• 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
P 1
, • MED CERT 09/25/2026
While preparing a patient for a procedure in which a neuromuscular blocking agent will be
used, the nurse reviews the patient's preprocedure laboratory values. Which abnormality
would cause the most concern?
a. Hyponatremia
b. Hypercalcemia
c. Hypomagnesemia
d. Hypokalemia - Correct Answer :ANS: D
Low potassium levels can enhance paralysis, whereas high potassium levels can reduce
paralysis. Because electrolyte status can influence the depth of neuromuscular blockade, it is
important to maintain normal electrolyte balance. There are no indications that sodium,
calcium, and/or magnesium have effects similar to those of potassium in relation to
neuromuscular blocking agents.
Which of the following areas of the body shows the effects of tubocurarine last?
a. Levator muscle of the eyelids and the muscles of mastication
b. Muscles in the lower extremities
c. Muscles controlling the glottis
d.Muscles of respiration and the diaphragm - Correct Answer :ANS: D
Although tubocurarine can paralyze all skeletal muscles, not all muscles are affected at once.
The last muscles affected by tubocurarine are the muscles of respiration, including the
intercostals, and the diaphragm. The first to become paralyzed are the levator muscle of the
eyelids and the muscles of mastication. Paralysis occurs next in the muscles of the limbs,
abdomen, and glottis.
A patient will receive atracurium (Tracrium) during surgery for neuromuscular blockade. The
nurse caring for this patient will correctly perform which of the following actions?
P 2
, • MED CERT 09/25/2026
a. Assess the patient for signs of CNS depression.
b. Ensure that dantrolene is available in case of a serious adverse reaction.
c. Monitor the patient's blood pressure closely.
d. Review the preprocedure laboratory values related to renal and hepatic function.
- Correct Answer :ANS: C
Atracurium is used for muscle relaxation during surgery. Unlike other drugs in this class, it can
cause hypotension secondary to antihistamine release. Cholinesterase inhibitors can reverse
this reaction. Drugs in this class do not cause CNS depression. Dantrolene is the agent used to
treat malignant hyperthermia, which is triggered by succinylcholine. Atracurium is eliminated
primarily by plasma cholinesterase and not by the renal or hepatic routes.
While preparing a patient for a second esophageal dilation procedure, the nurse explains that
succinylcholine (Anectine) will be used for muscle relaxation. The patient is anxious and
reports not being able to swallow for several hours after the previous procedure. What will
the nurse do?
a. Be prepared to provide mechanical ventilation after the procedure.
b. Have dantrolene available, because this patient is at increased risk for side effects.
c.Reassure the patient that this is expected after neuromuscular blockade.
d.Request an order for a pseudocholinesterase level. - Correct Answer :ANS: D
Succinylcholine is used for muscle relaxation during short procedures, such as esophageal
dilation, because of its short duration. The effects wear off minutes after the drug is
withdrawn, because plasma pseudocholinesterase quickly degrades it. Patients who have
prolonged effects may have low plasma pseudocholinesterase levels and should be evaluated
if this is suspected. Mechanical ventilation may be necessary if the drug is given, but the
prudent nurse would rather avoid this by taking preventive measures instead of treating the
adverse reaction after the fact. Dantrolene should always be available when succinylcholine is
used because of the risk of malignant hyperthermia; however, nothing indicates that this
P 3
, • MED CERT 09/25/2026
particular patient is at greater risk than others. Prolonged neuromuscular blockade is not a
normal reaction.
A nurse is reviewing nursing actions for emergency treatment of malignant hyperthermia with
a group of nursing students. Which statement by a student indicates a need for further
teaching?
a. "Analgesics should be given to help with muscle pain."
b. "Dantrolene helps to slow the metabolic activity in skeletal muscles."
c. "If malignant hyperthermia occurs, the succinylcholine must be stopped immediately."
d. "The patient may need an intravenous infusion of cold saline." - Correct Answer :ANS: A
Malignant hyperthermia is a rare but potentially fatal adverse reaction that can be triggered
by succinylcholine. Muscle pain is an expected adverse effect of succinylcholine that is
thought to be caused by the muscle contractions that occur during induction; analgesics can
be given, but this effect usually occurs 10 to 12 hours after the procedure and is not an
emergency. Dantrolene is given because it slows metabolic activity in skeletal muscles,
resulting in decreased heat production. Succinylcholine should be stopped immediately if
malignant hyperthermia occurs. Cold saline, given intravenously, often is necessary to lower a
patient's temperature.
A patient receives a neuromuscular blocking agent before a procedure. The patient's eyes
close. The nurse knows this is a sign that the patient:
a. has fallen asleep.
b. has received a toxic dose of the medication.
c. is beginning to feel the drug's effects.
d. may need mechanical ventilation. - Correct Answer :ANS: C
Neuromuscular blocking agents relax skeletal muscle to produce flaccid paralysis; the first
muscles to be affected are the levator muscle of the eyelids and the muscles of mastication.
These agents do not affect the CNS. Because the drug has just taken effect, a toxic dose is
not yet a concern. Mechanical ventilation is necessary when the drug affects the intercostal
muscles and the diaphragm, interfering with respiration.
