Week 4 Sherpath

Question 1

Which cardiovascular effects would the nurse monitor for in a patient after the administration of epinephrine?

Select all that apply.

Increase in heart rate

Decrease in heart rate

Decrease in blood pressure

Peripheral vasoconstriction

Increase in systolic blood pressure

Answer 1

Increase in heart rate

Peripheral vasoconstriction

Increase in systolic blood pressure

Question 2

When would the nurse anticipate onset of action of epinephrine when administered during cardiac arrest?

1 to 2 minutes

15 to 30 minutes

1 to 2 hours

4 to 6 hours

Answer 2

1 to 2 minutes

Question 3

In which time frame will the effect of albuterol via inhalation occur?

5 to 15 minutes

90 minutes

2 to 6 hours

10 hours

Answer 3

5 to 15 minutes

Question 4

Which information would the nurse provide to Alyssa and her parents about the use of an epinephrine autoinjector (EpiPen)?

Select all that apply.

“Take the medication as it is prescribed.”

“It is acceptable to use the EpiPen when the particles are pink to brown in color.”

“Keep an EpiPen available at all times, and store extra medication in a cool, dark place.”

“There is no need to notify the health care provider if the EpiPen is needed more than twice a week.”

“The EpiPen must be administered immediately upon the first occurrence of difficulty breathing, wheezing, hives, itching, hoarseness, or swelling of the lips and tongue.”

Answer 4

“Take the medication as it is prescribed.”

“Keep an EpiPen available at all times, and store extra medication in a cool, dark place.”

“The EpiPen must be administered immediately upon the first occurrence of difficulty breathing, wheezing, hives, itching, hoarseness, or swelling of the lips and tongue.”

Question 5

Which laboratory values would the nurse review with the administration of epinephrine?

Select all that apply.

TSH

Sodium

Potassium

Hematocrit

Liver function

Renal function

Answer 5

Liver function

Renal function

Question 6

The nurse would instruct the patient to complete which action after the self-injection of epinephrine?

Massage the site.

Clean the site with alcohol.

Cover the site with a dry dressing.

Perform a self-assessment for signs of infection.

Answer 6

Massage the site.

Question 7

The nurse would educate the patient about which common side effect associated with albuterol?

Diarrhea

Chest pain

Nervousness

Neuropathic pain of the feet

Answer 7

Nervousness

Question 8

Which drug mimics the effects of sympathetic nervous system (SNS) neurotransmitters?

Epinephrine

Atropine

Serotonin

Acetylcholine

Answer 8

Epinephrine

Question 9

Which mechanism of albuterol reduces airway resistance?

Activation of dopamine receptors

Activation of beta2-mediated bronchodilators

Stimulation of beta1-mediated bronchodilators

Stimulation of gamma-aminobutyric acid (GABA) receptors within the respiratory system

Answer 9

Activation of beta2-mediated bronchodilators

Question 10

Which phrase describes the primary use of albuterol for a patient with emphysema?

Prevent bronchospasm

Decrease fluid loss by decreasing respirations

Prevent the development of pneumonia

Increase the respiratory rate of the patient

Answer 10

Prevent bronchospasm

Question 11

Which assessment data will the nurse collect before administering albuterol?

Select all that apply.

Pupillary response

Vital signs

Breath sounds

Skin assessment

Color of nail beds

Mucous membrane color

Answer 11

Vital signs

Breath sounds

Question 12

Which assessment finding would be of greatest concern to the nurse after administration of epinephrine?

Blood pressure 150/90 mm Hg

Patient report of chest pain

Patient report of tremors

Blood glucose level 190 mg/dL

Answer 12

Patient report of chest pain

Question 13

Which assessment findings indicate effectiveness of albuterol?

Select all that apply.

Increased heart rate

Clear breath sounds

Increased respiratory rate

Diminished breath sounds

Oxygen saturation 95%

Answer 13

Clear breath sounds

Oxygen saturation 95%

Question 14

The nurse observes redness and irritation at the intravenous (IV) infusion site of a patient who received IV epinephrine. Why would the nurse be concerned about this finding?

Epinephrine can cause tissue necrosis.

Epinephrine can cause an allergic reaction.

Epinephrine absorption rate may be altered due to the redness.

The patient may have an infection at the infusion site that will prolong hospitalization.

Answer 14

Epinephrine can cause tissue necrosis.

Question 15

Which side effect would the nurse monitor a patient for after administering albuterol via inhalation?

Increased heart rate

Increased respiratory rate

Decreased blood pressure

Decreased oxygen saturation

Answer 15

Increased heart rate

Question 16

How would the nurse determine the effectiveness of albuterol therapy?

Auscultate the patient’s lung sounds.

Monitor the patient’s blood pressure.

Evaluate the patient’s ability to use the inhaler.

Measure the patient’s respiratory rate.

Answer 16

Auscultate the patient’s lung sounds.

Question 17

The nurse is providing instructions for a patient with a new EpiPen. Which instruction would the nurse include when teaching a patient how to use an EpiPen?

Store the EpiPen in the refrigerator.

Hold the device in place for 5 to 10 seconds.

Administer the EpiPen at a 45-degree angle.

Avoid touching the site after the injection.

Answer 17

Hold the device in place for 5 to 10 seconds.

Question 18

A patient reports using an EpiPen an average of four times weekly. Which action would the nurse take?

Notify the health care provider.

Instruct the patient on site rotation.

Work with the patient to develop a plan to minimize chances of infection.

Provide the patient with a new log sheet to record injections.

Answer 18

Notify the health care provider.

Question 19

Which instruction would the nurse include when teaching a patient how to use an albuterol inhaler?

Rinse the mouth after each use.

Do not take more than four inhalations at one time.

Report throat dryness to the health care provider.

Limit fluid intake while taking albuterol treatments.

Answer 19

Rinse the mouth after each use.

Question 20

Which statement by a patient taking albuterol indicates the need for further education?

“I may feel shaky after I use my inhaler.”

“I will drink plenty of water while I am taking this inhaler.”

“I can take up to six puffs of my inhaler if I feel short of breath.”

“I will notify my health care provider if my breathing gets worse.”

Answer 20

“I can take up to six puffs of my inhaler if I feel short of breath.”

Question 21

Which routes will the nurse instruct the patient to use for self-administration of epinephrine via an EpiPen?

Select all that apply.

Oral

Intradermal

Intravenous

Intramuscular

Subcutaneous

Answer 21

Intramuscular

Subcutaneous

Question 22

Which receptors are categorized as cholinergic?

Select all that apply.

Muscarinic

Nicotinic

Acetylcholine

Gamma-aminobutyric acid (GABA)

Adrenergic

Answer 22

Muscarinic

Nicotinic

Question 23

Which names describe the class of drugs that affect the parasympathetic nervous system?

Select all that apply.

Cholinergic agonists

Parasympatholytics

Vasoconstrictors

Monoamine oxidase inhibitors

Calcium channel blockers

Answer 23

Cholinergic agonists

Parasympatholytics

Question 24

In which way does the pharmacokinetics of atropine differ from that of bethanechol?

Atropine is excreted in the urine, whereas bethanechol is excreted by the lungs.

Atropine can be given orally or topically, whereas bethanechol can only be given orally.

Atropine is absorbed poorly, whereas bethanechol is absorbed rapidly.

Atropine is not metabolized, whereas bethanechol is metabolized by the liver.

Answer 24

Atropine can be given orally or topically, whereas bethanechol can only be given orally.

Question 25

Bethanechol binds with which receptors to cause activation?

Cholinergic

Nicotinic

Adrenergic

Channel-linked

Answer 25

Cholinergic

Question 26

Which intervention would the nurse add to Mr. Graves’ plan of care?

Assess for rhonchi and wheezes.

Encourage voiding before taking the medication.

Monitor for signs of a paralytic ileus.

Request a diet high in fiber.

Answer 26

Assess for rhonchi and wheezes.

Question 27

Which instruction would the nurse include in Mr. Graves’ patient education plan?

Limit activity outdoors during hot temperatures to avoid hyperthermia.

Use artificial tears to avoid dry eyes.

Wear sunglasses to decrease sensitivity to bright light.

Sit up slowly from a lying position to avoid dizziness.

Answer 27

Sit up slowly from a lying position to avoid dizziness.

Question 28

The presence of which conditions are contraindications to treatment with atropine?

Select all that apply.

Narrow-angle glaucoma

Tachycardia

Benign prostatic hypertrophy

Paralytic ileus

Second-degree heart block

Answer 28

Narrow-angle glaucoma

Tachycardia

Benign prostatic hypertrophy

Question 29

Which medication is used as an antidote for cholinergic overdose?

