Chapter 16: Cholinergic Agonists and
Antagonists McCuistion: Pharmacology:
A Patient-Centered Nursing Process
Approach, 11th Edition
The nurse is preparing to administer a drug and learns that it is an indirect-acting cholinergic
agonist. The nurse understands that this drug
a. acts on muscarinic receptors.
b. acts on nicotinic receptors.
c. inhibits cholinesterase.
d. inhibits cholinergic receptors.
ANS: C
Agents that inhibit cholinesterase, which is the enzyme that breaks down acetylcholine,
indirectly enhance the reactions of acetylcholine.
A nursing student asks why a direct-acting cholinergic agonist drug that is selective to
muscarinic receptors is described as being non-specific. the nurse will explain that this is
because
a. muscarinic receptors are present in many different tissues.
b. the action of cholinesterase alters the bioavailability at different sites.
c. these drugs can also affect nicotinic receptors.
d. they vary in their reversible and irreversible effects.
ANS: A
Although drugs classified as direct-acting cholinergic agonists are primarily selective for
muscarinic receptors, some are considered non-specific because muscarinic receptors are
located in different sites, causing actions in various organs. They are not affected differently
by cholinesterase activity and have negligible actions on nicotinic receptors.
The nurse is preparing to administer bethanechol (Urecholine) to a patient who is
experiencing urinary retention. the nurse notes that the patient has a blood pressure of 90/60
mm Hg. the nurse will perform which action?
a. Administer the drug and monitor urine output.
b. Administer the medication and monitor vital signs frequently.
c. Give the medication and notify the provider of the increased heart rate.
, d. Hold the medication and notify the provider of the decreased blood pressure.
ANS: D
Bethanechol treatment can result in hypotension. the nurse should hold the drug and notify
the provider of the low blood pressure.
The nurse administers bethanechol (Urecholine) to a patient to treat urinary retention. After
30 minutes, the patient voids 800 mL of urine and reports having a loose stool but no
cramping or gastrointestinal pain. The patient's blood pressure is 110/70 mm Hg. the nurse
will perform which action?
a. Notify the provider of bethanechol adverse effects.
b. Record the urine output and the blood pressure and continue to monitor.
c. Request an order for intravenous atropine sulfate.
d. Suggest another dose of bethanechol to the provider.
ANS: B
The patient is exhibiting desired effects and mild side effects of bethanechol, so the nurse
should record information and continue to monitor the patient. There is no need to notify the
provider, give an antidote, or repeat the dose.
The nurse is teaching a patient who will begin taking bethanechol (Urecholine). Which
statement by the patient indicates a need for further teaching?
a. "Excessive sweating is a normal reaction to this medication."
b. "Excess salivation is a serious side effect."
c. "I should get out of bed slowly while taking this drug."
d. "I will not take the drug if my heart rate is less than 60 beats per minute."
ANS: A
Patients taking bethanechol should be instructed to report increased salivation and
diaphoresis since they can be early signs of overdosing. They should also be taught to rise
slowly to avoid orthostatic hypotension and to hold the drug if their heart rate is low.
The nurse is caring for a male patient with myasthenia gravis who will begin taking
neostigmine. When performing a health history, the nurse will be concerned and further
investigate the history of which condition in this patient?
a. Benign prostatic hypertrophy
b. Chronic constipation
c. Erectile dysfunction
d. Upper respiratory infection
ANS: A
Antagonists McCuistion: Pharmacology:
A Patient-Centered Nursing Process
Approach, 11th Edition
The nurse is preparing to administer a drug and learns that it is an indirect-acting cholinergic
agonist. The nurse understands that this drug
a. acts on muscarinic receptors.
b. acts on nicotinic receptors.
c. inhibits cholinesterase.
d. inhibits cholinergic receptors.
ANS: C
Agents that inhibit cholinesterase, which is the enzyme that breaks down acetylcholine,
indirectly enhance the reactions of acetylcholine.
A nursing student asks why a direct-acting cholinergic agonist drug that is selective to
muscarinic receptors is described as being non-specific. the nurse will explain that this is
because
a. muscarinic receptors are present in many different tissues.
b. the action of cholinesterase alters the bioavailability at different sites.
c. these drugs can also affect nicotinic receptors.
d. they vary in their reversible and irreversible effects.
ANS: A
Although drugs classified as direct-acting cholinergic agonists are primarily selective for
muscarinic receptors, some are considered non-specific because muscarinic receptors are
located in different sites, causing actions in various organs. They are not affected differently
by cholinesterase activity and have negligible actions on nicotinic receptors.
The nurse is preparing to administer bethanechol (Urecholine) to a patient who is
experiencing urinary retention. the nurse notes that the patient has a blood pressure of 90/60
mm Hg. the nurse will perform which action?
a. Administer the drug and monitor urine output.
b. Administer the medication and monitor vital signs frequently.
c. Give the medication and notify the provider of the increased heart rate.
, d. Hold the medication and notify the provider of the decreased blood pressure.
ANS: D
Bethanechol treatment can result in hypotension. the nurse should hold the drug and notify
the provider of the low blood pressure.
The nurse administers bethanechol (Urecholine) to a patient to treat urinary retention. After
30 minutes, the patient voids 800 mL of urine and reports having a loose stool but no
cramping or gastrointestinal pain. The patient's blood pressure is 110/70 mm Hg. the nurse
will perform which action?
a. Notify the provider of bethanechol adverse effects.
b. Record the urine output and the blood pressure and continue to monitor.
c. Request an order for intravenous atropine sulfate.
d. Suggest another dose of bethanechol to the provider.
ANS: B
The patient is exhibiting desired effects and mild side effects of bethanechol, so the nurse
should record information and continue to monitor the patient. There is no need to notify the
provider, give an antidote, or repeat the dose.
The nurse is teaching a patient who will begin taking bethanechol (Urecholine). Which
statement by the patient indicates a need for further teaching?
a. "Excessive sweating is a normal reaction to this medication."
b. "Excess salivation is a serious side effect."
c. "I should get out of bed slowly while taking this drug."
d. "I will not take the drug if my heart rate is less than 60 beats per minute."
ANS: A
Patients taking bethanechol should be instructed to report increased salivation and
diaphoresis since they can be early signs of overdosing. They should also be taught to rise
slowly to avoid orthostatic hypotension and to hold the drug if their heart rate is low.
The nurse is caring for a male patient with myasthenia gravis who will begin taking
neostigmine. When performing a health history, the nurse will be concerned and further
investigate the history of which condition in this patient?
a. Benign prostatic hypertrophy
b. Chronic constipation
c. Erectile dysfunction
d. Upper respiratory infection
ANS: A
