Exam (elaborations) NURSING 1140 Pharm Exam Study Guide - Pharmacology Exam Study Guide Test Bank Complete Latest 2021 (Keiser University)

NURSING 1140 Pharm Exam Study Guide - Pharmacology Exam Study Guide Test Bank Complete Latest 2021 (Keiser University) Pharm Exam study guide A patient’s heart rate is found to be 72 beats per minute and regular. The nurse evaluates which situation in the patient’s peripheral nervous system? Standard Text: Select all that apply. 1. The sympathetic system is in control. 2. The parasympathetic system is dominating. 3. Both parasympathetic and sympathetic systems are influencing cardiac status. 4. The autonomic nervous system is affecting cardiac status. 5. The somatic nervous system is affecting cardiac status. Correct Answer: 2,3,4 Rationale 2: Restful cardiac response indicates that the primary input is from the parasympathetic system. Rationale 3: These two systems work in tandem to regulate the cardiac response. Rationale 4: Both the sympathetic and parasympathetic systems are part of the autonomic system. 2. A nurse is reading about the development of drugs that inhibit the parasympathetic nervous system. The nurse would look for articles about which drug classes? Standard Text: Select all that apply. 1. Anticholinergics 2. Parasympathomimetics 3. Parasympatholytics 4. Cholinergics 5. Muscarinic blockers Correct Answer: 1,3,5 Rationale 1: Anticholinergics inhibit the parasympathetic nervous system. Rationale 3: Parasympatholytic drugs inhibit the parasympathetic nervous system. Rationale 5: Muscarinic blockers inhibit the parasympathetic nervous system. Question 3 Type: Hot Spot Mark the site of the ganglionic synapse on this diagram. 1. A 2. B 3. C 4. D Answer: 3 Rationale: The ganglionic synapse is the gap between the preganglionic neuron and the postganglionic neuron. Question 4 Type: MCMA A patient has been prescribed an oral drug containing atropine. The nurse would hold the drug and Contact the prescriber if which patient statements are made? Standard Text: Select all that apply. 1. “I would like to wait a few minutes to take this as I just drank some aloe juice.” 2. “Can I take this at the same time as my procainamide?” 3. “I have had a headache this morning.” 4. “I am allergic to penicillin.” 5. “My gallbladder surgery is scheduled for next week.” Correct Answer: 1,2 Rationale 1: Atropine should be used with caution in those who use aloe. Rationale 2: There is a drug–drug interaction between atropine and procainamide. Question 5 Type: MCSA The nurse has completed medication education about pyridostigmine (Mestinon), an indirect cholinergic drug, for the patient with myasthenia gravis. The nurse determines that learning has occurred when the patient makes which statement? 1. "My heart may beat slower while I am on this drug." 2. "I will need to increase my fluid intake with this medication." 3. "I must take this medication immediately before eating a full meal." 4. "It is really important to take my medication on time." Correct Answer: 4 Rationale 4: Maintaining an optimum blood level of the drug is crucial in promoting muscle functioning, so it is important for the patient to take his medication on time and as directed. Question 6 Type: MCSA The physician has ordered bethanechol (Urecholine), a cholinergic drug, for the patient with urinary retention. The patient also has an enlarged prostate gland. What is the priority action by the nurse? 1. Hold the drug and prepare to catheterize the patient. 2. Administer the drug and measure urinary output. 3. Administer the drug and push fluids. 4. Hold the drug and contact the physician. Correct Answer: 4. Rationale 4: Bethanechol (Urecholine) relaxes the urinary sphincter and increases voiding pressure. It is contraindicated with any physical obstruction of the urinary tract, such as an enlarged prostate gland. Question 7 Type: MCSA The preop patient will be receiving glycopyrrolate (Robinul), an anticholinergic drug, and asks the nurse, "Why do I need to have that shot?" What is the best response by the nurse? 1. "It will decrease your respiratory secretions during surgery." 2. "It will increase your urinary output during surgery." 3. "It will help you breathe better during surgery." 4. "It will help maintain your blood pressure during surgery." Correct Answer: 1 Rationale 1: Anticholinergics dry secretions; a decrease in respiratory secretions is indicated prior to surgery. Question 8 Type: MCSA The nurse is preparing to administer medications to a group of patients. One of the medications is benztropine (Cogentin), an anticholinergic drug. This drug is contraindicated in which patient? 1. The patient with a fractured femur 2. The patient with tachycardia 3. The patient with an irritable colon 4. The patient with diarrhea Correct Answer: 2 Rationale 2: Anticholinergic drugs increase the heart rate; a patient with tachycardia should not receive benztropine (Cogentin). Question 9 Type: MCSA The nurse is preparing to administer medications to a group of patients. One of the medications is atropine, an anticholinergic drug. This drug is contraindicated in which patient? 1. The patient with glaucoma 2. The patient with hyperthyroidism 3. The patient with a hiatal hernia 4. The patient with lung cancer Correct Answer: 1 Rationale 1: Anticholinergic drugs can increase pressure in the eye; they must be avoided in patients with glaucoma. Question 10 Type: MCSA The physician orders dicyclomine (Bentyl), an anticholinergic drug, for a patient. What is the nurse's priority assessment prior to administering this drug? 1. Does the patient have light sensitivity? 2. Is the patient able to urinate? 3. Does the patient have a history of alcoholism? 4. Is the patient dizzy upon standing? Correct Answer: 2. Rationale 2: Anticholinergic drugs can cause or increase urinary hesitancy or retention. Question 11 Type: MCSA The patient is quadriplegic and receives oxybutynin (Ditropan), an anticholinergic drug, to increase his bladder capacity. What is an important assessment of this patient by the nurse? 1. Is he irritable? 2. Is he constipated? 3. Is he gaining weight? 4. Is he lethargic? Correct Answer: 2. Rationale 2: Anticholinergics slow gastrointestinal (GI) motility and can increase the risk for constipation. Question 12 Type: MCMA The nursing instructor teaches the student nurses about the nervous system. The instructor determines that learning has occurred when the students make which statement(s)? Standard Text: Select all that apply. 1. "The central nervous system includes the brain and spinal cord." 2. "The peripheral nervous system has mainly sensory functions." 3. "The somatic nervous system gives us voluntary control over our gastrointestinal (GI) tract." 4. "The nervous system helps us react to environmental changes." 5. "The somatic nervous system gives us voluntary control over moving." Correct Answer: 1,4,5 Rationale 1: The central nervous system includes the brain and spinal cord. Rationale 4: The nervous system provides reaction to environmental changes. Rationale 5: The somatic nervous system provides voluntary control over moving. Question 13 Type: MCMA The nursing instructor teaches the student nurses about the autonomic nervous system. The instructor determines that learning has occurred when the students make which statement(s)? Standard Text: Select all that apply. 1. "The sympathetic and parasympathetic systems are not always opposite in their effects." 2. "The parasympathetic nervous system is the "fight-or-flight" response." 3. "Sympathetic stimulation causes dilation of arterioles." 4. "The parasympathetic nervous system causes bronchial constriction." 5. "The sympathetic nervous system is activated under stress." Correct Answer: 1,4,5 Rationale 1: The sympathetic and parasympathetic systems are not always opposite in their effects. Rationale 4: The parasympathetic nervous system causes bronchial constriction. Rationale 5: The sympathetic nervous system is activated under stress. Question 14 Type: MCSA The student nurse asks the nursing instructor, "Do the medications we are studying actually make more neurotransmitters?" What is the best response by the nursing instructor? 1. "No, but medications can heal diseases of the autonomic nervous system." 2. "Yes, some of the newer medications are very good at doing this." 3. "Yes, but the newer drugs that do this have some serious side effects." 4. "No, medications can only increase or decrease the action of neurotransmitters." Correct Answer: 4 Rationale 4: Medications cannot manufacture new neurotransmitters; they can only increase or decrease their action. Question 15 Type: MCSA The ability of a person to use his arm muscles to lift a weight is primarily regulated by 1. the somatic nervous system. 2. the sympathetic nervous system. 3. the autonomic nervous system. 4. the parasympathetic nervous system. Correct Answer: 1 Rationale 1: The somatic nervous system (a division of the peripheral nervous system) controls voluntary movement such as lifting a weight. Question 16 Type: MCSA Which of the following responses are regulated by the sympathetic nervous system? 1. Increased heart rate, bronchial constriction 2. Peripheral artery dilation, reduced peristalsis 3. Increased secretions, sex organ stimulation 4. Relaxation of bladder, pupil dilation Correct Answer: 4 Rationale 4: Relaxation of the bladder and pupil dilation is regulated by the sympathetic nervous system. Question 17 Type: MCSA A person who had her adrenergic receptors activated would experience 1. fight-or-flight effects. 