NURS 316 EVALUATION EXAM ACTUAL QUESTIONS
AND SOLUTIONS GRADED A+
✔✔What are common adverse/side effects experienced by patients taking an
anticholinergic agent? - ✔✔Bradycardia, Heart block, Hypotension, Heart failure,
Drowsiness, Vertigo, Masks symptoms of hypoglycemia, orthostatic hypotension.
✔✔If a patient is experiencing urinary frequency and incontinence, what drug
classification will most likely be prescribed? (example?) - ✔✔Anticholinergic
✔✔When a patient experiences extravasation of an IV medication, what drug
classification will most likely be injected into the tissue at the site? (example?) -
✔✔Anticholinergic; PHENTOLAMINE
✔✔bradykinin: - ✔✔Source: plasma kinin
Result: increased sensitivity to pain
✔✔What are the cardinal signs of inflammation? Please describe the physiologic
processes that result in each sign. - ✔✔• Redness
• Heat
• Swelling
• Pain
• Loss of function
✔✔What is the role of the enzyme cyclooxygenase (COX) in the inflammatory process?
- ✔✔The enzymes that produce prostaglandins are called cyclooxygenase (COX).
There are two types of COX enzymes, COX-1 and COX-2. Both enzymes produce
prostaglandins that promote inflammation, pain, and fever; however, only COX-1
produces prostaglandins that activate platelets and protect the stomach and intestinal
lining.
✔✔Compare COX 1 and COX 2 receptors. - ✔✔COX 1: produces PGs that activate
platelets and protect stomach and intestinal lining
o Constitutive
o Cytoprotective PGs (provide protection)
o Desirable effects: gastroprotection, increased platelet aggregation, renal protection,
vasodilation, bronchodilation via PG, TXA2
COX 2: doesn't involve GI system
o Inducible
o Inflammatory PGs
o Undesirable effects: inflammation, pain, fever, decreased platelet aggregation
• Basically COX 1 receptors can elicit adverse effect involving GI system
✔✔A-delta fiber: - ✔✔o Myelinated
, o Larger diameter
o Fast
o Responds primarily to mechanical stimuli; some thermal
o Synapses with spinal motor neurons: protective reflex
o Responsible for acute, sharp pain
✔✔C-fiber: - ✔✔o Unmyelinated
o Small diameter
o "Slow"
o Responds to any noxious stimuli
o Responsible for dull, aching, prolonged pain & chronic pain
✔✔Arrange the following in order from greatest risk of bleeding (1) to least risk of
bleeding (5): - ✔✔2. Aspirin
3. Ibprophen
1. Ketorolac
4. Celecoxib
5. Acetaminophen
✔✔Name the three main opioid receptors in the body. To which one type of opioid
receptor do most opioids bind? - ✔✔mu, kappa, delta
✔✔What is the primary therapeutic effect of opioids? - ✔✔Analgesia (sedation via
opioid receptors throughout body)
✔✔What assessments will you perform prior to administering an opioid analgesic? -
✔✔• Monitor VS (hold opioid medications for RR < ____
• Monitor patients when ambulating
• Monitor intake/output
• Watch for s/s urinary retention (encourage voiding q4h)
• Encourage fiber supplements, stool softeners (drink plenty of water)
• Monitor lung sounds
• Deep breathing and coughing to prevent atelectasis (no lung movement)
• Administer IVP opioid analgesics, dilute and administer slowly over 3-5 min
• Monitor PCA use and pump settings carefully
✔✔What are the greatest safety risks to patients receiving opioid analgesics? -
✔✔Urinary retention & respiratory depression (atelectasis)
✔✔What is the pharmacologic action of opioid antagonists? - ✔✔• Bind strongly to
opioid receptors without receptor activation (no analgesia)
• Block effects of narcotics
• Useful in reversing narcotic respiratory depression or hypotension from overdose
✔✔erythropoiesis: - ✔✔production of RBCs
AND SOLUTIONS GRADED A+
✔✔What are common adverse/side effects experienced by patients taking an
anticholinergic agent? - ✔✔Bradycardia, Heart block, Hypotension, Heart failure,
Drowsiness, Vertigo, Masks symptoms of hypoglycemia, orthostatic hypotension.
✔✔If a patient is experiencing urinary frequency and incontinence, what drug
classification will most likely be prescribed? (example?) - ✔✔Anticholinergic
✔✔When a patient experiences extravasation of an IV medication, what drug
classification will most likely be injected into the tissue at the site? (example?) -
✔✔Anticholinergic; PHENTOLAMINE
✔✔bradykinin: - ✔✔Source: plasma kinin
Result: increased sensitivity to pain
✔✔What are the cardinal signs of inflammation? Please describe the physiologic
processes that result in each sign. - ✔✔• Redness
• Heat
• Swelling
• Pain
• Loss of function
✔✔What is the role of the enzyme cyclooxygenase (COX) in the inflammatory process?
- ✔✔The enzymes that produce prostaglandins are called cyclooxygenase (COX).
There are two types of COX enzymes, COX-1 and COX-2. Both enzymes produce
prostaglandins that promote inflammation, pain, and fever; however, only COX-1
produces prostaglandins that activate platelets and protect the stomach and intestinal
lining.
✔✔Compare COX 1 and COX 2 receptors. - ✔✔COX 1: produces PGs that activate
platelets and protect stomach and intestinal lining
o Constitutive
o Cytoprotective PGs (provide protection)
o Desirable effects: gastroprotection, increased platelet aggregation, renal protection,
vasodilation, bronchodilation via PG, TXA2
COX 2: doesn't involve GI system
o Inducible
o Inflammatory PGs
o Undesirable effects: inflammation, pain, fever, decreased platelet aggregation
• Basically COX 1 receptors can elicit adverse effect involving GI system
✔✔A-delta fiber: - ✔✔o Myelinated
, o Larger diameter
o Fast
o Responds primarily to mechanical stimuli; some thermal
o Synapses with spinal motor neurons: protective reflex
o Responsible for acute, sharp pain
✔✔C-fiber: - ✔✔o Unmyelinated
o Small diameter
o "Slow"
o Responds to any noxious stimuli
o Responsible for dull, aching, prolonged pain & chronic pain
✔✔Arrange the following in order from greatest risk of bleeding (1) to least risk of
bleeding (5): - ✔✔2. Aspirin
3. Ibprophen
1. Ketorolac
4. Celecoxib
5. Acetaminophen
✔✔Name the three main opioid receptors in the body. To which one type of opioid
receptor do most opioids bind? - ✔✔mu, kappa, delta
✔✔What is the primary therapeutic effect of opioids? - ✔✔Analgesia (sedation via
opioid receptors throughout body)
✔✔What assessments will you perform prior to administering an opioid analgesic? -
✔✔• Monitor VS (hold opioid medications for RR < ____
• Monitor patients when ambulating
• Monitor intake/output
• Watch for s/s urinary retention (encourage voiding q4h)
• Encourage fiber supplements, stool softeners (drink plenty of water)
• Monitor lung sounds
• Deep breathing and coughing to prevent atelectasis (no lung movement)
• Administer IVP opioid analgesics, dilute and administer slowly over 3-5 min
• Monitor PCA use and pump settings carefully
✔✔What are the greatest safety risks to patients receiving opioid analgesics? -
✔✔Urinary retention & respiratory depression (atelectasis)
✔✔What is the pharmacologic action of opioid antagonists? - ✔✔• Bind strongly to
opioid receptors without receptor activation (no analgesia)
• Block effects of narcotics
• Useful in reversing narcotic respiratory depression or hypotension from overdose
✔✔erythropoiesis: - ✔✔production of RBCs
