316-- prepU week 6

After teaching a patient who is prescribed a scopolamine patch, the nurse determines that the teaching was successful when the patient states that she will change the patch in which time frame?

Every 3 days

The nurse would be alert for what in a client who is taking rivastigmine and ibuprofen?

GI bleeding

People with memory problems may take which of the following herbal products has been used to improve mental performance?

Ginseng

The nurse would contact the physician before administering an adrenergic drug to a client who is also taking which drug?

MAO inhibitor

The nurse is administering pilocarpine. Which administration technique would be considered appropriate?

The nurse administers the medication into the eye.

What statement is true concerning the administration of cholinergic agonists?

The parasympathetic nervous system is stimulated by these medications.

Which observation might indicate that timolol is achieving the desired effect in a patient?

The patient's IOP decreases

The nurse is preparing a male client for pacemaker surgery. The physician orders atropine to be given 30 minutes before the patient leaves for the operating room. The nurse knows that the physician ordered this medication for what reason?

To dry up respiratory secretions to prevent aspiration during surgery

A client is experiencing urinary retention after surgery. The nurse would anticipate administering:

Bethanechol

Prior to the administration of a sympatholytic drug, the nurse should check a patient's blood pressure and:

apical pulse

A priority nursing assessment for a patient who is to receive an alpha- or beta-adrenergic agonist would be to:

assess heart rate

A patient is taking rivastigmine for Alzheimer disease. The nurse will evaluate the patient regularly for:

weight loss

Which of the following can the nurse recommend to a client's caregiver to decrease the client's risk for injury?

• Encourage the use of side rails • Keep the bed in a low position • Use night-lights

A patient is receiving doxazosin. The nurse would assess the patient for development of which conditions?

• Hypotension • Edema • Weakness

When assessing a patient who is experiencing a stress response, what would the nurse expect to find?

• Tachycardia • Pupil dilation • Diaphoresis

T or F-- Anticholinergics block acetylcholine at the muscarinic receptors.

True

T or F-- Patients who are receiving alpha-specific adrenergic agents should not stop taking the drug abruptly.

True

Norepinephrine is made by nerve cells using which substance?

Tyrosine

A 75-year-old male client is experiencing extrapyramidal symptoms secondary to an antipsychotic drug. Which drug would the nurse expect the physician to order to relieve these symptoms?

Anticholinergics

A nurse is caring for a 55-year-old client who is receiving sustained-release metoprolol. What statement by the patient would lead the nurse to believe that the client needs additional instruction?

"I can take any OTC pain reliever while on metoprolol."

Which patient statement indicates to the nurse that the patient is experiencing an adverse effect of hyoscyamine?

"I feel like my heart is going to jump out of my chest."

The pharmacology instructor is discussing age-related susceptibility to adverse effects of cholinergic drugs. Which statement could the instructor make to accurately describe the influence of age?

"Physiologic changes resulting from the normal aging process place older adults at higher risk for adverse effects."

The nurse is teaching a patient about safe use of adrenergic drugs. Which statement should be included in the teaching?

"Talk to your doctor before taking any other medications."

What does the body create using choline?

Acetylcholine

Which agent would be used to counteract a severe reaction occurring with the use of neostigmine?

Atropine

A 71-year-old black woman with a history of diabetes for a follow-up appointment after visiting ED for increased angina. As a beta2 receptor blockade has been prescribed to better control the chest pain, what other teaching is very important about this pharmacological intervention?

Beta2 receptor blockade use results in less effective glucose metabolism, especially when accompanied with anti-diabetic meds

The body uses tyrosine in the diet to make what substance?

Norepinephrine

Which is an example of a peripherally acting antiadrenergic drug?

Prazosin

Most of the free norepinephrine molecules are taken up by the nerve terminal that releases them in which process?

Reuptake

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 r/t dizziness and fatigue

Which agent would a nurse expect to administer transdermally?

Scopolamine

Myasthenia gravis is a(n):

autoimmune disorder

A patient is receiving sotalol. Which instruction would be most important for the nurse to provide to the patient to ensure maximum effectiveness of the drug?

"Be sure to take the drug on an empty stomach."

Which patient statement indicates the need for additional teaching about propranolol?

"I can stop the drug once my BP is controlled."

Nicotinic receptors would be found in which location?

