Deck 14: Cholinergic Antagonists

Question 1

A client prescribed an anticholinergic treatment for Parkinson disease reports he has benign prostatic hyperplasia (BPH)with urinary retention.Which intervention by the nurse is the most appropriate?

A)Instruct the client that the medication will not have an effect on BPH symptoms.
B)Instruct the client to drink less caffeine.
C)Instruct the client to drink more water.
D)Notify the health care provider about the client's report of BPH.

Answer 1

Notify the health care provider about the client's report of BPH.

Question 2

A client is admitted with an exacerbation of chronic obstructive pulmonary disease (COPD).Which medications would help with this client's symptoms?
Select all that apply.

A)Ipratropium (Atrovent)
B)Tiotropium (Spiriva)
C)Oxybutynin (Ditropan)
D)Benztropine (Cogentin)
E)Glycopyrrolate (Robinul)

Answer 2

Ipratropium (Atrovent)
Tiotropium (Spiriva)

Question 3

Before a procedure in which a neuromuscular blocking agent is used,the nurse will evaluate a client's electrolyte levels.Which abnormality would provoke the most concern?

A)Hypomagnesemia
B)Hyperkalemia
C)Hyponatremia
D)Hypercalcemia

Answer 3

Hyperkalemia

Question 4

When doxacurium (a long-acting,nondepolarizing neuromuscular blocker)is given,the nurse can expect prolonged muscle relaxation in clients with which condition?

A)Hepatitis
B)Heart failure
C)Renal insufficiency
D)Chronic obstructive pulmonary disease

Question 5

A client is receiving titrated doses of mecamylamine (Inversine).Which assessment findings indicate this client is experiencing adverse effects from this medication?
Select all that apply.

A)Orthostatic hypotension
B)Nausea
C)Dry mouth
D)Facial flushing
E)Body rash

Question 6

Which nondepolarizing neuromuscular blocker has the shortest duration of action?

A)Pancuronium
B)Vecuronium
C)Rocuronium
D)Mivacurium

Question 7

Which assessment findings does the nurse expect in a client who received a medication that is a muscarinic antagonist?
Select all that apply.

A)Dilated pupils
B)Increased heart rate
C)Hypoactive bowel sounds
D)Deep rapid respirations
E)Excessive salivation

Question 8

Which assessment finding indicates that a neuromuscular blocking agent has not produced the expected effect?

A)Consciousness
B)Hypotension
C)Restlessness
D)Drowsiness

Question 9

The nurse is caring for a client who is prescribed mecamylamine for hypertension.Which teaching point should the nurse emphasize with this client?

A)Take the drug with food.
B)Take the drug early in the morning.
C)Expect diarrhea as the major side effect.
D)Change positions slowly.

Question 10

The nurse prepares a client for a diagnostic procedure where succinylcholine will be administered.Which information should be given to the client?

A)Succinylcholine is not associated with any side effects.
B)Transient muscle pain is common after receiving succinylcholine.
C)Nerve damage can occur after receiving succinylcholine.
D)There is a high risk of arrhythmias with administration of succinylcholine.

Question 11

A client concurrently receiving which medication would be at risk for an intensified succinylcholine reaction?

A)Acetaminophen
B)Aminoglycosides
C)Ibuprofen
D)Opioids

Question 12

Which statement is accurate regarding the difference between succinylcholine,which is the only depolarizing neuromuscular blocker,and a nondepolarizing neuromuscular blocker?

A)Succinylcholine produces paralysis that is preceded by a brief period of muscle contraction.
B)Succinylcholine produces a state of flaccid paralysis.
C)Succinylcholine will produce sedation-like effects.
D)Succinylcholine produces a more prolonged state of paralysis.

Question 13

A client is suspected of having myasthenia gravis.A small dose of tubocurarine is administered,and the client develops increased muscle weakness.What would the nurse expect to immediately administer?

A)A sympathetic stimulant
B)A cholinesterase inhibitor
C)A calcium channel blocker
D)A dopamine agonist

Question 14

A client receives succinylcholine for paralysis during an endoscopy.During the procedure,the client's muscles become rigid,and the skin feels hot to the touch.Which effect will the nurse document in the medical record once the client is stabilized?

A)Septicemia
B)Esophageal perforation
C)Hyperthyroid storm
D)Malignant hyperthermia

Question 15

The nurse counsels a client who has received the ganglionic-blocking agent mecamylamine (Inversine)about side effects.Which side effect will the nurse include in the teaching session?

A)Sweating
B)Diarrhea
C)Urinary incontinence
D)Blurred vision

Question 16

When tubocurarine is administered,the nurse will first see paralysis of which muscles?

A)The levator muscles of the eyelid and muscles of mastication
B)The muscles in the lower extremities
C)The muscles controlling sphincters
D)The muscles of respiration and the diaphragm

Question 17

While a client is paralyzed with neuromuscular blockers,which assessment finding would the nurse expect?

A)Conscious
B)Stuporous but can be aroused
C)Heavily sedated but conscious
D)Unconscious

Question 18

A client admitted with exacerbation of asthma reports using ipratropium (Atrovent)up to 24 inhalations each day.Which assessment findings indicate the client is experiencing anticholinergic syndrome?
Select all that apply.

A)Photophobia
B)Difficulty swallowing
C)Agitation
D)Blurred vision
E)Excessive salivation

Question 19

The nurse is preparing discharge teaching for a client prescribed an anticholinergic drug.Which teaching topic is most appropriate for the nurse to include?

A)Decrease caffeine intake.
B)Drink warm fluids to assist with symptoms of dry mouth.
C)Increase dietary intake of high-fiber foods.
D)Take a daily laxative.

Question 20

During a surgical procedure,a client begins to demonstrate respiratory depression and hypotension after receiving a nondepolarizing blocker.Which treatments are indicated for this client?
Select all that apply.

A)Neostigmine (Prostigmin)
B)An antihistamine
C)Succinylcholine (Anectine)
D)A diuretic
E)Quinidine

Question 21

The nurse is preparing discharge instructions for a client prescribed an anticholinergic medication.What should be included in this teaching?
Select all that apply.

A)Report palpitations to the health care provider.
B)Report shortness of breath to the health care provider.
C)Expect to be dizzy with this medication.
D)Difficulty swallowing is an expected effect of this medication.
E)Fainting might occur.

Question 22

A client is scheduled for surgery to repair an abdominal aortic aneurysm.Which neuromuscular blocking agents will be the best choice for this client?
Select all that apply.

A)Tubocurarine
B)Mivacurium (Mivacron)
C)Pancuronium (Pavulon)
D)Vecuronium (Norcuron)
E)Succinylcholine (Anectine)

Question 23

A client is being prepared to receive succinylcholine (Anectine).For which types of procedures is this neuromuscular blocker indicated?
Select all that apply.

A)Intubation
B)Electroconvulsive therapy
C)Total hip replacement
D)Craniotomy
E)Mitral valve replacement

Question 24

A client received mivacurium (Mivacron)for a surgical procedure.Which assessment findings indicate adverse effects of this medication?
Select all that apply.

A)Bradycardia
B)Hypotension
C)Increased heart rate
D)Decreased heart rate
E)Hyperactive bowel sounds

Question 25

What will the nurse most likely assess in the client with Parkinson disease who is prescribed a muscarinic antagonist?

A)Diarrhea
B)Reduced tremors and rigidity
C)Increased urine output
D)Rhinorrhea