Test Bank For Pharmacology Connections to Nursing Practice 5th Edition All Chapters - 9780137659166.pdf

Chapter 21: Cholinergic-
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Blocking DrugsTest Bank
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MULTIPLEhCHOICE

1. Thehnursehishabouthtohadministerhahstathdosehofhintravenoushatropinehsulfatehtohahpatienthwhohishe
xperiencinghahsymptomatichcardiachdysrhythmia.hDuringhadministrationhofhthishdrug,hthehnurseh
willhmonitorhthehpatienthcloselyhforhwhichhadverseheffect?
a. Tachycardia
b. Bradycardia
c. Ectopichbeats
d. Cardiachstandstill
ANS:h A
Cardiovascularheffectshofhcholinergichblockershincludehincreasedhhearthratehandhdysrhythmias.hOne
hindicationhforhusehishthehtreatmenthofhsinushbradycardiahaccompaniedhbyhhemodynamichcomprom

ise.hThehotherhoptionsharehincorrect.

DIF: COGNITIVEhLEVEL:hApplyingh(Application)
REF:hp.h337hTOP:h NURSINGhPROCESS:hEvaluation
MSC:h NCLEX:hPhysiologicalhIntegrity:hPharmacologicalhandhParenteralhTherapies

2. Ahpatienthhashahprescriptionhforhoxybutyninh(Ditropan),hanhanticholinergichdrug.hWhenhrevie
winghthehpatient’shmedicalhhistory,hwhichhcondition,hifhpresent,hwouldhbehconsideredhahcontra
indicationhtohtherapyhwithhthishdrug?
a. Diarrhea
b. Hypertension
c. Neurogenichbladder
d. Uncontrolledhangle-closurehglaucoma
ANS:h D
Contraindicationshincludehdrughallergy,hurinaryhorhgastrichretention,handhuncontrolledhangle-
hclosurehglaucoma.hNeurogenichbladderhishanhindicationhforhoxybutynin.hThehotherhoptionsharehinc

orrect.

DIF: COGNITIVEhLEVEL:hApplyingh(Application)
REF:hp.h339hTOP:h NURSINGhPROCESS:hAssessment
MSC:h NCLEX:hPhysiologicalhIntegrity:hPharmacologicalhandhParenteralhTherapies

3. Thehnursehishreviewinghthehusehofhanticholinergichdrugs.hAnticholinergichdrugshblockhthehe
ffectshofhwhichhnervoushsystem?
a. Centralhnervoushsystem
b. Somatichnervoushsystem
c. Sympathetichnervoushsystem
d. Parasympathetichnervoushsystem
ANS:h D
Anticholinergichdrugshblockhorhinhibiththehactionshofhacetylcholinehinhthehparasympathetichnervous
hsystem.hThehotherhoptionsharehincorrect.




DIF: COGNITIVEhLEVEL:hRememberingh(Knowledge) REF:h p.h335

, TOP:h NURSINGhPROCESS:hGeneral
MSC:h NCLEX:hPhysiologicalhIntegrity:hPharmacologicalhandhParenteralhTherapies

4. Ahpatienthhashreceivedhanhaccidentalhoverdosehofhintravenoushatropine.hWhichhdrughwillhthehn
ursehpreparehtohadminister?
a. atenololh(Tenormin)
b. bethanecholh(Urecholine)
c. dicyclomineh(Bentyl)
d. physostigmineh(Antilirium)
ANS:h D
Physostigminehsalicylatehishthehantidotehtohanhatropinehoverdosehinhpatientshwhohshowhextremehd
eliriumhorhagitationhandhcouldhinflicthinjuryhtohthemselves.hItshroutinehusehashanhantidotehforhchol
inergic-blockerhoverdosehishcontroversial,hhowever.hThehotherhoptionsharehincorrecthchoices.

