prep u questions or pharm 2

A client is prescribed donepezil. The nurse would expect to administer this drug at which frequency?

once a day

A client is prescribed propantheline. The nurse would administer this drug by which route?

oral

The physiology instructor explains to the nursing students that stimulation of what leads to vasodilation of blood vessels?

beta2 stimulation

A male client asks the nurse why he needs the preoperative anticholinergic medication ordered by the anesthesiologist. The nurse explains that anticholinergic drugs are given preoperatively to prevent which anesthesia associated complication?

bradycardia

Epinephrine causes relaxation of:

bronchioles

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 new patient has come to the clinic. The patient tells the nurse that the patient takes Aricept. It would be important for the nurse to assess the patient's medical and medication history because many bodily functions are affected by the:

cholinergic medications' ability to stimulate the parasympathetic nervous system.

What is the primary goal for prescribing an anticholinergic agent for a preoperative client?

decrease respiratory secretions

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

The nurse is preparing a teaching plan for a patient who is to receive a nonselective beta blocker. The nurse would make sure to address safety measures as a priority for the patient receiving:

propranlol

Anticholinergic drugs are used in ophthalmology because they produce which effect?

pupil dilation

A priority nursing assessment for a client who is to receive an alpha- or beta-adrenergic agonist would be to which action?

assess heart rate

A client experiences an overdose of a cholinergic drug. Which medication would the nurse anticipate that the client will receive as a reversal agent?

atropine

A nurse suspects that a client is experiencing shock based on which assessments? Select all that apply.

tachypnea, disorientation, cyanosis

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

A patient is receiving sotalol. Which instruction would be most important for the nurse to provide to the patient to ensure maximum effectiveness of the drug?

"Be sure to take the drug on an empty stomach.

Which patient statement indicates the need for additional teaching about propranolol?

"I can stop the drug once my blood pressure is controlled."

A patient has just received carbachol (Miostat). Which statement indicates the patient understands the nurse's teaching about this medication?

"I should expect the medication to decrease pressure in my eye."

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 patient should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine?

A 47-year-old female with hypertension

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 Explanation:

The nurse is providing education to a client who has been prescribed an anticholinesterase drug. What caution would the nurse include in the teaching?

Anticholinesterase drugs should be taken with food or milk to decrease the risk of gastric distress and ulceration.

A client has been admitted to the cardiac unit for heart failure and has been ordered carvedilol (Coreg). The client's blood pressure is 80/50. What should the nurse do?

Call the provider and advise them of the client's blood pressure prior to administering the medication.

The home health nurse is caring for a 77-year-old male patient who has just been discharged from the hospital. The patient is taking dobutamine for congestive heart failure. What would be most important to monitor in this patient?

Compliance with drug regimen Explanation:

A nurse is caring for a 25-year-old client who has been prescribed an adrenergic drug for shock. Which action should the nurse implement?

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

Stimulation of the sympathetic nervous system results in all of the following EXCEPT:

Decreased rate of cellular metabolism

A 57-year-old female client has a history of two myocardial infarctions in the past 3 years. She presents to the health care provider's office with symptoms of an overactive bladder. She requests an anticholinergic medication that she saw advertised on television. What does the nurse expect the provider to do for this client?

Explain to the client that the medication is contraindicated because of her medical history

A client is administered epinephrine in conjunction with a local anesthetic. What effect will epinephrine produce?

Increased vasoconstrictive effects

A client has received a dose of dopamine intravenously. The client's IV was infiltrated, and the dopamine was injected into the subcutaneous tissues. Which medication will prevent the vasoconstriction and tissue necrosis based on this action?

Phentolamine mesylate (Regitine)

A nursing student is preparing a care plan and is choosing a nursing diagnosis for her client with Alzheimer's disease. The client is taking Exelon. Which would be an appropriate nursing diagnosis for this client?

Risk for Injury related to dizziness and fatigue

The adrenergic branch of the autonomic nervous system is also known by which name?

Sympathetic nervous system

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 has been prescribed the nonselective beta-adrenergic blocker, timolol for the treatment of open angle glaucoma. What instructions should the nurse provide to assure the effectiveness of the medication?

