Chapter 19: Cholinergic Agonists and Anticholinergics

Chapter 19: Cholinergic Agonists and Anticholinergics

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse is preparing to administer a drug and learns that it is an indirect-acting cholinergic agonist. The nurse understands that this drug

a.	acts on muscarinic receptors.
b.	acts on nicotinic receptors.
c.	inhibits cholinesterase.
d.	inhibits cholinergic receptors.

 

 

ANS:  C

Agents that inhibit cholinesterase, which is the enzyme that destroys acetylcholine, indirectly enhance the actions of acetylcholine.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension)    REF:   Page 270

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. A nursing student asks why a direct-acting cholinergic agonist drug that is selective to muscarinic receptors is described as being non-specific. The nurse will explain that this is because

a.	muscarinic receptors are present in many different tissues.
b.	the action of cholinesterase alters the bioavailability at different sites.
c.	these drugs can also affect nicotinic receptors.
d.	they vary in their reversible and irreversible effects.

 

 

ANS:  A

Although drugs classified as direct-acting cholinergic agonists are primarily selective for muscarinic receptors, they are non-specific because muscarinic receptors are located in different sites, causing actions in various organs. They are not affected differently by cholinesterase activity and have negligible actions on nicotinic receptors.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension)    REF:   Pages 269-270

TOP:   NURSING PROCESS: N/A

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. The nurse is preparing to administer bethanechol (Urecholine) to a patient who is experiencing urinary retention. The nurse notes that the patient has a blood pressure of 90/60 mm Hg and a heart rate of 98 beats per minute. The nurse will perform which action?

a.	Administer the drug and monitor urine output.
b.	Administer the medication and monitor vital signs frequently.
c.	Give the medication and notify the provider of the increased heart rate.
d.	Hold the medication and notify the provider of the decreased blood pressure.

 

 

ANS:  D

Side effects of this medication are a decrease in the pulse rate and vasodilation, which can exacerbate bradycardia and hypotension. The nurse should hold the drug and notify the provider.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 271

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. The nurse administers bethanechol (Urecholine) to a patient to treat urinary retention. After 30 minutes, the patient voids 800 mL of urine and reports having a loose stool but no cramping or gastrointestinal pain. The patient’s blood pressure is 110/70 mm Hg. The nurse will perform which action?

a.	Notify the provider of bethanechol adverse effects.
b.	Record the urine output and the blood pressure and continue to monitor.
c.	Request an order for intravenous atropine sulfate.
d.	Suggest another dose of bethanechol to the provider.

 

 

ANS:  B

The patient is exhibiting desired effects and mild side effects of bethanechol, so the nurse should record information and continue to monitor the patient. There is no need to notify the provider, give an antidote, or repeat the dose.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 271

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies