Drugs

Question 1

What is the mechanism of action of Bethanechol?

Answer 1

Binds reversibly to muscarinic cholinergic receptors and activates them.

Question 2

What is the route of administration of Bethanechol and what is the onset and duration?

Answer 2

Oral
30-60 min onset
duration: 1 hour

Question 3

What is the absorption of Bethanechol?

Answer 3

minimal systemic absorption

Question 4

The nurse understands that the mechanism of action of Bethanechol is to:

A. Block muscarinic cholinergic receptors to decrease bladder tone
B. Bind reversibly to muscarinic cholinergic receptors and activate them
C. Inhibit the release of acetylcholine at muscarinic receptors
D. Increase norepinephrine release to stimulate urinary contraction

Answer 4

Answer: B. Bind reversibly to muscarinic cholinergic receptors and activate them

Rationale: Bethanechol is a muscarinic agonist that binds reversibly to muscarinic cholinergic receptors, activating them and thereby increasing smooth muscle tone, which is beneficial for treating urinary retention. It does not block receptors, inhibit acetylcholine release, or stimulate norepinephrine.

Question 5

The nurse understands that Bethanechol promotes urination by causing which of the following effects on the bladder?

A. Contraction of the trigone and sphincter muscles
B. Relaxation of the detrusor muscle
C. Contraction of the detrusor muscle and relaxation of the trigone and sphincter
D. Relaxation of all bladder muscles

Answer 5

Answer: C. Contraction of the detrusor muscle and relaxation of the trigone and sphincter

Rationale: Bethanechol stimulates muscarinic receptors, resulting in detrusor muscle contraction (which increases bladder pressure) and relaxation of the trigone and sphincter muscles, allowing for urination. This combination facilitates urine flow.

Question 6

A patient taking Bethanechol for urinary retention reports feeling an urgent need to urinate. The nurse recognizes that this effect is due to Bethanechol’s action on which part of the bladder?

A. Increased tone in the trigone
B. Contraction of the detrusor muscle
C. Relaxation of the detrusor muscle
D. Contraction of the internal sphincter

Answer 6

Answer: B. Contraction of the detrusor muscle

Rationale: Bethanechol’s activation of muscarinic receptors causes the detrusor muscle to contract, creating pressure within the bladder that leads to the sensation of urgency and facilitates urination. This is its intended action in treating urinary retention.

Question 7

The nurse knows that Bethanechol may have effects on the eyes due to its action on muscarinic receptors. Which ocular effect should the nurse anticipate?

A. Dilation of pupils with blurred near vision
B. Constriction of pupils with enhanced near-focusing
C. Dilation of pupils and enhanced distance focusing
D. Constriction of pupils with blurred distance vision.

Answer 7

Answer: B. Constriction of pupils with enhanced near-focusing

Rationale: Bethanechol’s activation of muscarinic receptors in the eyes causes miosis (pupil constriction) and contraction of the ciliary muscle, leading to improved near-focusing but potentially causing blurred vision for distant obj

Question 8

What is the method of administration for Bethanechol?

A. Intravenous
B. Oral
C. Subcutaneous
D. Intramuscular

Answer 8

Answer: B. Oral

Rationale: Bethanechol is administered orally to treat conditions such as urinary retention. It is not given via intravenous, subcutaneous, or intramuscular routes.

Question 9

What is the duration of onset for Bethanechol?

A. 5-10 minutes
B. 15-30 minutes
C. 30-60 minutes
D. 1-2 hours

Answer 9

Answer: C. 30-60 minutes

Rationale: The onset of action for Bethanechol is typically within 30 to 60 minutes after oral administration, making it effective for managing conditions like urinary retention within that timeframe.

Question 10

What is the duration of action for Bethanechol?

A. 30 minutes
B. 1 hour
C. 2-4 hours
D. 6-8 hours

Answer 10

Answer: B. 1 hour

Rationale: The duration of action for Bethanechol is approximately 1 hour, which means its effects are typically felt for this length of time after administration.

Question 11

Which statement is true regarding the systemic absorption of Bethanechol?

