing for activity tolerance C) Assessing orientation to person, place, and time D) Assessing heart rate

B) Assessing for activity tolerance

A pt in distress has been given dobutamine, a med intended to increase myocardial activity and heart rate. This med likely stimulates what adrenergic receptor? A) Alpha 1 B) Beta 1 C) Beta 2 D) Alpha 2

B) Beta 1

Select all that apply: Isoproterenol is a nonspecific beta agonist. The nurse might expect to administer this drug for which of the following conditions? A) Preterm labor B) Bronchospasm C) Cardiac standstill D) Shock E) Heart block in transplanted hearts F) Heart failure

B) Bronchospasm C) Cardiac standstill D) Shock E) Heart block in transplanted hearts

A pt with Sjogren's syndrome is experiencing dry mouth. Which agent would the nurse expect to be prescribed? A) Carbachol B) Cevimeline C) Edrophonium D) Bethanechol

B) Cevimeline

Adverse effects associated w/ the use of cholinergic drugs include: A) Constipation and insomnia B) Diarrhea and urinary urgency C) Tachycardia and HTN D) Dry mouth and tachycardia

B) Diarrhea and urinary urgency

A nurse would question an order for beta1 selective adrenergic blocker for a pt with: A) Cardiac arrhythmias B) HTN C) Cardiogenic shock D) Open-angel glaucoma

C) Cardiogenic shock

A pt with which of the following would most likely be prescribed an alpha1 selective adrenergic blocking agent? A) COPD and hypotension B) HTN and BPH C) Erectile dysfunction and hypotension D) Shock states and bronchospasm

B) HTN and BPH

Select all that apply: A nurse would question the order for an adrenergic agonist for a pt who is also receiving which of the following: A) Anticholinergic drugs B) Halogenated hydrocarbon anesthetics C) Beta-blockers D) Benzodiazepines E) MAOIs F) TCAs

B) Halogenated hydrocarbon anesthetics C) Beta-blockers E) MAOIs F) TCAs

The nurse is assessing a pt who has been taking direct acting cholinergic agonists. What assessment findings should the nurse attribute to this med? A) BP 121/68 B) Heart rate 62 C) Drowsiness D) Three BMs over past 4 days

B) Heart rate 62; med causes bradycardia, hypotension, diarrhea, and urinary urgency

What effects are associated with the use of cholinergic agonists? A) Increased heart rate B) Increased gastric motility C) Pupil dilation D) Increased contractility of the heart

B) Increased gastric motility

Alzheimer's disease is marked by a progressive loss of memory and is associate w/: A) Degeneration of dopamine producing cells in the basal ganglia B) Loss of acetylcholine producing neurons and their target neuron in the CNS C) Loss of acetylcholine receptor sites in the PNS D) Increased levels of acetylcholinesterase in the CNS

B) Loss of acetylcholine producing neurons and their target neuron in the CNS

The parasympathetic nervous system, in most situations, opposes the actions of the SNS, allowing the ANS to: A) Generally have no effect B) Maintain a fine control over internal homeostasis C) Promote digestion D) Respond to stress more effectively

B) Maintain a fine control over internal homeostasis

A nurse is reviewing the parasympathetic nervous system prior to caring for a pt w/ a neurologic disorder. What statement best describes the parasympathetic nervous system? A) The system is often referred to as the thoracolumbar system B) Many of the cells originate in the sacral area of the spinal cord C) The cells typically have preganglionic fibers that are relatively short D) The ganglia are located in chains running alongside the spinal cord

B) Many of the cells originate in the sacral area of the spinal cord

SATA. What should the nurse include when teaching the family of a pt with Alzheimer's about the possible adverse effects associated with the prescribed Donepezil? A) Constipation B) Muscle cramps C) Insomnia D) Rash E) HTN

B) Muscle cramps C) Insomnia D) Rash

A pt is suspected of having pheochromocytoma. What agent would the nurse identify as being used to help diagnose this disorder? A) Carvedilol B) Phentolamine C) Labetalol D) Atenolol

B) Phentolamine

The adrenergic agent of choice for treating the signs and symptoms of allergic rhinitis is: A) Norepinephrine B) Phenylephrine C) Dobutamine D) Dopamine

B) Phenylephrine

The nurse reviews orders written by a new intern for a pt with BPH. What order should the nurse question? A) Terazosin 4 mg PO daily at bedtime to treat BPH B) Prazosin 1 mg t.i.d PO to treat BPH C) Alfuzosin 10 mg PO daily to treat BPH D) Tamsulosin 0.6 mg PO 30 minutes after eating once daily to treat BPH

B) Prazosin 1 mg t.i.d PO to treat BPH

Select all that apply: When assessing a pt, the nurse would interpret what findings as indications for stimulation of the parasympathetic nervous system? A) Decreased GI secretions B) Pupil constriction C) Vasoconstriction D) Increased level of consciousness E) Bronchoconstriction F) Decreased heart rate

B) Pupil constriction E) Bronchoconstriction F) Decreased heart rate

The nurse is conducting a comprehensive assessment of a pt. What finding should the nurse attribute to the action of the PNS? A) Polydipsia & requests H2O often B) Pupils constricted C) Pulse: 88 D) BP: 136/86

B) Pupils constricted

Indirect acting cholinergic agents: A) React with acetylcholine receptor sites on the membranes of effector cells B) React chemically with acetylcholinesterase to increase acetylcholine concentrations C) Are used to increase bladder tone and urinary excretion D) Should be given with food to slow absorption

B) React chemically with acetylcholinesterase to increase acetylcholine concentrations

A pt is to receive Metoprolol. What would the nurse include in the teaching plan for this pt? A) This drug causes less dizziness than other similar drugs B) Take this drug with food to help promote its absorption C) This drug should likely have no effect on your sexual activity level D) You should notice an increase in your energy level with this drug

B) Take this drug with food to help promote its absorption

The pregnant woman with myasthenia gravis has been taken off of all indirect-acting cholinergic agents normally to treat her condition. The woman asks the nurse, "What would happen if I took my medicine for myasthenia gravis anyway? What is the nurse's best explanation for why the drug is contraindicated during pregnancy? A) Taking indirect-acting cholinergic agents while pregnant could result in a uterine rupture B) Taking your indirect-acting cholinergic agent could stimulate labor C) Taking your indirect-acting agent could cause birth defects D) Taking your indirect-acting cholinergic agent could cause overstimulation of your heart

B) Taking your indirect-acting cholinergic agent could stimulate labor

SATA. An older adult pt has been diagnosed with benign prostatic hypertrophy. What medications could potentially be used to treat the pt's health problem? A) Carteolol B) Terazosin C) Prazasin D) Alfuzosin E) Phentolamine

B) Terazosin D) Alfuzosin

A pt has been receiving a Dobutamine infusion and is being monitored closely. What assessment finding would suggest an inadequate therapeutic response? A) The pt's respiratory rate is 26 breaths per minute B) The pt has peripheral edema in the lower extremities and sacrum C) The pt's urine output over the past 6 hours is 125 mL of concentrated urine D) The pt's oral temperature has risen over the past several hours to 100.6 F

B) The pt has peripheral edema in the lower extremities and sacrum

The home nurse arrives at the pt's home when the pt is eating lunch. What should prompt the nurse to address dietary needs of the pt receiving home infusion of Dobutamine? A) The pt's meal includes a tuna fish sandwich, carrot and celery strips, a glass of milk, and a slice of apple pie B) The pt's meal includes homemade vegetable soup, salt-free crackers, a diet cola, chocolate cake, and coffee C) The pt's meal includes an egg salad sandwich, fresh vegetables with ranch dressing, and lemonade D) The pt's meal includes a chef's salad, rye crisps, and a glass of milk

B) The pt's meal includes homemade vegetable soup, salt-free crackers, a diet cola, chocolate cake, and coffee

A female college student who has been trying to lose weight with little success has expressed an interest in trying Ephedra. What should the nurse teach the pt? A) The drug would be contraindicated during pregnancy B) There are serious risks associated with the use of Ephedra C) Ephedra is no longer legally available in the US D) Despite being classified as a herb, Ephedra is only available with a prescription E) Ephedra has been banned due to abuse potential

B) There are serious risks associated with the use of Ephedra

The nurse is caring for a pt who is under psychological and physiological stress. During sympathetic stimulation, the nurse should identify which neurotransmitter as being released by the preganglionic nerves of the sympathetic nervous system? A) Norepinephrine B) Dopamine C) Acetylcholine D) Epinephrine

C) Acetylcholine

A pt in a HTN crisis has been given labetalol IV. The pts BP has not decreased significantly. What is the care team's best action? A) Administer a different beta blocker B) Administer another dose immediately C) Administer another dose in 10 min D) Administer the drug continuously until improvement is noted

C) Administer another dose in 10 min

Nicotinic receptors are found in what location? A) Sweat glands B) Bladder C) Adrenal medulla D) GI tract

C) Adrenal medulla

A pt w/ asthma is prescribed albuterol to dilate the bronchioles. The nurse understand that this drug is likely acting on which receptors? A) Beta 1 B) Alpha 1 C) Beta 2 D) Alpha 2

C) Beta 2

A pt receiving Neostigmine uses Naproxen for relief of low back pain. The nurse would caution the pt to report what? A) Increased bruising B) Muscle weakness C) Blood in stool D) Blurred vision

C) Blood in stool

The nurse determines that the beta2 receptors in the SNS have been stimulated by which finding? A) Increased heart rate B) Increased myocardial contraction C) Bronchial dilation D) Uterine contraction

C) Bronchial dilation

The nurse would anticipate administering drugs that generally block all adrenergic receptor sites to treat: A) Allergic rhinitis B) COPD C) Cardiac-related conditions D) Premature labor

C) Cardiac-related conditions

A hostpital pt w/ obesity and diabetic retinopathy reports feeling intensely anxious about his situation. What action by the nurse best addresses the effects of the pts stress? A) Monitor the pts O2 saturation constantly B) Place the pt on cardiac monitoring C) Check the pts capillary glucose levels often D) Assess the pts skin integrity often

C) Check the pts capillary glucose levels often

When the sympathetic nervous system is stimulated, what cells of the adrenal medulla secrete epinephrine and norepinephrine directly into the bloodstream? A) Effector B) Dihydroxyphenylalanine C) Chromaffin D) Axon

C) Chromaffin

What is the alternative name for the PNS? A) Thoracolumbar B) Lumbar-sacral C) Craniosacral D) Craniolumbar

C) Craniosacral

A pt in cardiogenic shock has been prescribed a naturally occurring catecholamine. The nurse should prepare what med? A) Isoproterenol B) Ephedrine C) Dopamine D) Dobutamine

C) Dopamine

The nurse is providing care for an older adult pt who has recently been prescribed Bisoprolol 10 mg PO daily. Before administering the first dose, the nurse should: A) Encourage fluid intake B) Assess the pt's peripheral pulses bilaterally C) Ensure that falls precautions are in place D) Ensure that there is a recent ECG available

C) Ensure that falls precautions are in place

Adverse effects associated with adrenergic agonists are related to the generalized stimulation of the SNS and could include: A) Slowed heart rate B) Constriction of the pupils C) Hypertension D) Increased GI secretions

C) Hypertension

The nurse is caring for a pt who has a long-standing diagnosis of myasthenia gravis and who takes Pyridostigmine. What statement by the pt should the nurse prioritize for the follow-up? A) I just don't seem to have much of an appetite these days B) I'm drinking lots, but sometimes I just can't quench my thirst C) I'm feeling so much weaker than I usually do D) I'm worried that I'm getting worse, not better

