Pharm Chapter 46, 47, 60, 59

What does the body create using choline? Cholesterol Acetylcholine Dopamine Tyramine

Acetylcholine

A male client is prescribed a topical ophthalmic medication. The nurse teaches the client that the medication should be discarded at what point? (Select all that apply.) a. If his condition improves b. After the expiration date c. If the color changes d. If it becomes cloudy e. If stinging occurs during administration

b c d

The nurse is assessing a client who has been prescribed a cholinergic agonist. The nurse should recognize that the therapeutic effects of this medication are due to what process? blocking of cholinergic receptor sites throughout the brain and spinal cord antagonism of gamma-aminobutyric acid (GABA) receptor sites throughout the body increased activity of acetylcholine receptor sites throughout the body increased activity of dopamine receptor sites throughout the brain and spinal cord

increased activity of acetylcholine receptor sites throughout the body

A nurse asks a student nurse how intraocular pressure (IOP) is maintained. What statement indicates that the student nurse has an appropriate understanding of this process? "Schlemm's canal provides fluid to the venous circulation." "It is a balance between the production and drainage of aqueous humor." "Fluid exchange between ophthalmic blood vessels and optic nerve." "Lens provides the ability of light rays to form images on the retina."

"It is a balance between the production and drainage of aqueous humor."

A client is prescribed ciprofloxacin. Which statement by the nurse is correct regarding the adverse effects of the medication? "Adverse effects include irritability and difficulty hearing." "Adverse effects include increased respiratory rate and gastrointestinal distress." "Adverse effects include difficulty with blood pressure regulation and sunburns." "Adverse effects include nausea, vomiting, and tendinitis or tendon rupture."

"Adverse effects include nausea, vomiting, and tendinitis or tendon rupture."

Which statement made by a client who has been prescribed varenicline indicates an understanding of the planned smoking cessation program? "I need to get involved in a support program as a part of my therapy." "I'll pick a date to stop smoking and begin the drug that day." "There is no more smoking after day 35 of my treatment plan." "If in 12 weeks I'm still smoking, the medication will need to be changed."

"I need to get involved in a support program as a part of my therapy."

A nurse caring for a client receiving bethanechol for urinary retention should advise the client that voiding usually occurs how long after oral administration? 12 to 24 hours 30 to 90 minutes 2 to 4 hours 5 to 15 minutes

30 to 90 minutes

Which client is most directly exhibiting the function of afferent nerves? A client who has winced with pain during an intramuscular injection A client who admits to having intense preoperative anxiety A client who has developed personality changes and memory loss following a traumatic brain injury A client who is lifting a weight during physical therapy

A client who has winced with pain during an intramuscular injection

Nicotinic receptors would be found in which location? Adrenal medulla Sweat glands Gastrointestinal tract Bladder

Adrenal medulla

Nerve fibers secreting norepinephrine are called: Ganglia Adrenergic Ligand Afferent

Adrenergic

Nerve fibers secreting norepinephrine are called: Ligand Adrenergic Ganglia Afferent

Adrenergic

Decreased acetylcholine levels are characteristic of what disorder? Parkinson's disease. Huntington's disease. Alzheimer's disease. multiple sclerosis.

Alzheimer's disease.

The nurse is reviewing a client's medication list before teaching the client about Cipro, a new drug the health care provider has ordered. The nurse warns the client to avoid what until the client finishes the Cipro? Antacids Acetaminophen Cough syrup Multivitamins

Antacids

A client with dementia of Alzheimer disease is prescribed memantine. Before administering the drug to the client, which would the nurse observe while obtaining the client's health history? Sleeping patterns Eating habits Resistance power Behavior patterns

Behavior patterns

A client with asthma is prescribed albuterol to dilate the bronchioles. The nurse understands that this drug is likely acting on which receptors? Beta-2 Beta-1 Alpha-1 Alpha-2

Beta-2

The anatomy and physiology instructor is discussing adrenergic receptors with the nursing class. What adrenergic receptor would the instructor tell the students is found in the heart and can stimulate increased myocardial activity and increase heart rate? Beta2 Alpha1 Beta1 Alpha2