A. Bethanechol has high systemic absorption.
B. Bethanechol has minimal systemic absorption.
C. Bethanechol is only effective with intravenous administration.
D. Bethanechol has rapid systemic absorption.

Answer 11

Answer: B. Bethanechol has minimal systemic absorption.

Rationale: Bethanechol has minimal systemic absorption when taken orally, which helps limit systemic side effects while still providing localized therapeutic effects, particularly in the bladder.

Question 12

What is the primary use of Bethanechol?

A. To decrease heart rate
B. To increase voiding pressure in urinary retention
C. To relieve constipation
D. To induce sedation

Answer 12

Answer: B. To increase voiding pressure in urinary retention.

Rationale: Bethanechol is primarily used to treat urinary retention by increasing voiding pressure through contraction of the detrusor muscle in the bladder, facilitating urination.

Question 13

In addition to treating urinary retention, Bethanechol is also used for which condition?

A. Hypertension
B. Gastroesophageal reflux disease (GERD)
C. Diabetes mellitus
D. Asthma

Answer 13

Answer: B. Gastroesophageal reflux disease (GERD)

Rationale: Bethanechol is used not only to manage urinary retention but also to treat gastroesophageal reflux disease (GERD) by increasing gastric motility and enhancing lower esophageal sphincter tone, helping to reduce reflux.

Question 14

Which of the following are potential adverse effects of Bethanechol on the CV system?

A. Tachycardia and hypertension
B. Bradycardia and hypotension
C. Hyperglycemia and insomnia
D. Dry mouth and constipation

Answer 14

Answer: B. Bradycardia and hypotension

Rationale: Bethanechol can cause bradycardia (slow heart rate) and hypotension (low blood pressure) due to its cholinergic effects on the body, which can lead to increased vagal tone. These effects are important for the nurse to monitor in patients receiving this medication.

Question 15

Which of the following adverse effects should the nurse monitor for in a patient receiving Bethanechol, especially if the patient has a history of asthma?

A. Tachycardia
B. Bronchoconstriction
C. Hyperglycemia
D. Urinary retention

Answer 15

Answer: B. Bronchoconstriction

Rationale: Bethanechol can cause bronchoconstriction due to its stimulation of muscarinic receptors in the lungs. This effect is particularly concerning for patients with asthma, as it may exacerbate their condition by narrowing the airways. Nurses should closely monitor respiratory status in these patients.

Question 16

A patient with hyperthyroidism is receiving Bethanechol. Which potential cardiovascular effect should the nurse be aware of when administering this medication?

A. Decreased heart rate and hypotension
B. Increased heart rate and potential for arrhythmia
C. Normal heart rate with no change in rhythm
D. Decreased blood pressure and bradycardia

Answer 16

Answer: B. Increased heart rate and potential for arrhythmia

Rationale: In patients with hyperthyroidism, the heart rate may already be elevated, and Bethanechol can exacerbate this by causing bradycardia and increasing vagal tone. However, in this context, it’s important to note that the patient’s condition may lead to increased heart rate and potential arrhythmias. Monitoring cardiac status is crucial when administering this medication to patients with hyperthyroidism.

Question 17

Which of the following describes the effect of Atropine on the eyes?

A. Constriction of the pupils and near focusing
B. Contraction of the ciliary muscle for near vision
C. Relaxation of the ciliary muscle for far vision
D. Increased tear production

Answer 17

Answer: C. Relaxation of the ciliary muscle for far vision

Rationale: Atropine causes relaxation of the ciliary muscle, allowing the lens to focus on distant objects, which facilitates far vision. It also leads to pupil dilation (mydriasis) by blocking muscarinic receptors in the eye.

Question 18

What is a potential CNS effect of Atropine at increasing doses?

A. Mild sedation followed by sleep
B. Increased focus and alertness
C. Mild excitation progressing to hallucinations and possibly death
D. Muscle relaxation without CNS involvement

Answer 18

Answer: C. Mild excitation progressing to hallucinations and possibly death

Rationale: In small doses, Atropine can cause mild CNS excitation. However, as doses increase, it may lead to more severe effects, including hallucinations and, at very high doses, can be fatal. This progression underscores the need for careful dosing and monitoring.

