Chapter 17: Adrenergic Agonists

Chapter 17: Adrenergic Agonists

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. A patient presents to the emergency department with edema of the glottis, bronchoconstriction, and a blood pressure of 82/38. Friends state that the reaction was a result of an insect sting. Which drug should the nurse prepare to administer?

a.	Ephedrine
b.	Diphenhydramine (Benadryl)
c.	Dopamine
d.	Epinephrine (Adrenaline)

 

 

ANS:   D

Epinephrine is the drug of choice for anaphylaxis.

Ephedrine is not a drug of choice in an anaphylaxis situation.

Diphenhydramine is an antihistamine and is indicated for minor allergic reactions, not evident in this patient, who is symptomatic of anaphylaxis.

Dopamine, which can be used to bring blood pressure up, would not reverse the signs and symptoms of anaphylaxis.

 

DIF:    Cognitive Level: Application             REF:    p. 153

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity: Reduction of Risk Potential

 

2. After dopamine is administered to a patient who has been experiencing hypotensive episodes, other than an increase in blood pressure, which indicator would the nurse use to evaluate a successful response?

a.	Decrease in pulse and blood pressure
b.	Increase in urine output
c.	Weight gain
d.	Improved gastric motility

 

 

ANS:   B

Dopamine would cause an increase in urine output, because cardiac output is increased as a result of the increase in blood pressure.

The effectiveness of dopamine would not be measured by a decrease in pulse and blood pressure, because dopamine’s primary effect is to increase blood pressure.

Dopamine’s effectiveness would not be evaluated by a weight gain.

Dopamine’s effectiveness would not be evaluated by improved gastric motility.

 

DIF:    Cognitive Level: Analysis                  REF:    pp. 157-158

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. A nurse in the intensive care unit is preparing to administer dobutamine (Dobutrex). For which of the following patients would dobutamine (Dobutrex) most likely be indicated?

a.	The patient with hypertension
b.	The patient with tachycardia
c.	The patient with asthma
d.	The patient with heart failure

 

 

ANS:   D

Dobutamine is indicated for heart failure, because it helps alleviate symptoms by activating beta₁ receptors on the heart, which increases myocardial contractility and thereby cardiac output.

Dobutamine is indicated for patients with hypotension to increase blood pressure, therefore it would be contraindicated in patients with hypertension.

Tachycardia is a side effect of dobutamine and is not among its therapeutic uses.

Dobutamine is not indicated for asthma, because it is a beta₁-adrenergic drug.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 158

TOP:    Nursing Process: Diagnosis

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. A patient is brought to the emergency department for a superficial stab wound to the forearm. Sutures are required, and a prescriber orders a local anesthetic with epinephrine. The nurse understands that the rationale for the use of epinephrine with a local anesthetic is to cause which of the following effects?

a.	Reduce anesthetic-induced nausea.
b.	Prolong anesthetic absorption.
c.	Reduce the pain of an injection.
d.	Prevent hypertension induced by the anesthetic.

 

 

ANS:   B

Epinephrine prolongs anesthetic absorption, because it is an alpha₁ agonist. It is frequently combined with a local anesthetic to delay anesthetic absorption.

Epinephrine does not act as an antiemetic, therefore it would not reduce anesthetic-induced nausea.

Epinephrine is not used to reduce the pain of an injection.

Anesthesia does not induce hypertension, therefore epinephrine is not indicated for use in such cases.

 

DIF:    Cognitive Level: Analysis                  REF:    pp. 151-153

TOP:    Nursing Process: Diagnosis

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies