Chapter 3: The Autonomic Nervous System
1. A nurse is preparing a drug for administration to a patient. The drug does not have
an indicated use for the patients medical diagnosis. What should the nurse do? A)
Administer the drug as ordered.
B) Question the prescriber concerning the ordered drug.
C) Ask a coworker his or her thoughts about the ordered drug for the patient.
D) Ask the patient why the drug has been prescribed for him or her.
Ans: B
Feedback:
If the nurse is not sure about giving a drug, the order should be questioned. The nurse
should never give a medication that is not clear. Mistakes do happen and the drug
ordered, if not approved for the condition that the patient has, could be an error on
someones part. The person who wrote the order should be questioned, not a co worker,
who probably does not know why an off-label drug is being used. It would be
unprofessional and inappropriate to ask the patient about the drug.
2. According to Center for Disease Control and Prevention (CDC) recommendations, what
is the role of the nurse in preparing for the possibility of bioterrorism?
A) Post updated information on signs and symptoms of infections caused by
biological agents
B) Provide guidelines for treating patients exposed to, or potentially exposed to,
biological agents
C) Remain current on recognition and treatment of infections caused by biological
weapons
D) Advocate for increased funding for research involving bioterrorism and patient
treatment
Ans: C
Feedback:
Nurses need to remain current about recognition of and treatment for those exposed to
biological weapons because nurses are often called upon to answer questions, reassure
the public, offer educational programs, and serve on emergency preparedness
committees. The CDC posts updated information on signs and symptoms of infections
caused by biological agents that nurses would read. The CDC also provides guidelines
for how to treat patients exposed to biological agents and the nurse must remain current
on this information. Although nurses could advocate for funding, this is not usually the
role of the nurse.
, 3. How can the nurse find the most up-to-date information about emergency preparedness
related to bioterrorism agents?
A) Read textbooks devoted to the topic.
B) Ask coworkers to explain current events.
C) Read journal articles about bioterrorism agents.
D) Visit the Centers for Disease Control and Prevention (CDC) Web site.
Ans: D
Feedback:
The most current information will be found on the CDC Web site because new
information can be posted immediately whereas textbooks and journal articles take
time to print. Coworkers may or may not remain current on emergency preparedness
and should not be the primary source of information.
4. The nurse is assessing a diabetic patient who has presented at the clinic reporting several
hypoglycemic episodes during the past 3 weeks. The nurse questions the patient about
the use of herbal or alternative therapies, suspecting what herbal remedy could cause the
hypoglycemic episodes?
A) St. Johns wort
B) Kava
C) Fish oil D) Ginseng
Ans: D
Feedback:
Ginseng is known to decrease blood sugar levels. If the patient used this in combination
with his or her oral antidiabetic agent, diet, and exercise, his or her blood sugar could
drop below therapeutic levels. St. Johns wort interacts with many drugs, but not with
antidiabetic agents. Kava is associated with liver toxicity. Fish oil has been associated
with decreased coronary artery disease.
5. A 22-year-old patient calls the clinic and tells the nurse that she has been depressed and is
thinking about taking St. Johns wort but wants to know if it is safe first. The nurse begins
by questioning what other medications the patient takes and would be concerned about a
drug-alternative drug interaction if the patient is also taking what type of medication?
A) Antihistamines
B) Analgesics
, C) Antibiotics
D) Oral contraceptives
Ans: D
Feedback:
St. Johns wort can interact with oral contraceptives that alter drug metabolism, which
can decrease the effectiveness of the contraceptive. Analgesics, antibiotics, and
antihistamines can be taken in combination with St. Johns wort without known adverse
effects.
6. A patient tells the clinic nurse that he or she has been taking over-the-counter (OTC)
Pepcid to relieve acid indigestion for several years. This is the first time the patient has
ever reported this issue to a health care provider. As part of the teaching plan for this
patient, the nurse explains what risk associated with not sharing OTC drug use with the
provider?
A) The OTC drug could be more expensive than seeking health care advice.
B) The drug could mask symptoms of a serious problem that is undiagnosed.
C) Use of the drug could cause a rebound effect of Pepcid.
D) The drug could interact with several cold medicines.
Ans: D
Feedback:
OTC drugs allow patients to self-diagnose and treat routine signs and symptoms without
seeing a health care provider. This self-prescribed treatment, however, could mask a
more serious underlying medical problem and result in a poor outcome for the patient.
The issues of drug rebound and drug interaction need to be considered, but the safety
issue related to self-diagnosis and self-prescription presents the greatest risk to the
patient. Patients should always be encouraged to discuss the use of OTC products with
their health care provider.
7. What patient populations would the nurse expect is most likely to be prescribed a drug
for an off-label use?
