Question 1

A client is prescribed oxymetazoline (OcuClear)ophthalmic solution for redness of the eye and eye irritation.Which statements are appropriate for the nurse to include in this client's teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

Transient stinging, blurred vision, and headache or brow pain are possible side effects of oxymetazoline ophthalmic solution. However, expect some dizziness and vomiting are not common side effects of this drug, and therefore, should not be included in the client's teaching.

Question 2

A client is prescribed a high-dose dopamine infusion.The nurse would expect to see an increase in blood pressure because of dopamine's effect on which receptors?

Accepted Answer

High-dose dopamine infusions stimulate alpha-1 adrenergic receptors, leading to vasoconstriction and an increase in blood pressure. Dopaminergic receptors are stimulated by low-dose dopamine infusions, while beta-1 and beta-2 adrenergic receptors are stimulated by other medications such as epinephrine and albuterol.

Question 3

The nurse is starting a high-dose dopamine infusion for a client diagnosed with shock.The nurse should monitor the client for which side effect of this drug?

Accepted Answer

High-dose dopamine infusion can cause ventricular tachycardia as a side effect. It is important for the nurse to closely monitor the client's cardiac rhythm and report any abnormalities to the healthcare provider promptly.

Question 4

One of the reasons epinephrine causes an intense fight-or-flight response throughout the body is because it stimulates which receptors?

Accepted Answer

Epinephrine stimulates all four types of adrenergic receptors (alpha-1, alpha-2, beta-1, and beta-2), leading to a widespread physiological response. Activation of the alpha-1 receptors leads to vasoconstriction and pupil dilation, while activation of the alpha-2 receptors inhibits insulin release and leads to decreased norepinephrine release. Activation of the beta-1 receptors increases heart rate and contractility, and activation of the beta-2 receptors leads to bronchodilation and vasodilation in skeletal muscle.

Question 5

Why are adrenergic agonists such as epinephrine given parenterally or by inhalation instead of orally?

Accepted Answer

Adrenergic agonists like epinephrine are metabolized by the enzyme catechol-O-methyltransferase (COMT) in the intestinal tract, which significantly reduces their effectiveness when taken orally. This is why they are administered parenterally or by inhalation to ensure they reach their target tissues before being metabolized.

Question 6

A client is prescribed salmeterol (Serevent)by inhalation for asthma.The client asks the nurse how the medication can help.The nurse's response should be based on the fact that salmeterol (Serevent)is which type of agonist?

Accepted Answer

Salmeterol (Serevent) is a selective beta-2 agonist, which means it specifically targets and stimulates beta-2 adrenergic receptors in the lungs. This stimulation relaxes the smooth muscles in the airways, leading to bronchodilation and improvement in asthma symptoms.

Question 7

The nurse is getting ready to use an EpiPen auto-injector for a client who was bitten by a wasp.In order for the EpiPen to be fully effective,where will the nurse educate the client to store it?

Accepted Answer

The answer of The nurse is getting ready to use...

Question 8

A client who was stung by a bee is treated with an EpiPen auto-injection.Which assessment finding indicates that the drug is working?

Accepted Answer

Epinephrine, administered through an EpiPen, works by causing vasoconstriction which leads to an increase in blood pressure, counteracting the effects of a severe allergic reaction or anaphylaxis.

Question 9

Isoproterenol is an effective bronchodilator.It also produces adverse cardiovascular effects because of its effect on which receptors?

Accepted Answer

Isoproterenol stimulates beta-2 adrenergic receptors and causes bronchodilation. However, it also stimulates beta-1 adrenergic receptors leading to an increased heart rate, contractility, and potential arrhythmias. It does not significantly affect alpha-1 or alpha-2 receptors, nor dopamine receptors.

