Pharm questions 136-
180 with 100% correct
answers.
136. A patient with asthma uses albuterol (Ventolin) for wheezing.
The nurse assesses the patient and notes vital signs of HR, 96 beats
per minute; RR, 18 breaths per minute; and BP, 116/78 mm Hg. The
patient has clear breath sounds and hand tremors. What will the
nurse do?
a. Ask the patient how often the inhaler is used.
b. Check the patient's blood glucose level.
c. Request an order for isoproterenol (Isuprel) to reduce side
effects.
d. Stop the medication and report the tremors to the provider. -
answer a. Ask the patient how often the inhaler is used.
Tachycardia is a response to activation of beta1 receptors. It can
occur when large doses of albuterol are used and selectivity
decreases. The nurse should question the patient about the number
of inhalations used. Isoproterenol can cause hyperglycemia in
diabetic patients. Isoproterenol has more side effects than
albuterol. Tremors are an expected side effect and are not an
indication for stopping the drug.
137. A nurse is teaching parents how to use an Epi-Pen for their
child, who has a peanut allergy. Which statement by the parents
indicates understanding of the teaching?
,a. "After using the Epi-Pen, we must go to the emergency
department."
b. "The Epi-Pen should be stored in the refrigerator, because
epinephrine is sensitive to heat."
c. "The teacher should call us when symptoms start so that we can
bring the Epi-Pen to school."
d. "We should jab the device into the thigh until it is empty of
solution." - answer a. "After using the Epi-Pen, we must go to the
emergency department."
After using the Epi-Pen, it is important that the individual get
medical attention as quickly as possible. The effects of epinephrine
fade in 10 to 20 minutes, and the anaphylactic reaction can be
biphasic and prolonged. Epinephrine is sensitive to heat, but storing
the device in the refrigerator can compromise the injection
mechanism; the device should be stored at room temperature in a
dark place. Individuals who need an Epi-Pen must have the device
with them at all times; any delay in treatment can be fatal, because
anaphylaxis can occur within minutes after exposure. The Epi-Pen
contains 2 mL of epinephrine, but only 0.3 mL is injected; the device
will not be empty with a successful injection.
138. Because they cause vasoconstriction, alpha1-adrenergic
agonists are especially useful for:
a. extending the duration of local anesthetics.
b. producing mydriasis to facilitate ophthalmic examinations.
c. slowing the heart rate in tachycardic patients.
d. treating hypotension. - answer a. extending the duration of local
anesthetics.
The vasoconstrictive effects of alpha1-adrenergic agonists, such as
epinephrine, help delay absorption of a local anesthetic, prolonging
the anesthetic's effects. These agents can increase blood pressure
but are not the primary drugs used except in emergency situations.
, Alpha1 receptors in the radial muscles of the iris, not
vasoconstriction, cause mydriasis. Reflex bradycardia is a side
effect and not a clinical use of these agents.
139. A patient is admitted to the intensive care unit for treatment of
shock. The prescriber orders isoproterenol (Isuprel). The nurse
expects this drug to increase tissue perfusion in this patient by
activating:
a. alpha1 receptors to cause vasoconstriction.
b. alpha1 receptors to increase blood pressure.
c. beta1 receptors to cause a positive inotropic effect.
d. beta2 receptors to cause bronchodilation. - answer c. beta1
receptors to cause a positive inotropic effect.
Isoproterenol is used for shock because of its actions on beta1
receptors in the heart. It has a positive inotropic effect, which
improves cardiac output and thus increases tissue perfusion.
Isoproterenol does not affect alpha1 receptors. Although it activates
beta2 receptors to cause bronchodilation, this is not indicated for
the treatment of shock.
140. A pregnant patient with diabetes and hypertension is given
isoproterenol (Isuprel) to delay preterm labor. Which side effect
might the nurse expect?
a. Bronchospasm
b. Decreased urine output
c. Hyperglycemia
d. Hypotension - answer c. Hyperglycemia
180 with 100% correct
answers.
136. A patient with asthma uses albuterol (Ventolin) for wheezing.
The nurse assesses the patient and notes vital signs of HR, 96 beats
per minute; RR, 18 breaths per minute; and BP, 116/78 mm Hg. The
patient has clear breath sounds and hand tremors. What will the
nurse do?
a. Ask the patient how often the inhaler is used.
b. Check the patient's blood glucose level.
c. Request an order for isoproterenol (Isuprel) to reduce side
effects.
d. Stop the medication and report the tremors to the provider. -
answer a. Ask the patient how often the inhaler is used.
Tachycardia is a response to activation of beta1 receptors. It can
occur when large doses of albuterol are used and selectivity
decreases. The nurse should question the patient about the number
of inhalations used. Isoproterenol can cause hyperglycemia in
diabetic patients. Isoproterenol has more side effects than
albuterol. Tremors are an expected side effect and are not an
indication for stopping the drug.
137. A nurse is teaching parents how to use an Epi-Pen for their
child, who has a peanut allergy. Which statement by the parents
indicates understanding of the teaching?
,a. "After using the Epi-Pen, we must go to the emergency
department."
b. "The Epi-Pen should be stored in the refrigerator, because
epinephrine is sensitive to heat."
c. "The teacher should call us when symptoms start so that we can
bring the Epi-Pen to school."
d. "We should jab the device into the thigh until it is empty of
solution." - answer a. "After using the Epi-Pen, we must go to the
emergency department."
After using the Epi-Pen, it is important that the individual get
medical attention as quickly as possible. The effects of epinephrine
fade in 10 to 20 minutes, and the anaphylactic reaction can be
biphasic and prolonged. Epinephrine is sensitive to heat, but storing
the device in the refrigerator can compromise the injection
mechanism; the device should be stored at room temperature in a
dark place. Individuals who need an Epi-Pen must have the device
with them at all times; any delay in treatment can be fatal, because
anaphylaxis can occur within minutes after exposure. The Epi-Pen
contains 2 mL of epinephrine, but only 0.3 mL is injected; the device
will not be empty with a successful injection.
138. Because they cause vasoconstriction, alpha1-adrenergic
agonists are especially useful for:
a. extending the duration of local anesthetics.
b. producing mydriasis to facilitate ophthalmic examinations.
c. slowing the heart rate in tachycardic patients.
d. treating hypotension. - answer a. extending the duration of local
anesthetics.
The vasoconstrictive effects of alpha1-adrenergic agonists, such as
epinephrine, help delay absorption of a local anesthetic, prolonging
the anesthetic's effects. These agents can increase blood pressure
but are not the primary drugs used except in emergency situations.
, Alpha1 receptors in the radial muscles of the iris, not
vasoconstriction, cause mydriasis. Reflex bradycardia is a side
effect and not a clinical use of these agents.
139. A patient is admitted to the intensive care unit for treatment of
shock. The prescriber orders isoproterenol (Isuprel). The nurse
expects this drug to increase tissue perfusion in this patient by
activating:
a. alpha1 receptors to cause vasoconstriction.
b. alpha1 receptors to increase blood pressure.
c. beta1 receptors to cause a positive inotropic effect.
d. beta2 receptors to cause bronchodilation. - answer c. beta1
receptors to cause a positive inotropic effect.
Isoproterenol is used for shock because of its actions on beta1
receptors in the heart. It has a positive inotropic effect, which
improves cardiac output and thus increases tissue perfusion.
Isoproterenol does not affect alpha1 receptors. Although it activates
beta2 receptors to cause bronchodilation, this is not indicated for
the treatment of shock.
140. A pregnant patient with diabetes and hypertension is given
isoproterenol (Isuprel) to delay preterm labor. Which side effect
might the nurse expect?
a. Bronchospasm
b. Decreased urine output
c. Hyperglycemia
d. Hypotension - answer c. Hyperglycemia
