Instructor Proof

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/EChapter 13

Question 1Type: MCSAThe patient receives methyldopa (Aldomet), an adrenergic drug. The nurse determines that the patient is having side effects when the patient makes which statement?

1. "Will you check my pupils? I can't see very well at all."2. "I am so thirsty; will you please bring me another pitcher of water?"3. "I am so anxious; I really need to walk around the room."4. "I feel so sleepy that I don't think I can eat my dinner."Correct Answer: 3Rationale 1: Adrenergic drugs mimic the effect of the sympathetic nervous system (SNS). This can result in anxiety and restlessness. Adrenergic drugs increase alertness, so the patient would not be sleepy. Anticholinergic, not adrenergic drugs, dry secretions, therefore the patient would not be thirsty. Adrenergic drugs dilate the pupils, so vision should not be affected.Rationale 2: Adrenergic drugs mimic the effect of the sympathetic nervous system (SNS). This can result in anxiety and restlessness. Adrenergic drugs increase alertness, so the patient would not be sleepy. Anticholinergic, not adrenergic drugs, dry secretions, therefore the patient would not be thirsty. Adrenergic drugs dilate the pupils, so vision should not be affected.Rationale 3: Adrenergic drugs mimic the effect of the sympathetic nervous system (SNS). This can result in anxiety and restlessness. Adrenergic drugs increase alertness, so the patient would not be sleepy. Anticholinergic, not adrenergic drugs, dry secretions, therefore the patient would not be thirsty. Adrenergic drugs dilate the pupils, so vision should not be affected.Rationale 4: Adrenergic drugs mimic the effect of the sympathetic nervous system (SNS). This can result in anxiety and restlessness. Adrenergic drugs increase alertness, so the patient would not be sleepy. Anticholinergic, not adrenergic drugs, dry secretions, therefore the patient would not be thirsty. Adrenergic drugs dilate the pupils, so vision should not be affected.Global Rationale: Cognitive Level: ApplyingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: EvaluationLearning Outcome: 13-5Question 2Type: MCSAThe patient receives metaproterenol (Alupent), an adrenergic drug. A consulting physician orders carteolol (Cartrol), a beta blocker. What best describes the nurse's assessment?

1. The patient is at risk for a hypertensive crisis.2. The effects of metaproterenol (Alupent) will be decreased.3. The drugs are compatible; there will not be any adverse effects.4. The effects of metaproterenol (Alupent) will be increased.Correct Answer: 2Rationale 1: Beta-adrenergic blockers block the receptors that are stimulated by adrenergic drugs; the effects of metaproterenol (Alupent) would be decreased, not increased. The drugs are not compatible; the effects of metaproterenol (Alupent) would be decreased. A hypertensive crisis is unlikely.Rationale 2: Beta-adrenergic blockers block the receptors that are stimulated by adrenergic drugs; the effects of metaproterenol (Alupent) would be decreased, not increased. The drugs are not compatible; the effects of metaproterenol (Alupent) would be decreased. A hypertensive crisis is unlikely.Rationale 3: Beta-adrenergic blockers block the receptors that are stimulated by adrenergic drugs; the effects of metaproterenol (Alupent) would be decreased, not increased. The drugs are not compatible; the effects of metaproterenol (Alupent) would be decreased. A hypertensive crisis is unlikely.Rationale 4: Beta-adrenergic blockers block the receptors that are stimulated by adrenergic drugs; the effects of metaproterenol (Alupent) would be decreased, not increased. The drugs are not compatible; the effects of metaproterenol (Alupent) would be decreased. A hypertensive crisis is unlikely.Global Rationale: Cognitive Level: ApplyingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: AssessmentLearning Outcome: 13-5Question 3Type: MCSAThe nurse has been doing medication education for the patient receiving atenolol (Tenormin), a beta blocker. The nurse determines that learning has occurred when the patient makes which statement?

1. "I need to take my pulse every day."2. "If I have any side effects, I will stop the medication."3. "I cannot take this drug if I develop glaucoma."4. "I cannot continue to have my morning cup of coffee."Correct Answer: 1Rationale 1: Beta blockers slow the heart rate; therefore the patient must monitor his pulse every day. Beta blockers should not be stopped suddenly. Caffeine is not prohibited with beta blockers. Adrenergic blockers, not beta blockers, are used to treat glaucoma.Rationale 2: Beta blockers slow the heart rate; therefore the patient must monitor his pulse every day. Beta blockers should not be stopped suddenly. Caffeine is not prohibited with beta blockers. Adrenergic blockers, not beta blockers, are used to treat glaucoma.Rationale 3: Beta blockers slow the heart rate; therefore the patient must monitor his pulse every day. Beta blockers should not be stopped suddenly. Caffeine is not prohibited with beta blockers. Adrenergic blockers, not beta blockers, are used to treat glaucoma.Rationale 4: Beta blockers slow the heart rate; therefore the patient must monitor his pulse every day. Beta blockers should not be stopped suddenly. Caffeine is not prohibited with beta blockers. Adrenergic blockers, not beta blockers, are used to treat glaucoma.Global Rationale: Cognitive Level: ApplyingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: EvaluationLearning Outcome: 13-8Question 4Type: MCSAThe physician ordered prazosin (Minipress), an alpha-adrenergic blocker, for the patient. The nurse plans to do medication education. What will the best plan of the nurse include?