Question 10

Phenylephrine is to be used for a client to reverse hypotension caused by spinal anesthesia.For which symptoms should the nurse assess the client as contraindications to this drug? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

Phenylephrine is a sympathomimetic agent that can cause vasoconstriction, leading to increased blood pressure. It is contraindicated in patients with angina and severe hypertension due to the risk of exacerbating these conditions by further increasing blood pressure. It is also contraindicated in narrow-angle glaucoma because it can increase intraocular pressure.

Question 11

A client receives epinephrine for anaphylactic shock.The nurse should be aware of which mechanism by which epinephrine acts?

Accepted Answer

Epinephrine acts directly by stimulating adrenergic receptors, specifically alpha and beta receptors. This leads to various physiological responses including increased heart rate and blood pressure, bronchodilation, and decreased allergic reactions.

Question 12

A client is prescribed tetrahydrozoline (Tyzine)for redness of the eye.Which rationale supports the use of this medication?

Accepted Answer

Tetrahydrozoline (Tyzine) is a vasoconstrictor that causes constriction of the arterioles in the eye, which reduces redness and swelling. It does not affect the pupil or the muscles of the iris, nor does it absorb fluid in the conjunctival sac.

Question 13

A client is prescribed albuterol (Proventil)oral tablets for asthma.What should the nurse include when teaching the client about this medication?

Accepted Answer

The nurse should teach the client that albuterol (Proventil) oral tablets should be taken 15 minutes before exercise to prevent exercise-induced asthma. Doubling the dosage without consulting a healthcare provider can lead to adverse effects, and taking the medication every 5 minutes is not a recommended dosing schedule. While albuterol is effective in treating acute attacks, this is not the most important aspect to teach the client in regards to oral tablet use.

Question 14

A client diagnosed with asthma asks the nurse why an albuterol (Proventil)inhaler is better than isoproterenol (Isuprel).The nurse's response should be based on the physiologic concept that isoproterenol affects which receptors?

Accepted Answer

Isoproterenol affects both beta-1 and beta-2 receptors, while albuterol (Proventil) primarily affects beta-2 receptors. Beta-2 receptor activation causes bronchodilation, which is the desired effect in treating asthma. Isuprel, which affects both beta-1 and beta-2 receptors, can increase heart rate and blood pressure, making it a less desirable option for patients with asthma.

Question 15

The nurse is teaching a client about the use of phenylephrine (Neo-Synephrine)nasal spray.Which statement by the nurse is the most appropriate to include in the teaching plan? Note: Credit will be given only if all corrected choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

A) Phenylephrine can increase blood pressure and heart rate, so it's important to avoid caffeine-containing beverages that can also increase these parameters.
D) Overuse of phenylephrine can lead to side effects such as palpitations and nervousness, which should be reported to the healthcare provider.
E) Phenylephrine should be avoided in individuals with heart disease as it can worsen the condition. 
B) Using the spray for more than three days can cause rebound congestion, so it's important to limit the use to as short a duration as possible.
C) Phenylephrine nasal spray is prescribed specifically for the individual user and should not be used by others in the family as it can be harmful.

Question 16

A client taking an MAO inhibitor for hypertension asks the nurse for medication to relieve nasal congestion.The nurse should know that phenylephrine will be a poor choice for this client because it might cause which condition?

Accepted Answer

Phenylephrine is a sympathomimetic drug that can increase blood pressure, which is already a concern in a client taking an MAO inhibitor for hypertension. The best choice would be a non-vasoconstrictive nasal decongestant, such as saline nasal spray or a topical steroid nasal spray, which would not interact with the MAO inhibitor or raise blood pressure.

Question 17

A client is given ephedrine (Efedron)for bronchial asthma.The nurse should ask the client to report which effect of this drug?

Accepted Answer

Ephedrine is a sympathomimetic drug which works by stimulating the beta2-adrenergic receptors and thus helps in bronchodilation. However, it can also have a stimulatory effect on the heart leading to palpitations. Therefore, the nurse should ask the client to report any unusual heartbeats or palpitations. Drowsiness, excessive vomiting, and increased appetite are not common side effects of ephedrine.