The proper method for instilling eye drops

A nurse is preparing to administer a cholinergic medication. To prepare to administer the medication, the nurses is assessing the client for anticholinergic effects. Cholinergic medications act like which neurotransmitter?

acetylocholine

The nervous system is closely linked with both the immune system and the endocrine system. What neurotransmitter is used by the preganglionic cells?

acetylocholine

A 78-year-old client is about to begin home care and has been prescribed an anticholinergic. What should the home care nurse explain to the client and her family about this medication?

all of the above

A nurse is caring for a patient who is having a sympathetic response. A sympathetic response involves:

an increase in blood pressure, bronchi dilation, and decreased bowel sounds

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

increased heart rate

The client is receiving Bethanechol for bladder atony. What assessment findings indicate the effect of this medication?

increased urinary output

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

intraocular pressure decreases

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?

labetalol

A nurse is conducting a medication resolution of a new resident of a care facility and notes that the woman has been taking neostigmine. The nurse should recognize that the woman may have a history of what health problem?

myasthenia gravis

A female client is going on a cruise to Nova Scotia with her husband to celebrate their 15th wedding anniversary. She is concerned because she has experienced severe, debilitating seasickness in the past. What would the nurse expect the health care provider to order?

scopolamine

Which agent would a nurse expect to administer transdermally?

scopolamine

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

The nurse is providing medication education to a client prescribed an adrenergic blocker. Which nervous system is the specific focus of this classification of medications?

sympathetic

The nurse is preparing a client for pacemaker surgery. The health care provider orders atropine to be given 30 minutes before the client is taken to the operating room. The nurse knows this medication is ordered for what reason?

To dry up respiratory secretions to prevent aspiration during surgery

Sympathetic stimulation of the heart causes:

an increased rate and force of myocardial contraction.

Anticholinergic drugs are used in ophthalmology to

dilate the pupils

Diagnostic testing has revealed that a client has deficient levels of acetylcholine. When planning the client's assessment, the neurological nurse should expect to identify evidence of decreased stimulation of what nerves? (Select all that apply.)

-Motor nerves affecting skeletal muscles Preganglionic nerves in the sympathetic and parasympatheti-nervous systems Postganglionic nerves of the parasympatheti-nervous system Explanation:

What is the recommended dosage for atropine for a client with a bradyarrhythmia?

0.3-0.6 mg

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 nurse administered neostigmine to a client with myasthenia gravis. The nurse is doubling the dose that the client was taking at home. Three hours later, the nurse is assessing the client and notes the following symptoms: nausea with vomiting, diarrhea, and sweating. What does the nurse interpret these symptoms to be?

This is cholinergic crisis, and the provider needs to be notified immediately.

Clients with what disorder should not be given anticholinergic drugs?

glaucoma

A nurse caring for a client receiving bethanechol for urinary retention should advise the client that voiding usually occurs how long after oral administration?

30 to 90 minutes

A client is experiencing urinary retention. The client has been prescribed terazosin (Hytrin). What condition contributes to the urinary retention?

Benign prostatic hypertrophy

A client who has been prescribed bethanechol asks a nurse to explain how the drug works. What would be a correct response?

Bethanechol is a direct-acting cholinergic drug that causes contraction of the smooth muscles of the bladder and passage of urine."

The nursing instructor is teaching students about Alzheimer's disease. The instructor informs the students that clients with this illness experience problems with memory and thinking. The reason that this happens is which?

Degeneration of cholinergic pathways

A 70-year-old client is taking a cholinergic blocking drug. The family has noticed the client is a confused, excited, and not voiding normally. What would be the appropriate action by the nurse in this situation?

Instruct the client's family to withhold the next dose and the nurse will contact the prescribing provider.

A client is administered atropine to increase the heart rate. What is the action of atropine?

It blocks the parasympathetic vagal stimulation.

A client diagnosed with myasthenia gravis is administered a cholinergic drug named neostigmine. How does this drug produce its therapeutic effect?

It stimulates the parasympathetic nervous system

The nurse is caring for a client with asthma who has been experiencing shortness of breath and who has been administered a medication to cause bronchodilation. What aspect of autonomic nervous function has the nurse most likely influenced?

Stimulation of beta-adrenergic receptors

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 client experiencing a serious allergic reaction to a bee sting is brought to the emergency department. The client's right hand is swollen, red, and painful. She is extremely upset, short of breath, and the nurse detects wheezing and stridor. The nurse is ordered to administer epinephrine to relieve which of the clients symptoms?

acute brone

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

all the above

What represents the two types of receptors that are found in the adrenergic nervous system? Select all that apply.

alpha receptors and beta receptors

The nurse is caring for a client who is known to have deficient levels of dopamine because of a dietary lack of tyrosine. The nurse should expect to assess for evidence of:

decreased adrenergic response.

A client is scheduled for surgery in 2 hours. The health care provider orders preoperative medications glycopyrrolate 1 mg and meperidine (Demerol) 50 mg IM. Before administering these medications, the nurse should assess the client for what disorder?

glaucoma

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

norepinephrine

The nursing instructor is discussing cholinergic drugs. The nursing students understand what system is acted upon by this family of drugs?

parasympathic nervous system

A patient is experiencing a heart rate of 42 beats per minute. Which system contributes to bradycardia?

paraympathetic nervous system

Phentolamine is the agent used to treat extravasation of dobutamine.

true

The nurse is caring for a client who is receiving an indirect-acting cholinergic medication and knows it is indicated as a treatment for myasthenia gravis as well as which other condition?

alzheimer's disease

A client is experiencing anaphylaxis. What drug will the nurse most likely administer?

epinerphrine

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

epnhedra

A student asks the pharmacology instructor to explain the action of anticholinergic agents. What would be the instructor's best response?

They act to block the effects of the parasympathetic nervous system

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?

autonaumic nervous system

The nurse is caring for a client who suddenly stopped taking a chronically prescribed beta-adrenergic blocking drug prescribed for hypertension. The client's blood pressure (BP) ranged from 110/70 to 130/70 mm Hg and heart rate (HR) ranged 60 to 90 beats per minute while taking the drug. The nurse would predict which assessment findings to support the expected beta-adrenergic responsiveness?

BP: 200/100 mm Hg; HR 110

The anatomy and physiology instructor is discussing adrenergic receptors with the nursing class. What adrenergic receptor would the instructor tell the students is found in the heart and can stimulate increased myocardial activity and increase heart rate?

Beta 1

A client with a neurogenic bladder secondary to a spinal tumor has been taking bethanechol. When the nurse finds the client anxious, diaphoretic, and visibly flushed, what action should the nurse take to best assure the client's safety?

Contact the health care provider as the client may be experiencing a cholinergic crisis.

Propranolol (Inderal) is used extensively as treatment for what condition?

angina

A 75-year-old male client is experiencing extrapyramidal symptoms secondary to an antipsychotic drug. Which drug would the nurse expect the health care provider to order to relieve these symptoms?

anticholinergics

A 71-year-old Black woman with a history of diabetes presents for a follow-up appointment after visiting the emergency department for increased angina. Atenolol has been prescribed to better control the chest pain. What teaching is important about this pharmacologic intervention?

atenolol results in less effective glucose metabolism.

A client being treated for myasthenia gravis is receiving neostigmine. When the client's pulse drops to 50 after the administration, which medication should be administered to treat the bradycardia?

atropine

Which agent would be used to counteract a severe reaction occurring with the use of neostigmine?

atropine

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

What would a nurse expect to administer if a client who is receiving isoproterenol develops a severe reaction?

beta-adrenergic blockers

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

beta-adrenergic blocking drug

Which symptom should the nurse monitor for when caring for a client whose sinus bradycardia has been treated with large doses of atropine?

flushing

The nurse is aware that cholinergic blocking agents will be used preoperatively for what type of anesthesia?

general

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

hypoglycemia

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?

hypothalmus

What is the resulting physiologic effect when the parasympathetic nervous system is stimulated?

increased GI mobility

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:

increased blood pressure

hich agent would the nurse expect to find when reviewing over-the-counter allergy products?

phenylphrine

Most of the free norepinephrine molecules are taken up by the nerve terminal that releases them in which process?

reuptake

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

true

The client is ordered bethanechol subcutaneously. After giving the client the injection of bethanechol, the nurse should make sure that what is available?

urinal, bed pan, call light

A 4 year old has been prescribed an anticholinergic medication. The nurse should instruction the parents to monitor and report changes in basic function

urinary output

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?

ympathetic nervous system