A patient’s heart rate is found to be 72 beats per minute and regular. The nurse evaluates which situation in the patient’s peripheral nervous
... [Show More] system?
Standard Text: Select all that apply.
1. The sympathetic system is in control.
2. The parasympathetic system is dominating.
3. Both parasympathetic and sympathetic systems are influencing cardiac status.
4. The autonomic nervous system is affecting cardiac status.
5. The somatic nervous system is affecting cardiac status.
Correct Answer: 2,3,4
Rationale 2: Restful cardiac response indicates that the primary input is from the parasympathetic system.
Rationale 3: These two systems work in tandem to regulate the cardiac response.
Rationale 4: Both the sympathetic and parasympathetic systems are part of the autonomic system.
2. A nurse is reading about the development of drugs that inhibit the parasympathetic nervous system. The nurse would look for articles about which drug classes?
Standard Text: Select all that apply.
1. Anticholinergics
2. Parasympathomimetics
3. Parasympatholytics
4. Cholinergics
5. Muscarinic blockers
Correct Answer: 1,3,5
Rationale 1: Anticholinergics inhibit the parasympathetic nervous system. Rationale 3: Parasympatholytic drugs inhibit the parasympathetic nervous system. Rationale 5: Muscarinic blockers inhibit the parasympathetic nervous system.
Question 3 Type: Hot Spot
Mark the site of the ganglionic synapse on this diagram.
1. A
2. B
3. C
4. D
Answer: 3
Rationale: The ganglionic synapse is the gap between the preganglionic neuron and the postganglionic neuron.
Question 4 Type: MCMA
A patient has been prescribed an oral drug containing atropine. The nurse would hold the drug and Contact the prescriber if which patient statements are made?
Standard Text: Select all that apply.
1. “I would like to wait a few minutes to take this as I just drank some aloe juice.”
2. “Can I take this at the same time as my procainamide?”
3. “I have had a headache this morning.”
4. “I am allergic to penicillin.”
5. “My gallbladder surgery is scheduled for next week.”
Correct Answer: 1,2
Rationale 1: Atropine should be used with caution in those who use aloe. Rationale 2: There is a drug–drug interaction between atropine and procainamide. Question 5
Type: MCSA
The 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. "My heart may beat slower while I am on this drug."
2. "I will need to increase my fluid intake with this medication."
3. "I must take this medication immediately before eating a full meal."
4. "It is really important to take my medication on time."
Correct Answer: 4
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 and as directed.
Question 6 Type: MCSA
The 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: 4.
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.
Question 7 Type: MCSA
The 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: 1
Rationale 1: Anticholinergics dry secretions; a decrease in respiratory secretions is indicated prior to surgery.
Question 8 Type: MCSA
The 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 femur
2. The patient with tachycardia
3. The patient with an irritable colon
4. The patient with diarrhea
Correct Answer: 2
Rationale 2: Anticholinergic drugs increase the heart rate; a patient with tachycardia should not receive benztropine (Cogentin).
Question 9 Type: MCSA
The 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 glaucoma
2. The patient with hyperthyroidism
3. The patient with a hiatal hernia
4. The patient with lung cancer
Correct Answer: 1
Rationale 1: Anticholinergic drugs can increase pressure in the eye; they must be avoided in patients with glaucoma.
Question 10 Type: MCSA
The 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: 2. Rationale 2: Anticholinergic drugs can cause or increase urinary hesitancy or retention.
Question 11 Type: MCSA
The 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: 2. Rationale 2: Anticholinergics slow gastrointestinal (GI) motility and can increase the risk for constipation.
Question 12
Type: MCMA
The nursing instructor teaches the student nurses about the nervous system. The instructor determines that learning has occurred when the students make which statement(s)?
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: 1,4,5
Rationale 1: The central nervous system includes the brain and spinal cord. Rationale 4: The nervous system provides reaction to environmental changes. Rationale 5: The somatic nervous system provides voluntary control over moving. Question 13
Type: MCMA
The 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)?
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: 1,4,5
Rationale 1: The sympathetic and parasympathetic systems are not always opposite in their effects.
Rationale 4: The parasympathetic nervous system causes bronchial constriction.
Rationale 5: The sympathetic nervous system is activated under stress.
Question 14 Type: MCSA
The 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: 4
Rationale 4: Medications cannot manufacture new neurotransmitters; they can only increase or decrease their action.
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