MED 143 Adrenergic Agonists – Chapter 30 Questions & Answers Verified 2023

MED 143 Adrenergic Agonists – Chapter 30 Questions & Answers Verified 2023. What action do sympathomimetic drugs have in the body? A) Decreased heart rate B) Decreased blood pressure C) Increased respirations D) Increased intraocular pressure Ans: C Feedback: Sympathomimetic drugs increase respirations. Heart rate and blood pressure are also increased and intraocular pressure is decreased. 3.An 80-year-old patient has been brought to the emergency department in shock. The patient is receiving dopamine (Intropin). What potentially serious adverse effect will the nurse monitor for? A) Blood dyscrasia B) Cardiac arrhythmia C) Hepatic toxicity D) Renal insufficiency Ans: B Feedback: Dopamine therapy can result in cardiac arrhythmias, which can be life threatening. Older patients are more likely to experience the adverse effects associated with adrenergic agonists and should be started on lower doses and monitored closely for arrhythmias and blood pressure changes. Blood dyscrasias, hepatic toxicity, and renal insufficiency are not commonly associated with dopamine use. In fact, at lower doses, dopamine increases renal perfusion. 4.A patient comes to the clinic complaining of seasonal rhinitis. What adrenergic agonist would be prescribed for treatment of seasonal rhinitis? A) Dobutamine (Dobutrex) B) Ephedrine (generic) C) Dopamine (Intropin) D) Norepinephrine (Levophed) Page 1 Ans: B Feedback: Ephedrine has been used to treat seasonal rhinitis by stimulating the release of norepinephrine from nerve endings and directly acting on adrenergic receptor sites. Although ephedrine was formerly used for situations ranging from the treatment of shock to chronic management of asthma and allergic rhinitis, its use in many areas is declining because of the availability of less toxic drugs with more predictable onset and action. Dobutamine is used to treat congestive heart failure. Dopamine and norepinephrine are used to treat shock. 5.The patient is taking midodrine (ProAmatine). What is the most important nursing action to include in the plan of care for this patient? A) Monitor urine output. B) Monitor blood pressure. C) Monitor heart rate. D) Monitor respirations. Ans: B Feedback: Midodrine is an oral drug used to treat orthostatic hypotension in patients who do not respond to traditional therapy. It activates alpha-adrenergic receptors, leading to peripheral vasoconstriction and an increase in vascular tone and blood pressure. This effect can cause serious supine hypertension. Patients should be monitored in the standing, sitting, and supine positions to determine whether this will be a problem. It is also important to monitor heart rate, respirations, and urine output in this patient. However, assessing for supine hypertension would pose the greatest threat to the patient and would take priority. 6.The nurse is planning discharge teaching for a patient who is taking clonidine (Catapres). What would be most important for the nurse to include when teaching about adverse effects? A) Pupil constriction B) Strange dreams C) Increased urine output D) Increased appetite Ans: B Feedback: Central nervous system effects from clonidine therapy include feelings of anxiety, restlessness, depression, fatigue, strange dreams, and personality changes. However, bad dreams would be the most upsetting and stressful effect for the patient. Pupil dilation, decreased urine output, and anorexia are all adverse effects of clonidine. 7.What drug would the nurse expect to administer if beta-specific adrenergic agonist effects are desired to prevent bronchospasm during anesthesia? Page 2 A) Dobutamine (Dobutrex) B) Ephedrine (generic) C) Isoproterenol (Isuprel) D) Phenylephrine (Neo-Synephrine) Ans: C Feedback: Isoproterenol is a beta-specific adrenergic agonist used to prevent bronchospasm during anesthesia. Phenylephrine is an alpha-specific adrenergic agonist. Both dobutamine and ephedrine are alpha- and beta-adrenergic agonists. 8.The nurse is preparing discharge teaching for four patients. Which patient should be advised by the nurse that over-the-counter cold and allergy preparations contain phenylephrine and should be avoided? A) A 47-year-old woman with hypertension B) A 52-year-old man with adult onset diabetes C) A 17-year-old girl with symptoms of an upper respiratory infection D) A 62-year-old man with gout Ans: A Feedback: Phenylephrine, a potent vasoconstrictor and alpha1-agonist with little or no effect on the heart or bronchi, is used in many combination cold and allergy products. Patients with hypertension should avoid these drugs because serious increases in blood pressure could occur. Use of this drug in patients with diabetes and gout are not contraindicated. An upper respiratory infection may be an indication for the drug. 9.The nurse is writing a plan of care for a patient receiving an alpha-specific adrenergic agonist. What should this plan of care include? A) Monitoring the patient for diarrhea B) Monitoring blood pressure and heart rate every 2 to 4 hours C) Assessing skin turgor for dehydration D) Assessing for fatigue and lethargy Ans: B Feedback: Sympathetic stimulation will cause hypertension and increased heart rate so it is important these be monitored. Sympathetic stimulation will also result in increased sweating, decreased gastrointestinal activity, and a sense of anxiety and heightened awareness. Diarrhea, dehydration, fatigue, and lethargy would not be expected. 10.A nurse receives an order for clonidine (Catapres) for a 25-year-old pregnant woman. What is the nurse's priority action? A) Weigh the patient to obtain correct dose/kg/day. B) Have a second nurse check the dose before administering the drug. C) Consult with the physician about the order. Page 3 D) Make sure the patient is wearing a fetal monitor. Ans: C Feedback: The nurse would consult with the physician to ensure awareness of the pregnancy and desire to administer this drug. There are no adequate studies about use during pregnancy and lactation, so use should be reserved for situations in which the benefit to the mother outweighs any potential risk to the fetus or neonate. The nurse should question the prescriber regarding this order. It would not be necessary to implement the other options. 11.The nursing students are studying sympathomimetic drugs. How do these drugs act on the body? A) Stimulate beta receptors and block alpha-receptors B) Stimulate alpha-receptors and block beta-receptors C) Block adrenergic receptors D) Stimulate both alpha and beta-receptors Ans: D Feedback: Drugs that are generally sympathomimetic are called alpha-agonists (stimulate alphareceptors) and beta-agonists (stimulate beta-receptors). These agonists stimulate all of the adrenergic receptors; that is they affect both alpha and beta-receptors.