1. Instruct the patient to not take any OTC herbal preparations.2. Instruct the patient to not take hot tub baths or hot showers.3. Instruct the patient to decrease his intake of sodium.4. Instruct the patient to wear sunglasses when outdoors.Correct Answer: 2Rationale 1: Alpha-adrenergic blockers are vasodilators, and taking hot tub baths or showers could result in further vasodilation resulting in hypotension or fainting.Alpha blockers do not cause photophobia; sunglasses are not required with this drug. There is no relationship between alpha blockers and sodium intake. It is a good idea to avoid herbal preparations, but this is not the primary plan.Rationale 2: Alpha-adrenergic blockers are vasodilators, and taking hot tub baths or showers could result in further vasodilation resulting in hypotension or fainting.Alpha blockers do not cause photophobia; sunglasses are not required with this drug. There is no relationship between alpha blockers and sodium intake. It is a good idea to avoid herbal preparations, but this is not the primary plan.Rationale 3: Alpha-adrenergic blockers are vasodilators, and taking hot tub baths or showers could result in further vasodilation resulting in hypotension or fainting.Alpha blockers do not cause photophobia; sunglasses are not required with this drug. There is no relationship between alpha blockers and sodium intake. It is a good idea to avoid herbal preparations, but this is not the primary plan.Rationale 4: Alpha-adrenergic blockers are vasodilators, and taking hot tub baths or showers could result in further vasodilation resulting in hypotension or fainting.Alpha blockers do not cause photophobia; sunglasses are not required with this drug. There is no relationship between alpha blockers and sodium intake. It is a good idea to avoid herbal preparations, but this is not the primary plan.Global Rationale: Cognitive Level: ApplyingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: PlanningLearning Outcome: 13-9Question 5Type: MCSAThe nurse has completed medication education about pyridostigmine (Mestinon), an indirect cholinergic drug, for the patient with myasthenia gravis. The nurse determines that learning has occurred when the patient makes which statement?

1. "I must monitor my blood pressure while on this drug."2. "I will need to increase my fluid intake with this medication."3. "I must take this medication with meals for proper absorption."4. "It is really important to take my medication on time."Correct Answer: 4Rationale 1: Maintaining an optimum blood level of the drug is crucial in promoting muscle functioning, so it is important for the patient to take his medication on time. There is no reason to increase fluid intake with this drug. This drug may be taken with or without meals. There is no reason to monitor blood pressure while taking this drug.Rationale 2: Maintaining an optimum blood level of the drug is crucial in promoting muscle functioning, so it is important for the patient to take his medication on time. There is no reason to increase fluid intake with this drug. This drug may be taken with or without meals. There is no reason to monitor blood pressure while taking this drug.Rationale 3: Maintaining an optimum blood level of the drug is crucial in promoting muscle functioning, so it is important for the patient to take his medication on time. There is no reason to increase fluid intake with this drug. This drug may be taken with or without meals. There is no reason to monitor blood pressure while taking this drug.Rationale 4: Maintaining an optimum blood level of the drug is crucial in promoting muscle functioning, so it is important for the patient to take his medication on time. There is no reason to increase fluid intake with this drug. This drug may be taken with or without meals. There is no reason to monitor blood pressure while taking this drug.Global Rationale: Cognitive Level: ApplyingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: EvaluationLearning Outcome: 13-8Question 6Type: MCSAThe physician has ordered bethanechol (Urecholine), a cholinergic drug, for the patient with urinary retention. The patient also has an enlarged prostate gland. What is the priority action by the nurse?