Question 19

Which of the following are acceptable routes of administration for Atropine?

A. Oral and intradermal
B. Intravenous, intramuscular, subcutaneous, and topical (eye)
C. Topical (skin) and oral
D. Rectal and sublingual

Answer 19

Answer: B. Intravenous, intramuscular, subcutaneous, and topical (eye)

Rationale: Atropine can be administered via multiple routes: intravenous (IV), intramuscular (IM), subcutaneous (SC), and topically in the eye. These routes allow for flexibility in administration based on the clinical need and the urgency of the situation.

Question 20

Atropine is commonly used pre-anesthesia for which purpose?

A. To induce sedation before surgery
B. (preventative measure) prevent bradycardia and reduce secretions during surgery
C. To enhance muscle relaxation
D. To increase respiratory rate

Answer 20

Answer: B. To prevent bradycardia and reduce secretions during surgery.

Rationale: Atropine is often used pre-anesthesia to prevent bradycardia (slow heart rate) and reduce salivary and respiratory secretions, which can help reduce complications during surgery. It does not induce sedation or directly affect muscle relaxation.

Question 21

Why is Atropine used in eye exams?

A. To constrict the pupils for better vision
B. To dilate the pupils for examination of the retina
C. To treat eye infections
D. To relieve eye pain

Answer 21

Answer: B. To dilate the pupils for examination of the retina

Rationale: Atropine is used to dilate (widen) the pupils, which allows healthcare providers to better view the retina and other structures at the back of the eye during an exam. This effect is achieved by blocking muscarinic receptors, which leads to pupil dilation (mydriasis).

Question 22

Atropine is administered in the treatment of which cardiac condition?

A. Tachycardia
B. Hypertension
C. Bradycardia
D. Arrhythmias due to hyperkalemia

Answer 22

Answer: C. Bradycardia

Rationale: Atropine is used to treat bradycardia (abnormally slow heart rate) by blocking the vagus nerve’s effect on the heart, which helps to increase heart rate. This is especially useful in emergency settings to stabilize a patient with symptomatic bradycardia.

Question 23

Atropine may be used in the management of biliary colic for which therapeutic effect?

A. Increasing gallbladder contractions
B. Relaxing smooth muscle to ease gallstone passage
C. Enhancing bile production
D. Decreasing bile acidity

Answer 23

Answer: B. Relaxing smooth muscle to ease gallstone passage

Rationale: Atropine can help manage biliary colic by relaxing the smooth muscle of the biliary tract, which may ease the passage of gallstones and reduce pain. This antispasmodic effect makes it useful in alleviating symptoms associated with biliary colic.

Question 24

Atropine is used as an antidote for poisoning by which type of substance?

A. Beta blockers
B. Muscarinic agonists
C. Opioids
D. Benzodiazepines

Question 25

Which of the following adverse effects may occur in a patient taking Atropine due to its action on muscarinic receptors?

A. Increased salivation and lacrimation
B. Dry mouth and constipation
C. Miosis and blurred vision
D. Diarrhea and urinary frequency

Answer 25

Answer: B. Dry mouth and constipation

Rationale: Atropine blocks muscarinic receptors, leading to decreased salivary secretion (dry mouth) and reduced gastrointestinal motility (constipation). This is due to its anticholinergic effects.

Question 26

Why should Atropine be avoided in patients with glaucoma?

A. It increases intraocular pressure, worsening the condition
B. It dilates the pupils, improving vision
C. It lowers intraocular pressure, leading to blurred vision
D. It increases tear production, causing eye irritation

Answer 26

Answer: A. It increases intraocular pressure, worsening the condition

Rationale: Atropine can increase intraocular pressure by preventing drainage in the eye, which can worsen symptoms in patients with glaucoma, making it contraindicated in this condition.

Question 27

What risk is associated with Atropine’s effect of anhidrosis (lack of sweating)?

A. Dehydration
B. Hyperthermia
C. Hypotension
D. Hypothermia

Answer 27

Answer: B. Hyperthermia

Rationale: Anhidrosis, or the lack of sweating, is an adverse effect of Atropine that increases the risk of hyperthermia, as sweating is necessary to cool the body.