Beta1

A nurse is reviewing the medication history of several clients. One of the clients is receiving a direct-acting cholinergic drug. The nurse would identify which drug? Bethanechol Guanidine Pyridostigmine Ambenonium

Bethanechol

After teaching a group of nursing students about various ophthalmic drugs, the instructor determines that the teaching was successful when the students correctly choose which drug as a carbonic anhydrase inhibitor? Brinzolamide Travoprost Pilocarpine Latanoprost

Brinzolamide

Neurons communicate through the use of synapses. These synapses may link neurons into functional circuits. How do the neurons communicate through the synapses? Chemically Electrically Excitatorily Inhibitorily

Chemically

A nurse is caring for a 49-year-old client who has been taking bethanechol for treatment of neurogenic bladder. After one week, the client develops sweating, heavy salivation, and bronchospasm. What would the nurse suspect is happening with this client? Pulmonary edema Anaphylactic reaction Myasthenic crisis Cholinergic crisis

Cholinergic crisis

The client with necrotizing otitis externa has been prescribed ciprofloxacin. The nurse instructs the client to avoid what foods within 2 hours of taking the medication? Citrus fruits Dairy products Bacon and sausage Green leafy vegetables

Dairy products

The client is to receive an IV cholinergic medication. When the nurse administers the drug what reaction will the nurse anticipate? Increase in anxiety Increase in heart rate Decrease in heart rate Decrease in anxiety

Decrease in heart rate

A client's left adrenal medulla has been injured in a motor vehicle accident. What is a possible implication of this injury? Disruption of the sodium-potassium pump Disruptions in the levels of norepinephrine and epinephrine Impaired action potential Dopamine deficiency

Disruptions in the levels of norepinephrine and epinephrine

Parkinson's disease is associated with a decrease in which of the following neurotransmitters? Acetylcholine Glutamate Dopamine Serotonin

Dopamine

The nurse is caring for a client in the emergency department who has a history of myasthenia gravis. The client has symptoms that could be interpreted as either myasthenic crisis or cholinergic crisis. The nurse is aware that the health care provider will order what medication to help determine the type of crisis the client is experiencing? Edrophonium

Edrophonium

The body uses tyrosine in the diet to make what substance? Glutamate Norepinephrine Serotonin Estrogen

Norepinephrine

What is the resulting physiologic effect when the parasympathetic nervous system is stimulated? Pupil dilation Increased heart rate Increased GI motility Decreased GI secretions

Increased GI motility

The nurse is caring for a client with necrotizing otitis externa. What is the most appropriate nursing diagnosis for this client? Pain related to inflammation of the middle ear Impaired skin integrity related to auricle lesion Impaired hearing related to fluid in the middle ear Infection related to trauma

Infection related to trauma

The nurse is aware that some medications have additional actions besides treating glaucoma. Which of the following medications can also be used to increase eyelash growth? Mydriacyl Timoptic Diamox Latisse

Latisse

While explaining the autonomic nervous system (ANS) to nursing students, the pharmacology instructor explains the role of neurotransmitters, medications, and hormones in activating receptors on target cells. Which of the following terms collectively refers to those 3 receptor-binding agents? Effector enzymes Second messengers Adrenergic fibers Ligands

Ligands

A nursing instructor is conducting a teaching session about the parasympathetic nervous system. The instructor determines the session is successful when the students correctly choose which receptors are involved with stimulating smooth muscles? Alpha Beta Nicotinic Muscarinic

Muscarinic

Imbalanced Nutrition: Less Than Body Requirements is a common nursing diagnosis for clients term-49prescribed cholinesterase inhibitors. The client's daughter asks the nurse why this is common. The nurse knows that which is a common side effect of cholinesterase inhibitors? Hyperactivity Hypertension Hypotension Nausea and vomiting

