Chapter 6: Adrenergic Agonists
MULTIPLE CHOICE
1. The nurse is caring for a patient who has asthma and administers a selective beta2-adrenergic
agonist to treat bronchospasm. The nurse will expect this drug to also cause which side effect?
a. Increased blood glucose
b. Increased blood pressure
c. Increased heart rate
d. Increased gastrointestinal (GI) motility
ANS: A
Drugs that act on beta2 receptors activate glyconeogenesis in the liver causing increased blood
glucose. Selective beta2 drugs act on beta2 receptors only and not on beta1 receptors, so they
do not cause increased blood pressure or increased heart rate. Adrenergic agonists cause
decreased GI motility.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 256
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. A patient who has asthma is diagnosed with hypertension. The nurse understands that
which drug will be safe to give this patient? a. Pindolol (Visken)
b. Metoprolol (Lopressor)
c. Nadolol (Corgard)
d. Propranolol (Inderal)
ANS: B
Metoprolol is a selective adrenergic blocker that has a greater affinity for receptors that
decrease heart rate and blood pressure and is less likely to cause bronchospasm. The other
adrenergic blockers are not selective and can cause bronchoconstriction.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 263
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. The nurse administers subcutaneous epinephrine to a patient who is experiencing an
anaphylactic reaction. The nurse should expect to monitor the patient for which
symptom? a. Bradycardia
b. Decreased urine output
c. Hypotension
d. Nausea and vomiting
ANS: B
Epinephrine can cause renal vasoconstriction and thereby reduce renal perfusion and
decrease urinary output. Epinephrine causes tachycardia and elevates blood pressure.
Nausea and vomiting are not expected to occur.
, DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 258
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
4. An adult patient is brought to the emergency department for treatment of an asthma
exacerbation. The patient uses inhaled albuterol as needed to control wheezing. The nurse
notes expiratory wheezing, tremors, restlessness, and a heart rate of 120 beats per minute. The
nurse suspects that the patient has a. over-used the albuterol.
b. not been using albuterol.
c. taken a beta-adrenergic blocker.
d. taken a monoamine oxidase (MAO) inhibitor.
ANS: A
High doses of albuterol may affect beta1 receptors, causing an increase in heart rate. Patients
having an asthma exacerbation may over-use their albuterol inhalers when seeking relief.
Patients may have wheezing and increased heart rate during an untreated asthma
exacerbation, but they will not have tremors and restlessness.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 259
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. The nurse is caring for a patient who is receiving intravenous dopamine (Intropin). The
nurse notes erythema and swelling at the IV insertion site. What is the nurses initial action? a.
Apply warm soaks to the area.
b. Monitor the patient closely for hypertension.
c. Obtain an order for an electrocardiogram.
d. Notify the provider of a need for phentolamine mesylate (Regitine).
ANS: D
Extravasation of dopamine causes tissue necrosis; if extravasation occurs, the antidote
phentolamine mesylate should be infiltrated into the area.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 262
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is teaching a patient how to use phenylephrine HCl (Neo-Synephrine) nasal spray
to treat congestion from a viral upper respiratory infection. What instruction will the nurse give
the patient?
a. Stop using the medication after 3 days.
b. Spray the medication into the nose while lying supine.
c. Use frequently since systemic side effects do not occur.
d. Use the medication with any other over-the-counter medications.
ANS: A
MULTIPLE CHOICE
1. The nurse is caring for a patient who has asthma and administers a selective beta2-adrenergic
agonist to treat bronchospasm. The nurse will expect this drug to also cause which side effect?
a. Increased blood glucose
b. Increased blood pressure
c. Increased heart rate
d. Increased gastrointestinal (GI) motility
ANS: A
Drugs that act on beta2 receptors activate glyconeogenesis in the liver causing increased blood
glucose. Selective beta2 drugs act on beta2 receptors only and not on beta1 receptors, so they
do not cause increased blood pressure or increased heart rate. Adrenergic agonists cause
decreased GI motility.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 256
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. A patient who has asthma is diagnosed with hypertension. The nurse understands that
which drug will be safe to give this patient? a. Pindolol (Visken)
b. Metoprolol (Lopressor)
c. Nadolol (Corgard)
d. Propranolol (Inderal)
ANS: B
Metoprolol is a selective adrenergic blocker that has a greater affinity for receptors that
decrease heart rate and blood pressure and is less likely to cause bronchospasm. The other
adrenergic blockers are not selective and can cause bronchoconstriction.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 263
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. The nurse administers subcutaneous epinephrine to a patient who is experiencing an
anaphylactic reaction. The nurse should expect to monitor the patient for which
symptom? a. Bradycardia
b. Decreased urine output
c. Hypotension
d. Nausea and vomiting
ANS: B
Epinephrine can cause renal vasoconstriction and thereby reduce renal perfusion and
decrease urinary output. Epinephrine causes tachycardia and elevates blood pressure.
Nausea and vomiting are not expected to occur.
, DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 258
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
4. An adult patient is brought to the emergency department for treatment of an asthma
exacerbation. The patient uses inhaled albuterol as needed to control wheezing. The nurse
notes expiratory wheezing, tremors, restlessness, and a heart rate of 120 beats per minute. The
nurse suspects that the patient has a. over-used the albuterol.
b. not been using albuterol.
c. taken a beta-adrenergic blocker.
d. taken a monoamine oxidase (MAO) inhibitor.
ANS: A
High doses of albuterol may affect beta1 receptors, causing an increase in heart rate. Patients
having an asthma exacerbation may over-use their albuterol inhalers when seeking relief.
Patients may have wheezing and increased heart rate during an untreated asthma
exacerbation, but they will not have tremors and restlessness.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 259
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. The nurse is caring for a patient who is receiving intravenous dopamine (Intropin). The
nurse notes erythema and swelling at the IV insertion site. What is the nurses initial action? a.
Apply warm soaks to the area.
b. Monitor the patient closely for hypertension.
c. Obtain an order for an electrocardiogram.
d. Notify the provider of a need for phentolamine mesylate (Regitine).
ANS: D
Extravasation of dopamine causes tissue necrosis; if extravasation occurs, the antidote
phentolamine mesylate should be infiltrated into the area.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 262
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is teaching a patient how to use phenylephrine HCl (Neo-Synephrine) nasal spray
to treat congestion from a viral upper respiratory infection. What instruction will the nurse give
the patient?
a. Stop using the medication after 3 days.
b. Spray the medication into the nose while lying supine.
c. Use frequently since systemic side effects do not occur.
d. Use the medication with any other over-the-counter medications.
ANS: A
