Exam 1 : Pharmacology
The nurse administers a medication that only stimulates nicotinic receptors. What effects would the nurse expect to occur? Select all that apply. muscle contraction release of epinephrine from adrenal medulla signs and symptoms of a stress reaction slowing heart rate increased bladder contraction
muscle contraction release of epinephrine from adrenal medulla signs and symptoms of a stress reaction
Parasympathetic stimulation causes the release of nitrous oxide from the endothelium of blood vessels. Which of the following results from this release? Increased inflammation Increased platelet aggregation Relaxation of vascular smooth muscle Constriction of blood vessels
Relaxation of vascular smooth muscle
What is the resulting physiologic effect when the parasympathetic nervous system is stimulated? Decreased GI secretions Increased GI motility Increased heart rate Pupil dilation
Increased GI motility
What is a prototype drug?
Individual drug that represents a group of drugs
What is the role of the Controlled Substance Act?
Set rules for the manufacture and distribution of drugs with abuse
What statement best explains the central and peripheral nervous system?
The two main divisions that control the nervous system are the central and peripheral nervous system.
Which of the client's medications should the nurse expect to be absorbed most slowly? Oral acetaminophen, given for a fever Intramuscular meperidine, given for pain A subcutaneous anticoagulant An intravenous antibiotic
Oral acetaminophen, given for a fever
Nerve fibers secreting norepinephrine are called:
Adrenergic
The nurse administers a drug that causes vasoconstriction, contracted piloerection muscles, pupil dilation and urinary retention. What receptor is this drug most likely stimulating? Alpha1-receptors Alpha2-receptors Beta1-receptors Beta2-receptors
Alpha1-receptors
The nurse is describing the differing functions of the sympathetic nervous system (SNS) and parasympathetic nervous system to a client. The nurse has explained how the SNS is associated with a "fight-or-flight" reaction. How should the nurse describe the characteristics of the parasympathetic nervous system?
"Rest and digest"
The nurse provides health education for a diverse group of clients. For which client should the nurse emphasize the risk of teratogenic drug effects? 20-year-old female client who has been diagnosed with a chlamydial infection 40-year-old male client who has a history of intravenous drug use and who has endocarditis 60-year-old female client who is tetraplegic and who has developed a sacral pressure ulcer 6-year-old girl who has a urinary tract infection and who is accompanied by her parents
20-year-old female client who has been diagnosed with a chlamydial infection
The nurse is caring for a client who is experiencing pain. The client describes the pain as "9" on a scale of 1 to 10, with 10 being the worst pain. What nursing interventions would be necessary for the nurse to implement? Select all that apply. Assess blood pressure. Count respirations. Use Glasgow coma scale. Check hemoglobin lab. Evaluate pupils.
Assess blood pressure. Count respirations. Evaluate pupils.
A client has developed a tolerance to a drug. How should the nurse address this when providing care? Assess whether the client needs larger doses to achieve the effect. Assess the client for signs and symptoms of an allergy to the drug. Advocate for a change in the client's medication. Assess the client for signs and symptoms of adverse drug effects.
Assess whether the client needs larger doses to achieve the effect.
A client in distress has been given dobutamine, a medication intended to increase myocardial activity and heart rate. This medication likely stimulates what adrenergic receptor? Beta-1 Alpha-1 Alpha-2 Beta-2
Beta-1
A client with asthma is prescribed albuterol to dilate the bronchioles. The nurse understands that this drug is likely acting on which receptors? Beta-2 Alpha-1 Alpha-2 Beta-1
Beta-2
Which effect results from activation of beta2 receptors? Pupil constriction Bronchoconstriction Bronchodilation Decreased heart rate
Bronchodilation
What is the difference between chemical, generic and brand names of drugs?
Chemical Description of the drug using nomenclature from chemistry Generic refers to a drug produced after the active ingredient of the brand name drug. Only 1 generic name per drug Brand Names under which the drug is marketed Multiple brand names for one drug
Neurotransmission is important in the function of the CNS. For neurotransmission to occur, how do neurons communicate with other cells? Selectively Chemically Excitably Accessibly
Chemically
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? Increased heart rate Poor motility of the gastrointestinal tract Pupil dilation Decreased heart rate
Decreased heart rate
The nurse is preparing to administer a prescribed drug to a client with a history of renal disease. Why should the nurse anticipate administering a lower dose than for a client with healthy kidneys? Excretion is likely to take place slowly. The client likely has impaired drug metabolism. Distribution will be delayed, increasing the risk of adverse effects. Absorption will be increased because of fluid accumulation.