C) I'm feeling so much weaker than I usually do

All alpha and beta adrenergic agonists can be administered via what route? A) Subcutaneous B) IM C) IV D) PO

C) IV

The nurse is assessing a hospital pt who has just been prescribed Clonidine. What action should the nurse prioritize? A) Assessing the IV site for extravasation B) Auscultating breath sounds q1h for the first dose C) Implementing falls' precautions D) Monitoring oxygen saturation

C) Implementing falls' precautions

A pt is receiving Carvedilol. The nurse should monitor what component of the pt's laboratory testing most closely? A) Blood urea nitrogen and creatinine B) Leukocytes C) Liver enzymes D) Red cell indices

C) Liver enzymes

What is the enzyme responsible for breaking down norepinephrine to make it inactive? A) Dopamine B) Acetylcholinesterase C) Monoamine oxidase D) Epinephrine

C) Monoamine oxidase

Stimulation of what type of receptor will cause GI motility? A) Nicotinic receptors B) Beta 1 receptors C) Muscarinic receptors D) Alpha 1 receptors

C) Muscarinic receptors

You would caution a pt who is taking an adrenergic blocker: A) To avoid exposure to infection B) To stop the drug if he or she experiences flu-like symptoms C) Never to stop the drug abruptly D) To avoid exposure to the sun

C) Never to stop the drug abruptly

Which agent would the nurse expect to find in the ingredient list of OTC allergy products? A) Midodrine B) Clonidine C) Phenylephrine D) Dopamine

C) Phenylephrine

Nerve gas is an irreversible acetylcholinesterase inhibitor that can cause muscle paralysis and death. An antidote to such an agent is: A) Atropine B) Propranolol C) Pralidoxime D) Neostigmine

C) Pralidoxime

What drug would the nurse expect to be administered as the antidote for the irreversible indirect-acting cholinergic agonists? A) Donepezil B) Pyridostigmine C) Pralidoxime D) Edrophonium

C) Pralidoxime

A nurse administers a decongestant that stimulates alpha 1 receptors. What would most likely occur? A) Decreased GI activity B) Bronchodilation C) Pupil dilation D) Tachycardia

C) Pupil dilation Decreased GI - Beta 2; Bronchodilation - Beta 2; Tachycardia - Beta 1

A pt with myasthenia gravis is no longer able to swallow. Which of the following would the nurse expect they physician to order? A) Rivastigmine B) Memantine C) Pyridostigmine D) Edrophonium

C) Pyridostigmine

When describing the functions of the ANS, which of the following would the instructor include? A) Maintenance of balance and posture B) Maintenance of the special senses C) Regulation of integrated internal body functions D) Coordination of peripheral and central nerve pathways

C) Regulation of integrated internal body functions

What is the duration of action the nurse would expect following administration of bethanechol? A) 30-60 min B) 6-8 hr C) 2-4 hr D) 1-6 hr

D) 1-6 hr

An adrenergic agent being used to treat shock infiltrates into the tissue with intravenous administration. Which action by the nurse would be most appropriate? A) Watch the area for any signs of necrosis and report it to the physician B) Notify the physician and decrease the rate of infusion C) Remove the IV and prepare phentolamine for administration to the area D) Apply ice and elevate the arm

C) Remove the IV and prepare phentolamine for administration to the area

Select all that apply: When assessing a pt receiving a beta specific adrenergic agonist, the nurse would identify what findings as adverse effects of the drug? A) Bradycardia B) Steatorrhea (fatty stools) C) Restlessness D) Headache E) Pupil constriction

C) Restlessness D) Headache

A pt is to receive Pilocarpine. The nurse understands that this drug should be most likely used to treat which of the following: A) Myasthenia gravis B) Neurogenic bladder C) Sjogren's disease dry mouth D) Alzheimer's disease

