Chapter 18: Adrenergic Drugs
1. The nurse is aware that adrenergic drugs produce effects similar to which of these nervous
systems?
a. Central nervous system
b. Somatic nervous system
c. Sympathetic nervous system
d. Parasympathetic nervous system
Adrenergic drugs mimic the effects of the sympathetic nervous system.
2. When an adrenergic drug stimulates beta1-adrenergic receptors, the result is an increased force
of contraction, which is known as what type of effect?
a. Positive inotropic
b. Anti-adrenergic
c. Negative dromotropic
d. Positive chronotropic
An increased force of contraction is known as a positive inotropic effect.
3. When a patient is taking an adrenergic drug, the nurse expects to observe which effect?
a. Increased heart rate
b. Bronchial constriction
c. Constricted pupils
d. Increased intestinal peristalsis
Increased heart rate is one of the effects of adrenergic drugs. Sympathetic nervous system stimulation
also results in bronchodilation, dilated pupils, and decreased gastrointestinal mobility, depending upon
which receptors are stimulated.
4. An adrenergic agonist is ordered for a patient in shock. The nurse will note that this drug has had
its primary intended effect if which expected outcome occurs?
,a. Volume restoration
b. Increased cardiac output
c. Decreased urine output
d. Reduced anxiety
For a patient in shock, a primary benefit of an adrenergic agonist drug is to increase cardiac output. A
drug in this category should not be used in place of volume restoration, nor does it provide volume
restoration (IV fluids do this). Adrenergic agonists may enhance urine output if cardiac output and
perfusion to the kidneys increase. These drugs do not reduce anxiety.
5. The nurse is administering a stat dose of epinephrine. Epinephrine is appropriate for which
situation?
a. Severe hypertension
b. Angina
c. Cardiac arrest
d. Tachycardia
Treatment of cardiac arrest is an indication for the use of epinephrine. The other options are not
indications for epinephrine.
6. A patient is on a low-dose dobutamine drip for heart failure. She had been feeling better but
now has a sense of tightness in her chest, palpitations, and a bit of anxiety. Her heart rate is up
to 110 per minute, and her blood pressure is 150/98 mm Hg (increased from previous readings
of 86 per minute and 120/80 mm Hg). What is the nurse’s immediate concern for this patient?
a. She is experiencing normal adverse effects of dobutamine therapy.
b. She may be experiencing an allergic reaction to the dobutamine.
c. The medication may be causing a worsening of a pre-existing cardiac disorder.
d. The dosage of the dobutamine needs to be increased to control the symptoms better.
Because dobutamine is a vasoactive adrenergic, it works by increasing the cardiac output in heart failure
patients by increasing myocardial contractility and stroke volume. However, adrenergic drugs may
worsen a pre-existing cardiac disorder, such as causing a myocardial infarction in a patient with coronary
artery disease. The other options are incorrect.
,7. A 14-year-old patient has been treated for asthma for almost 4 months. Two weeks ago, she was
given salmeterol as part of her medication regimen. However, her mother has called the clinic to
report that it does not seem to work when her daughter is having an asthma attack. Which
response by the nurse is appropriate?
a. “It takes time for a therapeutic response to develop.”
b. “She is too young for this particular medication; it will be changed.”
c. “She needs to take up to two puffs every 4 hours to ensure adequate blood levels.”
d. “This medication is indicated for prevention of bronchospasms, not for relief of acute
symptoms.”
Salmeterol is indicated for the prevention of bronchospasms, not treatment of acute symptoms. The
dosage is usually two puffs twice daily, 12 hours apart, for maintenance effects in patients older than 12
years of age. The other options are incorrect.
8. A hospitalized patient is experiencing a severe anaphylactic reaction to a dose of intravenous
penicillin. Which drug will the nurse expect to use to treat this condition?
a. Ephedra
b. Epinephrine
c. Phenylephrine
d. Pseudoephedrine
Epinephrine is the drug of choice for the treatment of anaphylaxis. The other drugs listed are incorrect
choices.
9. The nurse recognizes that adrenergic drugs cause relaxation of the bronchi and bronchodilation
by stimulating which type of receptors?
a. Dopaminergic
b. Beta1 adrenergic
c. Beta2 adrenergic
d. Alpha1 adrenergic
Stimulation of beta2-adrenergic receptors results in bronchodilation. The other choices are incorrect.
, 10. The nurse is preparing to administer dopamine. Which is the correct technique for administering
dopamine?
a. Orally
b. Intravenous (IV) push injection
c. Intermittent IV infusions (IV piggyback)
d. Continuous IV infusion with an infusion pump
Dopamine is available only as an IV injectable drug and is given by continuous infusion, using an infusion
pump. The other options are incorrect.
1. The nurse is presenting information to a class of students about adrenergic drugs. Which are the
effects of drugs that stimulate the sympathetic nervous system? (Select all that apply.)
a. Dilation of bronchioles
b. Constriction of bronchioles
c. Decreased heart rate
d. Increased heart rate
e. Dilated pupils
f. Constricted pupils
g. Glycogenolysis
Stimulation of the sympathetic nervous system causes bronchodilation, increased heart rate, pupil
dilation, and glycogenolysis as well as many other effects (see Table 18-1). The other responses are
effects that occur as a result of the stimulation of the parasympathetic nervous system.
1. The nurse is to administer epinephrine 0.3 mg subcutaneously. The ampule contains 1 mL of
medication and is labeled “Epinephrine 1:1000.” Identify how many milliliters of epinephrine will
the nurse give. _______
ANS: 0.3 mL
Note that 1:1000 indicates 1 gram per 1000 mL or 1000 mg per 1000 mL, which is a concentration of 1
mg/mL.
