Pharm 2 test 2 (CH 12)
What common adverse effect are adrenergic drugs known to cause?
Tremors
A patient is taking an anticholinergic agent. For which common adverse effects does the nurse monitor this patient? (Select all that apply.) A. Chills B. Dryness of mouth C. Diarrhea D. Urinary retention E. Blurred vision
Ans: B, D, E
Which condition is dopamine commonly used to treat? (Select all that apply.) A. Stroke B. Asthma C. Shock D. Hypertension
Ans: C and D
A patient taking labetalol (Normodyne) has also been prescribed procainamide (Procanbid). What symptom does the nurse monitor for in this patient? A. Seizures resulting from decreased sodium and potassium levels B. Tachycardia C. Increased blood pressure D. Bradycardia
Ans: D
Which term describes the collective symptoms of blurred vision; constipation; urinary retention; and dry nose, mouth and throat?
Anticholinergic effects
The two major neurotransmitters of the autonomic nervous system are 1. norepinephrine and epinephrine. 2. dopamine and serotonin. 3. acetylcholine and norepinephrine. 4. endorphins and enkephalins.
ANS: 3
A patient with Parkinsons disease asks the nurse why anticholinergics are used in the treatment. Which response by the nurse is most accurate? a. These drugs help you urinate. b. These drugs will decrease your eye pressure. c. These drugs inhibit the action of acetylcholine. d. These drugs will assist in lowering your heart rate.
ANS: C
The autonomic nervous system can be subdivided into which types of adrenergic receptors? a. Nicotinic and muscarinic b. Afferent and efferent c. Alpha and beta d. Agonists and antagonists
ANS: C
What is the primary response to alpha 1 receptor stimulation? a. Bronchodilation b. Tachycardia c. Vasoconstriction d. Uterine relaxation
ANS: C
Which condition would alert the nurse of the need to use beta adrenergic blockers cautiously? a. Hypertension b. Raynauds phenomenon c. Emphysema d. Cardiac dysrhythmias
ANS: C
Why are beta blockers used cautiously in patients with respiratory conditions? a. They mask the signs and symptoms of acute hypoglycemia. b. They cause extensive vasodilation and cardiac overload. c. They may produce severe bronchoconstriction. d. They increase hypertensive episodes.
ANS: C
Patients with which conditions are potentially more sensitive to the effects of adrenergic agents? (Select all that apply.) A. Lung disease B. Thyroid disease C. Heart disease D. Impaired hepatic function E. Hypotension
Ans: B, C, D
For a patient receiving adrenergic agents, the nurse assesses for concurrent use of which medications that may inhibit therapeutic activity? (Select all that apply.) A. Asprin B. Bretylium tosylate (Bretylate) C. Propranolol (Inderal) D. Diphenhydramine (Benadryl) E. Omeprazole (Prilosec)
Ans: B and C
A patient who has recently experienced a heart attack is prescribed a beta-adrenergic blocking agent. Which symptom of this therapy would be of concern to the nurse?
Decrease in hear rate from 88/min to 46/min
A patient who has recently been prescribed a beta-adrenergic blocking agent presents to the emergency department with a serious adverse effect. Which adverse effect is the patient likely exhibiting? 1. Hypertension 2. Angina pectoris 3. Bronchoconstriction 4. Cardiac dysrhythmias
ANS: 3
Adrenergic agents that stimulate the beta receptors of the autonomic nervous system have the following effects: (Select all that apply.) 1. constriction of the coronary arterioles. 2. relaxation of the urinary bladder. 3. increased renal perfusion. 4. increased heart rate. 5. increased blood glucose.
ANS: 1, 2, 4, 5
The peripheral nervous system includes the following components: (Select all that apply.) 1. afferent nerves. 2. brain. 3. efferent nerves. 4. spinal cord. 5. skeletal muscles.
ANS: 1, 3
A patient is being discharged on an adrenergic bronchodilator. Which common adverse effect(s) will the nurse include in discharge teaching? (Select all that apply.) a. Palpitations b. Dizziness c. Orthostatic hypotension d. Hypoglycemia e. Tremors f. Bradycardia
ANS: A, B, C, E
Neurotransmitter(s) include: (Select all that apply.) a. gamma aminobutyric acid. b. acetylcholine. c. serotonin. d. glucose. e. histamine. f. epinephrine.
ANS: A, B, C, E, F
Which adverse effect(s) is/are common when a patient is receiving a cholinergic agent? (Select all that apply.) a. Nausea b. Hypertension c. Dizziness d. Bradycardia e. Constipation
ANS: A, C, D
A patient with chronic obstructive pulmonary disease (COPD) reports having insomnia and a racing heart after starting terbutaline therapy. Which explanation by the nurse is most accurate? a. The symptoms are typical and indicate that the medication is at a therapeutic level. b. The symptoms will tend to resolve with continued therapy. c. The symptoms are unusual and need to be reported to the health care provider immediately. d. The symptoms are indicative of toxicity.
ANS: B
Which category of medications is used for peripheral vascular diseases characterized by excessive vasoconstriction, such as Raynauds disease? a. Adrenergic agents b. Alpha adrenergic blocking agents c. Beta adrenergic blocking agents d. Cholinergic agents
ANS: B
Which nerve endings liberate norepinephrine? a. Cholinergic b. Adrenergic c. Anticholinergic d. Muscarinic
ANS: B
Which statement(s) is/are true about efferent nerves? (Select all that apply.) a. They transmit signals to the spinal cord and brain. b. They leave the CNS to carry impulses to other body parts. c. They are part of the peripheral nervous system. d. They transmit signals that control contractions of smooth and skeletal muscle. e. They transmit signals that control contractions of some glandular secretions.