2. rest-and-digest effects. 3. increased blood volume. 4. bronchial constriction. Correct Answer: 1 Rationale 1: Adrenergic receptors are found within the sympathetic nervous system. Sympathetic nervous system activation produces the fight-or-flight response. Question 18 Type: MCSA Which substance would inhibit the function of the autonomic nervous system? 1. Drugs that bind and then stimulate the postsynaptic neuron 2. Drugs that prohibit neurotransmitter reuptake 3. Drugs that increase neurotransmitter synthesis 4. Drugs that prevent the storage of neurotransmitter in vesicles Correct Answer: 4 Rationale 4: The more neurotransmitter available, the greater the function/stimulation of the autonomic nervous system. Question 19 Type: MCSA Which cholinergic receptor type is found at the ganglionic synapse of both the sympathetic and parasympathetic nervous systems? 1. Alpha receptors 2. Muscarinic 3. Nicotinic 4. Beta receptors Correct Answer: 3. Rationale 3: Nicotinic receptors are found at the ganglionic synapse of both sympathetic and parasympathetic nervous systems. Question 20 Type: MCMA A patient is prescribed an anticholinergic drug. What discharge instructions should the nurse provide? Standard Text: Select all that apply. 1. Wear sunglasses in bright light. 2. Limit fluid intake. 3. Increase fiber intake. 4. Avoid hot showers. 5. Avoid milk and dairy products. Correct Answer: 1,3,4 Rationale 1: Anticholinergic drugs may cause photosensitivity. Rationale 3: Use of anticholinergics increases risk for constipation. Fiber intake should be increased. Rationale 4: Use of anticholinergics reduces ability of patients to sweat and self-regulate temperature. Hot environments, including hot showers and baths, should be avoided. Question 21 Type: MCSA Which statement is accurate regarding exogenous acetylcholine? 1. Acetylcholine has almost no therapeutic effects because it is rapidly destroyed once given. 2. Acetylcholine is broken down rapidly within the body, preventing it from producing adverse effects. 3. Acetylcholine will cause the heart rate to increase and blood pressure to drop. 4. When given in small amounts, acetylcholine will produce profound parasympathetic effects. Correct Answer: 1 Rationale 1: Exogenous acetylcholine is not generally administered, because it is rapidly destroyed by the body. Question 22 Type: MCSA The nurse explains that atropine (Atropair) increases heart rate in which manner? 1. Blocking the beta receptors of the parasympathetic nervous system. 2. Directly stimulating the sympathetic nervous system. 3. Potentiating the effects of acetylcholine on nicotinic receptors. 4. Blocking the effects of acetylcholine by occupying muscarinic receptors. Correct Answer: 4 Rationale 4: Atropine is a cholinergic-blocking agent that occupies muscarinic receptors. Question 23 Type: MCMA Which patient situations are considered involuntary responses to autonomic nervous system control? Standard Text: Select all that apply. 1. Sweating when hot 2. Stepping over a chair to prevent falling 3. Complaining of nausea 4. Salivating at the smell of food 5. Breathing deeper when running Correct Answer: 1,4,5 Rationale 1: Sweating is an involuntary response that is controlled by the sympathetic nervous system. Rationale 2: Muscle movement is controlled by the somatic nervous system. Rationale 3: Complaining of nausea is a result of sensory neuron input and is not part of the autonomic system. Rationale 4: Salivation is involuntary and is controlled by the autonomic nervous system. Question 24 Type: MCMA A patient has sustained a large blood loss. During the assessment, the nurse realizes that which findings are under the control of the nervous system? Standard Text: Select all that apply. 1. Heart rate 2. Blood pressure 3. Pupil size 4. Bowel sounds 5. Fluid volume Correct Answer: 1,2,3,4 Rationale 1: The brain, spinal cord, and peripheral nerves act as a smoothly integrated whole to accomplish minute-to-minute changes in essential functions such as heart rate. Rationale 2: The brain, spinal cord, and peripheral nerves act as a smoothly integrated whole to accomplish minute-to-minute changes in essential functions such as blood pressure. Rationale 3: The brain, spinal cord, and peripheral nerves act as a smoothly integrated whole to accomplish minute-to-minute changes in essential functions such as pupil size. Rationale 4: The brain, spinal cord, and peripheral nerves act as a smoothly integrated whole to accomplish minute-to-minute changes in essential functions such as intestinal motility. Question 25 Type: MCMA The nurse is caring for a patient with multisystem organ failure. Which patient assessment findings are under the control of the sympathetic nervous system? Standard Text: Select all that apply. 