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.   Nasal spray
B.   Liquid oral solutions
C.   Subcutaneous infusions
D.   Oral disintegrating tablets
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.   Nausea and Apical pulse of 56 beats per minute
B.   Urinary retention and Hypoactive bowel sounds
C.   Dry mouth and Hypoactive bowel sounds
D.   Urinary retention and Dry mouth
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. Electroencephalogram ready to place. Telemetry monitor on the patient. Blood pressure equipment for frequent monitoring.
B.   Atropine available for immediate use. Epinephrine available for immediate use. Electroencephalogram ready to place. Blood pressure equipment for frequent monitoring.
C.   Atropine available for immediate use. Epinephrine available for immediate use. Telemetry monitor on the patient.Blood pressure equipment for frequent monitoring.
D.   Atropine available for immediate use. Epinephrine available for immediate use. Telemetry monitor on the patient. Electroencephalogram ready to place.
Question #4
After the nurse provided instruction for a patient receiving pyridostigmine, which patient statement indicates more education is needed?
A.   “I will take the medication 30 minutes before meals.”
B.   “I hope to feel improvement in muscle strength.”
C.   “I will review any over-the-counter medications with my health care provider.”
D.   “The medical alert in my health care record should cover me.”
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.   Increased responsibility for self-care
B.   Limit sleep during the day
C.   A walking program at least once a week
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.   Ability to swallow without difficulty
D.   Decreased respiration
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.   Memantine
B.   Atropine
C.   Donepezil
D.   Rivastigmine
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.   Macular degeneration
B.   Glaucoma
C.   Dry eye syndrome
D.   Cataracts
Question #10
Which drug may be administered to a patient who has a tricyclic antidepressant overdose?
A.   Memantine
B.   Carbachol
C.   Physostigmine
D.   Tacrine
Question #11
Which medication should be administered to a patient who has a cholinergic crisis?
A.   Donepezil
B.   Pyridostigmine
C.   Atropine
D.   Echothiophate
Question #12
Which drug is indicated in the treatment of myasthenia gravis?
A.   Pilocarpine
B.   Neostigmine
C.   Rivastigmine
D.   Succinylcholine
Question #13
Which drug is the antidote to a cholinergic overdose?
A.   Epinephrine
B.   Rivastigmine
C.   Memantine
D.   Atropine
Question #14
Which cholinergic medication is prescribed to a patient who is unable to void after surgery?
A.   Cevimeline
B.   Donepezil
C.   Bethanechol
D.   Succinylcholine
Question #15
Which is the first nursing intervention for a patient who has experienced an overdose of rivastigmine and is having difficulty breathing?
A.   Administer epinephrine.
B.   Measure the patient’s urinary output.
C.   Monitor the patient’s heart rate.
D.   Assess the patient’s breath sounds.
Question #16
Which route of administration is preferred for treating xerostomia with pilocarpine?
A.   Ocular
B.   Intramuscular
C.   Oral
D.   Intravenous
Question #17
Which medication may be administered to a patient who has myasthenia gravis?
A.   Pyridostigmine
B.   Donepezil
C.   Bethanechol
D.   Memantine
Question #18
Which condition is a contraindication to the administration of bethanechol?
A.   Urinary retention
B.   Chronic refractory heartburn
C.   Hyperthyroidism
D.   Gastric atony
Question #19
Which finding indicates donepezil is having a therapeutic effect?
A.   Relaxed muscles
B.   Wakefulness
C.   Increased cognition
D.   Urination
Question #20
Which medication is a direct-acting cholinergic drug?
A.   Neostigmine and Galantamine
B.   Neostigmine and Edrophonium
C.   Pilocarpine and Succinylcholine
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.   Gastrointestinal
B.   Neurologic
C.   Urinary
D.   Musculoskeletal
Question #22
Administration of which drug will assist in reversing neuromuscular blockade after general anesthesia?
A.   A high dose of donepezil orally
B.   Physostigmine intravenously
C.   An antihistamine intravenously
D.   Dextrose solution intravenously
Question #23
Which assessment finding is adverse effects associated with the administration of cholinergic medications?