Question 28

How does Atropine affect patients with asthma?

A. It causes bronchoconstriction, worsening asthma symptoms
B. It dilates bronchi but can thicken respiratory secretions
C. It reduces airway secretions, improving breathing
D. It increases mucus production and bronchoconstriction

Answer 28

Answer: B. It dilates bronchi but can thicken respiratory secretions

Rationale: Atropine causes bronchodilation, which can be beneficial in asthma. However, it also thickens respiratory secretions, which can complicate breathing, so its use in asthma requires careful consideration.

Question 29

When administering Atropine, which class of medications should the nurse advise the patient to avoid due to an increased risk of enhanced antimuscarinic effects?

A. Beta blockers and calcium channel blockers
B. Antihistamines, antipsychotics, and tricyclic antidepressants
C. Benzodiazepines and SSRIs
D. ACE inhibitors and angiotensin II receptor blockers

Answer 29

Answer: B. Antihistamines, antipsychotics, and tricyclic antidepressants

Rationale: Antihistamines, antipsychotics, and tricyclic antidepressants can have antimuscarinic properties that may potentiate the effects of Atropine. Combining these drugs can increase the risk of adverse antimuscarinic effects, such as dry mouth, blurred vision, urinary retention, and constipation, so these combinations should be avoided.

Question 30

Which of the following effects is more pronounced with Scopolamine compared to Atropine?

A. Increased heart rate
B. Increased CNS sedation
C. Pupil dilation
D. Decreased salivation

Answer 30

Answer: B. Increased CNS sedation

Rationale: Scopolamine is known for its sedative effects on the central nervous system, which are more pronounced than those of Atropine. This makes it useful in certain situations, such as in palliative care.

Question 31

What is a primary therapeutic use of Scopolamine?

A. Treatment of bradycardia
B. Management of motion sickness
C. Promotion of gastric motility
D. Prevention of allergic reactions

Answer 31

Answer: B. Management of motion sickness

Rationale: Scopolamine is primarily used to prevent nausea and vomiting associated with motion sickness. It is commonly administered in transdermal patches for this purpose.

Question 32

In which of the following scenarios might Scopolamine be appropriately used?

A. Treating acute asthma exacerbations
B. managing symptoms in a palliative care setting
C. Increasing heart rate in symptomatic bradycardia
D. Dilating pupils for eye examinations

Answer 32

Answer: B. Managing symptoms in a palliative care setting

Rationale: Scopolamine is used to suppress nausea and is often utilized in palliative care settings to improve comfort. Its sedative properties can also be beneficial in managing nausea for patients in these settings.

Question 33

In addition to asthma and COPD, Ipratropium Bromide can be used via nasal inhalation for which condition?

A. Allergic rhinitis
B. Sinusitis
C. Acute bronchospasm
D. Pulmonary hypertension

Answer 33

Answer: A. Allergic rhinitis

Rationale: Ipratropium Bromide can also be administered via nasal inhalation to help relieve symptoms associated with allergic rhinitis by reducing nasal secretions.

Question 34

What is a significant advantage of Ipratropium Bromide in terms of side effects?

A. It has a high systemic absorption rate.
B. It has minimal systemic absorption, resulting in few side effects.
C. It is a long-acting medication with no side effects.
D. It is only administered in hospital settings.

Answer 34

Answer: B. It has minimal systemic absorption, resulting in few side effects.

Rationale: Due to its minimal systemic absorption, Ipratropium Bromide is associated with fewer systemic side effects compared to other medications used for asthma and COPD, making it a safer option for many patients.

Question 35

Which statement accurately describes the mechanism of action of penicillins?

A. They inhibit protein synthesis in bacterial cells.
B. They disrupt the bacterial cell wall synthesis.
C. They prevent nucleic acid synthesis in bacteria.
D. They inhibit folate synthesis in bacteria.

Answer 35

Answer: B. They disrupt the bacterial cell wall synthesis.

Rationale: Penicillins are beta-lactam antibiotics that work by inhibiting the synthesis of the bacterial cell wall, which is essential for bacterial integrity. This action is bactericidal, meaning it kills the bacteria.

