Chapter 33- Anticholinergic Agents.txt

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miscella
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162111
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Chapter 33- Anticholinergic Agents.txt
Updated:
2012-07-11 15:07:49
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antichollinergic
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Pharm ch 34 antichollinergic
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  1. 1.
    • A student asks the pharmacology instructor to explain the action of anticholinergic agents. What would be the instructor's best response?
    • A)
    • They block nicotinic receptors
    • B)
    • They compete with serotonin for muscarinic acetylcholine receptor sites
    • C)
    • They act to block the effects of the parasympathetic nervous system
    • D)
    • The increase norepinephrine at the neuromuscular junction
  2. 2.
    • A patient calls the clinic and talks to the nurse. The patient tells the nurse they are going on a cruise and they are concerned about motion sickness. The patient says that a friend has recommended that he see his primary care physician and get a prescription for scopolamine. What adverse effect would the nurse inform the patient that using scopolamine may result in?
    • A)
    • Pupil constriction
    • B)
    • Tachycardia
    • C)
    • Diarrhea
    • D)
    • Urinary incontinence
  3. 3.
    • A 29-year-old male is going on a company sponsored deep-sea fishing trip in two weeks. He comes to the clinic requesting a scopolamine patch because he is afraid that he will get sick. The medication is prescribed for him and the nurse's instructions concerning use of the patch will include what?
    • A)
    • Shave the area before applying the patch.
    • B)
    • The patch's effectiveness will last about 72 hours.
    • C)
    • When replacing the patch, apply the new patch in the same area.
    • D)
    • Do not clean the application area before applying the patch.
  4. 4.
    • The nurse is taking a health history on a new patient who has been prescribed propantheline (ProBanthine) as adjunctive therapy for peptic ulcers. During the health history what will the nurse ask specifically about?
    • A)
    • Diabetes mellitus
    • B)
    • Obsessive-compulsive disorder
    • C)
    • Insomnia
    • D)
    • Glaucoma
  5. 5.
    • A nurse is admitting a patient for outpatient eye surgery. The nurse routinely administers preoperative medications for eye surgery and is aware that an increased dosage of a mydriatic is likely when given to a member of what ethnic group?
    • A)
    • African Americans
    • B)
    • German Americans
    • C)
    • Irish Americans
    • D)
    • Scandinavian Americans
  6. 6.
    • A patient has been newly diagnosed with irritable bowel syndrome (IBS). The nurse knows that the most likely choice of anticholinergic drug to be prescribed for this patient is what?
    • A)
    • Atropine (Generic)
    • B)
    • Dicyclomine (Antispas)
    • C)
    • Glycopyrrolate (Robinul)
    • D)
    • Propantheline (ProBanthine)
  7. 7.
    • A patient has come to the clinic for a follow-up visit. They have been taking glycopyrrolate (Robinul) for adjunctive management of their peptic ulcer disease for one year. What would the nurse question the patient concerning?
    • A)
    • Diarrhea
    • B)
    • Diet
    • C)
    • Headaches
    • D)
    • Oral hygiene
  8. 8.
    • A 73-year-old male with Parkinson's disease comes to the clinic for routine care. The man has a co-morbidity of benign prostatic hyperplasia (BPH). An anticholinergic drug is prescribed for the patient. What is the most important instruction the nurse can give to the patient in regard to his medication and medical diagnoses?
    • A)
    • Avoid a warm environment
    • B)
    • Avoid driving his car while taking the drug
    • C)
    • Call his doctor if he cannot urinate
    • D)
    • Take the drug with food to avoid GI upset
  9. 9.
    • A patient has been given atropine to cause mydriasis and cycloplegia. What is the expected outcome for this patient?
    • A)
    • Constricted pupils and blurred vision
    • B)
    • Dilated pupils and improved vision
    • C)
    • Dilated pupils and blurred vision
    • D)
    • Dry eyes and constricted pupils
  10. 10.
    • Because the effects of atropine are dose related, at what dose of atropine would the nurse expect to see a patient having difficulty speaking?
