ANS - Autonomic Nervous System Homework Qs

Question 1

The nurse is assessing an adolescent after the administration of epinephrine. Which side effect is most important for the nurse to identify?
A. Tachycardia
B. Hypoglycemia
C. Constricted pupils
D. Decreased blood pressure

Answer 1

Tachycardia

Epinephrine is a sympathetic nervous system stimulant that primarily causes tachycardia.

Question 2

Which side effect would the nurse assess for after epinephrine is administered to an infant with severe bronchospasms?
A. Tachycardia
B. Hypotension
C. Respiratory arrest
D. Central nervous system depression

Answer 2

Tachycardia

Epinephrine stimulates beta- and alpha-receptors, increasing heart rate and blood pressure.

Question 3

A 12-year-old child has just received a dose of epinephrine. Which assessment is the priority after this medication is administered?
A. Heart rate
B. Glucose level
C. Neurological status
D. Blood pressure

Answer 3

Heart rate

Heart rate assessment is crucial due to the risk of significant tachycardia.

Question 4

A client is experiencing anaphylaxis from an insect sting. Which medication should the nurse administer?
A. Dopamine.
B. Ephedrine.
C. Epinephrine.
D. Diphenhydramine.

Answer 4

Epinephrine

Epinephrine is the medication of choice for treating anaphylaxis.

Question 5

A nurse is monitoring a client who received epinephrine for angioedema (facial swelling) after a first dose of losartan. Which of the following data indicates a therapeutic response to the epinephrine?
A. Respirations are unlabored.

B. Client reports decreased groin pain of 3 on a 1 to 10 scale.

C. The client’s blood pressure when arising from resting position is at premedication levels.

D. The client tolerates a second dose of medication with no greater than 1+ peripheral edema.

Answer 5

Respirations are unlabored.

Improvement in respiratory effort is the most important indicator of therapeutic response.

Question 6

A nurse is caring for a client who received an injection of penicillin G procaine. The client begins to experience dyspnea and tongue swelling. Which of the following actions should the nurse perform first?
A. Obtain intravenous fluids for administration.

B. Record the observed data in medical record.

C. Deliver a dose of aminophylline by inhalation.

D. Administer epinephrine subcutaneously, intramuscular or IV

Answer 6

Administer epinephrine subcutaneously, intramuscular, or IV

Administering epinephrine is the priority action in anaphylaxis.

Question 7

A client with a history of methamphetamine use is admitted to the medical unit. Which clinical manifestation would the nurse expect when assessing the client who is under the influence on admission?
A. Constricted pupils
B. Intractable diarrhea
C. Increased heart rate
D. Decreased respirations

Answer 7

Increased heart rate

Methamphetamine activates the sympathetic nervous system, increasing heart rate.

Question 8

Which body system is affected by excessive use of amphetamine/dextroamphetamine?
A. Renal
B. Cardiac
C. Musculoskeletal
D. Gastrointestinal

Answer 8

Cardiac

Excessive use can lead to increased heart rate and dysrhythmias.

Question 9

A client is admitted to the acute medical unit for severe amphetamine intoxication. Which medications are indicated to counteract the effects of stimulant intoxication?

A. Diazepam (anti-seizure/relaxation) & Propranol (anti-hypertensive/slows heart rate)

B. Digoxin (for Congestive Heart Failure/strengthens heart beat) & sertraline (anti-depressant)

C. Atropine (Anti-Cholinergic/speeds up heart, dries things out) & nitroglycerine (anti-hypertensive/vasodilation)

D. alendronate (Builds strong bones) & pancuronium (muscle paralytic)

Answer 9

Diazepam (anti-seizure/relaxation) & Propranol (anti-hypertensive/slows heart rate)

Diazepam reduces seizure risk, and Propranolol decreases adrenergic stimulation.

Question 10

Which drug category applies to cocaine?
A. Opioids
B. Stimulants
C. Barbiturates
D. Hallucinogens

Answer 10

Stimulants

Cocaine is classified as a stimulant, causing effects similar to amphetamines.

Question 11

Which medication is the first choice of medication for the treatment of attention-deficit/hyperactivity disorder (ADHD)?
A. Clonidine
B. Guanfacine
C. Atomoxetine
D. Methylphenidate

Answer 11

Methylphenidate

Methylphenidate is the first-line treatment for ADHD.

Question 12

The nurse is teaching the parents of a child with attention-deficit/hyperactivity disorder. Which medication would the nurse include as the frequently prescribed medication for this disorder?
A. Lorazepam
B. Haloperidol
C. Methylphenidate
D. Methocarbamol

Answer 12

Methylphenidate

Methylphenidate stimulates the release of norepinephrine in the brain.

Question 13

Which medications would NOT be indicated for management of attention-deficit/hyperactivity disorder (ADHD)?
A. Amphetamines
B. Benztropine
C. Methylphenidate
D. Dextroamphetamine

Answer 13

Benztropine

Benztropine is used for antipsychotic side effects, not ADHD treatment.

Question 14

Methylphenidate is prescribed to treat a child’s attention-deficit/hyperactivity disorder (ADHD). Which effect of methylphenidate is used in the treatment of ADHD in children?
A. Diuretic
B. Synergistic
C. Paradoxical/Opposite
D. Hypotensive

Answer 14

Paradoxical/Opposite

Methylphenidate has a calming effect on children with ADHD.

Question 15

A child with attention-deficit/hyperactivity disorder (ADHD) is prescribed methylphenidate. The mother asks about its action and side effects. Which response by the nurse is most appropriate?
A. ‘This medicine increases the appetite.’
B. ‘This medicine must be continued until adulthood.’
C. ‘It is a short-acting medicine that must be given with each meal.’
D. ‘It is a stimulant that has a calming effect on children with ADHD.’

Answer 15

‘It is a stimulant that has a calming effect on children with ADHD.’

Methylphenidate often leads to weight loss due to appetite suppression.

Question 16

A nurse is teaching the parents of a child who has ADHD about methylphenidate. Which of the following statements should the nurse include in the teaching?
A. “Administer the medication at bedtime.”

B. “Your child might gain weight while taking this medication.”

C. “This medication might increase the amount of saliva your child produces.”

D. “Restrict your child’s intake of caffeine while she is taking this medication.”

Answer 16

“Restrict your child’s intake of caffeine while she is taking this medication.”

Question 17

The clinic nurse is collecting data from a client who is taking prescribed methylphenidate for the treatment of attention deficit hyperactivity disorder (ADHD) and is requesting an increase in the dose. Which statement by the client would require immediate follow-up by the nurse?
A. “I think I have lost weight since I started taking the medication.”
B. “This medication is not calming me down even with green tea.”
C. “I take more naps during the day on this medication.”
D. “I am performing better at work but need to be more engaged.”

Answer 17

“This medication is not calming me down even with green tea.”

Combining caffeine with methylphenidate can exacerbate side effects.

Question 18

A health care provider prescribes methylphenidate for a child with attention-deficit/hyperactivity disorder (ADHD). Which instruction would the nurse provide when teaching the parents about this medication?
A. Monitor the effect of the medication on their child’s behavior.
B. Increase or decrease the dosage, depending on the child’s behavior.
C. Avoid imposing too many rules, because this will frustrate the child.
D. Reinforce to the child that behavior can be controlled.

Answer 18

Monitor the effect of the medication on their child’s behavior.

Administering with meals helps manage appetite suppression.

Question 19

Methylphenidate has been prescribed with meals for a child with attention-deficit/hyperactivity disorder (ADHD). Which rationale would the nurse provide for the parents about the timing of the medication administration?
A. Ritalin depresses the appetite.
B. This will ensure proper absorption.
C. It is an oral mucous membrane irritant.
D. Children tend to forget to take it before meals.

Answer 19

Ritalin depresses the appetite.

Methylphenidate can suppress appetite.

Question 20

The nurse is teaching the parents of a child with attention-deficit/hyperactivity disorder (ADHD) about the prescribed medication methylphenidate. Which time identifies when the daily dose will be administered?
A. Before breakfast
B. Just after breakfast
C. Immediately before lunch
D. As soon as the child awakens

Answer 20

Just after breakfast

This timing helps to minimize appetite suppression.

Question 21

Which test would the nurse identify as specific for the diagnosis of myasthenia gravis?
A. Electromyography
B. Pyridostigmine test
C. Edrophonium chloride test
D. History of physical deterioration

Answer 21

Edrophonium chloride test

This test provides immediate increases in muscle strength.

Question 22

A client is undergoing diagnostic testing for myasthenia gravis. Which test would the nurse identify as the most specific for this diagnosis?
A. Electromyography
B. Pyridostigmine test
C. Edrophonium chloride test
D. History of physical deterioration

Answer 22

Edrophonium chloride test

Question 23

A client suspected of having myasthenia gravis is scheduled for an edrophonium chloride test. To treat a common complication associated with the test, the nurse will have which medication available?
A. Atropine
B. Phenytoin
C. Neostigmine
D. Diphenhydramine

Answer 23

Atropine

Atropine is an anticholinergic used to counteract severe muscle weakness.

Question 24

A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis. The nurse prepares for intravenous administration of edrophonium chloride (Tensilon). What is the expected outcome for this client following administration of this pharmacologic agent?
A. Progressive difficulty with swallowing.
B. Decreased respiratory effort.
C. Improvement in generalized fatigue.
D. Decreased muscle weakness.

Answer 24

Decreased muscle weakness.

Edrophonium chloride temporarily reduces muscle weakness.

Question 25

Which conclusion would the nurse make about the development of loose stools and increased salivation two days after a client with myasthenia gravis begins taking pyridostigmine? A. The client is experiencing a myasthenic crisis. B. The medication is causing cholinergic side effects. C. The medication is triggering a paradoxical reaction. D. The client is exhibiting toxic effects of the medication.

Answer 25

The medication is causing cholinergic side effects. ## Footnote These effects result from increased parasympathetic activity.

Question 26

The anticholinesterase medication pyridostigmine is prescribed for the client with myasthenia gravis. When providing medication teaching, the nurse explains that the client should expect a decrease in which function? A. Bowel function B. Heart rate C. Skeletal muscle contraction D. Urinary frequency

Answer 26

Heart rate ## Footnote Increased cholinergic activity typically results in bradycardia.

Question 27

A client presents to the clinic for a follow-up appointment after starting pyridostigmine for management of myasthenia gravis. Which new client problem is NOT an adverse effect of pyridostigmine? A. Increased urinary frequency B. Diplopia (double vision) C. Muscle twitching D. Diarrhea

Answer 27

Diplopia (double vision) ## Footnote Diplopia is a symptom of myasthenia gravis, not a side effect of the medication.

Question 28

A client with myasthenia gravis begins taking pyridostigmine. Two days later, the client develops loose stools and increased salivation. Which conclusion would the nurse make about these new developments? A. The client is experiencing a myasthenic crisis. B. The medication is causing cholinergic side effects. C. The medication is triggering a paradoxical reaction. D. The client is exhibiting toxic effects of the medication.

Answer 28

The medication is causing cholinergic side effects. ## Footnote This timing coincides with the peak action of the medication.

Question 29

The health care provider prescribes neostigmine for a client with myasthenia gravis. Which client statement indicates understanding regarding medication management plans? A. 'I must keep the medication in a container in the refrigerator.' B. 'I should take the medication at the exact time that is listed on the prescription.' C. 'I will plan to take the medication between meals.' D. 'I expect that the onset of the medication’s action will occur several hours after I take it.'

Answer 29

'I should take the medication at the exact time that is listed on the prescription.' ## Footnote This minimizes dysphagia during feeding.

Question 30

Pyridostigmine bromide is prescribed for a client with myasthenia gravis. The nurse evaluates that the medication regimen is understood when the client makes which statement? A. 'I will take the medication on an empty stomach.' B. 'I need to set an alarm so I take the medication on time.' C. 'It will be important to check my heart rate before taking the medication.' D. 'I should monitor for an increase in blood pressure after taking the medication.'

Answer 30

'I need to set an alarm so I take the medication on time.' ## Footnote This action prolongs the effect of acetylcholine at the myoneural junction.

Question 31

A client with myasthenia gravis is receiving pyridostigmine bromide to control symptoms. Recently, the client has begun experiencing increased difficulty in swallowing. Which nursing action is effective in preventing aspiration of food? A. Place a tracheostomy set in the client’s room. B. Assess respiratory status after meals. C. Request for the diet to be changed from soft to clear liquids. D. Coordinate mealtimes with the peak effect of the medication.

Answer 31

Coordinate mealtimes with the peak effect of the medication. ## Footnote Neostigmine is an anticholinesterase that acts at the myoneural junction.

Question 32

Pyridostigmine is prescribed for a client with myasthenia gravis. Why would the nurse instruct the client to take pyridostigmine about 1 hour before meals? A. This timing limits first pass metabolism. B. Taking it on an empty stomach increases absorption. C. Taking it before meals decreases gastric irritation. D. Taking it before meals improves the ability to chew.

Answer 32

Taking it before meals improves the ability to chew. ## Footnote Cholinergics increase tone in the genitourinary tract by intensifying acetylcholine action.

Question 33

A client begins treatment with pyridostigmine bromide therapy for myasthenia gravis. Which action would the nurse perform in administration of the medication? A. Administer the medication after meals. B. Administer the medication on an empty stomach. C. Evaluate the client’s psychological responses between medication doses. D. Evaluate the client’s muscle strength every hour after the medication is given.

Answer 33

Evaluate the client’s muscle strength every hour after the medication is given.

Question 34

Which action would the nurse perform when beginning pyridostigmine bromide therapy for a client with myasthenia gravis? A. Administer the medication after meals. B. Administer the medication on an empty stomach. C. Evaluate the client’s psychological responses between medication doses. D. Evaluate the client’s muscle strength every hour after the medication is given.

Answer 34

Evaluate the client’s muscle strength every hour after the medication is given.

Question 35

A client with myasthenia gravis has been receiving neostigmine and asks about its action. Which information would the nurse consider when formulating a response? A. Stimulates the cerebral cortex B. Blocks the action of cholinesterase C. Replaces deficient neurotransmitters D. Accelerates transmission along neural sheaths

Answer 35

Blocks the action of cholinesterase

Question 36

The health care provider prescribes a cholinergic medication to treat a client’s urinary problem. Which effect would the nurse anticipate? A. Urinary frequency decreases. B. Urinary retention is prevented. C. Pain is controlled. D. Urinary urgency decreases.

Answer 36

Urinary retention is prevented.

Question 37

Cholinergic agonists are prescribed for which type of urinary condition? A. Kidney stones B. Urine retention C. Spastic bladder D. Urinary tract infections

Answer 37

Urine retention

Question 38

The nurse has administered fentanyl, atropine, cefazolin, and benzocaine to a client for an endoscopic procedure. The nurse is monitoring the client and notes that the heart rate has increased from the pre-procedure baseline. The nurse knows that which of the following medications is most likely responsible for the client's increased heart rate? A. Fentanyl B. Atropine C. Cefazolin D. Benzocaine

Answer 38

Atropine ## Footnote Atropine is an anticholinergic that can increase heart rate and dilate pupils.

Question 39

During a procedure, the client’s heart rate drops to 38 beats/min. Which medication is indicated to treat bradycardia? A. Digoxin B. Lidocaine C. Amiodarone D. Atropine sulfate

Answer 39

Atropine sulfate ## Footnote Atropine blocks vagal stimulation of the SA node, increasing heart rate.

Question 40

A nurse is caring for a client who has a cardiopulmonary arrest. The nurse anticipates the emergency response team will administer which of the following medications if the client’s restored rhythm is symptomatic bradycardia? A. Epinephrine B. Magnesium C. Atropine D. Sodium bicarbonate

Answer 40

Atropine ## Footnote Atropine is administered for symptomatic bradycardia during CPR.

Question 41

When a client exhibits severe bradycardia, which type of medication will the nurse be prepared to administer? A. Nitrate B. Anticholinergic C. Antihypertensive D. Cardiac glycoside

Answer 41

Anticholinergic ## Footnote Anticholinergics block parasympathetic effects, increasing heart rate.

Question 42

The nurse is caring for a client who has been prescribed atropine preoperatively. The nurse understands the intended purpose for administering this preoperatively is to induce which effect? A. Reduce heart rate B. Elevate blood pressure C. Enhance sedation D. Decrease secretions

Answer 42

Decrease secretions ## Footnote Atropine reduces secretions to decrease aspiration risk during surgery.

Question 43

Which action is likely to reduce the pancreatic and gastric secretions of a client with pancreatitis? A. Encourage clear liquids. B. Obtain a prescription for morphine. C. Assist the client into a semi-Fowler position. D. Administer prescribed anticholinergic medication such as atropine.

Answer 43

Administer prescribed anticholinergic medication such as atropine. ## Footnote Anticholinergics block impulses stimulating pancreatic and gastric secretions.

Question 44

The nurse is discharging a client with a new prescription for tiotropium to help manage the symptoms of chronic obstructive pulmonary disease. What information should the nurse include in the discharge teaching? A. It may be a few days before you feel the full effects of tiotropium. B. This medication cannot be used to relieve sudden breathing problems. C. Be sure to swallow the capsules with a full glass of water. D. A common side effect is nausea and loose stools.

Answer 44

This medication cannot be used to relieve sudden breathing problems. ## Footnote Tiotropium cannot be used for sudden breathing problems and should never be swallowed.

Question 45

The nurse in an urology office is developing a plan of care for a client newly diagnosed with urge urinary incontinence due to an overactive bladder. Which interventions should the nurse include? A. Administer anti-seizure medications B. Administration of cholinergic drugs C. Administration of anticholinergic drugs D. Administration of loop diuretics

Answer 45

Administration of anticholinergic drugs ## Footnote Anticholinergics relax smooth muscle and increase bladder capacity.

Question 46

The nurse is caring for a client who was recently prescribed atropine as a treatment for symptomatic bradycardia. Which condition should the nurse question as a contraindication when taking this medication? A. Urinary incontinence B. Right-sided heart failure C. Glaucoma D. Increased intracranial pressure

Answer 46

Glaucoma ## Footnote Atropine can increase intraocular pressure, worsening glaucoma.

Question 47

Which ophthalmic solution is contraindicated for clients with glaucoma? A. Timolol B. Atropine C. Pilocarpine D. Epinephrine

Answer 47

Atropine ## Footnote Atropine dilates pupils, increasing intraocular pressure.

Question 48

A health care provider prescribes tolterodine for a client with an overactive bladder. Which action is important to include in client teaching? A. Maintain a strict record of fluid intake and urinary output. B. Chew the extended-release capsule thoroughly before swallowing. C. Report episodes of diarrhea or any increase in respiratory secretions. D. Avoid activities requiring alertness until the response to medication is known.

Answer 48

Avoid activities requiring alertness until the response to medication is known. ## Footnote Tolterodine can cause dizziness and blurred vision.

Question 49

An adult client is given a prescription for a scopolamine patch (Transderm Scop) to prevent motion sickness while on a cruise. Which information should the nurse provide to the client? A. Apply the patch at least 4 hours prior to departure. B. Change the patch every other day while on the cruise. C. Place the patch on a hairless area at the base of the skull. D. Drink no more than 2 alcoholic drinks during the cruise.

Answer 49

Apply the patch at least 4 hours prior to departure. ## Footnote Scopolamine has a peak onset in 6 hours.

Question 50

A nurse at an ophthalmology clinic is providing teaching to a client who has open-angle glaucoma and a new treatment regimen of timolol and pilocarpine eye drops. Which of the following instructions should the nurse provide? A. Administer the medications by touching the tip of the dropper to the sclera of the eye. B. Hold pressure on the conjunctiva sac for 2 min following application of drops. C. Administer the medications 5 min apart. D. It is not necessary to remove contact lenses before administering medications.

Answer 50

Administer the medications 5 min apart. ## Footnote This prevents contamination and ensures proper absorption.

Question 51

Pilocarpine is used as part of the diagnostic process of a toddler suspected of cystic fibrosis. The nurse knows that the pilocarpine would stimulate which process? A. Secretion of mucus B. Activity of sweat glands C. Excretion of pancreatic enzymes D. Release of bile from the gallbladder

Answer 51

Activity of sweat glands ## Footnote Pilocarpine stimulates sweat production for diagnostic testing.

Question 52

A nurse is teaching the parents of a school-age child who has ADHD about atomoxetine. Which of the following instructions should the nurse include in the teaching? A. "Limit caloric intake to prevent excessive weight gain." B. "Avoid crowds due to the increased risk for infection." C. "Expect hyperactivity as a common adverse effect." D. "Give the dose in the morning to help prevent insomnia."

Answer 52

"Give the dose in the morning to help prevent insomnia." ## Footnote Atomoxetine can cause insomnia as a common adverse effect.