Rosenthal: Lehne's
Pharmacotherapeutics For Advanced
Practice Nurses And Physician
Assistants Questions And Answers |
Certified
/. A nursing student asks about drugs that interfere with the termination of transmitter
action. Which statement by the nurse is correct?
a. "Drugs act on this process by altering the diffusion of the transmitter away from the
synaptic gap."
b. "Drugs can interfere with termination by either increasing or decreasing reuptake of
the transmitter."
c. "Drugs in this category lead to decreased activation by the transmitter in the
synapse."
d. "These drugs reduce either reuptake or degradation of the transmitter, causing an
increase in receptor activation." - Answer-✅ANS: D Drugs that interfere with termination
of transmitter action do so by blocking transmitter reuptake or inhibiting transmitter
degradation, resulting in increased receptor activation, because more of the transmitter
remains available. Diffusion of the transmitter occurs naturally, but it is a slow process
with little clinical significance. Drugs that alter this process cause a decrease in
reuptake, not an increase. The effect of drugsthat interfere with termination oftransmitter
action is increased activation.DIF: Cognitive Level: ApplicationREF: p. 76TOP: Nursing
Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
/.A nurse is teaching a group of nursing students about neuropharmacology. Which
statement by a student about peripheral nervous system (PNS) drugs indicates a need
for further teaching?
a. "Drugs affecting axonal conduction have a variety of uses."
b. "Drugs that alter synaptic transmission can be highly selective."
c. "Many PNS drugs act by altering synaptic transmission."
d. "These drugs work by influencing receptor activity." - Answer-✅ANS: A Local
anesthetics are drugs that work by altering axonal conduction. Any drug affecting axonal
conduction would be nonselective, because axonal conduction of impulses is essentially
the same in all neurons. In contrast, drugs that affect synaptic transmission can be
highlyselective, because each transmitter has different effects on receptor sites. Most
PNS drugs work on synaptic transmission processes. Through their effects on
transmitters, they influence receptor activity.DIF: Cognitive Level: AnalysisREF: pp. 73-
,74TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic
Integrity: Pharmacologic and Parenteral Therapies
/.A nurse is preparing to administer a medication and learns that it is a nonselective
agonist drug. What does the nurse understand about this drug?
a. It directly activates receptors to affect many physiologic processes.
b. It directly activates receptors to affect a specific physiologic process.
c. It prevents receptor activation to affect many physiologic processes.
d. It prevents receptor activation to affect a specific physiologic processes. - Answer-
✅ANS: A Drugs that directly activate receptors are called agonists, so this drug will
directly activate the receptor site. Drugs that are nonselective activate a variety of
receptor sites. A selective agonist would directly activate specific receptorsto affect a
specific process. An antagonist would prevent receptor activation.DIF: Cognitive Level:
AnalysisREF: p. 76TOP: Nursing Process: Assessment MSC: NCLEX Client Needs
Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
/.A patient has allergies and takes an antihistamine. The patient wants to know how the
drug works. The nurse understands that antihistamines work because they are what?
a. Activators
b. Agonists
c. Antagonists
d. Antidotes - Answer-✅ANS: C Antihistamines bind to receptors to prevent activation
by histamine; this makes antihistamines antagonist drugs. Antihistamines do not
activate receptors. Agonist drugs activate receptors; they are not antidotes.DIF:
Cognitive Level: ApplicationREF: p. 76TOP: Nursing Process: Implementation MSC:
NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies
/.A patient receiving botulinum toxin injections to control muscle spasticity asks how the
drug works. The nurse knows that this drug affects the transmitter acetylcholine by:
a. inhibiting its release.
b. interfering with its storage.
c. preventing its reuptake.
d. promoting its synthesis. - Answer-✅ANS: A Acetylcholine is a neurotransmitter that
activates receptors that increase skeletal muscle contraction. Botulinum toxin inhibits
the release of this transmitter. It does not interfere with storage, reuptake, or synthesis
of acetylcholine.DIF: Cognitive Level: ApplicationREF: p. 76TOP: Nursing Process:
Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
/.A nurse is administering drug X to a patient. The drug information states that the drug
acts by activating receptors in the peripheral nervous system by increasing transmitter
synthesis. The nurse understands that the effect of this drug is to:
a. activate axonal conduction.
b. enhance transmitter storage.
c. increase receptor activation.
,d. synthesize supertransmitters. - Answer-✅ANS: C Drugs that increase transmitter
synthesis increase receptor activation. Other drugs that alter transmitter synthesis can
decrease synthesis and would cause decreased receptor activation. Drugs that affect
transmitter production do not exert their effects on axonal conduction. The amount of
transmitter produced does not directly affect transmitter storage. Some drugs that alter
transmitter synthesis cause the synthesis of transmitter molecules that are more
effective than the transmitter itself; however, this is not accomplished by increasing
transmitter synthesis.DIF: Cognitive Level: ApplicationREF: p. 77TOP: Nursing Process:
Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
/.A patient receives morphine and shows signs of toxicity. The prescriber orders
naloxone [Narcan] to reverse the effects of the morphine. The nurse understands that
the naloxone reverses morphine toxicity by which action on morphine receptor sites?
a. Blocking transmitter reuptake
b. Inhibiting transmitter release
c. Interfering with transmitter storage
d. Preventing activation of receptors - Answer-✅ANS: D Morphine and its antagonist,
naloxone, act directly at the same receptors. Morphine causes activation, and naloxone
prevents activation. Neither morphine nor naloxone acts to alter transmitter reuptake,
release, or storage.DIF: Cognitive Level: ComprehensionREF: p. 76TOP: Nursing
Process: Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
/.A nurse learns about a drug that interferes with transmitter storage in the PNS. The
transmitter affected by this drug causes an increased heart rate. What response will the
nurse expect to see when this drug is administered?
a. Bradycardia
b. Positive inotropic effects
c. Prolonged receptor activation
d. Tachycardia - Answer-✅ANS: A Drugs that interfere with transmitter storage reduce
receptor activation, because disruption of storage decreasesthe amount oftransmitter
available for release. Because thistransmitter increases the heart rate, the result will be
a decrease in the heart rate. Inotropic effects control the force of contraction, not the
rate of contraction. Decreased transmitter storage would result in decreased receptor
activation. Tachycardia would occur if transmitter availability were increased.DIF:
Cognitive Level: ApplicationREF: p. 77TOP: Nursing Process: Evaluation MSC: NCLEX
Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
/.What is the target organ when a beta1 agonist is administered?
a. Heart
b. Kidney
c. Respiratory
d. Liver - Answer-✅ANS: A A beta1 agonist increases the patient's heart rate and blood
pressure and is used in heart failure. Beta1 agonists would not be used for kidney,
respiratory, or liver failure. DIF: Cognitive Level: Knowledge REF: pp. 88TOP: Nursing
, Process: Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
/.A nurse is teaching a group of nursing students about neurotransmitters. Which
statement by a student about acetylcholine indicates a need for further teaching?
a. "It activates three cholinergic receptor subtypes." b. "It has effects in the
parasympathetic, sympathetic, and somatic nervous systems."
c. "It is used at most junctions of the peripheral nervous system."
d. "Its transmission is terminated by reuptake into the cholinergic nerve terminal." -
Answer-✅ANS: D Acetylcholine (ACh) is destroyed by acetylcholinesterase, an enzyme
that degrades ACh into two inactive products: acetate and choline. Choline is taken up
into the nerve terminal. ACh activates three receptor sites: nicotinicN, nicotinicM, and
muscarinic. ACh has effects throughout the peripheral nervous system (PNS) and is
used at most junctions in the PNS.DIF: Cognitive Level: AnalysisREF: pp. 90TOP:
Nursing Process: Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
/.A nurse is administering an agonist drug that acts on postganglionic neurons ofthe
sympathetic nervous system. Which response will the nurse expect to see? a.
Decreased sweating
b. Bronchodilation
c. Increased cardiac output
d. Pinpoint pupils - Answer-✅ANS: C Norepinephrine (NE) is the most common
neurotransmitter released by allpostganglionic neurons of the sympathetic nervous
system except those going to sweat glands where ACh is the neurotransmitter. NE acts
on alpha1, alpha2, and beta1 receptors to increase the force and rate of cardiac
contraction, thus increasing cardiac output. ACh would increase sweating.
Bronchodilation occurs when epinephrine activates beta2 receptors on bronchial
smooth muscle. NE affects alpha1 receptorsto dilate the pupils.DIF: Cognitive Level:
ApplicationREF: pp. 79TOP: Nursing Process: Planning MSC: NCLEX Client Needs
Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
/.A nurse is teaching a patient about a medication that alters sympathetic nervous
system functions. To evaluate understanding, the nurse asks the patient to describe
which functions the sympathetic nervous system regulates. Which answer indicates the
need for further teaching?
a. "The digestive functions of the body"
b. "The cardiovascular system"
c. "The fight-or-flight response"
d. "Body temperature" - Answer-✅ANS: A The sympathetic nervous system does not
regulate digestive functions of the body—the parasympathetic nervous system does;
further education is needed. The sympathetic nervous systemregulates the
cardiovascular system, the fight-or-flight response, and the body temperature; no further
education is needed.DIF: Cognitive Level: AnalysisREF: pp. 79TOP: Nursing Process:
Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic
and Parenteral Therapies
Pharmacotherapeutics For Advanced
Practice Nurses And Physician
Assistants Questions And Answers |
Certified
/. A nursing student asks about drugs that interfere with the termination of transmitter
action. Which statement by the nurse is correct?