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
P 1
, • MED CERT 09/25/2026
While preparing a patient for a procedure in which a neuromuscular blocking agent will be
used, the nurse reviews the patient's preprocedure laboratory values. Which abnormality
would cause the most concern?
a. Hyponatremia
b. Hypercalcemia
c. Hypomagnesemia
d. Hypokalemia - Correct Answer :ANS: D
Low potassium levels can enhance paralysis, whereas high potassium levels can reduce
paralysis. Because electrolyte status can influence the depth of neuromuscular blockade, it is
important to maintain normal electrolyte balance. There are no indications that sodium,
calcium, and/or magnesium have effects similar to those of potassium in relation to
neuromuscular blocking agents.
Which of the following areas of the body shows the effects of tubocurarine last?
a. Levator muscle of the eyelids and the muscles of mastication
b. Muscles in the lower extremities
c. Muscles controlling the glottis
d.Muscles of respiration and the diaphragm - Correct Answer :ANS: D
Although tubocurarine can paralyze all skeletal muscles, not all muscles are affected at once.
The last muscles affected by tubocurarine are the muscles of respiration, including the
intercostals, and the diaphragm. The first to become paralyzed are the levator muscle of the
eyelids and the muscles of mastication. Paralysis occurs next in the muscles of the limbs,
abdomen, and glottis.
A patient will receive atracurium (Tracrium) during surgery for neuromuscular blockade. The
nurse caring for this patient will correctly perform which of the following actions?
P 2
, • MED CERT 09/25/2026
a. Assess the patient for signs of CNS depression.
b. Ensure that dantrolene is available in case of a serious adverse reaction.
c. Monitor the patient's blood pressure closely.
d. Review the preprocedure laboratory values related to renal and hepatic function.
- Correct Answer :ANS: C
Atracurium is used for muscle relaxation during surgery. Unlike other drugs in this class, it can
cause hypotension secondary to antihistamine release. Cholinesterase inhibitors can reverse
this reaction. Drugs in this class do not cause CNS depression. Dantrolene is the agent used to
treat malignant hyperthermia, which is triggered by succinylcholine. Atracurium is eliminated
primarily by plasma cholinesterase and not by the renal or hepatic routes.
While preparing a patient for a second esophageal dilation procedure, the nurse explains that
succinylcholine (Anectine) will be used for muscle relaxation. The patient is anxious and
reports not being able to swallow for several hours after the previous procedure. What will
the nurse do?
a. Be prepared to provide mechanical ventilation after the procedure.
b. Have dantrolene available, because this patient is at increased risk for side effects.
c.Reassure the patient that this is expected after neuromuscular blockade.
d.Request an order for a pseudocholinesterase level. - Correct Answer :ANS: D
Succinylcholine is used for muscle relaxation during short procedures, such as esophageal
dilation, because of its short duration. The effects wear off minutes after the drug is
withdrawn, because plasma pseudocholinesterase quickly degrades it. Patients who have
prolonged effects may have low plasma pseudocholinesterase levels and should be evaluated
if this is suspected. Mechanical ventilation may be necessary if the drug is given, but the
prudent nurse would rather avoid this by taking preventive measures instead of treating the
adverse reaction after the fact. Dantrolene should always be available when succinylcholine is
used because of the risk of malignant hyperthermia; however, nothing indicates that this
P 3
, • MED CERT 09/25/2026
particular patient is at greater risk than others. Prolonged neuromuscular blockade is not a
normal reaction.
A nurse is reviewing nursing actions for emergency treatment of malignant hyperthermia with
a group of nursing students. Which statement by a student indicates a need for further
teaching?
a. "Analgesics should be given to help with muscle pain."
b. "Dantrolene helps to slow the metabolic activity in skeletal muscles."
c. "If malignant hyperthermia occurs, the succinylcholine must be stopped immediately."
d. "The patient may need an intravenous infusion of cold saline." - Correct Answer :ANS: A
Malignant hyperthermia is a rare but potentially fatal adverse reaction that can be triggered
by succinylcholine. Muscle pain is an expected adverse effect of succinylcholine that is
thought to be caused by the muscle contractions that occur during induction; analgesics can
be given, but this effect usually occurs 10 to 12 hours after the procedure and is not an
emergency. Dantrolene is given because it slows metabolic activity in skeletal muscles,
resulting in decreased heat production. Succinylcholine should be stopped immediately if
malignant hyperthermia occurs. Cold saline, given intravenously, often is necessary to lower a
patient's temperature.
A patient receives a neuromuscular blocking agent before a procedure. The patient's eyes
close. The nurse knows this is a sign that the patient:
a. has fallen asleep.
b. has received a toxic dose of the medication.
c. is beginning to feel the drug's effects.
d. may need mechanical ventilation. - Correct Answer :ANS: C
Neuromuscular blocking agents relax skeletal muscle to produce flaccid paralysis; the first
muscles to be affected are the levator muscle of the eyelids and the muscles of mastication.
These agents do not affect the CNS. Because the drug has just taken effect, a toxic dose is
not yet a concern. Mechanical ventilation is necessary when the drug affects the intercostal
muscles and the diaphragm, interfering with respiration.
P 4
