NURSU 452 ANS Review Quiz

Which organ has only beta-1 receptors?

Heart

During a procedure, the client's heart rate drops to 38 beats/min. Which medication is indicated to treat bradycardia?

Atropine sulfate

When a client exhibits severe bradycardia, which type of medication will the nurse be prepared to administer?

Anticholinergic

The nurse teaches a client's family about the administration of donepezil for treatment of dementia of the Alzheimer type. Which side effect identified by the caregiver indicates to the nurse that further teaching is needed?

Constipation

A client begins treatment with pyridostigmine bromide therapy for myasthenia gravis. Which action would the nurse perform in administration of the medication?

Evaluate the client's muscle strength every hour after the medication is given.

Which assessment finding indicates the presence of bradykinesia?

Jerky spontaneous movement

When a client with syncope from a vagal response asks why it is important to avoid bearing down during a bowel movement, which response by the nurse is correct?

"Bearing down stimulates a nerve response that decreases your heart rate and blood pressure."

Which portion of the nervous system is primarily responsible for the clinical manifestations that occur during a crisis?

Sympathetic nervous system

Which medication would be listed as the antidote to a nerve agent in the disaster plan for a terrorist attack?

Atropine

Which ophthalmic solution is contraindicated for clients with glaucoma?

Atropine

The health care provider prescribes a cholinergic medication to treat a client's urinary problem. Which effect would the nurse anticipate?

Urinary retention is prevented.

Cholinergic agonists are prescribed for which type of urinary condition?

Urine retention

Pyridostigmine bromide is prescribed for a client with myasthenia gravis. The nurse evaluates that the medication regimen is understood when the client makes which statement?

"I need to set an alarm so I take the medication on time."

After educating a client with an overactive bladder about starting extended release anticholinergic medication therapy, which response by the client requires a need for correction?

"I will chew the medication to release its ingredients."

A client presents to the clinic for a follow-up appointment after starting pyridostigmine for management of myasthenia gravis. Which new client problems are adverse effects of pyridostigmine? Select all that apply. One, some, or all responses may be correct.

Increased urinary frequency Muscle twitching Diarrhea Pyridostigmine is an acetylcholinesterase inhibitor. By inhibiting the enzyme that breaks down acetylcholine, it increases cholinergic activity. The increased cholinergic activity is responsible for the most common adverse effects of pyridostigmine such as diarrhea and increased urinary frequency. Another adverse effect is muscle twitching that occurs as pyridostigmine affects the muscle weakness that is characteristic of myasthenia gravis. Respiratory depression is a clinical manifestation of myasthenia gravis that can occur due to respiratory muscle weakness. Weakness of eye muscles results in ptosis or diplopia in about half of clients with myasthenia gravis.

Which would the nurse include when teaching a client with Parkinson disease about carbidopa-levodopa?

The medication should be taken with meals.

While receiving an adrenergic beta 2 agonist medication for asthma, the client complains of palpitations, chest pain, and a throbbing headache. Which nursing action is the most appropriate?

Withhold the medication and notify the health care provider.

A client with schizophrenia who is receiving an antipsychotic medication begins to exhibit a shuffling gait and tremors. The primary health care provider prescribes the anticholinergic medication benztropine, 2 mg daily. The nurse should inquire about which symptom when assessing the client?

Constipation

Which characteristic would a client who has been taught about myasthenia gravis identify as being common to both myasthenic and cholinergic crises?

Difficulty breathing

Which complication would the nurse assess in both clients who have Parkinson disease and clients who have myasthenia gravis?

Difficulty swallowing

A client is diagnosed with Parkinson disease and receives a prescription for levodopa therapy. Which mechanism of action would the nurse identify for this medication?

Restores the dopamine levels in the brain

A client asks the nurse what causes myasthenia gravis. Which description of pathology would the nurse use in response to the client?

A decreased number of functioning acetylcholine receptor (AChR) sites

Which catecholamine receptor is responsible for increased heart rate?

Beta-1 receptor

Which findings would support a client's diagnosis of Parkinson disease? Select all that apply. One, some, or all responses may be correct.

Nonintentional tremors Masklike facial expression Rigidity to passive movement Nonintentional tremors associated with Parkinson disease result from degeneration of the dopaminergic pathways and excess cholinergic activity in the feedback circuit. A masklike facial expression results from nigral and basal ganglia depletion of dopamine, an inhibitory neurotransmitter. Cogwheel rigidity is increased resistance to passive motion and is a classic sign of Parkinson disease. Constipation, not diarrhea, is a common problem because of a weakness of muscles used in defecation. The tendency is for the head and neck to be drawn forward, not hyperextended, because of loss of basal ganglia control.

A client with myasthenia gravis begins taking pyridostigmine. Two days later, the client develops loose stools and increased salivation. Which conclusion would the nurse make about these new developments?

The medication is causing cholinergic side effects.