Deck 45: Drugs Used to Treat the Muscular System

Question 1

Which symptoms will be most important for the nurse to assess for early signs of respiratory distress in the patient who has been given a neuromuscular blocking agent?

A) Nasal flaring and retraction of intercostal muscles
B) Dyspnea, increased respiratory rate, and cyanosis
C) Restlessness, anxiety, and lethargy
D) Pallor, stridor, and diaphoresis

Answer 1

Restlessness, anxiety, and lethargy

Question 2

Which common adverse effects occur with neuromuscular blocking agents?

A) Fever
B) Flushing
C) Nausea
D) Ataxia

Answer 2

Flushing

Question 3

Which laboratory values will the nurse review prior to beginning medication therapy for skeletal and muscle disorders?

A) Sodium, magnesium, and chloride
B) C-reactive protein (CRP), human leukocyte antigen (HLA), and liver function tests
C) Arterial blood gases (ABGs), complete blood count (CBC), and electrolytes
D) Glucose, high-density lipoproteins (HDL), and prothrombin time (PT)

Answer 3

C-reactive protein (CRP), human leukocyte antigen (HLA), and liver function tests

Question 4

An employee at a factory has not been to work because of low back muscle spasms. His wife contacts the occupational health nurse to report that her spouse is on a centrally acting skeletal muscle relaxant and is having problems with sleepiness. Based on the medication action, what will the nurse tell her? (Select all that apply.)

A) "The health care provider should be notified because these drugs are contraindicated in the treatment of low back pain."
B) "Your husband should avoid activities requiring alertness, such as driving or operating power equipment."
C) "I need additional and specific information regarding the amount of your husband's sedation."
D) "I will review baseline laboratory studies, discuss your husband's status with the health care provider, and call you back."
E) "Sedation is an adverse effect of these medications and tends to resolve with continued therapy."

Question 5

A patient who has undergone a lengthy surgical procedure under general anesthesia is unable to breathe on his own following the procedure. Which drug will the nurse expect to be administered as an antidote to the neuromuscular blocking agent?

A) Dantrolene (Dantrium)
B) Neostigmine methylsulfate (Prostigmin)
C) Ether
D) Baclofen (Lioresal)

Question 6

Patients with which conditions must be carefully assessed to determine whether they would tolerate treatment with a neuromuscular blocking agent? (Select all that apply.)

A) Pregnancy
B) Hepatic disease
C) Pulmonary disease
D) Renal disease
E) Neurologic disorders
F) Psychiatric disorders

Question 7

A patient taking antipsychotic medication for schizophrenia is admitted with a temperature of 106 ^$\circ$ F. The admitting diagnosis is neuroleptic malignant syndrome secondary to antipsychotic medication. Which drug is indicated in treatment of this condition?

A) Edrophonium (Tensilon)
B) Dantrolene (Dantrium)
C) Baclofen (Lioresal)
D) Metaxolone (Skelaxin)

Question 8

Which drug interaction may occur when an aminoglycoside or tetracycline is given in conjunction with neuromuscular blocking agents?

A) Deep sedation
B) Decreased effectiveness of antibiotics
C) Increased neuromuscular blocking activity
D) Sensitivity to antibiotics and possible allergic reaction

Question 9

In the intensive care unit, the nurse is taking care of a patient who is on a ventilator and is receiving succinylcholine (Anectine). Which is a priority nursing diagnosis for this patient?

A) Pain
B) Disturbed Body Image
C) Risk for Injury
D) Self-Care Deficit

Question 10

Which assessment is most important for the nurse to obtain when a patient is being treated with a neuromuscular blocking agent?

A) Skin assessment for rash and urticaria
B) Blood pressure assessment for orthostatic hypotension
C) Respiratory assessment for patent airway
D) Assessment for fluid volume overload

Question 11

Which medication will be prescribed for a patient complaining of muscle spasms secondary to a back injury?

A) Acetaminophen (Tylenol)
B) Morphine sulfate
C) Bethanechol (Urecholine)
D) Cyclobenzaprine (Flexeril)

Question 12

The nurse is examining a patient in the emergency department whose chief complaint is a dislocated shoulder. Which assessment data is needed to evaluate the patient? (Select all that apply.)

A) Details related to the mechanism of injury
B) Degree of impairment
C) Pain level
D) Inspection of the affected part for swelling, capillary refill, bruising, redness, localized tenderness, deformities, and paresthesia
E) Elevation of the affected extremity

Question 13

The patient's family asks why neuromuscular blocking agents are used before electroconvulsive therapy. Which explanation by the nurse is most accurate?

A) "They stimulate respirations while therapy is delivered."
B) "They prevent aspiration of respiratory secretions during the therapy."
C) "They decrease intracranial pressure secondary to therapy."
D) "They reduce the risk of injury during therapy."

Question 14

What are the reasons that neuromuscular blocking agents are used? (Select all that apply.)

A) Alleviation of pain
B) Reducing the use and adverse effects of general anesthetics
C) Easing endotracheal intubation and prevent laryngospasm
D) Producing amnesia during painful procedures
E) Decreasing muscular activity in electroshock therapy

Question 15

What is the reason for paraplegic patient to receive baclofen (Lioresal)?

A) It interrupts reflexes at the level of the spinal cord.
B) It acts directly on the skeletal muscles to reduce spasticity.
C) It interrupts transmission of impulses from motor nerves to muscles at the skeletal neuromuscular junction.
D) It produces generalized mild weakness of skeletal muscles and decreases the force of reflex muscle contractions.