BSN 315 PHARMACOLOGY 2 REAL
EXAM QUESTIONS WITH CORRECT
ANSWERS WITH EXPLANATIONS.
A patient is having outpatient surgery that should last only 45 minutes. The
patient is planning to go home immediately after the surgery is complete.
What nondepolarizing neuromuscular junction blocker will most likely be
used as an adjunct therapy to general anesthesia for this patient?
A)Atracurium (Tracrium)
B)Cisatracurium (Nimbex)
C)Pancuronium (Pavulon)
D)Rocuronium (Zemuron)
Ans:D
Fedback:
Rocuronium has a rapid onset of action and a short duration, making it a
drug of choice for outpatient surgical procedures when the patient will be
leaving to go home and will need to be awake, alert, and mobile. Atracurium,
cisatracurium, and pancuronium are associated with longer paralysis and
recovery.
A patient is taking aminophylline for their chronic obstructive pulmonary
disease. The patient is about to undergo emergency surgery and will receive
an neuromuscular junction (NMJ) blocker as part of the procedure. It is
important for the nurse to take what action?
A)Make sure the patient receives the aminophylline on a regular schedule to
maintain therapeutic levels.
B)Monitor the patient very closely for signs of early arousal and return of
muscle function.
,C)Carefully explain all that is going on because the patient will be unable to
talk.
D)Switch the patient to theophyllines before the procedure begins.
Ans:B
Feedback:
Aminophylline can cause a decreased effectiveness of NMJ blockers, leading
to reduced paralysis and early return of movement. If a patient has
emergency surgery and has been taking aminophylline, the patient should
be carefully monitored for early arousal and return of movement. The patient
will not be awake during surgery using an NMJ blocker and will be intubated
to ensure respirations. Aminophylline and other xanthine derivatives like the
theophyllines will have the same effect.
The nurse is caring for a patient who is being maintained on mechanical
ventilation. Atracurium is administered to limit the resistance to mechanical
ventilation. What is the nurse's priority assessment?
A)Hypotension
B)Tachycardia
C)Bradycardia
D)Increased secretions
Ans:C
Feedback:
Bradycardia is a common adverse effect associated with atracurium. The
nurse should monitor the patient regularly to avoid serious adverse effects.
Increased secretions and hypotension are common with tubocurarine. Option
B is a distracter.
,The nurse is preparing a patient for surgery who will receive a neuromuscular
junction blocker during the procedure. It is important for the nurse to review
the patient's medication history for concurrent use of what?
A)Angiotensin-converting enzyme (ACE) inhibitors
B)Beta blockers
C)Calcium channel blockers
D)Montelukast
Ans:C
Feedback:
When calcium channel blockers are used concurrently with neuromuscular
junction blockers, the patient is at increased risk of prolonged paralysis. The
dose of the neuromuscular junction blocker should be lowered if this
combination cannot be avoided and the patient should be monitored closely.
There is no anticipated drug-drug interaction with ACE inhibitors, beta
blockers, or montelukast.
An elderly patient has received a neuromuscular junction blocker during
surgery. What would be an appropriate nursing diagnosis for this patient?
A)Excess fluid volume
B)Risk for impaired skin integrity
C)Deficient fluid volume
D)Chronic confusion
Ans:B
Feedback:
An elderly or frail patient will need extra nursing care to prevent skin
breakdown during the period of paralysis because skin tends to be thinner
and more susceptible to breakdown. Therefore, risk of impaired skin integrity
would be an appropriate nursing diagnosis. Fluid excess or deficit should not
be a concern and the patient may be acutely confused when awakening, but
, there is no reason to think he or she would remain chronically confused if he
was not before surgery.
What are the primary uses of neuromuscular junction blockers (NMJ)
blockers? (Select all that apply.)
A)To facilitate endotracheal intubation
B)To sedate patient for general anesthesia
C)To prevent injury during electroconvulsive therapy
D)To provide greater ease in extubating patient
E)To facilitate mechanical ventilation
Ans:A, C, E
Feedback:
NMJ blockers are primarily used as adjuncts to general anesthesia, to
facilitate endotracheal intubation, to facilitate mechanical ventilation, and to
prevent injury during electroconvulsive therapy. NMJ blockers do not sedate
the patient who will be paralyzed after administration but will remain alert
unless another medication is given. These medications would not be given
before extubation because respiratory muscles would be paralyzed, resulting
in the inability to breathe.
The pharmacology instructor is discussing nondepolarizing neuromuscular
junction blockers (NMJ) blockers with the nursing class. How would the
instructor explain the action of nondepolarizing NMJ blockers?
A)Blocks acetylcholine (ACh) from acting B)Acts like ACh then prevents
repolarization
C)Takes the place of ACh in the depolarizing/repolarizing process
D)Stops depolarization in the axion
Ans:B
EXAM QUESTIONS WITH CORRECT
ANSWERS WITH EXPLANATIONS.
A patient is having outpatient surgery that should last only 45 minutes. The
patient is planning to go home immediately after the surgery is complete.
What nondepolarizing neuromuscular junction blocker will most likely be
used as an adjunct therapy to general anesthesia for this patient?
A)Atracurium (Tracrium)
B)Cisatracurium (Nimbex)
C)Pancuronium (Pavulon)
D)Rocuronium (Zemuron)
Ans:D
Fedback:
Rocuronium has a rapid onset of action and a short duration, making it a
drug of choice for outpatient surgical procedures when the patient will be
leaving to go home and will need to be awake, alert, and mobile. Atracurium,
cisatracurium, and pancuronium are associated with longer paralysis and
recovery.
A patient is taking aminophylline for their chronic obstructive pulmonary
disease. The patient is about to undergo emergency surgery and will receive
an neuromuscular junction (NMJ) blocker as part of the procedure. It is
important for the nurse to take what action?
A)Make sure the patient receives the aminophylline on a regular schedule to
maintain therapeutic levels.
B)Monitor the patient very closely for signs of early arousal and return of
muscle function.
,C)Carefully explain all that is going on because the patient will be unable to
talk.
D)Switch the patient to theophyllines before the procedure begins.
Ans:B
Feedback:
Aminophylline can cause a decreased effectiveness of NMJ blockers, leading
to reduced paralysis and early return of movement. If a patient has
emergency surgery and has been taking aminophylline, the patient should
be carefully monitored for early arousal and return of movement. The patient
will not be awake during surgery using an NMJ blocker and will be intubated
to ensure respirations. Aminophylline and other xanthine derivatives like the
theophyllines will have the same effect.
The nurse is caring for a patient who is being maintained on mechanical
ventilation. Atracurium is administered to limit the resistance to mechanical
ventilation. What is the nurse's priority assessment?
A)Hypotension
B)Tachycardia
C)Bradycardia
D)Increased secretions
Ans:C
Feedback:
Bradycardia is a common adverse effect associated with atracurium. The
nurse should monitor the patient regularly to avoid serious adverse effects.
Increased secretions and hypotension are common with tubocurarine. Option
B is a distracter.
,The nurse is preparing a patient for surgery who will receive a neuromuscular
junction blocker during the procedure. It is important for the nurse to review
the patient's medication history for concurrent use of what?
A)Angiotensin-converting enzyme (ACE) inhibitors
B)Beta blockers
C)Calcium channel blockers
D)Montelukast
Ans:C
Feedback:
When calcium channel blockers are used concurrently with neuromuscular
junction blockers, the patient is at increased risk of prolonged paralysis. The
dose of the neuromuscular junction blocker should be lowered if this
combination cannot be avoided and the patient should be monitored closely.
There is no anticipated drug-drug interaction with ACE inhibitors, beta
blockers, or montelukast.
An elderly patient has received a neuromuscular junction blocker during
surgery. What would be an appropriate nursing diagnosis for this patient?
A)Excess fluid volume
B)Risk for impaired skin integrity
C)Deficient fluid volume
D)Chronic confusion
Ans:B
Feedback:
An elderly or frail patient will need extra nursing care to prevent skin
breakdown during the period of paralysis because skin tends to be thinner
and more susceptible to breakdown. Therefore, risk of impaired skin integrity
would be an appropriate nursing diagnosis. Fluid excess or deficit should not
be a concern and the patient may be acutely confused when awakening, but
, there is no reason to think he or she would remain chronically confused if he
was not before surgery.
What are the primary uses of neuromuscular junction blockers (NMJ)
blockers? (Select all that apply.)
A)To facilitate endotracheal intubation
B)To sedate patient for general anesthesia
C)To prevent injury during electroconvulsive therapy
D)To provide greater ease in extubating patient
E)To facilitate mechanical ventilation
Ans:A, C, E
Feedback:
NMJ blockers are primarily used as adjuncts to general anesthesia, to
facilitate endotracheal intubation, to facilitate mechanical ventilation, and to
prevent injury during electroconvulsive therapy. NMJ blockers do not sedate
the patient who will be paralyzed after administration but will remain alert
unless another medication is given. These medications would not be given
before extubation because respiratory muscles would be paralyzed, resulting
in the inability to breathe.
The pharmacology instructor is discussing nondepolarizing neuromuscular
junction blockers (NMJ) blockers with the nursing class. How would the
instructor explain the action of nondepolarizing NMJ blockers?
A)Blocks acetylcholine (ACh) from acting B)Acts like ACh then prevents
repolarization
C)Takes the place of ACh in the depolarizing/repolarizing process
D)Stops depolarization in the axion
Ans:B