DIF: COGNITIVEhLEVEL:hUnderstandingh(Comprehension)
REF:hp.h337hTOP:h NURSINGhPROCESS:hPlanning
MSC:h NCLEX:hPhysiologicalhIntegrity:hPharmacologicalhandhParenteralhTherapies

5. Ah72-year-
oldhmanhhashahnewhprescriptionhforhanhanticholinergichdrug.hHehishanhactivehmanhandhenjoyshoutd
oorhactivities,hsuchhashgolfinghandhdoinghhishownhyardhwork.hWhathwillhthehnursehemphasizehtohh
imhduringhthehteachinghsessionhabouthhishdrughtherapy?
a. Drowsinesshmayhinterferehwithhhishoutdoorhactivities.
b. Increasedhsalivationhmayhoccurhduringhexercisehandhoutsidehactivities.
c. Fluidhvolumehdeficitshmayhoccurhashahresulthofhanhincreasedhincidencehofhdiarrhea.
d. Hehwillhneedhtohtakehmeasureshtohreducehthehoccurrencehofhheathstrokehduringhhisha
ctivities.
ANS:h D
Elderlyhpatientshwhohtakehanhanticholinergichdrughneedhtohbehremindedhthaththeyharehathahgreate
rhriskhforhsufferinghheathstrokehbecausehofhdecreasedhsweatinghandhlosshofhnormalhheat-
hregulatinghmechanisms.




DIF: COGNITIVEhLEVEL:hApplyingh(Application)
REF:hp.h342hTOP:h NURSINGhPROCESS:hImplementation
MSC:h NCLEX:hPhysiologicalhIntegrity:hReductionhofhRiskhPotential

6. Thehnursehwillhmonitorhforhwhichhadverseheffecthwhenhadministeringhanhanticholinergichdrug?
a. Excessivehurination
b. Diaphoresis
c. Dryhmouth
d. Pupillaryhconstriction
ANS:h C
Anticholinergichdrugshcommonlyhcausehthehadverseheffectshofhdryhmouth,hblurredhvision,hconstipat
ion,handhurinaryhretention.hTheyhalsohcausehmydriasish(pupillaryhdilation).

DIF: COGNITIVEhLEVEL:hUnderstandingh(Comprehension)
REF:hp.h341hTOP:h NURSINGhPROCESS:hAssessment
MSC:h NCLEX:hPhysiologicalhIntegrity:hPharmacologicalhandhParenteralhTherapies

, 7. Thehnursehishreviewinghahpatient’shmedicationhhistoryhandhnoteshthaththehpatienthishtakinghthehc
holinergichblockerhtolterodineh(Detrol).hWhichhishanhindicationhforhthishmedication?
a. Irritablehbowelhdisease
b. Inductionhofhmydriasis
c. Urgehincontinence
d. Reductionhofhsecretionshpreoperatively

ANS:h C
Tolterodineh(Detrol)hishusedhforhurinaryhfrequency,hurgency,handhurgehincontinencehcausedhbyhblad
derh(detrusor)hoveractivity.hThehconditionshinhthehotherhoptionsharehnothindications.

DIF: COGNITIVEhLEVEL:hUnderstandingh(Comprehension)
REF:hp.h336hTOP:h NURSINGhPROCESS:hPlanning
MSC:h NCLEX:hPhysiologicalhIntegrity:hPharmacologicalhandhParenteralhTherapies

8. Ahpatienthhashbeenhtakinghtolterodineh(Detrol),hbuthtodayhherhprescriberhchangedhherhtohahnewerhd
rug,hdarifenacinh(Enablex).hWhathadvantagehdoeshdarifenacinhhavehoverhthehtolterodine?
a. Thehnewerhcholinergic-blockerhdrugsharehmoreheffective.
b. Ithhelpshreducehurinaryhretention.
c. Ithcanhbehusedhinhpatientshwithhnarrow-anglehglaucoma.
d. Thehincidencehofhdryhmouthhishmuchhlowerhwithhdarifenacin.
ANS:h D
Thehincidencehofhdryhmouthhishmuchhlowerhwithhusehofhthehnewerhcholinergic-
blockerhdrugs,hsuchhashdarifenacin,hbecausehthehactionshofhthesehdrugsharehmorehspecifichforhthehbl
adderhashopposedhtohthehsalivaryhglands.hThesehdrugsharehcontraindicatedhifhnarrow-
anglehglaucomahorhurinaryhretentionhishpresent.hThehnewerhcholinergic-
blockerhdrugsharehnothnecessarilyhmoreheffective.

DIF: COGNITIVEhLEVEL:hUnderstandingh(Comprehension)
REF:hp.h339hTOP:h NURSINGhPROCESS:hImplementation
MSC:h NCLEX:hPhysiologicalhIntegrity:hPharmacologicalhandhParenteralhTherapies

9. Thehnursehworkinghinhahpreoperativehadmittinghunithadministershanhanticholinergichmedicationht
ohahpatienthbeforehsurgery.hWhathishthehpurposehofhthishdrughinhthehpreoperativehsetting?
a. Controlhthehhearthrate
b. Relaxhthehpatient
c. Reducehurinaryhfrequency
d. Reducehoralhandhgastrointestinalhsecretions

ANS:h D
Anticholinergichdrugsharehgivenhpreoperativelyhtohcontrolhoralhandhgastrointestinalhsecretionshduri
nghsurgery.hThehotherhoptionsharehincorrect.

DIF: COGNITIVEhLEVEL:hApplyingh(Application)
REF:hp.h336hTOP:h NURSINGhPROCESS:hPlanning
MSC:h NCLEX:hPhysiologicalhIntegrity:hPharmacologicalhandhParenteralhTherapies

10. Inhpreparationhforheyehsurgery,hthehnursehmonitorshforhwhichhdesiredhdrugheffecthinhahpatienthw
hohishreceivinghahcholinergic-blockingheyedrophmedication?
a. Miosis
b. Mydriasis

, c. Increasedhintraocularhfluidhproduction
d. Enhancedhtearhproduction

ANS:h B
Cholinergic-
blockingheyedropshcausehdilationhofhthehpupilh(mydriasis)handhparalysishofhthehocularhlensh(cycl
oplegia),hbothhofhwhichharehimportanthforheyehsurgery.hThehotherhoptionsharehincorrect.

DIF: COGNITIVEhLEVEL:hApplyingh(Application)
REF:hp.h336hTOP:h NURSINGhPROCESS:hEvaluation
MSC:h NCLEX:hPhysiologicalhIntegrity:hPharmacologicalhandhParenteralhTherapies

11. Ahpatienthhashahnewhprescriptionhforhthehtransdermalhformhofhscopolamine.hThehnursehknowsht
haththishformhofhscopolaminehishusedhforhwhichhcondition?
a. Angina
b. Chronichpain
c. Hypertension
d. Motionhsickness
ANS:h D
Transdermalhscopolamineh(Transderm-
)hishahpatchhthathcanhbehappliedhjusthbehindhthehearh
4htoh5hhourshbeforehtravelhforhthehpreventionhofhmotionhsickness.hThehotherhoptionsharehincorrec
t.

DIF: COGNITIVEhLEVEL:hApplyingh(Application)
REF:hp.h339hTOP:h NURSINGhPROCESS:hPlanning
MSC:h NCLEX:hPhysiologicalhIntegrity:hPharmacologicalhandhParenteralhTherapies


MULTIPLEhRESPONSE

1. Thehnursehishreviewinghthehindicationshforhatropinehsulfate.hAtropinehishappropriatehforhwhichho
fhthesehpatients?h(Selecthallhthathapply.)
a. Ahpatienthwhohhashsuddenlyhdevelopedhsymptomatichbradycardiahwithhahhearthrateho
fh32hbeats/minute
b. Ahpatienthwhohhashsuddenlyhdevelopedhsymptomatichtachycardiahwithhahhearthrateho
fh180hbeats/minute
c. Ahpatienthwithhseverehnarrow-anglehglaucoma
d. Ahpatienthwhohishabouthtohhavehsurgery
e. Ahpatienthnewlyhdiagnosedhwithhmyastheniahgravis
f. Ahpatienthwithhanticholinesterasehinhibitorhpoisoning
ANS:h A,hD,hF
Anticholinergichdrugsharehusedhforhsymptomatichbradycardiahandhcertainhotherhcardiachconditi
ons.hIthishgivenhpreoperativelyhtohcontrolhsecretionshduringhsurgeryhandhishusedhashanhantidotehf
orhanticholinesterasehinhibitorhpoisoning.hThehotherhoptionsharehcontraindicationshtohthehusehofh
atropine.

DIF: COGNITIVEhLEVEL:hAnalyzingh(Analysis) REF:
p.h337hTOP:h NURSINGhPROCESS:hPlanning
MSC:h NCLEX:hPhysiologicalhIntegrity:hPharmacologicalhandhParenteralhTherapies