Pharm Chap 12-13

What is the primary response to alpha-1-receptor stimulation? a. Bronchodilation b. Tachycardia c. Vasoconstriction d. Uterine relaxation

c

Before the initiation of anticholinergic medications, it is important for the nurse to screen patients for which condition? a. Hypertension b. Infectious diseases c. Diabetes d. Closed-angle glaucoma

d

Which disease is associated with insufficient sleep? a. Cancer b. Glaucoma c. Myocardial infarction d. Renal failure

c

Prior to the administration of metoprolol, a beta-adrenergic blocking agent, which is most important for the nurse to assess? a. Blood pressure b. Lung sounds c. Mental status d. Urine output

a

The nurse is assessing a patient who is being evaluated in an outpatient clinic for complaints of back pain. The patient reports taking diphenhydramine for insomnia related to job stress. Which statement by the nurse is accurate regarding this medication? a. "This medication should only be taken for 1 week." b. "This medication can cause nausea." c. "The medication should not be taken after eating a high-fat meal." d. "This is an herbal medication that has been used for hundreds of years."

a

Which disorder(s) would indicate the use of anticholinergic agents? (Select all that apply.) a. Glaucoma b. Benign prostatic hypertrophy c. Bradycardia d. Parkinson's disease e. Preparation for surgery f. Stimulation of the vagus nerve

c d e

Which category of medications is used for peripheral vascular diseases characterized by excessive vasoconstriction, such as Raynaud's disease? a. Adrenergic agents b. Alpha-adrenergic blocking agents c. Beta-adrenergic blocking agents d. Cholinergic agents

b

Which body function(s) is/are controlled by the autonomic nervous system? (Select all that apply.) a. Blood pressure b. Skeletal muscle contraction c. GI secretion d. Body temperature e. Urination

a c d e

A patient has been prescribed lorazepam (Ativan), a benzodiazepine used to treat insomnia. Which action will the nurse take? a. Advise the patient to take the medication with food. b. Assess the patient's blood pressure in sitting and lying positions. c. Inform the patient to discontinue the medication once sleep improves. d. Instruct the patient to lie down before taking the medication.

b

Why are benzodiazepines often preferred over barbiturates? (Select all that apply.) a. They have selective action at specific receptor sites. b. There is a wide range of safety between therapeutic and lethal levels. c. REM sleep is decreased to a lesser extent. d. Accidental overdoses are well tolerated. e. There are no hypotensive episodes when rising to a sitting position.

a b c d

Neurotransmitter(s) include: (Select all that apply.) a. gamma aminobutyric acid. b. acetylcholine. c. serotonin. d. glucose. e. histamine. f. epinephrine.

a b c e f

Which adverse effect(s) is/are common when a patient is receiving a cholinergic agent? (Select all that apply.) a. Nausea b. Hypertension c. Dizziness d. Bradycardia e. Constipation

a c d

A patient with a history of type 1 diabetes after myocardial infarction has been placed on a beta-adrenergic blocking agent. Which statement by the patient indicates a need for further teaching? a. "This medication should not be discontinued suddenly." b. "This medication lowers my blood pressure by helping me get rid of fluid." c. "I may not have my usual symptoms of a hypoglycemic reaction while on this drug." d. "This medication may take a few weeks to work."

b

The nurse is caring for an older patient recently admitted to an assisted living center who is experiencing insomnia associated with the recent relocation. At bedtime, which nursing action will assist the patient to sleep? a. Offering the patient hot tea b. Encouraging the patient to ambulate in the hallway c. Performing back massage d. Administering an analgesic

c

The nurse is explaining the use of medications to a patient with insomnia. Which statement about sedatives is true? a. A sedative will produce sleep. b. Sedatives increase the total time in REM sleep. c. Increased relaxation occurs with sedatives. d. Sedatives are more potent than hypnotics.

c

Which condition would alert the nurse of the need to use beta-adrenergic blockers cautiously? a. Hypertension b. Raynaud's phenomenon c. Emphysema d. Cardiac dysrhythmias

c

Why are beta blockers used cautiously in patients with respiratory conditions? a. They mask the signs and symptoms of acute hypoglycemia. b. They cause extensive vasodilation and cardiac overload. c. They may produce severe bronchoconstriction. d. They increase hypertensive episodes.

c

An older adult patient is to receive atenolol, a beta-adrenergic blocking agent. Prior to administration of the drug, the nurse assesses an apical pulse rate of 58 and notes ankle edema. Which action will the nurse take first? a. Determine the therapeutic blood level. b. Encourage the patient to decrease water intake. c. Elevate the patient's legs. d. Withhold the medication.

d

Which sleep pattern stage diminishes as an effect of aging? a. Stage I b. Stage II c. Stage III d. Stage IV

d

A patient receiving diazepam (Valium) is complaining of nausea and vomiting and is becoming jaundiced. Which type of blood work will be performed? a. Renal function tests b. Liver function tests c. Clotting times d. Electrolyte panels

b

The nurse finds that a patient is extremely agitated, yells frequently, and is attempting to get out of bed without assistance. What is the nurse's initial action? a. Administer zolpidem after taking the patient's vital signs. b. Close the patient's door for privacy after administering Tylenol. c. Administer benzodiazepine before calling the healthcare provider. d. Spend uninterrupted time listening to the patient.

