Pharmacology Test Bank Question Test
2
A nurse is caring for a patient who has
myasthenia gravis. The prescriber has ordered
neostigmine (Prostigmin). An important initial
nursing action before administration of the
medication includes assessing:
a. the ability to raise the eyelids.
b. level of fatigue.
c. skeletal muscle strength.
d. swallowing ability. - CORRECT ANSWER-ANS:
D
Many patients hospitalized for myasthenia gravis
do not have the muscle strength to swallow well
and need a parenteral form of the medication;
therefore, assessing the patient's ability to
swallow is an important initial safety measure.
Evaluating the patient's ability to raise the eyelids,
level of fatigue, and skeletal muscle strength are
all important assessments both before drug
administration and during drug treatment,
because they indicate the effectiveness of the
drug and help determine subsequent doses.
,A nurse working in the emergency department is
assigned to a child who is arriving by ambulance
after being involved in a spill of organophosphate
insecticides. What will the nurse expect to be the
initial priority for treating this child?
a. Administering diphenhydramine to control
secretions
b. Giving diazepam to control seizures
c. Providing mechanical ventilation and oxygen
d. Reporting the spill to the Environmental
Protection Agency - CORRECT ANSWER-ANS: C
All of these courses of action may be part of the
treatment. However, the initial concern is to
prevent death from apnea caused by
laryngospasm, bronchoconstriction, and paralysis
leading to apnea; therefore, maintaining an airway
is the most important consideration. Pralidoxime
is the specific antidote and should be given next.
Atropine is used to control secretions. Diazepam
is given when seizures occur. Reporting the
accident to the proper authorities is not a priority
during a life-threatening emergency.
,A patient who has myasthenia gravis will be
taking neostigmine (Prostigmin). What will the
nurse emphasize when teaching this patient about
the medication?
a. "Stop taking the drug if you have diarrhea."
b. "Take a supplementary dose before exercise."
c. "Use atropine if you have excessive salivation."
d. "Withhold the dose if ptosis occurs." -
CORRECT ANSWER-ANS: B
Neostigmine doses must be adjusted continually,
and patients usually need supplemental doses
before exertion; therefore, patients must be taught
how to modify doses as needed. Increased
gastrointestinal (GI) secretions can cause loose
stools; this is a known adverse effect that does
not warrant stopping the drug. Atropine will help
with excessive salivation but should not be used
routinely, because it can mask the early signs of
anticholinesterase overdose. Ptosis is one of the
symptoms of myasthenia gravis and is an
indication for taking neostigmine.
Two nurses are discussing the major differences
between physostigmine (Antilirium) and
, neostigmine (Prostigmin). One nurse correctly
makes which statement about physostigmine
(Antilirium)?
a. "It is not effective for treating poisoning by
muscarinic blocking drugs."
b. "It can readily cross the blood-brain barrier."
c. "It does not cause any side effects."
d. "It can be given by all routes." - CORRECT
ANSWER-ANS: B
The basic pharmacology of physostigmine is
nearly identical to that of neostigmine, except that
physostigmine readily crosses membranes,
including the blood-brain barrier; neostigmine
does not. Physostigmine and neostigmine are
both effective for treating poisoning by muscarinic
blocking drugs. Neither physostigmine nor
neostigmine is devoid of side effects.
Physostigmine can be given only intramuscularly
(IM) or intravenously (IV); neostigmine is given
orally (PO), IM, IV, and subcutaneously (subQ).
A nurse is helping a nursing student who is
administering a medication to a patient with
2
A nurse is caring for a patient who has
myasthenia gravis. The prescriber has ordered
neostigmine (Prostigmin). An important initial
nursing action before administration of the
medication includes assessing:
a. the ability to raise the eyelids.
b. level of fatigue.
c. skeletal muscle strength.
d. swallowing ability. - CORRECT ANSWER-ANS:
D
Many patients hospitalized for myasthenia gravis
do not have the muscle strength to swallow well
and need a parenteral form of the medication;
therefore, assessing the patient's ability to
swallow is an important initial safety measure.
Evaluating the patient's ability to raise the eyelids,
level of fatigue, and skeletal muscle strength are
all important assessments both before drug
administration and during drug treatment,
because they indicate the effectiveness of the
drug and help determine subsequent doses.
,A nurse working in the emergency department is
assigned to a child who is arriving by ambulance
after being involved in a spill of organophosphate
insecticides. What will the nurse expect to be the
initial priority for treating this child?
a. Administering diphenhydramine to control
secretions
b. Giving diazepam to control seizures
c. Providing mechanical ventilation and oxygen
d. Reporting the spill to the Environmental
Protection Agency - CORRECT ANSWER-ANS: C
All of these courses of action may be part of the
treatment. However, the initial concern is to
prevent death from apnea caused by
laryngospasm, bronchoconstriction, and paralysis
leading to apnea; therefore, maintaining an airway
is the most important consideration. Pralidoxime
is the specific antidote and should be given next.
Atropine is used to control secretions. Diazepam
is given when seizures occur. Reporting the
accident to the proper authorities is not a priority
during a life-threatening emergency.
,A patient who has myasthenia gravis will be
taking neostigmine (Prostigmin). What will the
nurse emphasize when teaching this patient about
the medication?
a. "Stop taking the drug if you have diarrhea."
b. "Take a supplementary dose before exercise."
c. "Use atropine if you have excessive salivation."
d. "Withhold the dose if ptosis occurs." -
CORRECT ANSWER-ANS: B
Neostigmine doses must be adjusted continually,
and patients usually need supplemental doses
before exertion; therefore, patients must be taught
how to modify doses as needed. Increased
gastrointestinal (GI) secretions can cause loose
stools; this is a known adverse effect that does
not warrant stopping the drug. Atropine will help
with excessive salivation but should not be used
routinely, because it can mask the early signs of
anticholinesterase overdose. Ptosis is one of the
symptoms of myasthenia gravis and is an
indication for taking neostigmine.
Two nurses are discussing the major differences
between physostigmine (Antilirium) and
, neostigmine (Prostigmin). One nurse correctly
makes which statement about physostigmine
(Antilirium)?
a. "It is not effective for treating poisoning by
muscarinic blocking drugs."
b. "It can readily cross the blood-brain barrier."
c. "It does not cause any side effects."
d. "It can be given by all routes." - CORRECT
ANSWER-ANS: B
The basic pharmacology of physostigmine is
nearly identical to that of neostigmine, except that
physostigmine readily crosses membranes,
including the blood-brain barrier; neostigmine
does not. Physostigmine and neostigmine are
both effective for treating poisoning by muscarinic
blocking drugs. Neither physostigmine nor
neostigmine is devoid of side effects.
Physostigmine can be given only intramuscularly
(IM) or intravenously (IV); neostigmine is given
orally (PO), IM, IV, and subcutaneously (subQ).
A nurse is helping a nursing student who is
administering a medication to a patient with