A) Adolescent and middle-aged adult patients
B) Patients with diabetes or heart disease
C) Obstetric and neonatal patients
D) Pediatric and geriatric patients
Ans: D
1. A nurse is preparing a drug for administration to a patient. The drug does not have
an indicated use for the patients medical diagnosis. What should the nurse do? A)
Administer the drug as ordered.
B) Question the prescriber concerning the ordered drug.
C) Ask a coworker his or her thoughts about the ordered drug for the patient.
D) Ask the patient why the drug has been prescribed for him or her.
Ans: B
Feedback:
If the nurse is not sure about giving a drug, the order should be questioned. The nurse
should never give a medication that is not clear. Mistakes do happen and the drug
ordered, if not approved for the condition that the patient has, could be an error on
someones part. The person who wrote the order should be questioned, not a co worker,
who probably does not know why an off-label drug is being used. It would be
unprofessional and inappropriate to ask the patient about the drug.
2. According to Center for Disease Control and Prevention (CDC) recommendations, what
is the role of the nurse in preparing for the possibility of bioterrorism?
A) Post updated information on signs and symptoms of infections caused by
biological agents
B) Provide guidelines for treating patients exposed to, or potentially exposed to,
biological agents
C) Remain current on recognition and treatment of infections caused by biological
weapons
D) Advocate for increased funding for research involving bioterrorism and patient
treatment
Ans: C
Feedback:
Nurses need to remain current about recognition of and treatment for those exposed to
biological weapons because nurses are often called upon to answer questions, reassure
the public, offer educational programs, and serve on emergency preparedness
committees. The CDC posts updated information on signs and symptoms of infections
caused by biological agents that nurses would read. The CDC also provides guidelines
for how to treat patients exposed to biological agents and the nurse must remain current
on this information. Although nurses could advocate for funding, this is not usually the
role of the nurse.
, 3. How can the nurse find the most up-to-date information about emergency preparedness
related to bioterrorism agents?
A) Read textbooks devoted to the topic.
B) Ask coworkers to explain current events.
C) Read journal articles about bioterrorism agents.
D) Visit the Centers for Disease Control and Prevention (CDC) Web site.
Ans: D
Feedback:
The most current information will be found on the CDC Web site because new
information can be posted immediately whereas textbooks and journal articles take
time to print. Coworkers may or may not remain current on emergency preparedness
and should not be the primary source of information.
4. The nurse is assessing a diabetic patient who has presented at the clinic reporting several
hypoglycemic episodes during the past 3 weeks. The nurse questions the patient about
the use of herbal or alternative therapies, suspecting what herbal remedy could cause the
hypoglycemic episodes?
A) St. Johns wort
B) Kava
C) Fish oil D) Ginseng
Ans: D
Feedback:
Ginseng is known to decrease blood sugar levels. If the patient used this in combination
with his or her oral antidiabetic agent, diet, and exercise, his or her blood sugar could
drop below therapeutic levels. St. Johns wort interacts with many drugs, but not with
antidiabetic agents. Kava is associated with liver toxicity. Fish oil has been associated
with decreased coronary artery disease.
5. A 22-year-old patient calls the clinic and tells the nurse that she has been depressed and is
thinking about taking St. Johns wort but wants to know if it is safe first. The nurse begins
by questioning what other medications the patient takes and would be concerned about a
drug-alternative drug interaction if the patient is also taking what type of medication?
A) Antihistamines
B) Analgesics
, C) Antibiotics
D) Oral contraceptives
Ans: D
Feedback:
St. Johns wort can interact with oral contraceptives that alter drug metabolism, which
can decrease the effectiveness of the contraceptive. Analgesics, antibiotics, and
antihistamines can be taken in combination with St. Johns wort without known adverse
effects.
6. A patient tells the clinic nurse that he or she has been taking over-the-counter (OTC)
Pepcid to relieve acid indigestion for several years. This is the first time the patient has
ever reported this issue to a health care provider. As part of the teaching plan for this
patient, the nurse explains what risk associated with not sharing OTC drug use with the
provider?
A) The OTC drug could be more expensive than seeking health care advice.
B) The drug could mask symptoms of a serious problem that is undiagnosed.
C) Use of the drug could cause a rebound effect of Pepcid.
D) The drug could interact with several cold medicines.
Ans: D
Feedback:
OTC drugs allow patients to self-diagnose and treat routine signs and symptoms without
seeing a health care provider. This self-prescribed treatment, however, could mask a
more serious underlying medical problem and result in a poor outcome for the patient.
The issues of drug rebound and drug interaction need to be considered, but the safety
issue related to self-diagnosis and self-prescription presents the greatest risk to the
patient. Patients should always be encouraged to discuss the use of OTC products with
their health care provider.
7. What patient populations would the nurse expect is most likely to be prescribed a drug
for an off-label use?
A) Adolescent and middle-aged adult patients
B) Patients with diabetes or heart disease
C) Obstetric and neonatal patients
D) Pediatric and geriatric patients
Ans: D