a. "Drugs act on this process by altering the diffusion of the transmitter away from the
synaptic gap."
b. "Drugs can interfere with termination by either increasing or decreasing reuptake of
the transmitter."
c. "Drugs in this category lead to decreased activation by the transmitter in the
synapse."
d. "These drugs reduce either reuptake or degradation of the transmitter, causing an
increase in receptor activation." - Answer-✅ANS: D Drugs that interfere with termination
of transmitter action do so by blocking transmitter reuptake or inhibiting transmitter
degradation, resulting in increased receptor activation, because more of the transmitter
remains available. Diffusion of the transmitter occurs naturally, but it is a slow process
with little clinical significance. Drugs that alter this process cause a decrease in
reuptake, not an increase. The effect of drugsthat interfere with termination oftransmitter
action is increased activation.DIF: Cognitive Level: ApplicationREF: p. 76TOP: Nursing
Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
/.A nurse is teaching a group of nursing students about neuropharmacology. Which
statement by a student about peripheral nervous system (PNS) drugs indicates a need
for further teaching?
a. "Drugs affecting axonal conduction have a variety of uses."
b. "Drugs that alter synaptic transmission can be highly selective."
c. "Many PNS drugs act by altering synaptic transmission."
d. "These drugs work by influencing receptor activity." - Answer-✅ANS: A Local
anesthetics are drugs that work by altering axonal conduction. Any drug affecting axonal
conduction would be nonselective, because axonal conduction of impulses is essentially
the same in all neurons. In contrast, drugs that affect synaptic transmission can be
highlyselective, because each transmitter has different effects on receptor sites. Most
PNS drugs work on synaptic transmission processes. Through their effects on
transmitters, they influence receptor activity.DIF: Cognitive Level: AnalysisREF: pp. 73-
,74TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic
Integrity: Pharmacologic and Parenteral Therapies
/.A nurse is preparing to administer a medication and learns that it is a nonselective
agonist drug. What does the nurse understand about this drug?
a. It directly activates receptors to affect many physiologic processes.
b. It directly activates receptors to affect a specific physiologic process.
c. It prevents receptor activation to affect many physiologic processes.
d. It prevents receptor activation to affect a specific physiologic processes. - Answer-
✅ANS: A Drugs that directly activate receptors are called agonists, so this drug will
directly activate the receptor site. Drugs that are nonselective activate a variety of
receptor sites. A selective agonist would directly activate specific receptorsto affect a
specific process. An antagonist would prevent receptor activation.DIF: Cognitive Level:
AnalysisREF: p. 76TOP: Nursing Process: Assessment MSC: NCLEX Client Needs
Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
/.A patient has allergies and takes an antihistamine. The patient wants to know how the
drug works. The nurse understands that antihistamines work because they are what?
a. Activators
b. Agonists
c. Antagonists
d. Antidotes - Answer-✅ANS: C Antihistamines bind to receptors to prevent activation
by histamine; this makes antihistamines antagonist drugs. Antihistamines do not
activate receptors. Agonist drugs activate receptors; they are not antidotes.DIF:
Cognitive Level: ApplicationREF: p. 76TOP: Nursing Process: Implementation MSC:
NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies
/.A patient receiving botulinum toxin injections to control muscle spasticity asks how the
drug works. The nurse knows that this drug affects the transmitter acetylcholine by:
a. inhibiting its release.
b. interfering with its storage.
c. preventing its reuptake.
d. promoting its synthesis. - Answer-✅ANS: A Acetylcholine is a neurotransmitter that
activates receptors that increase skeletal muscle contraction. Botulinum toxin inhibits
the release of this transmitter. It does not interfere with storage, reuptake, or synthesis
of acetylcholine.DIF: Cognitive Level: ApplicationREF: p. 76TOP: Nursing Process:
Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
/.A nurse is administering drug X to a patient. The drug information states that the drug
acts by activating receptors in the peripheral nervous system by increasing transmitter
synthesis. The nurse understands that the effect of this drug is to:
a. activate axonal conduction.
b. enhance transmitter storage.
c. increase receptor activation.
