Chapter 46 Autonomic & CNS - Drug Therapy

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

-Synapses -Receptors -Neurotransmitters Explanation: Specific components of the neurotransmission network include neurotransmitters, synapses, and receptors.

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? A) The client has "pinpoint" pupils. B) The client's blood pressure is 119/72 mmHg. C) The client describes a frontal lobe headache. D) The client's attention span is unusually short.

The client has "pinpoint" pupils. Explanation: Pupil constriction is among the effect of parasympathetic stimulation of muscarinic cholinergic receptors. Pain and cognition are not affected by these receptors. The client's blood pressure is well within acceptable ranges; there is no obvious indication of parasympathetic stimulation.

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

an increase in blood pressure, bronchi dilation, and decreased bowel sounds Explanation: Increase in blood pressure, bronchi dilation, and decreased bowel sounds are responses to sympathetic stimulation. Decrease in sweating, respirations, heart rate, and blood flow to skeletal muscles and increase in motility and secretions of GI tract and inflammatory reactions, and pupil and bronchi constrictions indicate parasympathetic stimulation.

After teaching a group of students about the functions of the nervous system, the instructor determines that the teaching was effective when the students identify that a function is: A) control of body functions. B) generation of incoming stimuli. C) prevention of stimulus exposure. D) separation of responses.

control of body functions. Explanation: The nervous system is responsible for controlling body function, analyzing incoming stimuli, and integrating internal and external responses.

The nurse is caring for a client who is known to have deficient levels of dopamine because of a dietary lack of tyrosine. The nurse should expect to assess for evidence of: A) increased adrenergic response. B) hyperfunction of the sympathetic nervous system. C) decreased adrenergic response. D) overstimulation of nicotinic receptors.

decreased adrenergic response. Explanation: Dopamine is a precursor to norepinephrine, which is one of the two major postganglionic neurotransmitters of the sympathetic nervous system. Consequently, low levels of dopamine could plausibly lead to a decreased adrenergic response. This would not affect the function of cholinergic neurons. Hypofunction, not hyperfunction, of the SNS would be likely.

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: A) antagonizing alpha2-receptors. B) stimulating beta2-receptors. C) converting a larger proportion of dopamine to norepinephrine. D) decreasing the reuptake of acetylcholine.

stimulating beta2-receptors. Explanation: Stimulation of beta2-receptors causes bronchial dilation. Manipulation of acetylcholine levels does not cause this effect, not does increasing norepinephrine levels. Antagonizing the alpha2-receptors would not have this effect.

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

tyrosine Explanation: Norepinephrine is made by adrenergic nerves using tyrosine from the diet. Thiamine and tryptophan are unrelated. trichinosis is a sexually transmitted infection.

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

tyrosine Explanation: Norepinephrine is made by adrenergic nerves using tyrosine from the diet. Thiamine and tryptophan are unrelated. trichinosis is a sexually transmitted infection.

A client's nerve has been stimulated by pain and the resulting electrical action potential has reached the end of the axon. What will happen next? A) A neurotransmitter will be released into the synaptic cleft B) The signal will revert back to the neuronal cell body C) The signal will cross the synaptic cleft and continue via a new neuron D) The adjacent nerve will be electrically stimulated

A neurotransmitter will be released into the synaptic cleft Explanation: When the electrical action potential reaches the end of an axon, the electrical impulse comes to a halt. The transmission of information between two nerves or between a nerve and a gland or muscle is chemical. The nerve axon, called the presynaptic nerve, releases a chemical called a neurotransmitter into the synaptic cleft, and the neurotransmitter reacts with a very specific receptor site on the postsynaptic cell to cause a reaction. The signal does not revert back to the cell body.

Nicotinic receptors would be found in which location? A) Sweat glands B) Bladder C) Adrenal medulla D) Gastrointestinal tract

Adrenal medulla Explanation: Nicotinic receptors are found in the CNS, the adrenal medulla, the autonomic ganglia, and the neuromuscular junction. Muscarinic receptors are found in the sweat glands, bladder and GI tract.

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

Beta-2 Explanation: Bronchodilation occurs with stimulation of beta-2 receptor sites. Vasoconstriction and increased peripheral vascular resistance occurs with alpha-1 receptor stimulation. Overstimulation of effector sites and moderate insulin release occurs with alpha-2 stimulation. Increased heart rate occurs with beta-1 receptor stimulation.

Which effect results from activation of beta2 receptors? A) Bronchoconstriction B) Pupil constriction C) Bronchodilation D) Decreased heart rate

Bronchodilation Explanation: Activation of beta2 receptors results in bronchodilation.

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

Disruptions in the levels of norepinephrine and epinephrine Explanation: The adrenal medulla produces epinephrine and norepinephrine, but not dopamine. Impaired adrenal medullary functions would be unlikely to affect action potentials or the function of the sodium potassium pump throughout the nervous system.

A nurse is reviewing the structure and function of the nervous system in preparation for working on a neurological floor. What characteristic of neurons should the nurse identify? A) Neurons convey action potentials to other neurons without being in physical contact. B) Neurons are unique among body cells because they do not have a nucleus. C) Dendrites are roughly equal in size to axons. D) The ability to generate new nerves after injury ceases near puberty.

Neurons convey action potentials to other neurons without being in physical contact. Explanation: Nerve to nerve communication occurs across synaptic clefts; the two nerves that communicate to each other are not in physical contact. Neurons have nuclei and axons are sometimes exponentially longer than dendrites. New nerves cannot be produced.

The anatomy and physiology instructor is discussing the role of neurotransmitters in the autonomic nervous system. Which would the instructor identify as the main adrenergic neurotransmitter? A) Dopamine B) Epinephrine C) Norepinephrine D) Acetylcholine

Norepinephrine Explanation: Adrenergic refers to the sympathetic nervous system. The main neurotransmitter of the sympathetic nervous system is norepinephrine.

A nurse is reading an article about the fight or flight response that includes a discussion of a neurotransmitter. Which neurotransmitter most likely would be addressed? A) Serotonin B) Dopamine C) Norepinephrine D) GABA

Norepinephrine Explanation: Norepinephrine is a catecholamine involved in the fight or flight response. GABA is important in preventing overexcitability or stimulation of nerve activity. Serotonin is an important neurotransmitter involved in arousal and sleep. Dopamine is involved in the coordination of impulses and responses, both motor and intellectual.

What statement best explains the central and peripheral nervous system? A) The central nervous system (CNS) can be broken down into the somatic and autonomic pathways. B) Structures of the central nervous system include the brain, neurons, and ganglia. C) Structures of the peripheral nervous system include the hypothalamus, brain stem, and spinal column. D) 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. Explanation: The nervous system has two main divisions: the central nervous system and the peripheral nervous system. The CNS includes the brain and spinal cord, while the PNS includes the neurons and ganglia around outside the CNS. The efferent portion of the PNS has two subdivisions: the somatic and autonomic nervous system.

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

activities designed to maintain a constant internal environment, to respond to stress or emergencies, and to repair body tissues. Explanation: The functions of the ANS can be broadly described as activities designed to maintain a constant internal environment (homeostasis), to respond to stress or emergencies, and to repair body tissues.

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) an increase in blood pressure, bronchi dilation, and decreased bowel sounds C) a decrease in sweating, decrease in respirations, and pupil constriction. D) a decrease in heart rate, decrease in blood flow to skeletal muscles, and increase in inflammatory reactions.

an increase in blood pressure, bronchi dilation, and decreased bowel sounds Explanation: Increase in blood pressure, bronchi dilation, and decreased bowel sounds are responses to sympathetic stimulation. Decrease in sweating, respirations, heart rate, and blood flow to skeletal muscles and increase in motility and secretions of GI tract and inflammatory reactions, and pupil and bronchi constrictions indicate parasympathetic stimulation.