Deck 22: Drugs Affecting the Sympathetic Adrenergicnervous System

Question 1

A nurse preparing to administer propranolol (Inderal)recalls that it exerts its antihypertensive effect through which of the following mechanisms?

A) Increased peripheral resistance
B) $\beta$ -agonistic selectivity
C) Increased renin production
D) $\beta$ -antagonistic properties

Answer 1

$\beta$ -antagonistic properties

Question 2

The nurse reviewing medication orders understands that which of the following would not be an appropriate route of administration for epinephrine?

A) Subcutaneous injection
B) Inhalation
C) Intramuscular injection
D) Oral

Answer 2

Oral

Question 3

The nurse determines that the client is having a satisfactory effect of dopamine (Intropin)after noting which of the following signs?

A) Urine output of 45 mL/hr
B) Systolic blood pressure of 90 mm Hg
C) Heart rate of 58 beats/min
D) Cool extremities

Answer 3

Urine output of 45 mL/hr

Question 4

Catecholamines produce a marked increase in myocardial contractility.This reaction is also called a

A) positive inotropic effect.
B) negative dromotropic effect.
C) negative chronotropic effect.
D) positive somatotropic effect.

Question 5

The family of a client with heart failure asks why dopamine (Intropin)is infusing by the intravenous line.Using appropriate language,the nurse explains that in this case it

A) reduces peripheral resistance.
B) enhances cerebrovascular blood flow.
C) promotes renal vasodilation.
D) promotes adrenal medulla inhibition.

Question 6

Which of the following nursing diagnoses is appropriate for a client receiving dopamine therapy?

A) Increased cardiac output
B) Excess fluid volume
C) Ineffective tissue perfusion
D) Impaired sensory perception

Question 7

After reviewing a client's medication list and seeing an order for an $\alpha$ -adrenergic blocking drug,what would the nurse recall about this type of medication?

A) It stimulates normal neural or hormonal activity
B) It inhibits $\alpha$ receptors in vascular smooth vessels
C) It inhibits vasospasms and leads to vasodilation
D) It is used exclusively for the treatment of hypotension

Question 8

When teaching clients about $\beta$ -blocking medications such as atenolol (Tenormin)and metoprolol (Lopressor),they should be informed that

A) These medications may be taken on an empty stomach or with 3 to 5 ounces of antacids
B) Hot baths and showers will help enhance the therapeutic effects and are encouraged
C) Alcohol intake is encouraged for its vasodilating effects
D) Abrupt medication withdrawal may lead to a rebound hypertensive crisis

Question 9

The client is receiving a drug that results in $\beta$ ₂-adrenergic receptor stimulation.The nurse anticipates that an expected effect in the client will be which of the following?

A) Vasodilation of the periphery
B) Cardiac deceleration
C) Bronchial dilation
D) Uterine contraction

Question 10

Client education related to an isoproterenol (Isuprel)inhaler should include which of the following statements?

A) "Make sure to allow 5 to 10 minutes between the first and second inhalations."
B) "This drug may turn your saliva and sputum pink,so don't be alarmed unless other symptoms are present."
C) "Luckily,this drug is stable in light,air,and heat,so storage is easy."
D) "Systemic absorption is not of concern with the inhalant technique."

Question 11

The nurse plans to administer dopamine (Intropin)as ordered at which of the following dosage ranges to achieve a renal vasodilating effect with increased urine output?

A) 0.1 to 0.4 mcg/kg/min
B) 0.5 to 2 mcg/kg/min
C) 3 to 5 mcg/kg/min
D) 6 to 10 mcg/kg/min

Question 12

The nurse would assess for which of the following as a response by the client to administration of an adrenergic drug?

A) Vasodilation of the blood vessels to the skin
B) Bronchial constriction
C) Increased heart rate and contractility
D) Increased intestinal motility

Question 13

Mr.S.states that he has taken epinephrine for years to manage his asthma and that he has taken it for prophylactic use as well.As his nurse,you inform him that prophylactic use

A) may lead to tolerance of its effects.
B) causes episodes of syncope from hypotension.
C) is used for severe asthmatics with high blood pressure.
D) can lead to few problems or drug interactions.

