Question 1

What do common side effects of bethanechol include?

Accepted Answer

Bethanechol is a muscarinic agonist that can cause increased smooth muscle activity, leading to abdominal cramping. Other options are not typical side effects of bethanechol.

Question 2

The nurse is administering Habitrol to a client.What effects will the nurse most likely assess in this client?
Select all that apply.

Accepted Answer

Habitrol is a form of nicotine replacement therapy used to help people stop smoking. Nicotine can cause increased alertness, increased heart rate, increased blood pressure, and nausea as it stimulates the release of adrenaline and other stress hormones, and affects various parts of the body including the cardiovascular and gastrointestinal systems. Muscle pain is not a commonly reported effect of nicotine or Habitrol.

Question 3

In the postoperative client,the nurse recognizes that bethanechol (Urecholine)might be given to treat which condition?

Accepted Answer

Bethanechol (Urecholine) is a cholinergic agonist that is used to treat urinary atony (inability to void urine) by increasing the tone of the detrusor muscle and stimulating bladder contraction. It is commonly used postoperatively in clients with a history of urinary retention or neurogenic bladder dysfunction.

Question 4

A client with myasthenia gravis is receiving pyridostigmine (Mestinon).Which medications should the nurse prior to administering to this client?
Select all that apply.

Accepted Answer

The answer of A client with myasthenia gravis is receiving...

Question 5

While assessing a client before administering neostigmine for myasthenia gravis management,the nurse documents that the client has increased muscle strength compared with the last assessment over an hour ago.Which interpretation of this data by the nurse is the most accurate?

Accepted Answer

An increase in muscle strength suggests that the neostigmine is working and improving the client's symptoms of myasthenia gravis. Toxicity or increasing the dose would not be appropriate based solely on this assessment. With an improvement in muscle strength, the next dose should still be given as prescribed.

Question 6

A client entering the hospital for a prostatectomy questions whether he should take his normal medications for myasthenia gravis prior to coming to the hospital.In particular,he needs to know when to take his ambenonium (Mytelase).Which action by the nurse is the most appropriate?

Accepted Answer

The answer of A client entering the hospital for a...

Question 7

A client is prescribed bethanechol (Urecholine)10 mg PO tid.What will the nurse determine as an adverse effect of this medication?
Select all that apply.

Accepted Answer

Bethanechol is a cholinergic agonist that stimulates the parasympathetic nervous system, leading to increased gastrointestinal motility, increased urinary bladder tone, and decreased heart rate. Adverse effects of bethanechol may include nausea and vomiting (A), blurred vision (B), and orthostatic hypotension (C). Increased peristalsis (D) and increased respiratory rate (E) are actually desired effects of the medication.

Question 8

A client with myasthenia gravis is prescribed neostigmine.The client telephones to report severe abdominal pain for the last 4 hours.Which response by the nurse is the most appropriate?

Accepted Answer

Severe abdominal pain in a client taking neostigmine may indicate a bowel obstruction, and immediate evaluation is necessary to prevent further complications. Increasing medication dosage or taking a laxative will not address the underlying issue and may even exacerbate the problem. Side effects of neostigmine do not usually involve severe abdominal pain that lasts for hours.

Question 9

A client is prescribed donepezil (Aricept)for treatment of Alzheimer disease.What will the nurse instruct the client about this medication?
Select all that apply.

Accepted Answer

The answer of A client is prescribed donepezil (Aricept)for treatment...

Question 10

Prior to administering a prescribed muscarinic agonist,the nurse reviews the client's medical history and decides to withhold the medication until contacting the health care provider.Which findings in the medical history support withholding the medication?
Select all that apply.

Accepted Answer

Muscarinic agonists can exacerbate conditions like bowel obstruction (absent bowel sounds), asthma (bronchoconstriction), and cardiac issues (ventricular dysrhythmia).

Question 11

Which side effect from an anticholinergic agent such as atropine is unexpected?

Accepted Answer

Diarrhea is an unexpected side effect of an anticholinergic agent, as it is typically more commonly associated with cholinergic agents. The other side effects listed (dry mouth, urinary retention, dilated pupils) are all expected effects of atropine.

Question 12

Which action is the most appropriate description for cholinesterase inhibitors?

Accepted Answer

Cholinesterase inhibitors work by blocking the enzyme acetylcholinesterase, which breaks down acetylcholine. This leads to an increase in acetylcholine at various sites including muscarinic receptors (affecting organs), ganglionic synapses (affecting the autonomic nervous system), and neuromuscular junctions (affecting muscle movement). Therefore, they intensify transmission at these sites.

Question 13

The nurse is preparing to administer a prototype drug to a client with myasthenia gravis.What will the nurse identify as characteristics of this medication?
Select all that apply.

Accepted Answer

The prototype drug for myasthenia gravis affects nicotinic acetylcholine synapses in skeletal muscle (A), is often referred to as the prototype drug (B), and must be used with caution in heart failure due to potential cardiovascular effects (E).

Question 14

Cholinergic drugs are most often indicated in which situation?

Accepted Answer

Cholinergic drugs, such as pilocarpine, can be used to lower intraocular pressure in clients with glaucoma by constricting the pupil and increasing aqueous humor outflow. They are not indicated for the other options listed.

Question 15

The nurse differentiates between a cholinergic crisis and a myasthenic crisis by taking which action?

Accepted Answer

Administering edrophonium and observing the client's response helps differentiate between a cholinergic crisis and a myasthenic crisis. In a myasthenic crisis, symptoms improve after edrophonium administration, while in a cholinergic crisis, symptoms may worsen.