1. Hold the drug and prepare to catheterize the patient.2. Administer the drug and measure urinary output.3. Administer the drug and push fluids.4. Hold the drug and contact the physician.Correct Answer: 4Rationale 1: Bethanechol (Urecholine) relaxes the urinary sphincter and increases voiding pressure. It is contraindicated with any physical obstruction of the urinary tract, such as an enlarged prostate gland. Measuring urinary output is inappropriate; the patient should not receive the drug. There should be no need for catheterization as long as the drug is not given. The drug should not be given; pushing fluids would exacerbate the problem.Rationale 2: Bethanechol (Urecholine) relaxes the urinary sphincter and increases voiding pressure. It is contraindicated with any physical obstruction of the urinary tract, such as an enlarged prostate gland. Measuring urinary output is inappropriate; the patient should not receive the drug. There should be no need for catheterization as long as the drug is not given. The drug should not be given; pushing fluids would exacerbate the problem.Rationale 3: Bethanechol (Urecholine) relaxes the urinary sphincter and increases voiding pressure. It is contraindicated with any physical obstruction of the urinary tract, such as an enlarged prostate gland. Measuring urinary output is inappropriate; the patient should not receive the drug. There should be no need for catheterization as long as the drug is not given. The drug should not be given; pushing fluids would exacerbate the problem.Rationale 4: Bethanechol (Urecholine) relaxes the urinary sphincter and increases voiding pressure. It is contraindicated with any physical obstruction of the urinary tract, such as an enlarged prostate gland. Measuring urinary output is inappropriate; the patient should not receive the drug. There should be no need for catheterization as long as the drug is not given. The drug should not be given; pushing fluids would exacerbate the problem.Global Rationale: Cognitive Level: AnalyzingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: ImplementationLearning Outcome: 13-7Question 7Type: MCSAThe preop patient will be receiving glycopyrrolate (Robinul), an anticholinergic drug, and asks the nurse, "Why do I need to have that shot?" What is the best response by the nurse?

1. "It will decrease your respiratory secretions during surgery."2. "It will increase your urinary output during surgery."3. "It will help you breathe better during surgery."4. "It will help maintain your blood pressure during surgery."Correct Answer: 1Rationale 1: Anticholinergics dry secretions; a decrease in respiratory secretions is indicated prior to surgery. Anticholinergic drugs do not maintain blood pressure. Anticholinergic drugs do not facilitate respirations. Anticholinergic drugs do not increase urinary output.Rationale 2: Anticholinergics dry secretions; a decrease in respiratory secretions is indicated prior to surgery. Anticholinergic drugs do not maintain blood pressure. Anticholinergic drugs do not facilitate respirations. Anticholinergic drugs do not increase urinary output.Rationale 3: Anticholinergics dry secretions; a decrease in respiratory secretions is indicated prior to surgery. Anticholinergic drugs do not maintain blood pressure. Anticholinergic drugs do not facilitate respirations. Anticholinergic drugs do not increase urinary output.Rationale 4: Anticholinergics dry secretions; a decrease in respiratory secretions is indicated prior to surgery. Anticholinergic drugs do not maintain blood pressure. Anticholinergic drugs do not facilitate respirations. Anticholinergic drugs do not increase urinary output.Global Rationale: Cognitive Level: ApplyingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: ImplementationLearning Outcome: 13-8Question 8Type: MCSAThe nurse is preparing to administer medications to a group of patients. One of the medications is benztropine (Cogentin), an anticholinergic drug. This drug is contraindicated in which patient?

1. The patient with a fractured femur2. The patient with tachycardia3. The patient with an irritable colon4. The patient with diarrheaCorrect Answer: 2Rationale 1: Anticholinergic drugs increase the heart rate; a patient with tachycardia should not receive benztropine (Cogentin). Anticholinergic drugs slow gastrointestinal (GI) motility; this would help with an irritable colon. Anticholinergic drugs slow gastrointestinal (GI) motility; this would help with diarrhea. There is no contraindication with a fractured femur and anticholinergic drugs.Rationale 2: Anticholinergic drugs increase the heart rate; a patient with tachycardia should not receive benztropine (Cogentin). Anticholinergic drugs slow gastrointestinal (GI) motility; this would help with an irritable colon. Anticholinergic drugs slow gastrointestinal (GI) motility; this would help with diarrhea. There is no contraindication with a fractured femur and anticholinergic drugs.Rationale 3: Anticholinergic drugs increase the heart rate; a patient with tachycardia should not receive benztropine (Cogentin). Anticholinergic drugs slow gastrointestinal (GI) motility; this would help with an irritable colon. Anticholinergic drugs slow gastrointestinal (GI) motility; this would help with diarrhea. There is no contraindication with a fractured femur and anticholinergic drugs.Rationale 4: Anticholinergic drugs increase the heart rate; a patient with tachycardia should not receive benztropine (Cogentin). Anticholinergic drugs slow gastrointestinal (GI) motility; this would help with an irritable colon. Anticholinergic drugs slow gastrointestinal (GI) motility; this would help with diarrhea. There is no contraindication with a fractured femur and anticholinergic drugs.Global Rationale: Cognitive Level: ApplyingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: PlanningLearning Outcome: 13-9Question 9Type: MCSAThe nurse is preparing to administer medications to a group of patients. One of the medications is atropine, an anticholinergic drug. This drug is contraindicated in which patient?

