• MED CERT 09/25/2026
Basic And Clinical Pharmacology 14th Edition Katzung
Trevor Test Bank Questions And Correct Answers
Available A+ Guranteed
| COMPLETE TEST BANK ALL CHAPTERS | QUESTIONS,
ANSWERS & RATIONALES
A patient with myasthenia gravis who is taking a cholinesterase inhibitor is being admitted to
the intensive care unit and is on mechanical ventilation. The prescriber has ordered a
P 1
, • MED CERT 09/25/2026
challenge dose of edrophonium to distinguish between a myasthenic crisis and a medication
overdose. The nurse will expect to do what?
a. Administer neostigmine if muscle strength decreases.
b. Be prepared to administer atropine if muscle weakness increases.
c. Give a second dose of edrophonium if no improvement is seen.
d. Give pralidoxime (Protopam) if cholinergic symptoms worsen. –
Correct Answer :ANS: B
Edrophonium is an ultra-short-acting cholinesterase inhibitor used to distinguish between a
myasthenic crisis and a cholinesterase inhibitor overdose, because weakness or paralysis can
occur with both. If the symptoms are intensified and muscle weakness increases, the crisis is
cholinergic, meaning that the patient is having toxic effects from the cholinesterase inhibitor
and needs atropine as an antidote. Neostigmine would be given if the patient shows
improved muscle strength, because that would indicate that the patient's symptoms are the
result of a myasthenic crisis. A second dose of edrophonium would only worsen the
symptoms. Pralidoxime is used to treat poisoning caused by irreversible cholinesterase
inhibitors.
A nurse is teaching a new emergency department nurse about emergency medications. When
asked to describe the uses of pralidoxime (Protopam), the new nurse makes which correct
statement?
a."It exerts its greatest effects at muscarinic and ganglionic sites."
b. "It is used to treat poisoning by reversible cholinesterase inhibitors."
c."It may not be effective if not given immediately."
d."It reverses the effects of organophosphate insecticides in the central nervous system." –
P 2
, • MED CERT 09/25/2026
Correct Answer :ANS: C
Pralidoxime must be given soon after organophosphate poisoning has occurred because of a
process called aging, in which the bond between the organophosphate inhibitor and
cholinesterase increases in strength, making pralidoxime ineffective. For some of these
poisons, aging can occur within minutes. Pralidoxime has its greatest effects at the
neuromuscular junction, not the muscarinic and ganglionic sites. It is used to treat poisoning
by irreversible cholinesterase inhibitors. It does not cross the blood-brain barrier and thus
does not have effects in the CNS.
A patient is experiencing toxic side effects from atropine, including delirium and
hallucinations. Which medication will the nurse expect to administer?
a. Donepezil (Aricept)
b. Edrophonium (Reversol)
c. Neostigmine (Prostigmin)
d. Physostigmine –
Correct Answer :ANS: D
Physostigmine is the drug of choice for treating poisoning from atropine and other drugs that
cause muscarinic blockade. Donepezil is used to treat Alzheimer's disease. Edrophonium is
used to distinguish between a myasthenic crisis and a cholinesterase inhibitor overdose.
Neostigmine does not cross the blood-brain barrier and would not effectively treat this
patient's CNS symptoms.
A nurse is teaching a group of nursing students about irreversible cholinesterase inhibitors.
Which statement by a student indicates understanding of the teaching?
a. "Diazepam is given to reverse inhibition of cholinesterase when overdose occurs."
P 3
, • MED CERT 09/25/2026
b "Irreversible cholinesterase inhibitors are rapidly absorbed by all routes."
c."These agents are often used to treat glaucoma."
d. "Toxic doses of these agents produce an anticholinergic crisis."
- Correct Answer :ANS: B
Almost all of these agents are highly lipid soluble, making them readily absorbed from all
routes of administration. Diazepam is used during overdose but only to control seizures and
not to reverse effects. The only clinical use for these agents is to treat glaucoma, but this use
is limited. Toxic doses of these agents produce a cholinergic, not an anticholinergic, crisis.
Chapter 16: Drugs That Block Nicotinic Cholinergic Transmission: Neuromuscular Blocking
Agents and Ganglionic Blocking Agents
Test Bank - Correct Answer :
A nurse is caring for an intubated patient who is receiving pancuronium for neuromuscular
blockade. The patient's eyes are closed, and the patient is not moving any extremities. The
heart rate is 76 beats per minute, and the blood pressure is 110/70 mm Hg. The nurse caring
for this patient will do what?
a. Request an order for an antihistamine to prevent a further drop in blood pressure.
b. Request an order for serum electrolytes to evaluate for hyperkalemia.
c. Review the patient's chart for a history of myasthenia gravis (MG).
d. Talk to the patient while giving care and explain all procedures. - Correct Answer :ANS: D
Pancuronium is a competitive neuromuscular blocker and is used to paralyze skeletal muscles
by neuromuscular blockade. The first muscles affected are those of the eyelids, so patients
given this medication cannot open their eyes. Inability to move the extremities is an expected
effect. Because these medications do not have central nervous system (CNS) effects, the
patient is conscious and awake; therefore, caregivers should continue to talk to the patient
while providing care. Atracurium, not pancuronium, can cause hypotension secondary to
P 4
Basic And Clinical Pharmacology 14th Edition Katzung
Trevor Test Bank Questions And Correct Answers
Available A+ Guranteed
| COMPLETE TEST BANK ALL CHAPTERS | QUESTIONS,
ANSWERS & RATIONALES
A patient with myasthenia gravis who is taking a cholinesterase inhibitor is being admitted to
the intensive care unit and is on mechanical ventilation. The prescriber has ordered a
P 1
, • MED CERT 09/25/2026
challenge dose of edrophonium to distinguish between a myasthenic crisis and a medication
overdose. The nurse will expect to do what?
a. Administer neostigmine if muscle strength decreases.
b. Be prepared to administer atropine if muscle weakness increases.
c. Give a second dose of edrophonium if no improvement is seen.
d. Give pralidoxime (Protopam) if cholinergic symptoms worsen. –
Correct Answer :ANS: B
Edrophonium is an ultra-short-acting cholinesterase inhibitor used to distinguish between a
myasthenic crisis and a cholinesterase inhibitor overdose, because weakness or paralysis can
occur with both. If the symptoms are intensified and muscle weakness increases, the crisis is
cholinergic, meaning that the patient is having toxic effects from the cholinesterase inhibitor
and needs atropine as an antidote. Neostigmine would be given if the patient shows
improved muscle strength, because that would indicate that the patient's symptoms are the
result of a myasthenic crisis. A second dose of edrophonium would only worsen the
symptoms. Pralidoxime is used to treat poisoning caused by irreversible cholinesterase
inhibitors.
A nurse is teaching a new emergency department nurse about emergency medications. When
asked to describe the uses of pralidoxime (Protopam), the new nurse makes which correct
statement?
a."It exerts its greatest effects at muscarinic and ganglionic sites."
b. "It is used to treat poisoning by reversible cholinesterase inhibitors."
c."It may not be effective if not given immediately."
d."It reverses the effects of organophosphate insecticides in the central nervous system." –
P 2
, • MED CERT 09/25/2026
Correct Answer :ANS: C
Pralidoxime must be given soon after organophosphate poisoning has occurred because of a
process called aging, in which the bond between the organophosphate inhibitor and
cholinesterase increases in strength, making pralidoxime ineffective. For some of these
poisons, aging can occur within minutes. Pralidoxime has its greatest effects at the
neuromuscular junction, not the muscarinic and ganglionic sites. It is used to treat poisoning
by irreversible cholinesterase inhibitors. It does not cross the blood-brain barrier and thus
does not have effects in the CNS.
A patient is experiencing toxic side effects from atropine, including delirium and
hallucinations. Which medication will the nurse expect to administer?
a. Donepezil (Aricept)
b. Edrophonium (Reversol)
c. Neostigmine (Prostigmin)
d. Physostigmine –
Correct Answer :ANS: D
Physostigmine is the drug of choice for treating poisoning from atropine and other drugs that
cause muscarinic blockade. Donepezil is used to treat Alzheimer's disease. Edrophonium is
used to distinguish between a myasthenic crisis and a cholinesterase inhibitor overdose.
Neostigmine does not cross the blood-brain barrier and would not effectively treat this
patient's CNS symptoms.
A nurse is teaching a group of nursing students about irreversible cholinesterase inhibitors.
Which statement by a student indicates understanding of the teaching?
a. "Diazepam is given to reverse inhibition of cholinesterase when overdose occurs."
P 3
, • MED CERT 09/25/2026
b "Irreversible cholinesterase inhibitors are rapidly absorbed by all routes."
c."These agents are often used to treat glaucoma."
d. "Toxic doses of these agents produce an anticholinergic crisis."
- Correct Answer :ANS: B
Almost all of these agents are highly lipid soluble, making them readily absorbed from all
routes of administration. Diazepam is used during overdose but only to control seizures and
not to reverse effects. The only clinical use for these agents is to treat glaucoma, but this use
is limited. Toxic doses of these agents produce a cholinergic, not an anticholinergic, crisis.
Chapter 16: Drugs That Block Nicotinic Cholinergic Transmission: Neuromuscular Blocking
Agents and Ganglionic Blocking Agents
Test Bank - Correct Answer :
A nurse is caring for an intubated patient who is receiving pancuronium for neuromuscular
blockade. The patient's eyes are closed, and the patient is not moving any extremities. The
heart rate is 76 beats per minute, and the blood pressure is 110/70 mm Hg. The nurse caring
for this patient will do what?
a. Request an order for an antihistamine to prevent a further drop in blood pressure.
b. Request an order for serum electrolytes to evaluate for hyperkalemia.
c. Review the patient's chart for a history of myasthenia gravis (MG).
d. Talk to the patient while giving care and explain all procedures. - Correct Answer :ANS: D
Pancuronium is a competitive neuromuscular blocker and is used to paralyze skeletal muscles
by neuromuscular blockade. The first muscles affected are those of the eyelids, so patients
given this medication cannot open their eyes. Inability to move the extremities is an expected
effect. Because these medications do not have central nervous system (CNS) effects, the
patient is conscious and awake; therefore, caregivers should continue to talk to the patient
while providing care. Atracurium, not pancuronium, can cause hypotension secondary to
P 4