Adrenal medulla

When describing the fight-or-flight response, an instructor describes various events that occur and substances that are secreted. Which substance would the instructor include as being responsible for sodium and water retention?

Aldosterone

Propranolol is used in the treatment of which disorders?

All of the above

Cholinesterase inhibitors are utilized for the treatment of which of the following medical conditions?

Alzheimer's disease

The nurse is caring for a client who is receiving an indirect-acting cholinergic medication and knows it is indicated as a treatment for myasthenia gravis as well as which other condition?

Alzheimer's disease

A 4-year-old girl is brought to the emergency department by her mother. The mother reports that the child has been vomiting, and the nurse notes that the child's face is flushed and she is diaphoretic. The mother thinks that the child may have swallowed carbachol drops. A diagnosis of cholinergic poisoning is made. Which drug would be administered?

Atropine

The client is experiencing digitalis toxicity and presents with symptomatic bradycardia. The nurse knows that which medication may be administered to treat bradycardia?

Atropine

Which drug is used to reverse an OD of cholinergic drugs?

Atropine

Which would be *most* important to have readily available for a client who is receiving an indirect-acting cholinergic agonist and develops a severe reaction?

Atropine

The nursing instructor is explaining the use of atropine with morphine in patients with renal colic. What role does atropine play in this indication?

Atropine acts mainly to decrease the spasm-producing effect of morphine.

A patient is admitted to the emergency room after a car accident. Based on the experience of the emergency room nurse, what system will affect a response to the emergency?

Autonomic Nervous System (ANS)

Nicotinic receptors are found in which area?

Autonomic basal ganglia

A patient is experiencing urinary retention. He has been prescribed terazosin (Hytrin). What condition contributes to the urinary retention?

BPH

Which symptoms will warrant the administration of atropine?

Bradycardia

Which effect results from activation of beta2 receptors?

Bronchodilation

A client has been admitted to the cardiac unit for heart failure. The nurse is going to administer carvedilol (Coreg). The client's blood pressure is 80/50. What should the nurse do?

Call the provider and advise them of the client's BP prior to administering the medication.

A patient has been administered dobutamine HCL. Which adverse reactions should the nurse monitor for in the patient?

Cardiac arrhythmias

A client calls the cardiology office and reports fatigue and drowsiness since starting a new medication. The nurse knows that which medications has these as common side effects?

Carvedilol

A nurse is caring for an elderly patient who is to be administered isoproterenol. Which change monitored in the patient should the nurse report immediately to the primary health care provider?

Changes in pulse rate

The nurse is caring for a client with glaucoma and is aware that which category of preanesthetic medication is contraindicated in this client?

Cholinergic blocking

Administration of which classes of medications can decrease secretions of the upper respiratory tract?

Cholinergic blocking drug

A client has been prescribed a beta blocker. The nurse knows that beta blockers can have which effect on the heart?

Decrease the HR

Which herbs has been removed from most weight-loss medications due to potential legal liability?

Ephedra

An instructor is preparing a teaching plan for a group of students about adrenergic agonists. Which would the nurse include as an alpha- and beta-adrenergic agonist?

Epinephrine

Which would the nurse expect to be given to a patient experiencing acute bronchospasm?

Epinephrine

A 57-year-old female client has a history of two myocardial infarctions in the past 3 years. She presents to the physician's office with symptoms of an overactive bladder. She requests an anticholinergic medication that she saw advertised on television. What does the nurse expect the physician to do for this client?

Explain to the client that the medication is contraindicated because of her medical hx

An increased dosage of digoxin would be needed if the patient is also taking midodrine.

False

T or F-- The drug of choice for treating hypertension in an older adult is atenolol.

False

A client with symptomatic bradycardia has been receiving atropine for the past 4 days. The client reports constipation, a common adverse effect of the drug. What is the most important suggestion the nurse could give the client?

Increase bulk in the diet

Which is an effect of epinephrine?

Increased HR

A nurse administers bethanechol (Urecholine). What assessment finding is attributable to the effect of this medication?

Increased urinary output

A 70-year-old woman is taking a cholinergic blocking drug. Her family has noticed that she is very excited, a little confused, and is not able to void normally. What action by the nurse would be most appropriate to deal with these symptoms?

Instruct the client to withhold the next dose and contact the prescribing provider.