1. Blood glucose level 210 mg/dL 2. Blood pressure 180/90 mmHg 3. Extremities are cool 4. Respiratory rate 14 and regular 5. Hyperactive bowel sounds Correct Answer: 1,2,3 Rationale 1: Metabolic effects such as an increase in blood glucose are a sympathetic nervous system function. Rationale 2: The constriction and relaxation of arterioles are controlled entirely by the sympathetic nervous system. Rationale 3: The sympathetic nervous system controls release of epinephrine and norepinephrine, which result in peripheral vasoconstriction. Question 26 Type: MCMA A student nurse is learning about a medication that affects the autonomic nervous system. When instructing the student about the effects of this medication, the nurse will begin by explaining the basic unit of this system. What does this include? Standard Text: Select all that apply. 1. The preganglionic neuron 2. The postganglionic neuron 3. The synaptic cleft 4. Norepinephrine 5. Dopamine Correct Answer: 1,2,3 Rationale 1: The basic unit of the autonomic nervous system is a two-neuron chain. The first neuron, called the preganglionic neuron, originates in the central nervous system. Rationale 2: The preganglionic neuron connects with the second nerve in the autonomic nervous system two-neuron chain through the ganglia, which contains the postganglionic neuron. Rationale 3: Autonomic messages must cross the synaptic cleft. Question 27 Type: SEQ The nurse educator is reviewing the process of synaptic transmission following the sympathetic pathway. In which order will the nurse explain the steps of synaptic transmission? 1. Action potential encounters adrenergic receptors 2. Action potential encounters cholinergic receptors 3. Action potential travels across the preganglionic neuron 4. Action potential travels across the postganglionic neuron 5. Target tissue is reached. Standard Text: Click and drag the options below to move them up or down. Correct Answer: 3,2,4,1,5 Question 28 Type: MCMA A patient is prescribed a medication that will block muscarinic receptors. The nurse realizes that this medication has implications for which body systems? Standard Text: Select all that apply. 1. Eyes 2. Respiratory 3. Cardiac 4. Endocrine 5. Metabolic Correct Answer: 1,2,3 Rationale 1: Medications that block muscarinic receptors are used during ophthalmic procedures. Rationale 2: Medications that block muscarinic receptors are used in the pharmacologic treatment of asthma. Rationale 3: Medications that block muscarinic receptors are used in the pharmacologic treatment of bradycardia. Question 29 Type: MCMA A patient has been prescribed scopolamine (Transderm-Scop) for the prevention of motion sickness. The nurse should teach the patient to immediately report which adverse effects? Standard Text: Select all that apply. 1. Slow heart rate 2. Cardiac palpitations 3. Decreased urinary output 4. Development of tremors 5. Diarrhea Correct Answer: 2,3,4 Rationale 2: Dysrhythmia is an adverse effect of this drug. Rationale 3: Decreased urinary output is an adverse effect of this drug. Rationale 4: Tremors are an adverse effect of this drug. Question 30 Type: MCMA A patient who has myasthenia gravis (MG) presents to the emergency department with abrupt onset of increased muscle weakness and difficulty swallowing. An attempt to distinguish worsening of the MG symptoms from overdose of the patient’s prescribed anticholinergic is planned. What medications should the nurse obtain for use in this procedure? Standard Text: Select all that apply. 1. Donepezil (Aricept) 2. Pyridostigmine (Mestinon) 3. Neostigmine (Prostigmin) 4. Edrophonium (Edrophonium Injectable) 5. Atropine (Atropine Injectable) Correct Answer: 4,5 Rationale 4: Edrophonium (Edrophonium Injectable) is given as a test dose. If muscular symptoms improve, the patient is having a myasthenic crisis. Rationale 5: Atropine (Atropine Injectable) is given if the test results in a cholinergic crisis. Chapter 13: Question 1 Type: MCSA The patient receives methyldopa (Aldomet), an adrenergic drug. The nurse determines that the patient is having side effects when the patient makes which statement? 1. "Will you check my pupils? I can't see very well at all." 2. "I am so thirsty; will you please bring me another pitcher of water?" 3. "I am so anxious; I really need to walk around the room." 4. "I feel so sleepy that I don't think I can eat my dinner." Correct Answer: 3.Rationale 3: Adrenergic drugs mimic the effect of the sympathetic nervous system (SNS). This can result in anxiety and restlessness. Question 2 Type: MCSA The patient receives metaproterenol (Alupent), an adrenergic drug. A consulting physician orders carteolol (Cartrol), a beta blocker. What best describes the nurse's assessment? 