1. The patient with glaucoma2. The patient with hyperthyroidism3. The patient with a hiatal hernia4. The patient with lung cancerCorrect Answer: 1Rationale 1: Anticholinergic drugs can increase pressure in the eye; they must be avoided in patients with glaucoma. Anticholinergic drugs are not contraindicated in patients with a hiatal hernia. Anticholinergic drugs are not contraindicated in patients with hyperthyroidism. Anticholinergic drugs are not contraindicated in patients with lung cancer.Rationale 2: Anticholinergic drugs can increase pressure in the eye; they must be avoided in patients with glaucoma. Anticholinergic drugs are not contraindicated in patients with a hiatal hernia. Anticholinergic drugs are not contraindicated in patients with hyperthyroidism. Anticholinergic drugs are not contraindicated in patients with lung cancer.Rationale 3: Anticholinergic drugs can increase pressure in the eye; they must be avoided in patients with glaucoma. Anticholinergic drugs are not contraindicated in patients with a hiatal hernia. Anticholinergic drugs are not contraindicated in patients with hyperthyroidism. Anticholinergic drugs are not contraindicated in patients with lung cancer.Rationale 4: Anticholinergic drugs can increase pressure in the eye; they must be avoided in patients with glaucoma. Anticholinergic drugs are not contraindicated in patients with a hiatal hernia. Anticholinergic drugs are not contraindicated in patients with hyperthyroidism. Anticholinergic drugs are not contraindicated in patients with lung cancer.Global Rationale: Cognitive Level: ApplyingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: PlanningLearning Outcome: 13-8Question 10Type: MCSAThe physician orders dicyclomine (Bentyl), an anticholinergic drug, for a patient. What is the nurse's priority assessment prior to administering this drug?

1. Does the patient have light sensitivity?2. Is the patient able to urinate?3. Does the patient have a history of alcoholism?4. Is the patient dizzy upon standing?Correct Answer: 2Rationale 1: Anticholinergic drugs can cause or increase urinary hesitancy or retention. Anticholinergic drugs are not contraindicated in a patient with light sensitivity. Anticholinergic drugs are not contraindicated in a patient with a history of alcoholism. Anticholinergic drugs are not contraindicated in a patient who is dizzy.Rationale 2: Anticholinergic drugs can cause or increase urinary hesitancy or retention. Anticholinergic drugs are not contraindicated in a patient with light sensitivity. Anticholinergic drugs are not contraindicated in a patient with a history of alcoholism. Anticholinergic drugs are not contraindicated in a patient who is dizzy.Rationale 3: Anticholinergic drugs can cause or increase urinary hesitancy or retention. Anticholinergic drugs are not contraindicated in a patient with light sensitivity. Anticholinergic drugs are not contraindicated in a patient with a history of alcoholism. Anticholinergic drugs are not contraindicated in a patient who is dizzy.Rationale 4: Anticholinergic drugs can cause or increase urinary hesitancy or retention. Anticholinergic drugs are not contraindicated in a patient with light sensitivity. Anticholinergic drugs are not contraindicated in a patient with a history of alcoholism. Anticholinergic drugs are not contraindicated in a patient who is dizzy.Global Rationale: Cognitive Level: ApplyingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: AssessmentLearning Outcome: 13-8Question 11Type: MCSAThe patient is quadriplegic and receives oxybutynin (Ditropan), an anticholinergic drug, to increase his bladder capacity. What is an important assessment of this patient by the nurse?

