Chapter 30 Adrenergic Agonists, prepU (GRADED A) Questions and Answers REF, Karch, A. M., Focus on Nursing Pharmacology, 8th ed | 100% VERIFIED.

Chapter 30: Adrenergic Agonists Question 1 See full question31s Report this Question Adrenergic drugs produce which effect? You Selected: Increased heart rate Correct response: Increa sed heart rate Explanation: Adrenergic drugs are used in cardiac arrest for their cardiac stimulant and peripheral vasoconstrictive effects. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 506. Chapter 30: Adrenergic Agonists - Page 506 Add a Note Question 2 See full question50s Report this Question Patients who are receiving alpha-specific adrenergic agents should not stop taking the drug abruptly. You Selected: True Correct response: True Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Alpha-Specific Adrenergic Agonists, p. 512. Chapter 30: Adrenergic Agonists - Page 512 Add a Note Question 3 See full question1m 20s Report this Question A nurse is caring for an elderly patient who is to be administered isoproterenol. Which change monitored in the patient should the nurse report immediately to the primary health care provider? You Selected: Changes in pulse rate Correct response: Changes in pulse rate Explanation: The nurse should report any changes observed in pulse rate or rhythm immediately. Changes in glucose level, appetite, or temperature need not be reported immediately to the primary care provider unless they are severe. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Table 30.3 Drugs in Focus: Beta-Specific Adrenergic Agonists, p. 516. Chapter 30: Adrenergic Agonists - Page 516 Add a Note Question 4 See full question7s Report this Question Which medication will most likely be administered to a client experiencing anaphylaxis? You Selected: epinephrine Correct response: epinephrine Explanation: Epinephrine is the adrenergic drug of choice for relief of anaphylactic shock, the most serious allergic reaction, as well as in treatment of cardiac arrest. Norepinephrine used to treat severe hypotension and shock that persists after adequate fluid volume replacement. Acetylcysteine is used for acetaminophen overdose. Dantrolene sodium is used to treat malignant hyperthermia. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 508. Chapter 30: Adrenergic Agonists - Page 508 Add a Note Question 5 See full question1m 28s Report this Question A client is administered epinephrine in conjunction with a local anesthetic. What effect will epinephrine produce? You Selected: increased vasoconstrictive effects Correct response: increased vasoconstrictive effects Explanation: Epinephrine is added to local anesthetics for vasoconstrictive effects, which include prolonging the action of the local anesthetic drug, preventing systemic absorption, and minimizing bleeding. Epinephrine will not decrease cerebral circulation or coronary circulation. Epinephrine will not increase bronchoconstriction. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Key Points, p. 515. Chapter 30: Adrenergic Agonists - Page 515 Add a Note Question 6 See full question59s Report this Question Which patient should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine? You Selected: A 47-year-old female with hypertension Correct response: A 47-year-old female with hypertension Explanation: Phenylephrine is an alpha-1 adrenergic agonist and a drug commonly used topically for relief of nasal and nasopharyngeal mucosal congestion and to produce mydriasis for ophthalmologic procedures. Phenylephrine acts as a vasopressor causing vasoconstriction of the arterioles. The vasoconstriction from phenylephrine use can increase peripheral resistance and blood pressure. People with hypertension should not take over-the-counter cold and allergy preparations containing phenylephrine because it can further increase their already elevated blood pressure. Patients with diabetes and gout have not been identified as being at risk for adverse reactions from the use of phenylephrine. A patient with an upper respiratory infection may actually benefit from use of the drug. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 512. Chapter 30: Adrenergic Agonists - Page 512 Add a Note Question 7 See full question1m 37s Report this Question The adrenergic branch of the nervous system controls many functions in the body. The nurse knows that which body functions are controlled by the adrenergic branch? (Select all that apply.) You Selected: Respiratory rate Heart rate Muscle blood flow Correct response: Heart rate Respiratory rate Muscle blood flow Explanation: The adrenergic branch of the nervous system controls heart rate, respiratory rate, and blood flow to the muscles. Muscle movement (fine or gross) is controlled by the somatic nervous system. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 506. Chapter 30: Adrenergic Agonists - Page 506 Add a Note Question 8 See full question22s Report this Question Which would the nurse identify as a naturally occurring catecholamine? You Selected: Dopamine Correct response: Dopamine Explanation: Dopamine is a naturally occurring catecholamine. Dobutamine, ephedrine, and metaraminol are synthetic catecholamines. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 506. Chapter 30: Adrenergic Agonists - Page 506 Add a Note Question 9 See full question1m 54s Report this Question The nurse is reviewing the medical record of a client who is taking an alpha- and beta adrenergic agonist. What would be of least concern to the nurse? You Selected: St. John’s wort Correct response: St. John’s wort Explanation: Alpha- and beta-adrenergic agonists interact with caffeine, ma huang, and OTC cold preparations, increasing the risk for hypertension. St. John’s wort has not been shown to interact with these agents. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Box 30.4 Focus on Herbal and Alternative Therapies, p. 509. Chapter 30: Adrenergic Agonists - Page 509 Add a Note Question 10 See full question57s Report this Question A nurse is caring for a client who has been receiving an adrenergic medication. Which statement by the client alerts the nurse about an adverse effect of the medication and a reason to call the prescriber? You Selected: “I feel a “fluttering” feeling in my heart.” Correct response: “I feel a “fluttering” feeling in my heart.” Explanation: Management of the client receiving an adrenergic agent varies and depends on the medication being used, the reason for administration, and the client’s response to the drug. Nursing judgment is necessary when reporting adverse reaction. Report adverse effects such as the development of cardiac arrhythmias immediately regardless of the time of day or night. A report of a nervous feeling, or concern about the hospitalization need not be dealt with on an emergent basis. The client is not experiencing an allergic reaction. Question 1 See full question7m 23s Report this Question Epinephrine causes relaxation of: You Selected: bronchioles. Correct response: bronchioles. Explanation: Epinephrine is the adrenergic drug of choice for relieving the acute bronchospasm and laryngeal edema of anaphylactic shock. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Table 30.1 Drugs in Focus: Alpha- and Beta-Adrenergic Agonists, p. 507. Chapter 30: Adrenergic Agonists - Page 507 Add a Note Question 2 See full question33m 19s Report this Question An increased dosage of digoxin would be needed if the patient is also taking midodrine. You Selected: True Correct response: False Explanation: Midodrine can precipitate increased drug effects of digoxin; this combination should be avoided. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Clinically Important Drug–Drug Interactions, p. 514. Chapter 30: Adrenergic Agonists - Page 514 Add a Note Question 3 See full question32s Report this Question A priority nursing assessment for a client who is to receive an alpha- or beta-adrenergic agonist would be to which action? You Selected: assess heart rate. Correct response: assess heart rate. Explanation: The client's heart rate must be assessed prior to administration of alpha- and beta-adrenergic agonists. There would some need to check blood glucose, measure urinary output and respiratory although monitored it is not the priority measure. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 506. Chapter 30: Adrenergic Agonists - Page 506 Add a Note Question 4 See full question48s Report this Question A nurse in the intensive care unit is caring for a client in shock and has started IV administration of dopamine (Intropin). For a client in shock, dopamine helps to: You Selected: increase blood pressure. Correct response: increase blood pressure. Explanation: For a client in shock, dopamine helps to increase blood pressure. The alpha stimulation produces increased peripheral resistance, raising the blood pressure as the dose of dopamine increases. The drug's dosage is titrated upward until adequate perfusion of vital organs is achieved. Beta-1 stimulation produces increased cardiac output by increasing the force of contraction and heart rate. The drug does not have a direct effect on body temperature. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 506. Chapter 30: Adrenergic Agonists - Page 506 Add a Note Question 5 See full question56s Report this Question Which herbs has been removed from most weight-loss medications due to potential legal liability? You Selected: Ephedra Correct response: Ephedra Explanation: Ephedra has serious adverse reactions, such as hypertension and irregular heart beat. These side effects have been associated with stroke and heart attacks. The Food and Drug Administration has warnings against taking weight-loss pills that have ephedra in them. Gingko, ginseng, and rose hips have not had these serious side effects. Question 1 See full question32s Report this Question Which would the nurse expect to be prescribed to a client experiencing acute bronchospasm? You Selected: Epinephrine Correct response: Epinephrine Explanation: Epinephrine would be used to treat bronchospasm. Dopamine is indicated for the treatment of congestive heart failure. Metaraminol is used to treat shock if norepinephrine or dopamine cannot be used. Norepinephrine is used to treat shock and during cardiac arrest to promote sympathetic activity. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Table 30.1 Drugs in Focus: Alpha- and Beta-Adrenergic Agonists, p. 507. Chapter 30: Adrenergic Agonists - Page 507 Add a Note Question 2 See full question42s Report this Question Which agent would the nurse expect to find when reviewing over-the-counter allergy products? You Selected: Phenylephrine Correct response: Phenylephrine Explanation: Phenylephrine is found in many cold and allergy products because it is so effective in constricting topical vessels and decreasing the swelling and signs and symptoms of rhinitis. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 512. Chapter 30: Adrenergic Agonists - Page 512 Add a Note Question 3 See full question7m 38s Report this Question A patient has been administered dobutamine HCL. Which adverse reactions should the nurse monitor for in the patient? You Selected: Cardiac arrhythmias Correct response: Cardiac arrhythmias Explanation: The nurse should monitor for cardiac arrhythmias (bradycardia and tachycardia) because they are common adverse reactions observed in patients being administered dobutamine HCL. Dobutamine HCL does not cause urinary retention, elevated temperature, or sleeplessness. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Alpha- and Beta-Adrenergic Agonists, p. 508. Chapter 30: Adrenergic Agonists - Page 508 Add a Note Question 4 See full question6m 10s Report this Question Which client is most likely to benefit from the administration of an adrenergic agonist? You Selected: A man who is in cardiogenic shock following a myocardial infarction Correct response: A man who is in cardiogenic shock following a myocardial infarction Explanation: One of the most frequent indications for adrenergic agonist drugs is shock. Their use is contraindicated in labor, and they would exacerbate hypertension. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 506. Chapter 30: Adrenergic Agonists - Page 506 Add a Note Question 5 See full question1m 3s Report this Question What is the expected outcome when phenylephrine is administered? Select all that apply. You Selected: decreased renal perfusion increased systolic blood pressure increased diastolic blood pressure Correct response: increased systolic blood pressure increased diastolic blood pressure decreased renal perfusion Explanation: Phenylephrine is a synthetic adrenergic drug that stimulates alpha-adrenergic receptors to produce vasoconstriction. As a result, it constricts arterioles and raises systolic and diastolic blood pressures. Vasoconstriction decreases cardiac output and renal perfusion and increases peripheral vascular resistance and blood pressure. Question 1 See full question1m 44s Report this Question The nurse is reviewing the history of a patient who is to receive midodrine. Which would alert the nurse to a contraindication for the drug? You Selected: Glaucoma Correct response: Glaucoma Explanation: Glaucoma is a contraindication for the use of midodrine, an alpha-specific adrenergic agonist, because the condition could be exacerbated by the arterial constriction. Thyrotoxicosis requires cautious use of midodrine, an alpha specific adrenergic agonist. Diabetes requires cautious use of midodrine, an alpha specific adrenergic agonist. Vasomotor spasm requires cautious use of midodrine, an alpha-specific adrenergic agonist. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Alpha-Specific Adrenergic Agonists, p. 513. Chapter 30: Adrenergic Agonists - Page 513 Add a Note Question 2 See full question1m 40s Report this Question A client receives a beta-specific agonist. What would lead the nurse to determine that the drug is effective? You Selected: Bronchodilation Correct response: Bronchodilation Explanation: A beta-specific agonist would lead to bronchodilation. A beta-specific agonist would cause an increased heart rate. Tremor is an adverse effect of a beta-specific agonist. A beta-specific agonist would increase cardiac conductivity. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 516. Chapter 30: Adrenergic Agonists - Page 516 Add a Note Question 3 See full question17s Report this Question A patient is receiving salmeterol. The nurse would expect this drug to be given by which route? You Selected: Inhalation Correct response: Inhalation Explanation: Salmeterol, a beta-specific adrenergic agonist, is administered by inhalation. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Table 30.3 Drugs in Focus: Beta-Specific Adrenergic Agonists, p. 516. Chapter 30: Adrenergic Agonists - Page 516 Add a Note Question 4 See full question24s Report this Question After reviewing the routes of administration for beta-specific adrenergic agonists, a group of students demonstrate the need for additional study when they identify isoproterenol as being administered by which route? You Selected: Oral Correct response: Oral Explanation: Isoproterenol is administered IV, IM, or subcutaneously. It is not administered orally. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Table 30.3 Drugs in Focus: Beta-Specific Adrenergic Agonists, p. 516. Chapter 30: Adrenergic Agonists - Page 516 Add a Note Question 5 See full question18s Report this Question Phentolamine is the agent used to treat extravasation of dobutamine. You Selected: True Correct response: True Explanation: Maintain phentolamine on standby in case extravasation occurs. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Implementation with Rationale, p. 510. Chapter 30: Adrenergic Agonists - Page 510 Add a Note Question 6 See full question17s Report this Question Which of the following adrenergic receptors is responsible for increased heart rate and increased force of myocardial contraction? You Selected: β1 receptors Correct response: β1 receptors Explanation: receptors. Vasoconstriction of peripheral blood vessels occurs as the result of stimulation of α1 receptors. Stimulation of these receptors regulates the release of neurotransmitters and decreases the tone, motility, and secretions of the GI tract. Stimulation of these receptors leads to vasodilation of the peripheral vessels and also causes bronchodilation. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 508. Chapter 30: Adrenergic Agonists - Page 508 Add a Note Question 7 See full question13s Report this Question Which adrenergic receptor is responsible for vasodilation of peripheral vessels and bronchodilation? You Selected: β2 receptors Correct response: β2 receptors Explanation: Vasodilation of peripheral vessels and bronchodilation are the result of stimulation of β2 receptors. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 516. Chapter 30: Adrenergic Agonists - Page 516 Add a Note Question 8 See full question22s Report this Question A client is administered epinephrine in conjunction with a local anesthetic. What effect will epinephrine produce? You Selected: increased vasoconstrictive effects Correct response: increased vasoconstrictive effects Explanation: Epinephrine is added to local anesthetics for vasoconstrictive effects, which include prolonging the action of the local anesthetic drug, preventing systemic absorption, and minimizing bleeding. Epinephrine will not decrease cerebral circulation or coronary circulation. Epinephrine will not increase bronchoconstriction. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Key Points, p. 515. Chapter 30: Adrenergic Agonists - Page 515 Add a Note Question 9 See full question48s Report this Question Epinephrine is contraindicated in clients with which diseases or disorders? You Selected: Narrow-angle (or closed-angle) glaucoma Correct response: Narrow-angle (or closed-angle) glaucoma Explanation: Epinephrine and other adrenergic drugs are contraindicated in clients with narrow-angle glaucoma (closed-angle glaucoma) because the drugs increase intraocular pressure and mydriasis. Asthma, bronchoconstriction, and hypotension are among the disorders and diseases treated with adrenergic drugs. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Contraindications and Cautions, p. 513. Chapter 30: Adrenergic Agonists - Page 513 Add a Note Question 10 See full question49s Report this Question The adrenergic branch of the nervous system controls many functions in the body. The nurse knows that which body functions are controlled by the adrenergic branch? (Select all that apply.) You Selected: Respiratory rate Muscle blood flow Heart rate Correct response: Heart rate Respiratory rate Muscle blood flow Explanation: The adrenergic branch of the nervous system controls heart rate, respiratory rate, and blood flow to the muscles. Muscle movement (fine or gross) is controlled by the somatic nervous system. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 506. Chapter 30: Adrenergic Agonists - Page 506 Add a Note Question 11 See full question45s Report this Question A child is brought to the pediatrician's office with trouble breathing. On exam, the child has wheezing in bilateral lung fields. The nurse suspects the provider will order which medication? You Selected: Albuterol Correct response: Albuterol Explanation: Albuterol is a bronchodilator commonly used for wheezing. Alphagan is an alpha adrenergic agonist used in the eye. Amoxicillin is an antibacterial drug. ProAmatine is used for orthostatic hypotension. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Table 30.3 Drugs in Focus: Beta-Specific Adrenergic Agonists, p. 516. Chapter 30: Adrenergic Agonists - Page 516 Add a Note Question 12 See full question1m 1s Report this Question A client has an IV of dopamine administered in the right arm. The IV becomes dislodged from the vein and dopamine has been being given in the surrounding tissue instead of the vein. The nurse should stop the IV and: You Selected: sdminister phentolamine to the site to minimize necrosis. Correct response: sdminister phentolamine to the site to minimize necrosis. Explanation: Phentolamine is used to treat/prevent dermal necrosis after IV administration of norepinephrine or dopamine. Placing ice causes vasoconstriction which could increase the chance of necrosis. Wrapping the site tightly with gauze will not help the tissue absorb the dopamine. Beta blockers have most of their effects on the heart and they slow the heart rate. This will not prevent necrosis at the site of the dopamine infusion. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Nursing Considerations for Patients Receiving Alpha- and Beta-Adrenergic Agonists, p. 510. Chapter 30: Adrenergic Agonists - Page 510 Add a Note Question 13 See full question39s Report this Question A male client is prescribed an adrenergic ophthalmic medication. What should the nurse include in the teaching plan? You Selected: Hypertension may be a side effect of the medication. Correct response: Hypertension may be a side effect of the medication. Explanation: Ophthalmic preparations of adrenergic drugs should be used cautiously. For example, phenylephrine is used as a vasoconstrictor and mydriatic. Applying larger-than-recommended doses to the normal eye or usual doses to the traumatized, inflamed, or diseased eye may result in systemic absorption of the drug sufficient to cause increased blood pressure and other adverse effects. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Adverse Effects, p. 508. Chapter 30: Adrenergic Agonists - Page 508 Add a Note Question 14 See full question12s Report this Question Which would the nurse identify as a naturally occurring catecholamine? You Selected: Dopamine Correct response: Dopamine Explanation: Dopamine is a naturally occurring catecholamine. Dobutamine, ephedrine, and metaraminol are synthetic catecholamines. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 506. Chapter 30: Adrenergic Agonists - Page 506 Add a Note Question 15 See full question20s Report this Question The intravenous line of a client receiving dobutamine infiltrates and the drug extravasates. The nurse would infiltrate the site with: You Selected: phentolamine. Correct response: phentolamine. Explanation: If extravasation occurs, the nurse should infiltrate the site with 10 mL of saline containing 5 to 10 mg of phentolamine. Hyaluronidase and sodium bicarbonate may be used for extravasation of certain antineoplastic agents. Lactated Ringer’s solution would be inappropriate. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Implementation with Rationale, p. 510. Chapter 30: Adrenergic Agonists - Page 510 Add a Note Question 16 See full question19s Report this Question A client is receiving phenylephrine via intramuscular injection. The nurse would expect the drug to begin acting in approximately which amount of time? You Selected: 10 to 15 minutes Correct response: 10 to 15 minutes Explanation: Intramuscular phenylephrine has an onset of action within 10 to 15 minutes. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Prototype Summary: Phenylephrine, p. 514. Chapter 30: Adrenergic Agonists - Page 514 Add a Note Question 17 See full question24s Report this Question Which assessment finding would indicate to the nurse that the administered isoproterenol is effective? You Selected: Improved cardiac contractility Correct response: Improved cardiac contractility Explanation: The desired effects of isoproterenol include improved contractility and conductivity, increased heart rate, bronchodilation, relaxation of the uterus, and increased blood flow to skeletal muscles and splanchnic beds. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Beta-Specific Adrenergic Agonists, p. 516. Chapter 30: Adrenergic Agonists - Page 516 Add a Note Question 18 See full question14s Report this Question What would a nurse expect to administer if a client who is receiving isoproterenol develops a severe reaction? You Selected: Beta-adrenergic blockers Correct response: Beta-adrenergic blockers Explanation: To counteract the effects of isoproterenol, a beta-specific adrenergic agonist, the nurse would administer a beta-adrenergic blocker. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Clinically Important Drug–Drug Interactions, p. 517. Chapter 30: Adrenergic Agonists - Page 517 Add a Note Question 19 See full question10s Report this Question The nurse is admitting a client with injuries following a bicycle crash. When reviewing the client's pre- admission medication regimen, the nurse reads that the client takes formoterol twice daily. When planning this client's care, the nurse should include: You Selected: frequent respiratory assessments. Correct response: frequent respiratory assessments. Explanation: Formoterol is given for the treatment of asthma, so the nurse should prioritize respiratory assessments. The inclusion of this particular medication does not create a need for increased cardiac, blood pressure or mental status assessments. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Beta-Specific Adrenergic Agonists, pp. 516-517. Chapter 30: Adrenergic Agonists - Page 516-517 Add a Note Question 20 See full question17s Report this Question An adrenergic drug would be prescribed to produce what physiological effect? You Selected: increased heart rate Correct response: increased heart rate Explanation: Adrenergic drugs cause an increase in heart rate and respiratory rate. They do not directly induce urinary incontinenceurine concentration, and they do not reduce blood pH. Question 1 See full question30s Report this Question A patient receives phenylephrine intravenously. The nurse would expect the drug to last for how long? You Selected: 15 to 20 minutes Correct response: 15 to 20 minutes Explanation: Phenylephrine, when given IV has a duration of action of 15 to 20 minutes. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Prototype Summary: Phenylephrine, p. 514. Chapter 30: Adrenergic Agonists - Page 514 Add a Note Question 2 See full question9m 3s Report this Question A nurse would instruct a patient to apply a clonidine patch at which frequency? You Selected: Every 7 days Correct response: Every 7 days Explanation: Clonidine transdermal has a duration of action of 7 days, so it needs to be replaced only every week. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists. Add a Note Question 3 See full question5s Report this Question An increased dosage of digoxin would be needed if the patient is also taking midodrine. You Selected: True Correct response: False Explanation: Midodrine can precipitate increased drug effects of digoxin; this combination should be avoided. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Clinically Important Drug–Drug Interactions, p. 514. Chapter 30: Adrenergic Agonists - Page 514 Add a Note Question 4 See full question34s Report this Question Which of the following adrenergic receptors is responsible for the vasoconstriction of peripheral blood vessels? You Selected: α1 receptors Correct response: α1 receptors Explanation: Vasoconstriction of peripheral blood vessels occurs as the result of stimulation of α1 receptors. Stimulation of these receptors regulates the release of neurotransmitters and decreases the tone, motility, and secretions of the GI tract. Stimulation of these receptors increases the heart rate and force of myocardial contraction. Stimulation of these receptors leads to vasodilation of the peripheral vessels and also causes bronchodilation. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 512. Chapter 30: Adrenergic Agonists - Page 512 Add a Note Question 5 See full question5s Report this Question Which medication will most likely be administered to a client experiencing anaphylaxis? You Selected: epinephrine Correct response: epinephrine Explanation: Epinephrine is the adrenergic drug of choice for relief of anaphylactic shock, the most serious allergic reaction, as well as in treatment of cardiac arrest. Norepinephrine used to treat severe hypotension and shock that persists after adequate fluid volume replacement. Acetylcysteine is used for acetaminophen overdose. Dantrolene sodium is used to treat malignant hyperthermia. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 508. Chapter 30: Adrenergic Agonists - Page 508 Add a Note Question 6 See full question38s Report this Question Epinephrine can be administered by multiple routes. Which is not an appropriate route? You Selected: Oral Correct response: Oral Explanation: Epinephrine is not given orally because enzymes in the gastrointestinal tract and liver destroy it. It may be given by inhalation, injection (intravenous, intramuscular, or subcutaneous), or topical application. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Table 30.1 Drugs in Focus: Alpha- and Beta-Adrenergic Agonists, p. 507. Chapter 30: Adrenergic Agonists - Page 507 Add a Note Question 7 See full question15s Report this Question Which receptor does phenylephrine stimulate? You Selected: Alpha1 Correct response: Alpha1 Explanation: Phenylephrine stimulates alpha1 receptors. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 512. Chapter 30: Adrenergic Agonists - Page 512 Add a Note Question 8 See full question1m 1s Report this Question The nurse knows that what is an added benefit of epinephrine in cardiac arrest situations due to asystole or pulseless electrical activity? You Selected: Stimulates electrical and mechanical activity Correct response: Stimulates electrical and mechanical activity Explanation: A benefit of epinephrine in arrest situations due to asystole or pulseless electrical activity is the added ability to stimulate electrical and mechanical activity and produce myocardial contraction. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Alpha- and Beta-Adrenergic Agonists, p. 508. Chapter 30: Adrenergic Agonists - Page 508 Add a Note Question 9 See full question27s Report this Question A client is being treated for asthma. What would the nurse expect to administer? You Selected: Beta-2–specific adrenergic agonist Correct response: Beta-2–specific adrenergic agonist Explanation: Most of the beta-specific adrenergic agonists are beta-2–specific adrenergic agonists, which are used to treat and manage bronchial spasm, asthma, and other obstructive pulmonary conditions. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Beta-Specific Adrenergic Agonists, p. 515. Chapter 30: Adrenergic Agonists - Page 515 Add a Note Question 10 See full question33s Report this Question Adrenergic drugs mimic the effects of stimulating what part of the nervous system? You Selected: sympathetic Correct response: sympathetic Explanation: An adrenergic drug is an agent that produces effects like those produced by stimulation of the sympathetic nervous system and therefore has widespread effects on body tissues. Question 1 See full question34s Report this Question After reviewing the topic of catecholamines, a group of students demonstrates the need for additional study when they identify which as a synthetic catecholamine? You Selected: Dopamine Correct response: Dopamine Explanation: Dopamine is a naturally occurring catecholamine. Dobutamine is a synthetic catecholamine. Ephedrine is a synthetic catecholamine. Metaraminol is a synthetic catecholamine. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Adrenergic Response, p. 497. Chapter 30: Adrenergic Agonists - Page 497 Add a Note Question 2 See full question25s Report this Question Which agent would the nurse identify as being available in a transdermal form? You Selected: Clonidine Correct response: Clonidine Explanation: Clonidine is available in an oral and transdermal form. Midodrine is available in oral form only. Phenylephrine is available in parenteral forms, topical forms, and ophthalmic forms. Salmeterol is available in an inhalation form. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Alpha-Specific Adrenergic Agonists, p. 513. Chapter 30: Adrenergic Agonists - Page 513 Add a Note Question 3 See full question27s Report this Question A nurse in the intensive care unit is caring for a client in shock and has started IV administration of dopamine (Intropin). For a client in shock, dopamine helps to: You Selected: increase blood pressure. Correct response: increase blood pressure. Explanation: For a client in shock, dopamine helps to increase blood pressure. The alpha stimulation produces increased peripheral resistance, raising the blood pressure as the dose of dopamine increases. The drug's dosage is titrated upward until adequate perfusion of vital organs is achieved. Beta-1 stimulation produces increased cardiac output by increasing the force of contraction and heart rate. The drug does not have a direct effect on body temperature. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 506. Chapter 30: Adrenergic Agonists - Page 506 Add a Note Question 4 See full question27s Report this Question The client is given epinephrine for an exacerbation of asthma. What response to the medication would the nurse expect? You Selected: Increased ease of breathing and increased heart rate Correct response: Increased ease of breathing and increased heart rate Explanation: Depending on the location and distribution of receptors, epinephrine exerts a variety of responses in different effector organs and tissues. In the cardiovascular system, epinephrine exerts positive inotropic and chronotropic effects on the myocardium by stimulating beta-1 adrenergic receptors. In the skin and viscera, epinephrine stimulates alpha-adrenergic receptors, causing vasoconstriction and vasodilation in skeletal muscle vessels. The overall effect is to increase systolic pressure and slightly decrease diastolic pressure. In the respiratory system, epinephrine causes bronchodilation by the stimulation of beta-2 adrenergic receptors and is used in this way to treat clients with asthma or to manage anaphylactic shock. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Alpha- and Beta-Adrenergic Agonists, p. 506. Chapter 30: Adrenergic Agonists - Page 506 Add a Note Question 5 See full question1m 7s Report this Question The nurse is administering epinephrine IV push. The nurse checks for patency of the IV prior to administration of the drug. The nurse realizes that if the IV is infiltrated, the medication will result in tissue extravasation. What is the reason for such an occurrence? You Selected: The medication causes vasoconstriction, limiting the blood flow to the area. Correct response: The medication causes vasoconstriction, limiting the blood flow to the area. Explanation: Extravasation can occur during parenteral administration; necrosis may result because of epinephrine's potent vasoconstrictive properties. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Table 30.1 Drugs in Focus: Alpha- and Beta-Adrenergic Agonists, p. 507. Chapter 30: Adrenergic Agonists - Page 507 Add a Note Question 6 See full question20s Report this Question Which condition is treated with an adrenergic agonist? You Selected: Anaphylaxis Correct response: Anaphylaxis Explanation: Epinephrine, a prototype adrenergic agonist, is used to relieve the acute bronchospasm and laryngeal edema of anaphylactic shock. Since adrenergic agonists act as cardiac stimulants, some versions may be used to treat severe bradycardia or hypotension. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 508. Chapter 30: Adrenergic Agonists - Page 508 Add a Note Question 7 See full question22s Report this Question In providing care to a client with wheezing, the nurse knows that a medication targets which receptors? You Selected: beta 2 Correct response: beta 2 Explanation: Beta 2 receptors are found on the bronchial smooth muscles, and medications that stimulate beta 2 receptors cause bronchodilation. Alpha 1 receptors cause vasoconstriction of peripheral blood vessels. Alpha 2 receptors decrease tone, motility, and secretions of the GI tract. Beta 1 receptors increase heart rate and force of myocardial contraction. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Beta-Specific Adrenergic Agonists, pp. 515-516. Chapter 30: Adrenergic Agonists - Page 515-516 Add a Note Question 8 See full question38s Report this Question What would be most important for the nurse to assess in a client receiving midodrine? You Selected: Positional blood pressure changes Correct response: Positional blood pressure changes Explanation: Midodrine is associated with a serious supine hypertension. Therefore, monitoring blood pressure changes in different positions (standing, sitting, and supine) would be most important. The drug is not associated with respiratory adverse effects. Decreased urinary output and anorexia may occur, but these would not be as important as monitoring the changes in the client’s blood pressure. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Therapeutic Actions and Indications, p. 512. Chapter 30: Adrenergic Agonists - Page 512 Add a Note Question 9 See full question24s Report this Question A client has been diagnosed with asthma and prescribed albuterol 2 inhalations q6h. When providing client education, what should the nurse teach the client? You Selected: Restlessness and anxiety are possible after administration Correct response: Restlessness and anxiety are possible after administration Explanation: Sympathetic stimulation associated with albuterol can cause anxiety, restlessness and increased blood pressure. There is no absolute need to precede its use with oxygen. Upright positioning is beneficial but not absolutely necessary. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 30: Adrenergic Agonists, Beta-Specific Adrenergic Agonists, p. 517. Chapter 30: Adrenergic Agonists - Page 517 Add a Note Question 10 See full question35s Report this Question Which medication is a synthetic catecholamine prescribed for the treatment of bradycardia? You Selected: isoproterenol Correct response: isoproterenol Explanation: Isoproterenol is a synthetic catecholamine that acts on beta1- and beta2-adrenergic receptors to stimulate heart rate. Neither pseudoephedrine, ephedrine, nor epinephrine is synthetic catecholamine. Show Less