Focus On Nursing Pharmacology 8th Edition Amy M. Karch - Solutions

Anticholinergic drugs are effective in early Parkinson disease. They act to a. Block stimulating effects of acetylcholine in the brain to bring activity back into balance. b. Block the signs and symptoms of the disease, making it more acceptable. c. Inhibit dopamine effects in the
A patient receiving an anticholinergic drug for Parkinson disease is planning a winter trip to Tahiti. The temperature in Tahiti is 70 degrees warmer than at home. What precautions should the patient be urged to take? a. Take the drug with plenty of water to stay hydrated. b. Reduce the
A patient taking levodopa and over-the-counter megavitamins might experience. a. A cure from Parkinson disease. b. The return of Parkinson symptoms. c. Improved health and well-being. d. A resistance to viral infections.
Spasmolytics, or centrally acting muscle relaxants, block the reflexes in the CNS that lead to spasm. While a patient is taking one of these drugs, which interventions should be implemented? a. Rest for the affected muscle b. Heat to the affected area c. Ice packs to the affected
Muscle spasticity is the result of a. Direct damage to a muscle cell. b. Overstretching of a muscle. c. Tearing of a ligament. d. Damage to neurons within the CNS.
A patient who has been diagnosed with Parkinson disease for many years and whose symptoms were controlled using Sinemet has started to exhibit increasing signs of the disease. Possible treatment might include.a. An increased exercise program. b. Adding iron to the person’s diet. c.
A muscle spasm often results from a. Damage to the basal ganglia. b. CNS damage. c. Injury to the musculoskeletal system. d. Chemical imbalance within the CNS.
Muscle relaxants would be used in which circumstances? a. To treat spasticity related to spinal cord injury.b. To treat spasticity that contributes to locomotion, upright position, or increase in function. c. To treat spasticity that is related to toxins, such as tetanus. d. To treat
Signs and symptoms of tetanus, which include severe muscle spasm, are best treated with a. Baclofen. b. Diazepam.c. Carisoprodol. d. Methocarbamol.
The drug of choice for a patient experiencing severe muscle spasms and pain precipitated by anxiety is. a. Methocarbamol. b. Baclofen. c. Diazepam. d. Carisoprodol.
Dantrolene (Dantrium) differs from the other skeletal muscle relaxants because. a. It acts in the highest levels of the CNS. b. It is used to treat muscle spasms as well as muscle spasticity. c. It cannot be used to treat neuromuscular disorders. d. It acts directly within the
The use of neuromuscular junction blockers may sometimes cause a condition known as malignant hyperthermia. The drug of choice for prevention or treatment of this condition is a. Baclofen. b. Diazepam. c. Dantrolene. d. Methocarbamol.
Dantrolene is associated with potentially fatal cellular damage. If your patient’s condition is being managed with dantrolene, the patient should a. Have repeated complete blood counts during therapy. b. Have renal function tests done monthly. c. Be monitored for signs of liver
According to the gate control theory, pain.a. Is caused by gates in the CNS. b. Can be blocked or intensified by gates in the CNS. c. Is caused by gates in peripheral nerve sensors. d. Cannot be affected by learned experiences.
Narcotics are drugs that react with opioid receptors throughout the body. Which conditions would the nurse expect to find when assessing a patient who was taking a narcotic? a. Hypnosis b. Sedation c. Analgesia d. Euphoria e. Orthostatic hypotension f. Increased
Opioid receptors are found throughout the body a. Only in people who have become addicted to opiates. b. In increasing numbers with chronic pain conditions. c. To incorporate pain perception and blocking. d. To initiate the release of endorphins.
The nurse would expect to administer a narcotic as the analgesic of choice for which patients? a. A patient with severe postoperative pain. b. A patient with severe chronic obstructive pulmonary disease and difficulty in breathing.c. A patient with severe, chronic pain. d. A patient
Most narcotics are controlled substances because they. a. Are very expensive.b. Can cause respiratory depression. c. Can be addictive. d. Can be used only in a hospital setting.
Injecting a narcotic into an area of the body that is chilled can be dangerous because a. An abscess will form. b. The injection will be very painful. c. An excessive amount may be absorbed all at once. d. Narcotics are inactivated in cold temperatures.
Proper administration of an ordered narcotic a. Can lead to addiction. b. Should be done promptly to prevent increased pain and the need for larger doses. c. Would include holding the drug as long as possible until the patient really needs it. d. Should rely on the patient’s
Migraine headaches. a. Occur during sleep and involve sweating and eye pain. b. Occur with stress and feel like a dull band around the entire head. c. Often occur when drinking coffee. d. Are throbbing headaches on one side of the head.
