Instructor Proof
Adams, Pharmacology for Nurse: A Pathophysiologic Approach,
4/EChapter 13
Question 1Type: MCSAThe patient receives methyldopa (Aldomet),
an adrenergic drug. The nurse determines that the patient is having
side effects when the patient makes which statement?
1. "Will you check my pupils? I can't see very well at all."2.
"I am so thirsty; will you please bring me another pitcher of
water?"3. "I am so anxious; I really need to walk around the
room."4. "I feel so sleepy that I don't think I can eat my
dinner."Correct Answer: 3Rationale 1: Adrenergic drugs mimic the
effect of the sympathetic nervous system (SNS). This can result in
anxiety and restlessness. Adrenergic drugs increase alertness, so
the patient would not be sleepy. Anticholinergic, not adrenergic
drugs, dry secretions, therefore the patient would not be thirsty.
Adrenergic drugs dilate the pupils, so vision should not be
affected.Rationale 2: Adrenergic drugs mimic the effect of the
sympathetic nervous system (SNS). This can result in anxiety and
restlessness. Adrenergic drugs increase alertness, so the patient
would not be sleepy. Anticholinergic, not adrenergic drugs, dry
secretions, therefore the patient would not be thirsty. Adrenergic
drugs dilate the pupils, so vision should not be affected.Rationale
3: Adrenergic drugs mimic the effect of the sympathetic nervous
system (SNS). This can result in anxiety and restlessness.
Adrenergic drugs increase alertness, so the patient would not be
sleepy. Anticholinergic, not adrenergic drugs, dry secretions,
therefore the patient would not be thirsty. Adrenergic drugs dilate
the pupils, so vision should not be affected.Rationale 4:
Adrenergic drugs mimic the effect of the sympathetic nervous system
(SNS). This can result in anxiety and restlessness. Adrenergic
drugs increase alertness, so the patient would not be sleepy.
Anticholinergic, not adrenergic drugs, dry secretions, therefore
the patient would not be thirsty. Adrenergic drugs dilate the
pupils, so vision should not be affected.Global Rationale:
Cognitive Level: ApplyingClient Need: Physiological Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
EvaluationLearning Outcome: 13-5Question 2Type: MCSAThe patient
receives metaproterenol (Alupent), an adrenergic drug. A consulting
physician orders carteolol (Cartrol), a beta blocker. What best
describes the nurse's assessment?
1. The patient is at risk for a hypertensive crisis.2. The
effects of metaproterenol (Alupent) will be decreased.3. The drugs
are compatible; there will not be any adverse effects.4. The
effects of metaproterenol (Alupent) will be increased.Correct
Answer: 2Rationale 1: Beta-adrenergic blockers block the receptors
that are stimulated by adrenergic drugs; the effects of
metaproterenol (Alupent) would be decreased, not increased. The
drugs are not compatible; the effects of metaproterenol (Alupent)
would be decreased. A hypertensive crisis is unlikely.Rationale 2:
Beta-adrenergic blockers block the receptors that are stimulated by
adrenergic drugs; the effects of metaproterenol (Alupent) would be
decreased, not increased. The drugs are not compatible; the effects
of metaproterenol (Alupent) would be decreased. A hypertensive
crisis is unlikely.Rationale 3: Beta-adrenergic blockers block the
receptors that are stimulated by adrenergic drugs; the effects of
metaproterenol (Alupent) would be decreased, not increased. The
drugs are not compatible; the effects of metaproterenol (Alupent)
would be decreased. A hypertensive crisis is unlikely.Rationale 4:
Beta-adrenergic blockers block the receptors that are stimulated by
adrenergic drugs; the effects of metaproterenol (Alupent) would be
decreased, not increased. The drugs are not compatible; the effects
of metaproterenol (Alupent) would be decreased. A hypertensive
crisis is unlikely.Global Rationale: Cognitive Level:
ApplyingClient Need: Physiological Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
AssessmentLearning Outcome: 13-5Question 3Type: MCSAThe nurse has
been doing medication education for the patient receiving atenolol
(Tenormin), a beta blocker. The nurse determines that learning has
occurred when the patient makes which statement?
1. "I need to take my pulse every day."2. "If I have any side
effects, I will stop the medication."3. "I cannot take this drug if
I develop glaucoma."4. "I cannot continue to have my morning cup of
coffee."Correct Answer: 1Rationale 1: Beta blockers slow the heart
rate; therefore the patient must monitor his pulse every day. Beta
blockers should not be stopped suddenly. Caffeine is not prohibited
with beta blockers. Adrenergic blockers, not beta blockers, are
used to treat glaucoma.Rationale 2: Beta blockers slow the heart
rate; therefore the patient must monitor his pulse every day. Beta
blockers should not be stopped suddenly. Caffeine is not prohibited
with beta blockers. Adrenergic blockers, not beta blockers, are
used to treat glaucoma.Rationale 3: Beta blockers slow the heart
rate; therefore the patient must monitor his pulse every day. Beta
blockers should not be stopped suddenly. Caffeine is not prohibited
with beta blockers. Adrenergic blockers, not beta blockers, are
used to treat glaucoma.Rationale 4: Beta blockers slow the heart
rate; therefore the patient must monitor his pulse every day. Beta
blockers should not be stopped suddenly. Caffeine is not prohibited
with beta blockers. Adrenergic blockers, not beta blockers, are
used to treat glaucoma.Global Rationale: Cognitive Level:
ApplyingClient Need: Physiological Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
EvaluationLearning Outcome: 13-8Question 4Type: MCSAThe physician
ordered prazosin (Minipress), an alpha-adrenergic blocker, for the
patient. The nurse plans to do medication education. What will the
best plan of the nurse include?