Nausea and vomiting

After teaching a group of students about indirect acting cholinergic agonists used to treat myasthenia gravis, the instructor determines that the teaching was effective when the students identify which agent? Rivastigmine Galantamine Neostigmine Tacrine

Neostigmine

A client is prescribed donepezil. The nurse would expect to administer this drug at which frequency? Twice a day Four times a day Three times a day Once a day

Once a day

The client is reporting sharp shooting pains to the left eye and loss of peripheral vision. What does the nurse suspect? Eye inflammation Open angle glaucoma Closed angle glaucoma Myopia

Open angle glaucoma

When teaching a client about Cortisporin Otic, the nurse will mention which of the following as a potential adverse effect? Drainage Redness Inflammation Ototoxicity

Ototoxicity

Parasympathetic stimulation causes the release of nitrous oxide from the endothelium of blood vessels. Which of the following results from this release? Increased inflammation Constriction of blood vessels Increased platelet aggregation Relaxation of vascular smooth muscle

Relaxation of vascular smooth muscle

A group of students are reviewing the drugs that are available for treating Alzheimer's disease. The students demonstrate understanding of the information when they identify which drug as appropriate for treatment? Pyridostigmine Rivastigmine Edrophonium Cevimeline

Rivastigmine

A signal has reached the terminus of a client's nerve and is in the space where the nerve is closest to the effector cell in a muscle. At what location is this signal? Neuron Synapse Schwann cell Soma

Synapse

A client has been prescribed topical cholinergic drug therapy for treatment of glaucoma. The nurse would inform the client that which effect might occur when beginning therapy? Nausea and increased salivation Temporary decrease in visual sharpness and headache Abdominal cramping and diarrhea Enhanced visual acuity and flushing of the skin

Temporary decrease in visual sharpness and headache

The nurse is conducting an assessment of a newly admitted client. What assessment finding should suggest to the nurse that the client's muscarinic cholinergic receptors are being stimulated? The client's blood pressure is 119/72 mmHg. The client's attention span is unusually short. The client has "pinpoint" pupils. The client describes a frontal lobe headache.

The client has "pinpoint" pupils.

What statement best explains the central and peripheral nervous system? Structures of the peripheral nervous system include the hypothalamus, brain stem, and spinal column. The central nervous system (CNS) can be broken down into the somatic and autonomic pathways. Structures of the central nervous system include the brain, neurons, and ganglia. The two main divisions that control the nervous system are the central and peripheral nervous system.

The two main divisions that control the nervous system are the central and peripheral nervous system.

A client has benign prostatic hypertrophy and has been prescribed neostigmine. The nurse is aware that this client must be monitored for what adverse effect of this medication? Pain with urination Urinary retention Pyuria Hematuria

Urinary retention

The physiology instructor explains to the nursing students that beta-2 stimulation leads to: Vasoconstriction of blood vessels Vasodilation of blood vessels Vasodilation of the aortic valve Vasoconstriction of the aortic valve

Vasodilation of blood vessels

A nurse is preparing to administer otic drops that contain benzocaine, antipyrine, and glycerin. The nurse predicts these drops provide which type of action(s)? Select all that apply. a. Local anesthetic b. Analgesic c. Emollient d. Antifungal e. Corticosteroid

a b c

The neurotransmission system of the human body is a communication network. What is this network composed of? (Mark all that apply.) a. Synapses b. Neurotransmitters c. Receptors d. Complexes e. Antigens

a b c

Which client's nicotinic receptors are likely being stimulated the most? a client who has increased bowel motility causing diarrhea a client who is anxious while waiting in the preoperative area a client taking a selective serotonin reuptake inhibitor for depression a client who is taking medications for the treatment of Parkinson's disease

a client who is anxious while waiting in the preoperative area

After the effector cell has been stimulated by acetylcholine (ACh), what enzyme stops this stimulation and allows the effector membrane to repolarize? norepinephrine acetylcholinesterase decarboxylase catecholamine

acetylcholinesterase

The functions of the autonomic nervous system (ANS) can be broadly described as: a. activities designed to maintain a constant internal environment, to respond to stress or emergencies, and to repair body tissues. b. the ability to produce an action potential and to convey electrical impulses. c. relaying motor impulses from the cortex to the thalamus. d. the ability to regulate and produce acetylcholine.

a. activities designed to maintain a constant internal environment, to respond to stress or emergencies, and to repair body tissues.

