Chapter 14: Muscarinic Agonists and Antagonists

Chapter 14: Muscarinic Agonists and Antagonists

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. A prescriber has ordered a pilocarpine (Pilocar). A nurse understands that the drug stimulates muscarinic receptors. The nurse would anticipate the drug to have which action?

a.	Treating a postoperative patient who has excessive secretions and mucus
b.	Lowering intraocular pressure in patients with glaucoma
c.	Inhibiting muscular activity in the bladder
d.	Preventing hypertensive crisis

 

 

ANS:   B

Pilocarpine is a muscarinic agonist used mainly for topical therapy of glaucoma that reduces intraocular pressure.

Pilocarpine is not indicated for the treatment of excessive secretions and mucus; in fact, pilocarpine is used to treat dry mouth.

Pilocarpine does not inhibit muscular activity in the bladder.

Pilocarpine is not used to prevent hypertensive crisis.

 

DIF:    Cognitive Level: Application             REF:    p. 123

TOP:    Nursing Process: Planning

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

 

2. A patient has developed muscarinic antagonist toxicity from ingestion of an unknown chemical. The nurse should prepare to administer

a.	atropine (Sal-Tropine) IV.
b.	physostigmine (Antilirium).
c.	an acetylcholinesterase activator.
d.	pseudoephedrine (Ephedrine).

 

 

ANS:   B

Physostigmine is indicated for muscarinic antagonist toxicity.

Atropine is a drying agent and would only complicate the drying action that arises from the muscarinic antagonist.

An acetylcholinesterase activator would only contribute to dryness that arises from the muscarinic antagonist.

Ephedrine is not indicated for muscarinic antagonist toxicity.

 

DIF:    Cognitive Level: Application             REF:    pp. 123-124

TOP:    Nursing Process: Planning

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

 

3. A nurse plans to administer atropine (Sal-Tropine) to a patient on multiple concurrent medications. The nurse feels confident that which class of drugs would be safe to administer with atropine?

a.	Antihistamines
b.	Phenothiazine antipsychotics
c.	Tricyclic antidepressants
d.	Narcotic analgesics

 

 

ANS:   D

Narcotic analgesics can be safely administered with atropine.

Antihistamines, phenothiazine antipsychotics, and tricyclic antidepressants all produce significant muscarinic blockade and therefore should not be administered with atropine.

 

DIF:    Cognitive Level: Application             REF:    p. 125

TOP:    Nursing Process: Implementation

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

 

4. A nurse is caring for a patient being treated for newly diagnosed irritable bowel syndrome. The nurse should anticipate the administration of which muscarinic antagonist?

a.	Bethanechol (Urecholine)
b.	Pirenzepine and telenzepine
c.	Physostigmine
d.	Dicyclomine (Bentyl)

 

 

ANS:   D

The nurse should administer dicyclomine, which is indicated for irritable bowel syndrome.

Bethanechol is a muscarinic agonist, not an antagonist, and would not be used to treat a patient with irritable bowel syndrome.

Pirenzepine and telenzepine are indicated for peptic ulcer disease, not irritable bowel syndrome.

Physostigmine is indicated for antimuscarinic poisoning.

 

DIF:    Cognitive Level: Application             REF:    p. 128

TOP:    Nursing Process: Planning

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