The Nervous System Cholinergic Drugs Affecting the Autonomic Nervous System

Question 1

Which Muscarinic antagonist should the nurse expect to be prescribed?
a) oxybutynin
b) benztropine
c) ipratropium
d) donepezil

Answer 1

a) oxybutynin

Question 2

An older patient taking a cholinergic antagonist asks why fiber needs to be increased in the diet.

Which response should the nurse make?
a) “These drugs interfere with absorption of nutrients.”
b) “These drugs cause a dry mouth and increased thirst.”
c) “These drugs slow peristalsis, causing constipation.”
d) “These drugs can cause malnutrition and lower protein stores.”

Answer 2

c) “These drugs slow peristalsis, causing constipation.”

Question 3

The nurse is preparing to administer a cholinergic antagonist to an older patient with decreased mobility.

Which nursing intervention should the nurse include to prevent complications from this drug?
a) enforce fluid restriction
b) increase dietary fiber
c) keep the room warm
d) maintain a well-lit room

Answer 3

b) increase dietary fiber

Question 4

The nurse is preparing to administer bethanechol (Urecholine) to a patient with urinary retention.

For which finding should the nurse realize this medication is contraindicated?
a) xerostomia
b) open-angle glaucoma
c) atrial fibrillation
d) epilepsy

Answer 4

d) epilepsy

Question 5

A patient with an apical pulse of 44 beats/min reports dizziness.

Which cholinergic antagonist should the nurse expect the healthcare provider to prescribe?
a) atropine
b) tolterodine
c) tiotropium
d) dicyclomine

Answer 5

a) atropine

Question 6

A patient with urinary retention is prescribed bethanechol (Urecholine).

For which side effect should the nurse monitor the patient?
a) changes in respiratory rate and pattern
b) seizures
c) orthostatic blood pressure changes
d) urinary incontinence

Answer 6

c) orthostatic blood pressure changes

Question 7

A patient with Parkinson’s disease who is prescribed benztropine asks about the purpose of the drug.

Which response should the nurse make?
a) “Benztropine will manage the excessive drooling.”
b) “Benztropine is used to decrease the muscle tremors and rigidity.”
c) “Benztropine is a medication to manage gastrointestinal symptoms.”
d) “Benztropine is used to manage sedation and confusion.”

Answer 7

b) “Benztropine is used to decrease the muscle tremors and rigidity.”

Question 8

A patient is diagnosed with glaucoma.

Which medication should the nurse anticipate being prescribed for this patient?
a) neostigmine
b) physostigmine
c) cevimeline
d) pilocarpine

Answer 8

d) pilocarpine

Question 9

The nurse is reviewing the medication profile for a patient in the hospital.

Which medication classification should the nurse identify that dries secretions?
a) muscarinic antagonist
b) nicotinic antagonist
c) muscarinic agonist
d) nicotinic agonist

Answer 9

a) muscarinic antagonist

Question 10

A patient is prescribed ipratropium.

Which information should the nurse include when teaching the patient about this medication?
a) It decreases the heart rate and cardiac workload.
b) It causes pupillary constriction and decreases photophobia.
c) It causes bronchodilation and opens airways.
d) It increases the amount and consistency of secretions.

Answer 10

c) It causes bronchodilation and opens airways.

Question 11

The nurse notes that a patient with bradycardia is prescribed atropine.

For which finding in the medical record should the nurse withhold the medication and contact the healthcare provider?
a) irritable bowel syndrome
b) glaucoma
c) urinary incontinence
d) peptic ulcer disease

Answer 11

b) glaucoma

Question 12

The nurse notes that a patient is prescribed pilocarpine in the right eye three times a day.

Which medical diagnosis should the nurse expect for this patient?
a) eye infection
b) dry eye syndrome
c) cataract
d) glaucoma

Answer 12

d) glaucoma

Question 13

A patient with pneumonia has increased dyspnea, crackles in the lung bases, and an oxygen saturation level of 89%.

Which finding should the nurse expect to assess after administering ipratropium to this patient?
a) increased oxygen saturation
b) decreased pulmonary congestion
c) increased nasal congestion
d) decreased physical endurance

Answer 13

a) increased oxygen saturation

Question 14

A patient is prescribed atropine.

For which additional medication should the nurse question be giving this medication?
a) lisinopril
b) melatonin
c) quinidine
d) guaifenesin

Answer 14

c) quinidine

Question 15

The nurse assesses a patient receiving a muscarinic agonist.

For which finding should the nurse administer atropine?
a) dry mouth and mucous membranes
b) hallucinations and confusion
c) inability to urinate for 8 hours
d) blurred vision

Answer 15

b) hallucinations and confusion

Question 16

The nurse teaches about the use of donepezil (Aricept) for Alzheimer disease.

Which statement should indicate that additional teaching about the medication is required?
a) “This medication increases acetylcholine in the brain’s synapses.”
b) “This medication improves memory and cognitive function.”
c) “This medication only improves symptoms in the short term.”
d) “This medication will cure Alzheimer disease.”

Answer 16

d) “This medication will cure Alzheimer disease.”

Question 17

A patient with bradycardia has glaucoma.

Which drug should the nurse recall is contraindicated for this patient?
a) atropine
b) oxybutynin
c) hyoscyamine
d) donepezil

Answer 17

a) atropine

Question 18

A patient with a history of chronic obstructive pulmonary disease reports increased dyspnea at times during the day.

Which muscarinic antagonist should the nurse suspect to be beneficial for this patient?
a) tropism
b) tropicamide
c) ipratropium
d) benztropine

Answer 18

c) ipratropium

Question 19

A patient is prescribed a direct-acting cholinergic agonist.

Which action should the nurse expect to occur from this medication?
It binds to acetylcholine receptors, enhancing the action potential on the postsynaptic neuron.
a) It binds to the enzyme acetylcholinesterase that prevents acetylcholine from being destroyed.
b) It binds to acetylcholine receptors, enhancing the action potential on the postsynaptic neuron.
c)It increases the amount of acetylcholine remaining at the synaptic cleft.
d) It enhances the action potential on the postsynaptic neuron.

Answer 19

b) It binds to acetylcholine receptors, enhancing the action potential on the postsynaptic neuron.

Question 20

The nurse is asked to explain cholinergic drugs.

In which area should the nurse explain these drugs act in the somatic nervous system?
a) In the neuroeffector junctions
b) In the ganglia
c) In the acetylcholine (ACh) synapses located in the autonomic ganglia
d) In the neuromuscular junction, resulting in skeletal muscle contraction

Answer 20

d) In the neuromuscular junction, resulting in skeletal muscle contraction

Question 21

A patient is prescribed atropine.

Which intervention should the nurse include in the plan of care for this patient?
a) Monitor heart rate and rhythm
b) place in the prone position
c) increase oral fluid intake
d) promote independent ambulation

Answer 21

a) Monitor heart rate and rhythm

Question 22

A patient reports long-term use of bethanechol (Urecholine).

Which finding should indicate to the nurse that the medication is no longer effective?
a) Blurred vision
b) Difficulty swallowing
c) distended bladder
d) increased diaphoresis

Answer 22

c) distended bladder

Question 23

A patient with myasthenia gravis is prescribed pyridostigmine (Regonol).

Which assessment finding should indicate that the medication is effective?
a) Abdominal cramping
b) Lack of eye drooping
c) hyperglycemia
d) increased heart rate

Answer 23

b) Lack of eye drooping

Question 24

The nurse reviews the use of neuromuscular blockers and actions with a group of new colleagues.

Which statement should indicate that teaching was effective?
a) “Neuromuscular blockers inhibit transmission at the ganglia in the sympathetic nervous system.”
b) “Neuromuscular blockers compete with acetylcholine for binding with muscarinic receptors.”
c) “Neuromuscular blockers allow the symptoms of the sympathetic nervous system to predominate.”
d) “Neuromuscular blockers affect skeletal muscles in the somatic nervous system.”

Answer 24

d) “Neuromuscular blockers affect skeletal muscles in the somatic nervous system.”

Question 25

The nurse administers a muscarinic antagonist to a patient. Which response should the nurse expect that demonstrates suppression of acetylcholine at the receptor sites? a) Drying of secretions b) Pupil constriction c) Decreased heart rate d) Bronchoconstriction

Answer 25

a) Drying of secretions

Question 26

An older patient is receiving atropine. For which side effect should the nurse add interventions to prevent injury in this patient? a) Tachycardia b) Dry mouth c) Blurred vision d) Constipation

Answer 26

c) Blurred vision

Question 27

The nurse is preparing to administer a muscarinic antagonist to a patient. Which mechanism of action should the nurse expect from this drug? a) Blocks cholinergic synapse receptors in the ganglia or somatic nervous system b) Blocks cholinergic synapse receptors in the parasympathetic nervous system c) Binds to cholinergic synapse receptors in the sympathetic nervous system d) Binds to cholinergic synapse receptors in the parasympathetic nervous system

Answer 27

b) Blocks cholinergic synapse receptors in the parasympathetic nervous system

Question 28

A patient is experiencing cramping and diarrhea related to irritable bowel syndrome. Which muscarinic antagonist should the nurse expect to be prescribed? a) Methscopolamine b) Fesoterodine c) Solifenacin d) Dicyclomine

Answer 28

d) Dicyclomine

Question 29

A patient taking bethanechol (Urecholine) asks when to expect to feel the effects of the medication. Which information should the nurse provide the patient? a) 30–90 minutes b) 5–10 minutes c) 1–6 hours d) 1–2 days

Answer 29

a) 30–90 minutes

Question 30

Which of the following is a component of the brain? a) Cerebellum b) Hippocampus c) RAS d) Basal ganglia

Answer 30

a) Cerebellum

Question 31

Which of the following best described an agonist? a) Inhibits the effect of the endogenous substance b) Promotes the effect of the endogenous substance c) Promotes the effect of the endogenous substance to a set point d) Inhibits the effect of the endogenous substance to a set point

Answer 31

b) Promotes the effect of the endogenous substance

Question 32

Which of the following is related to the parasympathetic nervous system? *Select all that apply a) Norepinephrine b) Rest and Digest c) Acetylcholine d) Fight or Flight

Answer 32

B) Rest and Digest C) Acetylcholine

Question 33

Which of the following is related to the sympathetic nervous system? *Select all that apply a) Norepinephrine b) Rest and Digest c) Acetylcholine d) Fight or Flight

Answer 33

A) Norepinephrine D) Fight or Flight

Question 34

Stimulation of alpha and beta receptors have effects like which neurotransmitter? a) Acetylcholine b) Norepinephrine c) Dopamine d) Serotonin

Answer 34

b) Norepinephrine

Question 35

A beta agonist will treat which of the following conditions? a) Overactive bladder b) Asthma c) Hypertension d) Dementia

Answer 35

b) Asthma

Question 36

Which of the following are involved in the sympathetic nervous system? *Select all that apply a) Muscarinic receptors b) Beta receptors c) Nicotinic receptors d) Alpha receptors

Answer 36

b) Beta receptors d) Alpha receptors

Question 37

Which of the following are involved in the parasympathetic nervous system? *Select all that apply a) Muscarinic receptors b) Beta receptors c) Nicotinic receptors d) Alpha receptors

Answer 37

a) Muscarinic receptors c) Nicotinic receptors