1. Is he irritable?2. Is he constipated?3. Is he gaining weight?4. Is he lethargic?Correct Answer: 2Rationale 1: Anticholinergics slow gastrointestinal (GI) motility and can increase the risk for constipation. Anticholinergic drugs do not cause lethargy. Anticholinergic drugs do not cause weight gain. Anticholinergic drugs do not cause irritability.Rationale 2: Anticholinergics slow gastrointestinal (GI) motility and can increase the risk for constipation. Anticholinergic drugs do not cause lethargy. Anticholinergic drugs do not cause weight gain. Anticholinergic drugs do not cause irritability.Rationale 3: Anticholinergics slow gastrointestinal (GI) motility and can increase the risk for constipation. Anticholinergic drugs do not cause lethargy. Anticholinergic drugs do not cause weight gain. Anticholinergic drugs do not cause irritability.Rationale 4: Anticholinergics slow gastrointestinal (GI) motility and can increase the risk for constipation. Anticholinergic drugs do not cause lethargy. Anticholinergic drugs do not cause weight gain. Anticholinergic drugs do not cause irritability.Global Rationale: Cognitive Level: ApplyingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: AssessmentLearning Outcome: 13-8Question 12Type: MCMAThe nursing instructor teaches the student nurses about the nervous system. The instructor determines that learning has occurred when the students make which statement(s)?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.1. "The central nervous system includes the brain and spinal cord."2. "The peripheral nervous system has mainly sensory functions."3. "The somatic nervous system gives us voluntary control over our gastrointestinal (GI) tract."4. "The nervous system helps us react to environmental changes."5. "The somatic nervous system gives us voluntary control over moving."Correct Answer: 1,4,5Rationale 1: The central nervous system includes the brain and spinal cord. The somatic nervous system provides voluntary control over moving. The nervous system provides reaction to environmental changes. The peripheral nervous system has both sensory and motor divisions. The somatic nervous system gives voluntary control over skeletal muscles.Rationale 2: The central nervous system includes the brain and spinal cord. The somatic nervous system provides voluntary control over moving. The nervous system provides reaction to environmental changes. The peripheral nervous system has both sensory and motor divisions. The somatic nervous system gives voluntary control over skeletal muscles.Rationale 3: The central nervous system includes the brain and spinal cord. The somatic nervous system provides voluntary control over moving. The nervous system provides reaction to environmental changes. The peripheral nervous system has both sensory and motor divisions. The somatic nervous system gives voluntary control over skeletal muscles.Rationale 4: The central nervous system includes the brain and spinal cord. The somatic nervous system provides voluntary control over moving. The nervous system provides reaction to environmental changes. The peripheral nervous system has both sensory and motor divisions. The somatic nervous system gives voluntary control over skeletal muscles.Rationale 5: The central nervous system includes the brain and spinal cord. The somatic nervous system provides voluntary control over moving. The nervous system provides reaction to environmental changes. The peripheral nervous system has both sensory and motor divisions. The somatic nervous system gives voluntary control over skeletal muscles.Global Rationale: Cognitive Level: ApplyingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: EvaluationLearning Outcome: 13-1Question 13Type: MCMAThe nursing instructor teaches the student nurses about the autonomic nervous system. The instructor determines that learning has occurred when the students make which statement(s)?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.1. "The sympathetic and parasympathetic systems are not always opposite in their effects."2. "The parasympathetic nervous system is the "fight-or-flight" response."3. "Sympathetic stimulation causes dilation of arterioles."4. "The parasympathetic nervous system causes bronchial constriction."5. "The sympathetic nervous system is activated under stress."Correct Answer: 1,4,5Rationale 1: The parasympathetic nervous system causes bronchial constriction. The sympathetic and parasympathetic systems are not always opposite in their effects. The sympathetic nervous system is activated under stress. The parasympathetic nervous system is the rest-and-digest response. Sympathetic stimulation causes constriction of arterioles.Rationale 2: The parasympathetic nervous system causes bronchial constriction The sympathetic and parasympathetic systems are not always opposite in their effects. The sympathetic nervous system is activated under stress. The parasympathetic nervous system is the rest-and-digest response. Sympathetic stimulation causes constriction of arterioles.Rationale 3: The parasympathetic nervous system causes bronchial constriction The sympathetic and parasympathetic systems are not always opposite in their effects. The sympathetic nervous system is activated under stress. The parasympathetic nervous system is the rest-and-digest response. Sympathetic stimulation causes constriction of arterioles.Rationale 4: The parasympathetic nervous system causes bronchial constriction The sympathetic and parasympathetic systems are not always opposite in their effects. The sympathetic nervous system is activated under stress. The parasympathetic nervous system is the rest-and-digest response. Sympathetic stimulation causes constriction of arterioles.Rationale 5: The parasympathetic nervous system causes bronchial constriction The sympathetic and parasympathetic systems are not always opposite in their effects. The sympathetic nervous system is activated under stress. The parasympathetic nervous system is the rest-and-digest response. Sympathetic stimulation causes constriction of arterioles.Global Rationale: Cognitive Level: ApplyingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: EvaluationLearning Outcome: 13-3Question 14Type: MCSAThe student nurse asks the nursing instructor, "Do the medications we are studying actually make more neurotransmitters?" What is the best response by the nursing instructor?

1. "No, but medications can heal diseases of the autonomic nervous system."2. "Yes, some of the newer medications are very good at doing this."3. "Yes, but the newer drugs that do this have some serious side effects."4. "No, medications can only increase or decrease the action of neurotransmitters."Correct Answer: 4Rationale 1: Medications cannot manufacture new neurotransmitters, they can only increase or decrease their action. There are virtually no diseases of the autonomic nervous system to heal. Even the newest medications cannot manufacture new neurotransmitters. Medications cannot manufacture new neurotransmitters, even if they have serious side effects.Rationale 2: Medications cannot manufacture new neurotransmitters, they can only increase or decrease their action. There are virtually no diseases of the autonomic nervous system to heal. Even the newest medications cannot manufacture new neurotransmitters. Medications cannot manufacture new neurotransmitters, even if they have serious side effects.Rationale 3: Medications cannot manufacture new neurotransmitters, they can only increase or decrease their action. There are virtually no diseases of the autonomic nervous system to heal. Even the newest medications cannot manufacture new neurotransmitters. Medications cannot manufacture new neurotransmitters, even if they have serious side effects.Rationale 4: Medications cannot manufacture new neurotransmitters, they can only increase or decrease their action. There are virtually no diseases of the autonomic nervous system to heal. Even the newest medications cannot manufacture new neurotransmitters. Medications cannot manufacture new neurotransmitters, even if they have serious side effects.Global Rationale: Cognitive Level: ApplyingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: ImplementationLearning Outcome: 13-4Question 15Type: MCSAThe ability of a person to use his arm muscles to lift a weight is primarily regulated by

