Question 1

Which of the following is a cardiovascular effect of cholinergic drugs?&#10;A)Bradycardia&#10;B)Tachycardia&#10;C)Vasoconstriction&#10;D)Palpitations

Accepted Answer

The cardiovascular effects of cholinergic drugs are decreased heart rate and vasodilation.

Question 2

A patient tells the nurse that she wants to begin taking a ginkgo biloba preparation for memory enhancement.The nurse should warn this patient about possible drug interactions with which substances?&#10;A)Digoxin,diuretics,and steroids&#10;B)Caffeine-containing products&#10;C)Alcoholic beverages&#10;D)Aspirin,any nonsteroidal anti-inflammatory drugs (NSAIDs),warfarin (Coumadin),and heparin

Accepted Answer

When using ginkgo biloba,drug interactions may occur with the ingestion of aspirin,any NSAIDs,and the anticoagulants warfarin and heparin.

Question 3

A patient has had abdominal surgery and is being discharged on a cholinergic drug to assist in increasing gastrointestinal peristalsis.Which therapeutic effects should the nurse teach the patient to watch for?

A)Decreased pulse rate
B)Abdominal cramping
C)Passage of flatus
D)Decreased frequency and urgency of voiding patterns

Passage of flatus

Accepted Answer

Patients experiencing a postoperative decrease in gastrointestinal peristalsis should watch for an increase in bowel sounds,the passage of flatus,and the occurrence of bowel movements that indicate increased gastrointestinal peristalsis.

Question 4

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 physician's office and is upset because her mother has not shown any improvement.Which of the following is the nurse's best response to the patient's daughter?

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)"Have her take the medication on an empty stomach for improved absorption."

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Accepted Answer

Donepezil therapy is not a cure for Alzheimer's disease but may help to improve symptoms in the early stages.It may take up to 6 weeks to see improvement.
The family should be taught that the medication must be taken exactly as ordered and with meals.The medication should also not be abruptly stopped and the dosage should not be increased without the physician's approval due to the possibility of serious complications.

Question 5

Which drug is considered the antidote for anticholinergic poisoning and for poisoning by organophosphates and carbonates,such as common insecticides?&#10;A)pilocarpine&#10;B)bethanechol (Duvoid)&#10;C)physostigmine&#10;D)cholinesterase

Accepted Answer

Indirect-acting drugs such as physostigmine inhibit acetylcholinesterase (AChE),thus reversing the neuromuscular blockade produced by anticholinergic poisoning.

Question 6

MATCHING&#10;For each effect listed below,indicate which of the following stimulations it is due to:&#10;&#10;Decreased blood pressure&#10;A)Muscarinic stimulation&#10;B)Nicotinic stimulation&#10;C)Both muscarinic stimulation and nicotinic stimulation&#10;

Accepted Answer

Muscarinic stimulation can lead to decreased blood pressure, which is primarily due to the activation of parasympathetic nervous system and the consequent reduction in heart rate and vasodilation. Nicotinic stimulation, on the other hand, can increase blood pressure through the activation of sympathetic nervous system and the release of adrenaline and noradrenaline. Therefore, option A (muscarinic stimulation) is the only correct choice for decreased blood pressure.

Question 7

The desired effects of cholinergic drugs come from stimulation of which receptors?&#10;A)Muscarinic&#10;B)Nicotinic&#10;C)Cholinergic&#10;D)Ganglionic

Accepted Answer

The desired effects come from muscarinic receptor stimulation;many of the undesirable adverse effects are due to nicotinic receptor stimulation.

Question 8

The nurse is providing teaching regarding drug therapy to the husband of a woman with Alzheimer's disease.The patient was diagnosed 3 months ago and has mild memory loss.She will be receiving donepezil (Aricept).Which statement accurately describes the drug's actions?

A)It prevents memory loss in later stages.
B)It will reverse the course of Alzheimer's disease.
C)It provides sedation to prevent agitation and restlessness.
D)It may help to improve the symptoms of Alzheimer's disease.

Accepted Answer

Donepezil is used to treat the mild-to-moderate dementia of Alzheimer's disease and may improve the symptoms of the disease.

Question 9

MATCHING&#10;For each effect listed below,indicate which of the following stimulations it is due to:&#10;&#10;Pupil constriction&#10;A)Muscarinic stimulation&#10;B)Nicotinic stimulation&#10;C)Both muscarinic stimulation and nicotinic stimulation&#10;

Accepted Answer

The answer of MATCHING&#10;For each effect listed below,indicate which of...

Question 10

When an overdose of an intravenous cholinergic drug occurs,which of the following drugs can reverse a cholinergic crisis if administered promptly?&#10;A)atenolol (Tenormin)&#10;B)bethanechol (Duvoid)&#10;C)dobutamine&#10;D)atropine sulfate

Accepted Answer

Prompt administration of atropine sulfate can reverse a toxic dose of a cholinergic drug.

Question 11

MATCHING&#10;For each effect listed below,indicate which of the following stimulations it is due to:&#10;&#10;Increased heart rate&#10;A)Muscarinic stimulation&#10;B)Nicotinic stimulation&#10;C)Both muscarinic stimulation and nicotinic stimulation&#10;

Accepted Answer

The answer of MATCHING&#10;For each effect listed below,indicate which of...

Question 12

A patient has been newly diagnosed with myasthenia gravis.What important information should the nurse teach this patient regarding the administration of cholinergic drugs?&#10;A)The medication should be taken with meals to avoid gastrointestinal distress.&#10;B)Daytime dosages should be given close together for maximal therapeutic effect.&#10;C)The medication should be taken 30 minutes before eating to improve swallowing and chewing.&#10;D)Expected adverse effects are increased muscle weakness,abdominal cramping,and diarrhea,which should subside in a few days.

Accepted Answer

The answer of A patient has been newly diagnosed with...

Question 13

Which of the following is the main use of most direct-acting cholinergic drugs?&#10;A)They are the antidotes for anticholinergic poisoning.&#10;B)They are used topically to reduce intraocular pressure.&#10;C)They are used orally in preparation for ocular surgery.&#10;D)They are used for the diagnosis and treatment of myasthenia gravis.

Accepted Answer

The answer of Which of the following is the main...

Deck 20: Cholinergic Drugs