Chapter 19: Indirect-Acting Antiadrenergic Agents

Chapter 19: Indirect-Acting Antiadrenergic Agents

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. Clonidine (Catapres) is prescribed for a hypertensive patient. Which instruction should the nurse include in patient education?

a.	“You may have difficulty falling asleep while taking this drug.”
b.	“If you have problems tolerating the drug, you may stop taking it.”
c.	“Many patients taking this drug experience excessive salivation.”
d.	“Take frequent sips of water to relieve dryness in your mouth.”

 

 

ANS:   D

Clonidine, as do most indirect-acting antiadrenergic medications, causes xerostomia, or dry mouth, as a side effect. The patient should be encouraged to take frequent sips of water to lessen the effect.

Clonidine may cause drowsiness, not insomnia.

As with other antihypertensive agents, clonidine should not be withdrawn abruptly. The patient should never stop the medication, but rather should contact the prescriber.

Clonidine is likely to cause xerostomia, or dry mouth, not excessive salivation.

 

DIF:    Cognitive Level: Application             REF:    p. 177

TOP:    Nursing Process: Implementation

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

 

2. A patient who has been taking methyldopa (Aldomet) for a year calls the clinic to report, “My eyes look yellow.” A nurse should instruct the patient to do which of the following?

a.	Keep taking the drug, the discoloration will fade.
b.	Come in to have blood work done as soon as possible.
c.	Discontinue the medication until the next appointment in 6 weeks.
d.	Stop the medication, because it may be causing kidney damage.

 

 

ANS:   B

The nurse should suspect jaundice, which may be the result of hepatotoxicity. The nurse should have the patient come in as soon as possible for blood work to prevent further liver damage. Once impaired liver function has been established, indirect-acting antiadrenergic medications are contraindicated.

If the patient continues taking the drug, further liver damage will result; this should not be recommended to the patient. It disregards the signs of impaired liver function that the patient has.

Discontinuing the medication abruptly may cause the patient to develop rebound hypertension; this should not be recommended. The patient should be seen as soon as possible for blood work to prevent further liver damage.

The medication is known to cause liver damage, not kidney damage, and it should not be stopped abruptly because of the potential for rebound hypertension.

 

DIF:    Cognitive Level: Application             REF:    p. 178

TOP:    Nursing Process: Implementation

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

 

3. A nurse is making a home visit to a patient just discharged from the hospital. The patient states, “I’ve just started taking clonidine (Catapres), but it’s making me so drowsy.” Select the nurse’s most appropriate response to the patient regarding this concern.

a.	“Discontinue the medication, and contact your prescriber.”
b.	“Are you taking this medication for pain or high blood pressure?”
c.	“Drowsiness is very common early in therapy, but the effects will lessen with time.”
d.	“Are you having any blurred vision?”

 

 

ANS:   C

Central nervous system depression, evidenced in this patient by drowsiness, is common in about 35% of the population. These responses become less intense with continued drug use.

The patient should not discontinue the medication abruptly because of the potential for rebound hypertension. The patient should contact the prescriber prior to stopping the medication.

The nurse should be aware of the reason the patient is taking the medication; also, this response disregards the patient’s concern about drowsiness.

Blurred vision is not a side effect of clonidine and therefore not relevant.

 

DIF:    Cognitive Level: Application             REF:    p. 177

TOP:    Nursing Process: Implementation

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

 

4. The nurse has received an order for a patient to begin reserpine (Serpasil). What patient education should the nurse include regarding the possible side effects of the medication?

a.	“You will have increased urination while on this medication.”
b.	“You will need to take a laxative with this medication.”
c.	“You may feel like you are getting swollen hands and feet.”
d.	“You may experience nausea and vomiting.”

 

 

ANS:   C

Reserpine can cause sodium and water retention, and therefore edema, which the patient may report as having swollen hands and feet. The patient should be told that this is a common side effect of the medication, and reducing sodium in the diet should be recommended.

Reserpine can cause sodium and water retention, and therefore edema, and may reduce, not increase, urination.

Reserpine does not cause constipation, therefore no laxatives are required.

Reserpine does not cause nausea and vomiting.

 

DIF:    Cognitive Level: Application             REF:    pp. 175-176

TOP:    Nursing Process: Implementation

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