Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
1. A student asks the pharmacology instructor to explain the action of anticholinergic
agents. What would be the instructor’s best response?
a. They block nicotinic receptors.
b. They compete with serotonin for muscarinic acetylcholine receptor sites.
c. They act to block the effects of the parasympathetic nervous system.
d. They increase norepinephrine at the neuromuscular junction.
Ans: C
Feedback:
Drugs that are used to block the effects of acetylcholine are called anticholinergic
drugs. Because this action lyses, or blocks, the effects of the parasympathetic nervous
system, they are also called parasympatholytic agents. The drug works by blocking
only the muscarinic effectors in the parasympathetic nervous system. They compete
with acetylcholine for the muscarinic acetylcholine receptor sites. They do not block
the nicotinic receptors and have little or no effect at the neuromuscular junction.
2. A patient calls the clinic and talks to the nurse. The patient tells the nurse he or she
is going on a cruise and is concerned about motion sickness. The patient says that a
friend has recommended that he or she see his or her primary care physician to get
a prescription for scopolamine. What adverse effect would the nurse inform the
patient that using scopolamine may result in?
a. Pupil constriction
b. Tachycardia
c. Diarrhea
d. Urinary incontinence
Ans: B
Feedback:
Scopolamine blocks the parasympathetic nervous system, which may result in dilated
pupils and increased heart rate (i.e., tachycardia). Blocking the parasympathetic
system also results in decreased GI activity and urinary bladder tone causing
constipation and urinary retention.
3. A 29-year-old man is going on a company-sponsored deep-sea fishing trip in 2
weeks. He comes to the clinic requesting a scopolamine patch because he is afraid
that he will get seasick. The medication is prescribed for him and the nurse’s
instructions concerning use of the patch will include what?
a. Shave the area before applying the patch.
b. The patch’s effectiveness will last about 72 hours.
, c. When replacing the patch, apply the new patch in the same area.
d. Do not clean the application area before applying the patch.
Ans: B
Feedback:
The scopolamine patch is replaced every 3 days (i.e., 72 hours). The scopolamine
patch should be applied to a clean, dry, intact, and hairless area of the body. The area
should not be shaved because abrasion of the skin could occur and lead to increased
absorption. Patches should be placed at new sites each time to avoid skin irritation.
The old patch should be removed and the area cleaned.
4. The nurse is taking a health history on a new patient who has been prescribed
propantheline(generic) as adjunctive therapy for peptic ulcers. While collecting the
health history, what will the nurse specifically assess for?
a. Diabetes mellitus
b. Obsessive-compulsive disorder
c. Insomnia
d. Glaucoma
Ans: D
Feedback:
Propantheline is contraindicated for a patient with glaucoma because the drug could
result in increased intraocular pressure due to pupil dilation. Diabetes mellitus,
obsessive-compulsive disorder, and insomnia are not recognized as being adversely
affected by this drug.
5. A nurse is admitting a patient for outpatient eye surgery. The nurse routinely
administers preoperative medications for eye surgery and is aware that an
increased dosage of a mydriatic is likely when given to a member of what ethnic
group?
a. African Americans
b. German Americans
c. Irish Americans
d. Scandinavian Americans
Ans: A
Feedback:
African Americans with dark eyes usually require an increased dosage and may have
a prolonged time to peak effect. The need for an increased dose appears to be related
to the amount of pigment in the person’s eyes because people with darker-pigmented
eyes require a higher dose. German, Irish, and Scandinavian Americans generally
have less pigmentation in their eyes and are therefore less likely to need a greater
dose.
1. A student asks the pharmacology instructor to explain the action of anticholinergic
agents. What would be the instructor’s best response?
a. They block nicotinic receptors.
b. They compete with serotonin for muscarinic acetylcholine receptor sites.
c. They act to block the effects of the parasympathetic nervous system.
d. They increase norepinephrine at the neuromuscular junction.
Ans: C
Feedback:
Drugs that are used to block the effects of acetylcholine are called anticholinergic
drugs. Because this action lyses, or blocks, the effects of the parasympathetic nervous
system, they are also called parasympatholytic agents. The drug works by blocking
only the muscarinic effectors in the parasympathetic nervous system. They compete
with acetylcholine for the muscarinic acetylcholine receptor sites. They do not block
the nicotinic receptors and have little or no effect at the neuromuscular junction.
2. A patient calls the clinic and talks to the nurse. The patient tells the nurse he or she
is going on a cruise and is concerned about motion sickness. The patient says that a
friend has recommended that he or she see his or her primary care physician to get
a prescription for scopolamine. What adverse effect would the nurse inform the
patient that using scopolamine may result in?
a. Pupil constriction
b. Tachycardia
c. Diarrhea
d. Urinary incontinence
Ans: B
Feedback:
Scopolamine blocks the parasympathetic nervous system, which may result in dilated
pupils and increased heart rate (i.e., tachycardia). Blocking the parasympathetic
system also results in decreased GI activity and urinary bladder tone causing
constipation and urinary retention.
3. A 29-year-old man is going on a company-sponsored deep-sea fishing trip in 2
weeks. He comes to the clinic requesting a scopolamine patch because he is afraid
that he will get seasick. The medication is prescribed for him and the nurse’s
instructions concerning use of the patch will include what?
a. Shave the area before applying the patch.
b. The patch’s effectiveness will last about 72 hours.
, c. When replacing the patch, apply the new patch in the same area.
d. Do not clean the application area before applying the patch.
Ans: B
Feedback:
The scopolamine patch is replaced every 3 days (i.e., 72 hours). The scopolamine
patch should be applied to a clean, dry, intact, and hairless area of the body. The area
should not be shaved because abrasion of the skin could occur and lead to increased
absorption. Patches should be placed at new sites each time to avoid skin irritation.
The old patch should be removed and the area cleaned.
4. The nurse is taking a health history on a new patient who has been prescribed
propantheline(generic) as adjunctive therapy for peptic ulcers. While collecting the
health history, what will the nurse specifically assess for?
a. Diabetes mellitus
b. Obsessive-compulsive disorder
c. Insomnia
d. Glaucoma
Ans: D
Feedback:
Propantheline is contraindicated for a patient with glaucoma because the drug could
result in increased intraocular pressure due to pupil dilation. Diabetes mellitus,
obsessive-compulsive disorder, and insomnia are not recognized as being adversely
affected by this drug.
5. A nurse is admitting a patient for outpatient eye surgery. The nurse routinely
administers preoperative medications for eye surgery and is aware that an
increased dosage of a mydriatic is likely when given to a member of what ethnic
group?
a. African Americans
b. German Americans
c. Irish Americans
d. Scandinavian Americans
Ans: A
Feedback:
African Americans with dark eyes usually require an increased dosage and may have
a prolonged time to peak effect. The need for an increased dose appears to be related
to the amount of pigment in the person’s eyes because people with darker-pigmented
eyes require a higher dose. German, Irish, and Scandinavian Americans generally
have less pigmentation in their eyes and are therefore less likely to need a greater
dose.
