Deck 20: Cholinergic Drugs

Question 1

A cholinergic drug is prescribed for a patient. The nurse checks the patient's medical history, knowing that this drug is contraindicated in which disorders? (Select all that apply.)

A) Bladder atony
B) Gastrointestinal obstruction
C) Bradycardia
D) Alzheimer's disease
E) Hypotension
F) Chronic obstructive pulmonary disease

Answer 1

Gastrointestinal obstruction
Bradycardia
Hypotension
Chronic obstructive pulmonary disease

Question 2

A patient is receiving memantine (Namenda) 10 mg PO daily. The patient is unable to swallow pills, so an oral solution that contains 2 mg/mL is ordered. How much will the patient receive per dose?

Answer 2

5 mL
2 mg : 1 mL :: 10 mg : x mL
(2 × x) = (1 × 10); 2x = 10; x = 5mL

Question 3

When monitoring a patient who is taking a cholinergic drug, the nurse will watch for which cardiovascular effect?

A) Bradycardia
B) Tachycardia
C) Vasoconstriction
D) Palpitations

Answer 3

Bradycardia

Question 4

A cholinergic drug is prescribed for a patient with a new diagnosis of myasthenia gravis, and the nurse provides instructions to the patient about the medication. What is important to include in the teaching?

A) Take the medication with meals to avoid gastrointestinal distress.
B) Give daytime doses close together for maximal therapeutic effect.
C) Take the medication 30 minutes before eating to improve swallowing and chewing.
D) Take the medication only if difficulty swallowing occurs during a meal.

Question 5

A patient is receiving a dose of edrophonium (Tensilon). The nurse recognizes that this drug is given to determine the diagnosis of which disease?

A) Parkinson's disease
B) Multiple sclerosis
C) Myasthenia gravis
D) Alzheimer's disease

Question 6

The nurse is providing teaching regarding drug therapy to the husband of a woman with Alzheimer's disease. She was diagnosed 3 months ago, has mild memory loss, and will be receiving donepezil (Aricept). What is the drug's expected action?

A) Prevents memory loss in later stages
B) Reverses the course of Alzheimer's disease
C) Provides sedation to prevent agitation and restlessness
D) May help to improve the symptoms of Alzheimer's disease

Question 7

The nurse notes in a patient's medication history that the patient is taking pilocarpine (Pilocar). Based on this finding, the nurse interprets that the patient has which disorder?

A) Anticholinergic poisoning
B) Glaucoma
C) Bladder atony
D) Myasthenia gravis

Question 8

A patient has been taking donepezil (Aricept) for 2 weeks as part of the treatment for early stages of Alzheimer's disease. Her daughter calls the prescriber's office and is upset because "Mother has not improved one bit!" Which response by the nurse is appropriate?

A) "Increase the dosage to twice daily."
B) "It takes time for the cure to take effect."
C) "It may take up to 6 weeks to see an improvement."
D) "Take the medication on an empty stomach for improved absorption."

Question 9

A factory worker has been admitted to the emergency department after an industrial accident involving organophosphate insecticides. The nurse will prepare to administer which drug?

A) pilocarpine (Salagen)
B) bethanechol (Urecholine)
C) pyridostigmine (Mestinon)
D) tacrine (Cognex)

Question 10

A patient who has been diagnosed with Sjögren's syndrome will be given cevimeline for the treatment of xerostomia. The nurse will monitor for what therapeutic effect?

A) Reduction of salivation
B) Stimulation of salivation
C) Reduction of gastrointestinal peristalsis
D) Improvement of fine-motor control

Question 11

A patient who has had abdominal surgery has been discharged on a cholinergic drug to assist in increasing gastrointestinal peristalsis. The nurse will teach this patient to look for which therapeutic effect?

A) Decreased pulse rate
B) Abdominal cramping
C) Passage of flatus
D) Decreased urge to void

Question 12

The nurse is reviewing the mechanism of action of cholinergic drugs. The undesired effects of cholinergic drugs come from the stimulation of which receptors?

A) Muscarinic
B) Nicotinic
C) Cholinergic
D) Ganglionic

Question 13

A patient has had an overdose of an intravenous cholinergic drug. The nurse expects to administer which drug as an antidote?

A) atenolol (Tenormin)
B) bethanechol (Urecholine)
C) dobutamine
D) atropine sulfate

Question 14

A patient calls the clinic to speak to the nurse about taking an herbal product that contains ginkgo ( Ginkgo biloba ) to "help my memory." He states that he has read much information about the herbal product. Which statement by the patient indicates a need for further education?

A) "I know the FDA has not approved this herbal product, but I'd like to try it to see if it helps my memory."
B) "I need to watch for possible side effects, such as headaches, or stomach or intestinal upset."
C) "I will take aspirin or ibuprofen ( Motrin ) if I have a headache."
D) "Ginkgo may cause increased bleeding, so I'll have to be careful when doing yard work."