Question 36

Penicillins are only effective against bacteria during which phase of their life cycle?

A. Dormant phase
B. Growth phase
C. Reproductive phase
D. Resting phase

Answer 36

Answer: B. Growth phase

Rationale: Penicillins are most effective when bacteria are actively growing and dividing. They target the mechanisms involved in cell wall synthesis, which only occurs during these phases.

Question 37

Why are penicillins considered safe for use in humans?

A. They target mammalian cells effectively.
B. They disrupt the bacterial cell wall, which mammalian cells do not have.
C. They are metabolized by the liver in humans.
D. They enhance human immune response.

Answer 37

Answer: B. They disrupt the bacterial cell wall, which mammalian cells do not have.

Rationale: Penicillins target the bacterial cell wall, a structure that mammalian cells lack, making them relatively safe for use in humans as they do not affect human cells directly.

Question 38

Which class of antibiotics do penicillins belong to?

A. Macrolides
B. Aminoglycosides
C. Tetracyclines
D. Beta-lactams

Answer 38

Answer: D. Beta-lactams

Rationale: Penicillins are classified as beta-lactam antibiotics, characterized by their beta-lactam ring structure, which is essential for their antibacterial activity.

Question 39

What is the primary mechanism of action of penicillin in weakening the bacterial cell wall?

A. Inhibition of DNA replication
B. Inhibition of transpeptidases
C. Activation of ribosomal function
D. Disruption of metabolic pathways

Answer 39

Answer: B. Inhibition of transpeptidases

Rationale: Penicillin inhibits transpeptidases, which are enzymes crucial for the synthesis of the bacterial cell wall. This inhibition weakens the cell wall, making bacteria more susceptible to lysis.

Question 40

How does penicillin disrupt the integrity of the bacterial cell wall?

A. By promoting protein synthesis
B. By activating autolysins
C. By blocking DNA gyrase
D. By increasing cell membrane permeability

Answer 40

Answer: B. By activating autolysins

Rationale: Penicillin activates autolysins, which are enzymes that break down the bacterial cell wall. This action, combined with the inhibition of transpeptidases, leads to cell lysis and death.

Question 41

Which of the following best describes the role of transpeptidases in bacterial cell wall synthesis?

A. They facilitate the division of bacterial DNA.
B. They help create strength in the polymer strands of the cell wall.
C. They transport nutrients into the bacterial cell.
D. They produce energy for bacterial metabolism.

Answer 41

Answer: B. They help create strength in the polymer strands of the cell wall.

Rationale: Transpeptidases are enzymes that cross-link the polymer strands in the bacterial cell wall, contributing to its structural integrity. Inhibition of these enzymes by penicillin weakens the cell wall.

Question 42

What are the primary molecular targets of penicillin in bacterial cells?

A. Ribosomes
B. DNA polymerase
C. Penicillin-binding proteins (PBPs)
D. Cell membrane phospholipids

Answer 42

Answer: C. Penicillin-binding proteins (PBPs)

Rationale: Penicillin targets penicillin-binding proteins (PBPs), which are essential for the synthesis of the bacterial cell wall. These proteins facilitate the cross-linking of peptidoglycan layers, critical for maintaining cell wall integrity.

Question 43

During which phase of bacterial growth are penicillin-binding proteins (PBPs) expressed?

A. Dormant phase
B. Lag phase
C. Growth and division phase
D. Stationary phase

Answer 43

Answer: C. Growth and division phase

Rationale: PBPs are only expressed when bacteria are actively growing and dividing. This is why penicillin is most effective during these phases, as it targets the processes necessary for cell wall synthesis.

Question 44

Which of the following penicillin-binding proteins (PBPs) is considered most critical for the action of penicillin?

A. PBP-2 & 4
B. PBP-4 & 6
C. PBP-1 & 3
D. PBP-8 & 1

Answer 44

Answer: C. PBP-1 & 3

Rationale: PBP-1 and PBP-3 are the most critical penicillin-binding proteins for the action of penicillin, as they are involved in the essential processes of bacterial cell wall synthesis and integrity.