Ch. 12 Cholinergic Drugs

A patient with Parkinson's disease who is prescribed benztropine asks about the purpose of the drug. Which response should the nurse make? a. "Benztropine is used to decrease the muscle tremors and rigidity." b."Benztropine will manage the excessive drooling." c. "Benztropine is used to manage sedation and confusion." d. "Benztropine is a medication to manage gastrointestinal symptoms."

a. "Benztropine is used to decrease the muscle tremors and rigidity."

A patient with an apical pulse of 44 beats/min reports dizziness. Which cholinergic antagonist should the nurse expect the healthcare provider to prescribe? a. Atropine b. Tiotropium c. Tolterodine d. Dicyclomine

a. Atropine

The nurse administers a muscarinic antagonist to a patient. Which response should the nurse expect that demonstrates suppression of acetylcholine at the receptor sites?

a. Decreased heart rate b. Drying of secretions c. Pupil constriction d. Bronchoconstriction

The nurse notes that a patient is prescribed pilocarpine in the right eye three times a day. Which medical diagnosis should the nurse expect for this patient? a. Glaucoma b. Dry eye syndrome c. Eye infection d. Cataract

a. Glaucoma

The nurse is asked to explain cholinergic drugs. In which area should the nurse explain these drugs act in the somatic nervous system? a. In the neuromuscular junction, resulting in skeletal muscle contraction b. In the ganglia c. In the acetylcholine (ACh) synapses located in the autonomic ganglia d. In the neuroeffector junctions

a. In the neuromuscular junction, resulting in skeletal muscle contraction. Cholinergic drugs affect the somatic nervous system by acting at the neuromuscular junction, which results in skeletal muscle contraction.

A patient with a history of chronic obstructive pulmonary disease reports increased dyspnea at times during the day. Which muscarinic antagonist should the nurse suspect to be beneficial for this patient? a. Ipratropium b. Trospium c. Tropicamide d. Benztropine

a. Ipratropium

A patient is prescribed a direct-acting cholinergic agonist. Which action should the nurse expect to occur from this medication? a. It binds to acetylcholine receptors, enhancing the action potential on the postsynaptic neuron. b. It enhances the action potential on the postsynaptic neuron. c. It increases the amount of acetylcholine remaining at the synaptic cleft. d. It binds to the enzyme acetylcholinesterase that prevents acetylcholine from being destroyed.

a. It binds to acetylcholine receptors, enhancing the action potential on the postsynaptic neuron.

The nurse is reviewing the medication profile for a patient in the hospital. Which medication classification should the nurse identify that dries secretions? a. Muscarinic antagonist b. Nicotinic antagonist c. Muscarinic agonist d. Nicotinic agonist

a. Muscarinic antagonist

A patient is prescribed ipratropium. Which should the nurse teach the patient about this medication? a. It causes bronchodilation and opens airways. b. It increases the amount and consistency of secretions. c. It decreases the heart rate and cardiac workload. d. It causes pupillary constriction and decreases photophobia.

a. it causes bronchodilation and opens airways

The nurse assesses a patient receiving a muscarinic agonist. For which finding should the nurse administer atropine? a. Inability to urinate for 8 hours b. Hallucinations and confusion c. Dry mouth and mucous membrane d. Blurred vision

b. Hallucinations and confusion Hallucinations and confusion are signs of muscarinic toxicity. Atropine is the antidote.

A patient with myasthenia gravis is prescribed pyridostigmine (Regonol). Which assessment finding should indicate that the medication is effective? a. Hyperglycemia b. Lack of eye drooping c. Abdominal cramping d. Increased heart rate

b. Lack of eye drooping

A patient is prescribed atropine. Which intervention should the nurse include in the plan of care for this patient? a. place in the prone position. b. Monitor heart rate and rhythm. c. Promote independent ambulation. d. Increase oral fluid intake.

b. Monitor heart rate and rhythm

An older patient is receiving atropine. For which side effect should the nurse add interventions to prevent injury in this patient? a. Dry mouth b. Blurred vision c. Tachycardia

b. blurred vision Atropine can cause blurred vision, increasing the patient's risk for injury. Tachycardia, dry mouth, and constipation affect other body systems, including cardiac and gastrointestinal systems; however, they do not increase this patient's risk for injury.

The nurse reviews the use of neuromuscular blockers and actions with a group of new colleagues. Which statement should indicate that teaching was effective? a. "Neuromuscular blockers compete with acetylcholine for binding with muscarinic receptors." b. "Neuromuscular blockers inhibit transmission at the ganglia in the sympathetic nervous system." c. "Neuromuscular blockers affect skeletal muscles in the somatic nervous system." d. "Neuromuscular blockers allow the symptoms of the sympathetic nervous system to predominate."

c. "Neuromuscular blockers affect skeletal muscles in the somatic nervous system."

