Nursing 1141- Pharmacology » Fall 2022 » Mastery EAQ Ch. 20
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Question #1
Which option could the nurse offer to the family of a patient who has difficulty swallowing donepezil tablets?
A.
Subcutaneous infusions
B.
Liquid oral solutions
C.
Oral disintegrating tablets
D.
Nasal spray
Question #2
Which assessment finding will the nurse anticipate for a patient who self-administered extra doses of pyridostigmine to improve mobility when experiencing an upper respiratory infection?
A.
Urinary retention and Dry mouth
B.
Dry mouth and Hypoactive bowel sounds
C.
Urinary retention and Hypoactive bowel sounds
D.
Nausea and Apical pulse of 56 beats per minute
Question #3
Which equipment will the nurse prepare for the procedure of a patient receiving a diagnostic test using edrophonium?
A.
Atropine available for immediate use. Epinephrine available for immediate use. Telemetry monitor on the patient. Electroencephalogram ready to place.
B.
Atropine available for immediate use. Electroencephalogram ready to place. Telemetry monitor on the patient. Blood pressure equipment for frequent monitoring.
C.
Atropine available for immediate use. Epinephrine available for immediate use. Electroencephalogram ready to place. Blood pressure equipment for frequent monitoring.
D.
Atropine available for immediate use. Epinephrine available for immediate use. Telemetry monitor on the patient.Blood pressure equipment for frequent monitoring.
Question #4
After the nurse provided instruction for a patient receiving pyridostigmine, which patient statement indicates more education is needed?
A.
“I will review any over-the-counter medications with my health care provider.”
B.
“I will take the medication 30 minutes before meals.”
C.
“The medical alert in my health care record should cover me.”
D.
“I hope to feel improvement in muscle strength.”
Question #5
Which intervention could the nurse add to the plan of care to support cognitive function in a patient who will begin donepezil for the treatment of Alzheimer dementia?
A.
A walking program at least once a week
B.
Increased responsibility for self-care
C.
Limit sleep during the day
D.
Add more stimuli to the environment
Question #6
After administration of edrophonium, which evaluation is a positive result?
A.
Increased arm strength
B.
Ability to speak clearly
C.
Decreased respiration
D.
Ability to swallow without difficulty
Question #7
Bethanechol is used to treat which condition in a postoperative patient?
A.
Postoperative hypotension
B.
Urinary atony
C.
Respiratory atelectasis
D.
Postoperative ischemic colitis
Question #8
Which medication is a noncholinergic drug used in the treatment of Alzheimer’s disease?
A.
Atropine
B.
Memantine
C.
Rivastigmine
D.
Donepezil
Question #9
When obtaining a health history, the nurse looks for which diagnosis for a patient who is receiving pilocarpine eye drops twice a day?
A.
Dry eye syndrome
B.
Cataracts
C.
Glaucoma
D.
Macular degeneration
Question #10
Which drug may be administered to a patient who has a tricyclic antidepressant overdose?
A.
Physostigmine
B.
Tacrine
C.
Carbachol
D.
Memantine
Question #11
Which medication should be administered to a patient who has a cholinergic crisis?
A.
Echothiophate
B.
Atropine
C.
Pyridostigmine
D.
Donepezil
Question #12
Which drug is indicated in the treatment of myasthenia gravis?
A.
Rivastigmine
B.
Pilocarpine
C.
Neostigmine
D.
Succinylcholine
Question #13
Which drug is the antidote to a cholinergic overdose?
A.
Atropine
B.
Rivastigmine
C.
Memantine
D.
Epinephrine
Question #14
Which cholinergic medication is prescribed to a patient who is unable to void after surgery?
A.
Cevimeline
B.
Succinylcholine
C.
Donepezil
D.
Bethanechol
Question #15
Which is the first nursing intervention for a patient who has experienced an overdose of rivastigmine and is having difficulty breathing?
A.
Assess the patient’s breath sounds.
B.
Measure the patient’s urinary output.
C.
Monitor the patient’s heart rate.
D.
Administer epinephrine.
Question #16
Which route of administration is preferred for treating xerostomia with pilocarpine?
A.
Intramuscular
B.
Ocular
C.
Intravenous
D.
Oral
Question #17
Which medication may be administered to a patient who has myasthenia gravis?
A.
Memantine
B.
Pyridostigmine
C.
Donepezil
D.
Bethanechol
Question #18
Which condition is a contraindication to the administration of bethanechol?
A.
Hyperthyroidism
B.
Chronic refractory heartburn
C.
Gastric atony
D.
Urinary retention
Question #19
Which finding indicates donepezil is having a therapeutic effect?
A.
Urination
B.
Wakefulness
C.
Relaxed muscles
D.