d

The nurse is caring for a patient taking a cholinergic agent. When auscultating lung sounds, the nurse notes inspiratory and expiratory wheezing bilaterally. The best action for the nurse to take would be to: a. provide the next dose of the cholinergic agent immediately. b. assess heart rate and blood pressure. c. reposition the patient. d. withhold the next dose and notify the physician.

d

When reviewing a patient's history and physical information, the nurse notes that the patient has physician's orders for chloral hydrate and warfarin. During assessment of this patient, the nurse observes areas of petechiae and ecchymosis on the upper and lower extremities. The most appropriate lab work for the nurse to assess next is: a. liver function studies. b. C-reactive protein. c. sedimentation rate. d. prothrombin time.

d

A patient hospitalized in an acute care setting reports to the nurse that since starting on an adrenergic medication, he has been feeling "dizzy and weak." The most appropriate action for the nurse is to: a. immediately notify the physician. b. teach the patient to move slowly from standing to sitting. c. discontinue the adrenergic blocker. d. monitor the blood pressure in both the supine and standing positions.

d

For what conditions are benzodiazepines prescribed? a. Chronic amnesia b. Chronic insomnia c. Preoperative sedation d. Psychotic episodes

c

In addition to facilitating sleep, what is another benefit of sedatives? a. Increased pain control postoperatively b. Reduced bronchial secretions c. Decreased patient anxiety d. Increased patient alertness

c

The autonomic nervous system can be subdivided into which types of adrenergic receptors? a. Nicotinic and muscarinic b. Afferent and efferent c. Alpha and beta d. Agonists and antagonists

c

The nurse is assessing a patient prior to discharge from same day surgery following an incisional breast biopsy. When assessing the patient's central nervous system (CNS) function following sedative-hypnotic therapy, what will the nurse include? (Select all that apply.) a. Level of alertness b. Orientation c. Ability to perform motor functions d. Blood pressure e. Usual pattern of sleep

a b c

What can occur as a result of rapid withdrawal from long-term use of barbiturate therapy? (Select all that apply.) a. Anxiety b. Delirium c. Weakness d. Grand mal seizures e. Severe pain

a b c d

A patient is being discharged on an adrenergic bronchodilator. Which common adverse effect(s) will the nurse include in discharge teaching? (Select all that apply.) a. Palpitations b. Dizziness c. Orthostatic hypotension d. Hypoglycemia e. Tremors f. Bradycardia

a b c e

Barbiturates have which common adverse effect(s)? (Select all that apply.) a. Residual daytime sedation b. Headache c. Hyperactivity d. Blurred vision e. Impaired coordination

a b d e

A patient with chronic obstructive pulmonary disease (COPD) reports having insomnia and a racing heart after starting terbutaline therapy. Which explanation by the nurse is most accurate? a. "The symptoms are typical and indicate that the medication is at a therapeutic level." b. "The symptoms will tend to resolve with continued therapy." c. "The symptoms are unusual and need to be reported to the healthcare provider immediately." d. "The symptoms are indicative of toxicity."

b

The nurse is administering Somnote to a patient. When providing medication education to the patient, the nurse will include that Somnote should be: a. thoroughly chewed. b. taken with a full glass of water. c. taken on an empty stomach. d. taken only before bedtime.

b

Which nerve endings liberate norepinephrine? a. Cholinergic b. Adrenergic c. Anticholinergic d. Muscarinic

b

Which two phases make up normal sleep? a. Hypnagogic and hypnopompic b. Rapid eye movement (REM) and non REM c. Alpha and beta d. Delta and theta

b

Which statement(s) is/are true about efferent nerves? (Select all that apply.) a. They transmit signals to the spinal cord and brain. b. They leave the CNS to carry impulses to other body parts. c. They are part of the peripheral nervous system. d. They transmit signals that control contractions of smooth and skeletal muscles. e. They transmit signals that control contractions of some glandular secretions.

b c d e

Which instruction(s) given by the nurse will assist a patient to cope with the common adverse effects of anticholinergic medications? (Select all that apply.) a. "Take the medication with meals." b. "Increase fluids daily." c. "Decrease fiber in the diet." d. "Suck on candy or ice chips." e. "Monitor blood glucose."

b d

A long-term care resident is taking an anticholinergic agent. The nurse observes the resident to be disoriented and hallucinating. The priority nursing action is to: a. report development of alterations to the charge nurse. b. assess blood glucose. c. provide for resident's safety. d. medicate with antianxiety medication.

c

A patient with Parkinson's disease asks the nurse why anticholinergics are used in the treatment. Which response by the nurse is most accurate? a. "These drugs help you urinate." b. "These drugs will decrease your eye pressure." c. "These drugs inhibit the action of acetylcholine." d. "These drugs will assist in lowering your heart rate."

c

An older adult patient received a hypnotic agent at 9:00 PM. At 2:00 AM, the nurse discovers that the patient has removed her gown and is attempting to get out of bed without assistance. What type of medication effect is the patient exhibiting? a. Allergic b. Hypersensitivity c. Paradoxical d. Therapeutic

c