MED 143 ADRENERGIC BLOCKING ANTAGONISTS – CHAPTER 31 QUESTIONS AND ANSWERS VERIFIED 2023

MED 143 ADRENERGIC BLOCKING ANTAGONISTS – CHAPTER 31 QUESTIONS AND ANSWERS VERIFIED 2023. What medication, if ordered for an 8-year-old patient, should the nurse question? (Select all that apply.) A) Amiodarone (Cordarone) 400 mg orally per 24 hours B) Labetalol (Normodyne) 100 mg orally b.i.d. C) Phentolamine (Regitine) 1 mg intramuscularly 1 to 2 hours before surgery D) Prazosin (Minipress) 3 mg orally t.i.d. E) Carvedilol (Coreg) 6.25 mg orally b.i.d. Ans: A, B, E Feedback: Amiodarone, labetalol, and carvedilol are not indicated for pediatric use and do not have established pediatric dosages. Phentolamine and prazosin have established pediatric dosages and would not need to be questioned. 3.A nurse is working with a patient who is taking an adrenergic blocking agent. While assessing the patient's medication history, the nurse discovers that the patient takes several alternative therapies. What herb is the nurse concerned may interact with the adrenergic blocking agent and affect the patient's blood glucose level? A) Ginseng B) Nightshade C) Di huang D) Saw Palmetto Ans: C Feedback: Di huang is an alternative therapy that can lower blood glucose when used in combination with adrenergic blocking agents. Ginseng increases antihypertensive effects; nightshade slows the heart rate; and saw palmetto increases the risk of urinary tract complications when used in combination with adrenergic blocking agents. 4.A priority nursing assessment for a patient who is to receive an alpha- or beta-adrenergic blocking agent would be what? Page 1 A) Monitoring respiratory rate B) Checking blood glucose level C) Measuring urine output D) Assessing heart rate Ans: D Feedback: The most serious adverse effect would be severe bradycardia, so the nurse's priority would be assessing the heart rate. If the patient were identified as having diabetes, then monitoring blood glucose levels would become important because these drugs can aggravate diabetes by blocking sympathetic response including masking the usual signs and symptoms of hypoglycemia and hyperglycemia. Respiratory rate could be impacted if the patient was identified as having a condition causing bronchospasm and diabetes because the combination could worsen both conditions. Measuring urine output should be part of the patient's care, but it is not the priority assessment. 5.Bisoprolol (Zebeta) would be the drug of choice for which patient with a diagnosis of hypertension? A) A 7-year-old patient B) A 15-year-old patient C) A 37-year-old patient D) A 69-year-old patient Ans: D Feedback: Bisoprolol is the drug of choice for older adults. It is not associated with as many adverse effects in the elderly and regular dosing profiles can be used. This drug does not have an established pediatric dosage. Although the 37-year-old patient is an adult, there are additional choices for this patient, with a more favorable adverse effect profile. 6.What would be the teaching priority for a diabetic patient being treated with a nonselective beta-blocker? A) To take his own pulse B) To weigh himself once a week at the same time of day C) To avoid smoke-filled rooms D) To understand signs and symptoms of hypo- or hyperglycemic reaction Ans: D Feedback: Because the beta-blockers stop the signs and symptoms of a sympathetic stress reaction, the signs and symptoms associated with hypo- or hyperglycemia, the diabetic patient taking a beta-blocker will need to understand this and learn new indicators of these reactions. Taking his pulse, weekly weighing, and avoiding smoke-filled rooms are good health practices and should be done, but not specifically needed by a diabetic patient taking a beta-blocker. Page 2 7.The nurse is caring for a patient who is receiving an adrenergic blocking agent. While writing the care plan for this patient what nursing diagnoses would be most appropriate concerning comfort? A) Acute pain related to cardiovascular and systemic effects B) Decreased cardiac output related to cardiovascular effects C) Ineffective airway clearance related to lack of bronchodilating effects D) Deficient knowledge regarding drug therapy Ans: A Feedback: All four options would be appropriate nursing diagnoses for a patient receiving an adrenergic blocking agent. However, acute pain would be the only nursing diagnosis related to the patient's comfort level. 8.A nurse is providing discharge instructions to a patient who is taking atenolol (Tenormin) to treat hypertension. What would the nurse teach the patient regarding a possible drug– drug interaction? A) Antibiotics B) Oral contraceptives C) Nonsteroidal anti-inflammatory drugs (NSAIDs) D) Antifungal agents Ans: C Feedback: A decreased hypertensive effect can occur if a beta-selective adrenergic blocking agent is used in combination with NSAIDs. If this combination is used, the patient should be monitored closely and dosage adjustments made. Antibiotics, oral contraceptives, and antifungal agents are not known to have a drug–drug interaction. 9.A busy patient with many responsibilities is to have a medication ordered to treat her hypertension. To increase compliance with drug therapy, what drug would be a good choice for this patient? A) Acebutolol (Sectral) B) Atenolol (Tenormin) C) Bisoprolol (Zebeta) D) Metoprolol (Lopressor) Ans: D Feedback: Metoprolol would be the best choice because it has an extended release form that only needs to be taken once a day, which should increase patient compliance. Acebutolol, atenolol, and bisoprolol do not come in extended release forms. 10.The nurse provides patient teaching for a patient who has a new order for nadolol (Corgard) to treat hypertension. What statement by the patient concerning nadolol Page 3 (Corgard) would indicate that the teaching has been effective? A) “I should cover my head at all times while I am outdoors.” B) “Since I am taking this drug, I no longer need to worry about diet and exercise.” C) “I will not stop taking this drug abruptly and will talk to my doctor before discontinuing.” D) “I may have a very dry mouth while taking this drug.” Ans: C Feedback: A patient receiving an adrenergic blocker must be aware that abruptly stopping the medication may result in a serious reaction. When changing medications or discontinuing their use, these drugs need to be tapered off gradually. This drug is not associated with photophobia or the anticholinergic effect of dry mouth. If the teaching were effective, the patient would be aware that he would need to continue lifestyle modifications, including diet and exercise. 11.The nurse frequently administers propranolol (Inderal) as treatment for what condition? A) Hypotension B) Angina C) Prevent first myocardial infarction (MI) D) Cluster headaches