Deck 19: Cholinergic Agonists and Anticholinergics

Question 1

The client who is being treated with an anticholinergic medication should receive which instruction?

A) Encourage the use of alcohol before bedtime for sleep disorders.
B) Suggest hard candy, chewing gum, and oral hygiene for dry mouth.
C) Instruct the client to report dizziness and a slow pulse rate immediately.
D) Instruct the client to avoid lifting heavy objects.

Answer 1

Suggest hard candy, chewing gum, and oral hygiene for dry mouth.

Question 2

The client that would be a poor candidate for treatment with an atropine-like drug is the client who has:

A) parkinsonism.
B) a peptic ulcer.
C) cirrhosis.
D) glaucoma.

Answer 2

glaucoma.

Question 3

The client has been started on Artane. The nurse notes that the client's bowel sounds are decreasing. What is the highest priority action on the part of the nurse?

A) Administer the drug; this is an expected reaction.
B) Administer the drug; this is an expected side effect.
C) Hold the drug; this is an adverse reaction to the drug.
D) Hold the drug; this is a life-threatening response.

Answer 3

Hold the drug; this is a life-threatening response.

Question 4

A nurse is teaching a client about bethanechol hydrochloride (Urecholine). The nurse informs the client that this drug warrants which precaution?

A) Rising slowly from lying positions
B) Counting pulse rate frequently to assess for bradycardia
C) Avoiding diarrhea by eating binding foods
D) Maintaining aspiration precautions because of excess saliva

Question 5

The client has been started on Detrol LA and tells the nurse that he is experiencing constipation. What is the highest priority action on the part of the nurse?

A) Hold the next dose of the medication; this is an adverse reaction.
B) Administer the drug: this is an expected response to the drug.
C) Notify the physician; this is a side effect of the medication.
D) Call the pharmacist; this is evidence of toxicity of the drug.

Question 6

Reversible cholinesterase inhibitors can be an effective treatment for glaucoma because of which action of the drug?

A) It causes the eyeball to decrease in size.
B) It causes the aqueous humor of the eye to expand.
C) It produces pupillary constriction.
D) It produces pupillary dilation.

Question 7

The nurse notes that a client with glaucoma has been ordered an anticholinergic medication. What is the highest priority action on the part of the nurse?

A) Administer the medication; this is appropriate for this client.
B) Check the client's allergy history since it can cause anaphylaxis.
C) Call the pharmacist; the drug interacts with many other medications.
D) Call the physician; this is an inappropriate drug for this client.

Question 8

The client that would be a poor candidate for treatment with bethanechol chloride (Urecholine) is the client who is experiencing:

A) severe bradycardia and hypotension.
B) tachycardia and hypertension.
C) urinary retention and abdominal distention.
D) hypertension and urinary retention.

Question 9

The nurse is reviewing the history of a client who has been prescribed tolterodine tartrate (Detrol, Detrol LA) for treatment of incontinence. The nurse plans to contact the health care provider if the client has:

A) cataracts.
B) hyperthyroidism.
C) narrow-angle glaucoma.
D) parkinsonism.

Question 10

A client with nausea and vomiting has been prescribed an antihistamine and an anticholinergic. The nurse anticipates that which expected side effect of these medications will be observed in the client?

A) Drowsiness and dry mouth
B) Bradycardia and fatigue
C) Tachycardia and dyspnea
D) Abdominal cramps and nausea

Question 11

The client has myasthenia gravis. The highest priority client teaching is:

A) instructing the client to take the drug on a strict schedule to avoid respiratory muscle weakness.
B) informing the client if a dose of the drug is missed to double the drug dose when the next dose is scheduled.
C) instructing the client that if muscle weakness occurs, to rest, and if it persists to call the healthcare provider the next day.
D) informing the client that if respiratory distress occurs, rest, double the drug dose, and call the healthcare provider.

Question 12

A client experiences bradycardia as a result of vagal stimulation. What will the nurse expect to administer?

A) Bethanechol chloride (Urecholine)
B) Benztropine (Cogentin)
C) Metoclopramide (Reglan)
D) Atropine sulfate (atropine)

Question 13

The client has been started on Detrol LA. She is also being treated with a tricyclic antidepressant. What effect should the nurse anticipate from the interaction of the medications?

A) Increased action of the Detrol LA
B) Decreased action of the Detrol LA
C) Increased action of the tricyclic medication
D) Decreased action of the tricyclic medication

Question 14

A client is receiving bethanechol chloride (Urecholine) as part of his treatment regimen. He is experiencing swallowing difficulties. The highest priority action on the part of the nurse is to contact the physician to administer the drug by _____ injection.

A) intramuscular
B) intravenous
C) subcutaneous
D) intradermal

Question 15

Which response can the nurse expect to see in the client who has parkinsonism and is being treated with anticholinergics?

A) Decreased cognition
B) Increased muscle tone
C) Diuresis
D) Decreased tremors and rigidity

Question 16

The client is being treated with a large dose of an anticholinergic medication. She complains of feeling disoriented. What should be the nurse's highest priority action based on the client's complaint?

A) Call the pharmacist; the dose of the medication may be incorrect.
B) Call the physician; the medication is causing an adverse reaction.
C) Call the pharmacist; the medication may be reaching a toxic level.
D) Call the physician; the medication is causing an expected side effect.

Question 17

The nurse notes that Artane has been ordered as a preoperative medication for the client. What is the highest priority action on the part of the nurse?

A) Administer the medication; this is an expected preoperative medication for the client.
B) Administer the drug cautiously; anaphylaxis can occur quickly with this drug.
C) Call the physician to question the order based on the client's allergy history.
D) Call the physician to question the order; this is not a usual preoperation medication.

Question 18

The client has been diagnosed with early-stage Alzheimer's dementia. What cholinesterase inhibitor is most likely to be ordered for this client?

A) Ambenonium chloride (Mytelase)
B) Bethanechol chloride (Urecholine)
C) Atropine sulfate
D) Donepezil (Aricept)

Question 19

A client is ordered bethanechol chloride (Urecholine) for urinary retention. A nurse is adding up the client's intake and output for the 8-hour shift. The client's I = 850 mL, O = 350 mL. What should the nurse do?

A) Administer an extra dose of bethanechol.
B) Palpate the client's bladder.
C) Increase the client's fluid intake.
D) Continue the plan of care.