A.   Dry cough, Dizziness, Bradycardia, Hypotension
B.   Sweating, Dizziness, Dry cough, Hypotension
C.   Sweating, Dizziness, Bradycardia, Dry cough
D.   Sweating, Dizziness, Bradycardia, Hypotension
Question #24
Which assessment finding in a patient receiving memantine indicates a significant side effect?
A.   Blood pressure 70/40 mm Hg
B.   Raised, erythematous rash
C.   Respiratory rate 30 breaths/min
D.   Inability to sleep
Question #25
Which drug is used to reverse the effects of nondepolarizing neuromuscular blocking drugs after surgery?
A.   Donepezil, Memantine, Pyridostigmine
B.   Neostigmine, Pyridostigmine, Physostigmine
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.   "Do not take this medication with food."
C.   "Be cautious with activity until you know how the medication affects you."
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 have noticed that I have been urinating more frequently."
C.   "I feel like I am coughing up more phlegm."
D.   "I can tell my muscle strength has gotten better."
Question #28
Which condition is an indicator of a potential cholinergic drug overdose?
A.   Blood pressure 150/95 mm Hg
B.   Respiratory rate 24 breaths/min
C.   Constipation
D.   Heart rate 30 beats/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.   Memantine
B.   Edrophonium
C.   Bethanechol
D.   Physostigmine
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.   Donepezil
B.   Rivastigmine
C.   Memantine
D.   Galantamine
Question #32
Which assessment is essential to be performed by the nurse before administering donepezil?
A.   Body mass index
B.   Bowel sounds
C.   Vital signs
D.   Blood glucose level
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.   "Let me assess what other medications the patient is taking."
B.   "I will call the health care provider and ask for the medication to be changed."
C.   "The medication has an onset of action of about 3 weeks."
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.   Gastrointestinal (GI) upset, Ataxia, Dyspnea
B.   Ataxia, Dyspnea, Hypotension
C.   Insomnia, Hypotension, Gastrointestinal (GI) upset
D.   Ataxia, Insomnia, Dyspnea
Question #35
Which condition is contraindicated for therapy with pyridostigmine?
A.   Hypothyroidism, Psoriatic arthritis.
B.   Emphysema, Psoriatic arthritis.
C.   Asthma, Coronary artery disease
D.   Emphysema, Hypothyroidism
Question #36
Which instruction will the nurse give to a patient who is prescribed pyridostigmine?
A.   "Take the medication 30 minutes after eating."
B.   "Notify your health care provider if you have a headache."
C.   "Do not eat solid food."
D.   "Seek medical help if you develop nausea and vomiting."
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 dilation of the pupils. Muscarinic-receptor stimulation causes constriction of blood vessels. Nicotinic-receptor stimulation causes increased blood pressure.
D.   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.
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.   Temporary improvement in cognitive skills
B.   Cognitive stabilization for a few months
C.   Gradual decrease in cognitive function
D.   Rapid cognitive changes with decline
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.   2 mg
C.   5 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.   Hypoglycemia, Hypothyroidism, Dyspnea
B.   Dyspnea, Bronchoconstriction, Orthostatic hypotension
C.   Bronchoconstriction, Hypoglycemia, Hypothyroidism
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. Provide a high-fiber diet. Administer a stool softener. Ambulate the patient as tolerated. Increase fluid intake as tolerated.
B.   Administer atropine. Provide a high-fiber diet. Administer a stool softener. Ambulate the patient as tolerated. Increase fluid intake as tolerated.
C.   Inject bethanechol. Provide a high-fiber diet. Administer a stool softener. Administer atropine. Increase fluid intake as tolerated.
D.   Inject bethanechol. Administer atropine. 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.   18 mg
B.   7 mg
C.   12 mg
D.   10 mg
Question #43
Which information would be in the teaching plan for a patient starting donepezil?
A.   "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."
B.   "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."
C.   "Do not take the medication if you feel tired." "Take the medication on an empty stomach." "Your drug dose will be gradually increased."
