What To Do In These Situations? Nursing Quiz
A nurse is a caregiver for patients and helps to manage physical needs, prevent illness, and treat health conditions. They are responsible for the holistic care of patients, which encompasses the psychosocial, developmental, cultural, and spiritual needs of the individual.
- 1.
The nurse is aware that adrenergic drugs produce effects similar to which of these nervous systems?
- A.
Somatic Nervous System
- B.
Central Nervous System
- C.
Parasympathetic Nervous System
- D.
Sympathetic Nervous System
Correct Answer
D. Sympathetic Nervous SystemExplanation
Adrenergic drugs produce effects similar to the Sympathetic Nervous System. The Sympathetic Nervous System is responsible for the body's "fight or flight" response, which includes increased heart rate, elevated blood pressure, dilation of the pupils, and increased sweating. Adrenergic drugs mimic the effects of the sympathetic nervous system by activating adrenergic receptors in various organs and tissues, leading to similar physiological responses.Rate this question:
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- 2.
When an adrenergic drug stimulates beta1-adrenergic receptors, the result is an increased force of contraction, which is known as what type of effect?
- A.
Anti-adrenergic
- B.
Negative Dromotropic
- C.
Positive Inotropic
- D.
Positive Chronotropic
Correct Answer
C. Positive InotropicExplanation
When an adrenergic drug stimulates beta1-adrenergic receptors, it leads to an increased force of contraction in the heart. This effect is known as a positive inotropic effect.Rate this question:
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- 3.
When a patient is taking an adrenergic drug, the nurse expects to observe which effect?
- A.
Bronchial Constriction
- B.
Increased heart rate
- C.
Constricted Pupils
- D.
Increased intestinal peristalsis
Correct Answer
B. Increased heart rateExplanation
When a patient is taking an adrenergic drug, the nurse expects to observe an increased heart rate. Adrenergic drugs stimulate the sympathetic nervous system, which is responsible for the "fight or flight" response. This response includes an increase in heart rate as the body prepares for physical exertion or stress. Therefore, it is expected that the patient's heart rate will be elevated while taking adrenergic drugs.Rate this question:
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- 4.
An adrenergic agonist is ordered for a patient in shock. The nurse will not that this drug has had its primary intended effect if which expected outcome occurs?
- A.
Decreased urine output
- B.
Reduced Anxiety
- C.
Increased blood pressure
- D.
Volume Restoration
Correct Answer
C. Increased blood pressureExplanation
If the adrenergic agonist is effective, it will increase blood pressure. Adrenergic agonists stimulate the adrenergic receptors in the sympathetic nervous system, causing vasoconstriction and increased heart rate, which ultimately leads to an increase in blood pressure. This is the primary intended effect of the drug in a patient who is in shock, as low blood pressure is a characteristic feature of shock. Therefore, if the patient's blood pressure increases after administration of the adrenergic agonist, it indicates that the drug is working as intended.Rate this question:
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- 5.
The nurse is administering a stat dose of epinephrine. Epinephrine is appropriate for which situation?
- A.
Cardiac Arrest
- B.
Tachycardia
- C.
Angina
- D.
Severe hypertension
Correct Answer
A. Cardiac ArrestExplanation
Epinephrine is appropriate for cardiac arrest because it is a potent vasoconstrictor and stimulates the heart, leading to increased blood flow and oxygenation. It helps to restore normal heart rhythm and blood pressure during a cardiac arrest situation.Rate this question:
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- 6.
A 14-year-old has been treated for asthma for almost 4 months. Two weeks ago, she was given salmeterol as part of her medication regimen. However, her mother has called the clinic to report that it does not seem to work when her daughter is having an asthma attack. Which response by the nurse is appropriate?
- A.
“She should take up to two puffs every 4 hours to ensure adequate blood levels.”
- B.
"This medication is indicated for prevention of bronchospasms, not for relief of acute symptoms.”
- C.
“She is too young for this particular medication; it should be changed.”
- D.
“It takes time for a therapeutic response to develop.”
Correct Answer
B. "This medication is indicated for prevention of bronchospasms, not for relief of acute symptoms.”Explanation
The correct answer is "This medication is indicated for prevention of bronchospasms, not for relief of acute symptoms.” This response by the nurse is appropriate because salmeterol is a long-acting beta-agonist that is used for the prevention of asthma symptoms, not for immediate relief during an asthma attack. It is important for the nurse to educate the mother about the purpose of the medication and discuss the appropriate use of rescue medications for acute symptoms.Rate this question:
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- 7.
A hospitalized patient is experiencing a severe anaphylactic reaction to a dose of intravenous penicillin. Which drug will the nurse use to treat this condition?
- A.
Phenylephrine
- B.
Pseudoephedrine
- C.
Epinephrine
- D.
Ephedra
Correct Answer
C. EpinepHrineExplanation
Epinephrine is the drug of choice for treating severe anaphylactic reactions. It is a potent vasoconstrictor and bronchodilator that helps to reverse the symptoms of anaphylaxis, such as bronchoconstriction, hypotension, and edema. It acts quickly to increase blood pressure, open up the airways, and reduce swelling. Phenylephrine and pseudoephedrine are both decongestants that do not have the same rapid and potent effects as epinephrine. Ephedra is an herbal supplement that is not typically used in the treatment of anaphylaxis.Rate this question:
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- 8.