The nurse is caring for a client who has been diagnosed with myasthenia gravis. To ensure client safety, the nurse reviews treatment for myasthenic crisis, which requires what intervention? a decrease in glucocorticoid therapy withdrawal of anticholinesterase drugs withdrawal of immunoglobulin drugs additional anticholinesterase inhibitors

additional anticholinesterase inhibitors

The nurse administers a drug that causes vasoconstriction, contracted piloerection muscles, pupil dilation and urinary retention. What receptor is this drug most likely stimulating? alpha1-receptors alpha2-receptors beta2-receptors beta1-receptors

alpha1-receptors

What helps to prevent overstimulation of effector sites on nerve membranes? alpha2-receptors alpha1-receptors beta1-receptors beta2-receptors

alpha2-receptors

A nurse is caring for a patient who is having a sympathetic response. A sympathetic response involves: a decrease in sweating, decrease in respirations, and pupil constriction. a decrease in heart rate, decrease in blood flow to skeletal muscles, and increase in inflammatory reactions. increased motility, secretions in the GI tract, and constriction of bronchi and pupils an increase in blood pressure, bronchi dilation, and decreased bowel sounds

an increase in blood pressure, bronchi dilation, and decreased bowel sounds

The nurse is explaining the physiological changes that lead to glaucoma to a client who is newly diagnosed with the condition. The nurse correctly includes that glaucoma results from: a decrease in intraocular pressure (IOP). an increase in intraocular pressure (IOP). a tear in the retina. a cloudiness in the lens or lens capsule of the eye.

an increase in intraocular pressure (IOP).

Sympathetic stimulation of the heart causes: an increased rate and force of myocardial contraction. decreased blood flow and impaired digestion. a decreased rate and force of myocardial contraction. an excitatory response that stimulates the brain to generalized decreased activity.

an increased rate and force of myocardial contraction.

A client is reporting diarrhea, rigidity, and spasm after receiving pyridostigmine. Which medication is appropriate to suggest to the prescriber? atropine loperamide morphine sulfate alprazolam

atropine

What drug is prescribed for mushroom poisoning? bethanechol pralidoxime atropine neostigmine

atropine

The nurse is preparing a client for an eye examination and administers atropine sulfate (ophthalmic). The nurse instructs the client that this medication has what effects on the eye? (Select all that apply.) a. Produces miosis b. Produces pupillary constriction c. Produces pupillary dilation d. Produces accommodation of near vision e. Produces mydriasis

c e

The nurse is assessing a client. What assessment finding is the clearest indicator of autonomic function? a. The client's muscle strength is equal bilaterally b. The client's hearing is intact c. The client's respiratory rate is 22 breaths per minute d. The client can discern hot sensation from cold

c. The client's respiratory rate is 22 breaths per minute

Characteristics that allow neurons to communicate with other body cells include: a. stimulation of "association areas" to analyze information received. b. relaying motor impulses from the cortex to the thalamus. c. the ability to be stimulated and to convey electrical impulses. d. the ability to regulate body temperature.

c. the ability to be stimulated and to convey electrical impulses.

What medication is commonly prescribed for an adult client diagnosed with external otitis media? amoxicillin cephalexin neomycin-polymyxin B-hydrocortisone ciprofloxacin

ciprofloxacin

A nurse is caring for a patient who is having a sympathetic response. A sympathetic response involves: a. increased motility, secretions in the GI tract, and constriction of bronchi and pupils b. a decrease in heart rate, decrease in blood flow to skeletal muscles, and increase in inflammatory reactions. c. a decrease in sweating, decrease in respirations, and pupil constriction. d. an increase in blood pressure, bronchi dilation, and decreased bowel sounds

