Pharm ch30
The nurse is writing a plan of care for a patient receiving an alpha-specific adrenergic agonist. What should this plan of care include? A) Monitoring the patient for diarrhea B) Monitoring blood pressure and heart rate every 2 to 4 hours C) Assessing skin turgor for dehydration D) Assessing for fatigue and lethargy
B
The nurse receives an order to begin a dopamine (Intropin) infusion at 5 mcg/kg/min. The patient weighs 50 kg. Each milliliter of solution contains 3 mg of dopamine. How many mL/h will the nurse set the pump to deliver? A) 3 mL/h B) 5 mL/h C) 3,000 mL/h D) 83.3 mL/h
B
The patient is taking midodrine (ProAmatine). What is the most important nursing action to include in the plan of care for this patient? A) Monitor urine output. B) Monitor blood pressure. C) Monitor heart rate. D) Monitor respirations.
B
When assessing a patient who has been prescribed midodrine, what would the nurse assess for? A) Pancreatic disease B) Renal failure C) Open-angle glaucoma D) Hypothyroidism
B
A 4-year-old is admitted to the emergency department in shock after a motor vehicle accident. The patient weighs 12.5 kg. What would be the minimum safe dose of adrenalin if the pediatric dose is 0.005 to 0.01 mg/kg IV? A) 0.0625 mg B) 0.075 mg C) 0.08 mg D) 0.085 mg
A
A patient in shock is receiving an infusion of dopamine when it is discovered that an extravasation has occurred. What drug should be on standby for this occurrence? A) Phenylephrine B) Propranolol C) Phenylalanine D) Phentolamine
D
In what age group are adrenergic agonists contraindicated? A) Older adults B) Adolescents C) Children D) No age group
D
A patient is admitted to the emergency department in shock. Isoproterenol (Isuprel) is administered. What would the nurse expect the effect of the isoproterenol to be? A) Increased blood pressure B) Decreased blood pressure C) Increased body temperature D) Decreased heart rate
A
How does ephedrine act on the body? A) Stimulates the release of norepinephrine B) Acts indirectly on beta-adrenergic receptor sites C) Stimulates the release of dopamine D) Acts indirectly on alpha-adrenergic receptor sites
A
The home health nurse is caring for a 77-year-old male patient who has just been discharged from the hospital. The patient is receiving an infusion of dobutamine (Dobutrex) to treat congestive heart failure. What is the priority nursing assessment? A) Capillary refill time and vital signs B) Effectiveness of comfort measures C) Dietary intake and hydration D) Compliance with treatment plan
A
The nurse is admitting a mental health patient and collects the medication history. The patient says he takes Haldol, midodrine, hydrochlorothiazide, acetaminophen, and Cymbalta. The nurse will call the provider to discuss what dangerous drug combination? A) Haldol and midodrine B) Hydrochlorothiazide and midodrine C) Cymbalta and midodrine D) Acetaminophen and midodrine
A
The nurse is preparing discharge teaching for four patients. Which patient should be advised by the nurse that over-the-counter cold and allergy preparations contain phenylephrine and should be avoided? A) A 47-year-old woman with hypertension B) A 52-year-old man with adult onset diabetes C) A 17-year-old girl with symptoms of an upper respiratory infection D) A 62-year-old man with gout
A
The nurse needs to be aware, before administering, that what drug has a duration of action of only 1 to 2 minutes? A) Isoproterenol B) Dopamine C) Phenylephrine D) Ephedrine
A
The nursing instructor is quizzing a student who is preparing to administer an alpha-specific adrenergic agonist to a patient. The instructor asks the student what the student will assess in this patient after administering the drug. What is the student's best response? A) Blood pressure B) Respirations C) Mental status D) Vision
A
The pharmacology instructor is discussing adrenergic agonists with the nursing class. Which drugs would the instructor tell the nursing students are generally indicated for the treatment of shock, bronchospasm, and some types of asthma? A) Sympathomimetic drugs B) Beta-blocking drugs C) Parasympathetic stimulating drugs D) Anticatecholamine drugs
A
The student nurse is administering an ophthalmic adrenergic agonist. What action would reflect the need for further education about how to administer a medication ophthalmically? A) Rests the tip of the dropper against the lower eyelid B) Grasps the lower eyelid and pulls it away to form a pocket C) Applies gentle pressure to the inside corner of the eye for 3 to 5 minutes D) Instructs the patient to close his or her eyes and look downward
A
What is the nurse's rationale for administering clonidine to treat hypertension? A) Clonidine stimulates alpha2-receptors. B) Clonidine stimulates alpha1-receptors. C) Clonidine stimulates beta2-receptors. D) Clonidine stimulates beta1-receptors.