1. the somatic nervous system.2. the sympathetic nervous system.3. the autonomic nervous system.4. the central nervous system.Correct Answer: 1Rationale 1: The somatic nervous system (a division of the peripheral nervous system) controls voluntary movement such as lifting a weight. The autonomic nervous system involves involuntary responses, and is divided into the sympathetic and parasympathetic divisions.Rationale 2: The somatic nervous system (a division of the peripheral nervous system) controls voluntary movement such as lifting a weight. The autonomic nervous system involves involuntary responses, and is divided into the sympathetic and parasympathetic divisions.Rationale 3: The somatic nervous system (a division of the peripheral nervous system) controls voluntary movement such as lifting a weight. The autonomic nervous system involves involuntary responses, and is divided into the sympathetic and parasympathetic divisions.Rationale 4: The somatic nervous system (a division of the peripheral nervous system) controls voluntary movement such as lifting a weight. The autonomic nervous system involves involuntary responses, and is divided into the sympathetic and parasympathetic divisions.Global Rationale: Cognitive Level: RememberingClient Need: Health Promotion and Maintenance

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: AssessmentLearning Outcome: 13-1 and 13-2Question 16Type: MCSAWhich of the following responses are regulated by the sympathetic nervous system?

1. Increased heart rate, bronchial constriction2. Peripheral artery dilation, reduced peristalsis3. Increased secretions, sex organ stimulation4. Relaxation of bladder, pupil dilationCorrect Answer: 4Rationale 1: Relaxation of the bladder and pupil dilation is regulated by the sympathetic nervous system. Rationale 2: Relaxation of the bladder and pupil dilation is regulated by the sympathetic nervous system. Rationale 3: Relaxation of the bladder and pupil dilation is regulated by the sympathetic nervous system. Rationale 4: Relaxation of the bladder and pupil dilation is regulated by the sympathetic nervous system. Global Rationale: Cognitive Level: RememberingClient Need: Health Promotion and Maintenance

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: AssessmentLearning Outcome: 13-2Question 17Type: MCSAA person who had her adrenergic receptors activated would experience

1. fight-or-flight effects.2. rest-and-digest effects.3. increased blood volume.4. bronchial constriction.Correct Answer: 1Rationale 1: Adrenergic receptors are found within the sympathetic nervous system. Sympathetic nervous system activation produces the fight-or-flight response. Rationale 2: Adrenergic receptors are found within the sympathetic nervous system. Sympathetic nervous system activation produces the fight-or-flight response. Rationale 3: Adrenergic receptors are found within the sympathetic nervous system. Sympathetic nervous system activation produces the fight-or-flight response. Rationale 4: Adrenergic receptors are found within the sympathetic nervous system. Sympathetic nervous system activation produces the fight-or-flight response. Global Rationale: Cognitive Level: RememberingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: AssessmentLearning Outcome: 13-3Question 18Type: MCSAWhich of the following would inhibit the function of the autonomic nervous system?

1. Drugs that bind and then stimulate the postsynaptic neuron2. Drugs that prohibit neurotransmitter reuptake3. Drugs that increase neurotransmitter synthesis4. Drugs that prevent the storage of neurotransmitter in vesiclesCorrect Answer: 4Rationale 1: The more neurotransmitter available, the greater the function/stimulation of the autonomic nervous system. Rationale 2: The more neurotransmitter available, the greater the function/stimulation of the autonomic nervous system. Rationale 3: The more neurotransmitter available, the greater the function/stimulation of the autonomic nervous system. Rationale 4: The more neurotransmitter available, the greater the function/stimulation of the autonomic nervous system. Global Rationale: Cognitive Level: RememberingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: AssessmentLearning Outcome: 13-4Question 19Type: MCSAWhich receptor type is found at the ganglionic synapse of both the sympathetic and parasympathetic nervous systems?

1. Alpha receptors2. Muscarinic3. Nicotinic4. Beta receptorsCorrect Answer: 3Rationale 1: Nicotinic receptors are found at the ganglionic synapse of both sympathetic and parasympathetic nervous systems. Rationale 2: Nicotinic receptors are found at the ganglionic synapse of both sympathetic and parasympathetic nervous systems.Rationale 3: Nicotinic receptors are found at the ganglionic synapse of both sympathetic and parasympathetic nervous systems.Rationale 4: Nicotinic receptors are found at the ganglionic synapse of both sympathetic and parasympathetic nervous systems.Global Rationale: Cognitive Level: RememberingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: AssessmentLearning Outcome: 13-5Question 20Type: MCSAWhich statement is accurate concerning drugs classified as adrenergic antagonists?