The triptans are a class of drugs that bind to selective serotonin receptor sites and cause.a. Cranial vascular dilation. b. Cranial vascular constriction. c. Clinical depression. d. Nausea and vomiting.
The only triptan that has been approved for use in treating cluster headaches as well as migraines is.a. Naratriptan. b. Rizatriptan. c. Sumatriptan.d. Zolmitriptan.
The most dangerous period for many patients undergoing general anesthesia is during which stage? a. Stage 1, when communication becomes difficult b. Stage 2, when systemic stimulation occurs c. Stage 3, when skeletal muscles relax d. There is no real danger during general
Balanced anesthesia combines different classes of drugs to achieve the best effects with the fewest adverse effects. Balanced anesthesia usually involves the use of which types of drugs? a. Anticholinergics b. Narcotics c. Sedative/hypnotics d. Adrenergic beta-blockers e.
While a patient is receiving a general anesthetic, he or she must be continually monitored because.a. The patient has no pain sensation. b. Generalized CNS depression affects all body functions. c. The patient cannot move. d. The patient cannot communicate.
Which comfort measures are important for a patient receiving a local anesthetic?a. Skin care and turning b. Reassurance over loss of control and sensation c. Use of antihypertensive agents d. Use of analgesics as needed e. Ice applied to the area involved f. Safety
Recovery after a general anesthetic refers to the period of time a. from the beginning of anesthesia until the patient is ready for surgery. b. during the surgery when anesthesia is maintained at a certain level. c. from discontinuation of the anesthetic until the patient has
A nurse would anticipate the use of general anesthetics for which reasons? a. To produce analgesia b. To produce amnesia c. To activate the reticular activating system d. To block muscle reflexes e. To cause unconsciousness f. To prevent nausea
The nursing instructor determines that teaching about general anesthetics was successful when the students identify which person as being most qualified to administer general anesthetics? a. Nursing supervisor b. Graduate nurse c. Trained physician d. Surgeon.
Local anesthetics are used to block feeling in specific body areas. If given in increasing concentrations, local anesthetics can cause loss in the following order: a. Temperature sensation, touch sensation, proprioception, and skeletal muscle tone. b. Touch sensation, skeletal muscle
Nondepolarizing NMJ blockers a. Antagonize ACh to prevent depolarization of muscle cells. b. Act as agonists of ACh, leading to depolarization of muscle cells. c. Prevent the repolarization of muscle cells. d. Are associated with painful muscle contractions on administration.
The nurse would expect administration of an NMJ blocker as the drug of choice to accomplish which actions? a. Facilitate endotracheal intubation.b. Facilitate mechanical ventilation. c. Prevent injury during electroconvulsive therapy. d. Relieve pain during labor and
Curare is used as a poison on arrow tips in some cultures. Curare.a. Is a depolarizing NMJ blocker. b. Causes muscle paralysis in the brain. c. Is not affected by cooking. d. Has no clinical use today.
Succinylcholine has a more rapid onset of action and a shorter duration of activity than the nondepolarizing NMJ blockers because it.a. Does not bind well to receptor sites. b. Rapidly crosses the blood–brain barrier and is lost. c. Is broken down by acetylcholinesterase that is found
When planning the care of a patient who is to receive an NMJ blocker, the nurse would expect which about the patient? a. Transfer to an intensive care unit would be essential. b. Intubation would be necessary to maintain respirations. c. He would have no memory of any events. d.
Malignant hyperthermia can occur with any NMJ blocker, but it most often occurs with succinylcholine. The nurse would expect to see which drug ordered? a. Phenobarbital b. Pancuronium c. Dantrolene d. Diazepam.
Patient recovery from an NMJ blocker. a. Is predictable based on the drug given. b. Can be affected by genetic enzyme deficiency. c. Can always be ensured because of the drug half-life. d. Can be shortened by administration of oxygen.
When preparing NMJ blockers for administration, it is important that they.a. Are not mixed in with any alkaline solutions. b. Are not exposed to light. c. Are not mixed with any other drug. d. Are not mixed with heparin.
When describing the functions of the ANS, which would the instructor include? a. Maintenance of balance and posture b. Maintenance of the special senses c. Regulation of integrated internal body functions d. Coordination of peripheral and central nerve pathways.
