Chapter 33 Anticholinergic Agents prepU (GRADED A) Questions and Answers REF, Karch, A. M., Focus on Nursing Pharmacology, 8th ed | 100% VERIFIED.

Chapter 33: Anticholinergic Agents Question 1 See full question34s Report this Question While preparing a client for an eye examination, the nurse explains that the eyedrops, an ophthalmic antic holinergic preparation, will cause what pupil reaction? You Selected: dilatation Correct response: dilatation Explanation: Anticholinergic drugs are applied topically for mydriatic and cycloplegic effects to aid examination or surgery by dilating the pupils. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Anticholinergics/Parasympatholytics, p. 557. Chapter 33: Anticholinergic Agents - Page 557 Add a Note Question 2 See full question12s Report this Question A client is prescribed dicyclomine. The nurse would expect to administer this drug by which route? You Selected: Oral Correct response: Oral Explanation: Dicyclomine is administered orally. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Pharmacokinetics, p. 558. Chapter 33: Anticholinergic Agents - Page 558 Add a Note Question 3 See full question30s Report this Question Which patient statement indicates to the nurse that the patient is experiencing an adverse effect of hyoscyamine? You Selected: "I feel like my heart is going to jump out of my chest." Correct response: "I feel like my heart is going to jump out of my chest." Explanation: Tachycardia and palpitations are adverse effects of hyoscyamine. Urinary retention would be an adverse effect of hyoscyamine. Blurred vision is an adverse effects of hyoscyamine. Constipation would be an adverse effect of hyoscyamine. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Adverse Effects, p. 559. Chapter 33: Anticholinergic Agents - Page 559 Add a Note Question 4 See full question57s Report this Question The nurse should observe clients receiving a cholinergic blocking drug during the hot summer months because these clients are at increased risk of which adverse effect? You Selected: Heat prostration Correct response: Heat prostration Explanation: The nurse should observe clients receiving a cholinergic blocking drug during the hot summer months because these clients are at increased risk of heat prostration. Sunburn is not an adverse reaction for cholinergic blocking drugs. Clients receiving atropine for third-degree heart block may develop tachycardia or arrhythmias, not specifically heart attack. Cholinergic blockers decrease sweating, so dehydration is not seen. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Adverse Effects, p. 560. Chapter 33: Anticholinergic Agents - Page 560 Add a Note Question 5 See full question12s Report this Question A client is receiving propantheline as adjunctive therapy for peptic ulcers. The nurse instructs the client to take the medication at which time? You Selected: 30 minutes before meals Correct response: 30 minutes before meals Explanation: A client receiving propantheline as an adjunctive therapy for peptic ulcers should take the medication 30 minutes before meals and at bedtime. One hour after meals will interfere with the action of the medication. Only as needed does not produce therapeutic effects and giving this medication during meals will interfere with the action of the medication. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Table 33.1 Drugs in Focus: Anticholinergic Agents/Parasympatholytics (continued), p. 556. Chapter 33: Anticholinergic Agents - Page 556 Add a Note Question 6 See full question20s Report this Question A client is administered atropine to increase the heart rate. What is the action of atropine? You Selected: It blocks the parasympathetic vagal stimulation. Correct response: It blocks the parasympathetic vagal stimulation. Explanation: Moderate to large doses of atropine increase the heart rate by blocking parasympathetic vagal stimulation. The exacerbation of the parasympathetic vagal stimulation is opposite to the effect of atropine. The blockage of histamine is seen with the antihistamine medications, not anticholinergic agents. Atropine does not block cell wall synthesis. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Anticholinergics/Parasympatholytics, p. 557. Chapter 33: Anticholinergic Agents - Page 557 Add a Note Question 7 See full question1m 2s Report this Question The health care provider has ordered scopolamine transdermally for motion sickness. Which statement by the client, prescribed transdermal scopolamine, indicates an understanding of the medication's administration guideline? You Selected: "I will change the patch every 3 days." Correct response: "I will change the patch every 3 days." Explanation: Scopolamine is used for motion sickness. The disk protects against motion sickness for 72 hours (3 days). The scopolamine patch is applied behind the ear, not to the chest. The patch is used prior to the client experiencing nausea. The patch is not changed every 4 hours. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Anticholinergics/Parasympatholytics, p. 555. Chapter 33: Anticholinergic Agents - Page 555 Add a Note Question 8 See full question19s Report this Question A client with symptomatic bradycardia has been receiving atropine for the past 4 days and the client reports constipation. What is the most important suggestion the nurse could give the client? You Selected: Increase bulk in the diet. Correct response: Increase bulk in the diet. Explanation: Constipation is a troubling adverse effect that may be managed by adding fiber to the diet, increasing hydration, and exercising moderately. Sucking on hard candies may help prevent a dry mouth but would not prevent constipation; the suggestions of avoiding driving at night or being attentive to oral care will help the client prevent other adverse effects of the therapy. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Nursing Considerations for Patients Receiving Anticholinergic Agents, pp. 561- 562. Chapter 33: Anticholinergic Agents - Page 561-562 Add a Note Question 9 See full question12s Report this Question Anticholinergic drugs are used in ophthalmology to You Selected: dilate the pupils. Correct response: dilate the pupils. Explanation: Anticholinergic drugs are applied topically for mydriasis (dilation of the pupil) and cycloplegia (paralysis of the ciliary structure of the eye) to aid in examination or surgery of the eye. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Table 33.1 Drugs in Focus: Anticholinergic Agents/Parasympatholytics (continued), p. 556. Chapter 33: Anticholinergic Agents - Page 556 Add a Note Question 10 See full question38s Report this Question The nurse is educating a client who has been prescribed atropine, an anticholinergic drug. Which instructions should the nurse provide to the client? You Selected: "Do not drive or operate machinery." Correct response: "Do not drive or operate machinery." Explanation: Effects of anticholinergic drugs such as atropine include blurred vision and impaired ability to sweat. Clients should be cautioned to avoid activities that may be made dangerous by blurred vision; this may include driving and operating machinery. To avoid overheating, clients should avoid strenuous activity and take other measures to stay cool (e.g., frequent cool baths). Clients experiencing eye pain may have undiagnosed glaucoma; they should stop taking the medications and contact their health care providers. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Implementation with Rationale, p. 562. Chapter 33: Anticholinergic Agents - Page 562 Add a Note Question 11 See full question13s Report this Question A 70-year-old client is taking a cholinergic blocking drug. The family has noticed the client is a confused, excited, and not voiding normally. What would be the appropriate action by the nurse in this situation? You Selected: Instruct the client's family to withhold the next dose and the nurse will contact the prescribing provider. Correct response: Instruct the client's family to withhold the next dose and the nurse will contact the prescribing provider. Explanation: Older clients taking cholinergic blocking medications may exhibit symptoms such as excitement, mental confusion, and urinary retention. If a client is exhibiting these symptoms, the medication should be withheld for the next dose and the nurse should contact the prescribing provider. Ignoring symptoms is not advised because they could become worse. Increasing the dose would probably increase the symptoms and it is not appropriate for the nurse to change medication dosage without a provider order. It is not a medical emergency, so going to the emergency department is not necessary. The family is given the instruction due to the fact the client is confused. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Implementation with Rationale, p. 562. Chapter 33: Anticholinergic Agents - Page 562 Add a Note Question 12 See full question15s Report this Question An elderly woman is given scopolamine while on a cruise. She becomes very agitated and confused and is taken to the sick-bay of the ship. The nurse knows that which is a likely reason for these symptoms? You Selected: Older clients have a greater chance of adverse reactions to cholinergic blocking drugs. Correct response: Older clients have a greater chance of adverse reactions to cholinergic blocking drugs. Explanation: Older clients receiving cholinergic blocking drugs may have a greater chance of adverse reactions, including excitement, agitation, mental confusion, drowsiness, and urinary retention. Dementia does not prevent visual adverse effects. Urinary retention does not cause agitation. Drowsiness from cholinergic blocking drugs is unrelated to the sleep pattern of a client. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Table 33.1 Drugs in Focus: Anticholinergic Agents/Parasympatholytics (continued), p. 556. Chapter 33: Anticholinergic Agents - Page 556 Add a Note Question 13 See full question10s Report this Question A 57-year-old female client has a history of two myocardial infarctions in the past 3 years. She presents to the health care provider’s office with symptoms of an overactive bladder. She requests an anticholinergic medication that she saw advertised on television. What does the nurse expect the provider to do for this client? You Selected: Explain to the client that the medication is contraindicated because of her medical history Correct response: Explain to the client that the medication is contraindicated because of her medical history Explanation: Anticholinergic drugs are contraindicated for clients with BPH, myasthenia gravis, hyperthyroidism, narrow-angle glaucoma, tachydysrhythmias, myocardial infarction, heart failure, or conditions associated with esophageal reflux. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Contraindications and Cautions, p. 558. Chapter 33: Anticholinergic Agents - Page 558 Add a Note Question 14 See full question13s Report this Question A 75-year-old male client is experiencing extrapyramidal symptoms secondary to an antipsychotic drug. Which drug would the nurse expect the health care provider to order to relieve these symptoms? You Selected: Anticholinergics Correct response: Anticholinergics Explanation: Anticholinergic medications are indicated in the relief of central nervous system symptoms of Parkinson’s disease or extrapyramidal symptoms associated with some antipsychotic drugs. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Anticholinergics/Parasympatholytics, p. 554. Chapter 33: Anticholinergic Agents - Page 554 Add a Note Question 15 See full question12s Report this Question Which agent would a nurse expect to administer transdermally? You Selected: Scopolamine Correct response: Scopolamine Explanation: Only scopolamine is available as a transdermal system. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Box 33.1 Focus on Drug Therapy across the Lifespan, p. 555. Chapter 33: Anticholinergic Agents - Page 555 Add a Note Question 16 See full question3m 44s Report this Question A client with hypertension is to receive an anticholinergic agent. The nurse would be especially alert for: You Selected: increased blood pressure. Correct response: increased blood pressure. Explanation: A client with hypertension who receives an anticholinergic is at risk for additive hypertensive effects due to the dominance of the sympathetic system with parasympathetic blockage. Bladder obstruction, paralytic ileus, and increased intraocular pressure are contraindications for the use of an anticholinergic agent. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Nursing Considerations for Patients Receiving Anticholinergic Agents, p. 561. Chapter 33: Anticholinergic Agents - Page 561 Add a Note Question 17 See full question37s Report this Question A female client is going on a cruise to Nova Scotia with her husband to celebrate their 15th wedding anniversary. She is concerned because she has experienced severe, debilitating seasickness in the past. What would the nurse expect the health care provider to order? You Selected: Scopolamine Correct response: Scopolamine Explanation: Scopolamine is an anticholinergic drug that is effective in relieving nausea and vomiting associated with motion sickness and radiation therapy for cancer. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Table 33.1 Drugs in Focus: Anticholinergic Agents/Parasympatholytics, p. 556. Chapter 33: Anticholinergic Agents - Page 556 Add a Note Question 18 See full question51s Report this Question A client has been prescribed an anticholinergic medication. What instructions should the nurse provide related to safety when outside in hot weather? You Selected: Keep well hydrated Correct response: Keep well hydrated Explanation: Adults taking an anticholinergic medication should be encouraged to drink plenty of fluids and to avoid hot temperatures because heat intolerance can occur and it will be important to maintain hydration should this happen. While the other options are appropriate suggestions, none are directly related to the safety issue of heat intolerance caused by the medication. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Implementation with Rationale, p. 562. Chapter 33: Anticholinergic Agents - Page 562 Add a Note Question 19 See full question11s Report this Question Which anticholinergic agent is sometimes used to manage motion sickness when delivered by transdermal patch? You Selected: Scopolamine Correct response: Scopolamine Explanation: 1.5 mg of scopolamine is delivered via transdermal patch. This description does not relate to any of the other options. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Scopolamine, p. 556. Chapter 33: Anticholinergic Agents - Page 556 Add a Note Question 20 See full question3m 29s Report this Question The nurse is teaching a client about some of the cholinergic blocking drugs that are available over the counter without a prescription. Which medication would the nurse include as being available without a prescription? Select all that apply. You Selected: Belladonna Dicyclomine Diphenhydramine Correct response: Diphenhydramine Scopolamine Explanation: Diphenhydramine, scopolamine, and atropine maybe contained in products available to clients without a prescription. Oxybutynin relaxes smooth muscle of the bladder and urinary tract and is used for overactive bladder; belladonna from which atropine and scopolamine are made from and used for many purposes including dilation of the pupil; and dicyclomine used for irritable bowel syndrome, are all prescription meds. Question 1 See full question34s Report this Question Which symptom should the nurse monitor for when caring for a client whose sinus bradycardia has been treated with large doses of atropine? You Selected: flushing Correct response: flushing Explanation: Large doses cause facial flushing because of dilation of blood vessels in the neck. Pallor, edema, and incontinence are not caused by dilation of blood vessels in the neck. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Table 33.1 Drugs in Focus: Anticholinergic Agents/Parasympatholytics, p. 555. Chapter 33: Anticholinergic Agents - Page 555 Add a Note Question 2 See full question11s Report this Question The nurse is preparing a client for pacemaker surgery. The health care provider orders atropine to be given 30 minutes before the client is taken to the operating room. The nurse knows this medication is ordered for what reason? You Selected: To dry up respiratory secretions to prevent aspiration during surgery Correct response: To dry up respiratory secretions to prevent aspiration during surgery Explanation: Atropine is an anticholinergic agent. The principal actions of atropine are a reduction in salivary, bronchial, and sweat gland secretions; mydriasis; cycloplegia; changes in heart rate; contraction of the bladder detrusor muscle and of the gastrointestinal smooth muscle; decreased gastric secretion; and decreased gastrointestinal motility. The reason this client is given the medication preoperatively is to dry up secretions to prevent aspiration during surgery. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Table 33.1 Drugs in Focus: Anticholinergic Agents/Parasympatholytics, p. 555. Chapter 33: Anticholinergic Agents - Page 555 Add a Note Question 3 See full question17s Report this Question Administration of which classes of medications can decrease secretions of the upper respiratory tract? You Selected: Cholinergic blocking drug Correct response: Cholinergic blocking drug Explanation: Cholinergic antagonists are the class of medications used to decrease secretions of the upper respiratory tract. Antianxiolytics decrease preoperative anxiety. Opioids decrease both anxiety and pain preoperatively. Antiemetics are used to decrease nausea after surgery. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Anticholinergics/Parasympatholytics, pp. 555-558. Chapter 33: Anticholinergic Agents - Page 555-558 Add a Note Question 4 See full question1m 51s Report this Question A client is prescribed glycopyrrolate. The nurse understands that this drug may be administered by which route? (Select all that apply.) You Selected: Intramuscular Intravenous Oral Correct response: Oral Intramuscular Subcutaneous Intravenous Explanation: Glycopyrrolate can be given orally, intramuscularly, subcutaneously, and intravenously. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Pharmacokinetics, p. 558. Chapter 33: Anticholinergic Agents - Page 558 Add a Note Question 5 See full question1m 9s Report this Question A nursing mother is being prepared for an eye condition which requires a prescription for atropine. What nursing intervention should the nurse implement to assure safe and effective atropine therapy? You Selected: Discuss an alternative feeding method until the atropine is no longer prescribed Correct response: Discuss an alternative feeding method until the atropine is no longer prescribed Explanation: Because of the potential for serious adverse effects on the baby, nursing mothers should be assisted in finding another method of feeding the baby if an anticholinergic drug is needed. None of the other options effectively manage the safety risk to the infant. Question 1 See full question18s Report this Question Clients with what disorder should not be given anticholinergic drugs? You Selected: Glaucoma Correct response: Glaucoma Explanation: Anticholinergic drugs are contraindicated for patients with benign prostatic hypertrophy, myasthenia gravis, hyperthyroidism, glaucoma, tachydysrhythmia, myocardial infarction, heart failure, or conditions associated with esophageal reflux. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Contraindications and Cautions, p. 558. Chapter 33: Anticholinergic Agents - Page 558 Add a Note Question 2 See full question10s Report this Question Unwanted anticholinergic effects include: You Selected: constipation and dry mouth. Correct response: constipation and dry mouth. Explanation: Unwanted anticholinergic effects include dry mouth, constipation, and mydriasis. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Adverse Effects, p. 559. Chapter 33: Anticholinergic Agents - Page 559 Add a Note Question 3 See full question17s Report this Question Which would the nurse include in a teaching plan for a client who is prescribed an anticholinergic agent? You Selected: Avoiding activities that require alertness Correct response: Avoiding activities that require alertness Explanation: Safety measures are important because of the possible CNS effects. Avoiding temperature extremes and exertion in warm temperatures is important because of possible heat intolerance. Drinking fluids is important to maintain hydration and combat dry mouth. Constipation may occur with an anticholinergic; therefore increased fiber intake would be appropriate. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Nursing Considerations for Patients Receiving Anticholinergic Agents, p. 561. Chapter 33: Anticholinergic Agents - Page 561 Add a Note Question 4 See full question22s Report this Question After teaching a female client who is prescribed a scopolamine patch, the nurse determines that the teaching was successful when the client states that she will change the patch in which time frame? You Selected: Every 3 days Correct response: Every 3 days Explanation: Scopolamine patch is changed every 3 days. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Box 33.3, p. 558. Chapter 33: Anticholinergic Agents - Page 558 Add a Note Question 5 See full question12s Report this Question A client is prescribed glycopyrrolate preoperatively. The nurse integrates understanding of the drug’s action, explaining that this drug will help achieve which effect? You Selected: Reduction of oral secretions Correct response: Reduction of oral secretions Explanation: The cholinergic blocking drug glycopyrrolate is used in conjunction with anesthesia to reduce oral secretions. Increased muscle rigidity, relaxation, and prolongation of anesthesia are not seen with the use of this drug. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Table 33.1 Drugs in Focus: Anticholinergic Agents/Parasympatholytics (continued), p. 556. Chapter 33: Anticholinergic Agents - Page 556 Add a Note Question 6 See full question55s Report this Question What disease process would cause a nurse to question a client’s new prescription for benztropine? You Selected: narrow-angle glaucoma Correct response: narrow-angle glaucoma Explanation: Narrow-angle glaucoma will result in increased intraocular pressure, and the client should not receive the anticholinergic agent. Clients who suffer from diabetes mellitus, myocardial infarction, or hyperparathyroidism can be prescribed anticholinergic agents. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Nursing Considerations for Patients Receiving Anticholinergic Agents, p. 561. Chapter 33: Anticholinergic Agents - Page 561 Add a Note Question 7 See full question1m 52s Report this Question Which symptoms will warrant the administration of atropine? You Selected: Bradycardia Correct response: Bradycardia Explanation: Atropine is the drug of choice to treat sinus bradycardia. Blurred vision, paralytic ileus, and urinary retention are not treated with atropine. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Table 33.1 Drugs in Focus: Anticholinergic Agents/Parasympatholytics, p. 555. Chapter 33: Anticholinergic Agents - Page 555 Add a Note Question 8 See full question9s Report this Question A client who is going on a cruise is concerned about motion sickness and sees the health care provider, who prescribes scopolamine. The nurse informs the client that using scopolamine may cause the client to experience: You Selected: drowsiness. Correct response: drowsiness. Explanation: Scopolamine at therapeutic doses produces CNS depression characterized by drowsiness, euphoria, amnesia, fatigue, and dreamless sleep resulting from decreased periods of rapid eye movement. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Central Nervous System, p. 559. Chapter 33: Anticholinergic Agents - Page 559 Add a Note Question 9 See full question4m 18s Report this Question A 75-year-old male client is started on flavoxate, an anticholinergic drug used in the treatment of overactive bladder. When teaching the client about the medication, the nurse should explain that the client may be at increased risk of: You Selected: falls related to visual effects. Correct response: falls related to visual effects. Explanation: Among the effects of anticholinergic drugs such as flavoxate are mydriasis and blurred vision. These effects can increase the risk of falls, particularly in older clients. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Table 33.1 Drugs in Focus: Anticholinergic Agents/Parasympatholytics, p. 555. Chapter 33: Anticholinergic Agents - Page 555 Add a Note Question 10 See full question51s Report this Question The nurse is caring for a client with glaucoma and is aware that which category of preanesthetic medication is contraindicated in this client? You Selected: Cholinergic blocking Correct response: Cholinergic blocking Explanation: Cholinergic blocking agents are contraindicated in clients with prostatic hypertrophy, gluacoma, and myocardial ischemia. Opioids, antiemetics, and antianxiety drugs are not contraindicated in clients with glaucoma. Question 1 See full question1m 12s Report this Question After teaching a group of students about anticholinergic agents, the instructor determines the need for additional teaching when the students identify what condition as a contraindication for use? You Selected: Hypertension Correct response: Hypertension Explanation: Anticholinergic agents should be used cautiously for patients with hypertension because of the possible additive hypertensive effects. Myasthenia gravis is a contraindication for the use of anticholinergics. Toxic megacolon is a contraindication for the use of anticholinergics. Prostatic hypertrophy is a contraindication for the use of anticholinergics. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Contraindications and Cautions, pp. 558-559. Chapter 33: Anticholinergic Agents - Page 558-559 Add a Note Question 2 See full question20s Report this Question A nurse is administering a cholinergic-blocking drug preoperatively to a patient. What intervention should the nurse perform after administering the drug to the patient? You Selected: Raise the side rails of the bed. Correct response: Raise the side rails of the bed. Explanation: The nurse should raise the side rails of the patient's bed after administration of the drug. The nurse need not provide cold milk or provide frequent sips of water as fluids cannot be given after administering the drug. If a cholinergic-blocking drug is administered preoperatively, the nurse tells the patient to void before the drug is given. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Box 33.2 Focus on Cultural Considerations, p. 558. Chapter 33: Anticholinergic Agents - Page 558 Add a Note Question 3 See full question17s Report this Question A client with asthma will soon begin treatment with atropine as an adjunct to a normal drug regimen. What teaching point should the nurse include in client education related to this new aspect of drug treatment? You Selected: “It's possible that your eyes will take longer to adjust to bright lights.” Correct response: “It's possible that your eyes will take longer to adjust to bright lights.” Explanation: As an anticholinergic drug, atropine has the potential to cause visual disturbances, dry mouth, constipation, and urinary retention. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Implementation with Rationale, p. 562. Chapter 33: Anticholinergic Agents - Page 562 Add a Note Question 4 See full question17s Report this Question Because of the systemic effects of anticholinergic drugs, patients using these drugs are more susceptible to: You Selected: heat stroke related to decreased perspiration. Correct response: heat stroke related to decreased perspiration. Explanation: By blocking cholinergic receptors, anticholinergic drugs reduce sweating, which decreases heat loss and increases the risk of hyperthermia and heat stroke. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, DISCUSSION, p. 563. Chapter 33: Anticholinergic Agents - Page 563 Add a Note Question 5 See full question47s Report this Question A 78-year-old client is about to begin home care and has been prescribed an anticholinergic. What should the home care nurse explain to the client and her family about this medication? You Selected: All the above Correct response: All the above Explanation: The effects of anticholinergic drugs include decreased gastrointestinal motility, decreased sweat production, and blurred vision. These effects put the older adult at increased risk of constipation, heat stroke, and falls. The risk of constipation can be reduced by increasing fiber and fluids in the diet. The risk of falls can be reduced by assisting the client during ambulation. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Anticholinergics/Parasympatholytics, p. 554. Chapter 33: Anticholinergic Agents - Page 554 Add a Note Question 6 See full question13s Report this Question A male client asks the nurse why he needs the preoperative anticholinergic medication ordered by the anesthesiologist. The nurse explains that anticholinergic drugs are given preoperatively to prevent which anesthesia associated complication? You Selected: Bradycardia Correct response: Bradycardia Explanation: Anticholinergic drugs are given preoperatively to prevent anesthesia-associated complications such as bradycardia, excessive respiratory secretions, and hypotension. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Table 33.1 Drugs in Focus: Anticholinergic Agents/Parasympatholytics, p. 555. Chapter 33: Anticholinergic Agents - Page 555 Add a Note Question 7 See full question1m 11s Report this Question A 4 year old has been prescribed an anticholinergic medication. The nurse should instruction the parents to monitor and report changes in basic function You Selected: Urinary output Correct response: Urinary output Explanation: Children are often more sensitive to the adverse effects of anticholinergic medications including constipation and urinary retention. This classification of medication is not typically associated with any of the other options. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents. Add a Note Question 8 See full question2m 22s Report this Question After administering a cholinergic blocking drug to a client, the client reports some blurred vision. The nurse observes that the client’s pupils are dilated. The nurse documents this finding as which adverse effects? You Selected: Mydriasis Correct response: Mydriasis Explanation: Mydriasis refers to dilation of the pupil. Cycloplegia refers to the paralysis of the ciliary muscles of the eye, resulting in an inability to focus. Idiosyncrasy refers to an unusual or abnormal response that differs from the response normally expected to a specific drug or dosage. Photophobia refers to an increased sensitivity to light. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Anticholinergic Agents, p. 557. Chapter 33: Anticholinergic Agents - Page 557 Add a Note Question 9 See full question10s Report this Question The nurse prepares to administer a preoperative anticholinergic to a client. What is a desired effect based upon the characteristics of the prescribed medication? You Selected: dry mucous membranes Correct response: dry mucous membranes Explanation: Anticholinergic medications block the actions of the endogenous neurotransmitters of the parasympathetic stimulation. The medication would lead to drying of mucous membranes, a desired effect for a preoperative drug. The other listed responses of wheezing, which is because of bronchoconstriction; heart rate of 50, which is bradycardia; and pupils’ constriction and increase in mucous secretions would be present when a client receives a cholinergic medication resulting from the activation of the parasympathetic nervous system. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Anticholinergics/Parasympatholytics, pp. 554-556. Chapter 33: Anticholinergic Agents - Page 554-556 Add a Note Question 10 See full question1m 12s Report this Question A client diagnosed with myasthenia gravis is experiencing rhinorrhea. Which medication should not be administered to the client? You Selected: ipratropium Correct response: ipratropium Explanation: Ipratropium is administered for rhinorrhea but is contraindicated in clients who have been diagnosed with myasthenia gravis because of its anticholinergic effects. Azelastine hydrochloride, fexofenadine, and nedocromil sodium are not contraindicated for clients with myasthenia gravis. Question 1 See full question53s Report this Question A patient receives atropine intravenously. The nurse would expect the drug to be effective for how long? You Selected: 6 hours Correct response: 4 hours Explanation: Atropine given IV has a duration of action of 4 hours. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Prototype Summary: Atropine, p. 561. Chapter 33: Anticholinergic Agents - Page 561 Add a Note Question 2 See full question28s Report this Question Which cholinergic-blocking drugs are used in the treatment of chronic obstructive pulmonary disease (COPD)? (Select all that apply.) You Selected: Ipratropium (Atrovent) Tiotropium (Spiriva) Correct response: Ipratropium (Atrovent) Tiotropium (Spiriva) Explanation: Ipratropium (Atrovent) and tiotropium (Spiriva) are inhaled cholinergic-blocking drugs used in the treatment of chronic obstructive pulmonary disease (COPD). Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, NURSING CARE GUIDE FOR E.K.: HEART DISEASE, p. 563. Chapter 33: Anticholinergic Agents - Page 563 Add a Note Question 3 See full question13s Report this Question A nurse is caring for a patient who has been prescribed scopolamine hydrobromide for pre-anesthetic sedation. The drug is known to cause heat prostration during the hot summer months. What signs of heat prostration should the nurse monitor for when caring for this patient? You Selected: Fever Correct response: Fever Explanation: The nurse should look for any signs of fever, tachycardia, flushing, warm dry skin, and mental confusion in the patient who is administered scopolamine hydrobromide during the summer season. Dry mouth, skin rashes, and urinary retention are the adverse reactions associated with the administration of various cholinergic-blocking drugs. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Table 33.1 Drugs in Focus: Anticholinergic Agents/Parasympatholytics (continued), p. 556. Chapter 33: Anticholinergic Agents - Page 556 Add a Note Question 4 See full question27s Report this Question A male client is prescribed an anticholinergic drug by his health care provider. He likes to hike with his grandchildren. The home care nurse instructs the client that anticholinergic medications have which effect? You Selected: Prevents sweating and heat loss and increasing the risk of heat stroke Correct response: Prevents sweating and heat loss and increasing the risk of heat stroke Explanation: Anticholinergic drugs are commonly used in home care with children and adults. The home care nurse may need to teach older clients or caregivers that the drugs prevent sweating and heat loss and increase risks of heat stroke if precautions to avoid overheating are not taken. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 33: Anticholinergic Agents, Table 33.2 Effects of Parasympathetic Blockade and Associated Therapeutic Uses, p. 559. Chapter 33: Anticholinergic Agents - Page 559 Add a Note Question 5 See full question29s Report this Question The nurse administers atropine intramuscularly at 9:00 AM. At which time would the nurse expect the drug’s peak effects to occur? You Selected: 9:30 AM Correct response: 9:30 AM Explanation: When given intramuscularly, atropine peaks in approximately 30 minutes; for this situation, the peak effects would be noted at approximately 9:30 AM. Show Less