Increased cognition
Question #20
Which medication is a direct-acting cholinergic drug?
A.
Pilocarpine and Succinylcholine
B.
Neostigmine and Galantamine
C.
Neostigmine and Edrophonium
D.
Galantamine and Edrophonium
Question #21
After administering bethanechol to a patient after surgery, which system would the nurse assess to determine a therapeutic effect?
A.
Urinary
B.
Musculoskeletal
C.
Gastrointestinal
D.
Neurologic
Question #22
Administration of which drug will assist in reversing neuromuscular blockade after general anesthesia?
A.
Dextrose solution intravenously
B.
A high dose of donepezil orally
C.
Physostigmine intravenously
D.
An antihistamine intravenously
Question #23
Which assessment finding is adverse effects associated with the administration of cholinergic medications?
A.
Sweating, Dizziness, Bradycardia, Dry cough
B.
Sweating, Dizziness, Bradycardia, Hypotension
C.
Dry cough, Dizziness, Bradycardia, Hypotension
D.
Sweating, Dizziness, Dry cough, Hypotension
Question #24
Which assessment finding in a patient receiving memantine indicates a significant side effect?
A.
Inability to sleep
B.
Respiratory rate 30 breaths/min
C.
Raised, erythematous rash
D.
Blood pressure 70/40 mm Hg
Question #25
Which drug is used to reverse the effects of nondepolarizing neuromuscular blocking drugs after surgery?
A.
Neostigmine, Pyridostigmine, Physostigmine
B.
Donepezil, Memantine, Pyridostigmine
C.
Donepezil, Neostigmine, Memantine
D.
Physostigmine, Donepezil, Memantine
Question #26
Which information is essential for the nurse to tell the patient and family in relation to donepezil?
A.
"You will take this medication once per week."
B.
"Be cautious with activity until you know how the medication affects you."
C.
"Do not take this medication with food."
D.
"Do not drink grapefruit juice while on this medication."
Question #27
The nurse is caring for a patient who was prescribed bethanechol 1 month ago. Which statement made by the patient indicates the medication is effective?
A.
"My family says that my memory has improved."
B.
"I feel like I am coughing up more phlegm."
C.
"I have noticed that I have been urinating more frequently."
D.
"I can tell my muscle strength has gotten better."
Question #28
Which condition is an indicator of a potential cholinergic drug overdose?
A.
Heart rate 30 beats/min
B.
Constipation
C.
Blood pressure 150/95 mm Hg
D.
Respiratory rate 24 breaths/min
Question #29
Which drug will be used to help confirm the diagnosis of myasthenia gravis in a patient with ptosis, diplopia, and difficulty swallowing?
A.
Physostigmine
B.
Memantine
C.
Edrophonium
D.
Bethanechol
Question #30
Which intervention will assist the patient in coping with orthostatic hypotension caused by cholinergic drug therapy?
A.
Call for someone before rising.
B.
Increase fluid intake to increase blood volume.
C.
Move from a sitting to standing position slowly.
D.
Take ibuprofen before rising.
Question #31
Which indirect-acting cholinergic drug is used to treat a patient who has both Parkinson’s disease and dementia?
A.
Rivastigmine
B.
Donepezil
C.
Memantine
D.
Galantamine
Question #32
Which assessment is essential to be performed by the nurse before administering donepezil?
A.
Body mass index
B.
Blood glucose level
C.
Vital signs
D.
Bowel sounds
Question #33
Which response would the nurse give to a person who reports no improvement in a family member who has been taking donepezil for a week?
A.
"The medication has an onset of action of about 3 weeks."
B.
"I will call the health care provider and ask for the medication to be changed."
C.
"Let me assess what other medications the patient is taking."
D.
"Sometimes family members aren’t the best at assessing these things."
Question #34
Which information would the nurse include regarding adverse effects when teaching a patient and family about a new prescription for donepezil (Aricept)?
A.
Insomnia, Hypotension, Gastrointestinal (GI) upset
B.
Gastrointestinal (GI) upset, Ataxia, Dyspnea
C.
Ataxia, Dyspnea, Hypotension
D.
Ataxia, Insomnia, Dyspnea
Question #35
Which condition is contraindicated for therapy with pyridostigmine?
A.
Emphysema, Hypothyroidism
B.
Emphysema, Psoriatic arthritis.
C.
Hypothyroidism, Psoriatic arthritis.
D.
Asthma, Coronary artery disease
Question #36
Which instruction will the nurse give to a patient who is prescribed pyridostigmine?
A.
"Notify your health care provider if you have a headache."
B.
"Take the medication 30 minutes after eating."
C.
"Seek medical help if you develop nausea and vomiting."
D.
"Do not eat solid food."
