TEST BANK INTRODUCTORY CLINICAL PHARMACOLOGY 12TH
EDITION By Susan M Ford
Chapter 25, Cholinergic Drugs
1. A client has been prescribed pyridostigmine for myasthenia gravis. The nurse
would be alert for the development of which adverse reaction following the
administration?
A) Seizure disorder
B) Reduction of visual acuity
C) Abdominal discomfort
D) Cardiac arrhythmias
Answer: D
Rationale: The nurse should monitor for cardiac arrhythmias as a general adverse
reaction in the client. Seizure disorder, reduction of visual acuity, and abdominal
discomfort are not pyridostigmine-related adverse reactions. Reduction of visual
acuity is related to topical ophthalmics. When the client is receiving bethanechol
for urinary retention, the nurse needs to examine for abdominal discomfort, which
is an adverse reaction of bethanechol and not pyridostigmine. Seizures are a
potential adverse reaction with lithium toxicity.
Question format: Multiple Choice
Chapter: 25
Learning Objective: 3
Cognitive Level: Apply
Client Needs: Physiological Integrity: Pharmacological Therapies
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 313, Summary Drug Table
2. A client with urinary retention is prescribed bethanechol. The nurse will
administer this cautiously if which disorder is noted in the client's medical record?
A) Raynaud disease
B) Bradycardia
C) Coronary artery disease
D) Hyperthyroidism
Answer: B
Rationale: The nurse should administer bethanechol cautiously if a client has
bradycardia, hypertension, epilepsy, cardiac arrhythmias, recent coronary
occlusion, or megacolon. Individuals with coronary artery disease and
hyperthyroidism should not receive bethanechol as it is contraindicated.
Individuals with Raynaud disease should not receive alpha-adrenergic blocking
drugs.
Question format: Multiple Choice
Chapter: 25
Learning Objective: 2
Cognitive Level: Apply
, Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 310, Precautions
3. A client was emergently administered bethanechol. Which finding on ongoing
assessment should the nurse prioritize and notify the health care provider
immediately?
A) Failure to void
B) Frequent emesis
C) Increased abdominal pain
D) Hematuria
Answer: A
Rationale: Bethanechol is used to treat acute nonobstructive urinary retention.
The nurse should notify the primary health care provider if the client fails to void
after drug administration. Nausea, emesis, and increased abdominal pain are
adverse effects of bethanechol. Hematuria is s potential adverse reaction to
sulfasalazine, a disease-modifying antirheumatic drug (DMARD).
Question format: Multiple Choice
Chapter: 25
Learning Objective: 3
Cognitive Level: Apply
Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 311, Urinary Retention
4. The nurse is caring for a client with myasthenia gravis and has been administering
pyridostigmine. The nurse suspects the client needs an increased dose based on
which assessment finding?
A) Clenching of the jaw
B) Muscle spasms
C) Difficulty breathing
D) Abdominal cramping
Answer: C
Rationale: The nurse should monitor for difficulty breathing as a symptom of drug
underdosage. Additional signs of underdosing include signs of the disease, rapid
fatigability of muscles, and drooping of eyelids. Signs of overdosing include
muscle rigidity and spasms, salivation, and clenching of jaw. Abdominal cramping
may occur in the client who is receiving guanidine.
Question format: Multiple Choice
Chapter: 25
Learning Objective: 3
Cognitive Level: Analyze
Client Needs: Physiological Integrity: Pharmacological Therapies
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 311, Managing Myasthenia Gravis
EDITION By Susan M Ford
Chapter 25, Cholinergic Drugs
1. A client has been prescribed pyridostigmine for myasthenia gravis. The nurse
would be alert for the development of which adverse reaction following the
administration?
A) Seizure disorder
B) Reduction of visual acuity
C) Abdominal discomfort
D) Cardiac arrhythmias
Answer: D
Rationale: The nurse should monitor for cardiac arrhythmias as a general adverse
reaction in the client. Seizure disorder, reduction of visual acuity, and abdominal
discomfort are not pyridostigmine-related adverse reactions. Reduction of visual
acuity is related to topical ophthalmics. When the client is receiving bethanechol
for urinary retention, the nurse needs to examine for abdominal discomfort, which
is an adverse reaction of bethanechol and not pyridostigmine. Seizures are a
potential adverse reaction with lithium toxicity.
Question format: Multiple Choice
Chapter: 25
Learning Objective: 3
Cognitive Level: Apply
Client Needs: Physiological Integrity: Pharmacological Therapies
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 313, Summary Drug Table
2. A client with urinary retention is prescribed bethanechol. The nurse will
administer this cautiously if which disorder is noted in the client's medical record?
A) Raynaud disease
B) Bradycardia
C) Coronary artery disease
D) Hyperthyroidism
Answer: B
Rationale: The nurse should administer bethanechol cautiously if a client has
bradycardia, hypertension, epilepsy, cardiac arrhythmias, recent coronary
occlusion, or megacolon. Individuals with coronary artery disease and
hyperthyroidism should not receive bethanechol as it is contraindicated.
Individuals with Raynaud disease should not receive alpha-adrenergic blocking
drugs.
Question format: Multiple Choice
Chapter: 25
Learning Objective: 2
Cognitive Level: Apply
, Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 310, Precautions
3. A client was emergently administered bethanechol. Which finding on ongoing
assessment should the nurse prioritize and notify the health care provider
immediately?
A) Failure to void
B) Frequent emesis
C) Increased abdominal pain
D) Hematuria
Answer: A
Rationale: Bethanechol is used to treat acute nonobstructive urinary retention.
The nurse should notify the primary health care provider if the client fails to void
after drug administration. Nausea, emesis, and increased abdominal pain are
adverse effects of bethanechol. Hematuria is s potential adverse reaction to
sulfasalazine, a disease-modifying antirheumatic drug (DMARD).
Question format: Multiple Choice
Chapter: 25
Learning Objective: 3
Cognitive Level: Apply
Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 311, Urinary Retention
4. The nurse is caring for a client with myasthenia gravis and has been administering
pyridostigmine. The nurse suspects the client needs an increased dose based on
which assessment finding?
A) Clenching of the jaw
B) Muscle spasms
C) Difficulty breathing
D) Abdominal cramping
Answer: C
Rationale: The nurse should monitor for difficulty breathing as a symptom of drug
underdosage. Additional signs of underdosing include signs of the disease, rapid
fatigability of muscles, and drooping of eyelids. Signs of overdosing include
muscle rigidity and spasms, salivation, and clenching of jaw. Abdominal cramping
may occur in the client who is receiving guanidine.
Question format: Multiple Choice
Chapter: 25
Learning Objective: 3
Cognitive Level: Analyze
Client Needs: Physiological Integrity: Pharmacological Therapies
Integrated Process: Clinical Problem-solving Process (Nursing Process)
Reference: p. 311, Managing Myasthenia Gravis