,d. synthesize supertransmitters. - Answer-✅ANS: C Drugs that increase transmitter
synthesis increase receptor activation. Other drugs that alter transmitter synthesis can
decrease synthesis and would cause decreased receptor activation. Drugs that affect
transmitter production do not exert their effects on axonal conduction. The amount of
transmitter produced does not directly affect transmitter storage. Some drugs that alter
transmitter synthesis cause the synthesis of transmitter molecules that are more
effective than the transmitter itself; however, this is not accomplished by increasing
transmitter synthesis.DIF: Cognitive Level: ApplicationREF: p. 77TOP: Nursing Process:
Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
/.A patient receives morphine and shows signs of toxicity. The prescriber orders
naloxone [Narcan] to reverse the effects of the morphine. The nurse understands that
the naloxone reverses morphine toxicity by which action on morphine receptor sites?
a. Blocking transmitter reuptake
b. Inhibiting transmitter release
c. Interfering with transmitter storage
d. Preventing activation of receptors - Answer-✅ANS: D Morphine and its antagonist,
naloxone, act directly at the same receptors. Morphine causes activation, and naloxone
prevents activation. Neither morphine nor naloxone acts to alter transmitter reuptake,
release, or storage.DIF: Cognitive Level: ComprehensionREF: p. 76TOP: Nursing
Process: Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
/.A nurse learns about a drug that interferes with transmitter storage in the PNS. The
transmitter affected by this drug causes an increased heart rate. What response will the
nurse expect to see when this drug is administered?
a. Bradycardia
b. Positive inotropic effects
c. Prolonged receptor activation
d. Tachycardia - Answer-✅ANS: A Drugs that interfere with transmitter storage reduce
receptor activation, because disruption of storage decreasesthe amount oftransmitter
available for release. Because thistransmitter increases the heart rate, the result will be
a decrease in the heart rate. Inotropic effects control the force of contraction, not the
rate of contraction. Decreased transmitter storage would result in decreased receptor
activation. Tachycardia would occur if transmitter availability were increased.DIF:
Cognitive Level: ApplicationREF: p. 77TOP: Nursing Process: Evaluation MSC: NCLEX
Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
/.What is the target organ when a beta1 agonist is administered?
a. Heart
b. Kidney
c. Respiratory
d. Liver - Answer-✅ANS: A A beta1 agonist increases the patient's heart rate and blood
pressure and is used in heart failure. Beta1 agonists would not be used for kidney,
respiratory, or liver failure. DIF: Cognitive Level: Knowledge REF: pp. 88TOP: Nursing
, Process: Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
/.A nurse is teaching a group of nursing students about neurotransmitters. Which
statement by a student about acetylcholine indicates a need for further teaching?
a. "It activates three cholinergic receptor subtypes." b. "It has effects in the
parasympathetic, sympathetic, and somatic nervous systems."
c. "It is used at most junctions of the peripheral nervous system."
d. "Its transmission is terminated by reuptake into the cholinergic nerve terminal." -
Answer-✅ANS: D Acetylcholine (ACh) is destroyed by acetylcholinesterase, an enzyme
that degrades ACh into two inactive products: acetate and choline. Choline is taken up
into the nerve terminal. ACh activates three receptor sites: nicotinicN, nicotinicM, and
muscarinic. ACh has effects throughout the peripheral nervous system (PNS) and is
used at most junctions in the PNS.DIF: Cognitive Level: AnalysisREF: pp. 90TOP:
Nursing Process: Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
/.A nurse is administering an agonist drug that acts on postganglionic neurons ofthe
sympathetic nervous system. Which response will the nurse expect to see? a.
Decreased sweating
b. Bronchodilation
c. Increased cardiac output
d. Pinpoint pupils - Answer-✅ANS: C Norepinephrine (NE) is the most common
neurotransmitter released by allpostganglionic neurons of the sympathetic nervous
system except those going to sweat glands where ACh is the neurotransmitter. NE acts
on alpha1, alpha2, and beta1 receptors to increase the force and rate of cardiac
contraction, thus increasing cardiac output. ACh would increase sweating.
Bronchodilation occurs when epinephrine activates beta2 receptors on bronchial
smooth muscle. NE affects alpha1 receptorsto dilate the pupils.DIF: Cognitive Level:
ApplicationREF: pp. 79TOP: Nursing Process: Planning MSC: NCLEX Client Needs
Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
/.A nurse is teaching a patient about a medication that alters sympathetic nervous
system functions. To evaluate understanding, the nurse asks the patient to describe
which functions the sympathetic nervous system regulates. Which answer indicates the
need for further teaching?
a. "The digestive functions of the body"
b. "The cardiovascular system"
c. "The fight-or-flight response"
d. "Body temperature" - Answer-✅ANS: A The sympathetic nervous system does not
regulate digestive functions of the body—the parasympathetic nervous system does;
further education is needed. The sympathetic nervous systemregulates the
cardiovascular system, the fight-or-flight response, and the body temperature; no further
education is needed.DIF: Cognitive Level: AnalysisREF: pp. 79TOP: Nursing Process:
Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic
and Parenteral Therapies