Question #37
Which information is true concerning cholinergic stimulation?
A.
Nicotinic-receptor stimulation causes increased blood pressure. Muscarinic-receptor stimulation causes increased gastrointestinal motility. Nicotinic-receptor stimulation causes increased contraction of skeletal muscle.
B.
Nicotinic-receptor stimulation causes dilation of the pupils. Muscarinic-receptor stimulation causes constriction of blood vessels. Muscarinic-receptor stimulation causes increased gastrointestinal motility.
C.
Nicotinic-receptor stimulation causes increased contraction of skeletal muscle. Nicotinic-receptor stimulation causes dilation of the pupils. Muscarinic-receptor stimulation causes constriction of blood vessels.
D.
Nicotinic-receptor stimulation causes dilation of the pupils. Muscarinic-receptor stimulation causes constriction of blood vessels. Nicotinic-receptor stimulation causes increased blood pressure.
Question #38
Which cue will the nurse monitor for in a patient who had rivastigmine discontinued after hospitalization for complications and will not resume the medication?
A.
Rapid cognitive changes with decline
B.
Temporary improvement in cognitive skills
C.
Cognitive stabilization for a few months
D.
Gradual decrease in cognitive function
Question #39
Fill in the blank. The nurse is planning to administer physostigmine to a child who has accidentally taken an excess dose of atropine. The child’s weight is 30 kg, and the drug dosage is 0.03 mg/kg given every 10 minutes in 1 hour. How many milligrams of the drug will be administered to the child?
A.
10 mg
B.
5 mg
C.
2 mg
D.
7 mg
Question #40
A patient taking rivastigmine for memory enhancement presents with excessive salivation and abdominal cramping. Which additional assessment finding supports the diagnosis of a cholinergic crisis?
A.
Dyspnea, Bronchoconstriction, Orthostatic hypotension
B.
Bronchoconstriction, Hypoglycemia, Hypothyroidism
C.
Hypoglycemia, Hypothyroidism, Dyspnea
D.
Orthostatic hypotension, Hypoglycemia, Hypothyroidism
Question #41
Which intervention will increase peristalsis postoperatively in a patient who has not had a bowel movement and who has hypoactive bowel sounds?
A.
Inject bethanechol. Administer atropine. Administer a stool softener. Ambulate the patient as tolerated. Increase fluid intake as tolerated.
B.
Inject bethanechol. Provide a high-fiber diet. Administer a stool softener. Administer atropine. Increase fluid intake as tolerated.
C.
Administer atropine. Provide a high-fiber diet. Administer a stool softener. Ambulate the patient as tolerated. Increase fluid intake as tolerated.
D.
Inject bethanechol. Provide a high-fiber diet. Administer a stool softener. Ambulate the patient as tolerated. Increase fluid intake as tolerated.
Question #42
Fill in the blank. An adult patient was prescribed an intravenous (IV) dose of physostigmine. What is the maximum safe dose of the drug that can be administered to the patient in 2 hours?
A.
10 mg
B.
18 mg
C.
7 mg
D.
12 mg
Question #43
Which information would be in the teaching plan for a patient starting donepezil?
A.
"Do not take the medication if you feel tired." "Take the medication on an empty stomach." "Get up slowly from a sitting or lying position."
B.
"Do not take the medication if you feel tired." "Take the medication on an empty stomach." "Your drug dose will be gradually increased."
C.
"Tell your health care provider if you have gastric pain that does not subside." "Do not take the medication if you feel tired." "Take the medication on an empty stomach."
D.
"Your drug dose will be gradually increased." "Get up slowly from a sitting or lying position." "Tell your health care provider if you have gastric pain that does not subside."
Question #44
Cholinesterase inhibitors such as pyridostigmine are used for which purpose?
A.
Relieve severe constriction of the bronchioles. Treat a patient with a prolonged history of sleep deprivation. An antidote in biochemical warfare
B.
An antidote to tricyclic antidepressant toxicity. Relieve severe constriction of the bronchioles. Treat a patient with a prolonged history of sleep deprivation
C.
Relieve severe constriction of the bronchioles. Diagnose and treat myasthenia gravis. Treat a patient with a prolonged history of sleep deprivation
D.
Diagnose and treat myasthenia gravis. An antidote in biochemical warfare. An antidote to tricyclic antidepressant toxicity
Question #45
Which patient history indicates that it is safe to receive prescribed bethanechol?
A.
Decreased urination with possible renal calculi
B.
Post orthopedic surgery, low urinary output and bronchial wheezing
C.
Peptic ulcer and nonobstructive urinary retention
D.
Urinary retention from neurogenic atony of the bladder
Question #46
Which information is essential to include in the teaching care plan for a patient who has been prescribed donepezil?