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.   An antidote to tricyclic antidepressant toxicity. Relieve severe constriction of the bronchioles. Treat a patient with a prolonged history of sleep deprivation
B.   Relieve severe constriction of the bronchioles. Diagnose and treat myasthenia gravis. Treat a patient with a prolonged history of sleep deprivation
C.   Diagnose and treat myasthenia gravis. An antidote in biochemical warfare. An antidote to tricyclic antidepressant toxicity
D.   Relieve severe constriction of the bronchioles. Treat a patient with a prolonged history of sleep deprivation. An antidote in biochemical warfare
Question #45
Which patient history indicates that it is safe to receive prescribed bethanechol?
A.   Peptic ulcer and nonobstructive urinary retention
B.   Post orthopedic surgery, low urinary output and bronchial wheezing
C.   Decreased urination with possible renal calculi
D.   Urinary retention from neurogenic atony of the bladder
Question #46
  
A.   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.
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. Stop the medication if you have headaches.
D.   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.
Question #47
Which assessment finding indicates potential interactions of bethanechol and pyridostigmine?
A.   Ataxia and Bleeding
B.   Ataxia and Cramps
C.   Diarrhea and Syncope
D.   Bleeding and Cramps
Question #48
Which assessment is essential before a patient is started on memantine therapy?
A.   Cardiovascular status, Pain assessment, Complete blood count, Neurologic status
B.   Neurologic status, Cardiovascular status, Gastrourinary (GU) status, Assess for suicidal tendencies
C.   Pain assessment, Complete blood count, 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.   Add more stimuli to the environment
C.   Increased responsibility for self-care
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.   “The medical alert in my health care record should cover me.”
B.   “I will take the medication 30 minutes before meals.”
C.   “I will review any over-the-counter medications with my health care provider.”
D.   “I hope to feel improvement in muscle strength.”
Question #51
Cholinergic agonist drugs have the potential to cause which effect?
A.   Pupil dilation and Decreased sweat gland secretion
B.   Decreased gastric motility and Decreased sweat gland secretion
C.   Decreased heart rate and Increased respiratory secretions
D.   Decreased gastric motility and Pupil dilation
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 bowel sounds
B.   Administration of another dose in an hour
C.   Assessment of blood pressure
D.   Administration of a second drug
Question #53
Which assessment finding indicates an adverse reaction in a patient receiving bethanechol for the treatment of urinary retention?
A.   Hair loss and Constipation
B.   Constipation and Mydriasis
C.   Hair loss and Mydriasis
D.   Hypertension and Syncope
Question #54
Which assessment outcome indicates a therapeutic effect of the administration of pyridostigmine to a patient who has myasthenia gravis?
A.   Able to walk long distances
B.   Increased muscle strength
C.   Improved memory
D.   No longer dizzy
Question #55
Which therapeutic outcome is expected from the administration of cevimeline to a patient with Sjögren’s syndrome?
A.   Improved vision
B.   Increased muscle strength
C.   Relief of dry skin
D.   Moist oral mucous membranesn
Question #56
The nurse administers physostigmine to a patient who has been exposed to pesticides. Which therapeutic effect is expected?
A.   Decreased heart rate
B.   Pupil dilation
C.   Pupil constriction
D.   Elevated heart rate
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.   Lidocaine
B.   Epinephrine
C.   Atropine
D.   Dopamine
Question #58
Which information would the nurse include in the teaching plan of a patient who has started to take donepezil?
A.   "This medication should cure your Alzheimer’s disease."
B.   "This medication will increase your ability to sleep without dreaming."
C.   "This medication will enhance your memory."
D.   "You will only need to take this medication for 3 months."
Question #59
Which condition is a contraindication to the use of bethanechol?
A.   Peptic ulcer, Parkinsonism, Hyperthyroidism, Coronary artery disease
B.   Emphysema, Type 2 diabetes mellitus, Peptic ulcer, Parkinsonism,
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 after dissolving in water.
B.   Administer with fruit juices.
C.   Administer after meals.
D.   Administer 30 minutes before meals.

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