1. Instruct the patient to not take any OTC herbal
preparations.2. Instruct the patient to not take hot tub baths or
hot showers.3. Instruct the patient to decrease his intake of
sodium.4. Instruct the patient to wear sunglasses when
outdoors.Correct Answer: 2Rationale 1: Alpha-adrenergic blockers
are vasodilators, and taking hot tub baths or showers could result
in further vasodilation resulting in hypotension or fainting.Alpha
blockers do not cause photophobia; sunglasses are not required with
this drug. There is no relationship between alpha blockers and
sodium intake. It is a good idea to avoid herbal preparations, but
this is not the primary plan.Rationale 2: Alpha-adrenergic blockers
are vasodilators, and taking hot tub baths or showers could result
in further vasodilation resulting in hypotension or fainting.Alpha
blockers do not cause photophobia; sunglasses are not required with
this drug. There is no relationship between alpha blockers and
sodium intake. It is a good idea to avoid herbal preparations, but
this is not the primary plan.Rationale 3: Alpha-adrenergic blockers
are vasodilators, and taking hot tub baths or showers could result
in further vasodilation resulting in hypotension or fainting.Alpha
blockers do not cause photophobia; sunglasses are not required with
this drug. There is no relationship between alpha blockers and
sodium intake. It is a good idea to avoid herbal preparations, but
this is not the primary plan.Rationale 4: Alpha-adrenergic blockers
are vasodilators, and taking hot tub baths or showers could result
in further vasodilation resulting in hypotension or fainting.Alpha
blockers do not cause photophobia; sunglasses are not required with
this drug. There is no relationship between alpha blockers and
sodium intake. It is a good idea to avoid herbal preparations, but
this is not the primary plan.Global Rationale: Cognitive Level:
ApplyingClient Need: Physiological Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
PlanningLearning Outcome: 13-9Question 5Type: MCSAThe nurse has
completed medication education about pyridostigmine (Mestinon), an
indirect cholinergic drug, for the patient with myasthenia gravis.
The nurse determines that learning has occurred when the patient
makes which statement?
1. "I must monitor my blood pressure while on this drug."2. "I
will need to increase my fluid intake with this medication."3. "I
must take this medication with meals for proper absorption."4. "It
is really important to take my medication on time."Correct Answer:
4Rationale 1: Maintaining an optimum blood level of the drug is
crucial in promoting muscle functioning, so it is important for the
patient to take his medication on time. There is no reason to
increase fluid intake with this drug. This drug may be taken with
or without meals. There is no reason to monitor blood pressure
while taking this drug.Rationale 2: Maintaining an optimum blood
level of the drug is crucial in promoting muscle functioning, so it
is important for the patient to take his medication on time. There
is no reason to increase fluid intake with this drug. This drug may
be taken with or without meals. There is no reason to monitor blood
pressure while taking this drug.Rationale 3: Maintaining an optimum
blood level of the drug is crucial in promoting muscle functioning,
so it is important for the patient to take his medication on time.
There is no reason to increase fluid intake with this drug. This
drug may be taken with or without meals. There is no reason to
monitor blood pressure while taking this drug.Rationale 4:
Maintaining an optimum blood level of the drug is crucial in
promoting muscle functioning, so it is important for the patient to
take his medication on time. There is no reason to increase fluid
intake with this drug. This drug may be taken with or without
meals. There is no reason to monitor blood pressure while taking
this drug.Global Rationale: Cognitive Level: ApplyingClient Need:
Physiological Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
EvaluationLearning Outcome: 13-8Question 6Type: MCSAThe physician
has ordered bethanechol (Urecholine), a cholinergic drug, for the
patient with urinary retention. The patient also has an enlarged
prostate gland. What is the priority action by the nurse?
1. Hold the drug and prepare to catheterize the patient.2.
Administer the drug and measure urinary output.3. Administer the
drug and push fluids.4. Hold the drug and contact the
physician.Correct Answer: 4Rationale 1: Bethanechol (Urecholine)
relaxes the urinary sphincter and increases voiding pressure. It is
contraindicated with any physical obstruction of the urinary tract,
such as an enlarged prostate gland. Measuring urinary output is
inappropriate; the patient should not receive the drug. There
should be no need for catheterization as long as the drug is not
given. The drug should not be given; pushing fluids would
exacerbate the problem.Rationale 2: Bethanechol (Urecholine)
relaxes the urinary sphincter and increases voiding pressure. It is
contraindicated with any physical obstruction of the urinary tract,
such as an enlarged prostate gland. Measuring urinary output is
inappropriate; the patient should not receive the drug. There
should be no need for catheterization as long as the drug is not
given. The drug should not be given; pushing fluids would
exacerbate the problem.Rationale 3: Bethanechol (Urecholine)
relaxes the urinary sphincter and increases voiding pressure. It is
contraindicated with any physical obstruction of the urinary tract,
such as an enlarged prostate gland. Measuring urinary output is
inappropriate; the patient should not receive the drug. There
should be no need for catheterization as long as the drug is not
given. The drug should not be given; pushing fluids would
exacerbate the problem.Rationale 4: Bethanechol (Urecholine)
relaxes the urinary sphincter and increases voiding pressure. It is
contraindicated with any physical obstruction of the urinary tract,
such as an enlarged prostate gland. Measuring urinary output is
inappropriate; the patient should not receive the drug. There
should be no need for catheterization as long as the drug is not
given. The drug should not be given; pushing fluids would
exacerbate the problem.Global Rationale: Cognitive Level:
AnalyzingClient Need: Physiological Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
ImplementationLearning Outcome: 13-7Question 7Type: MCSAThe preop
patient will be receiving glycopyrrolate (Robinul), an
anticholinergic drug, and asks the nurse, "Why do I need to have
that shot?" What is the best response by the nurse?
1. "It will decrease your respiratory secretions during
surgery."2. "It will increase your urinary output during
surgery."3. "It will help you breathe better during surgery."4. "It
will help maintain your blood pressure during surgery."Correct
Answer: 1Rationale 1: Anticholinergics dry secretions; a decrease
in respiratory secretions is indicated prior to surgery.
Anticholinergic drugs do not maintain blood pressure.
Anticholinergic drugs do not facilitate respirations.
Anticholinergic drugs do not increase urinary output.Rationale 2:
Anticholinergics dry secretions; a decrease in respiratory
secretions is indicated prior to surgery. Anticholinergic drugs do
not maintain blood pressure. Anticholinergic drugs do not
facilitate respirations. Anticholinergic drugs do not increase
urinary output.Rationale 3: Anticholinergics dry secretions; a
decrease in respiratory secretions is indicated prior to surgery.
Anticholinergic drugs do not maintain blood pressure.
Anticholinergic drugs do not facilitate respirations.
Anticholinergic drugs do not increase urinary output.Rationale 4:
Anticholinergics dry secretions; a decrease in respiratory
secretions is indicated prior to surgery. Anticholinergic drugs do
not maintain blood pressure. Anticholinergic drugs do not
facilitate respirations. Anticholinergic drugs do not increase
urinary output.Global Rationale: Cognitive Level: ApplyingClient
Need: Physiological Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
ImplementationLearning Outcome: 13-8Question 8Type: MCSAThe nurse
is preparing to administer medications to a group of patients. One
of the medications is benztropine (Cogentin), an anticholinergic
drug. This drug is contraindicated in which patient?
1. The patient with a fractured femur2. The patient with
tachycardia3. The patient with an irritable colon4. The patient
with diarrheaCorrect Answer: 2Rationale 1: Anticholinergic drugs
increase the heart rate; a patient with tachycardia should not
receive benztropine (Cogentin). Anticholinergic drugs slow
gastrointestinal (GI) motility; this would help with an irritable
colon. Anticholinergic drugs slow gastrointestinal (GI) motility;
this would help with diarrhea. There is no contraindication with a
fractured femur and anticholinergic drugs.Rationale 2:
Anticholinergic drugs increase the heart rate; a patient with
tachycardia should not receive benztropine (Cogentin).
Anticholinergic drugs slow gastrointestinal (GI) motility; this
would help with an irritable colon. Anticholinergic drugs slow
gastrointestinal (GI) motility; this would help with diarrhea.
There is no contraindication with a fractured femur and
anticholinergic drugs.Rationale 3: Anticholinergic drugs increase
the heart rate; a patient with tachycardia should not receive
benztropine (Cogentin). Anticholinergic drugs slow gastrointestinal
(GI) motility; this would help with an irritable colon.
Anticholinergic drugs slow gastrointestinal (GI) motility; this
would help with diarrhea. There is no contraindication with a
fractured femur and anticholinergic drugs.Rationale 4:
Anticholinergic drugs increase the heart rate; a patient with
tachycardia should not receive benztropine (Cogentin).
Anticholinergic drugs slow gastrointestinal (GI) motility; this
would help with an irritable colon. Anticholinergic drugs slow
gastrointestinal (GI) motility; this would help with diarrhea.
There is no contraindication with a fractured femur and
anticholinergic drugs.Global Rationale: Cognitive Level:
ApplyingClient Need: Physiological Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
PlanningLearning Outcome: 13-9Question 9Type: MCSAThe nurse is
preparing to administer medications to a group of patients. One of
the medications is atropine, an anticholinergic drug. This drug is
contraindicated in which patient?
1. The patient with glaucoma2. The patient with
hyperthyroidism3. The patient with a hiatal hernia4. The patient
with lung cancerCorrect Answer: 1Rationale 1: Anticholinergic drugs
can increase pressure in the eye; they must be avoided in patients
with glaucoma. Anticholinergic drugs are not contraindicated in
patients with a hiatal hernia. Anticholinergic drugs are not
contraindicated in patients with hyperthyroidism. Anticholinergic
drugs are not contraindicated in patients with lung
cancer.Rationale 2: Anticholinergic drugs can increase pressure in
the eye; they must be avoided in patients with glaucoma.
Anticholinergic drugs are not contraindicated in patients with a
hiatal hernia. Anticholinergic drugs are not contraindicated in
patients with hyperthyroidism. Anticholinergic drugs are not
contraindicated in patients with lung cancer.Rationale 3:
Anticholinergic drugs can increase pressure in the eye; they must
be avoided in patients with glaucoma. Anticholinergic drugs are not
contraindicated in patients with a hiatal hernia. Anticholinergic
drugs are not contraindicated in patients with hyperthyroidism.
Anticholinergic drugs are not contraindicated in patients with lung
cancer.Rationale 4: Anticholinergic drugs can increase pressure in
the eye; they must be avoided in patients with glaucoma.
Anticholinergic drugs are not contraindicated in patients with a
hiatal hernia. Anticholinergic drugs are not contraindicated in
patients with hyperthyroidism. Anticholinergic drugs are not
contraindicated in patients with lung cancer.Global Rationale:
Cognitive Level: ApplyingClient Need: Physiological Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
PlanningLearning Outcome: 13-8Question 10Type: MCSAThe physician
orders dicyclomine (Bentyl), an anticholinergic drug, for a
patient. What is the nurse's priority assessment prior to
administering this drug?
1. Does the patient have light sensitivity?2. Is the patient
able to urinate?3. Does the patient have a history of alcoholism?4.
Is the patient dizzy upon standing?Correct Answer: 2Rationale 1:
Anticholinergic drugs can cause or increase urinary hesitancy or
retention. Anticholinergic drugs are not contraindicated in a
patient with light sensitivity. Anticholinergic drugs are not
contraindicated in a patient with a history of alcoholism.
Anticholinergic drugs are not contraindicated in a patient who is
dizzy.Rationale 2: Anticholinergic drugs can cause or increase
urinary hesitancy or retention. Anticholinergic drugs are not
contraindicated in a patient with light sensitivity.
Anticholinergic drugs are not contraindicated in a patient with a
history of alcoholism. Anticholinergic drugs are not
contraindicated in a patient who is dizzy.Rationale 3:
Anticholinergic drugs can cause or increase urinary hesitancy or
retention. Anticholinergic drugs are not contraindicated in a
patient with light sensitivity. Anticholinergic drugs are not
contraindicated in a patient with a history of alcoholism.
Anticholinergic drugs are not contraindicated in a patient who is
dizzy.Rationale 4: Anticholinergic drugs can cause or increase
urinary hesitancy or retention. Anticholinergic drugs are not
contraindicated in a patient with light sensitivity.
Anticholinergic drugs are not contraindicated in a patient with a
history of alcoholism. Anticholinergic drugs are not
contraindicated in a patient who is dizzy.Global Rationale:
Cognitive Level: ApplyingClient Need: Physiological Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
AssessmentLearning Outcome: 13-8Question 11Type: MCSAThe patient is
quadriplegic and receives oxybutynin (Ditropan), an anticholinergic
drug, to increase his bladder capacity. What is an important
assessment of this patient by the nurse?
1. Is he irritable?2. Is he constipated?3. Is he gaining
weight?4. Is he lethargic?Correct Answer: 2Rationale 1:
Anticholinergics slow gastrointestinal (GI) motility and can
increase the risk for constipation. Anticholinergic drugs do not
cause lethargy. Anticholinergic drugs do not cause weight gain.
Anticholinergic drugs do not cause irritability.Rationale 2:
Anticholinergics slow gastrointestinal (GI) motility and can
increase the risk for constipation. Anticholinergic drugs do not
cause lethargy. Anticholinergic drugs do not cause weight gain.
Anticholinergic drugs do not cause irritability.Rationale 3:
Anticholinergics slow gastrointestinal (GI) motility and can
increase the risk for constipation. Anticholinergic drugs do not
cause lethargy. Anticholinergic drugs do not cause weight gain.
Anticholinergic drugs do not cause irritability.Rationale 4:
Anticholinergics slow gastrointestinal (GI) motility and can
increase the risk for constipation. Anticholinergic drugs do not
cause lethargy. Anticholinergic drugs do not cause weight gain.
Anticholinergic drugs do not cause irritability.Global Rationale:
Cognitive Level: ApplyingClient Need: Physiological Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
AssessmentLearning Outcome: 13-8Question 12Type: MCMAThe nursing
instructor teaches the student nurses about the nervous system. The
instructor determines that learning has occurred when the students
make which statement(s)?
Note: Credit will be given only if all correct choices and no
incorrect choices are selected.
Standard Text: Select all that apply.1. "The central nervous
system includes the brain and spinal cord."2. "The peripheral
nervous system has mainly sensory functions."3. "The somatic
nervous system gives us voluntary control over our gastrointestinal
(GI) tract."4. "The nervous system helps us react to environmental
changes."5. "The somatic nervous system gives us voluntary control
over moving."Correct Answer: 1,4,5Rationale 1: The central nervous
system includes the brain and spinal cord. The somatic nervous
system provides voluntary control over moving. The nervous system
provides reaction to environmental changes. The peripheral nervous
system has both sensory and motor divisions. The somatic nervous
system gives voluntary control over skeletal muscles.Rationale 2:
The central nervous system includes the brain and spinal cord. The
somatic nervous system provides voluntary control over moving. The
nervous system provides reaction to environmental changes. The
peripheral nervous system has both sensory and motor divisions. The
somatic nervous system gives voluntary control over skeletal
muscles.Rationale 3: The central nervous system includes the brain
and spinal cord. The somatic nervous system provides voluntary
control over moving. The nervous system provides reaction to
environmental changes. The peripheral nervous system has both
sensory and motor divisions. The somatic nervous system gives
voluntary control over skeletal muscles.Rationale 4: The central
nervous system includes the brain and spinal cord. The somatic
nervous system provides voluntary control over moving. The nervous
system provides reaction to environmental changes. The peripheral
nervous system has both sensory and motor divisions. The somatic
nervous system gives voluntary control over skeletal
muscles.Rationale 5: The central nervous system includes the brain
and spinal cord. The somatic nervous system provides voluntary
control over moving. The nervous system provides reaction to
environmental changes. The peripheral nervous system has both
sensory and motor divisions. The somatic nervous system gives
voluntary control over skeletal muscles.Global Rationale: Cognitive
Level: ApplyingClient Need: Physiological Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
EvaluationLearning Outcome: 13-1Question 13Type: MCMAThe nursing
instructor teaches the student nurses about the autonomic nervous
system. The instructor determines that learning has occurred when
the students make which statement(s)?
Note: Credit will be given only if all correct choices and no
incorrect choices are selected.
Standard Text: Select all that apply.1. "The sympathetic and
parasympathetic systems are not always opposite in their
effects."2. "The parasympathetic nervous system is the
"fight-or-flight" response."3. "Sympathetic stimulation causes
dilation of arterioles."4. "The parasympathetic nervous system
causes bronchial constriction."5. "The sympathetic nervous system
is activated under stress."Correct Answer: 1,4,5Rationale 1: The
parasympathetic nervous system causes bronchial constriction. The
sympathetic and parasympathetic systems are not always opposite in
their effects. The sympathetic nervous system is activated under
stress. The parasympathetic nervous system is the rest-and-digest
response. Sympathetic stimulation causes constriction of
arterioles.Rationale 2: The parasympathetic nervous system causes
bronchial constriction The sympathetic and parasympathetic systems
are not always opposite in their effects. The sympathetic nervous
system is activated under stress. The parasympathetic nervous
system is the rest-and-digest response. Sympathetic stimulation
causes constriction of arterioles.Rationale 3: The parasympathetic
nervous system causes bronchial constriction The sympathetic and
parasympathetic systems are not always opposite in their effects.
The sympathetic nervous system is activated under stress. The
parasympathetic nervous system is the rest-and-digest response.
Sympathetic stimulation causes constriction of arterioles.Rationale
4: The parasympathetic nervous system causes bronchial constriction
The sympathetic and parasympathetic systems are not always opposite
in their effects. The sympathetic nervous system is activated under
stress. The parasympathetic nervous system is the rest-and-digest
response. Sympathetic stimulation causes constriction of
arterioles.Rationale 5: The parasympathetic nervous system causes
bronchial constriction The sympathetic and parasympathetic systems
are not always opposite in their effects. The sympathetic nervous
system is activated under stress. The parasympathetic nervous
system is the rest-and-digest response. Sympathetic stimulation
causes constriction of arterioles.Global Rationale: Cognitive
Level: ApplyingClient Need: Physiological Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
EvaluationLearning Outcome: 13-3Question 14Type: MCSAThe student
nurse asks the nursing instructor, "Do the medications we are
studying actually make more neurotransmitters?" What is the best
response by the nursing instructor?
1. "No, but medications can heal diseases of the autonomic
nervous system."2. "Yes, some of the newer medications are very
good at doing this."3. "Yes, but the newer drugs that do this have
some serious side effects."4. "No, medications can only increase or
decrease the action of neurotransmitters."Correct Answer:
4Rationale 1: Medications cannot manufacture new neurotransmitters,
they can only increase or decrease their action. There are
virtually no diseases of the autonomic nervous system to heal. Even
the newest medications cannot manufacture new neurotransmitters.
Medications cannot manufacture new neurotransmitters, even if they
have serious side effects.Rationale 2: Medications cannot
manufacture new neurotransmitters, they can only increase or
decrease their action. There are virtually no diseases of the
autonomic nervous system to heal. Even the newest medications
cannot manufacture new neurotransmitters. Medications cannot
manufacture new neurotransmitters, even if they have serious side
effects.Rationale 3: Medications cannot manufacture new
neurotransmitters, they can only increase or decrease their action.
There are virtually no diseases of the autonomic nervous system to
heal. Even the newest medications cannot manufacture new
neurotransmitters. Medications cannot manufacture new
neurotransmitters, even if they have serious side effects.Rationale
4: Medications cannot manufacture new neurotransmitters, they can
only increase or decrease their action. There are virtually no
diseases of the autonomic nervous system to heal. Even the newest
medications cannot manufacture new neurotransmitters. Medications
cannot manufacture new neurotransmitters, even if they have serious
side effects.Global Rationale: Cognitive Level: ApplyingClient
Need: Physiological Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
ImplementationLearning Outcome: 13-4Question 15Type: MCSAThe
ability of a person to use his arm muscles to lift a weight is
primarily regulated by
1. the somatic nervous system.2. the sympathetic nervous
system.3. the autonomic nervous system.4. the central nervous
system.Correct Answer: 1Rationale 1: The somatic nervous system (a
division of the peripheral nervous system) controls voluntary
movement such as lifting a weight. The autonomic nervous system
involves involuntary responses, and is divided into the sympathetic
and parasympathetic divisions.Rationale 2: The somatic nervous
system (a division of the peripheral nervous system) controls
voluntary movement such as lifting a weight. The autonomic nervous
system involves involuntary responses, and is divided into the
sympathetic and parasympathetic divisions.Rationale 3: The somatic
nervous system (a division of the peripheral nervous system)
controls voluntary movement such as lifting a weight. The autonomic
nervous system involves involuntary responses, and is divided into
the sympathetic and parasympathetic divisions.Rationale 4: The
somatic nervous system (a division of the peripheral nervous
system) controls voluntary movement such as lifting a weight. The
autonomic nervous system involves involuntary responses, and is
divided into the sympathetic and parasympathetic divisions.Global
Rationale: Cognitive Level: RememberingClient Need: Health
Promotion and Maintenance
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
AssessmentLearning Outcome: 13-1 and 13-2Question 16Type: MCSAWhich
of the following responses are regulated by the sympathetic nervous
system?
1. Increased heart rate, bronchial constriction2. Peripheral
artery dilation, reduced peristalsis3. Increased secretions, sex
organ stimulation4. Relaxation of bladder, pupil dilationCorrect
Answer: 4Rationale 1: Relaxation of the bladder and pupil dilation
is regulated by the sympathetic nervous system. Rationale 2:
Relaxation of the bladder and pupil dilation is regulated by the
sympathetic nervous system. Rationale 3: Relaxation of the bladder
and pupil dilation is regulated by the sympathetic nervous system.
Rationale 4: Relaxation of the bladder and pupil dilation is
regulated by the sympathetic nervous system. Global Rationale:
Cognitive Level: RememberingClient Need: Health Promotion and
Maintenance
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
AssessmentLearning Outcome: 13-2Question 17Type: MCSAA person who
had her adrenergic receptors activated would experience
1. fight-or-flight effects.2. rest-and-digest effects.3.
increased blood volume.4. bronchial constriction.Correct Answer:
1Rationale 1: Adrenergic receptors are found within the sympathetic
nervous system. Sympathetic nervous system activation produces the
fight-or-flight response. Rationale 2: Adrenergic receptors are
found within the sympathetic nervous system. Sympathetic nervous
system activation produces the fight-or-flight response. Rationale
3: Adrenergic receptors are found within the sympathetic nervous
system. Sympathetic nervous system activation produces the
fight-or-flight response. Rationale 4: Adrenergic receptors are
found within the sympathetic nervous system. Sympathetic nervous
system activation produces the fight-or-flight response. Global
Rationale: Cognitive Level: RememberingClient Need: Physiological
Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
AssessmentLearning Outcome: 13-3Question 18Type: MCSAWhich of the
following would inhibit the function of the autonomic nervous
system?
1. Drugs that bind and then stimulate the postsynaptic neuron2.
Drugs that prohibit neurotransmitter reuptake3. Drugs that increase
neurotransmitter synthesis4. Drugs that prevent the storage of
neurotransmitter in vesiclesCorrect Answer: 4Rationale 1: The more
neurotransmitter available, the greater the function/stimulation of
the autonomic nervous system. Rationale 2: The more
neurotransmitter available, the greater the function/stimulation of
the autonomic nervous system. Rationale 3: The more
neurotransmitter available, the greater the function/stimulation of
the autonomic nervous system. Rationale 4: The more
neurotransmitter available, the greater the function/stimulation of
the autonomic nervous system. Global Rationale: Cognitive Level:
RememberingClient Need: Physiological Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
AssessmentLearning Outcome: 13-4Question 19Type: MCSAWhich receptor
type is found at the ganglionic synapse of both the sympathetic and
parasympathetic nervous systems?
1. Alpha receptors2. Muscarinic3. Nicotinic4. Beta
receptorsCorrect Answer: 3Rationale 1: Nicotinic receptors are
found at the ganglionic synapse of both sympathetic and
parasympathetic nervous systems. Rationale 2: Nicotinic receptors
are found at the ganglionic synapse of both sympathetic and
parasympathetic nervous systems.Rationale 3: Nicotinic receptors
are found at the ganglionic synapse of both sympathetic and
parasympathetic nervous systems.Rationale 4: Nicotinic receptors
are found at the ganglionic synapse of both sympathetic and
parasympathetic nervous systems.Global Rationale: Cognitive Level:
RememberingClient Need: Physiological Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
AssessmentLearning Outcome: 13-5Question 20Type: MCSAWhich
statement is accurate concerning drugs classified as adrenergic
antagonists?
1. They are also known as anticholinergics.2. Their actions will
block the neurotransmitter acetylcholine.3. Their actions are the
opposite of those of sympathomimetics.4. They will stimulate the
sympathetic nervous system.Correct Answer: 3Rationale 1: Adrenergic
antagonists inhibit the actions of the sympathetic nervous system.
They are also known as sympatholytics. They block adrenergic
receptors, not cholinergic receptors. Rationale 2: Adrenergic
antagonists inhibit the actions of the sympathetic nervous system.
They are also known as sympatholytics. They block adrenergic
receptors, not cholinergic receptors. Rationale 3: Adrenergic
antagonists inhibit the actions of the sympathetic nervous system.
They are also known as sympatholytics. They block adrenergic
receptors, not cholinergic receptors. Rationale 4: Adrenergic
antagonists inhibit the actions of the sympathetic nervous system.
They are also known as sympatholytics. They block adrenergic
receptors, not cholinergic receptors. Global Rationale: Cognitive
Level: UnderstandingClient Need: Physiological Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
EvaluationLearning Outcome: 13-6Question 21Type: MCSAWhich of the
following statements is accurate regarding exogenous
acetylcholine?
1. Acetylcholine has almost no therapeutic effects because it is
rapidly destroyed once given.2. Acetylcholine is broken down
rapidly within the body, preventing it from producing adverse
effects.3. Acetylcholine will cause the heart rate to increase and
blood pressure to drop.4. When given in small amounts,
acetylcholine will produce profound parasympathetic effects.Correct
Answer: 1Rationale 1: Exogenous acetylcholine is not generally
administered, because it is rapidly destroyed by the body. It does
produce many adverse effects. Acetylcholine can lower blood
pressure, but it also lowers heart rate. Rationale 2: Exogenous
acetylcholine is not generally administered, because it is rapidly
destroyed by the body. It does produce many adverse effects.
Acetylcholine can lower blood pressure, but it also lowers heart
rate. Rationale 3: Exogenous acetylcholine is not generally
administered, because it is rapidly destroyed by the body. It does
produce many adverse effects. Acetylcholine can lower blood
pressure, but it also lowers heart rate. Rationale 4: Exogenous
acetylcholine is not generally administered, because it is rapidly
destroyed by the body. It does produce many adverse effects.
Acetylcholine can lower blood pressure, but it also lowers heart
rate. Global Rationale: Cognitive Level: UnderstandingClient Need:
Physiological Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
EvaluationLearning Outcome: 13-6Question 22Type: MCSAThe nurse
knows that atropine (Atropair) increases heart rate by
1. blocking the beta receptors of the parasympathetic nervous
system.2. directly stimulating the sympathetic nervous system.3.
potentiating the effects of acetylcholine on nicotinic receptors.4.
Blocking the effects of acetylcholine by occupying muscarinic
receptors.Correct Answer: 4Rationale 1: Atropine is a
cholinergic-blocking agent that occupies muscarinic receptors. It
is classified as an anticholinergic agent because it inhibits the
effects of the parasympathetic nervous system, which induces the
fight-or-flight responses of the sympathetic nervous
system.Rationale 2: Atropine is a cholinergic-blocking agent that
occupies muscarinic receptors. It is classified as an
anticholinergic agent because it inhibits the effects of the
parasympathetic nervous system, which induces the fight-or-flight
responses of the sympathetic nervous system. Rationale 3: Atropine
is a cholinergic-blocking agent that occupies muscarinic receptors.
It is classified as an anticholinergic agent because it inhibits
the effects of the parasympathetic nervous system, which induces
the fight-or-flight responses of the sympathetic nervous system.
Rationale 4: Atropine is a cholinergic-blocking agent that occupies
muscarinic receptors. It is classified as an anticholinergic agent
because it inhibits the effects of the parasympathetic nervous
system, which induces the fight-or-flight responses of the
sympathetic nervous system. Global Rationale: Cognitive Level:
UnderstandingClient Need: Physiological Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
AssessmentLearning Outcome: 13-8Question 23Type: MCMAWhich patient
responses are considered involuntary responses to autonomic nervous
system control?
Note: Credit will be given only if all correct choices and no
incorrect choices are selected.Standard Text: Select all that
apply.1. Becoming angry2. Tripping over a chair3. Complaining of
nausea4. Feeling depressed5. Being happyCorrect Answer:
1,4,5Rationale 1: Becoming angry is considered an involuntary
response that is a signal from higher centers in the brain to the
autonomic nervous system.Rationale 2: Tripping over a chair is a
voluntary response.Rationale 3: Complaining of nausea is a
voluntary response.Rationale 4: Feeling depressed is considered an
involuntary response that is a signal from higher centers in the
brain to the autonomic nervous system.Rationale 5: Being happy is
considered an involuntary response that is a signal from higher
centers in the brain to the autonomic nervous system.Global
Rationale: Cognitive Level: AnalyzingClient Need: Psychosocial
Integrity
Client Need Sub: Nursing/Integrated Concepts: Nursing Process:
AssessmentLearning Outcome: 13-9Question 24Type: MCMAA patient has
sustained a large blood loss. During the assessment, the nurse
realizes that which findings are under the control of the nervous
system?
Note: Credit will be given only if all correct choices and no
incorrect choices are selected.Standard Text: Select all that
apply.1. Heart rate2. Blood pressure3. Pupil size4. Bowel sounds5.