A.
Stop the medication if you have headaches. Eat something if you feel nauseated. You may have some trouble sleeping. Tell your health care provider if you have stomach pains.
B.
Get up slowly. Eat something if you feel nauseated. Stop the medication if you have headaches. Tell your health care provider if you have stomach pains.
C.
Get up slowly. Eat something if you feel nauseated. You may have some trouble sleeping. Tell your health care provider if you have stomach pains.
D.
Get up slowly. Eat something if you feel nauseated. You may have some trouble sleeping. Stop the medication if you have headaches.
Question #47
Which assessment finding indicates potential interactions of bethanechol and pyridostigmine?
A.
Ataxia and Bleeding
B.
Bleeding and Cramps
C.
Ataxia and Cramps
D.
Diarrhea and Syncope
Question #48
Which assessment is essential before a patient is started on memantine therapy?
A.
Pain assessment, Complete blood count, Gastrourinary (GU) status, Assess for suicidal tendencies
B.
Cardiovascular status, Pain assessment, Complete blood count, Neurologic status
C.
Neurologic status, Cardiovascular status, Gastrourinary (GU) status, Assess for suicidal tendencies
D.
Cardiovascular status, Gastrourinary (GU) status, Pain assessment, Complete blood count
Question #49
Which intervention could the nurse add to the plan of care to support cognitive function in a patient who will begin donepezil for the treatment of Alzheimer dementia?
A.
A walking program at least once a week
B.
Increased responsibility for self-care
C.
Add more stimuli to the environment
D.
Limit sleep during the day
Question #50
After the nurse provided instruction for a patient receiving pyridostigmine, which patient statement indicates more education is needed?
A.
“I hope to feel improvement in muscle strength.”
B.
“I will review any over-the-counter medications with my health care provider.”
C.
“I will take the medication 30 minutes before meals.”
D.
“The medical alert in my health care record should cover me.”
Question #51
Cholinergic agonist drugs have the potential to cause which effect?
A.
Decreased heart rate and Increased respiratory secretions
B.
Decreased gastric motility and Pupil dilation
C.
Pupil dilation and Decreased sweat gland secretion
D.
Decreased gastric motility and Decreased sweat gland secretion
Question #52
The nurse administers 10 mg bethanechol to a patient after surgery. The patient has not voided. Which intervention is needed next?
A.
Assessment of blood pressure
B.
Administration of a second drug
C.
Assessment of bowel sounds
D.
Administration of another dose in an hour
Question #53
Which assessment finding indicates an adverse reaction in a patient receiving bethanechol for the treatment of urinary retention?
A.
Hypertension and Syncope
B.
Hair loss and Constipation
C.
Constipation and Mydriasis
D.
Hair loss and Mydriasis
Question #54
Which assessment outcome indicates a therapeutic effect of the administration of pyridostigmine to a patient who has myasthenia gravis?
A.
Improved memory
B.
Able to walk long distances
C.
Increased muscle strength
D.
No longer dizzy
Question #55
Which therapeutic outcome is expected from the administration of cevimeline to a patient with Sjögren’s syndrome?
A.
Moist oral mucous membranesn
B.
Increased muscle strength
C.
Improved vision
D.
Relief of dry skin
Question #56
The nurse administers physostigmine to a patient who has been exposed to pesticides. Which therapeutic effect is expected?
A.
Elevated heart rate
B.
Decreased heart rate
C.
Pupil dilation
D.
Pupil constriction
Question #57
A patient taking rivastigmine is experiencing signs of a cholinergic crisis. Which medication would the nurse administer to improve the patient’s condition?
A.
Epinephrine
B.
Lidocaine
C.
Dopamine
D.
Atropine
Question #58
Which information would the nurse include in the teaching plan of a patient who has started to take donepezil?
A.
"This medication will increase your ability to sleep without dreaming."
B.
"This medication will enhance your memory."
C.
"You will only need to take this medication for 3 months."
D.
"This medication should cure your Alzheimer’s disease."
Question #59
Which condition is a contraindication to the use of bethanechol?
A.
Emphysema, Type 2 diabetes mellitus, Peptic ulcer, Parkinsonism,
B.
Peptic ulcer, Parkinsonism, Hyperthyroidism, Coronary artery disease
C.
Hyperthyroidism, Coronary artery disease, Emphysema, Type 2 diabetes mellitus
D.
Emphysema, Type 2 diabetes mellitus, Parkinsonism, Hyperthyroidism,
Question #60
Which nursing action is a priority when administering a cholinergic medication for myasthenia gravis?
A.
Administer with fruit juices.
B.
Administer after dissolving in water.
C.
Administer 30 minutes before meals.
D.
Administer after meals.
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