1. The nurse is aware that adrenergic drugs produce effects similar to which of these nervous
systems?
a. Central nervous system
b. Somatic nervous system
c. Sympathetic nervous system
d. Parasympathetic nervous system
Adrenergic drugs mimic the effects of the sympathetic nervous system.
2. When an adrenergic drug stimulates beta1-adrenergic receptors, the result is an increased force
of contraction, which is known as what type of effect?
a. Positive inotropic
b. Anti-adrenergic
c. Negative dromotropic
d. Positive chronotropic
An increased force of contraction is known as a positive inotropic effect.
3. When a patient is taking an adrenergic drug, the nurse expects to observe which effect?
a. Increased heart rate
b. Bronchial constriction
c. Constricted pupils
d. Increased intestinal peristalsis
Increased heart rate is one of the effects of adrenergic drugs. Sympathetic nervous system stimulation
also results in bronchodilation, dilated pupils, and decreased gastrointestinal mobility, depending upon
which receptors are stimulated.
4. An adrenergic agonist is ordered for a patient in shock. The nurse will note that this drug has had
its primary intended effect if which expected outcome occurs?
,a. Volume restoration
b. Increased cardiac output
c. Decreased urine output
d. Reduced anxiety
For a patient in shock, a primary benefit of an adrenergic agonist drug is to increase cardiac output. A
drug in this category should not be used in place of volume restoration, nor does it provide volume
restoration (IV fluids do this). Adrenergic agonists may enhance urine output if cardiac output and
perfusion to the kidneys increase. These drugs do not reduce anxiety.
5. The nurse is administering a stat dose of epinephrine. Epinephrine is appropriate for which
situation?
a. Severe hypertension
b. Angina
c. Cardiac arrest
d. Tachycardia
Treatment of cardiac arrest is an indication for the use of epinephrine. The other options are not
indications for epinephrine.
6. A patient is on a low-dose dobutamine drip for heart failure. She had been feeling better but
now has a sense of tightness in her chest, palpitations, and a bit of anxiety. Her heart rate is up
to 110 per minute, and her blood pressure is 150/98 mm Hg (increased from previous readings
of 86 per minute and 120/80 mm Hg). What is the nurse’s immediate concern for this patient?
a. She is experiencing normal adverse effects of dobutamine therapy.
b. She may be experiencing an allergic reaction to the dobutamine.
c. The medication may be causing a worsening of a pre-existing cardiac disorder.
d. The dosage of the dobutamine needs to be increased to control the symptoms better.
Because dobutamine is a vasoactive adrenergic, it works by increasing the cardiac output in heart failure
patients by increasing myocardial contractility and stroke volume. However, adrenergic drugs may
worsen a pre-existing cardiac disorder, such as causing a myocardial infarction in a patient with coronary
artery disease. The other options are incorrect.
,7. A 14-year-old patient has been treated for asthma for almost 4 months. Two weeks ago, she was
given salmeterol as part of her medication regimen. However, her mother has called the clinic to
report that it does not seem to work when her daughter is having an asthma attack. Which
response by the nurse is appropriate?
a. “It takes time for a therapeutic response to develop.”
b. “She is too young for this particular medication; it will be changed.”
c. “She needs to take up to two puffs every 4 hours to ensure adequate blood levels.”
d. “This medication is indicated for prevention of bronchospasms, not for relief of acute
symptoms.”
Salmeterol is indicated for the prevention of bronchospasms, not treatment of acute symptoms. The
dosage is usually two puffs twice daily, 12 hours apart, for maintenance effects in patients older than 12
years of age. The other options are incorrect.
8. A hospitalized patient is experiencing a severe anaphylactic reaction to a dose of intravenous
penicillin. Which drug will the nurse expect to use to treat this condition?
a. Ephedra
b. Epinephrine
c. Phenylephrine
d. Pseudoephedrine
Epinephrine is the drug of choice for the treatment of anaphylaxis. The other drugs listed are incorrect
choices.
9. The nurse recognizes that adrenergic drugs cause relaxation of the bronchi and bronchodilation
by stimulating which type of receptors?
a. Dopaminergic
b. Beta1 adrenergic
c. Beta2 adrenergic
d. Alpha1 adrenergic
Stimulation of beta2-adrenergic receptors results in bronchodilation. The other choices are incorrect.
, 10. The nurse is preparing to administer dopamine. Which is the correct technique for administering
dopamine?
a. Orally
b. Intravenous (IV) push injection
c. Intermittent IV infusions (IV piggyback)
d. Continuous IV infusion with an infusion pump
Dopamine is available only as an IV injectable drug and is given by continuous infusion, using an infusion
pump. The other options are incorrect.
1. The nurse is presenting information to a class of students about adrenergic drugs. Which are the
effects of drugs that stimulate the sympathetic nervous system? (Select all that apply.)
a. Dilation of bronchioles
b. Constriction of bronchioles
c. Decreased heart rate
d. Increased heart rate
e. Dilated pupils
f. Constricted pupils
g. Glycogenolysis
Stimulation of the sympathetic nervous system causes bronchodilation, increased heart rate, pupil
dilation, and glycogenolysis as well as many other effects (see Table 18-1). The other responses are
effects that occur as a result of the stimulation of the parasympathetic nervous system.
1. The nurse is to administer epinephrine 0.3 mg subcutaneously. The ampule contains 1 mL of
medication and is labeled “Epinephrine 1:1000.” Identify how many milliliters of epinephrine will
the nurse give. _______
ANS: 0.3 mL
Note that 1:1000 indicates 1 gram per 1000 mL or 1000 mg per 1000 mL, which is a concentration of 1
mg/mL.