1. They are also known as anticholinergics.2. Their actions will block the neurotransmitter acetylcholine.3. Their actions are the opposite of those of sympathomimetics.4. They will stimulate the sympathetic nervous system.Correct Answer: 3Rationale 1: Adrenergic antagonists inhibit the actions of the sympathetic nervous system. They are also known as sympatholytics. They block adrenergic receptors, not cholinergic receptors. Rationale 2: Adrenergic antagonists inhibit the actions of the sympathetic nervous system. They are also known as sympatholytics. They block adrenergic receptors, not cholinergic receptors. Rationale 3: Adrenergic antagonists inhibit the actions of the sympathetic nervous system. They are also known as sympatholytics. They block adrenergic receptors, not cholinergic receptors. Rationale 4: Adrenergic antagonists inhibit the actions of the sympathetic nervous system. They are also known as sympatholytics. They block adrenergic receptors, not cholinergic receptors. Global Rationale: Cognitive Level: UnderstandingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: EvaluationLearning Outcome: 13-6Question 21Type: MCSAWhich of the following statements is accurate regarding exogenous acetylcholine?

1. Acetylcholine has almost no therapeutic effects because it is rapidly destroyed once given.2. Acetylcholine is broken down rapidly within the body, preventing it from producing adverse effects.3. Acetylcholine will cause the heart rate to increase and blood pressure to drop.4. When given in small amounts, acetylcholine will produce profound parasympathetic effects.Correct Answer: 1Rationale 1: Exogenous acetylcholine is not generally administered, because it is rapidly destroyed by the body. It does produce many adverse effects. Acetylcholine can lower blood pressure, but it also lowers heart rate. Rationale 2: Exogenous acetylcholine is not generally administered, because it is rapidly destroyed by the body. It does produce many adverse effects. Acetylcholine can lower blood pressure, but it also lowers heart rate. Rationale 3: Exogenous acetylcholine is not generally administered, because it is rapidly destroyed by the body. It does produce many adverse effects. Acetylcholine can lower blood pressure, but it also lowers heart rate. Rationale 4: Exogenous acetylcholine is not generally administered, because it is rapidly destroyed by the body. It does produce many adverse effects. Acetylcholine can lower blood pressure, but it also lowers heart rate. Global Rationale: Cognitive Level: UnderstandingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: EvaluationLearning Outcome: 13-6Question 22Type: MCSAThe nurse knows that atropine (Atropair) increases heart rate by

1. blocking the beta receptors of the parasympathetic nervous system.2. directly stimulating the sympathetic nervous system.3. potentiating the effects of acetylcholine on nicotinic receptors.4. Blocking the effects of acetylcholine by occupying muscarinic receptors.Correct Answer: 4Rationale 1: Atropine is a cholinergic-blocking agent that occupies muscarinic receptors. It is classified as an anticholinergic agent because it inhibits the effects of the parasympathetic nervous system, which induces the fight-or-flight responses of the sympathetic nervous system.Rationale 2: Atropine is a cholinergic-blocking agent that occupies muscarinic receptors. It is classified as an anticholinergic agent because it inhibits the effects of the parasympathetic nervous system, which induces the fight-or-flight responses of the sympathetic nervous system. Rationale 3: Atropine is a cholinergic-blocking agent that occupies muscarinic receptors. It is classified as an anticholinergic agent because it inhibits the effects of the parasympathetic nervous system, which induces the fight-or-flight responses of the sympathetic nervous system. Rationale 4: Atropine is a cholinergic-blocking agent that occupies muscarinic receptors. It is classified as an anticholinergic agent because it inhibits the effects of the parasympathetic nervous system, which induces the fight-or-flight responses of the sympathetic nervous system. Global Rationale: Cognitive Level: UnderstandingClient Need: Physiological Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: AssessmentLearning Outcome: 13-8Question 23Type: MCMAWhich patient responses are considered involuntary responses to autonomic nervous system control?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.1. Becoming angry2. Tripping over a chair3. Complaining of nausea4. Feeling depressed5. Being happyCorrect Answer: 1,4,5Rationale 1: Becoming angry is considered an involuntary response that is a signal from higher centers in the brain to the autonomic nervous system.Rationale 2: Tripping over a chair is a voluntary response.Rationale 3: Complaining of nausea is a voluntary response.Rationale 4: Feeling depressed is considered an involuntary response that is a signal from higher centers in the brain to the autonomic nervous system.Rationale 5: Being happy is considered an involuntary response that is a signal from higher centers in the brain to the autonomic nervous system.Global Rationale: Cognitive Level: AnalyzingClient Need: Psychosocial Integrity

Client Need Sub: Nursing/Integrated Concepts: Nursing Process: AssessmentLearning Outcome: 13-9Question 24Type: MCMAA patient has sustained a large blood loss. During the assessment, the nurse realizes that which findings are under the control of the nervous system?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.1. Heart rate2. Blood pressure3. Pupil size4. Bowel sounds5. Fluid volumeCorrect Answer: 1,2,3,4Rationale 1: The brain, spinal cord, and peripheral nerves act as a smoothly integrated whole to accomplish minute-to-minute changes in essential functions such as heart rate.Rationale 2: The brain, spinal cord, and peripheral nerves act as a smoothly integrated whole to accomplish minute-to-minute changes in essential functions such as blood pressure.Rationale 3: The brain, spinal cord, and peripheral nerves act as a smoothly integrated whole to accomplish minute-to-minute changes in essential functions such as pupil size.Rationale 4: The brain, spinal cord, and peripheral nerves act as a smoothly integrated whole to accomplish minute-to-minute changes in essential functions such as intestinal motility.Rationale 5: Although the brain, spinal cord, and peripheral nerves act as a smoothly integrated whole to accomplish minute-to-minute changes in essential functions, fluid volume is not under the control of the nervous system.Global Rationale: Cognitive Level: AnalyzingClient Need: Physiological Integrity

Client Need Sub: Physiological AdaptationNursing/Integrated Concepts: Nursing Process: AssessmentLearning Outcome: 13-1Question 25Type: MCMAThe nurse is caring for a patient with multisystem organ failure. Which patient assessment findings are under the control of the sympathetic nervous system?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.1. Blood glucose level 210 mg/dL2. Blood pressure 180/90 mmHg3. Total cholesterol level 300 mg/dL4. Respiratory rate 14 and regular5. Hyperactive bowel soundsCorrect Answer: 1,2,3Rationale 1: Metabolic effects such as an increase in blood glucose are a sympathetic nervous system function.Rationale 2: The constriction and relaxation of arterioles is controlled entirely by the sympathetic nervous system.Rationale 3: Metabolic effects such as the mobilization of lipids for energy are a sympathetic nervous system function.Rationale 4: The respiratory rate would be faster and deeper when under sympathetic nervous system control.Rationale 5: When under the sympathetic nervous system control, peristalsis is temporarily suspended.Global Rationale: Cognitive Level: AnalyzingClient Need: Physiological Integrity

Client Need Sub: Physiological AdaptationNursing/Integrated Concepts: Nursing Process: AssessmentLearning Outcome: 13-3Question 26Type: MCMAA student nurse is learning about a medication that affects the autonomic nervous system. When instructing the student about the effects of this medication, the nurse will begin by explaining the basic unit of this system. What does this include?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.1. The preganglionic neuron2. The postganglionic neuron3. The synaptic cleft4. Norepinephrine5. DopamineCorrect Answer: 1,2,3Rationale 1: The basic unit of the autonomic nervous system is a two-neuron chain. The first neuron, called the preganglionic neuron, originates in the central nervous system.Rationale 2: The preganglionic neuron connects with the second nerve in the autonomic nervous system two-neuron chain through the ganglia, which contains the postganglionic neuron.Rationale 3: Autonomic messages must cross the synaptic cleft.Rationale 4: Acetylcholine is the neurotransmitter released at cholinergic receptors.Rationale 5: Dopamine is a neurotransmitter within the limbic system and hypothalamus and not the autonomic nervous system.Global Rationale: Cognitive Level: ApplyingClient Need: Physiological Integrity

Client Need Sub: Physiological AdaptationNursing/Integrated Concepts: Nursing Process: PlanningLearning Outcome: 13-4Question 27Type: SEQThe nurse educator is reviewing the process of synaptic transmission across the neuroeffector junction with a student. In which order will the nurse explain the steps of synaptic transmission?

Standard Text: Click and drag the options below to move them up or down.Correct Answer: Global Rationale: Cognitive Level: ApplyingClient Need: Physiological Integrity

Client Need Sub: Physiological AdaptationNursing/Integrated Concepts: Nursing Process: PlanningLearning Outcome: 13-4Question 28Type: MCMAA patient is prescribed a medication that will block muscarinic receptors. The nurse realizes that this medication has implications for which body systems?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.1. Eyes2. Respiratory3. Cardiac4. Endocrine5. MetabolicCorrect Answer: 1,2,3Rationale 1: Medications that block muscarinic receptors are used during ophthalmic procedures.Rationale 2: Medications that block muscarinic receptors are used in the pharmacologic treatment of asthma.Rationale 3: Medications that block muscarinic receptors are used in the pharmacologic treatment of bradycardia.Rationale 4: Medications that block muscarinic receptors are not used in the treatment of endocrine disorders.Rationale 5: Medications that block muscarinic receptors are not used in the treatment of metabolic disorders.Global Rationale: Cognitive Level: AnalyzingClient Need: Physiological Integrity

Client Need Sub: Physiological AdaptationNursing/Integrated Concepts: Nursing Process: AssessmentLearning Outcome: 13-6Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/ECopyright 2014 by Pearson Education, Inc.