Deck 18: Cholinergic Antagonists

Question 1

When doxacurium, a long-acting, non-depolarizing neuromuscular blocker, is given, the nurse can expect prolonged muscle relaxation in clients with:
1)Heart failure.
2)Chronic obstructive pulmonary disease.
3)Renal insufficiency.
4)Hepatitis.

Answer 1

3

Question 2

Discharge teaching for the client prescribed an anticholinergic drug would include:
1)Drink warm fluids to assist with symptoms of dry mouth.
2)Increase dietary intake of high-fiber foods.
3)Take a daily laxative.
4)Decrease caffeine intake.

Answer 2

2

Question 3

The nurse is caring for a client who received a neuromuscular blocker during surgery.Which finding indicates that the frequency of assessments may be decreased?
1)The client is fully conscious.
2)The client reports muscle pain.
3)All muscle function has fully recovered.
4)Vital signs are within normal limits.

Answer 3

3

Question 4

A client receives succinylcholine for paralysis during endoscopy.During the procedure, the client's muscles become rigid, and the skin feels hot to the touch.This client is most likely experiencing:
1)Esophageal perforation.
2)Malignant hyperthermia.
3)Septicemia.
4)Hyperthyroid storm.

Question 5

A client concurrently receiving which medication would be at risk for an intensified succinylcholine reaction?
1)Tetracycline
2)Ibuprofen
3)Opioids
4)Acetaminophen

Question 6

The nurse would counsel a client who has received the ganglionic-blocking agent trimethaphan about side effects, which can include:
1)Diarrhea.
2)Sweating.
3)Blurred vision.
4)Urinary incontinence.

Question 7

When tubocurarine is administered, the nurse first will see paralysis of:
1)The levator muscles of the eyelid and muscles of mastication.
2)The muscles in the lower extremities.
3)The muscles of respiration and the diaphragm.
4)The muscles controlling sphincters.

Question 8

The nurse prepares a client for a diagnostic procedure.Succinylcholine will be administered.What information should be given to the client?
1)There is a high risk of arrhythmias with administration of succinylcholine.
2)Nerve damage can occur after receiving succinylcholine.
3)Transient muscle pain is common after receiving succinylcholine.
4)Succinylcholine is not associated with any side effects.

Question 9

A client receiving dopaminergic drugs is being discharged from the hospital.Which of the following recommendations would the nurse include during discharge teaching?
1)Increase intake of high-fiber foods.
2)Avoid foods high in B₆, such as liver or sweet potatoes.
3)Decrease intake of low-protein foods.
4)Avoid low-carbohydrate foods.

Question 10

A client is suspected of having myasthenia gravis.A small dose of tubocurarine is administered, and the client develops increased muscle weakness.The nurse would expect to immediately administer:
1)A calcium channel blocker.
2)A dopamine agonist.
3)A sympathetic stimulant.
4)A cholinesterase inhibitor.

Question 11

Which of the following assessment findings indicates that a neuromuscular blocking agent has not produced the expected effect?
1)Restlessness
2)Hypotension
3)Consciousness
4)Drowsiness

Question 12

While a client is paralyzed with neuromuscular blockers, which assessment finding would the nurse expect?
1)Unconscious
2)Heavily sedated but conscious
3)Stuporous but can be aroused
4)Conscious

Question 13

Which non-depolarizing neuromuscular blocker has the shortest duration of action?
1)Pancuronium
2)Rocuronium
3)Vecuronium
4)Mivacurium

Question 14

The client asks the nurse how levodopa helps relieve symptoms from Parkinson's disease.Based on your knowledge of the drug, the most appropriate response would be:
1)"Levodopa increases the effects of acetylcholine in the brain."
2)"Levodopa increases the effects of dopamine in the brain."
3)"Levodopa increases the cholinergic effects in the brain."
4)"Levodopa increases the neuromuscular effects in the brain."

Question 15

A client requires emergency endotracheal intubation.Which drug would the nurse expect to administer?
1)Succinylcholine
2)Atropine
3)Pralidoxime
4)Galantamine

Question 16

Which statement is accurate regarding the difference between succinylcholine, a depolarizing neuromuscular blocker, and a non-depolarizing neuromuscular blocker?
1)Succinylcholine produces a state of flaccid paralysis.
2)Succinylcholine will produce sedation-like effects.
3)Succinylcholine produces paralysis that is preceded by a brief period of muscle contraction.
4)Succinylcholine produces a more prolonged state of paralysis.

Question 17

The goal of pharmacologic therapy in the client with Parkinson's disease is to:
1)Increase the amount of acetylcholine at presynaptic neurons.
2)Decrease the amount of available dopamine.
3)Balance cholinergic and dopaminic activity in the brain.
4)Block dopamine receptors at pre-synaptic and post-synaptic neurons.

Question 18

Before a procedure in which a neuromuscular blocking agent is used, the will nurse evaluate a client's electrolyte levels.Which abnormality would provoke the most concern?
1)Hyponatremia
2)Hypercalcemia
3)Hypomagnesemia
4)Hyperkalemia

Question 19

A client about to receive mecamylamine for hypertension should be advised to:
1)Change positions slowly.
2)Take the drug with food.
3)Take the drug early in the morning.
4)Expect diarrhea as the major side effect.

Question 20

A client prescribed an anticholinergic treatment for Parkinson's disease reports he has BPH (benign prostatic hypertrophy)with urinary retention.The most appropriate intervention for the nurse would be to:
1)Notify the health care provider about the client's report of BPH.
2)Instruct the client to drink more water.
3)Instruct the client to drink less caffeine.
4)Instruct the client that the medication will not have an effect on BPH symptoms.