d. an increase in blood pressure, bronchi dilation, and decreased bowel sounds

A nurse is preparing to apply a client's scheduled dose of bimatoprost. To reduce this client's risk of infection during administration, what action should the nurse take? preventing the applicator from coming in contact with any surface warming the drops prior to instillation Administering antibiotic eye drops immediately after administration of bimatoprost using sterile gloves when instilling the drug

preventing the applicator from coming in contact with any surface

The nurse administers a drug that stimulates beta2 receptors. What type of health condition would this drug treat? respiratory disease diabetes high lipid levels heart disease

respiratory disease

The nurse is caring for a client with asthma who has been administered albuterol in order to promote bronchodilation and relieve shortness of breath. When giving this medication, the nurse has affected the client's autonomic nervous system by: converting a larger proportion of dopamine to norepinephrine. stimulating beta2-receptors. antagonizing alpha2-receptors. decreasing the reuptake of acetylcholine.

stimulating beta2-receptors.

A client has begun to experience post-operative pain and the client's heart rate has increased from 72 beats per minute to 96 beats per minute. The nurse should attribute this change to the effect of: stimulation of muscarinic receptors in the parasympathetic nervous system. stimulation of beta1 receptors in the sympathetic nervous system. reuptake of norepinephrine in synapses of the sympathetic nervous system. conversion of norepinephrine to dopamine in synapses of the sympathetic nervous system.

stimulation of beta1 receptors in the sympathetic nervous system.

The nurse accompanies the health care provider into the client's room and remains after the client is told that they have cancer and a poor prognosis. The client's respirations become rapid and deep, their pupils dilate, and they appear diaphoretic. What type of response is the nurse witnessing? muscarinic receptor stimulation response nicotinic receptor stimulation response sympathetic nervous system (SNS) response parasympathetic nervous system (PNS) response

sympathetic nervous system (SNS) response

A client is having a stress response that is causing the release of norepinephrine. This norepinephrine will be made from what dietary precursor? tryptophan tyrosine trichinosis thiamine

tyrosine

A nurse administering rivastigmine (Exelon) oral solution can give the solution directly to the client or mix it in a small amount which of the following? Select all that apply: Tea Fruit juice Water Coffee Soda

water soda fruit juice

A client has a neurologic disorder characterized by a deficiency of acetylcholine. In what location is acetylcholine normally synthesized? in the synaptic cleft between nerves and effector cells in the adrenal medulla within the gray matter of the spinal cord within cholinergic nerves themselves

within cholinergic nerves themselves

The nursing instructor is explaining the role of the parasympathetic nervous system in influencing body functions. Which change in a patient's body functions would be directly related to the stimulation of the parasympathetic nervous system? Poor motility of the gastrointestinal tract Increased heart rate Decreased heart rate Pupil dilation

Decreased heart rate

The nursing instructor is explaining the role of the parasympathetic nervous system in influencing body functions. Which change in a patient's body functions would be directly related to the stimulation of the parasympathetic nervous system? Poor motility of the gastrointestinal tract Pupil dilation Decreased heart rate Increased heart rate

Decreased heart rate

The nurse is preparing a teaching plan for a client and caregiver concerning the cholinergic drug therapy that has been prescribed. Which teaching point should the nurse prioritize? Instructions to avoid fiber-rich food during therapy Evaluation of the client's previous history of disorders Review of the purpose of the drug therapy with the client and family Importance of adopting a self-monitoring blood pressure program

Review of the purpose of the drug therapy with the client and family

The nurse is developing a teaching plan for an outpatient receiving cholinergic drugs. What should be the role of the nurse when developing a teaching plan? Suggest the patient avoid fiber-rich food during therapy. Suggest the patient adapt a self blood pressure measurement habit. Review the patient's previous history of disorders. Review the purpose of the drug therapy with the patient and family.

Review the purpose of the drug therapy with the patient and family.

