Unit 5 Pharm Chapter 29 Flashcards
What is an alternative name for the parasympathetic nervous system?
A) Craniolumbar
B) Thoracolumbar
C) Craniosacral
D) Lumbosacral
C) Craniosacral
Rationale:The parasympathetic system is sometimes called the craniosacral system because the CNS neurons that originate parasympathetic impulses are found in the cranium. The SNS is also called the thoracolumbar system because the CNS cells that originate impulses for this system are located in the thoracic and lumbar sections of the spinal cord. The other two options are distractors.
What is the defining criterion of an adrenergic nerve?
A) The nerve can produce epinephrine.
B) The nurse is continuously stimulated.
C) The nerve promotes cardiac conduction.
D) The nerve arises from the adrenal medulla.
A) The nerve can produce epinephrine.
Rationale:To be an adrenergic nerve, the nerve must contain all of the enzymes and building blocks necessary to produce norepinephrine. None of the other listed characteristics is associated with adrenergic nerves.
When assessing a client, what finding would the nurse interpret as indicating stimulation of the parasympathetic nervous system? Select all that apply.
A) Increased level of consciousness
B) Vasoconstriction
C) Pupil constriction
D) Bronchoconstriction
E) Decreased GI secretions
F) Decreased heart rate
C) Pupil constriction
D) Bronchoconstriction
F) Decreased heart rate
Rationale:Parasympathetic nervous system stimulation results in pupil constriction, increased tearing, bronchoconstriction, decreased heart rate, vasodilation, and increased GI secretions. Level of consciousness is not directly affected.
What component would be included when describing the parasympathetic nervous system structure and function? Select all that apply.
A) The preganglionic fibers are short.
B) Ganglia are located close to or within the effector tissue.
C) Muscarinic and nicotinic receptors are found in the parasympathetic nervous system.
D) Adrenergic receptors are found in the parasympathetic nervous system.
E) The system is primarily involved in responding to stress.
B) Ganglia are located close to or within the effector tissue.
C) Muscarinic and nicotinic receptors are found in the parasympathetic nervous system
Rationale:Parasympathetic ganglia are located close to or within effector tissue. The parasympathetic nervous system contains both nicotinic and muscarinic receptors. The preganglionic fibers of the parasympathetic nervous system are long. The sympathetic nervous system is the stress response; the parasympathetic nervous system helps the body recuperate from the stress response. Cholinergic receptors are found in the parasympathetic nervous system.
What is the enzyme responsible for breaking down norepinephrine to make it inactive?
A) Dopamine
B) Monoamine oxidase
C) Acetylcholinesterase
D) Epinephrine
B) Monoamine oxidase
Rationale:Enzymes are also in the area, as well as in the liver, to metabolize or biotransform any remaining norepinephrine or any norepinephrine that is absorbed into circulation. These enzymes are monoamine oxidase (MAO) and catechol-O-methyltransferase (COMT). Acetylcholinesterase breaks down acetylcholine to make it inactive. Epinephrine and dopamine are not enzymes; they are neurotransmitters
The nurse is assessing a client who has urinary hesitation and occasional overflow incontinence. What adrenergic receptors may be overstimulated in this client?
A) Alpha2
B) Beta1
C) Beta2
D) Alpha1
D) Alpha1
Rationale:Alpha1-receptors are found in the blood vessels, iris, and urinary bladder. Alpha2-receptors are located on nerve membranes. Beta1-receptors are found in cardiac tissue. Beta2-receptors are found in the smooth muscle of the blood vessels, in bronchi, in the periphery, and in uterine muscle.
A hospital client with obesity and diabetic retinopathy admits to feeling intensely anxious about his or her situation. What action by the nurse best addresses the effects of the client’s stress?
A) Assess the client’s skin integrity often.
B) Monitor the client’s oxygen saturation constantly.
C) Place the client on cardiac monitoring.
D) Check the client’s capillary glucose levels often.
D) Check the client’s capillary glucose levels often.
Rationale:Sympathetic stimulation causes increased blood glucose, and the nurse should monitor this closely. The nurse should monitor the client’s vital signs as well, but cardiac monitoring and constant pulse oximetry are not likely necessary. The risk of hyperglycemia likely exceeds the risk of skin breakdown.
The nurse has administered a scheduled dose of clonidine, an alpha2-receptor agonist, to a client. The nurse should anticipate what effect?
A) Agitation
B) Increased bowel motility
C) Reduced norepinephrine stimulation
D) Increased heart rate and blood pressure
C) Reduced norepinephrine stimulation
Rationale:Alpha2-receptors are located on nerve membranes and act as modulators of norepinephrine release. Stimulation of these receptors is likely to cause sympatholytic effects such a reduced anxiety and blood pressure. Bowel motility is not likely to be affected. Agitation would decrease, not increase.
A nurse is reviewing the parasympathetic nervous system prior to caring for a client with a neurologic disorder. What statement best described the parasympathetic nervous system?
A) Many of the cells originate in the sacral area of the spinal cord.
B) The cells typically have preganglionic fibers that are relatively short.
C) The ganglia are located in chains running alongside the spinal cord.
D) The system is often referred to as the thoracolumbar system.
A) Many of the cells originate in the sacral area of the spinal cord.
Rationale:The parasympathetic nervous system has neurons in the cranium and sacral area of the spinal cord. The sympathetic nervous system is referred to as the thoracolumbar system. The sympathetic nervous system consists of short preganglionic fibers. Sympathetic nerve ganglia are located in chains running alongside the spinal cord.
When working with a client who is experiencing a stress response, the nurse should anticipate what effects? Select all that apply.
A) Increased bowel sounds
B) Pupil dilation
C) Diaphoresis
D) Hypotension
E) Tachycardia
B) Pupil dilation
C) Diaphoresis
E) Tachycardia
Rationale:In the stress response, tachycardia, pupil dilation, hypertension, decreased bowel sounds, and diaphoresis would be noted.
When the sympathetic nervous system is stimulated, what cells of the adrenal medulla secrete epinephrine and norepinephrine directly into the bloodstream?
A) Chromaffin
B) Dihydroxyphenylalanine
C) Effector
D) Axon
A) Chromaffin
Rationale:The chromaffin cells of the adrenal medulla also are adrenergic because they synthesize, store, and release norepinephrine, as well as epinephrine. Effector cells are those that are affected by the nerve impulse. Dihydroxyphenylalanine is produced by a nerve and is converted to dopamine.
A group of students are reviewing the autonomic nervous system. The students demonstrate a need for additional review when they identify what as being involved with the sympathetic nervous system?
A) Vagus nerve
B) Monoamine oxidase
C) Adrenergic receptors
D) Norepinephrine
A) Vagus nerve
Rationale:The vagus nerve, originating in the cranium, is one of the most important parts of the parasympathetic nervous system. The other answer options are involved with the sympathetic nervous system.
The nurse is caring for a client who is under psychological and physiological stress. During sympathetic stimulation, the nurse should identify which neurotransmitter as being released by the preganglionic nerves of the sympathetic nervous system?
A) Dopamine
B) Acetylcholine
C) Epinephrine
D) Norepinephrine
B) Acetylcholine
Rationale:Acetylcholine is the neurotransmitter released by preganglionic nerves of the sympathetic nervous system and the pre- and postganglionic nerves of the parasympathetic nervous system. Dopamine is converted to norepinephrine in the adrenergic cells. Norepinephrine is involved in postganglionic activity of the sympathetic nervous system. Epinephrine is involved in the adrenergic response, being secreted directly into the bloodstream by the adrenal medulla.
A client is experiencing sympathetic stimulation in response to a stressful event. Which substance will most affect the client’s sodium and water retention?
A) Cortisol
B) Aldosterone
C) Glucose
D) Thyroid hormone
B) Aldosterone
Rationale:Aldosterone causes sodium and water retention and potassium excretion. Thyroid hormone increases metabolism and efficient use of energy. The release of adrenal hormones, including cortisol, suppresses the immune and inflammatory reactions to preserve energy during the fight-or-flight response. Glucose is formed by glycogenolysis to increase the blood glucose level and provide energy.
The nurse is conducting a comprehensive assessment of a client. What finding should the nurse attribute to the action of the parasympathetic nervous system?
A) The client’s heart rate is 88 beats/min.
B) The client’s pupils are constricted.
C) The client’s blood pressure is 136/86 mm Hg.
D) The client has polydipsia and requests water often.
B) The client’s pupils are constricted.
Rationale:Pupil constriction is one of major parasympathetic effects. This client’s heart rate and blood pressure are in the range of high normal, so are unlikely to be heavily affected by the parasympathetic nervous system. Polydipsia is not a direct effect of parasympathetic stimulation.