Question 18

A client with Parkinson disease who is receiving entacapone (Comtan)is to be given epinephrine for cardiopulmonary resuscitation.The nurse should be aware that entacapone (Comtan)causes an increased effect of epinephrine on the heart due to which action?

Accepted Answer

Entacapone is a COMT inhibitor, which means it inhibits the enzyme COMT (catechol-O-methyltransferase) in the synaptic cleft. Epinephrine is metabolized by COMT, so inhibiting this enzyme with entacapone can increase the effect of epinephrine on the heart.

Question 19

A client diagnosed with narcolepsy is prescribed ephedrine,and asks the nurse how this medication will improve the problem.The nurse's response will be based on which physiologic concept?

Accepted Answer

Ephedrine is a sympathomimetic drug that can easily cross the blood-brain barrier and stimulate the release of norepinephrine, which helps to improve the symptoms of narcolepsy by increasing alertness and reducing fatigue. It is not used to treat epilepsy. Enzymes in the synaptic cleft do not destroy ephedrine, and its absorption through the intestinal tract is not a significant issue.

Question 20

A low-dose dopamine infusion is to be started for a client diagnosed with hypovolemic shock.Which assessment finding indicates the drug is having the desired therapeutic effect?

Accepted Answer

A low-dose dopamine infusion is used to increase urine output in clients with hypovolemic shock. It does not typically increase blood pressure (which would be the result of a higher dose), and nausea and tachycardia are not desired effects.

Quiz 15: Adrenergic Agonists

A client is prescribed a high-dose dopamine infusion.The nurse would expect to see an increase in blood pressure because of dopamine's effect on which receptors?

The nurse is starting a high-dose dopamine infusion for a client diagnosed with shock.The nurse should monitor the client for which side effect of this drug?

One of the reasons epinephrine causes an intense fight-or-flight response throughout the body is because it stimulates which receptors?

Why are adrenergic agonists such as epinephrine given parenterally or by inhalation instead of orally?

A client is prescribed salmeterol (Serevent) by inhalation for asthma.The client asks the nurse how the medication can help.The nurse's response should be based on the fact that salmeterol (Serevent) is which type of agonist?

The nurse is getting ready to use an EpiPen auto-injector for a client who was bitten by a wasp.In order for the EpiPen to be fully effective,where will the nurse educate the client to store it?

A client who was stung by a bee is treated with an EpiPen auto-injection.Which assessment finding indicates that the drug is working?

Isoproterenol is an effective bronchodilator.It also produces adverse cardiovascular effects because of its effect on which receptors?

A client receives epinephrine for anaphylactic shock.The nurse should be aware of which mechanism by which epinephrine acts?

A client is prescribed tetrahydrozoline (Tyzine) for redness of the eye.Which rationale supports the use of this medication?

A client is prescribed albuterol (Proventil) oral tablets for asthma.What should the nurse include when teaching the client about this medication?

A client diagnosed with asthma asks the nurse why an albuterol (Proventil) inhaler is better than isoproterenol (Isuprel) .The nurse's response should be based on the physiologic concept that isoproterenol affects which receptors?

A client taking an MAO inhibitor for hypertension asks the nurse for medication to relieve nasal congestion.The nurse should know that phenylephrine will be a poor choice for this client because it might cause which condition?

A client is given ephedrine (Efedron) for bronchial asthma.The nurse should ask the client to report which effect of this drug?

A client with Parkinson disease who is receiving entacapone (Comtan) is to be given epinephrine for cardiopulmonary resuscitation.The nurse should be aware that entacapone (Comtan) causes an increased effect of epinephrine on the heart due to which action?

A client diagnosed with narcolepsy is prescribed ephedrine,and asks the nurse how this medication will improve the problem.The nurse's response will be based on which physiologic concept?

A low-dose dopamine infusion is to be started for a client diagnosed with hypovolemic shock.Which assessment finding indicates the drug is having the desired therapeutic effect?