Atropine sulfate

Epinephrine

Vancomycin

Insulin

Answer 29

Atropine sulfate

Question 30

After administration of atropine, which information would the nurse provide to the patient?

Select all that apply.

Drink adequate amounts of fluids.

Chew gum or suck on hard candy.

Maintain good oral hygiene.

Avoid the use of artificial tears.

Limit the consumption of dietary fiber.

Answer 30

Drink adequate amounts of fluids.

Chew gum or suck on hard candy.

Maintain good oral hygiene.

Question 31

Which therapeutic effect of atropine is expected after administration?

Improved urination

Increased salivation

Increased heart rate

Relieved constipation

Answer 31

Increased heart rate

Question 32

A patient is receiving bethanechol at 0900. At which time does the nurse anticipate the onset of action for the drug?

0915

1000

1100

1500

Answer 32

1000

Question 33

Which responses are expected after the administration of a cholinergic agonist?

Select all that apply.

Stimulation of urination

Stimulation of gastrointestinal (GI) tone

Pupillary constriction

Increase in neuromuscular transmission

Decrease in bronchial secretions

Answer 33

Stimulation of urination

Stimulation of gastrointestinal (GI) tone

Pupillary constriction

Increase in neuromuscular transmission

Question 34

Which condition is the primary indication for treatment with atropine?

Symptomatic bradycardia

Urinary retention

Myasthenia gravis

Multiple sclerosis

Answer 34

Symptomatic bradycardia

Question 35

Which medical conditions may be exacerbated by the use of cholinergic agonists?

Select all that apply.

Irritable bowel syndrome

Urinary obstruction

Asthma

Diabetes

Cancer

Answer 35

Irritable bowel syndrome

Urinary obstruction

Asthma

Question 36

The nurse receives a prescription from the health care provider to administer bethanechol intravenously. Which action by the nurse is appropriate?

Call the health care provider to get the prescription changed to the oral form.

Administer the medication.

Wait until the pharmacy calls the health care provider about the prescription.

Change the prescription in the computer to the correct route.

Answer 36

Call the health care provider to get the prescription changed to the oral form.

Question 37

When administering atropine preoperatively to prevent aspiration of respiratory secretions, how many minutes before anesthesia will the nurse give the drug?

    to           minutes 

Use numbers only.

Answer 37

30 to 60 minutes

Question 38

Which side effect will the nurse assess for after the administration of atropine?

Blurred vision

Abdominal cramping

Aspiration

Diaphoresis

Answer 38

Blurred vision

Question 39

Which adverse effects would the nurse monitor for in a patient receiving atropine?

Select all that apply.

Tachycardia

Bradycardia

Hyperthermia

Diarrhea

Hypertension

Answer 39

Tachycardia

Bradycardia

Hyperthermia

Question 40

The patient is experiencing muscle weakness and increased salivation after receiving a cholinergic medication. Which action by the nurse is the priority?

Notify the health care provider about potential cholinergic overdose.

Administer atropine.

Evaluate for hypertension.

Auscultate breath sounds.

Answer 40

Notify the health care provider about potential cholinergic overdose.

Question 41

Which information will the nurse provide to the patient receiving atropine?

Change positions slowly to prevent hypotension.

Use lip balm to prevent dry lips.

Use loperamide to prevent diarrhea.

Eat a banana to avoid leg cramps.

Answer 41

Use lip balm to prevent dry lips.

Question 42

Which information will the nurse include in a teaching plan for a patient receiving bethanechol?

Increase dietary fiber.

Decrease fluid consumption to 1 L/day.

Take ibuprofen for headaches.

Take the medication 1 hour before meals or 2 hours after meals.

Answer 42

Take the medication 1 hour before meals or 2 hours after meals.

Question 43

Specifically related to the side effect of orthostatic hypotension, the nurse would educate the patient to take which action?

Rise slowly from a lying position.

Do not shower while standing up.

Sleep in the supine position.

Use the call light and ask for assistance when mobile.

Answer 43

Rise slowly from a lying position.

Question 44

Which side effect of bethanechol is the nurse managing by performing frequent oral care?

Excessive salivation

Tonsillitis

Pharyngitis

Dry mouth

Answer 44

Excessive salivation