The nurse recognizes that adrenergic drugs cause relaxation of the bronchi and bronchodilation by stimulating which type of receptors?
- A.
Beta2-adrenergic
- B.
Dopaminergic
- C.
Alpha1-adrenergic
- D.
Beta1-adrenergic
Correct Answer
A. Beta2-adrenergicExplanation
Adrenergic drugs cause relaxation of the bronchi and bronchodilation by stimulating beta2-adrenergic receptors. These receptors are found in the smooth muscle of the bronchi and when stimulated, they cause the muscles to relax, leading to bronchodilation. This helps to open up the airways and improve airflow, making it easier for the patient to breathe. Dopaminergic receptors are not involved in bronchodilation, while alpha1-adrenergic and beta1-adrenergic receptors have different effects on other parts of the body and are not specifically involved in bronchial relaxation.Rate this question:
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- 9.
A patient is receiving a moderate-level dose of dobutamine for shock and is complaining of feeling more “skipping beats” than yesterday. What is the nurse’s next action?
- A.
Monitor for other signs of a therapeutic response to the drug.
- B.
Adjust the rate to a higher dose to reduce the palpitations.
- C.
Assess the patient’s vital signs and cardiac rhythm.
- D.
Discontinue the dobutamine immediately.
Correct Answer
D. Discontinue the dobutamine immediately.Explanation
The patient's complaint of feeling more "skipping beats" could indicate a serious cardiac arrhythmia. Discontinuing the dobutamine immediately is necessary to prevent further harm to the patient. Monitoring for other signs of a therapeutic response, adjusting the dose, or assessing vital signs and cardiac rhythm may not be sufficient actions in this situation.Rate this question:
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- 10.
A patient is going home with a new prescription for the beta-blocker atenolol (Tenormin). The nurse will include which content when teaching the patient about this drug?
- A.
Be watchful for first-dose hypotension.
- B.
If adverse effects occur, skip a dose for a “drug holiday.”
- C.
Never stop taking this medication abruptly.
- D.
The medication should be stopped once symptoms subside.
Correct Answer
C. Never stop taking this medication abruptly.Explanation
The correct answer is "Never stop taking this medication abruptly." This is an important instruction for patients taking beta-blockers like atenolol because abruptly stopping the medication can lead to rebound hypertension, increased heart rate, and other withdrawal symptoms. It is important for patients to gradually taper off the medication under the guidance of their healthcare provider to avoid any adverse effects.Rate this question:
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- 11.
During initial rounds, the nurse notes that a dobutamine infusion has extravasated into the forearm of a patient. After stopping the infusion, the nurse follows standing orders and immediately injects phentolamine (Regitine) subcutaneously in a circular fashion around the extravasation site. What is the mechanism of action of the phentolamine in this situation?
- A.
It increases peripheral vascular resistance and reduces arterial pressure at the site.
- B.
It causes arterial vasoconstriction and reduced pain and swelling at the site.
- C.
It increases blood flow to the ischemic site by vasodilation to prevent tissue damage.
- D.
It neutralizes the extravasated dobutamine immediately.
Correct Answer
C. It increases blood flow to the ischemic site by vasodilation to prevent tissue damage.Explanation
Phentolamine is an alpha-adrenergic antagonist that works by blocking the alpha receptors on the smooth muscle of blood vessels. By doing so, it causes vasodilation, which increases blood flow to the ischemic site. This increased blood flow helps to prevent tissue damage caused by the extravasated dobutamine.Rate this question:
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- 12.
A 58-year-old man has had a myocardial infarction (MI), has begun rehabilitation, and is ready for discharge. He is given a prescription for metoprolol (Lopressor), and he becomes upset after reading the patient education pamphlet. “I don’t have high blood pressure—why did my doctor give me this medicine?” The nurse explains to him that
- A.
Studies have shown that this medication has greatly increased survival rates in patients who have had a heart attack.
- B.
This drug is being prescribed to prevent the high blood pressure that often occurs after a heart attack.
- C.
Beta-blockers will improve blood flow to the kidneys.
- D.
This medication will prevent blood clots that may lead to another heart attack.
Correct Answer
A. Studies have shown that this medication has greatly increased survival rates in patients who have had a heart attack.Explanation
Metoprolol (Lopressor) is a beta-blocker medication commonly prescribed after a heart attack. Studies have shown that this medication has greatly increased survival rates in patients who have had a heart attack. It helps to prevent further damage to the heart and reduces the risk of future heart attacks. Although the patient may not have high blood pressure, metoprolol is prescribed for its cardiac benefits rather than solely for blood pressure control. The nurse explains this to the patient, reassuring him that the medication is important for his overall heart health and recovery.Rate this question:
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- 13.
The teaching for a patient who is taking tamsulosin (Flomax) to reduce urinary obstruction due to benign prostatic hyperplasia will include which of these?
- A.
Fluids need to be restricted while on this medication.
- B.
Take the medication with breakfast to promote the maximum effects of the drug.
- C.
Get up slowly from a sitting or lying position.
- D.
Blood pressure must be monitored because the medication may cause hypertension.