The SNS a. Is called the thoracolumbar system. b. Is called the fight-or-flight system. c. Is called the craniosacral system. d. Uses ACh as its sole neurotransmitter. e. Uses epinephrine as its sole neurotransmitter. f. Is active during a stress reaction.
The ANS differs from other systems in the CNS in that it a. Uses only peripheral pathways. b. Affects organs and muscles via a two-neuron system. c. Uses a unique one-neuron system. d. By passes the CNS in all of its actions.
The sympathetic system uses catecholamines at the postganglionic receptors. Which are considered catecholamines? a. Dopamine b. Norepinephrine c. ACh d. Epinephrine e. MAO f. Serotonin.
The nurse determines that the beta2-receptors in the SNS have been stimulated by which finding? a. Increased heart rate b. Increased myocardial contraction c. Bronchial dilation d. Uterine contraction
If you suspect that a person is very stressed and is experiencing a sympathetic stress reaction, you would expect to find a. Increased bowel sounds and urinary output. b. Constricted pupils and warm, flushed skin. c. Slow heart rate and decreased systolic blood pressure. d.
Once a postganglionic receptor site has been stimulated, the neurotransmitter must be broken down immediately. The sympathetic system breaks down postganglionic neurotransmitters by using.a. Liver enzymes and acetylcholinesterase. b. Acetylcholinesterase and MAO. c. COMT and liver
The parasympathetic nervous system, in most situations, opposes the actions of the SNS, allowing the ANS to a. Generally have no effect. b. Maintain a fine control over internal homeostasis. c. Promote digestion. d. Respond to stress most effectively.
Isoproterenol is a nonspecific beta-agonist. The nurse might expect to administer this drug for which condition? a. Preterm labor b. Bronchospasm c. Cardiac standstill d. Shock e. Heart block in transplanted hearts f. Heart failure.
Cholinergic neurons, those using ACh as their neurotransmitter, would be least likely to be found in a. Motor nerves on skeletal muscles. b. Preganglionic nerves in the sympathetic and parasympathetic systems. c. Postganglionic nerves in the parasympathetic system. d. The
The instructor determines that teaching about adrenergic drugs has been successful when the class identifies the drugs as also being called. a. Sympatholytic agents. b. Cholinergic agents. c. Sympathomimetic agents. d. Anticholinergic agents.
Stimulation of the parasympathetic nervous system would cause.a. Slower heart rate and increased GI secretions. b. Faster heart rate and urinary retention. c. Vasoconstriction and bronchial dilation. d. Pupil dilation and muscle paralysis.
The adrenergic agent of choice for treating the signs and symptoms of allergic rhinitis is. a. Norepinephrine. b. Phenylephrine. c. Dobutamine. d. Dopamine.
A nurse would question the order for an adrenergic agonist for a patient who is also receiving which of the following? a. Anticholinergic drugs b. Halogenated hydrocarbon anesthetics c. Beta-blockers d. Benzodiazepines e. MAOIs f. TCAs.
An adrenergic agent being used to treat shock infiltrates into the tissue with IV administration. Which action by the nurse would be most appropriate? a. Watch the area for any signs of necrosis, and report it to the physician. b. Notify the physician, and decrease the rate of
Phenylephrine, an alpha-specific agonist, is found in many cold and allergy preparations. The nurse instructs the patient to be alert for which adverse effects? a. Urinary retention and pupil constriction b. Hypotension and slow heart rate. c. Personality changes and increased
Adverse effects associated with adrenergic agonists are related to the generalized stimulation of the SNS and could include. a. Slowed heart rate. b. Constriction of the pupils. c. Hypertension. d. Increased GI secretions.
A patient has elected to take an OTC cold preparation that contains phenylephrine. The nurse would advise the patient not to take that drug if the patient has a. Thyroid or CV disease. b. A cough and runny nose. c. Chronic obstructive pulmonary disease. d. Hypotension.
Adrenergic blocking drugs, because of their clinical effects, are also known as.a. Anticholinergics. b. Sympathomimetics. c. Parasympatholytics. d. Sympatholytics.
A nurse would question an order for a beta-adrenergic blocker if the patient was also receiving what other drugs? a. Clonidine b. Ergot alkaloids c. Aspirin d. NSAIDs e. Triptans f. Epinephrine
The nurse would anticipate administering drugs that generally block all adrenergic receptor sites to treat. a. Allergic rhinitis. b. COPD. c. Cardiac-related conditions. d. Premature labor.