A patient is diagnosed with urinary retention. Which medication should the nurse expect to be prescribed? a. Donepezil (Aricept) b. Neostigmine (Bloxiverz) . c. Bethanechol (Urecholine) d. Pyridostigmine (Regonol)

c. Bethanechol

The nurse is preparing to administer a muscarinic antagonist to a patient. Which mechanism of action should the nurse expect from this drug? a. Binds to cholinergic synapse receptors in the parasympathetic nervous system b. Binds to cholinergic synapse receptors in the sympathetic nervous system c. Blocks cholinergic synapse receptors in the parasympathetic nervous system d. Blocks cholinergic synapse receptors in the ganglia or somatic nervous system

c. Blocks cholinergic synapse receptors in the parasympathetic nervous system.

The nurse notes that a patient with bradycardia is prescribed atropine. For which finding in the medical record should the nurse withhold the medication and contact the healthcare provider? a. Peptic ulcer disease. b. Urinary incontinence. c. Glaucoma d. Irritable Bowel Syndrome

c. Glaucoma

The nurse is asked to explain cholinergic drugs. In which area should the nurse explain these drugs act in the somatic nervous system? a. In the neuroeffector junctions b. In the acetylcholine (ACh) synapses located in the autonomic ganglia c. In the neuromuscular junction, resulting in skeletal muscle contraction d. In the ganglia

c. In the neuromuscular junction, resulting in skeletal muscle contraction Cholinergic drugs affect the somatic nervous system by acting at the neuromuscular junction, which results in skeletal muscle contraction.

The nurse is preparing to administer a cholinergic antagonist to an older patient with decreased mobility. Which nursing intervention should the nurse include to prevent complications from this drug? a. Maintain a well-lit room. b. Keep the room warm. c. Increase dietary fiber. d. Enforce fluid restriction.

c. Increase dietary fiber

A patient with pneumonia has increased dyspnea, crackles in the lung bases, and an oxygen saturation level of 89%. Which should the nurse expect to assess after administering ipratropium to this patient? a. increased nasal congestion b. Decreased pulmonary congestion c. Increased oxygen saturation d. Decreased physical endurance

c. Increased oxygen saturation Ipratropium is a muscarinic antagonist whose effects cause bronchodilation, which in turn improves breathing.

A patient is prescribed atropine. For which additional medication should the nurse question giving this medication? a. Guaifenesin b. Lisinopril c. Quinidine

c. Quinidine

A patient asks why dicyclomine was prescribed. Which information should the nurse provide about its use? a. "It decreases gastric acid secretions in patients with peptic ulcer disease." b. "It relaxes smooth muscle in the urinary bladder, decreasing incontinence." c. "It relaxes smooth muscle in the bronchial tree, which opens the airways." d. "It decreases gastrointestinal motility related to irritable bowel syndrome."

d. "It decreases gastrointestinal motility related to irritable bowel syndrome."

A patient taking bethanechol (Urecholine) asks when to expect to feel the effects of the medication. Which information should the nurse provide the patient? a. 5-10 minutes b. 1-6 hours c. 1-2 days d. 30-60 minutes

d. 30-60 minutes

The nurse is preparing to administer a muscarinic antagonist to a patient. Which mechanism of action should the nurse expect from this drug? a. Blocks cholinergic synapse receptors in the ganglia or somatic nervous system b. Binds to cholinergic synapse receptors in the parasympathetic nervous system c. Binds to cholinergic synapse receptors in the sympathetic nervous system d. Blocks cholinergic synapse receptors in the parasympathetic nervous system

d. Blocks cholinergic synapse receptors in the parasympathetic nervous system

A patient reports long-term use of bethanechol (Urecholine). Which finding should indicate to the nurse that the medication is no longer effective? a. Difficulty swallowing b. Blurred vision c. Increased diaphoresis d. Distended bladder

d. Distended Bladder Bethanechol is used in the treatment of urinary retention

The nurse provides a dose of donepezil (Aricept) to a patient with new-onset Alzheimer's disease. Which outcome should the nurse expect in this patient? a. Slowed progression of Alzheimer's disease. b. A cure for Alzheimer's disease. c. Long-term ability to perform self-care. d. Improvement in memory and cognitive function.

d. Improvement in memory and cognitive function

A patient with a history of chronic obstructive pulmonary disease reports increased dyspnea at times during the day. Which muscarinic antagonist should the nurse suspect to be beneficial for this patient? a. Tropicamide b. Trospium c. Benztropine d. Ipratropium

d. Ipratropium Ipratropium is a muscarinic antagonist that dilates the airways by relaxing bronchial smooth muscle

A patient reports problems with urge urinary incontinence. Which muscarinic antagonist should the nurse expect to be prescribed? a. Ipratropium b. Donepezil c. Benztropine d. Oxybutynin

d. Oxybutynin

A patient with urinary retention is prescribed bethanechol (Urecholine). For which side effect should the nurse monitor the patient? a. Urinary incontinence b. Seizures c. Changes in respiratory rate and pattern d. orthostatic hypotension

d. orthostatic hypotension