Correct Answer
C. Get up slowly from a sitting or lying position.Explanation
Tamsulosin (Flomax) is an alpha-adrenergic blocker commonly used to treat urinary obstruction due to benign prostatic hyperplasia. One of the common side effects of this medication is orthostatic hypotension, which can cause dizziness or lightheadedness when standing up. Therefore, patients should be advised to get up slowly from a sitting or lying position to minimize the risk of falls or injuries. The other options are not relevant to the teaching for a patient taking tamsulosin.Rate this question:
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- 14.
During a teaching session about self-monitoring while taking a beta-blocker at home, the nurse has taught the patient to take his apical pulse daily for 1 minute. If the pulse rate decreases to less than 60 beats per minute, the nurse will instruct the patient to:
- A.
Reduce the dose of his beta-blocker by half.
- B.
Notify the prescriber
- C.
Continue the medication because this is an expected effect.
- D.
skip the medication dose that day, and check his pulse again the next day.
Correct Answer
B. Notify the prescriberExplanation
If the patient's pulse rate decreases to less than 60 beats per minute while taking a beta-blocker, it is important to notify the prescriber. This is because a pulse rate below 60 beats per minute may indicate bradycardia, which can be a potential side effect of beta-blockers. The prescriber needs to be informed so that they can evaluate the patient's condition and determine if any changes in medication dosage or treatment plan are necessary.Rate this question:
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- 15.
A 49-year-old patient is in the clinic for a follow-up visit 6 months after starting a beta-blocker for treatment of hypertension. During this visit, his blood pressure is 169/98 mm Hg, and he eventually confesses that he stopped taking this medicine 2 months ago because of an “embarrassing problem.” What problem did the most likely experience with this medication that caused him to stop taking it?
- A.
Urge incontinence
- B.
Dizziness when standing up
- C.
Excessive flatus
- D.
Impotence
Correct Answer
D. ImpotenceExplanation
Impotence is the most likely problem that the patient experienced with the beta-blocker medication, which caused him to stop taking it. Impotence, also known as erectile dysfunction, refers to the inability to achieve or maintain an erection sufficient for sexual intercourse. Beta-blockers can cause sexual side effects, including impotence, by interfering with the normal physiological responses involved in achieving an erection. This side effect can be embarrassing and distressing for patients, leading them to discontinue the medication.Rate this question:
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- 16.
A patient has a new prescription for tamsulosin (Flomax) as treatment for benign prostatic hyperplasia. The nurse is checking his current medication list and will contact the prescriber regarding a potential interaction if the patient is also taking which drug?
- A.
Levothyroxine (Synthroid) for hypothyroidism
- B.
Sildenafil (Viagra), an erectile dysfunction medication
- C.
Omeprazole (Prilosec), a proton pump inhibitor
- D.
Low-dose aspirin for stroke prevention
Correct Answer
B. Sildenafil (Viagra), an erectile dysfunction medicationExplanation
Tamsulosin and sildenafil (Viagra) both work by relaxing the smooth muscles in the prostate and bladder neck, which can cause a significant drop in blood pressure. Therefore, if a patient is taking both medications, it can lead to a dangerous drop in blood pressure and potentially cause dizziness, lightheadedness, or fainting. Hence, the nurse should contact the prescriber to discuss the potential interaction and explore alternative treatment options.Rate this question:
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- 17.
A patient is taking an alpha blocker as treatment for benign prostatic hyperplasia. The nurse will monitor for which potential drug effect?
- A.
Orthostatic Hypotension
- B.
Increased blood pressure
- C.
Decreased urine flow
- D.
Discolored urine
Correct Answer
A. Orthostatic HypotensionExplanation
The nurse will monitor for orthostatic hypotension as a potential drug effect of the alpha blocker medication. Alpha blockers work by relaxing the muscles in the prostate and bladder neck, which can cause a decrease in blood pressure. Orthostatic hypotension refers to a sudden drop in blood pressure when changing positions, such as standing up from a seated or lying position. This can lead to symptoms such as dizziness, lightheadedness, and even fainting. Therefore, it is important for the nurse to monitor the patient's blood pressure regularly and educate them about the potential side effect of orthostatic hypotension.Rate this question:
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- 18.
When monitoring a patient who is taking a cholinergic drug, the nurse will watch for which cardiovascular effect?
- A.
Bradycardia
- B.
Tachycardia
- C.
Vasoconstriction
- D.
Palpitations
Correct Answer
A. BradycardiaExplanation
When a patient is taking a cholinergic drug, it increases the activity of the parasympathetic nervous system, which can lead to a decrease in heart rate. This is known as bradycardia. The nurse will monitor the patient for this cardiovascular effect, as it can be a potential side effect of the medication.Rate this question:
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- 19.
A patient has had an overdose of an intravenous cholinergic drug. The nurse expects to administer which drug as an antidote?
- A.
Atenolol (Tenormin)
- B.
Bethanechol (Urecholine)
- C.
Dobutamine
- D.
atropine sulfate
Correct Answer
D. atropine sulfateExplanation
Atropine sulfate is the correct antidote for an overdose of an intravenous cholinergic drug. Cholinergic drugs stimulate the parasympathetic nervous system, while atropine sulfate is an anticholinergic drug that blocks the effects of acetylcholine. By administering atropine sulfate, the nurse can counteract the excessive cholinergic stimulation caused by the overdose and help restore normal physiological function. Atenolol, bethanechol, and dobutamine are not appropriate antidotes for cholinergic drug overdose.Rate this question:
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- 20.
