Principles of Pharmacology Test 2 (Latest Grade A) Correct Study Guide, Complete Solutions

Chapter 25- Muscle Relaxants 1. The nurse is teaching a class on muscular coordination and explains it is the movement of what electrolyte that contributes to the process of muscle contraction and relaxation? A) Calcium B) Chloride C) Magnesium D) Hydrogen A Feedback: Calcium is released from the sarcoplasmic reticulum, which leads to the binding of calcium with troponin–tropomyosin. This leads to contraction of the muscle fiber. The calcium pump then moves calcium back into the sarcoplasmic reticulum, which leads to relaxation of muscle fiber. Chloride, magnesium, and hydrogen are not involved in this process. 2. A mother brings her 9-year-old son to the clinic for a routine check up. The 9-year-old boy has cerebral palsy and is very spastic. The mother asks the nurse what causes the spasticity in her son. What is the nurse’s best response? A) “Your son’s spasticity is caused by injury to the muscle tissue.” B) “Your son’s spasticity is caused by deficiency of a neurotransmitter called serotonin.” C) “Your son’s spasticity is caused by damaged sensory neurons.” D) “Your son’s spasticity is caused by damaged motor neurons.” D Feedback: 1 Muscle spasticity is the result of damage to neurons within the central nervous system (CNS) rather than injury to peripheral structures such as the musculoskeletal system. Serotonin is not involved in the process of muscle contraction and relaxation. Although acetylcholine is released and increases muscle cell membrane permeability to sodium, which eventually leads to the release of calcium, this process does play a vital part in muscle contraction and relaxation. 3. A nurse is providing discharge teaching for a patient who will be going home on cyclobenzaprine (Flexeril) prescribed for his acute musculoskeletal pain. The nurse will stress that the patient should avoid what? A) Drinking alcohol B) Taking antiemetics C) Taking antihistamines D) Taking antibiotics A Feedback: Taking cyclobenzaprine with alcohol can cause an increase in central nervous system depression. The nurse should stress that this combination should be avoided due to possible injury or severe body system depression that could lead to coma or death. No significant concerns exist with the use of antiemetics, antihistamines, or antibiotics with this drug. 4. The nurse provides patient teaching about chlorzoxazone (Paraflex) in preparation for the patient’s discharge to home. The nurse evaluates the patient understands potential adverse effects when the patient makes what statement? 2 A) “This drug can cause diarrhea.” B) “My urine may turn orange to purple red while taking this drug.” C) “My skin may turn yellow but that will go away when I stop taking the drug.” D) “After I take a pill it will take 2 to 3 hours before I feel the effects.” B Feedback: The patient indicates an understanding of adverse effects of this drug by stating that his urine may be discolored while using the drug. Chlorzoxazone may discolor the urine, which will turn orange to purple-red when metabolized and excreted. Patients should be warned about this effect to prevent any fears of blood in the urine. Chlorzoxazone usually causes constipation, not diarrhea. The onset of action is usually within an hour after the drug has been taken. Yellow discoloration of the skin would indicate liver damage or dysfunction, which should be reported immediately. 5. The nurse admits a child diagnosed with tetanus. What medication will the nurse expect to administer? A) Methocarbamol (Robaxin) B) Baclofen (Lioresal) C) Dantrolene (Dantrium) D) Diphenhydramine (Benadryl) A Feedback: Methocarbamol is the drug of choice if a child needs to be treated for tetanus. Baclofen and dantrolene are not recommended for use with children. Diphenhydramine is not indicated for treatment of tetanus.