Chapter 21: Cholinergic Drugs

Question 1

Which is a cardiovascular effect of cholinergic drugs?

a. Bradycardia
b. Tachycardia
c. Vasoconstriction
d. Palpitations

Answer 1

a. Bradycardia

Question 2

How are most direct-acting cholinergic drugs mainly used?

a. As antidotes for anticholinergic poisoning
b. Topically to reduce intraocular pressure
c. Orally in preparation for ocular surgery
d. For the diagnosis and treatment of myasthenia gravis

Answer 2

b. Topically to reduce intraocular pressure

Question 3

A patient wants to begin taking ginkgo for memory enhancement. The nurse should warn this
patient about possible drug interactions with which substances?
a. Digoxin, diuretics, and steroids
b. Caffeine-containing products
c. Alcoholic beverages
d. Aspirin, any nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin
(Coumadin®), and heparin

Answer 3

d. Aspirin, any nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin
(Coumadin®), and heparin

Question 4

When an overdose of an intravenous cholinergic drug occurs, which drug, administered
promptly, can reverse a cholinergic crisis?
a. atenolol (Tenormin)
b. bethanechol (Duvoid®)
c. dobutamine
d. atropine sulphate

Answer 4

d. atropine sulphate

Question 5

A patient has had abdominal surgery and is being discharged on a cholinergic drug to assist in
increasing gastrointestinal peristalsis. Which therapeutic effects should the nurse teach the
patient to watch for?
a. Decreased pulse rate
b. Abdominal cramping
c. Passage of flatus
d. Decreased frequency and urgency of voiding patterns

Answer 5

c. Passage of flatus

Question 6

A patient has been newly diagnosed with myasthenia gravis. What important information
should the nurse give this patient about the administration of cholinergic drugs?
a. The medication should be taken with meals to avoid gastrointestinal distress.
b. Daytime dosages should be given close together for maximal therapeutic effect.
c. The medication should be taken 30 minutes before eating, to improve swallowing
and chewing.
d. Expected adverse effects are increased muscle weakness, abdominal cramping, and
diarrhea, which should subside in a few days.

Answer 6

c. The medication should be taken 30 minutes before eating, to improve swallowing
and chewing.

Question 7

Which drug is considered to be the antidote for anticholinergic poisoning and for poisoning by
organophosphates and carbonates, such as those in common insecticides?
a. pilocarpine
b. bethanechol (Duvoid)
c. physostigmine
d. cholinesterase

Answer 7

c. physostigmine

Question 8

The nurse is providing teaching regarding drug therapy to the husband of a woman with
Alzheimer’s disease. The patient was diagnosed 3 months ago and has mild memory loss. She
will be receiving donepezil (Aricept®). Which statement accurately describes the drug’s
actions?
a. It prevents memory loss in later stages.
b. It will reverse the course of Alzheimer’s disease.
c. It provides sedation to prevent agitation and restlessness.
d. It may help to improve the symptoms of Alzheimer’s disease.

Answer 8

d. It may help to improve the symptoms of Alzheimer’s disease.

Question 9

A patient has been taking donepezil (Aricept) for 2 weeks as part of the treatment for early
stages of Alzheimer’s disease. The patient’s daughter calls the physician’s office, upset
because her mother has not shown any improvement. What is the nurse’s best response to the
patient’s daughter?
a. “Increase the dosage to twice daily.”
b. “It takes time for the cure to take effect.”
c. “It may take up to 6 weeks to see an improvement.”
d. “Have her take the medication on an empty stomach for improved absorption.”

Answer 9

c. “It may take up to 6 weeks to see an improvement.”

Question 10

The desired effects of cholinergic drugs come from stimulation of which receptors?

a. Muscarinic
b. Nicotinic
c. Cholinergic
d. Ganglionic

Answer 10

a. Muscarinic

Question 11

For each effect in the lower list, indicate which stimulation in the upper list the effect is due
to.
a. Muscarinic stimulation
b. Nicotinic stimulation
c. Both muscarinic stimulation and nicotinic stimulation

1. Pupil constriction
2. Increased heart rate
3. Decreased blood pressure

Answer 11

a. Muscarinic stimulation
3. Decreased blood pressure
b. Nicotinic stimulation
2. Increased heart rate
c. Both muscarinic stimulation and nicotinic stimulation
1. Pupil constriction