Which is a cholinergic blocking drug available in an inhaler form for the treatment of COPD?

Ipratropium (Atrovent)

A patient is administered atropine to increase the heart rate. What is the action of atropine?

It blocks the parasympathetic vagal stimulation

A male client presents to the emergency department reporting rapid heart rate, severe headache, and pounding in his chest. While obtaining his history, the nurse learns that the client stopped taking his medications because he ran out and didn't have funds to fill his prescriptions. The nurse knows that which medications being abruptly stopped could be causing his symptoms?

Labetalol

A patient is being admitted to an Alzheimer's unit. The family tells the nurse that they can no longer care for the patient at home now that he is incontinent of urine and needs help with bathing and feeding. This patient is in which stage of Alzheimer's?

Late stage

A client is prescribed propantheline. The nurse would administer this drug by which route?

Oral

A patient with dementia of Alzheimer's disease is prescribed rivastigmine by the primary health care provider. Which is the correct method of administering rivastigmine to the patient?

Orally

A patient is suffering from a heart rate of 42 beats per minute. Which system contributes to bradycardia?

Parasympathetic nervous system

The nursing instructor is discussing cholinergic drugs. According to the instructor, what system is acted upon by this family of drugs?

Parasympathetic nervous system

A patient has received a dose of dopamine intravenously. The patient's IV was infiltrated, and the dopamine was injected into the subcutaneous tissues. Which medication will prevent the vasoconstriction and tissue necrosis based on this action?

Phentolamine mesylate (Regitine)

Which agent would the nurse expect to find when reviewing OTC allergy products?

Phenylephrine

The nurse is assessing a patient who is receiving clonidine. Which might the nurse assess?

Photophobia

A graduate of a nursing program is scheduled to take the NCLEX today. The test-taker's heart is racing and pupils are dilated. What can the test-taker attribute to this reaction?

Sympathetic Nervous System

The functions of the autonomic nervous system (ANS) can be broadly described as:

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

A patient has recently been prescribed a drug that treats his hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of:

an adrenergic antagonist

A patient is receiving a beta-1 selective blocker after a myocardial infarction to prevent reinfarction. The nurse understands that the rationale for using the drug would be to:

decrease cardiac workload.

Anticholinergic drugs are used in ophthalmology to:

dilate the pupils

The CNS structure containing groups of neurons responsible for vital cardiac, respiratory, and vasomotor functions is:

the medulla oblongata

When should a patient receiving propantheline (Pro-Banthine) as an adjunctive therapy for peptic ulcers be advised to take the medication?

30 minutes before meals

In which patient is metoprolol mostly likely contraindicated?

A 35-year-old post-MI female with a heart rate of 42 bpm

Which patient should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine?

A 47-year-old female with HTN

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?

Decreased HR

To be an adrenergic nerve, a nerve must contain all of the enzyme and building blocks necessary to produce:

Norepinephrine

The adrenergic branch of the autonomic nervous system is also known by which name?

Sympathetic nervous system

A nurse is monitoring the vital signs of a patient who has been administered epinephrine. Which of the readings should nurse report immediately to the primary health care provider?

Systolic blood pressure below 100 mm Hg

T or F-- Anticholinergic agents are also called parasympatholytic agents.

True

Norepinephrine is mainly:

an excitatory neurotransmitter that stimulates the brain to generalized increased activity

Sympathetic stimulation of the heart causes:

an increased rate and force of myocardial contraction

A nurse in the intensive care unit is caring for a patient in shock and has started IV administration of dopamine (Intropin). For a patient in shock, dopamine helps to:

increase BP

Adrenergic drugs produce which effect?

increased HR

A patient experiences diarrhea after receiving a nonselective adrenergic blocking agent. The nurse understands that this effect is most likely due to:

increased parasympathetic dominance

Students demonstrate understanding of the autonomic nervous system functions when they identify:

regulation of respiration

What would a nurse expect to administer if a client who is receiving isoproterenol develops a severe reaction?

Beta-adrenergic blockers

The nurse knows that which class of drugs prevents epinephrine and norepinephrine from occupying receptor sites on the cell membranes?

Beta-adrenergic blocking drugs

The adrenergic receptors are categorized as alpha or beta. Which action results from stimulation of alpha2 receptors?

inhibited release of norepinephrine