Autonomic Nervous System HW Qs

Question 1

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 1

B. Activity of sweat glands

Question 2

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 2

B. The medication is causing cholinergic side effects.

Question 3

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 3

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

Question 4

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 4

B. Heart rate

Question 5

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 5

B. ‘I should take the medication at the exact time that is listed on the prescription.’

Question 6

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 6

B. ‘I need to set an alarm so I take the medication on time.’

Question 7

A client presents to the clinic for a follow-up appointment after starting pyridostigmine for management of myasthenia gravis. Which new client problems are adverse effects of pyridostigmine? Select all that apply. One, some, or all responses may be correct.
A. Respiratory depression
B. Increased urinary frequency
C. Diplopia
D. Muscle twitching
E. Diarrhea

Answer 7

B. Increased urinary frequency
D. Muscle twitching
E. Diarrhea

Question 8

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 8

D. Coordinate mealtimes with the peak effect of the medication.

Question 9

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 9

D. Taking it before meals improves the ability to chew.

Question 10

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 10

B. The medication is causing cholinergic side effects.

Question 11

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 11

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

Question 12

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 12

B. Blocks the action of cholinesterase

Question 13

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 13

B. Urinary retention is prevented.

Question 14

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

Answer 14

B. Urine retention

Question 15

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 15

C. Edrophonium chloride test

Question 16

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 16

A. Atropine

Question 17

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 17

C. Edrophonium chloride test

Question 18

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 18

D. Decreased muscle weakness.

Question 19

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 19

A. Tachycardia

Question 20

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 20

A. Tachycardia

Question 21

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 21

A. Heart rate

Question 22

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

Answer 22

C. Epinephrine.

Question 23

A client develops extrapyramidal effects after taking a neuroleptic medication, and the nurse notes extrapyramidal effects. Which medication can limit these side effects?
A. Zolpidem
B. Hydroxyzine
C. Dantrolene
D. Benztropine mesylate

Answer 23

D. Benztropine mesylate

Question 24

A client receiving fluphenazine decanoate develops dystonia/extrapyramidal side effect early in therapy. Which medication would the nurse anticipate administering to reverse this side effect?
A. Nafarelin
B. Fluoxetine
C. Trandolapril
D. Benztropine

Answer 24

D. Benztropine

Question 25

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 25

D. Decrease secretions

Question 26

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 26

B. Atropine

Question 27

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 27

D. Atropine sulfate

Question 28

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 28

C. Glaucoma

Question 29

The nurse is reviewing the medical record of a client who received a new prescription for benztropine. For which condition in the client’s record should the nurse clarify the prescription with the health care provider?
A. Cataracts
B. Schizophrenia
C. Glaucoma
D. Parkinson’s disease

Answer 29

C. Glaucoma

Question 30

A client with Parkinson’s disease is prescribed benztropine (Cogentin). For which of the following should the nurse call the health care provider immediately?
A. The client is complaining of dizziness when standing up.
B. The client is exhibiting bradykinesia and slurred speech.
C. The client’s heart rate increased from 80 to 95 beats per minute.
D. The client has a history of primary angle-closure glaucoma.

Answer 30

D. The client has a history of primary angle-closure glaucoma.

Question 31

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

Answer 31

B. Atropine

Question 32

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 32

B. This medication cannot be used to relieve sudden breathing problems.

Question 33

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 33

B. Anticholinergic

Question 34

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.

Answer 34

D. Administer prescribed anticholinergic medication.

Question 35

The nurse in a 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 35

C. Administration of anticholinergic drugs

Question 36

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 36

C. Increased heart rate

Question 37

A client is admitted to the acute medical unit for severe amphetamine intoxication. Which medications are indicated to counteract the effects of stimulant intoxication? Select all that apply. One, some, or all responses may be correct.
A. Diazepam
B. Propranolol
C. Benztropine
D. Bupropion
E. Amitriptyline

Answer 37

A. Diazepam
B. Propranolol

Question 38

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

Answer 38

B. Stimulants

Question 39

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

Answer 39

B. Cardiac

Question 40

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 40

A. Apply the patch at least 4 hours prior to departure.

Question 41

Which medication class includes amitriptyline?
A. Tricyclics
B. Monoamine oxidase inhibitors (MAOIs)
C. Selective serotonin reuptake inhibitors (SSRIs)
D. Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Answer 41

A. Tricyclics

Question 42

Nortriptyline is prescribed for a depressed client. Which time period identifies when the nurse would expect a therapeutic response?
A. 1 to 3 days
B. 12 to 24 hours
C. 30 minutes to 2 hours
D. 2 to 3 weeks

Answer 42

D. 2 to 3 weeks

Question 43

An 80-year-old client with depression requires the prescription of antidepressant medication. Which tricyclic antidepressant medication causes fewer complications in older clients?
A. Doxepin
B. Amoxapine
C. Nortriptyline
D. Trimipramine

Answer 43

C. Nortriptyline

Question 44

A 65-year-old client is receiving amitriptyline. Which recommendation will the nurse make to the client concerning this medication?
A. ‘Obtain a complete cholesterol and lipid profile.’
B. ‘Have an eye examination to check for glaucoma.’
C. ‘Check your temperature daily for nighttime increases.’
D. ‘Watch for excessive sweating and possible weight loss.’

Answer 44

B. ‘Have an eye examination to check for glaucoma.’

Question 45

A depressed client has been prescribed a tricyclic antidepressant. Which time period indicates how long it usually takes before the client notices a significant change in the depression?
A. 4 to 6 days
B. 2 to 4 weeks
C. 5 to 6 weeks
D. 12 to 16 hours

Answer 45

B. 2 to 4 weeks

Question 46

Which statement accurately describes nortriptyline? Select all that apply. One, some, or all responses may be correct.
A. Overdosage is often lethal.
B. Constipation and urinary retention may occur.
C. It is a selective serotonin reuptake inhibitor (SSRI).
D. Weight gain is a common side effect.
E. It increases effectiveness of monoamine oxidase inhibitors (MAOIs).

Answer 46

A. Overdosage is often lethal.
B. Constipation and urinary retention may occur.
D. Weight gain is a common side effect.

Question 47

The nurse is teaching a nursing student about tricyclic antidepressant medications. Which statement made by the student indicates the need for further teaching? Select all that apply. One, some, or all responses may be correct.
A. Nortriptyline is contraindicated in older adult clients.
B. Desipramine is preferred for use in older adult clients.
C. Imipramine is used as an adjunct in the treatment of childhood enuresis.
D. Tricyclic antidepressant medications are prescribed for clients with seizure disorders.
E. Tricyclic antidepressant medications are contraindicated in clients with a history of seizures.

Answer 47

A. Nortriptyline is contraindicated in older adult clients.
D. Tricyclic antidepressant medications are prescribed for clients with seizure disorders.

Question 48

The nurse is teaching a client diagnosed with depression about a new prescription of nortriptyline. What information would be essential for the nurse to emphasize about this medication?
A. Episodes of diarrhea can be expected
B. The medication must be stored in the refrigerator
C. The use of alcohol should be avoided
D. Symptom relief occurs in a few days

Answer 48

C. The use of alcohol should be avoided

Question 49

An 11-year-old client reports having bedwetting issues (enuresis). Which medication would the nurse anticipate when developing a teaching plan?
A. Alprazolam
B. Imipramine
C. Lithium salts
d. Clomipramine

Answer 49

B. Imipramine

Question 50

Which adverse effect of imipramine requires further assessment and possible immediate medical intervention?
A. Dry mouth
B. Weight gain
C. Blurred vision
D. Urinary hesitancy

Answer 50

D. Urinary hesitancy

Question 51

Which nursing action is appropriate when administering imipramine?
A. Telling the client steroids will not be prescribed
B. Warning the client not to eat cheese
C. Monitoring the client for increased tolerance
D. Having the client checked for increased intraocular pressure

Answer 51

D. Having the client checked for increased intraocular pressure

Question 52

Which instruction would the nurse give to clients prescribed psychotropic medications who are experiencing anticholinergic-like side effects?
A. ‘Restrict fluid intake.’
B. ‘Eat a diet high in carbohydrates.’
C. ‘Suck on sugar-free hard candies.’
D. ‘Avoid products that contain aspirin.’

Answer 52

C. ‘Suck on sugar-free hard candies.’

Question 53

The nurse is teaching a client about tricyclic antidepressants. Which potential side effects would the nurse include? Select all that apply. One, some, or all responses may be correct.
A. Dry mouth
B. Drowsiness
C. Constipation
D. Severe hypertension
E. Orthostatic hypotension

Answer 53

A. Dry mouth
B. Drowsiness
C. Constipation
E. Orthostatic hypotension

Question 54

To which nursing home resident could a nurse safely administer tricyclic antidepressants without questioning the health care provider’s order?
A. A client with mild hypertension
B. A client with narrow-angle glaucoma
C. A client with coronary artery disease (CAD)
D. A client with benign prostatic hypertrophy (BPH)

Answer 54

A. A client with mild hypertension

Question 55

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 55

D. Avoid activities requiring alertness until the response to medication is known.

Question 56

Which medication is indicated for emergency treatment of bleeding esophageal varices?
A. Vasopressin
B. Neostigmine
C. Lansoprazole
D. Phytonadione

Answer 56

A. Vasopressin