Pharmacology Study Guide ***Exam 2*** Memorize

The nurse is assessing a client who has urinary hesitation and occasional overflow incontinence. What adrenergic receptors may be overstimulated in this client?

Alpha-1

Which receptor does phenylephrine stimulate?

Alpha1

A provider orders timolol (Timoptic) for glaucoma. The order reads Timoptic 1 gtt PO bid. The nurse knows that something is wrong with this order. What is it?

Timoptic is given in the eye, not PO.

A 35-year-old female has been diagnosed with hyperthyroidism. Her health care provider has prescribed propranolol to achieve which effect?

To decrease heart rate

Most nonselective adrenergic blockers are used to treat hypertension. True False

True

Which effect results from activation of beta2 receptors?

bronchodilation

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 heart rate

A nurse would instruct a patient to apply a clonidine patch at which frequency?

every 7 days

The nurse is admitting a client with injuries following a bicycle crash. When reviewing the client's pre-admission medication regimen, the nurse reads that the client takes formoterol twice daily. When planning this client's care, the nurse should include:

frequent respiratory assessments.

A nurse is caring for a client in the critical care unit. Phentolamine (Regitine, OraVerse) has been ordered for the management of tissue necrosis caused by extravasation of parenterally administered drugs. Before administering this drug, the nurse will check the client's chart for indications of:

history of acute myocardial infarction.

The client has been ordered a nonselective beta-blocking agent called propranolol, PO. Propranolol is used in the treatment of which disorders?

hypertension angina cardiac arrhythmias hypertrophic subaortic stenosis migraine prophylaxis myocardial infarction.

A patient with diabetes who uses insulin is also receiving labetalol. The nurse would monitor the patient closely for:

hypoglycemia.

The male client is prescribed prazosin (Minipress) for hypertension. He asks the nurse how the medication works. What is the nurse's best response?

"It works by making your blood vessels dilate."

A patient is to receive metoprolol. What would the nurse include in the teaching plan for this patient?

"Take this drug with food to help promote its absorption."

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

"Talk to your health care provider before taking any other medications."

Which would be included when describing the parasympathetic nervous system structure and function?

* Ganglia are located close to or within the effector tissue. * Muscarinic and nicotinic receptors are found in the parasympathetic nervous system.

After the nurse administers an adrenergic medication to the client, the nurse would provide which interventions because of the drug's actions on the body?

* Provide sunglasses to wear. * Increase fluid intake.

The nurse would predict which assessment findings after administering a parasympathomimetic medication to the client?

* Pupils are constricted bilaterally. * Client states, "I am able to empty my bladder easier." * Pulse before med: 90 and after med: 70.

A client is experiencing anxiety and consequent stimulation of the sympathetic nervous system. The nurse is aware that norepinephrine is being released into synapses. Overstimulation by this neurotransmitter will be prevented by what physiological processes?

* Reuptake into the presynaptic neuron * Deactivation by monoamine oxidase * Deactivation by catechol-O-methyl transferase (COMT)

The main nerve centers for the autonomic nervous system (ANS) are located in which locations?

* Spinal cord * Medulla * Hypothalamus

The nurse administers intravenous (IV) norepinephrine to the client diagnosed with shock. The nurse would predict which receptor subtypes to be activated resulting in a stimulatory response?

* alpha1 * alpha2 * beta1

Which body functions are controlled by the autonomic nervous system (ANS)?

* blood pressure * digestion * heart rate * metabolism

The nurse is caring for a client who is under psychological and physiological stress. During sympathetic stimulation, the nurse should identify which neurotransmitter is being released by the preganglionic nerves of the sympathetic nervous system?

Acetylcholine

What does the body create using choline?

Acetylcholine

First-dose effect occurs when the client experiences marked hypotension and syncope with sudden loss of consciousness with the first few doses of the sympatholytic. Which intervention might be helpful for the nurse to do to decrease the risk for first-dose effect?

Administer the dose at bedtime

Nicotinic receptors would be found in which location?

Adrenal medulla

A client is experiencing sympathetic stimulation in response to a stressful event. Which substance will most affect the client's sodium and water retention?

Aldosterone

Which of the following adrenergic receptors is responsible for the vasoconstriction of peripheral blood vessels?

Alpha 1 receptors

A client has been diagnosed with pheochromocytoma and has severe hypertension. The nurse knows that the client would be prescribed which type of medication?

An alpha-adrenergic blocker

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

Which of the following adrenergic receptors is responsible for increased heart rate and increased force of myocardial contraction?

Beta 1 receptors

A client with asthma is prescribed albuterol dilate the bronchioles. The nurse understands that this drug is likely acting on which receptors?

Beta-2

Which adrenergic receptor is responsible for vasodilation of peripheral vessels and bronchodilation?

Beta-2 Receptors

A client is being treated for asthma. What would the nurse expect to administer?

Beta-2-specific adrenergic agonist

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

Beta-adrenergic blocking drugs

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 medications.

A client receives a beta-specific agonist. What would lead the nurse to determine that the drug is effective?

Bronchodilation

The nurse is administering an adrenergic agonist to a client. The nurse realizes that this medication will cause stimulation of the sympathetic nervous system. Which effects will it produce?

Bronchodilation Decreased bladder tone

Deactivation of norepinephrine (NE) occurs by breakdown of NE by which enzyme?

COMT

A 21-year-old man experienced massive trauma and blood loss during a motorcycle accident and has been started on a dopamine infusion upon his arrival at the hospital. In light of this drug treatment, what assessment should the care team prioritize?

Cardiac monitoring

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

Which agent would the nurse identify as being available in a transdermal form?

Clonidine

A nurse is caring for a 25-year-old client who is being given an adrenergic drug for shock. Which action should the nurse do?

Continually assess the client for physiological changes and notify the primary care provider with changes.

A nurse suspects that a client is experiencing shock based on which assessments?

Cyanosis Disorientation Tachypnea

A client has been prescribed an adrenergic blocking drug for glaucoma. Which nursing interventions should the nurse include when teaching the client?

Demonstrate the technique of eye drop instillation

Adrenergic medications such as epinephrine and dopamine are commonly used for in the treatment of clients in which places?

Dentist's office Intensive care unit Emergency department

Which would the nurse identify as a naturally occurring catecholamine?

Dopamine

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

Ephedra

A patient with diabetes who receives an alpha-specific adrenergic agonist is at risk for hypoglycemia? True FALSE

FALSE

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

FALSE

Alpha- and beta-specific adrenergic agonists are primarily used to treat obstructive pulmonary conditions. True False

False

Nonselective beta blockers are the drugs of choice for treating hypertension in patients who smoke. True False

False

Which is NOT a function of the body's homeostatic control systems?

Feed cells under stress

The nurse is providing care for a client whose health history includes type 1 diabetes, peripheral vascular disease, environmental allergies and rheumatoid arthritis. The client is transitioning from living independently to living in a long-term care facility, which is causing the client intense stress. This stimulation of the client's sympathetic nervous system should prompt the nurse to prioritize what assessment?

Frequent blood glucose monitoring

The nurse is reviewing the history of a patient who is to receive midodrine. Which would alert the nurse to a contraindication for the drug?

Glaucoma

The sympathetic and the parasympathetic nervous systems are continuously at work in our bodies. This continual action provides a sense of balance to all parts of the body. What is the term used to represent this sense of balance?

Homeostasis

Which is an effect of epinephrine?

Increased heart rate

Which is expected after the administration of an adrenergic medication such as epinephrine?

Increased heart rate Vasoconstriction

A patient is receiving salmeterol. The nurse would expect this drug to be given by which route?

Inhalation

The adrenergic receptors are categorized as alpha or beta. Which action results from stimulation of alpha 2 receptors?

Inhibited release of norepinephrine

After reviewing the routes of administration for beta-specific adrenergic agonists, a group of students demonstrate the need for additional study when they identify isoproterenol as being administered by which route?

Oral

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

Photophobia

Which adverse effect might a client receiving clonidine exhibit?

Photophobia Personality changes Difficulty urinating

A nurse must recognize which class of medication a drug is part of in order to help in planning ongoing assessment and patient education. Which is an example of a drug in the class of beta-adrenergic blockers?

Propranolol (Inderal) Metoprolol (Lopressor) Atenolol (Tenormin)

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

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 has "pinpoint" pupils.

A client's pain is causing stimulation of the sympathetic nervous system, including alpha1-receptors. What assessment finding should the nurse ascribe to the stimulation of these receptors?

The client's pupils are dilated to 8 mm

A patient has been diagnosed with benign prostatic hypertrophy and has been prescribed prazosin (Minipress) to assist in the treatment of the symptoms. How does this alpha1-blocking agent decrease urinary retention?

The medication inhibits urinary bladder contraction.

When describing the sympathetic nervous system, the instructor would include:

The relatively long postganglionic fibers synapse with neuroeffectors.

Prior to beginning therapy with an adrenergic agent, the nurse would expect to obtain what assessments?

Vital signs Urinalysis Blood glucose

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 client has an IV of dopamine administered in the right arm. The IV becomes dislodged from the vein and dopamine has been being given in the surrounding tissue instead of the vein. The nurse should stop the IV and:

administer phentolamine (an alpha adrenergic blocking drug) to the site to minimize necrosis.

A client presents to the emergency department reporting rapid heart rate, severe headache, and pounding in the chest. While obtaining the clients history, the nurse learns the client stopped taking medications because the prescriptions ran out and had no funds to refill them. The nurse knows that which medications being abruptly stopped could be causing these symptoms?

an adrenergic blocking drug (lol ending)

A 75-year-old male with no history of hypertension has been prescribed nadolol. The nurse knows that the client is likely taking the drug to treat:

angina.

A client with chronic obstructive pulmonary disease (COPD) is experiencing bronchoconstriction. When choosing interventions to address this problem, the nurse should aim to influence the client's autonomic nervous system by stimulating:

beta-adrenergic receptors.

An adrenergic drug would be prescribed to produce what physiological effect?

increased heart rate

What is the expected outcome when phenylephrine is administered?

increased systolic blood pressure increased diastolic blood pressure decreased renal perfusion

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

intraocular pressure decreases

The intravenous line of a client receiving dobutamine infiltrates and the drug extravasates. The nurse would infiltrate the site with:

phentolamine

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:

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 beta1 receptors in the sympathetic nervous system.

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

Which type of cells synthesize and store norepinephrine and epinephrine?

Chromaffin

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

Epinephrine

Epinephrine acts in which receptors?

* Epinephrine acts on beta receptors. * Epinephrine acts on alpha receptors.

After the nurse administers a cholinergic medication to the client, the nurse would provide which interventions because of the drug's actions on the body?

* Auscultate lung sounds and report bronchoconstriction. * Instruct client to report diarrhea. * Compare muscle strength to baseline for improvement.

Which statements are correct regarding the autonomic nervous system (ANS) receptors?

* Drug effects depend on the branch of the ANS involved. * Medications can either stimulate or inhibit the ANS.

A client is receiving phenylephrine via intramuscular injection. The nurse would expect the drug to begin acting in approximately which amount of time?

10 to 15 minutes

A patient is using his incentive spirometer during the postoperative period. The skeletal muscles during the use of the incentive spirometer are stimulated by which neurotransmitter?

Acetylcholine

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

Norepinephrine

After teaching a group of students about beta-1 selective blockers, the instructor determines that the teaching was successful when the students identify what as a contraindication to using this group of drugs?

Sinus bradycardia

Which receptor is found in the beta cells of the pancreas?

Alpha-2

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

Decrease the heart rate

A patient suffers from bronchial asthma. Which medication is a mixed-acting adrenergic drug?

Ephedrine

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 medication will most likely be administered to a client experiencing anaphylaxis?

Epinephrine

A client has had a stroke and computed tomography reveals infarcts in multiple brain regions. An infarct in which region is most likely to affect the function of the client's autonomic nervous system?

Hypothalamus

Which assessment finding would indicate to the nurse that the administered isoproterenol is effective?

Improved cardiac contractility

The nurse knows that what is an added benefit of epinephrine in cardiac arrest situations due to asystole or pulseless electrical activity?

Stimulates electrical and mechanical activity

The nurse is administering epinephrine IV push. The nurse checks for patency of the IV prior to administration of the drug. The nurse realizes that if the IV is infiltrated, the medication will result in tissue extravasation. What is the reason for such an occurrence?

The medication causes vasoconstriction, limiting the blood flow to the area.

Patients who are receiving alpha-specific adrenergic agents should not stop taking the drug abruptly. True False

True

Phentolamine is the agent used to treat extravasation of dobutamine. True False

True

A client is taking an OTC allergy product. The nurse would expect to find that this product most likely contains:

phenylephrine

In the sympathetic nervous system, which is the origin of central nervous system nerves?

thoracic spinal cord

A 70-year-old man with diabetes mellitus is taking metoprolol (Lopressor) to manage his hypertension. The nurse would be sure to instruct the patient to:

understand the signs and symptoms of hypoglycemia.

A patient receives intravenous labetalol. The nurse would expect this drug to exert its maximum effectiveness within which time frame?

5 minutes

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

an adrenergic antagonist.

The nurse prepares to administer a preoperative anticholinergic to a client. What is a desired effect based upon the characteristics of the prescribed medication?

dry mucous membranes

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

increase blood pressure.

Which receptor is responsible for increasing blood pressure?

alpha1 receptors

What is the first drug of choice for treatment of a client with a history of a myocardial infarction (MI) 2 years ago?

beta-blockers

A male client is prescribed an adrenergic ophthalmic medication. What should the nurse include in the teaching plan?

Hypertension may be a side effect of the medication.