Excretion is likely to take place slowly.
A client develops bone marrow suppression related to a drug's effects. What would be most important for the nurse to do? Monitor laboratory blood values. Place the client on protective isolation. Facilitate cardiac monitoring. Prepare the client for dialysis.
Monitor laboratory blood values.
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?
Neurons convey action potentials to other neurons without being in physical contact.
Several factors impact synaptic transmission. What would a nurse know increases synaptic transmission? Reduction of chemicals Electrical impulse Calcium reaction Neurotransmitter
Neurotransmitter
A nurse has identified the half-life of drug that will be administered to a client for the first time. The nursing drug guide states the drug's half-life is 90 minutes. The nurse should identify what implication of this fact? -Ninety minutes after drug levels peak, there will be 50% of the peak level. - In 3 hours, there will be no detectable levels of the drug presents in the client's body. -Drug levels will rise steadily after administration, reaching 50% of maximum concentration after 90 minutes. -Peak drug levels will be achieved 90 minutes after the drug is administered.
Ninety minutes after drug levels peak, there will be 50% of the peak level.
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?
Norepinephrine
The neurotransmission system of the human body is a communication network. What is this network composed of? (Mark all that apply.)
Synapses Neurotransmitters Receptors
When working with a client who is experiencing a stress response, the nurse should anticipate what effects? Select all that apply. Tachycardia Pupil dilation Diaphoresis Hypotension Increased bowel sounds
Tachycardia Pupil dilation Diaphoresis
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. The client's attention span is unusually short. The client's blood pressure is 119/72 mmHg. The client describes a frontal lobe headache.
The client has "pinpoint" pupils.
A client has been prescribed a medication that antagonizes the beta receptors of the sympathetic nervous system. What assessment finding should the nurse attribute to the effects of this medication? The client's blood pressure is decreased The client's nausea is relieved The client denies shortness of breath The client denies feeling anxious
The client's blood pressure is decreased
The nurse is caring for a patient who is taking bisoprolol, a cardioselective beta blocker. She expects that the patient will have a drop in blood pressure, but during her assessment of the patient she notes the blood pressure to be 210/112, which is elevated. What is the explanation of this reaction? -The patient did not take the medication as prescribed. -The medication was metabolized too quickly, and therefore no response occurred. -The patient had an idiosyncratic response to the medication, causing the opposite effect. -The patient's genetic makeup causes the body to be unresponsive to this medication.
The patient had an idiosyncratic response to the medication, causing the opposite effect.
Which client's nicotinic receptors are likely being stimulated the most? a client who is anxious while waiting in the preoperative area a client who is taking medications for the treatment of Parkinson disease a client taking a selective serotonin reuptake inhibitor for depression a client who has increased bowel motility causing diarrhea
a client who is anxious while waiting in the preoperative area
A client's muscle weakness has been found to result from a lack of neurotransmitter communication between nerves and muscles. What neurotransmitter is most likely deficient?
acetylcholine
On the 1 AM rounds, the nurse finds a patient awake and frustrated that she cannot go to sleep. The nurse administers an ordered hypnotic to help the patient sleep. Two hours later, the nurse finds the patient out of bed, full of energy and cleaning her room. The nurse evaluates the patient's response to the hypnotic as an allergic reaction. an idiosyncratic response. a synergistic effect. a teratogenic effect.
an idiosyncratic response.
The nurse is called to a client's room 15 minutes after the client has received a new medication. The client reports pruritus as well as nausea. The nurse notes that the client appears pale, is sweating, and has begun to cough and wheeze. The nurse determines that the client is experiencing what type of reaction related to the new medication? toxic anaphylactic shock additive synergistic
anaphylactic shock
A client has not experienced the desired therapeutic effects of a medication. When considering factors that may affect the dynamic equilibrium that influences drug concentration, the nurse should: assess for factors that may reduce absorption. review the client's electrolyte levels. educate the client about drug-drug interactions. assess the client for adverse effects.
assess for factors that may reduce absorption.
The nurse administers a drug that stimulates beta2 receptors. What type of health condition would this drug treat? heart disease high lipid levels diabetes respiratory disease
respiratory disease
A client's nerves have been stimulated and the signal has reached the axon. How will communication continue? through the production of an electrical signal by the release of a neurotransmitter by physically stimulating the nerve on the other side of the synapse The nerve signal will cease at this point.
by the release of a neurotransmitter
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: control of body functions. generation of incoming stimuli. separation of responses. prevention of stimulus exposure.
control of body functions.
A nurse is caring for a client who has been receiving a drug by the intramuscular (IM) route at a dose of 0.25 mg. After discharge, the client will be prescribed the same medication orally at a dose of 2.5 mg. What phenomenon should the nurse describe when explaining the reason for the increased dosage for the oral dose? passive diffusion active transport glomerular filtration first-pass effect
first-pass effect
The client with a history of ischemic heart disease is taking aspirin 81 mg daily. The nurse should explain that less than 81 mg actually reaches target tissue due to which action? slow distribution the first-pass effect reduced absorption adverse effects
the first-pass effect
What drug administration route should be used to assure the best bioavailability as any particular drug? oral intravenous intramuscular subcutaneous
intravenous
Which client would a nurse expect to experience alterations in drug metabolism? 35-year-old woman with cervical cancer 41-year-old man with kidney stones 50-year-old man with cirrhosis of the liver 62-year-old woman in acute renal failure
50-year-old man with cirrhosis of the liver
What client is most likely to have impaired drug metabolism? A client who has a diagnosis of hepatitis C A client who is being treated for basal cell skin cancer A client who requires dialysis for renal failure A client who is dehydrated following several days of diarrhea
A client who has a diagnosis of hepatitis C
The nurse knows that a client is at high risk for developing drug tolerance because the client will be taking which drug for a long period of time? Amoxicillin (Amoxil) for an infection Furosemide (Lasix) for edema Hydromorphone (Dilaudid) for pain Darifenacin (Enablex) for overactive bladder
Hydromorphone (Dilaudid) for pain
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
What statement best explains the central and peripheral nervous system? Structures of the central nervous system include the brain, neurons, and ganglia The central nervous system (CNS) can be broken down into the somatic and autonomic pathways. The two main divisions that control the nervous system are the central and peripheral nervous system. Structures of the peripheral nervous system include the hypothalamus, brain stem, and spinal column.
The two main divisions that control the nervous system are the central and peripheral nervous system.
The physiology instructor explains to the nursing students that beta-2 stimulation leads to: Vasodilation of blood vessels Vasoconstriction of blood vessels Vasodilation of the aortic valve Vasoconstriction of the aortic valve
Vasodilation of blood vessels
A client is taking low-dose aspirin daily for her heart. The client is not receiving all the dosage of the aspirin that is being ingested because of: biotransformation. first-pass effect. liver metabolism. portal circulation.
first-pass effect.
A client is having a stress response that is causing the release of norepinephrine. This norepinephrine will be made from what dietary precursor? tyrosine thiamine tryptophan trichomoniasis
tyrosine
The nurse administers an anticholinergic medication to the client. When assessing this client, what finding should the nurse interpret as a secondary effect of the drug? urinary hesitancy urinary urgency hyperthermia profuse sweating
urinary hesitancy
A client has a neurologic disorder characterized by a deficiency of acetylcholine. In what location is acetylcholine normally synthesized? in the synaptic cleft between nerves and effector cells in the adrenal medulla within cholinergic nerves themselves within the gray matter of the spinal cord
within cholinergic nerves themselves
A client's left adrenal medulla has been injured in a motor vehicle accident. What is a possible implication of this injury? Disruptions in the levels of norepinephrine and epinephrine Dopamine deficiency Impaired action potential Disruption of the sodium-potassium pump
Disruptions in the levels of norepinephrine and epinephrine
A client has a diagnosis of Parkinson disease, a health problem that has effects on motor function and cognition. What neurotransmitter is most likely deficient in this client's CNS? Dopamine Norepinephrine Acetylcholine Gamma-aminobutyric acid (GABA)
Dopamine
Which of the following is an effect of activation of muscarinic2 receptors? Less "first messenger" is available to stimulate intracellular activity in the heart, smooth muscle, and brain. Activation of adenyl cyclase is increased in the heart, smooth muscle, and brain. More signal transduction occurs in the heart, smooth muscle, and brain. Less "second messenger" is available to stimulate intracellular activity in the heart, smooth muscle, and brain.
Less "second messenger" is available to stimulate intracellular activity in the heart, smooth muscle, and brain.
The nurse is assessing a client. What assessment finding is the clearest indicator of autonomic function? The client's respiratory rate is 22 breaths per minute The client's hearing is intact The client's muscle strength is equal bilaterally The client can discern hot sensation from cold
The client's respiratory rate is 22 breaths per minute
