Deck 4: Peripheral Nervous System Drugs

Question 1

A provider reviews the patient's chart before prescribing bethanechol for postoperative urinary retention. Which preexisting condition would be a contraindication to using this drug?

A) Asthma
B) Gastroesophageal reflux
C) Hypertension
D) Hypothyroidism

Answer 1

Asthma

Question 2

Dopamine is administered to a patient who has hypotension. Other than an increase in blood pressure, which indicator would the provider use to evaluate a successful response?

A) Decrease in pulse
B) Increase in urine output
C) Weight gain
D) Improved gastric motility

Answer 2

Increase in urine output

Question 3

A client with a history of motion sickness asks the provider about medication to manage this condition during a planned cruise. What medication will the provider likely prescribe?

A) Ipratropium
B) Scopolamine
C) Dicyclomine
D) Atropine

Answer 3

Scopolamine

Question 4

A patient will begin taking propranolol for hypertension. Which statement made by the prescriber is important when teaching this patient about the medication?

A) "Notify the clinic if you start waking at night with shortness of breath or have difficulty lying flat."
B) "It is safe to take this medication with your 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."

Question 5

A client is about to begin anticholinergic medication therapy. What instructions will the provider give to best minimize common side effects?

A) Wear dark glasses both indoors and outdoors.
B) Void just prior to taking the medication.
C) Minimize fiber intake to avoid diarrhea.
D) Hydrate well before engaging in outdoor exercise.

Question 6

Which assessment finding would be of greatest concern for a provider who is attempting to determine the appropriateness of prescribing the patient a nonselective $\beta$ agonist?

A) Pulse oximetry reading of 88%
B) Blood pressure of 100/60 mm Hg
C) Respiratory rate of 28 breaths/minute
D) Heart rate of 110 beats/minute

Question 7

A patient experiences delirium and hallucinations after beginning atropine treatment for bradycardia. Which medication will the provider prescribe to address these signs of possible atropine toxicity?

A) Donepezil
B) Edrophonium
C) Neostigmine
D) Physostigmine

Question 8

A pregnant patient is in premature labor. Which class of drug will her provider prescribe in an attempt to stop the contractions?

A) ( $\alpha$ ₁) agonist
B) Anticholinergic
C) ( $\beta$ ₂) agonist
D) ( $\beta$ ₂) antagonist

Question 9

A provider prescribed methyldopa for a patient with hypertension. The patient is educated about drug actions, adverse effects, and the ongoing blood tests necessary with this drug. What additional statement should the provider include during the teaching?

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 office immediately and stop taking the medication if your eyes look yellow."

Question 10

A patient prescribed phentolamine to treat pheochromocytoma now has a blood pressure of 76/52 mm Hg and a heart rate of 90 beats/minute. Which action will the provider take to provide effective care?

A) Prescribe epinephrine.
B) Ask to be notified if the heart rate increases.
C) Prescribe a $\beta$ blocker.
D) Prescribe norepinephrine.

Question 11

A patient who takes a $\beta$ blocker reports experiencing shortness of breath and has respirations of 28 breaths/minute, a blood pressure of 78/50 mm Hg, a pulse of 68 beats/minute, and crackles are auscultated in all lung fields. The provider begins treatment for what condition based on the assessment data?

A) Bronchoconstriction
B) Left-sided heart failure
C) Rebound cardiac excitation
D) Sinus bradycardia

Question 12

The prescriber has ordered neostigmine for a patient with myasthenia gravis. What physiological process would be assessed to best assure patient safety and the long-term effectiveness of the medication therapy?

A) The patient's ability to raise the eyelids
B) The level of fatigue the patient generally experiences
C) Current skeletal muscle strength the patient possesses
D) The patient's current swallowing ability

Question 13

The provider 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."

Question 14

The provider is assessing an older adult male patient prior to beginning a prescribed anticholinergic drug. Which question concerning preexisting conditions demonstrates the provider's understanding of possible contraindications to this therapy?

A) "Would you say that diarrhea is a problem you deal with regularly?"
B) "Do you have any vision problems that require a prescribed medication?"
C) "Have you ever been treated for prostate cancer?"
D) "Do you have problems with urinary incontinence?"

Question 15

For what purpose will a provider prescribe pilocarpine?

A) To reduce excessive secretions in a postoperative patient
B) To lower intraocular pressure in a patient with glaucoma
C) To inhibit muscular activity in a patient with an overactive bladder
D) To prevent a hypertensive crisis in a patient with chronic hypertension

Question 16

Bethanechol is being investigated for inclusion in treatment for which diagnosis?

A) Gastric ulcers
B) Gastroesophageal reflux
C) Hypotension
D) Intestinal obstruction

Question 17

A patient is wheezing and short of breath with a heart rate of 88 beats/minute, a respiratory rate of 24 breaths/minute, and a blood pressure of 124/78 mm Hg. The primary health care prescriber orders a nonselective $\beta$ agonist medication. Besides evaluating the patient for a reduction in respiratory distress, which side effect is of primary concern?

A) Hypotension
B) Tachycardia
C) Tachypnea
D) Urinary retention

Question 18

A male patient with benign prostatic hyperplasia (BPH) has stopped taking his $\alpha$ -adrenergic antagonist medication because of ejaculatory difficulties. Which medication will the provider to prescribe to best address the BPH and the patient's concerns?

A) Alfuzosin
B) Prazosin
C) Silodosin
D) Tamsulosin

Question 19

An older adult patient who lives alone and admits to being "somewhat forgetful" has an overactive bladder (OAB) and occasional constipation. The patient has tried behavioral therapy to treat the OAB without success. Which treatment will the provider likely prescribe for this patient?

A) Oxybutynin short-acting syrup
B) Oxybutynin [Ditropan XL] extended-release tablets
C) Oxybutynin [Oxytrol] transdermal patch
D) Percutaneous tibial nerve stimulation (PTNS)

Question 20

A patient with asthma uses albuterol for wheezing. The provider notes current vital signs of HR, 96 beats/minute; RR, 18 breaths/minute; and BP, 116/78 mm Hg. The patient has clear breath sounds and fine hand tremors. What action will the provider take initially to treat this patient effectively?

A) Ask how often the patient uses the inhaler.
B) Check the patient's blood glucose level.
C) Prescribe isoproterenol to reduce side effects.
D) Substitute isoproterenol to minimize the tremors.

Question 21

A patient reports that the clonidine recently prescribed for hypertension is causing drowsiness. Which response by the provider to this concern is appropriate?

A) "Drowsiness is a common side effect initially, but it will lessen with time."
B) "You may also experience hypotension when you stand 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 I'll prescribe an alternative medication."

Question 22

Clonidine is approved for the treatment of which conditions? (Select all that apply.)

A) ADHD
B) Hypertension
C) Opioid withdrawal
D) Severe pain
E) Smoking cessation

Question 23

A prescriber orders clonidine ER (Kapvay ER) tablets for a 12-year-old child to treat which condition?

A) ADHD
B) Hypertension
C) Severe pain
D) Tourette syndrome

Question 24

A patient is prescribed both a diuretic and a dobutamine in the immediate postoperative period. What adverse drug reactions will the prescriber consider as possible in this patient? (Select all that apply.)

A) Angina
B) Dysrhythmias
C) Hypotension
D) Oliguria
E) Tachycardia

Question 25

A prescriber has ordered methyldopa for a female patient diagnosed 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
E) Urinalysis