Question 16

A client with Alzheimer disease is admitted for an overdose of donepezil (Aricept).What will the nurse most likely assess in this client?
Select all that apply.

Accepted Answer

The answer of A client with Alzheimer disease is admitted...

Question 17

A client has received a dose of atropine to counteract the effects of a cholinergic medication prior to having surgery.On the way to the operating room (OR),the client complains of a sudden feeling of warmth.The client's skin is flushed,warm,and dry.Which nursing action is the most appropriate?

Accepted Answer

The sudden feeling of warmth, flushed and dry skin are common side effects of atropine. As long as the client's mental status and vital signs are normal, there is no need to delay surgery or notify the surgeon. It is important to document this finding and proceed to the OR as planned. Explaining the side effects of atropine to the client may provide some reassurance but is not the most appropriate nursing action in this situation.

Question 18

A client with myasthenia gravis is demonstrating weakness 4 hours after taking the last dose of pyridostigmine (Mestinon).What may be the cause of the client's weakness?
Select all that apply.

Accepted Answer

Myasthenia gravis is a chronic autoimmune disorder that affects the transmission of nerve impulses to muscles, leading to muscle weakness and fatigue. Pyridostigmine is a medication that helps improve muscle strength by increasing the amount of acetylcholine available at the neuromuscular junction. If the client is demonstrating weakness 4 hours after taking the last dose of pyridostigmine, it could be due to a higher dose being needed (choice A) or the development of drug resistance (choice B). A lower dose of medication (choice C) or rejection by the autonomic nervous system (choice D) are unlikely causes. Atropine is sometimes given to counteract the side effects of pyridostigmine, but it would not necessarily address the client's weakness in this case.

Question 19

A client who is suspected to have myasthenia gravis is given a small dose of postoperative medication.The client subsequently develops increased muscle weakness.Which medication should the nurse anticipate administering immediately?

Accepted Answer

A cholinesterase inhibitor (such as pyridostigmine) is the medication of choice for myasthenia gravis, as it helps to increase the availability of acetylcholine at the neuromuscular junction and improve muscle strength. Administration of a cholinesterase inhibitor can help to reverse the increased muscle weakness observed in this scenario. Choice A (a dopamine agonist) and D (a sympathetic stimulant) are not typically used in the treatment of myasthenia gravis, and choice B (a calcium channel blocker) can sometimes exacerbate symptoms.

Question 20

What is the most significant difference between neostigmine and pyridostigmine?

Accepted Answer

Neostigmine has a shorter duration of action compared to pyridostigmine. Pyridostigmine is commonly used for conditions that require long-lasting cholinergic effects, such as myasthenia gravis, whereas neostigmine is more commonly used for brief periods of cholinergic stimulation, such as during the reversal of neuromuscular blockade in anesthesia. Additionally, neither neostigmine nor pyridostigmine have no adverse effects, and both drugs can counteract neuromuscular blocking effects.

Quiz 13: Cholinergic Agonists

What do common side effects of bethanechol include?

The nurse is administering Habitrol to a client.What effects will the nurse most likely assess in this client? Select all that apply.

In the postoperative client,the nurse recognizes that bethanechol (Urecholine) might be given to treat which condition?

A client with myasthenia gravis is receiving pyridostigmine (Mestinon) .Which medications should the nurse prior to administering to this client? Select all that apply.

While assessing a client before administering neostigmine for myasthenia gravis management,the nurse documents that the client has increased muscle strength compared with the last assessment over an hour ago.Which interpretation of this data by the nurse is the most accurate?

A client entering the hospital for a prostatectomy questions whether he should take his normal medications for myasthenia gravis prior to coming to the hospital.In particular,he needs to know when to take his ambenonium (Mytelase) .Which action by the nurse is the most appropriate?

A client is prescribed bethanechol (Urecholine) 10 mg PO tid.What will the nurse determine as an adverse effect of this medication? Select all that apply.

A client with myasthenia gravis is prescribed neostigmine.The client telephones to report severe abdominal pain for the last 4 hours.Which response by the nurse is the most appropriate?

A client is prescribed donepezil (Aricept) for treatment of Alzheimer disease.What will the nurse instruct the client about this medication? Select all that apply.

Prior to administering a prescribed muscarinic agonist,the nurse reviews the client's medical history and decides to withhold the medication until contacting the health care provider.Which findings in the medical history support withholding the medication? Select all that apply.

Which side effect from an anticholinergic agent such as atropine is unexpected?

Which action is the most appropriate description for cholinesterase inhibitors?

The nurse is preparing to administer a prototype drug to a client with myasthenia gravis.What will the nurse identify as characteristics of this medication? Select all that apply.

Cholinergic drugs are most often indicated in which situation?

The nurse differentiates between a cholinergic crisis and a myasthenic crisis by taking which action?

A client with Alzheimer disease is admitted for an overdose of donepezil (Aricept) .What will the nurse most likely assess in this client? Select all that apply.

A client has received a dose of atropine to counteract the effects of a cholinergic medication prior to having surgery.On the way to the operating room (OR) ,the client complains of a sudden feeling of warmth.The client's skin is flushed,warm,and dry.Which nursing action is the most appropriate?

A client with myasthenia gravis is demonstrating weakness 4 hours after taking the last dose of pyridostigmine (Mestinon) .What may be the cause of the client's weakness? Select all that apply.

A client who is suspected to have myasthenia gravis is given a small dose of postoperative medication.The client subsequently develops increased muscle weakness.Which medication should the nurse anticipate administering immediately?

What is the most significant difference between neostigmine and pyridostigmine?