1.
Cholinergic (parasymphatomimetic) drugs have which of the following therapeutic effects?
Correct Answer
B. Increased GI motility
Explanation
Cholinergic effects mimic the parasympathetic nervous system (of rest and digest) as opposed to the sympathetic nervous system (fight or flight). Increasing GI motility helps the body digest. Urinary retention, mydriasis, and vasoconstriction are sympathetic nervous system responses.
2.
Cholinergic (parasympathomimetic) drugs are indicated for which of the following situations?
Correct Answer
B. Lowering intraocular pressure in clients with glaucoma
Explanation
Cholinergic agents stimulate the pupil to constrict (miosis), thus decreasing intraocular pressure.
3.
During postoperative teaching the nurse explains that the client is receiving bethanechol (Urecholine) to treat:
Correct Answer
C. Urinary atony
Explanation
Bethanechol is a direct-acting cholinergic agonist that stimulates the cholinergic receptors on the smooth muscle of the bladder, leading to bladder contraction and emptying.
4.
Adverse reactions to bethanechol include:
Correct Answer
D. Abdominal Cramping
Explanation
Side effects of bethanechol include abdominal cramps, diarrhea, hypotension, bradycardia, and headache.
5.
Cholinergic (parasympathomimetic) drugs should be used cautiously with clients who have a history of:
Correct Answer
A. Benign prostatic hyperplasia
Explanation
Increased bladder muscle contractions could prove harmful in clients with benign prostatic hyperplasia secondary to obstruction of urinary outflow.
6.
Side effects to expect from anticholinergic (parasympatholytic) agents, such as atropine, include all of the following except:
Correct Answer
D. Diarrhea
Explanation
Anticholinergic effects block the effects of the parasympathetic nervous system, producing sympathetic nervous system effects. The effect on the GI system would be to decrease GI motility, not increase it (diarrhea).
7.
A client presents with symptomatic bradycardia.The nurse prepares to administer which dose of atropine intravenously?
Correct Answer
B. 0.5 mg
Explanation
The recommended dose of atropine to treat symptomatic bradycardia is 0.5 to 1 mg.
8.
A client comes into the emergency room with an overdose of cholinergic drugs.The nurse prepares to administer which dose of atropine intravenously?
Correct Answer
D. 2 mg
Explanation
Higher doses of atropine (2-3 mg) are needed to treat cholinergic overdoses.
9.
A priority nursing diagnosis for a client receiving anticholinergic (parasympatholytic) drugs would be:
Correct Answer
B. Impaired gas exchange related to thickened respiratory secretions
Explanation
Although all of these nursing diagnoses are appropriate, the priority is determined by remembering the ABCs. Anticholinergic drugs decrease respiratory secretions, which could lead to mucous plugs and resultant impaired gas exchange.
10.
The nurse monitors a client prescribed dicyclomine (Bentyl) for which therapeutic effect?
Correct Answer
A. Decrease in GI motility
Explanation
Dicyclomine is an antispasmodic cholinergic blocker used to decrease GI motility in clients with functional GI disorders such as irritable bowel syndrome.
11.
A priority assessment of a client on antibiotic therapy includes questioning the client about.
Correct Answer
C. Allergies
Explanation
Antibiotic allergy is one of the most common drug allergies. They also have the potential to cause severe anaphylaxis and death.
12.
The nurse would monitor which of the following laboratory values for a client receiving intravenous gentamicin (Garamycin)?
Correct Answer
D. BUN and creatinine
Explanation
Gentamycin has a high potential for nephrotoxicity and is thus contraindicated in clients with elevated renal function tests such as BUN and creatinine.
13.
Discharge teaching for a client receiving tetracycline should include.
Correct Answer
B. "Use suncreen and protective clothing when outdoor"
Explanation
Photosensitivity is a common side effect of tetracycline. Exposure to the sun can cause severe burns.
14.
If tetracycline is administered to children 8 years of age, it can cause:
Correct Answer
D. Permanent discoloration of the teeth
Explanation
Tetracycline is contraindicated for children less than 8 years of age, because it can cause permanent discoloration of the teeth.
15.
A client who is allergic to penicillin is at increased risk an allergy to:
Correct Answer
B. Cefazolin sodium (Ancef)
Explanation
There is a cross-sensitivity between penicillin and cephalosporin antibiotics, because they both contain a beta-lactam ring and are thus chemically related.