chapter 18 adaptive quizzing - pharmacology

The health care provider has prescribed lidocaine with epinephrine for injection to be administered before obtaining a biopsy. The nurse will question the prescription after the patient makes which statement? 1 "I get faint when I see needles." 2 "I'm getting over a cold I've had for 3 days." 3 "I break out in a rash when I take antibiotics." 4 "I am taking a new medicine for high blood pressure."

"I am taking a new medicine for high blood pressure"

The patient has been ordered salmeterol as a medication to treat asthma symptoms. Which statement indicates that the patient understands how to take the medication?

"I will give myself one puff twice a day at 7 am and 7 pm."

The patient is being treated with oral midodrine. The nurse instructs the patient that which is the best time to take this medication? 1 2100 2 1500 3 1200 4 0700

0700

The patient is being treated with epinephrine in a code situation. The nurse finds on the crash cart a solution marked "epinephrine 1:10,000." What does the nurse interpret the strength of the medication to mean? 1 1 gram of medication contained in 1 mL of solution 2 1 kilogram of medication contained in 1 mL of solution 3 0.1 milligram of medication contained in 1 mL of solution 4 10 micrograms of medication contained in 1 mL of solution

1 gram of medication contained in 1 mL of solution

What is the most accurate outcome criteria for the nurse to use when determining if a patient is responding appropriately to use of an adrenergic drug? 1 Patient is able to correctly state three side effects of the medication. 2 Patient is alert to time, person, and place and makes coherent conversation. 3 Patient awakens easily during nurse's morning rounds and states, "I feel fine." 4 Patient's respiratory rate is 16 breaths/minute and blood pressure is 130/72 mm Hg.

Patient's respiratory rate is 16 breaths/minute and blood pressure is 130/72 mm Hg.

The patient has been placed on salmeterol. The patient tells the nurse, "I don't understand why this inhaler doesn't help when I'm having an asthma attack." The nurse frames the response based on which information? 1 Salmeterol is not designed to relieve acute symptoms. 2 Salmeterol can be given as needed throughout the day. 3 Salmeterol should never be combined with another inhalant. 4 Salmeterol must be administered according to specific instructions.

Salmeterol is not designed to relieve acute symptoms.

Epinephrine 1 mg intravenous (IV) push is ordered for a patient during a cardiac emergency situation. Epinephrine 1:10,000 strength is available. How many milliliters will the nurse administer? _______________ mL

When giving epinephrine, it is important to choose the correct dosage form. Ratio solutions indicate the number of grams of the medication per total milliliters of solution. Be sure you know what the numbers mean! A medication that is designated 1:10,000 has 0.1 milligram of medication per 1 mL of solution.

The nurse is caring for several patients who are being treated with adrenergic drugs to treat various conditions. Which patient is at greatest risk for experiencing an adverse reaction to the medication? A 32-year-old with sinusitis 2 A 17-year-old with bronchial asthma 3 A 55-year-old with cardiac symptoms 4 A 72-year-old who has an ophthalmic condition

a 72 year old who has an ophthalmic condition

midodrine

an alpha 1 agonist is mainly in the treatment of symptomatic orthostatic hypotension so the nurse should teach the patient to rise slowly out of bed each morning should not affect the temperature or respiratory rate reflex tachycardia may occur after taking this medication so patients might be instructed to evaluate pulse after dosing not check the pulse before dosing

dopamine epinephrine and norepinephrine

are endogenous catecholamines that are synthesized in the body are available as both endogenous and exogenous (synthetic) substances

beta 2 agonists

are helpful in treating conditions such as asthma

contraindications of adrenergic drugs

are know drug allergy and severe hypertension

dobutamine and phenylephrine

are synthetic catecholamines that are administered into the body to treat disorders caused by the deficiency of endogenous catecholamines

A patient with cardiac decompensation is receiving dobutamine as a continuous infusion. The patient's blood pressure has increased from 100/70 mm Hg to 130/80 mm Hg. What is the nurse's priority action? 1 Assess frequent blood pressure readings. 2 Assess the patient's electrocardiogram and slow the infusion. 3 Assess the patient's respiratory rate and measure arterial blood gases. 4 Assess the patient's intake and output and decrease intravenous fluids.

assess frequent blood pressure readings

mydriasis

dilation of the pupil of the eye

dopamine infiltration

bruising and edema are signs of dopamine infiltration. the infusion should be stopped immediately to prevent further harm to the patient after stopping the IV infusion the health care provider can be notified another IV line will likely need to be started but the dopamine must be stopped first. after the dopamine is stopped the arm will need to be elevated to reduce swelling

The nurse recognizes that which condition is an indication for the use of norepinephrine? 1 Asthma 2 Anaphylaxis 3 Hypertension 4 Cardiogenic shock

cardiogenic shock

beta 1 adrenergic receptors stimulation

causes increase renin secretion

What is the most important assessment to complete before the nurse administers a positive chronotropic medication? 1 Auscultate lungs. 2 Check apical pulse. 3 Count respiratory rate. 4 Take blood pressure.

check apical pulse

When administering adrenergic agonist medications to an older adult, the nurse will monitor this patient closely because of what common physiologic changes found in this age group? Select all that apply. 1 Increase in cardiac output 2 Increased filtering capacity of kidneys 3 Diminished stroke volume of the heart 4 Decline in efficiency of the heart muscle 5 Increase in contractility of the heart muscle

diminished stroke volume of the heart decline in efficiency of the heart muscle

In order to produce a sympathomimetic response, the nurse may administer which medication that is only available as a synthetic substance? 1 Dopamine 2 Epinephrine 3 Dobutamine 4 Norepinephrine

dobutamine

Which are examples of endogenous catecholamines? Select all that apply. 1 Dopamine 2 Epinephrine 3 Dobutamine 4 Phenylephrine 5 Norepinephrine

dopamine, epinephrine, and norepinephrine

The nurse is reviewing a patient's medical history and recognizes which conditions as usual contraindications to the use of adrenergic medications? Select all that apply. 1 Pregnancy 2 Migraines 3 Drug allergy 4 Hypertension 5 Diverticulitis

drug allergy hypertension

The patient has been using both a corticosteroid inhalant and a bronchodilator for treatment of asthma symptoms. Which patient statement indicates understanding of how to appropriately administer these medications? 1 "I will use the bronchodilator drug in the morning and the corticosteroid at bedtime." 2 "I will use both of the drugs in the morning, and both again at bedtime to get the full effect." 3 "I will use the bronchodilator first, and then immediately follow with the corticosteroid inhalant." 4 "I will use the bronchodilator first, wait 5 minutes, and then use the corticosteroid inhalant."

i will use the bronchodilator first wait 5 minutes and then use the corticosteroid inhalant

Which outcome would be most appropriate to establish for patients taking beta1 agonists? 1 Relaxation of uterine smooth muscle 2 Increased contractility of myocardium 3 Relaxation of bronchial smooth muscle 4 Increased resistance of peripheral vessels

increased contractility of myocardium

Which response is elicited by the activation of beta1 receptors located on the sinoatrial node? 1 Vasodilation 2 Vasoconstriction 3 Increased heart rate 4 Increased contractility

increased heart rate

The nurse is caring for a patient who is undergoing treatment with an alpha-adrenergic drug. The nurse is monitoring daily laboratory test results on the patient. Because of the patient's treatment with the alpha-adrenergic drug, the nurse anticipates that the laboratory tests will show which result? 1 Increased level of glucose 2 Increased level of calcium 3 Increased level of potassium 4 Increased level of magnesium

increased level of glucose

The nurse knows that which is an effect of beta1-adrenergic receptor stimulation? 1 Mydriasis 2 Ejaculation 3 Vasoconstriction 4 Increased renin secretion

increased renin secretions

a positive chonotropic agent

increases heart rate therefore the nurse will take an apical pulse before administering this type of medication

fenoldopam

is a peripheral dopamine agonist that causes blood pressure to drop

dobutamine

is a positive inotrope is a sythetic catecholamine

Epinephrine

is an adrenergic agonist that causes vasoconstriction and raises blood pressure

salmeterol

is designed to be administered as one puff twice a day, 12 hours apart

norepinephrine

is directly metabolized to dopamine and is used primarily in the treatment of hypotension and shock hyper tension is a contraindication to the use of this

orthostatic intolerance

is the development of symptoms when standing upright which are relieved when reclining.

epinephrine

is used in the treatment of anaphylaxis

Midodrine

is usually ordered to be given with forcing of fluids before the patient gets out of bed in the morning. Doses of the drug are often front-loaded in their dosing schedule so that most of the doses occur in the morning when patients with orthostatic intolerance are usually more symptomatic

midodrine

is usually ordered to be taken with forced fluids before the morning

A nurse obtaining a health history discovers that the patient has been recently diagnosed with mitral valve regurgitation. Because of concern of aggravating the patient's diagnosis, which prescribed medications will the nurse question? Select all that apply. 1 Midodrine 2 Dobutamine 3 Fenoldopam 4 Phenylephrine 5 Norepinephrine

midodrine, phenylephrine and norepinephrine becuase these meidcaitons are alpha1 receptor agonists that cause vasocontriction which will aggravate mitral valve regurgitation by increasing preload and impeding the forward flow of blood

The nurse is administering an alpha1 agonist to a postpartum patient. How will the nurse evaluate the therapeutic effectiveness of the medication? Select all that apply. 1 Monitor pulse rate. 2 Assess blood pressure. 3 Listen to breath sounds. 4 Palpate fundal firmness. 5 Auscultate bowel sounds. 6 Check level of consciousness.

monitor pulse rate assess blood pressure palpate fundal firmness

alpha 1 adrenergic receptor stimulation

mydriasis ejaculation vasoconstriction occur as a result

The patient has been placed on midodrine. Which patient statement indicates an understanding of the importance of administering the medication according to specified instructions? 1 "I will take the first dose with just a sip of water after I get up each morning." 2 "I will take the first dose midmorning after I have been up for a couple of hours." 3 "I will take the first dose after I get up in the morning and have eaten my breakfast." 4 "I will take the first dose in the morning with a full glass of water before I get out of bed."

no later than 6pm i will take the first dose in the morning with a full glass of water before i get out of bed

A patient who was recently prescribed an adrenergic medication now complains of itching in both legs. What is the nurse's best action? 1 Notify the health care provider. 2 Apply petroleum jelly on both legs. 3 Explain that itching is an expected side effect. 4 Recommend an over-the-counter antihistamine

notify the health care provider itching is not a common side effect of adrenergic medications

The patient has been ordered a new medication in the form of an inhalant. The patient tells the nurse that the inside of her mouth is irritated. What is the most important instruction to give this patient? 1 "Rinse all equipment thoroughly after each usage." 2 "Inspect your mouth frequently for evidence of irritation." 3 "Rinse your mouth thoroughly after using the medication." 4 "Make certain there is a waiting period between using the medications."

rinse your mouth thorougly after using the medication

The teaching plan for a patient taking midodrine should include which instruction? 1 Rise slowly out of bed each morning. 2 Check your pulse before taking this medication. 3 Take your temperature at the same time each day. 4 Count your respirations before taking this medication.

rise slowly out of bed each morning

When teaching an 83-year-old patient about the effects of adrenergic agonists, the nurse will advise the patient to avoid which activity? 1 Slow jog in summer 2 Daily walk around the block 3 Visiting wife in long-term care facility 4 Taking prescribed herbal supplements

slow jog in summer

During IV administration of dopamine, the nurse notes a bruise, "bluish in color," and edema at the intravenous (IV) insertion site on the patient's right arm. What is the nurse's priority action? 1 Stop the dopamine infusion. 2 Notify the health care provider. 3 Start a second IV line in the left hand. 4 Elevate the right arm above heart level.

stop the dopamine infusion

The nurse assesses the peripheral intravenous (IV) infusion site of a patient receiving intravenous dopamine and suspects extravasation. What is the nurse's priority action? 1 Stop the infusion. 2 Pull the IV immediately. 3 Apply a cold pad to the site. 4 Elevate the patient's extremity.

stop the infusion

unusual demands placed on the heart that may cause problems or/and complications

strenuous activities, excess stress, heat, and medication use

The patient is an older adult who has been placed on a beta-adrenergic agonist. The patient complains to the nurse of experiencing headaches after being on the drug for several days. What is the nurse's highest priority action? 1 Reassure the patient that this is an expected side effect of the medication. 2 Take the patient's blood pressure and notify the prescribing health care provider. 3 Question the patient about what over-the-counter medications he uses to treat headaches. 4 Instruct the patient to maintain a symptom diary documenting the incidence of the headaches.

take the patient's blood pressure and notify the prescribing health care provider

adrenergic drugs

the elderly and the very young may react with increased sensitivity to these drugs

beta-adrenergic agonists

will affect blood pressure and pulse rate the prescribing health care provider should be notified of incidence of chest pain palpitations headaches or seizures