Review Questions Chapters 12 - Cholinergic Drugs Affecting the Autonomic Nervous System PDF

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Review Questions Chapter 12: Cholinergic Drugs Affecting the Autonomic Nervous System 1. The nurse is preparing a plan for care for a patient with myasthenia gravis. Which outcome statement would be appropriate for a patient receiving a cholinergic agonist such as pyridostigmine (Mestinon) for this condition? The patient will exhibit: a. An increase in pulse rate, blood pressure, and respiratory rate. b. Enhanced urinary elimination. c. A decrease in muscle weakness, ptosis, and diplopia. (pp. 127) d. Prolonged muscle contractions and proprioception. Rationale: Myasthenia gravis is characterized by destruction of nicotinic receptors in the skeletal muscles. Cholinergic agonist work by stimulating muscle contraction helping reverse muscle weakness.

2. Anticholinergics may be ordered for which conditions? (Select all that apply.) a. Peptic ulcer disease (pp. 131) b. Bradycardia (pp. 132) c. Decreased sexual function. d. Irritable bowel syndrome (pp. 131) e. Urine retention Rationale: Anticholinergics help decrease the secretions of gastric acid in peptic ulcer disease, slow the intestinal motility, reducing the cramping and diarrhea associated with IBS, and can also be used to accelerate the heart rate in patient experiencing bradycardia.

3. Which factor in the patient’s history would cause the nurse to question a medication order for atropine? a. A 32-year-old man with a history of drug abuse b. A 65-year-old man with benign prostatic hyperplasia (pp. 131) c. An 8-year-old boy with chronic tonsillitis d. A 22-year-old woman on the second day of her menstrual cycle. Rationale: Atropine is contraindicated for patient with BPH because it might worsen urinary retention.

4. Older adult patients taking bethanechol (Urecholine) need to be assessed more frequently become of which adverse effect? a. Tachycardia b. Hypertension c. Dizziness (pp. 129) d. Urinary retention Rationale: Cholinergic drugs such as Urecholine cause dizziness, bradycardia, hypotension and decreased urinary output.

5. The patient taking benztropine (Cogentin) should be provided education on methods to manage which common adverse effect? a. Heartburn b. Constipation (pp. 133) c. Hypothermia d. Increased gastric motility. Rationale: Anti-cholinergic drugs such as Cogentin can cause constipation due to slowed peristalsis.

6. The patient or caregiver of a patient taking neostigmine (Prostigmin) should be taught to be observant for which adverse effect that my signal a possible overdose has occurred? a. Excessive sweating, salivation, and drooling (pp. 127) b. Extreme constipation c. Hypertension and tachycardia d. Excessively dry eyes and reddened sclera Rationale: Signs of intense parasympathetic stimulation include hypersalivation, small pupils, muscle twitching, unusual paleness, sweating, muscle weakness and difficult breathing, which can be mistaken for signs of myasthenia gravis....