A nursing student is preparing a care plan and is choosing a nursing diagnosis for her client with Alzheimer's disease. The client is taking Exelon. Which would be an appropriate nursing diagnosis for this client? Risk for Injury related to being confined to the Alzheimer's unit Learning Impairment related to decreased hearing Imbalanced Nutrition: More Than Body Requirements Risk for Injury related to dizziness and fatigue

Risk for Injury related to dizziness and fatigue

The nurse is admitting a client with necrotizing otitis externa. The nurse expects the client to exhibit which symptoms? (Select all that apply.) a. Otalgia b. Nasal congestion c. Pain while chewing d. Otorrhea e. Shoulder pain

a c d

The nurse is evaluating the effectiveness of antibiotic therapy for a client who has been treated for acute otitis media. What assessments will indicate a resolution of the infection? (Select all that apply.) a. No bulging of the tympanic membrane b. Normal body temperature c. Improved hearing d. Cherry red and dull tympanic membrane e. Presence of otalgia and otorrhea

a b c

The nurse is preparing to teach a client and caregiver about the prescribed cholinesterase inhibitor. Which actions should the nurse prioritize in the teaching to encourage the client's safety? Select all that apply. a. Encourage the use of assistive devices. b. Keep the bed in a low position. c. Use night lights. d. Observe frequent drug holidays. e. Decrease drug dose if mobility worsens.

a b c

A client has been treated with ofloxacin multiple times for an ear infection. The nurse instructs the client to report signs of local adverse reactions. What would this include? (Select all that apply.) a. ear irritation b. itching c. difficulty breathing d. burning e. nausea

a b d

A preoperative client admits to feeling intensely anxious about surgery and the nurse recognizes that the client's sympathetic nervous system is stimulated. What assessment findings should the nurse attribute to this stimulation? Select all that apply. a. Increased sweating b. Dilated pupils c. Increased bowel sounds d. Increased respiratory rate e. Increased blood pressure

a b d e

The ophthalmic preparation pilocarpine (Isopto Carpine) should be used cautiously in clients with which of the following? Select all that apply: a. Hypertension b. Asthma c. Diabetes d. Hypothyroidism e. Peptic ulcer disease

a b e

A nurse is teaching a client with glaucoma about the prescribed eye drops. The nurse emphasizes the importance of therapy to prevent which complication(s)? Select all that apply. a. Nerve damage b. Headache c. Visual loss d. Blindness e. Corneal tears

a c d

The neurotransmission system of the human body is a communication network. What is this network composed of? (Mark all that apply.) a. Complexes b. Receptors c. Neurotransmitters d. Antigens e. Synapses

b c e

When assessing a client receiving a cholinergic drug, the nurse would assess the client for increased neuromuscular blocking effects if the client is also receiving which additional drug(s)? Select all that apply. a. Tobramycin b. Clarithromycin c. Amoxicillin d. Neomycin e. Cephalexin

a d

A female client is taking cholinergic medication to control bladder retention. She presents to the emergency department with confusion, shortness of breath, and an apical pulse of 42 beats per minute and irregular. What action would the nurse expect the health care provider to take? a. Increase the cholinergic medication to increase cardiac contractility. b. Discontinue the cholinergic medication secondary to the diagnosis of bradycardia. c. Decrease the cholinergic medication to alleviate the symptom of confusion. d. Increase the cholinergic medication to increase oxygenation to the heart through vasodilation.

b

A nurse is preparing to teach a patient about timolol, which has been prescribed to treat newly diagnosed glaucoma. When reviewing the patient's current medication list, the nurse notes some medications that can increase the effect of timolol. Which of the following medications should not be used with timolol? Select all that apply. a. Hydroxyzine b. Antihypertensives c. Calcium-channel blockers d. Monoamine oxidase (MAO) inhibitors e. Central nervous system (CNS) depressants

b c d

A client with glaucoma asks the nurse why it is necessary to use drops every day. The nurse responds that the drops help lower intraocular pressure (IOP) and that if IOP remains high, which complications can develop? (Select all that apply.) a. hypertension b. optic nerve damage c. blindness d. diabetes e. visual loss

b c e