NSG 318 EXAM 2 QUESTIONS WITH VERIFIED SOLUTIONS LATEST UPDATE 2026

NSG 318 EXAM 2 QUESTIONS WITH VERIFIED SOLUTIONS LATEST UPDATE 2026 what substance is a synthetic catecholamine - Answers dobutamine what occurrence is an effect of beta-1 adrenergic receptor stimulation - Answers increased renin secretion which body parts are regulated by the ANS - Answers smooth muscles and glands -eyes -heart -urinary bladder -respiratory system -GI tract stimulation of what receptor will cause increased heart rate - Answers Beta 1 drugs that stimulate the PNS - Answers cholinergic agonists (by mimicking ACH) complications of anticholinergic drugs - Answers dry mouth, tachycardia, blurred vision (due to blockage of cholinergic receptors) what would a nurse monitor while observing the activation of muscarinic receptors - Answers increased bronchial secretion cholinergic drugs that stimulate muscarinic receptors are indicated for: - Answers lowering intraocular pressure in a pt with glaucoma antidote for overdose of atropine (flushing, dry skin and mucous membranes, mydriasis, alt mental status, fever) - Answers physostigmine Antidote for benzodiazepines - Answers Flumazenil when should you not give bethanechol - Answers if the pt has low BP (hypotension) which drug is used for myasthenia gravis - Answers neostigmine (prevents inactivation of ACH at neuromuscular junction, causing increased nerve transmission and skeletal muscle activation) Opthalamic disorder caused by paralysis of the ciliary muscles - Answers cycloplegia (loss of accommodation) what drug is a direct-acting cholinergic agonist commonly used to treat glaucoma - Answers pilocarpine hydrochloride what NSAID can be administered through IV - Answers Ketorolac (can also be transmitted orally) gout - Answers metabolic disorder of uric acid and purines; inflammatory condition of joints and tendons. caused by accumulation of uric acid and creates tophi, pain in joints foods containing salicylates - Answers prunes, raisins, licorice, paprika, curry prostaglandin function - Answers -vasodilation -inc capillary permeability -inc platelet aggregation (inflammation) Cardinal signs of inflammation - Answers redness, swelling, heat, pain, loss of function a pt is at an increased risk for a stroke. The nurse anticipates that the health care provider will prescribe: - Answers aspirin (low dose) antiinflammatories inhibit what substance - Answers prostaglandin which physiological change occurs during the delayed process of inflammation - Answers infiltration of leukocytes into the site pathophysiology of pain - Answers chemical mediators sensitize the pain receptors a pt with migraine headaches who is on SSRI therapy is prescribed sumatriptan. what possible complication might the nurse see in the pt - Answers serotonin syndrome (manifested by inc serotonin levels in the blood) which lab levels should the nurse monitor for a pt receiving acetaminophen therapy - Answers INC potassium, bilirubin, LDH, dec. WBC. RBC, platelets, albumin, ALP, ALT which med would a nurse administer to a pt admitted for tx of an opioid addiction - Answers methadone which narcotic drug is the drug of choice for pain relief during childbirth - Answers meperidine what medication is contraindicated for a pt with a head injury - Answers nalbuphine adjuvant analgesics - Answers used to treat chronic pain with neuropathic nature. used with opioids and nonopioids, anticonvulsants, antidepressants, corticosteroids, local anesthetics superficial pain - Answers Pain that originates from the skin or mucous membranes deep pain - Answers pain that occurs in tissues below skin level somatic pain - Answers Pain that originates from skeletal muscles, ligaments, or joints. visceral pain - Answers pain that originates from organs or smooth muscles cluster headaches - Answers -severe unilateral, nonthrobbing pain -located around eye -series of cluster attacks -more common in males migraine headaches - Answers -unilateral throbbing head pain, accompanied by nausea, vomiting and photophobia -triggers: cheese, chocolate, red wine, aspartame, fatigue, stress, monosodium glutamate, missed meals, odors, light, hormone changes, drugs, weather, sleep Migraine and Cluster Headaches Prevention: - Answers Beta-adrenergic Blockers: -propranolol -atenolol Anticonvulsants: -valproic acid -gabapentin Tricyclic antidepressants: -amitriptyline -imipramine function of adrenergics - Answers -dilates pupils -dilate bronchioles -inc HR -vasoconstriction -relax GI -relax bladder -relax uterus sympathomimetic - Answers agent that mimics the effects of the sympathetic nervous system Parasympatholytic - Answers agent blocking or inhibiting the effects of the parasympathetic nervous system alpha 1 receptors - Answers -inc cardiac contractility; vasoconstriction (inc BP) -dilates pupils, dec salivary gland secretion -inc bladder and prostate cx alpha 2 receptors - Answers -inhibits NE release (promotes vasodilation and dec BP) -dec GI motility and tone beta 1 receptors - Answers -inc cardiac contractility, HR -inc renin secretion and BP beta 2 receptors - Answers -dec GI tone and motility -bronchodilation -inc blood flow in skeletal muscles -relaxes smooth muscles of uterus -activates liver glycogenolysis (inc blood glucose) Direct acting adrenergic agonists - Answers directly activates adrenergic receptor (epinephrine, norepinephrine, dopamine) indirect acting adrenergic agonists - Answers stimulates release of NE from terminal nerve endings (amphetamine) mixed acting adrenergic agonists - Answers stimulates adrenergic receptor sites and stimulates release of NE from terminal nerve endings (ephedrine) adrenergic agonists - Answers Catecholamines: produce sympathetic response - endogenous (epinephrine, NE, dopamine) -synthetic (isoproterenol, dobutamine) Noncatecholamines: stimulate adrenergic receptors. most have longer duration of action than endogenous and synthetic (phenylephrine, metaproterneol, albuterol) Epinephrine - Answers -CLASSIFICATION: adrenergic agonist -USES: anaphylaxis, bronchospasms, status asthmaticus, cardiac arrest -ACTION: Alpha1 inc BP, Beta1 inc HR, Beta2 promotes bronchodilation -CONTRAINDICATIONS: cardiac dysrhythmias, hypertension, hyperthyroidism, DM, pregnancy -SIDE/ADVERSE EFFECTS: cardiac (palpitation, tachycardia, hypertension), restlessness, hyperglycemia, dyspnea, tissue necrosis at IV site, vfib, PE -INTERACTIONS: beta blockers, digoxin, TCA and MAOIs -INTERVENTIONS: monitor IV site, monitor vitals and EKG, monitor I&Os and assess for bladder distention, avoid nausea and vomiting for pt, monitor blood glucose in pt with DM adrenergic antagonists - Answers block effects of adrenergic neurotransmitter (block alpha and beta receptor sites) -alpha-adrenergic agonists and beta adrenergic agonists alpha1 blockers - Answers -vasodilation/dizziness -orthostatic hypotension, reflex tachycardia -pupil constrict -suppress ejaculation -dec cx of smooth muscles in bladder, neck, and prostate beta1 blockers - Answers -dec cardiac contractility -dec pulse beta2 blockers - Answers -bronchoconstriction -cx uterus -inhibits glycogenolysis (leads to hypoglycemia) alpha adrenergic antagonists - Answers drugs that inhibit a response at alpha-adrenergic receptor site -selective (block alpha1) -nonselective (block alpha1 and alpha2) -action (promote vasodilation) -use (dec symptoms of BPH) albuterol - Answers -CLASSIFICATION: beta2 adrenergic agonist -USE: tx of asthma, prophylactic tx for asthma, tx of bronchospasms -ACTION: stimulates beta2 adrenergic receptors in lungs (relaxes bronchial smooth muscle) bronchodilation Beta-adrenergic agonists - Answers -dec BP and pulse -nonselective beta blockers blocks beta1: dec BP and pulse blocks beta2: bronchoconstriction, use with caution w pt with COPD or asthma atenolol - Answers -CLASS: beta adrenergic agonist -USE: tx of hypertension, angina, and prophylaxis and tx of acute MI -ACTION: selectively blocks beta1-adrenergic receptor sites, dec sympathetic outflow to the periphery, suppresses RAAS cholinergic agonists - Answers drugs that stimulate PNS -cholinergic receptors: muscarinic (smooth muscles, slow HR), nicotinic (skeletal muscles) -direct acting (activate) -indirect acting (inhibits) Effects of Cholinergic Agonists - Answers -constrict pupil, inc accommodation -constrict bronchioles and inc secretions -dec HR and BP -vasodilation -inc peristalsis, motility and secretions (inc diarrhea) -cx bladder (stimulates urination) -inc salivation -inc ureter tone bethanechol - Answers CLASS: parasympathomimetic USE: tx urinary retention and neurogenic bladder ACTION: stimulates cholinergic receptors (cx bladder), inc GI secretions and peristalsis, constrict of pupil and bronchoconstriction CI: intestinal and urinary tract obstruction, IBS, peptic ulcer, severe bradycardia, hypotension, COPD, parkinsonism, hyperthyroidism, seizures, active asthma SIDE/ADVERSE EFFECTS: blurred vision, GI effects, urinary frequency and urgency, bronchoconstriction, weakness, bronchospasm INTERVENTIONS: monitor BP and HR, tell pt to rise slowly from lying pos., auscultate breath sounds, record I&Os, monitor pt for overdose Effects of anticholinergics - Answers -heart: inc HR (large doses) dec HR (small doses) -lungs: bronchodilation, dec secretions -GI: relaxes smooth muscle tone, dec motility and peristalsis -GU: relaxes detrusor muscle, inc internal sphincter constrict -Eye: dilates pupil, dec accommodation -Glands: dec salivation and perspiration -CNS: dec tremors and muscle rigidity, drowsiness, disorientation, and hallucinations (Mad as a hatter, Blind as a bat, Red as a beet, Hot as a hare, Dry as a bone) Atropine sulfate - Answers CLASS: parasympatholytic (anticholinergic) -USE: pre-operative med to dec salivation, inc HR for bradycardia, dilate pupils for dx exams -ACTION: inhibits ACH by occupying receptors, inc HR by blocking vagal stimulation, promotes pupil dilation by blocking iris sphincter muscle -CI: glaucoma, obstructive GI disorders, ulcerative colitis, tachycardia, BPH, myasthenia gravis, myocardial ischemia, renal or hepatic disorders, COPD, heart failure -SIDE/ADVERSE EFFECTS: dry mouth, constipation, dry skin, blurred vision, photophobia, urinary retention, tachycardia, paradoxic bradycardia, hypertension, hypotension, angina, PE, seizures, dysrhythmias, laryngospasm, Stevens-Johnson syndrome, coma INTERVENTIONS: monitor vitals, monitor I&Os, assess bowel sounds, provide mouth care and eye drops, avoid hot env. wear sunglasses in bright light after dilation CNS stimulants - Answers -med approved uses: ADHD, narcolepsy, reversal of resp. distress -categories: Amphetamines and caffeine (act on cerebral cortex) Analeptics, caffeine (act on brainstem and medulla) Anorexiants (act on satiety center in hypothalamic and limbic areas) ADHD patho - Answers dysregulation of transmitters (serotonin, NE, dopamine) ADHD epidemiology - Answers Usually occurs in children before age 7. More common in boys Narcolepsy characteristics - Answers recurrent attacks of drowsiness and sleep during daytime. falling asleep while driving, talking, eating, standing. sleep paralysis amphetamines - Answers -stimulate the release of NE and dopamine -inhibit reuptake of these transmitters -causes: euphoria, inc alertness, cardio probs -high potential of abuse, tolerance and dependence -excessive use may lead to psychosis insomnia management - Answers tx: sedative hypnotics -non-pharm: wake up at specific time in AM, limit naps, avoid caffeine, alcohol etc 6hrs before bed, avoid heavy meals, large amount of fluid, loud noise and intense exercise before bed, take warm bath, read, listen to quiet music, drink warm milk before bed sedatives - Answers used to tx sleep disorders sedative hypnotics - Answers drugs that cause calmness, sleepiness, and slow down bodily functions (barbiturates, benzodiazepines, nonbenzodiazepines) sedative hypnotic side effects - Answers -drowsiness (hangover) -vivid dreams -drug dependence/tolerance -excessive depression -respiratory depression -hypersensitivity Alprazolam (Xanax) - Answers CLASS: benzodiazepine USE: tx anxiety and panic disorders ACTION: CNS depression, binds receptors in limbic system and reticular formation, inc GABA and GABA receptors, shift of chloride ions leads to less excitability and stabilizes neuronal membranes CI: resp depression, acute alcohol intoxication, psychotic reactions, recent resp depressants, suicidal ideation, drug abuse SIDE/ADVERSE EFFECTS: drowsiness, dizziness, amnesia, memory impairment, GI effects, depression, tolerance, dependence, withdrawal, hypotension, tachycardia, seizures, hepatic failure, Stevens-Johnson syndrome INTERVENTIONS: observe for adverse reactions, nonpharm method education, report adverse reactions, should be gradually withdrawn antidote: Flumazenil Kava Kava - Answers Stress and anxiety, sedative effects shouldn't be taken with other CNS depressants, may inc sedative effects Valerian - Answers insomnia. when taken with alcohol and other CNS depressants, may inc sedative effects chamomile - Answers to tx sleeplessness, anxiety and stomach or intestinal ailments zolpidem (Ambien) - Answers CLASS: sedative hypnotic, non-benzodiazepine USE: tx insomnia ACTION: CNS depression, neurotransmitter inhibition CI: hypersensitivity to benzodiazepine, resp depression, lactation, renal/liver dysfunction, depression, suicidal ideation, pregnancy, children, older adults, debilitates ind. SIDE/ADVERSE EFFECTS: hangover, memory impairment, nightmares, binge eating, tolerance, psych or physical dependence, withdrawal, sleep-related behavior, hypotension, angioedema, depression, suicidal ideation, PE, heart failure INTERVENTIONS: monitor vitals for resp depression, bed alarm for elderly, avoid alcohol, antidepressants, antipsychotics and narcotics, med takes effect within 15-20 mins!!! Anesthetics (general) - Answers depresses CNS, alleviates pain, causes loss of consciousness anesthetics (local) - Answers pain relief in limited area, no loss of consciousness -dental procedures, suturing skin lacerations, ST surgery at localized area, nerve block below insertion of spinal anesthetic, dx procedures, regional blocks anesthetics routes - Answers Inhalation IV Topical