A patient who has had abdominal surgery has been discharged on a cholinergic drug to assist in increasing gastrointestinal peristalsis. The nurse will teach this patient to look for which therapeutic effect?
- A.
Decreased pulse rate
- B.
Abdominal cramping
- C.
Passage of flatus
- D.
Decreased urge to void
Correct Answer
C. Passage of flatusExplanation
The nurse will teach the patient to look for the therapeutic effect of passage of flatus because cholinergic drugs stimulate the parasympathetic nervous system, which increases gastrointestinal peristalsis. This can help relieve symptoms of abdominal distension and discomfort by promoting the movement of gas through the intestines, leading to the passage of flatus. Decreased pulse rate, abdominal cramping, and decreased urge to void are not expected therapeutic effects of cholinergic drugs in this context.Rate this question:
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- 21.
A cholinergic drug is prescribed for a patient with a new diagnosis of myasthenia gravis, and the nurse provides instructions to the patient about the medication. What is important include in the teaching?
- A.
Take the medication with meals to avoid gastrointestinal distress
- B.
Give daytime doses close together for maximal therapeutic effect.
- C.
Take the medication 30 minutes before eating to improve swallowing and chewing.
- D.
Take the medication only if difficulty swallowing occurs during a meal.
Correct Answer
C. Take the medication 30 minutes before eating to improve swallowing and chewing.Explanation
The correct answer is to take the medication 30 minutes before eating to improve swallowing and chewing. This is important because cholinergic drugs increase muscle strength and tone, which can help improve swallowing and chewing difficulties in patients with myasthenia gravis. Taking the medication before meals allows it to take effect before the patient starts eating, maximizing its therapeutic effect. Taking the medication with meals or only if difficulty swallowing occurs during a meal may not provide the same benefit.Rate this question:
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- 22.
The nurse is providing teaching regarding drug therapy to the husband of a woman with Alzheimer’s disease. She was diagnosed 3 months ago, has mild memory loss, and will be receiving donepezil (Aricept). What is the drug’s expected action?
- A.
May help to improve the symptoms of Alzheimer’s disease
- B.
Prevent memory loss in later stages
- C.
Reverses the course of Alzheimer’s disease
- D.
Provides sedation to prevent agitation and restlessness
Correct Answer
A. May help to improve the symptoms of Alzheimer’s diseaseExplanation
Donepezil (Aricept) is a medication commonly used to treat Alzheimer's disease. It works by increasing the levels of a chemical messenger in the brain called acetylcholine, which is involved in memory and other cognitive functions. By increasing acetylcholine levels, donepezil may help to improve the symptoms of Alzheimer's disease, such as memory loss and cognitive decline. However, it does not prevent memory loss in later stages, reverse the course of the disease, or provide sedation to prevent agitation and restlessness.Rate this question:
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- 23.
A patient has been taking donepezil (Aricept) for 2 weeks as part of the treatment for early stages of Alzheimer’s disease. Her daughter calls the prescriber’s office and is upset because “Mother has not improved one bit!” Which response by the nurse is appropriate?
- A.
“Increase the dosage to twice daily.”
- B.
“It takes time for the cure to take effect.”
- C.
“It may take up to 6 weeks to see an improvement.”
- D.
“Take the medication on an empty stomach for improved absorption.”
Correct Answer
C. “It may take up to 6 weeks to see an improvement.”Explanation
The appropriate response by the nurse is "It may take up to 6 weeks to see an improvement." This response acknowledges the daughter's concern and provides accurate information about the expected timeframe for improvement with donepezil. It is important for the nurse to educate the daughter about the realistic expectations of the medication and reassure her that improvement may take time.Rate this question:
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- 24.
A patient who has been diagnosed with Sjögren’s syndrome will be given cevimeline (Evoxac) for the treatment of xerostomia. The nurse will monitor for what therapeutic effect?
- A.
Reduction of salivation
- B.
Stimulation of salivation
- C.
Reduction of gastrointestinal peristalsis
- D.
Improvement of fine-motor control
Correct Answer
B. Stimulation of salivationExplanation
Cevimeline (Evoxac) is a medication that is commonly prescribed for the treatment of xerostomia, which is a symptom of Sjögren's syndrome. Xerostomia refers to dry mouth, which can significantly impact a patient's quality of life. The therapeutic effect of cevimeline is to stimulate salivation, which helps to alleviate the symptoms of dry mouth. By increasing the production of saliva, cevimeline helps to moisten the mouth, improve oral health, and facilitate the process of chewing and swallowing. Therefore, the nurse will monitor for the therapeutic effect of stimulation of salivation in a patient who is receiving cevimeline for the treatment of xerostomia.Rate this question:
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- 25.
The nurse is reviewing the mechanism of action of cholinergic drugs. The undesired effects of cholinergic drugs come from the stimulation of which receptors?
- A.
Nicotinic
- B.
Cholinergic
- C.
Muscarinic
- D.
Ganglionic
Correct Answer
A. NicotinicExplanation
Cholinergic drugs stimulate cholinergic receptors in the body. Nicotinic receptors are found in both the autonomic ganglia and the neuromuscular junctions of skeletal muscles. Stimulation of nicotinic receptors can lead to undesired effects such as skeletal muscle contractions, increased heart rate, and increased blood pressure. Therefore, the undesired effects of cholinergic drugs come from the stimulation of nicotinic receptors.Rate this question:
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- 26.
A patient calls the clinic to speak to the nurse about taking an herbal product that contains ginkgo (Ginkgo biloba) to “help my memory.” He states the he has read much information about the herbal product. Which statement by the patient indicates a need for further education?
- A.
“I will take aspirin or ibuprofen (Motrin) if I have a headache.”
- B.
“Ginkgo may cause increased bleeding, so I’ll have to be careful when doing yard work.”
- C.
“I need to watch for possible side effects, such as headaches, or stomach or intestinal upset.”
- D.
“I know the FDA has not approved this herbal product, but I’d like to try it to see if it helps my memory.”
Correct Answer
A. “I will take aspirin or ibuprofen (Motrin) if I have a headache.”Explanation
The patient's statement about taking aspirin or ibuprofen for a headache indicates a need for further education because ginkgo may cause increased bleeding, and taking these medications along with ginkgo could further increase the risk of bleeding. The patient should be advised to avoid taking aspirin or ibuprofen while using the herbal product to minimize the potential for adverse effects.Rate this question:
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- 27.
A patient is receiving a dose of edrophonium (Tensilon). The nurse recognizes that this drug is given to determine the diagnosis of which disease?
- A.
Myasthenia Gravis
- B.
Multiple Sclerosis
- C.
Parkinson’s disease
- D.
Alzheimer’s Disease
Correct Answer
A. Myasthenia GravisExplanation
Edrophonium (Tensilon) is a medication used to diagnose Myasthenia Gravis. Myasthenia Gravis is an autoimmune disorder characterized by muscle weakness and fatigue. Edrophonium works by inhibiting the enzyme acetylcholinesterase, which increases the availability of acetylcholine at the neuromuscular junction, temporarily improving muscle strength in patients with Myasthenia Gravis. Therefore, the administration of edrophonium helps determine the diagnosis of Myasthenia Gravis.Rate this question:
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- 28.
The nurse is reviewing the use of anticholinergic drugs with a patient and explains that anticholinergic drugs block the effects of which nervous system?
- A.
Central nervous system
- B.
Somatic nervous system
- C.
Sympathetic nervous system
- D.
Parasympathetic nervous system
Correct Answer
D. Parasympathetic nervous systemExplanation
Anticholinergic drugs block the effects of the parasympathetic nervous system. The parasympathetic nervous system is responsible for rest and digest functions, such as slowing heart rate, constricting pupils, and increasing digestion. By blocking the effects of the parasympathetic nervous system, anticholinergic drugs can have various effects, such as increasing heart rate, dilating pupils, and decreasing digestion.Rate this question:
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- 29.
A patient has received an accidental overdose of intravenous atropine. The nurse prepares and administers which drug?
- A.
Atenolol (Tenormin)
- B.
Bethanechol (Urecholine)
- C.
Dicyclomine (Bentyl)
- D.
Physostigmine (Antilirium)
Correct Answer
D. pHysostigmine (Antilirium)Explanation
Physostigmine (Antilirium) is the correct answer because it is an antidote for atropine overdose. Atropine is a medication that blocks the effects of acetylcholine, causing an increase in heart rate and drying of secretions. Physostigmine works by inhibiting the breakdown of acetylcholine, thereby counteracting the effects of atropine. Atenolol is a beta-blocker used for hypertension and does not reverse the effects of atropine. Bethanechol is a cholinergic agonist used for urinary retention and would exacerbate the symptoms of atropine overdose. Dicyclomine is an anticholinergic used for irritable bowel syndrome and would also worsen the symptoms of atropine overdose.Rate this question:
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- 30.
The nurse will monitor for which adverse effect when administering an anticholinergic drug?
- A.
Excessive urination
- B.
Diaphoresis
- C.
Dry mouth
- D.
Pupillary constrictio
Correct Answer
C. Dry mouthExplanation
When administering an anticholinergic drug, the nurse will monitor for the adverse effect of dry mouth. Anticholinergic drugs block the action of acetylcholine, a neurotransmitter responsible for various bodily functions, including saliva production. By blocking acetylcholine, these drugs can lead to a decrease in saliva production, resulting in dry mouth. Monitoring for this adverse effect is important as it can cause discomfort and may lead to other complications such as difficulty in swallowing or speaking.Rate this question:
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- 31.
The nurse working in a preoperative admitting unit administers an anticholinergic medication to a patient before surgery. What is the purpose of this drug in the preoperative setting?
- A.
Reduce oral and gastrointestinal secretions
- B.
Reduce urinary frequency
- C.
Relax the patient
- D.
Control the heart rate
Correct Answer
A. Reduce oral and gastrointestinal secretionsExplanation
The purpose of administering an anticholinergic medication before surgery is to reduce oral and gastrointestinal secretions. Anticholinergic drugs work by blocking the action of acetylcholine, a neurotransmitter that stimulates secretions in the body. By reducing secretions, the risk of aspiration during surgery is minimized, as well as the potential for complications related to excessive secretions in the respiratory and gastrointestinal tracts.Rate this question:
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- 32.
A patient with severe liver disease is receiving the angiotensin converting enzyme (ACE) inhibitor, captopril (Capoten). The nurse is aware that the advantage of this drug for this patient is which characteristic?
- A.
Captopril rarely causes first-dose hypotensive effects.
- B.
Captopril has little effect on electrolyte levels.
- C.
Captopril is a prodrug and is metabolized by the liver before becoming active.
- D.
Captopril is not a prodrug and does not need to be metabolized by the lover before becoming active
Correct Answer
D. Captopril is not a prodrug and does not need to be metabolized by the lover before becoming activeExplanation
Captopril is not a prodrug and does not need to be metabolized by the liver before becoming active. This is advantageous for a patient with severe liver disease because their liver may not be able to efficiently metabolize drugs. Since captopril is already active and does not require liver metabolism, it can be safely used in patients with liver disease.Rate this question:
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- 33.
The nurse is teaching a community education program on hypertension. He informs his students that ______ are parameters that determine the regulation of arterial blood pressure.
- A.
Cardiac output and systemic vascular resistance
- B.
Heart rate and peripheral resistance
- C.
Blood volume and renal blood flow
- D.
Myocardial contractility and arteriolar constriction
Correct Answer
A. Cardiac output and systemic vascular resistanceExplanation
The nurse is teaching the students about the parameters that determine the regulation of arterial blood pressure. Cardiac output refers to the amount of blood pumped by the heart per minute, while systemic vascular resistance refers to the resistance to blood flow in the blood vessels. Both of these parameters play a crucial role in regulating arterial blood pressure. When cardiac output increases or systemic vascular resistance increases, arterial blood pressure tends to increase as well. Therefore, it is important for the students to understand the relationship between cardiac output and systemic vascular resistance in order to comprehend the regulation of arterial blood pressure.Rate this question:
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- 34.
When counseling a male patient about the possible adverse effects of antihypertensive drugs, the nurse will discuss which potential problem?
- A.
Impotence
- B.
Bradycardia
- C.
Increased libido
- D.
Weight gain
Correct Answer
A. ImpotenceExplanation
When counseling a male patient about the possible adverse effects of antihypertensive drugs, the nurse will discuss the potential problem of impotence. Antihypertensive drugs can cause sexual dysfunction, including difficulty achieving or maintaining an erection, which can lead to impotence. This is an important potential side effect to discuss with male patients to ensure they are aware of the potential impact on their sexual health and to address any concerns or questions they may have.Rate this question:
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- 35.
The nurse is reviewing drug therapy for hypertension. According to the JNC 7 guidelines, antihypertensive drug therapy for a newly diagnosed stage 1 hypertensive African-American patient would most likely include which drug or drug classes.
- A.
Vasodilators alone
- B.
ACE Inhibitors alone
- C.
Calcium channel blockers with thiazide diuretics
- D.
Beta blockers with thiazide diuretics
Correct Answer
C. Calcium channel blockers with thiazide diureticsExplanation
According to the JNC 7 guidelines, antihypertensive drug therapy for a newly diagnosed stage 1 hypertensive African-American patient would most likely include calcium channel blockers with thiazide diuretics. This combination is recommended because African-Americans tend to have a higher prevalence of salt sensitivity, and thiazide diuretics help to reduce sodium and fluid retention. Calcium channel blockers work by relaxing the blood vessels, reducing peripheral resistance, and lowering blood pressure. Therefore, this combination is considered an effective treatment option for African-American patients with hypertension.Rate this question:
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- 36.
The nurse is creating a plan of care for a patient with a new diagnosis of hypertension. Which is a potential nursing diagnosis for the patient taking antihypertensive medications?
- A.
Diarrhea
- B.
Sexual dysfunction
- C.
Urge urinary incontinence
- D.
Impaired memory
Correct Answer
B. Sexual dysfunctionExplanation
When a patient is taking antihypertensive medications, sexual dysfunction can be a potential nursing diagnosis. Antihypertensive medications can cause side effects such as decreased libido, erectile dysfunction, and difficulties with sexual arousal and orgasm. These side effects can significantly impact a patient's quality of life and may require nursing interventions such as education on managing sexual dysfunction, providing emotional support, and collaborating with the healthcare team to adjust medication regimen if necessary.Rate this question:
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- 37.
A patient’s blood pressure elevates to 270/150 mm Hg, and a hypertensive emergency is obvious. He is transferred to the intensive care unit and started on a sodium nitroprusside (Nipride) drip to be titrated per his response. With the medication, the nurse knows that the maximum dose of this drug should be infused for how long?
- A.
10 minutes
- B.
30 minutes
- C.
1 hour
- D.
24 hours
Correct Answer
A. 10 minutesExplanation
The correct answer is 10 minutes because sodium nitroprusside is a potent vasodilator that is used in hypertensive emergencies to rapidly lower blood pressure. It has a very short half-life of only a few minutes, so it needs to be infused continuously at a high dose to maintain its effects. Infusing the maximum dose for 10 minutes allows for a rapid reduction in blood pressure while minimizing the risk of excessive hypotension.Rate this question:
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- 38.
A patient who has been taking antihypertensive drugs for a few months complains of having a persistent dry cough. The nurse explains that this cough is an adverse effect of which class of antihypertensive drugs?
- A.
Beta blockers
- B.
Angiotensin-converting enzyme (ACE) inhibitors
- C.
Angiotensin II receptor blockers (ARBs)
- D.
Calcium channel blockers
Correct Answer
B. Angiotensin-converting enzyme (ACE) inhibitorsExplanation
Angiotensin-converting enzyme (ACE) inhibitors can cause a persistent dry cough as an adverse effect. This is because ACE inhibitors can increase the levels of bradykinin, a substance that can irritate the airways and cause coughing. Beta blockers, angiotensin II receptor blockers (ARBs), and calcium channel blockers do not typically cause this side effect.Rate this question:
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- 39.
The nurse is reviewing the JNC 7 guidelines for treatment of hypertension. Which blood pressure would be classified as “prehypertension” according to the JNC 7 guidelines?
- A.
118/70 mm Hg
- B.
130/88 mm Hg
- C.
150/90 mm Hg
- D.
160/104 mm Hg
Correct Answer
B. 130/88 mm HgExplanation
According to the JNC 7 guidelines, blood pressure of 130/88 mm Hg would be classified as "prehypertension". This means that the individual's blood pressure is higher than normal, but not yet in the range of hypertension. Prehypertension is a warning sign that the individual is at risk for developing hypertension in the future, and lifestyle modifications such as diet and exercise may be recommended to prevent progression to hypertension.Rate this question:
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- 40.
A patient with type 2 diabetes mellitus has been found to have trace proteinuria. The prescriber writes an order for an angiotensin-converting enzyme (ACE) inhibitor. What is the main reason for prescribing this class of drug for this patient?
- A.
Cardioprotective effects
- B.
Renal protective effects
- C.
Reduces blood pressure
- D.
Promotes fluid output
Correct Answer
B. Renal protective effectsExplanation
The main reason for prescribing an ACE inhibitor for a patient with type 2 diabetes mellitus and trace proteinuria is because it has renal protective effects. ACE inhibitors have been shown to slow the progression of kidney disease in patients with diabetes by reducing the amount of protein that is leaked into the urine. This can help preserve kidney function and prevent further damage to the kidneys. Additionally, ACE inhibitors also have cardioprotective effects and can help reduce blood pressure, but the primary reason for prescribing them in this case is their renal protective effects.Rate this question:
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- 41.
When the nurse is administering topical nitroglycering ointment, which technique is correct?
- A.
Apply the ointment on the skin on the forearm.
- B.
Apply the ointment only in the case of a mild angina episode.
- C.
Remove the old ointment before new ointment is applied.
- D.
Massage the ointment gently into the skin, and then cover the area with plastic wrap.
Correct Answer
C. Remove the old ointment before new ointment is applied.Explanation
It is important to remove the old ointment before applying a new one to prevent buildup and ensure the effectiveness of the medication. This allows for proper absorption of the nitroglycerin into the skin.Rate this question:
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- 42.
The nurse is giving intravenous nitroglycerin to a patient who has just been admitted because of an acute myocardial infarction. Which statement is true regarding the administration of the intravenous form of this medication?
- A.
The solution will be slightly colored green or blue.
- B.
The intravenous form is given by bolus injection
- C.
It can be given in infusions with other medications.
- D.
Non-polyvinylchloride (non-PVC) plastic intravenous bags and tubing must be used.
Correct Answer
D. Non-polyvinylchloride (non-PVC) plastic intravenous bags and tubing must be used.Explanation
The correct answer is that non-polyvinylchloride (non-PVC) plastic intravenous bags and tubing must be used. This is because nitroglycerin is known to interact with PVC, causing the release of phthalates, which can be harmful to the patient. Therefore, using non-PVC materials ensures the safety of the patient during the administration of intravenous nitroglycerin.Rate this question:
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- 43.
A patient has been diagnosed with angina and will be given a prescription for sublingual nitroglycerin tablets. When teaching the patient how to use sublingual nitroglycerin, the nurse will include which instruction?
- A.
Take up to five doses at 15-minute intervals for an angina attack.
- B.
If the tablet does not dissolve quickly, chew the tablet for maximal effect.
- C.
If the chest pain is not relieved after one tablet, call 911 immediately.
- D.
Wait 1 minute between doses of sublingual tablets, up to three doses.
Correct Answer
C. If the chest pain is not relieved after one tablet, call 911 immediately.Explanation
This instruction is included because if the chest pain is not relieved after taking one tablet of sublingual nitroglycerin, it may indicate a more serious condition such as a heart attack. Calling 911 immediately is important to ensure prompt medical attention and intervention.Rate this question:
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- 44.
A calcium channel blocker (CCB) is prescribed for a patient, and the nurse provides instructions to the patient about the medication. Which instruction is correct?
- A.
Chew the tablet for faster release of the medication
- B.
To increase the effect of the drug, take it with grapefruit juice
- C.
If the adverse effects of chest pain, fainting, or dyspnea, occur, discontinue the medication immediately.
- D.
A high-fiber diet with plenty of fluids will help prevent the constipation that may occur.