1. The patient is at risk for a hypertensive crisis. 2. The effects of metaproterenol (Alupent) will be decreased. 3. The drugs are compatible; there will not be any adverse effects. 4. The effects of metaproterenol (Alupent) will be increased. Correct Answer: 2.Rationale 2: Beta-adrenergic blockers block the receptors that are stimulated by adrenergic drugs; the effects of metaproterenol (Alupent) would be decreased. Question 3 Type: MCSA The nurse has been doing medication education for the patient receiving atenolol (Tenormin), a beta blocker. The nurse determines that learning has occurred when the patient makes which statement? 1. "I need to take my pulse every day." 2. "If I have any side effects, I will stop the medication." 3. "I cannot take this drug if I develop glaucoma." 4. "I cannot continue to have my morning cup of coffee." Correct Answer: 1 Rationale 1: Beta blockers slow the heart rate; therefore, the patient must monitor his pulse every day. Question 4 Type: MCSA The physician ordered prazosin (Minipress), an alpha-adrenergic blocker, for the patient. The nurse plans to do medication education. What will the best plan of the nurse include? 1. Instruct the patient to not take OTC herbal preparations containing saw palmetto. 2. Instruct the patient to not take tub baths. 3. Instruct the patient to decrease his intake of sodium. 4. Instruct the patient to wear sunglasses when outdoors. Correct Answer: 1 Rationale 1: A hypotensive response may occur when saw palmetto is taken concurrently Question 5 A patient has been prescribed an alpha1 adrenergic agonist drug. The nurse would plan to monitor for effects from which organs? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Kidneys 2. Eyes 3. Heart 4. Bowels 5. Lungs Correct Answer: 1,2,4,5 Rationale 1: Alpha1 receptors have potential to affect the renal system. Rationale 2: Alpha1 receptors result in dilation of the pupils. Rationale 4: Alpha1 receptors have potential to affect receptors in the gastrointestinal tract. Rationale 5: Alpha1 receptors have potential to affect receptors in the respiratory system. Question 6 A patient is prescribed a drug that activates alpha2 receptors. The nurse would plan care based on which physiological response? 1. Inhibition of norepinephrine release 2. Absence of monoamine oxidase 3. Increased lipolysis 4. Destruction of presynaptic nerve terminals Correct Answer: 1 Rationale 1: The action of alpha2 receptors is to inhibit release of norepinephrine. Question 7 A nurse is reviewing medical records for usage of drugs that are beta2 agonists. The nurse should start with the medical records of patients with which conditions? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Heart failure 2. Asthma 3. COPD 4. Overactive bladder 5. Nasal congestion Correct Answer: 2,3 Rationale 2: Beta2 agonists are useful in the treatment of asthma. Rationale 3: Beta2 agonists are useful in the treatment of COPD. Question 9 A patient who is in heart failure is administered a beta1 agonist. The nurse would evaluate that the drug is effective if which changes occur? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Heart rate increases 2. Pulse becomes stronger 3. Pupils dilate 4. Dysrhythmias dissipate 5. Blood pressure drops Correct Answer: 1,2 Rationale 1: One of the effects of beta1 agonists is to increase the heart rate. Rationale 2: One of the effects of beta1 agonists is to increase force of cardiac contraction, which would be felt as a stronger pulse. Question 10 A patient has been prescribed isoproterenol (Isuprel). The nurse plans care based on the drug’s stimulation of which receptors? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Alpha1 2. Alpha2 3. Beta1 4. Beta2 5. Beta3 Correct Answer: 3,4 Rationale 3: Isoproterenol (Isuprel) is a nonselective drug that stimulates beta1 receptors. Rationale 4: Isoproterenol (Isuprel) is a nonselective drug that stimulates beta2 receptors. Question 11 Type: Hot Spot The nurse is providing discharge medication instruction to the family of a child who is severely allergic to peanuts. Mark the spot where the family or patient should inject epinephrine from an EpiPen should an allergic response occur. 1. A 2. B 3. C 4. D Answer: 4.Rationale: This drug should be injected into the thigh only. Question 12 A nurse is providing discharge medication instruction regarding use of injectable epinephrine (EpiPen). What information should the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. If you need to use this pen, seek medical advice as follow-up.