A
When studying for a pharmacology exam, a student asks her peers which agents affect both alpha- and beta-receptor sites. What would be an appropriate response to this student? (Select all that apply.) A) Dobutamine (Dobutrex) B) Epinephrine (Adrenalin, Sus-Phrine) C) Dopamine (Intropin) D) Clonidine (Catapres) E) Albuterol (Proventil)
A,B,C
The nurse is planning discharge teaching for a patient who is taking clonidine (Catapres). What would be most important for the nurse to include when teaching about adverse effects? A) Pupil constriction B) Strange dreams C) Increased urine output D) Increased appetite
B
A 4-year-old girl is prescribed an albuterol (Proventil) inhaler for her asthma. What is the recommended safe dosage for this patient? A) 1.25 to 2.5 mg q.i.d B) 1.25 to 2.5 mg b.i.d C) 2 mg q.i.d D) 0.5 to 1 mg b.i.d
B
A patient comes to the clinic complaining of seasonal rhinitis. What adrenergic agonist would be prescribed for treatment of seasonal rhinitis? A) Dobutamine (Dobutrex) B) Ephedrine (generic) C) Dopamine (Intropin) D) Norepinephrine (Levophed)
B
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? A) Blood dyscrasia B) Cardiac arrhythmia C) Hepatic toxicity D) Renal insufficiency
B
The clinic nurse is teaching a patient about transdermal clonidine (Catapres). What information would be included in the nurse's teaching plan? (Select all that apply.) A) Change the patch in the morning. B) Rotate the site where the patch is placed. C) Monitor blood pressure daily. D) Stop the drug immediately if adverse effects occur. E) Keep the physician informed of any new diagnoses or medications.
B,C,E
A nurse receives an order for clonidine (Catapres) for a 25-year-old pregnant woman. What is the nurse's priority action? A) Weigh the patient to obtain correct dose/kg/day. B) Have a second nurse check the dose before administering the drug. C) Consult with the physician about the order. D) Make sure the patient is wearing a fetal monitor.
C
Isoproterenol is reserved for use in emergency situations. What is the rationale for this? A) Its onset of action B) Its duration of action C) Its adverse effects D) Its peak plasma concentration
C
The nurse calculates the infusion rate for administering dopamine to a premature infant in the neonatal intensive care unit who is in cardiogenic shock secondary to a cardiac anomaly. What is the nurse's next priority action? A) Insert an intravenous catheter B) Obtain permission from parents C) Ask another nurse to perform independent calculation D) Show the nurse's calculations to the physician
C
The nurse is caring for a male patient who is taking a monoamine oxidase inhibitor (MAOI). The patient complains of seasonal rhinitis and the intern for his service orders phenylephrine nasal spray. What is the nurse's priority action? A) Verify patency of the nares. B) Review the patient's medication history. C) Question the order with the prescriber. D) Position the patient to give the drug as ordered.
C
The nurse is serving a breakfast tray to the patient receiving an alpha- and beta-adrenergic agonist medication. The nurse notifies dietary of the error with the patient's diet when finding what on the tray? A) Eggs B) Bacon C) Coffee D) Milk
C
The patient has been taking clonidine and is now being changed to another antihypertensive drug. How will the nurse instruct the patient regarding discontinuing the clonidine? A) "Check your blood pressure and pulse every 2 to 4 hours." B) "Inform your family the drug is being changed." C) "Reduce clonidine gradually over 2 to 4 days." D) "Keep an over-the-counter analgesic available to treat headaches."
C
What action do sympathomimetic drugs have in the body? A) Decreased heart rate B) Decreased blood pressure C) Increased respirations D) Increased intraocular pressure
C
What drug would the nurse expect to administer if beta-specific adrenergic agonist effects are desired to prevent bronchospasm during anesthesia? A) Dobutamine (Dobutrex) B) Ephedrine (generic) C) Isoproterenol (Isuprel) D) Phenylephrine (Neo-Synephrine)
C
When giving beta-specific adrenergic agonists, at what age is an adult dose given? A) 10 years B) 11 years C) 12 years D) 13 years
C
When transcribing new orders for sympathomimetic medications prescribed for a geriatric patient, the nurse expects the dosage will be what? A) The average adult dosage B) Slightly higher than adult dosages C) The lowest possible effective dosage D) Approximately half the normal adult dosage
C
The nurse is preparing to give isoproterenol parenterally. Before starting to administer the drug, what does the nurse ensure is on hand in case a severe reaction occurs? A) An alpha-adrenergic blocker B) An alpha-adrenergic stimulant C) A beta-adrenergic stimulant D) A beta-adrenergic blocker
D
The nursing students are studying sympathomimetic drugs. How do these drugs act on the body? A) Stimulate beta receptors and block alpha-receptors B) Stimulate alpha-receptors and block beta-receptors C) Block adrenergic receptors D) Stimulate both alpha and beta-receptors
D