Correct Answer
D. A high-fiber diet with plenty of fluids will help prevent the constipation that may occur.Explanation
A high-fiber diet with plenty of fluids will help prevent the constipation that may occur when taking a calcium channel blocker (CCB). CCBs are known to cause constipation as a side effect, and increasing fiber intake and staying hydrated can help alleviate this symptom.Rate this question:
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- 45.
When applying transdermal nitroglycerin patches, which instruction by the nurse is correct?
- A.
“Rotate application sites with each dose.”
- B.
“Use only the chest area for application sites."
- C.
"Temporarily remove the patch if you go swimming.”
- D.
“Apply the patch to the same site each time.”
Correct Answer
A. “Rotate application sites with each dose.”Explanation
The correct answer is "Rotate application sites with each dose." This instruction is correct because rotating the application sites helps to prevent skin irritation and tolerance to the medication. By changing the location of the patch with each dose, the skin has time to recover and reduces the risk of developing a rash or other adverse reactions. Additionally, rotating the application sites ensures that the medication is absorbed evenly and effectively throughout the body.Rate this question:
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- 46.
A patient has been taking a beta blocker for 4 weeks as part of his antianginal therapy. He also has type II diabetes and hyperthyroidism. When discussing possible adverse effects, the nurse will include which information?
- A.
“Watch for unusual weight loss.”
- B.
“Monitor your pulse for increased heart rate.”
- C.
Use the hot tub and sauna at the gym as long as time is limited to 15 minutes.”
- D.
“Monitor your blood glucose levels for possible hypoglycemia or hyperglycemia.”
Correct Answer
D. “Monitor your blood glucose levels for possible hypoglycemia or hyperglycemia.”Explanation
Beta blockers can affect blood glucose levels in patients with diabetes. They can mask symptoms of hypoglycemia, making it difficult for the patient to recognize low blood sugar levels. At the same time, they can also impair the body's ability to raise blood sugar levels, leading to hyperglycemia. Therefore, it is important for the patient to monitor their blood glucose levels regularly to ensure they are within a safe range.Rate this question:
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- 47.
Which action is often recommended to help reduce tolerance to transdermal nitroglycerin therapy?
- A.
Omit a dose once a week.
- B.
Leave the patch on for 2 days at a time.
- C.
Cut the patch in half for 1 week until the tolerance subsides
- D.
Remove the patch at bedtime, and then apply a new one in the morning.
Correct Answer
D. Remove the patch at bedtime, and then apply a new one in the morning.Explanation
Removing the patch at bedtime and applying a new one in the morning is often recommended to help reduce tolerance to transdermal nitroglycerin therapy. This practice allows for a nitrate-free interval during sleep, which helps prevent the development of tolerance. By removing the patch at night and applying a new one in the morning, the body is given a break from continuous exposure to nitroglycerin, which can help maintain the effectiveness of the therapy.Rate this question:
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- 48.
While assessing a patient who is taking a beta blocker for angina, the nurse knows to monitor for which adverse effect?
- A.
Nervousness
- B.
Hypertension
- C.
Bradycardia
- D.
Dry Cough
Correct Answer
C. BradycardiaExplanation
When a patient is taking a beta blocker for angina, the nurse should monitor for bradycardia as an adverse effect. Beta blockers work by blocking the beta receptors in the heart, which leads to a decrease in heart rate and cardiac output. Bradycardia is characterized by a heart rate that is slower than normal, and it can cause symptoms such as fatigue, dizziness, and fainting. Monitoring for bradycardia is important because it can indicate that the medication is having the desired effect, but it can also be a sign of a potentially serious complication.Rate this question:
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- 49.
When teaching a patient who has a new prescription for transdermal nitroglycerin patches, the nurse tells the patient that these patches are most appropriately used for which situation?
- A.
To prevent palpitations
- B.
To prevent the occurrence of angina
- C.
To relieve shortness of breath
Correct Answer
B. To prevent the occurrence of anginaExplanation
Transdermal nitroglycerin patches are most appropriately used to prevent the occurrence of angina. Angina is a symptom of coronary artery disease that causes chest pain or discomfort due to reduced blood flow to the heart muscle. Nitroglycerin patches work by relaxing and widening the blood vessels, improving blood flow to the heart and reducing the frequency and severity of angina episodes. Therefore, using these patches can help prevent the occurrence of angina and provide relief to the patient.Rate this question:
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- 50.
A patient about to receive a morning dose of digoxin has an apical pulse of 53 beats/minute. What will the nurse do next?
- A.
Administer the dose
- B.
Administer the dose, and notify the prescriber.
- C.
Check the radical pulse for 1 full minute.
- D.
Withhold the dose, and notify the prescriber.
Correct Answer
D. Withhold the dose, and notify the prescriber.Explanation
The correct answer is to withhold the dose and notify the prescriber. A normal apical pulse for an adult is between 60-100 beats per minute. A pulse rate of 53 beats per minute is considered bradycardia, which can be a potential side effect of digoxin. Administering the dose in this situation could further decrease the heart rate and lead to adverse effects. Therefore, it is important for the nurse to withhold the dose and notify the prescriber for further evaluation and instructions.Rate this question:
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Sep 02, 2024Quiz Edited by
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May 05, 2014Quiz Created by
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