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A nurse is teaching a nursing student about the two classes of adrenergic agonist drugs. Which statement by the nursing student indicates understanding of the teaching?
A “Catecholamines may be given orally.”
B “Catecholamines often require continuous infusion to be effective.”
C “Noncatecholamines do not cross the blood-brain barrier.”
D “Noncatecholamines undergo rapid degradation by monoamine oxidase.”
Dopamine is administered to a patient who has been experiencing hypotensive episodes. Other than an increase in blood pressure, which indicator would the nurse use to evaluate a successful response?
A Decrease in pulse
B Increase in urine output
C Weight gain
D Improved gastric motility
A nursing student asks the nurse about receptor specificity of adrenergic agonist medications. What will the nurse say?
A “As the dosage of these medications increases, drugs in this class are more selective.”
B “Dopamine is selective for dopamine receptors and has no effects on alpha or beta receptors.”
C “Epinephrine is the most selective alpha-adrenergic agonist medication.”D Specificity is relative and is dose dependent.”
A patient brought to the emergency department requires sutures. The prescriber orders a local anesthetic with epinephrine. The nurse understands that epinephrine is ordered to:
A prevent hypertension induced by the anesthetic.
B prolong absorption of the anesthetic.
C reduce anesthetic-induced nausea.
D reduce the pain of an injection.
A nurse is administering intravenous dopamine (Intropin) to a patient in the intensive care unit. Which assessment finding would cause the most concern?
A Blood pressure of 100/70 mm Hg
B Increased urine output
C Edema at the IV insertion site
A patient with asthma uses albuterol (Ventolin) for wheezing. The nurse assesses the patient and notes vital signs of HR, 96 beats per minute; RR, 18 breaths per minute; and BP, 116/78 mm Hg. The patient has clear breath sounds and hand tremors. What will the nurse do?
A Ask the patient how often the inhaler is used.
B Check the patient’s blood glucose level.
C Request an order for isoproterenol (Isuprel) to reduce side effects.Stop the medication and report the tremors to the provider
A nurse is teaching parents how to use an Epi-Pen for their child, who has a peanut allergy. Which statement by the parents indicates understanding of the teaching?
A “After using the Epi-Pen, we must go to the emergency department.”
B “The Epi-Pen should be stored in the refrigerator, because epinephrine is sensitive to heat.”
C “The teacher should call us when symptoms start so that we can bring the Epi-Pen to school.”
D “We should jab the device into the thigh until it is empty of solution.”
Because they cause vasoconstriction, alpha1-adrenergic agonists are especially useful for:
A extending the duration of local anesthetics.
B producing mydriasis to facilitate ophthalmic examinations.
C slowing the heart rate in tachycardic patients.D treating hypotension.
A patient is admitted to the intensive care unit for treatment of shock. The prescriber orders isoproterenol (Isuprel). The nurse expects this drug to increase tissue perfusion in this patient by activating:
A alpha1 receptors to cause vasoconstriction.
B alpha1 receptors to increase blood pressure.
C beta1 receptors to cause a positive inotropic effect.D beta2 receptors to cause bronchodilation.
A pregnant patient with diabetes and hypertension is given isoproterenol (Isuprel) to delay preterm labor. Which side effect might the nurse expect?
B Decreased urine output
A nursing student asks why albuterol, which is selective for beta2 receptors, causes an increased heart rate in some patients. How does the nurse respond?
A “Adrenergic agonists can lose their selectivity when given at higher doses.”
B “Bronchodilation lowers blood pressure, which causes a reflex tachycardia.”
C “Some patients metabolize the drug differently and have unusual side effects.”“Systemic effects are intensified with inhaled doses.”
A patient is receiving dobutamine (Dobutrex) as a continuous infusion in the immediate postoperative period. The patient also is receiving a diuretic. What adverse drug reactions are possible in this patient? (Select all that apply.)
A nurse is teaching nursing students about the use of alpha-adrenergic antagonists. Which statement by the student indicates the need for further teaching?
A “Alpha-adrenergic antagonists block alpha1 receptors on arterioles and veins.”
B “Dilation of arterioles has a direct effect on arterial pressure.”
C “Dilation of veins by alpha-adrenergic antagonists improves cardiac output.”
D “Venous dilation by alpha-adrenergic antagonists indirectly lowers arterial pressure.”
A patient with pheochromocytoma is admitted for surgery. The surgeon has ordered an alpha-blocking agent to be given preoperatively. What does the nurse understand about this agent?
A It is ordered to prevent perioperative hypertensive crisis.
B It prevents secretion of catecholamines by the adrenal tumor.
C It reduces contraction of smooth muscles in the adrenal medulla.
D It is given chronically after the surgery to prevent hypertension.
A patient with type I diabetes is taking NPH insulin, 30 units every day. A nurse notes that the patient is also taking metoprolol (Lopressor). What education should the nurse provide to the patient?
A “Metoprolol has no effect on diabetes mellitus or on your insulin requirements.”
B “Metoprolol interferes with the effects of insulin, so you may need to increase your insulin dose.”
C “Metoprolol may mask signs of hypoglycemia, so you need to monitor your blood glucose closely.”
D “Metoprolol may potentiate the effects of the insulin, so the dose should be reduced.”
The nurse is discussing home management with a patient who will begin taking an alpha-adrenergic antagonist for hypertension. Which statement by the patient indicates understanding of the teaching?
A “I need to stop the medication if my heart rate increases.”
B “I should not drive while taking this medication.”
C “I should take the first dose at bedtime.”
D “I will stop taking the medication if I feel dizzy.”
A nurse prepares to administer propranolol (Inderal) to a patient recovering from acute myocardial infarction. The patient’s heart rate is 52 beats per minute, and the rhythm is regular. What action should the nurse take next?
A Administer the drug as prescribed.
B Request an order for atropine.
C Withhold the dose and document the pulse rate.
D Withhold the dose and notify the prescriber.
A patient has benign prostatic hyperplasia (BPH) and will receive alfuzosin (Uroxatral). What is an important nursing action when administering this drug?
A Administer the first dose at bedtime to minimize the first-dose effect.
B Prepare the patient for potential ejaculatory dysfunction.
C Request an order for a diuretic to counter the effects of sodium retention.D Review the patient’s chart for liver function tests (LFTs).
A nurse is discussing phentolamine (OraVerse) with a nursing student. Which statement by the student indicates the need for further teaching?
A “Phentolamine can be used to block both epinephrine- and norepinephrine-mediated vasoconstriction.”
B “Phentolamine can be used to treat pheochromocytoma.”
C “Phentolamine is a competitive adrenergic agonist that acts selectively on alpha1 receptors.”
D “Side effects of phentolamine may include tachycardia and hypotension.”
A patient taking a beta blocker complains of shortness of breath. The patient has respirations of 28 breaths per minute, a blood pressure of 162/90 mm Hg, and a pulse of 88 beats per minute. The nurse auscultates crackles in all lung fields. The nurse understands that these assessments are consistent with:
B left-sided heart failure.
C rebound cardiac excitation.sinus bradycardia.
A male patient is being treated for benign prostatic hyperplasia and has stopped taking his alpha-adrenergic antagonist medication because of ejaculatory difficulties. Which medication does the nurse expect the provider to prescribe?
A Alfuzosin (Uroxatral)
B Prazosin (Minipress)
C Silodosin (Rapaflo)
D Tamsulosin (Flomax)
A patient is taking a beta-adrenergic antagonist medication for angina pectoris and asks the nurse how the drug works to relieve the discomfort associated with this condition. Which statement by the patient after the nurse’s teaching indicates understanding of the drug’s effects?
A “It causes bronchodilation, which increases oxygen flow.”
B “It helps reduce the heart’s oxygen needs.”
C “It improves blood flow to the heart.”
D “It increases cardiac output.”
A nurse is caring for a newborn 1 day after delivery. The infant’s mother used betaxolol during pregnancy. The nurse will expect to monitor this infant for which condition?
C Respiratory distressD Tachycardia
A patient will begin taking propranolol (Inderal) for hypertension. Which statement by the nurse is important when teaching this patient about the medication?
A “Check your hands and feet for swelling and report that to your provider.”
B “It is safe to take this medication with a calcium channel blocker.”
C “Stop taking the drug if you become short of breath.”
D “Take your pulse and do not take the medication if your heart rate is fast.”
A patient with migraines is started on a beta blocker. The nurse explains the benefits of taking the medication for migraines. Which statement by the patient indicates an understanding of the medication’s effects?
A “I need to take it every day to reduce the frequency of migraines.”
B “I will take it as needed to get relief from migraines.”
C “I will take it to shorten the duration of my migraines.”
D “I will take this drug when a migraine starts.”
Which are adverse effects of alpha blockade? (Select all that apply.)
B Reflex tachycardia
C Nasal congestion
A prescriber has ordered clonidine (Catapres) for a patient who has hypertension. The nurse teaches the patient about side effects of this drug. Which statement by the patient indicates understanding of the teaching?
A “I should chew sugar-free gum or drink water to reduce dry mouth.”
B “I should not drive as long as I am taking this drug.”
C “I should stand up slowly when taking this medication.”
D “I should stop taking this drug if I feel anxious or depressed.”
A prescriber has ordered methyldopa for a patient with hypertension. The nurse teaches the patient about drug actions, adverse effects, and the ongoing blood tests necessary with this drug. The nurse is correct to tell the patient what?
A “If you have a positive Coombs’ test result, you will need to discontinue the medication, because this means you have hemolytic anemia.”
B “Methyldopa can be used for its analgesic effects and for its hypertensive effects.”
C “Xerostomia and orthostatic hypotension are serious side effects and indications for withdrawing the medication.”
D “You will need to contact the provider and stop taking the medication if your eyes look yellow.”
A patient complains to the nurse that the clonidine (Catapres) recently prescribed for hypertension is causing drowsiness. Which response by the nurse to this concern is appropriate?
A “Drowsiness is a common side effect initially, but it will lessen with time.”
B “You may also experience orthostatic hypotension along with the drowsiness.”
C “You may be at risk for addiction if you have central nervous system side effects.”
D “You should discontinue the medication and contact your prescriber.”
A nurse is teaching nursing students about the pharmacology of methyldopa. Which statement by a student indicates the need for further teaching?
A “Methyldopa results in alpha2 agonist activation, but it is not itself an alpha2 agonist.”
B “Methyldopa is not effective until it is converted to an active compound.”
C “Methyldopa reduces blood pressure by reducing cardiac output.”
D “Methyldopa’s principal mechanism is vasodilation, not cardiosuppression.”
A nurse is teaching a patient about a new prescription for reserpine (Serpasil) for hypertension. Which statement by the patient indicates the need for further teaching?
A “Depressive side effects are common and will improve over time.”
B “I should report gastrointestinal side effects to the provider.”
C “I should stand up slowly when getting up and lie down if I feel dizzy.”
D “Therapeutic effects may not be optimal for a couple of weeks.”
A patient who has been taking clonidine (Catapres) for several weeks complains of drowsiness and constipation. What will the nurse do?
A Recommend that the patient take most of the daily dose at bedtime.
B Suggest asking the provider for a transdermal preparation of the drug.
C Suspect that the patient is overusing the medication.Tell the patient to stop taking the drug and call the provider
A patient with hypertension has a previous history of opioid dependence. Which medication would the nurse question?
A Clonidine (Catapres)
B Guanabenz (Wytensin)
D Reserpine (Serpasil)
A prescriber orders transdermal clonidine (Catapres TTS) for a patient with hypertension. What will the nurse teach this patient?
A That medication given by transdermal patch has fewer systemic side effects
B That localized skin reactions are uncommon
C To apply the patch to intact skin on the forearm or legD To change the patch every week
A prescriber has ordered methyldopa for a female patient with hypertension. The nurse understands that which laboratory tests are important before beginning therapy with this drug? (Select all that apply.)
A Coombs’ test
B Hemoglobin and hematocrit (H&H)
C Liver function tests
D Pregnancy test
A psychiatric nurse is teaching a patient about an antidepressant medication. The nurse tells the patient that therapeutic effects may not occur for several weeks. The nurse understands that this is likely the result of:
A changes in the brain as a result of prolonged drug exposure.
B direct actions of the drug on specific synaptic functions in the brain.
C slowed drug absorption across the blood-brain barrier.
A nurse is teaching a group of nursing students how the CNS adapts to psychotherapeutic medications. Which statement by a nursing student indicates a need for further teaching?
A “Adaptation can lead to tolerance of these drugs with prolonged use.”
B “Adaptation helps explain how physical dependence occurs.”
C “Adaptation often must occur before therapeutic effects develop.”
D “Adaptation results in an increased sensitivity to side effects over time.”
A group of nursing students asks a nurse to explain the blood-brain barrier. The nurse would be correct to say that the blood-brain barrier:
A prevents some potentially toxic substances from crossing into the central nervous system.
B causes infants to be less sensitive to CNS drugs and thus require larger doses.
C allows only ionized or protein-bound drugs to cross into the central nervous system.
D prevents lipid-soluble drugs from entering the central nervous system.
A nurse is teaching a group of students about how CNS drugs are developed. Which statement by a student indicates a need for further teaching?
A “Central nervous system drug development relies on observations of their effects on human behavior.”
B “Studies of new central nervous system drugs in healthy subjects can produce paradoxical effects.”
C “Our knowledge of the neurochemical and physiologic changes that underlie mental illness is incomplete.”
D “These drugs are developed based on scientific knowledge of CNS transmitters and receptors.”
A patient asks a nurse to explain what drug tolerance means. The nurse responds by telling the patient that when tolerance occurs, it means the patient:
A has developed a psychologic dependence on the drug.
B may need increased amounts of the drug over time.
C will cause an abstinence syndrome if the drug is discontinued abruptly.
D will have increased sensitivity to drug side effects.
Which monoamines act as neurotransmitters in the central nervous system? (Select all that apply.)
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