Southern New Hampshire University - IHP 310 Chapter 16: Cholinergic Agonists and Antagonists MULTIPLE CHOICE 1)The nurse is preparing to administer a drug and learns that it is an indirect-acting cholinergic agonist

Southern New Hampshire University - IHP 310

Chapter 16: Cholinergic Agonists and Antagonists

MULTIPLE CHOICE

1)The nurse is preparing to administer a drug and learns that it is an indirect-acting cholinergic agonist. The nurse understands that this drug

1. 1. acts on muscarinic receptors.
   2. acts on nicotinic receptors.
   3. inhibits cholinesterase.
   4. inhibits cholinergic receptors.
2. A nursing student asks why a direct-acting cholinergic agonist drug that is selective to muscarinic receptors is described as being non-specific. The nurse will explain that this is because
   1. muscarinic receptors are present in many different tissues.
   2. the action of cholinesterase alters the bioavailability at different sites.
   3. these drugs can also affect nicotinic receptors.
   4. they vary in their reversible and irreversible effects.
3. The nurse is preparing to administer bethanechol (Urecholine) to a patient who is experiencing urinary retention. The nurse notes that the patient has a blood pressure of 90/60 mm Hg and a heart rate of 98 beats per minute. The nurse will perform which action?
   1. Administer the drug and monitor urine output.
   2. Administer the medication and monitor vital signs frequently.
   3. Give the medication and notify the provider of the increased heart rate.
   4. Hold the medication and notify the provider of the decreased blood pressure.
4. The nurse administers bethanechol (Urecholine) to a patient to treat urinary retention. After 30 minutes, the patient voids 800 mL of urine and reports having a loose stool but no cramping or gastrointestinal pain. The patient’s blood pressure is 110/70 mm Hg. The nurse will perform which action?

1. Notify the provider of bethanechol adverse effects.
2. Record the urine output and the blood pressure and continue to monitor.
3. Request an order for intravenous atropine sulfate.
4. Suggest another dose of bethanechol to the provider.

5. The nurse is teaching a patient who will begin taking bethanechol (Urecholine). Which statement by the patient indicates a need for further teaching?
   1. “Excessive sweating is a normal reaction to this medication.”
   2. “Excess salivation is a serious side effect.”
   3. “I should get out of bed slowly while taking this drug.”
   4. “I will not take the drug if my heart rate is less than 60 beats per minute.”
6. The nurse is caring for a male patient with myasthenia gravis who will begin taking ambenonium chloride (Mytelase). When performing a health history, the nurse will be concerned about a history of which condition in this patient?
   1. Benign prostatic hypertrophy
   2. Chronic constipation
   3. Erectile dysfunction
   4. Upper respiratory infection
7. The nurse is preparing to administer the anticholinergic medication benztropine (Cogentin) to a patient who has Parkinson disease. The nurse understands that this drug is used primarily for which purpose?
   1. To decrease drooling and excessive salivation
   2. To improve mobility and muscle strength
   3. To prevent urinary retention
   4. To suppress tremors and muscle rigidity
8. The nurse is caring for a postoperative patient and notes that the patient received atropine sulfate preoperatively. Which assessment finding would prompt the nurse to notify the provider?
   1. Absent bowel sounds
   2. Drowsiness
   3. Dry mouth
   4. Heart rate of 78 beats per minute
9. A patient who has irritable bowel syndrome would most likely receive which type of drug to treat this condition?
   1. An anticholinergic
   2. A cholinergic esterase inhibitor
   3. A muscarinic agent
   4. A nicotinic agent

10. The nurse is teaching a patient about the use of an anticholinergic medication. What information will the nurse include when teaching this patient about this medication?
    1. “Check your heart rate frequently to monitor for bradycardia.”
    2. “Drink extra fluids while you are taking this medication.”
    3. “Rise from a chair slowly to avoid dizziness when taking this drug.”
    4. “Use gum or lozenges to decrease dry mouth caused by this drug.”
11. Which cholinesterase inhibitor would be prescribed for a patient who has Alzheimer disease?
    1. Ambenonium chloride (Mytelase)
    2. Benztropine (Cogentin)
    3. Donepezil HCl (Aricept)
    4. Neostigmine methylsulfate (Prostigmin)
12. The nurse is teaching a patient who is going on a cruise about the use of transdermal scopolamine. What information will the nurse include when teaching this patient?
    1. “Apply the patch as needed for nausea and vomiting.”
    2. “Apply the patch to your upper arm.”
    3. “Change the patch every 3 days.”
    4. “Restrict fluids while using this patch.”
13. The nurse is preparing to administer benztropine (Cogentin) to a patient who has Parkinson disease. When performing an assessment, which aspect of the patient’s history would cause the nurse to hold the medication and notify the provider?
    1. Asthma
    2. Glaucoma
    3. Irritable bowel syndrome
    4. Motion sickness
14. The nurse is caring for a patient in the post-anesthesia recovery unit. The nurse notes that the patient received atropine sulfate 2 mg 30 minutes prior to anesthesia induction. The patient has received 1000 mL of intravenous fluids and has 700 mL of urine in the urinary catheter bag. The patient reports having a dry mouth. The nurse notes a heart rate of 82 beats per minute. What action will the nurse perform?
    1. Administer a fluid bolus.
    2. Give the patient ice chips.
    3. Palpate the patient’s bladder.
    4. Reassess the patient in 15 minutes.
15. A patient who has Parkinson disease will begin treatment with benztropine (Cogentin). Which symptom of Parkinson disease would be a contraindication for this drug?
    1. Drooling
    2. Muscle rigidity
    3. Muscle weakness
    4. Tardive dyskinesia
16. A patient who is intubated develops bradycardia because of vagal stimulation. Which medication will the nurse anticipate administering to treat this symptom?
    1. 1. 1. Atropine sulfate (Atropine)
          2. Benztropine (Cogentin)
          3. Bethanechol chloride (Urecholine)
          4. Metoclopramide (Reglan)
17. The nurse is preparing to administer tolterodine tartrate (Detrol LA) to a patient who has incontinence. Which symptom would be a contraindication for this drug?
    1. 1. 1. Decreased bowel sounds
          2. Drooling
          3. Gastric upset
          4. Pain

MULTIPLE RESPONSE

1.   Cholinergic drugs have specific effects on the body. What are the actions of cholinergic medications? (Select all that apply.)

1. 1. 1. 1. Dilate pupils
         2. Decrease heart rate
         3. Stimulate gastric muscle
         4. Dilate blood vessels
         5. Dilate bronchioles
         6. Increase salivation
         7. Constrict pupils