C) Sjogren's disease dry mouth

The instructor determines that teaching about adrenergic drugs has been successful when the class identifies the drugs as also being called: A) Sympatholytic agents B) Cholinergic agents C) Sympathomimetic agents D) Anticholinergic agents

C) Sympathomimetic agents

What would the nurse include while teaching the pt in preparation for discharge about how to take Sotalol? A) Take the drug once every day, in the morning B) Take the drug with an antacid if stomach upset occurs C) Take the drug at least 30 min before a meal D) Take the drug with food or a snack to reduce stomach upset

C) Take the drug at least 30 min before a meal

What is the defining criterion of an adrenergic nerve? A) The nerve is continuously stimulated B) The nerve arises from the adrenal medulla C) The nerve can produce norepinephrine D) The nerve promotes cardiac conduction

C) The nerve can produce norepinephrine

The nurse is assessing a pt. What assessment finding is the clearest indicator of autonomic nervous system function? A) The pts hearing is intact B) The pts muscle strength is equal bilaterally C) The pts respiratory rate is 22 breaths per minute D) The pt can discern hot sensation from cold

C) The pts respiratory rate is 22 breaths per minute

What statement best describes the action of direct-acting cholinergic agonists? A) They mimic the action of the sympathetic nervous system B) They undergo a chemical rxn with acetylcholinesterase C) They occupy receptor sites for acetylcholine D) They prevent the breakdown of acetylcholine

C) They occupy receptor sites for acetylcholine

A male pt has been diagnosed with dementia and the nurse is teaching the pt and his wife about his new prescription for Donepezil. What should the nurse teach the pt and his wife? A) Diagnostic imaging in a few months will determine whether Donepezil is beneficial B) Your husband will need a drug holiday in which all his other medications are temporarily withheld, near the beginning of therapy C) This won't cure your husband's dementia, but it can slow the progression significantly D) This drug has benefits for many pts with Alzheimer's, but these are often not evident for 4-6 months

C) This won't cure your husband's dementia, but it can slow the progression significantly

A pt with glaucoma is to receive an ophthalmic, nonselective beta-blocker. What agent would the nurse expect to be prescribed? A) Nebivolol B) Propranolol C) Timolol D) Sotalol

C) Timolol

A pt is receiving Tamsulosin. The nurse should assess the pt's: A) Lungs and lower limbs for edema B) BP and heart rate C) Voiding pattern D) BP

C) Voiding pattern

A smoker who is being treated for HTN with a beta-blocker is most likely receiving: A) A nonspecific beta-blocker B) An alpha1 specific beta-blocker C) Beta and alpha blockers D) A beta1 specific blocker

D) A beta1 specific blocker

When reviewing cholinergic agonists, the nurse learns that there are direct acting and indirect acting cholinergic agonists. What is the agent acts directly or indirectly on? A) Nerve impulse transmission B) Acetylcholine potency C) Acetylcholine production D) Acetylcholine receptor sites

D) Acetylcholine receptor sites

A pt has been diagnosed with HTN and been prescribed Atenolol 50 mg PO daily. What is the nurse's best response to receiving this prescription? A) Contact the provider to question the frequency B) Contact the provider to question the dose C) Contact the provider to question the use of Atenolol D) Assess the pt, focusing on heart rate and BP

D) Assess the pt, focusing on heart rate and BP

The nurse has administered a 10 yr old pts scheduled dose of bethanechol. What follow-up assessment should the nurse prioritize? A) GI assessment B) Assessment for dry mouth C) Cognitive assessment D) Assessment of urine output

D) Assessment of urine output

When administering a direct acting cholinergic agonist to the older adult, what assessment should the nurse prioritize? A) Serum potassium level B) Serum blood sugar C) Respiratory function D) BP

D) BP

Phenylephrine, an alpha-specific agonist, is found in many cold and allergy preparations. The nurse instructs the patient to be alert for which adverse effects? A) Urinary retention and pupil constriction B) Hypotension and slow heart rate C) Personality changes and increased appetite D) Cardiac arrhythmias and difficulty urinating

D) Cardiac arrhythmias and difficulty urinating

A nurse is caring for a pt whose adrenergic blocker must be changed from oral form to a parenteral form. Which medication would need to be changed to a different medication? A) Amiodarone B) Phentolamine C) Labetalol D) Carvedilol

D) Carvedilol

The nurse is monitoring a pt who is receiving a Dobutamine infusion for treatment of heart failure. The nurse observes that the pt's heart rate has risen from 62 beats per minute to 64 beats per minute since the infusion began. What is the nurse's best action? A) Ensure that Dantrolene is readily available for STAT administration B) Anticipate the administration of Norepinephrine to potentiate the Dobutamine C) Ensure that the primary care provider is aware that the pt's heart rate has not increased significantly D) Continue to monitor the pt's cardiac status closely

D) Continue to monitor the pt's cardiac status closely

A nurse has administered a pts prescribed adrenergic agent and would anticipate what physiologic effect? A) Decreased renal perfusion B) Increased catecholamine levels C) Increased serum pH D) Decreased renin levels

D) Decreased renin levels

If you suspect that a person is a very stressed and is experiencing a sympathetic stress rxn, you would expect to find: A) Increased bowel sounds and urinary output B) Constricted pupils and warm, flushed skin C) Slow heart rate and decreased systolic blood pressure D) Dilated pupils and elevated systolic blood pressure

D) Dilated pupils and elevated systolic blood pressure

Which indirect-acting cholinergic agonist has the shortest duration of action? A) Neostigmine B) Namzaric C) Pyridostigmine D) Edrophonium

D) Edrophonium

A pt is found to have insufficient levels of acetylcholinesterase. The nurse should recognize what as a likely consequence? A) The effector cell would remain polarized B) The nerve cell would be unable to depolarize C) The ganglia would continue to be stimulated D) Effector cells would continue to be stimulated

D) Effector cells would continue to be stimulated

What drug would the nurse question if ordered for a pt who is experiencing a toxic rxn to a nondepolarizing neuromuscular junction blocker? A) Neostigmine B) Edrophonium C) Pyridostigmine D) Galantamine

D) Galantamine

The nurse would expect to administer Donepezil to a pt with Alzheimer's disease who: A) Cannot remember daily members' names B) Is mildly inhibited and can sill follow medical dosing regimens C) Is ablate carry on normal activities of daily living D) Has memory problems and would benefit from once-a-day dosing

D) Has memory problems and would benefit from once-a-day dosing

What aspect of a pts health history would contraindicate the use of a nonselective adrenergic blocker? A) Peripheral vascular disease B) Hypothyroidism C) Cholelithiasis D) Heart block

D) Heart block

After teaching a group of students about the effects of beta1 selective blockers, the instructor determines that additional teaching is needed when the students identify what action as an effect of this drug? A) Decreased heart rate B) Reduction in arrhythmia C) Decreased cardiac workload D) Increase release of renin

D) Increase release of renin

A pt is receiving Salmeterol. The nurse would expect this drug to be given by which route? A) Intravenous B) Intramuscular C) Oral D) Inhalation

D) Inhalation

Once a postganglionic receptor site has been stimulated the neurotransmitter must be broken down immediately. The sympathetic system breaks down postganglionic neurotransmitters by using: A) Liver enzymes and acetylcholinesterase B) Acetylcholinesterase and MAO C) COMT and liver enzymes D) MAO and COMT

D) MAO and COMT

A nurse administers Carbachol eye drops to a pt. What finding would indicate that the drug is effective? A) Ptosis B) Eye muscle paralysis C) Mydriasis (pupil dilation) D) Miosis

D) Miosis

The nurse is caring for a pt with myasthenia gravis. What medication is the nurse most likely to administer? A) Galantamine B) Tacrine C) Rivastigmine D) Neostigmine

D) Neostigmine

A pt is taking a med that is a monoamine oxidase inhibitor. The pts levels of what neurotransmitter may increase? A) Acetylcholine B) Dopamine C) GABA D) Norepinephrine

D) Norepinephrine

A pt with mild Alzheimer's disease is prescribed Donepezil. The nurse would instruct the pt's caregiver to administer this drug at which frequency? A) Twice daily, ideally at 0800 and 2000 B) Three times a day, with meals C) First thing in the morning D) Once daily, at bedtime

D) Once daily, at bedtime

A community dwelling pt has just told the the home health nurse that she ran out of her prescribed adrenergic antagonist 5 days ago and has not been able to refill her prescription yet. What is the nurse's priority action? A) Arrange for the pt to get a med refill B) Educate the pt about dangers of abruptly stopping the med C) Inform the care provider promptly D) Perform a comprehensive assessment of the pt

D) Perform a comprehensive assessment of the pt

The nurse has administered a scheduled dose of clonidine, an alpha 2 receptor agonist, to a pt. The nurse should anticipate what effect? A) Agitation B) Increase heart rate and BP C) Increased bowel motility D) Reduced norepinephrine stimulation

D) Reduced norepinephrine stimulation

After teaching group of students about beta1 selective blockers, the instructor determines that the teaching was successful when the students identify what absolute contraindication for using this group of drugs? A) Thyroid disease B) Diabetes C) COPD D) Sinus bradycardia

D) Sinus bradycardia

Adrenergic blocking drugs, because of their clinical effects, are also known as: A) Anticholinergics B) Sympathomimeitcs C) Parasympatholytics D) Sympatholytics

D) Sympatholytics

Cholinergic neurons, those using ACh as their neurotransmitter, would be least likely found in: A) Motor nerves on skeletal muscles B) Preganglionic nerves in the sympathetic and parasympathetic systems C) Postganglionic nerves in the parasympathetic system D) The adrenal medulla

D) The adrenal medulla

An older adult pt in the community has been taking Midodrine for several months. The home health nurse learns that the pt's supply of Midodrine ran out several days ago and that the pt has not taken it since. What assessment finding should the nurse attribute to the abrupt cessation of Midodrine? A) The pt is SOB on exertion B) The pt is oriented to person and place, but not time C) The pt has been having cluster headaches D) The pt's BP is 155/101 mm Hg

D) The pt's BP is 155/101 mm Hg

The nurse has administered a cholinergic agent to a pt. What assessment would best identify the intended therapeutic effects? A) Lung auscultation B) Activity tolerance and ambulation C) Weight and abdominal girth D) Urinary output

D) Urinary output

A group of students are reviewing the autonomic nervous system. The students demonstrate a need for additional review when they identify what as being involved with the sympathetic nervous system? A) Norepinephrine B) Monoamine oxidase C) Adrenergic receptors D) Vagus nerve

D) Vagus nerve

True or False: An increased dosage of Digoxin would be needed if the pt is also taking Midodrine.

False

True or False: Nonselective beta blockers are drugs of choice for treating HTN in pts who smoke.

False

True or False: A pt with diabetes who receives an alpha specific adrenergic agonist is at risk for hypoglycemia.

False; Can cause HYPERglycemia

True or false: Adrenergic blockers are often called sympathomimetic agents.

False; called sympatholytic agents

True or False: The drug of choice for treating HTN in an older adult is Atenolol.

False; correct answer is Bisoprolol

True or False: Beta specific adrenergic agonists are primarily used to treat obstructive pulmonary conditions.

True

True or False: Beta1 selective blockers should be gradually tapered over 2 weeks to prevent the risk of sever hypertension or stoke.

True

True or False: Phentolamine is the agent used to treat extravasation of Dobutamine.

True

True or False: Pts who are receiving alpha specific adrenergic agents should not stop taking the drug abruptly.

True

True or false: Most nonselective adrenergic blockers are used to treat HTN.

True