Question 14

A female nursing student states she has never hear of isoproterenol (Isuprel).While showing the student where the drug literature is kept on the unit,the critical care nurse also shares that it is an effective

A) selective $\alpha$ -adrenergic antagonist.
B) nonselective $\beta$ -adrenergic agonist.
C) $\beta$ ₁-adrenergic antagonist.
D) $\beta$ ₂-adrenergic agonist.

Question 15

Which of the following agents would the nurse anticipate being used to manage a hypertensive episode in a client with pheochromocytoma?

A) Phentolamine mesylate (Regitine)
B) Propranolol (Inderal)
C) Methysergide (Sansert)
D) Amrinone (Inocor)

Question 16

The nurse evaluates a client who received a dose of ergotamine tartrate and caffeine (Cafergot)for which of the following intended effects?

A) Lowered blood pressure
B) Relief of headache
C) Increased pulse rate
D) Reduced urge to drink coffee

Question 17

The three naturally occurring catecholamines in the body are

A) serotonin,acetylcholine,and phenylethylamine.
B) $\gamma$ -aminobutyric acid,melatonin,and oxytocin.
C) enkephalin,histamine,and bradykinin.
D) dopamine,norepinephrine,and epinephrine.

Question 18

The nurse should give which of the following instructions to a client who is receiving an ophthalmic administration of epinephrine?

A) Look upward during administration of the drug
B) Notify the physician if stinging of the eyes occurs
C) Notify the physician if a headache occurs
D) Increased perspiration and heart rate are signs of systemic absorption

Question 19

The nurse is caring for a client who will have a new drug order written for a $\beta$ -adrenergic blocking drug.Knowing that the client's condition warrants the use of a cardioselective $\beta$ -blocker,the nurse anticipates that which drug will be ordered?

A) Propranolol (Inderal)
B) Atenolol (Tenormin)
C) Pindolol (Visken)
D) Timolol (Timoptic)

Question 20

The nurse explains to a client that the onset of action for epinephrine administered by inhalant is

A) 30 to 40 minutes.
B) 20 to 30 minutes.
C) 10 to 20 minutes.
D) 3 to 5 minutes.

Question 21

A client has a new drug order for a $\beta$ -adrenergic blocking drug.The nurse would evaluate the client closely for an adverse effect after noting that the client has a history of which of the following health problems?

A) Pneumonia
B) Insulin-controlled diabetes mellitus
C) Hypertension
D) Intracranial aneurysm

Question 22

A client who has a diagnosis of chronic obstructive pulmonary disease requires the use of a $\beta$ -blocking agent.Which of the following drugs does the nurse anticipate will be ordered for this client?

A) Nadolol (Corgard)
B) Pindolol (Visken)
C) Carteolol (Cartrol)
D) Atenolol (Tenormin)

Question 23

The nurse would question an order for a $\beta$ -blocking drug if the client had a history of which of the following types of angina pectoris?

A) Stable
B) Unstable
C) Variant
D) Nocturnal

Question 24

A client with hypertension is started on drug therapy with timolol (Blocadren).The nurse evaluates that the client understands proper use of this drug when the client states to withhold the dose and notify the prescriber for a heart rate slower than how many beats per minute?

A) 30
B) 40
C) 50
D) 60

Question 25

The nurse determines that the intravenous site of a client receiving dopamine hydrochloride (Intropin)is extravasated after noting which of the following signs?

A) Coolness and hardness
B) Red streak along vein
C) Warmth
D) Swelling

Question 26

The nurse interprets that a client receiving drug therapy with propranolol (Inderal)would most likely need to have therapy terminated if which of the following cardiac rhythms developed?

A) Sinus tachycardia
B) Atrial fibrillation
C) Premature ventricular contractions
D) Second-degree atrioventricular block

Question 27

A client may be eligible to discontinue a $\beta$ -adrenergic blocking drug.The nurse explains that the drug cannot be stopped immediately but must be tapered down over what period of time?

A) 2 to 3 days
B) 1 to 2 weeks
C) 2 to 4 weeks
D) 4 to 6 weeks