Chapter 29: Autonomic Nervous System

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

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

C) Adrenal medulla

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 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 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

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

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

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 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 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

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

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

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 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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

C) Craniosacral

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

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

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 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

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