Chapter 17: Adrenergic Agonists

Chapter 17: Adrenergic Agonists

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A nurse is teaching a nursing student about the two classes of adrenergic agonist drugs. Which statement by the nursing student indicates understanding of the teaching?

a.	“Catecholamines may be given orally.”
b.	“Catecholamines often require continuous infusion to be effective.”
c.	“Noncatecholamines do not cross the blood-brain barrier.”
d.	“Noncatecholamines undergo rapid degradation by monoamine oxidase.”

 

 

ANS:  B

Catecholamines undergo rapid degradation by monoamine oxidase (MAO) and catechol-O-methyltransferase (COMT). Consequently, they have a brief duration of action, and continuous infusion often is required to maintain the drug’s effects. Catecholamines cannot be used orally. Catecholamines do not cross the blood-brain barrier; noncatecholamines do. Noncatecholamines are not degraded by MAO.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   p. 144

TOP:   Nursing Process: Diagnosis

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

2. 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
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, 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.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 150

TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

3. A nursing student asks the nurse about receptor specificity of adrenergic agonist medications. What will the nurse say?

a.	“As the dosage of these medications increases, drugs in this class are more selective.”
b.	“Dopamine is selective for dopamine receptors and has no effects on alpha or beta receptors.”
c.	“Epinephrine is the most selective alpha-adrenergic agonist medication.”
d.	“Specificity is relative and is dose dependent.”

 

 

ANS:  D

Receptor specificity is relative, not absolute, and is dose dependent. At low doses, selectivity is maximal, and selectivity declines as the dose increases. Dopamine is the only drug in this class that acts on dopamine receptors, but it also has effects on alpha and beta receptors. Epinephrine is the least selective of this class.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   p. 146

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

4. A patient brought to the emergency department requires sutures. The prescriber orders a local anesthetic with epinephrine. The nurse understands that epinephrine is ordered to:

a.	prevent hypertension induced by the anesthetic.
b.	allow a reduced dose of the anesthetic.
c.	reduce anesthetic-induced nausea.
d.	reduce the pain of an injection.

 

 

ANS:  B

Epinephrine prolongs absorption of the anesthetic, because it is an alpha₁ agonist. It is frequently combined with a local anesthetic for this purpose, so that the amount of anesthetic required may be reduced. Local anesthetics do not induce hypertension; therefore, epinephrine would not be needed to prevent it. Epinephrine does not act as an antiemetic and would not reduce anesthetic-induced nausea. Epinephrine is not used to reduce the pain of an injection.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   p. 149

TOP:   Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies