Pharmacology Exam 1
A client is experiencing sympathetic stimulation in response to a stressful event. Which substance will most affect the client's sodium and water retention?
Aldosterone
The nurse understands that vasoconstriction that leads to a rise in blood pressure is due to stimulation of which type of receptor?
Alpha - 1
Where are alpha-receptors found?
Alpha receptors are adrenergic receptors that are found in smooth muscles
Where are Beta 2 receptors located?
Smooth muscle of blood vessels and lungs
It is determined that a client's cardiac rhythm is being originated in the sinoatrial (SA) node. What mechanism is responsible for the triggering of this node?
Specialized cells within the node itself
The main nerve centers for the autonomic nervous system (ANS) are located in which locations?
Spinal cord Medulla Hypothalamus
Norepinephrine is made by nerve cells using which substance?
Tyrosine
What are "P" cells?
"They are simple cells that produce the electrical charge your heart needs to pump blood."
What is the sequence of action potential in cardiac cells
- Sodium rushes into the cell. - Sodium ion concentration equalizes. - Calcium slowly enters and potassium begins to leave the cell. - Potassium rapidly moves out of the cell. - Sodium is outside the cell and potassium is inside the cell.
What is considered high for LDL cholesterol?
190 mg/dL
A patient receives intravenous labetalol. The nurse would expect this drug to exert its maximum effectiveness within which time frame?
5 minutes
The skeletal muscles during the use of the incentive spirometer are stimulated by which neurotransmitter?
Acetylcholine
The nurse knows that under which condition is the use of a centrally acting anti-adrenergic drug contraindicated?
Active hepatic disease
When administering sotalol to a client, do they take it before or after meals?
Administer before meals
Which factor determines blood pressure? Preload or afterload?
Afterload
What are the sympathetic nervous system adrenergic receptors?
Alpha1 Alpha2 Beta1 Beta2 Beta3
A 75-year-old male with no history of hypertension has been prescribed nadolol. The nurse knows that the client is likely taking the drug to treat:
Angina
What is the major factor in the development of the dysfunctional endothelium?
Artherosclerosis
A priority nursing assessment for a client who is to receive an alpha- or beta-adrenergic agonist would be to which action?
Assess heart rate
While reviewing a patient's electrocardiogram, the nurse observes sawtooth-shaped P waves. This is indicative of:
Atrial Flutter
What would a nurse expect to administer if a client who is receiving isoproterenol develops a severe reaction?
Beta-adrenergic blockers
The nurse knows that which class of drugs prevents epinephrine and norepinephrine from occupying receptor sites on the cell membranes?
Beta-adrenergic blocking drugs
What is the first drug of choice for treatment of a client with a history of a myocardial infarction (MI) 2 years ago?
Beta-blockers
Where are beta-receptors found?
Beta-receptors are adrenergic receptors are found in the heart, lungs, and vascular smooth muscle
The male client is prescribed prazosin (Minipress) for hypertension. He asks the nurse how the medication works. What is the nurse's best response?
Blood vessel dilation
A client receives a beta-specific agonist. What would lead the nurse to determine that the drug is effective?
Bronchodilation
When describing the drugs classified as class IV antiarrhythmics, the nurse would identify these as:
Calcium channel blockers
What is the defining criterion of an adrenergic nerve?
Can produce epinephrine
A patient has been administered dobutamine HCL. Which adverse reactions should the nurse monitor for in the patient?
Cardiac arrhythmia
A 21-year-old man experienced massive trauma and blood loss during a motorcycle accident and has been started on a dopamine infusion upon his arrival at the hospital. In light of this drug treatment, what assessment should the care team prioritize?
Cardiac monitoring
The nurse knows that what other medication may be responsible for the increase in digoxin level?
Carvedilol
Which antiadrenergic drug is an alpha/beta blocker?
Carvedilol
A nurse is caring for an elderly patient who is to be administered isoproterenol. Which change monitored in the patient should the nurse report immediately to the primary health care provider?
Change in pulse rate
What are muscarinic receptors?
Cholinergic receptors that also respond to stimulation by muscarine
What are nicotinic receptors?
Cholinergic receptors that also respond to stimulation by nicotine
What are ganglia?
Clusters of cell bodies in the peripheral nervous system.
What is a side effect of nicotinic medications?
Common adverse effects of nicotinic acid include flushing of the skin and GI irritation.
The nurse is observing the monitor of a patient with a first-degree atrioventricular (AV) block. What is the nurse aware characterizes this block?
Delayed conduction, producing a prolonged PR interval
When reviewing a patient's ECG, the nurse identifies the QRS complex, understanding that this reflects:
Depolarization of the bundle of His and ventricles
What is the function of monoamine oxidase?
Enzyme that breaks down norepinephrine to make it inactive
Which herbs has been removed from most weight-loss medications due to potential legal liability?
Ephedra
An instructor is preparing a teaching plan for a group of students about adrenergic agonists. Which would the nurse include as an alpha- and beta-adrenergic agonist?
Epinephrine
An increased dosage of digoxin would be needed if the patient is also taking midodrine.
False - These two drugs are contraindicated
What is the main function of the autonomic nervous system
Homeostasis
Fluid moves into the arterial end of a capillary due to:
Hydrostatic Pressure
What type of pressure regulates fluid movement at the arterial end of the capillary
Hydrostatic Pressure
Which structure is responsible for the secretion of adrenocorticotropin hormone?
Hypothalamus
Alpha-1 receptors have which actions?
Increase blood pressure
An electrocardiogram (ECG) is prescribed for a client experiencing signs and symptoms associated with a cardiac dysfunction. Which function of the heart will this diagnostic tool help evaluate?
Ineffective pumping
When explaining blood supply to the heart muscle, the nurse explains that the left circumflex artery supplies the:
Left ventricle
Cronotropic medications
Make heart beat faster
Inotropic drugs..
Make heart beat harder
A backflow of blood is noted in the left ventricle from the left atrium. The patient is suffering from a defect in which valve?
Mitral Valve
What valve separates the left atrium and left ventricle?
Mitral Valve
What are cholinergic receptors?
Receptor sites on effectors that respond to acetylcholine
Phentolamine (Regitine, OraVerse) has been ordered for the management of tissue necrosis caused by extravasation of parenterally administered drugs. Before administering this drug, the nurse will check the client's chart for indications of:
Myocardial infarction
What are three nonselective adrenergic beta blockers?
Nebivolol Pindolol Timolol
Where are Nicotinic receptors found?
Nicotinic receptors are located in the CNS, the adrenal medulla, the autonomic ganglia, and the neuromuscular junction. Stimulation of nicotinic receptors causes skeletal muscle contractions, autonomic responses such as signs and symptoms of a stress reaction, and release of norepinephrine and epinephrine from the adrenal medulla.
Monoamine oxidase (MAO) is an enzyme that breaks down which neurotransmitter?
Norepinephrine
Where are Beta 1 receptors located?
On the heart
A client is experiencing edema as a result of the vascular system's inability to pull fluid back into the capillaries. Which cardiovascular pressure is at the root of this problem?
Oncotic Pressure
What type of pressure regulates fluid movement at the venous end of the capillary
Oncotic Pressure
Where are cholinergic receptors found?
Organs and muscles
A patient has received the evening meal and is recovering from surgery. What nervous system is stimulated?
Parasympathetic Nervous System
A patient is suffering from a heart rate of 42 beats per minute. Which system contributes to bradycardia?
Parasympathetic Nervous System
What medication is the agent used to treat extravasation of dobutamine.
Phentolamine (Alpha-1 blocker)
When applied topically to the eye, which drug produces dilation of the pupil without changing accommodation?
Phenylephrine
What are the class III antiarrhythmics?
Potassium channel blockers
What medication is considered a nonselective beta blocker.
Propranolol
What are adrenergic receptors?
Receptor sites on effectors that respond to norepinephrine/epinephrine
Drugs that produce activity similar to the neurotransmitter norepinephrine are known as which of the following?
Sympathomimetics
What is the function of the adrenal medullae?
The adrenal medullae are sympathetic ganglia responsible for releasing norepinephrine and epinephrine.
Define preload
The amount of pressure or stretching force against the ventricular wall at end diastole
Where are Beta 3 receptors located?
The kidneys and bladder. They relax the bladder for urination.
Where are Muscarinic receptors found?
They are found in visceral effector organs, such as the GI tract, bladder, and heart, in sweat glands, and in some vascular smooth muscle. Stimulation of muscarinic receptors causes pupil constriction, increased GI motility and secretions (including saliva), increased urinary bladder contraction, and a slowing of the heart rate.
Where are alpha 2 receptors located?
They are located on nerve membranes and act as modulators for norepinephrine release.
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?
This medication inhibits urinary bladder contraction
Contraction of the right atrium sends blood through the:
Tricuspid valve
A nurse assessing a client on digoxin suspects toxicity. Which visual disturbances would the nurse expect to assess?
Yellow or green vision
What are the class II anti-arrhythmics?
beta blockers
Where are alpha 1 receptors located?
blood vessels, iris, urinary bladder
When describing the adverse effects associated with ACE inhibitors, which would the nurse include?
constipation cough photosensitivity proteinuria
Pharmacokinetics indicate alpha1-blocking agents as a treatment choice for BPH due to their
prevention of smooth muscle contraction in nonvascular tissues.
Sterling's Law of the Heart
the more the cardiac muscle is stretched, the stronger the contraction - like a rubber band