ANS: B, C, D, E
Which instruction(s) given by the nurse will assist a patient to cope with the common adverse effects of anticholinergic medications? (Select all that apply.) a. Take the medication with meals. b. Increase fluids daily. c. Decrease fiber in the diet. d. Suck on candy or ice chips. e. Monitor blood glucose.
ANS: B, D
An older adult patient is to receive atenolol, a beta adrenergic blocking agent. Prior to administration of the drug, the nurse assesses an apical pulse rate of 58 and notes ankle edema. Which action will the nurse take first? a. Determine the therapeutic blood level. b. Encourage the patient to decrease water intake. c. Elevate the patients legs. d. Withhold the medication.
ANS: D
Before the initiation of anticholinergic medications, it is important for the nurse to screen patients for which condition? a. Hypertension b. Infectious diseases c. Diabetes d. Closed angle glaucoma
ANS: D
The nurse is caring for a patient taking a cholinergic agent. When auscultating lung sounds, the nurse notes inspiratory and expiratory wheezing bilaterally. The best action for the nurse to take would be to: a. provide the next dose of the cholinergic agent immediately. b. assess heart rate and blood pressure. c. reposition the patient. d. withhold the next dose and notify the physician.
ANS: D
What will a medication that stimulates the beta-2 receptors cause? A. Relaxation of the uterus B. Bronchoconstriction C. Increase heart rate D. Vasoconstriction of peripheral blood vessels
Ans: A
A patient has been prescribed an anticholinergic drug for IBS. For which adverse effect must the nurse teach the patient to be aware when beginning this drug?
Orthostatic hypotension
A patient with a history of type 1 diabetes after myocardial infarction has been placed on a beta adrenergic blocking agent. Which statement by the patient indicates a need for further teaching? a. This medication should not be discontinued suddenly. b. This medication lowers my blood pressure by helping me get rid of fluid. c. I may not have my usual symptoms of a hypoglycemic reaction while on this drug. d. This medication may take a few weeks to work.
ANS: B
Body functions such as blood pressure, heart rate, temperature are regulated by which nervous system?
Autonomic body system
Which disorder(s) would indicate the use of anticholinergic agents? (Select all that apply.) a. Glaucoma b. Benign prostatic hypertrophy c. Bradycardia d. Parkinsons disease e. Preparation for surgery f. Stimulation of the vagus nerve
ANS: C, D, E
A patient hospitalized in an acute care setting reports to the nurse that since starting on an adrenergic medication, he has been feeling dizzy and weak. The most appropriate action for the nurse is to: a. immediately notify the physician. b. teach the patient to move slowly from standing to sitting. c. discontinue the adrenergic blocker. d. monitor the blood pressure in both the supine and standing positions.
ANS: D
What does the nurse teach a patient about taking a beta-adrenergic blocking agent? A. If the medication is stopped abruptly, it may cause an exacerbation of anginal symptoms. B. The drug may be taken with cimetidine without any adverse reactions. C. The medication must be taken with meals. D. The drug may be stopped when the patient begins to have better blood pressure readings.
Ans: A
What nursing assessment is done before starting a patient on a beta-adrenergic blocking agent? A. Blood Pressure and Heart Rate B. Blood urea nitrogen (BUN) and creatinine levels C. Liver enzymes D. Complete blood count (CBC) and sedimentation rate
Ans: A
For which patients does the nurse expect an anticholinergic agent to be ordered? (Select all that apply.) A. Patient with nocturnal enuresis B. Patient with tachycardia C. Patient with hypertension D. Patient who needs an endotracheal tube E. Patient with Parkinson's disease
Ans: A, D, E
A patient taking albuterol (Proventil) has also started taking an over the counter (OTC) cold medication. What symptom does the nurse monitor for in this patient? A. Bradycardia B. Tachycardia C. Increased occurrence of bronchospasms D. Increased fluid retention
Ans: B
The anticholinergic agent atropine is used for the following conditions: (Select all that apply.) 1. dilation of the pupils. 2. constriction of the pupils. 3. decreased oral secretions (saliva). 4. increased GI motility. 5. decreased sweating.
ANS: 1, 3, 5
Cholinergic agents are drugs that have this effect: (Select all that apply.) 1. slowing the heart rate. 2. increasing the heart rate. 3. dilating the pupils. 4. constricting the pupils. 5. increased gastric motility.
ANS: 1, 4, 5
The two broad classes of drugs used to stimulate the adrenergic nervous system are 1. dopamine and norepinephrine. 2. epinephrine and serotonin. 3. catecholamines and noncatecholamines. 4. dopaminergic receptors and beta blockers.
ANS: 3
Which data in the patient's history and physical examination cause the nurse to question a preoperative medication order for atropine sulfate and morphine? 1. Excessive oral secretions 2. Bradycardia 3. Increased gastric motility 4. Prostatic enlargement
ANS: 4
Prior to the administration of metoprolol, a beta adrenergic blocking agent, which is most important for the nurse to assess? a. Blood pressure b. Lung sounds c. Mental status d. Urine output
ANS: A
A long term care resident is taking an anticholinergic agent. The nurse observes the resident to be disoriented and hallucinating. The priority nursing action is to: a. report development of alterations to the charge nurse. b. assess blood glucose. c. provide for residents safety. d. medicate with antianxiety medication.
ANS: C
Which body function(s) is/are controlled by the autonomic nervous system? (Select all that apply.) a. Blood pressure b. Skeletal muscle contraction c. GI secretion d. Body temperature e. Urination
ANS: A, C, D, E