    • A)
    • 0.5 mg
    • B)
    • 1.0 mg
    • C)
    • 2.0 mg
    • D)
    • 5.0 mg
  11. 11.
    • A 66-year-old woman presents at the clinic complaining of motion sickness. The physician orders a scopolamine patch. Which statement by the patient leads you to believe she knows how to use the patch?
    • A)
    • “I will place it on my chest each morning after I shower.”
    • B)
    • “I will use it only if I feel sick to my stomach.”
    • C)
    • “I will change the patch every 4 hours. I can use the patches for 1 week.”
    • D)
    • “I will change the patch every 3 days.”
  12. 12.
    • Your patient is scheduled for surgery in 2 hours. The physician orders preoperative medications glycopyrrolate (Robinul) 1 mg and meperidine (Demerol) 50 mg IM. Before administering these medications, you should assess your patient for what disorder?
    • A)
    • Tachycardia
    • B)
    • Glaucoma
    • C)
    • Hypertension
    • D)
    • Diabetes mellitus
  13. 13.
    • The pharmacology instructor is talking with his students about anticholinergic drugs. What would the instructor tell the students is the drug of choice for atropine poisoning?
    • A)
    • Bethanechol
    • B)
    • Neostigmine
    • C)
    • Edrophonium
    • D)
    • Physostigmine
  14. 14.
    • Because of the systemic effects of anticholinergic drugs older adults using these drugs are susceptible to what?
    • A)
    • Heat stroke related to decreased perspiration
    • B)
    • Diarrhea related to increased peristalsis
    • C)
    • Urinary frequency related to the diuretic effect of the medication
    • D)
    • Hypotension related to increased sympathetic response
  15. 15.
    • A 50-year-old female patient received atropine and meperidine (Demerol) preoperatively. After surgery, the patient complains of mouth dryness. What would the best response be to the patient?
    • A)
    • “This is caused by your preoperative medication, which decreased your saliva. It is only temporary and will improve.”
    • B)
    • “This is caused by loss of body fluid, which is induced by atropine.”
    • C)
    • “You are probably dehydrated. The IV fluids you are receiving will correct the problem.”
    • D)
    • “The preoperative medication causes an electrolyte imbalance that is corrected by IV potassium.”
  16. 16.
    • Anticholinergics have varied effects on the body. What is one of those effects?
    • A)
    • Preventing vagal stimulation
    • B)
    • Stimulating the release of acetylcholine
    • C)
    • Increasing respiratory tract secretions
    • D)
    • Increasing secretion of sweat glands
  17. 17.
    • Anticholinergic drugs are used in ophthalmology because they produce which effect?
    • A)
    • Sedation
    • B)
    • Pupil dilation
    • C)
    • Pupil constriction
    • D)
    • Decreased lacrimal secretions
  18. 18.
    • A male patient, age 75, is started on flavoxate (Urispas). What adverse effects should the patient be made aware of?
    • A)
    • Skin rash
    • B)
    • Headache
    • C)
    • Weight gain
    • D)
    • Blurred vision
  19. 19.
    • In ophthalmology anticholinergic, drugs are used because they produce which effect?
    • A)
    • Sedation
    • B)
    • Pupil dilation
    • C)
    • Pupil constriction
    • D)
    • Decreased lacrimal secretions
  20. 20.
    • What is the recommended dosage for atropine for a patient with a bradydysrhythmia?
    • A)
    • 0.2–0.4 mg
    • B)
    • 0.3–0.5 mg
    • C)
    • 0.4–0.6 mg
    • D)
    • 0.5–0.7 mg
  21. 21.
    • Anti-cholinergic drugs are used in the pediatric population for basically the same reasons as in the adult population. Anticholinergic drugs can have the same adverse effects in the pediatric population as in the adult population. What is a difference between the pediatric population and the adult population and anti-cholinergic drugs?
    • A)
    • Skin rashes do not occur in children
    • B)
    • Effects are more severe in children
    • C)
    • Facial flushing is rare
    • D)
    • Effects are less severe in children
  22. 22.
    • The nurse is writing a plan of care for a patient taking anticholinergic drugs. What is an appropriate goal for this patient's plan of care?
    • A)
    • The patient will ineffectively cope with expected effects of drugs
    • B)
    • The patient will demonstrate ability to self-administer drugs incorrectly
    • C)
    • The patient will experience relief of symptoms for which anticholinergics are given
    • D)
    • Verbalize appropriate knowledge of other drugs, their effects, and side effects
  23. 23.
    • The nursing instructor is talking with the nursing students about the use of anticholinergic drugs in patients with ureteral colic. What should the instructor tell the students about the use of anticholinergic drugs in this group of patients?
    • A)
    • Has little antispasmodic effect on the involved muscles
    • B)
    • Is not used alone for this purpose
    • C)
    • Relaxes ureteral colic
    • D)
    • Excites the stimulating effects of acetylcholine
  24. 24.
    • A 72-year-old female patient is being discharged home from the hospital on newly prescribed anticholinergic drugs. A referral to the home health nurse has been made. What should the home health nurse make sure the patient and caregivers know?
    • A)
    • Do not drive or use machinery
    • B)
    • Take lots of hot baths or showers
    • C)
    • There is a decreased risk of heat stroke
    • D)
    • Limit intake of fluid
  25. 25.
    • Anticholinergic drugs are used to treat a variety of disease processes. What should the patient newly prescribed anticholinergic drugs by taught by the nurse?
    • A)
    • Do not drive or operate machinery until you know how it affects you
    • B)
    • Take cool baths early in the morning and late at night
    • C)
    • Wear dark, warm clothing
    • D)
    • Decrease fluid intake and increase salt intake
  26. 26.
    • A patient taking anticholinergic drugs should be taught to minimize the risks of heat exhaustion and heat stroke. What would be one way to meet this goal?
    • A)
    • Take frequent, cold showers in the evenings and early mornings
    • B)
    • Wear dark, warm clothing during the summer months
    • C)
    • Routinely exercise indoors
    • D)
    • Avoid extremes of temperature
  27. 27.
    • A 27-year-old male patient is taking an anticholinergic drug as adjunctive therapy to treat his peptic ulcer disease. The patient comes to the clinic and tells the nurse that he “feels his heart beating.” What adverse effect is the patient experiencing from the anticholoinergic medication?
    • A)
    • Tachypnea
    • B)
    • Tachycardia
    • C)
    • Hypotension
    • D)
    • Urinary frequency
  28. 28.
    • You are the nurse in a respiratory clinic. The mother of a 10-year-old brings her child to the clinic for his asthma and the physician orders atrovent. Prior to giving the drug what would be a priority nursing action?
    • A)
    • Perform a physical assessment including a review of all body systems
    • B)
    • Assess drug effectiveness
    • C)
    • Assess for any adverse effects
    • D)
    • Establish change in disease process
  29. 29.
    • You are caring for a patient who has just been started on an anticholinergic medication as adjunct therapy for his peptic ulcers. When writing this patient's plan of care an appropriate nursing diagnosis would be what?
    • A)
    • Chronic pain related to GI, CNS, genitourinary, and cardiovascular effects
    • B)
    • Impaired urinary elimination related to bladder relaxation
    • C)
    • Risk for hyperthermia related to increased ability to sweat
    • D)
    • Increased cardiac output related to cardiovascular effects
  30. 30.
    • What does parasympathetic nervous system blockade cause? (Mark all that apply.)
    • A)
    • Decrease in heart rate
    • B)
    • Decrease in urinary bladder tone
    • C)
    • Increase in heart rate
    • D)
    • Pupil contraction
    • E)
    • Decrease in GI activity
  31. 1.C2.B3.B4.D5.A6.B7.D8.C9.C10.D11.D12.B13.D14.A15.A16.A17.B18.D19.B20.C21.B22.C23.C24.A25.A26.D27.B28.A29.B30.B, C, E
  32. B
    • 28.
    • A
    • 29.
    • B
    • 30.
    • B, C, E

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