Fluid volumeCorrect Answer: 1,2,3,4Rationale 1: The brain, spinal
cord, and peripheral nerves act as a smoothly integrated whole to
accomplish minute-to-minute changes in essential functions such as
heart rate.Rationale 2: The brain, spinal cord, and peripheral
nerves act as a smoothly integrated whole to accomplish
minute-to-minute changes in essential functions such as blood
pressure.Rationale 3: The brain, spinal cord, and peripheral nerves
act as a smoothly integrated whole to accomplish minute-to-minute
changes in essential functions such as pupil size.Rationale 4: The
brain, spinal cord, and peripheral nerves act as a smoothly
integrated whole to accomplish minute-to-minute changes in
essential functions such as intestinal motility.Rationale 5:
Although the brain, spinal cord, and peripheral nerves act as a
smoothly integrated whole to accomplish minute-to-minute changes in
essential functions, fluid volume is not under the control of the
nervous system.Global Rationale: Cognitive Level: AnalyzingClient
Need: Physiological Integrity
Client Need Sub: Physiological AdaptationNursing/Integrated
Concepts: Nursing Process: AssessmentLearning Outcome: 13-1Question
25Type: MCMAThe nurse is caring for a patient with multisystem
organ failure. Which patient assessment findings are under the
control of the sympathetic nervous system?
Note: Credit will be given only if all correct choices and no
incorrect choices are selected.Standard Text: Select all that
apply.1. Blood glucose level 210 mg/dL2. Blood pressure 180/90
mmHg3. Total cholesterol level 300 mg/dL4. Respiratory rate 14 and
regular5. Hyperactive bowel soundsCorrect Answer: 1,2,3Rationale 1:
Metabolic effects such as an increase in blood glucose are a
sympathetic nervous system function.Rationale 2: The constriction
and relaxation of arterioles is controlled entirely by the
sympathetic nervous system.Rationale 3: Metabolic effects such as
the mobilization of lipids for energy are a sympathetic nervous
system function.Rationale 4: The respiratory rate would be faster
and deeper when under sympathetic nervous system control.Rationale
5: When under the sympathetic nervous system control, peristalsis
is temporarily suspended.Global Rationale: Cognitive Level:
AnalyzingClient Need: Physiological Integrity
Client Need Sub: Physiological AdaptationNursing/Integrated
Concepts: Nursing Process: AssessmentLearning Outcome: 13-3Question
26Type: MCMAA student nurse is learning about a medication that
affects the autonomic nervous system. When instructing the student
about the effects of this medication, the nurse will begin by
explaining the basic unit of this system. What does this
include?
Note: Credit will be given only if all correct choices and no
incorrect choices are selected.Standard Text: Select all that
apply.1. The preganglionic neuron2. The postganglionic neuron3. The
synaptic cleft4. Norepinephrine5. DopamineCorrect Answer:
1,2,3Rationale 1: The basic unit of the autonomic nervous system is
a two-neuron chain. The first neuron, called the preganglionic
neuron, originates in the central nervous system.Rationale 2: The
preganglionic neuron connects with the second nerve in the
autonomic nervous system two-neuron chain through the ganglia,
which contains the postganglionic neuron.Rationale 3: Autonomic
messages must cross the synaptic cleft.Rationale 4: Acetylcholine
is the neurotransmitter released at cholinergic receptors.Rationale
5: Dopamine is a neurotransmitter within the limbic system and
hypothalamus and not the autonomic nervous system.Global Rationale:
Cognitive Level: ApplyingClient Need: Physiological Integrity
Client Need Sub: Physiological AdaptationNursing/Integrated
Concepts: Nursing Process: PlanningLearning Outcome: 13-4Question
27Type: SEQThe nurse educator is reviewing the process of synaptic
transmission across the neuroeffector junction with a student. In
which order will the nurse explain the steps of synaptic
transmission?
Standard Text: Click and drag the options below to move them up
or down.Correct Answer: Global Rationale: Cognitive Level:
ApplyingClient Need: Physiological Integrity
Client Need Sub: Physiological AdaptationNursing/Integrated
Concepts: Nursing Process: PlanningLearning Outcome: 13-4Question
28Type: MCMAA patient is prescribed a medication that will block
muscarinic receptors. The nurse realizes that this medication has
implications for which body systems?
Note: Credit will be given only if all correct choices and no
incorrect choices are selected.Standard Text: Select all that
apply.1. Eyes2. Respiratory3. Cardiac4. Endocrine5.
MetabolicCorrect Answer: 1,2,3Rationale 1: Medications that block
muscarinic receptors are used during ophthalmic
procedures.Rationale 2: Medications that block muscarinic receptors
are used in the pharmacologic treatment of asthma.Rationale 3:
Medications that block muscarinic receptors are used in the
pharmacologic treatment of bradycardia.Rationale 4: Medications
that block muscarinic receptors are not used in the treatment of
endocrine disorders.Rationale 5: Medications that block muscarinic
receptors are not used in the treatment of metabolic
disorders.Global Rationale: Cognitive Level: AnalyzingClient Need:
Physiological Integrity
Client Need Sub: Physiological AdaptationNursing/Integrated
Concepts: Nursing Process: AssessmentLearning Outcome: 13-6Adams,
Pharmacology for Nurse: A Pathophysiologic Approach, 4/ECopyright
2014 by Pearson Education, Inc.