You would caution a patient who is taking an adrenergic blocker.a. To avoid exposure to infection. b. To stop the drug if he or she experiences flu-like symptoms. c. That it can be dangerous to stop the drug abruptly. d. To avoid exposure to the sun.
The beta-blocker of choice for a patient who is hypertensive and has angina is.a. Nadolol. b. Propranolol. c. Timolol. d. Carteolol.
Phentolamine (Regitine), an alpha-adrenergic blocker, is most frequently used. a. To prevent cell death after extravasation of intravenous dopamine or norepinephrine. b. To treat COPD in patients with hypertension or arrhythmias. c. To treat hypertension and BPH in male
The beta-adrenergic blocker propranolol is approved for a wide variety of uses. Which of the following are approved indications? a. Migraine headaches b. Stage fright c. Bronchospasm d. Reinfarction after an MI. e. Erectile dysfunction f. Hypertension.
Indirect-acting cholinergic agents a. React with acetylcholine receptor sites on the membranes of effector cells. b. React chemically with acetylcholinesterase to increase acetylcholine concentrations. c. Are used to increase bladder tone and urinary excretion. d. Should be
A nurse is explaining myasthenia gravis to a family. Which of the following points would be included in the explanation? a. It is thought to be an autoimmune disease. b. It is associated with destruction of acetylcholine receptor sites. c. It is best treated with potent
A patient is to receive pilocarpine. The nurse understands that this drug would be most likely used to treat which of the following? a. Myasthenia gravis b. Neurogenic bladder c. Sjögren disease dry mouth d. Alzheimer disease.
A nurse would question an order for a cholinergic drug if the patient was also taking which drugs? a. Theophylline b. NSAIDs c. Cephalosporin d. Atropine e. Propranolol f. Memantine.
Myasthenia gravis is treated with indirect-acting cholinergic agents that a. Lead to accumulation of acetylcholine in the synaptic cleft. b. Block the GI effects of the disease, allowing for absorption. c. Directly stimulate the remaining acetylcholine receptors. d. Can be given
A patient with myasthenia gravis is no longer able to swallow. Which of the following would the nurse expect the physician to order?a. Rivastigmine b. Memantine c. Pyridostigmine d. Edrophonium
Alzheimer disease is marked by a progressive loss of memory and is associated with a. Degeneration of dopamine-producing cells in the basal ganglia. b. Loss of acetylcholine-producing neurons and their target neurons in the CNS.c. Loss of acetylcholine receptor sites in the
The nurse would expect to administer donepezil to a patient with Alzheimer disease who a. Cannot remember family members’ names. b. Is mildly inhibited and can still follow medical dosing regimens. c. Is able to carry on normal activities of daily living. d. Has memory
Adverse effects associated with the use of cholinergic drugs include a. Constipation and insomnia. b. Diarrhea and urinary urgency. c. Tachycardia and hypertension. d. Dry mouth and tachycardia.
Nerve gas is an irreversible acetylcholinesterase inhibitor that can cause muscle paralysis and death. An antidote to such an agent is.a. Atropine. b. Propranolol. c. Pralidoxime. d. Neostigmine.
Anticholinergic drugs are used. a. To allow the sympathetic system to become more dominant. b. To block the parasympathetic system, which is commonly hyperactive. c. As the drugs of choice for treating ulcers. d. To stimulate GI activity.
Which of the following best describes aldosterone? a. It causes the loss of sodium and water from the renal tubules. b. It is under direct hormonal control from the hypothalamus. c. It is released into the bloodstream in response to angiotensin I. d. It is released into the
Atropine and scopolamine work by blocking.a. Nicotinic receptors only. b. Muscarinic and nicotinic receptors. c. Muscarinic receptors only. d. Adrenergic receptors to allow cholinergic receptors to dominate.
Which of the following would the nurse be least likely to include when developing a teaching plan for a patient who is receiving an anticholinergic agent? a. Encouraging the patient to void before dosing b. Setting up a bowel program to deal with constipation c. Encouraging the
Which of the following suggestions would the nurse make to help a patient who is receiving an anticholinergic agent reduce the risks associated with decreased sweating? a. Covering the head and using sunscreen b. Ensuring hydration and temperature control c. Changing position slowly
Hormones exert their influence on human cells by influencing which of the following? a. Enzyme-controlled reactions b. Messenger RNA c. Lysosome activity d. Transcription RNA e. Cellular DNA f. Cyclic AMP activity.
When explaining the role of ADH to a group of students, which fact would the instructor include? a. It is produced by the anterior pituitary. b. It causes the retention of water by the kidneys. c. It is released by the hypothalamus. d. It causes the retention of sodium by the
The specific criteria that define a hormone would include which of the following? a. It is produced in small amounts. b. It is secreted directly into the bloodstream. c. It is slowly metabolized in the liver and lungs. d. It reacts with a specific receptor set on a target
The endocrine glands. a. Form part of the communication system of the body. b. Cannot be stimulated by hormones circulating in the blood. c. Cannot be viewed as integrating centers of reflex arcs. d. Are only controlled by the hypothalamus.
Some endocrine glands do not respond to the HPA. These glands include the. a. Thyroid gland. b. Ovaries. c. Parathyroid glands. d. Adrenal cortex. e. Endocrine pancreas. f. GI gastrin-secreting cells.
The posterior lobe of the pituitary gland.a. Secretes a number of stimulating hormones. b. Produces endorphins to modulate pain perception. c. Has no function that has yet been identified. d. Stores ADH and oxytocin, which are produced in the hypothalamus.
After teaching a group of students about the negative feedback system, identification of which of the following as an example would indicate that the students have understood the teaching?a. Growth hormone control b. Prolactin control c. Melanocyte-stimulating hormone control d.
Internal body homeostasis and communication are regulated by.a. The cardiovascular and respiratory systems. b. The nervous and cardiovascular systems. c. The endocrine and nervous systems. d. The endocrine and cardiovascular systems.
Hypothalamic hormones are normally present in small amounts. When used therapeutically, their main indication is. a. Diagnosis of endocrine disorders and treatment of specific cancers. b. Treatment of multiple endocrine disorders. c. Treatment of CNS-related abnormalities. d.
Octreotide (Sandostatin) would be the drug of choice in the treatment of acromegaly in a client with which factors? a. Diabetes b. Gallbladder disease c. Adrenal insufficiency d. Hypothalamic lesions e. Intolerance to other therapies f. Age older than 18 years.
Somatropin (Nutropin and others) is a genetically engineered GH that is used a. To diagnose hypothalamic failure. b. To treat precocious puberty. c. In the treatment of children with growth failure. d. To stimulate pituitary response.
A father brought his 15-year-old son to the endocrine clinic because the boy was only 5 ft tall. He wanted his son to receive GH therapy because short stature would be a detriment to his success as an adult. The boy would be considered for this therapy under which of the following
GH deficiencies a. Occur only in children.b. Always result in dwarfism. c. Are treated only in children because GH is usually produced only until puberty. d. Can occur in adults as well as children.
Patients who are receiving GH replacement therapy must be monitored closely. Routine follow-up examinations would include.a. A bowel program to deal with constipation. b. Tests of thyroid function and glucose tolerance. c. A calorie check to control weight gain. d. Tests of adrenal
Acromegaly and gigantism are both conditions related to excessive secretion of. a. Thyroid hormone. b. Melanin-stimulating hormone. c. Growth hormone. d. Oxytocin.
Diabetes insipidus is a relatively rare disease characterized by. a. Excessive secretion of ADH. b. Renal damage. c. The production of large amounts of dilute urine containing no glucose. d. Insufficient pancreatic activity.
Treatment with ADH preparations is associated with adverse effects, including a. Constipation and paralytic ileus. b. Cholecystitis and bile obstruction. c. Nocturia and bedwetting. d. “Hangover” symptoms, including headache, sweating, and tremors.
A patient who is receiving an ADH preparation for diabetes insipidus may need instruction in administering the drug.a. PO or IM. b. PO or intranasally. c. PR or PO. d. Intranasally or by dermal patch.
Adrenocortical agents are widely used a. To cure chronic inflammatory disorders. b. For short-term treatment to relieve inflammation. c. For long-term treatment of chronic disorders. d. To relieve minor aches and pains and to make people feel better.
Patients who are taking corticosteroids would be expected to report which findings? a. Weight gain b. Round or “moon face” appearance c. Feeling of well-being d. Weight loss e. Excessive hair growth f. Fragile skin.
If a nurse was asked to explain the adrenal medulla to a patient, it would be appropriate for him or her to tell that patient that it. a. Is the outer core of the adrenal gland. b. Is the site of production of aldosterone and corticosteroids. c. Is actually a neural ganglion of the

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Focus On Nursing Pharmacology 8th Edition Amy M. Karch - Solutions

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