Test Bank for Introductory
Clinical Pharmacology 12th
Edition by Susan M Ford
Chapter 26-30
C HAPTER 26: C HOLINERGIC B LOCKING D RUGS
Ford: Introductory Clinical Pharmacology 12th Edition
Multiple Choice
1. A client with biliary colic has been prescribed atropine. The nurse should
question this order after discovering which disorder in the client's past history?
A) Hepatic disease
B) Benign prostatic hypertrophy
C) M yocardial infarction
D) Urinary retention
Answer: C
Rationale: The nurse should know that the use of atropine is contraindicated
in clients with m yocardial infarction. Other contraindications include
myasthenia gravis, tachyarrhythmia, and congestive heart failure (unless
bradycardia is present). Hepatic disease, benign prostatic hypertrophy, and
urinary retention are conditions requiring cautious administration and are not
contraindications for use.
Question format: Multiple Choice
, Chapter: 26
Learning Objective: 1
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Pharmacological Therapies
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 317, Contraindications
2. The nurse is preparing t o administer solifenacin to a client with an overactive
bladder. Which potential reaction should the nurse prioritize after noting the
client is also prescribed digoxin?
A) Increased neuromuscular blocking effect
B) Increased effectiveness of digoxin
C) Increased serum levels of digoxin
D) Increased effectiveness of solifenacin
Answer: C
Rationale: The nurse should monitor for increased serum levels of digoxin
that occur due to the interaction of anticholinergics and digoxin. Increased
neuromuscular blocking is an effect of the interaction of aminogl ycoside
antibiotics with cholinergic drugs. Increased effectiveness of digoxin and
solifenacin are not the effects associated with the interaction of
anticholinergics and digoxin.
Question format: Multiple Choice
Chapter: 26
Learning Objective: 1
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Pharmacological Therapies
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 317, Interactions
3. A nurse is caring for a c lient who is prescribed darifenacin. Which activit y
should the nurse prioritize in the ongoing assessment?
A) Assessment of the client's medical history
, B) Evaluation of symptoms related to the client's diagnosis
C) Monitoring of the client's vital signs every 2 4 hours
D) Observation for behavioral changes in the client
Answer: B
Rationale: The nurse should evaluate the symptoms and reports related to the
client's diagnosis during the ongoing assessment of the treatment. The nurse
should assess the medical hist ory of the client before administration of the
drug as part of the pre -administration assessment. The vital signs of the
client should be monitored every shift. The nurse need not observe for
behavioral changes in the client based on the client's diagnosis and condition.
Question format: Multiple Choice
Chapter: 26
Learning Objective: 2
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Reduction of Risk Potential
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 318, Ongoing Assessment
4. The nurse has administered dicyclomine to an elderl y client. Which finding on
the ongoing assessment should the nurse prioritize?
A) Disorientation
B) Light-headedness
C) Blurred vision
D) M ydriasis
Answer: C
Rationale: The nurse should monitor for blurred vision in the client after
administration of dicyclomine. The other conditions observed are drowsiness,
tachycardia, dry mouth, and urinary hesitancy. Disorientation, light -
headedness, and m ydriasis are adverse reactions ass ociated with the
administration of trihex yphenidyl.
Question format: Multiple Choice
, Chapter: 26
Learning Objective: 2
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Reduction of Risk Potential
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 321, Summary Drug Table
5. A nurse is conducting a teaching session with a client who is prescribed
scopolamine during the summer. The nurse determines the session is successful
when the client correctl y chooses which sign to report immediatel y to the health
care provider which may indicate the client is experiencing heat prostration?
A) Dry mouth
B) Fever
C) Skin rash
D) Urinary retention
Answer: B
Rationale: During hot summer months, clients receiving a cholinergic
blocking drug such as scopolamine should be instructed on the risk of heat
prostration due to decreased sweating effect related to these medications.
Signs of heat prostration include fever; tachycardia; flushing; warm, dry
skin; and mental confusion. A dr y mouth is an adverse reaction to these
drugs. A skin rash is a potential adverse reaction related to a hypersensitivit y
to the medication. Urinary retention is an adverse reaction to scopolamine,
gl ycopyrrolate, and propantheline.
Question format: Multip le Choice
Chapter: 26
Learning Objective: 1
Cognitive Level: Anal yze
Client Needs: Physiological Integrit y: Pharmacological Therapies
Integrated Process: Teaching/Learning
Reference: p. 317, Other Reactions
Clinical Pharmacology 12th
Edition by Susan M Ford
Chapter 26-30
C HAPTER 26: C HOLINERGIC B LOCKING D RUGS
Ford: Introductory Clinical Pharmacology 12th Edition
Multiple Choice
1. A client with biliary colic has been prescribed atropine. The nurse should
question this order after discovering which disorder in the client's past history?
A) Hepatic disease
B) Benign prostatic hypertrophy
C) M yocardial infarction
D) Urinary retention
Answer: C
Rationale: The nurse should know that the use of atropine is contraindicated
in clients with m yocardial infarction. Other contraindications include
myasthenia gravis, tachyarrhythmia, and congestive heart failure (unless
bradycardia is present). Hepatic disease, benign prostatic hypertrophy, and
urinary retention are conditions requiring cautious administration and are not
contraindications for use.
Question format: Multiple Choice
, Chapter: 26
Learning Objective: 1
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Pharmacological Therapies
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 317, Contraindications
2. The nurse is preparing t o administer solifenacin to a client with an overactive
bladder. Which potential reaction should the nurse prioritize after noting the
client is also prescribed digoxin?
A) Increased neuromuscular blocking effect
B) Increased effectiveness of digoxin
C) Increased serum levels of digoxin
D) Increased effectiveness of solifenacin
Answer: C
Rationale: The nurse should monitor for increased serum levels of digoxin
that occur due to the interaction of anticholinergics and digoxin. Increased
neuromuscular blocking is an effect of the interaction of aminogl ycoside
antibiotics with cholinergic drugs. Increased effectiveness of digoxin and
solifenacin are not the effects associated with the interaction of
anticholinergics and digoxin.
Question format: Multiple Choice
Chapter: 26
Learning Objective: 1
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Pharmacological Therapies
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 317, Interactions
3. A nurse is caring for a c lient who is prescribed darifenacin. Which activit y
should the nurse prioritize in the ongoing assessment?
A) Assessment of the client's medical history
, B) Evaluation of symptoms related to the client's diagnosis
C) Monitoring of the client's vital signs every 2 4 hours
D) Observation for behavioral changes in the client
Answer: B
Rationale: The nurse should evaluate the symptoms and reports related to the
client's diagnosis during the ongoing assessment of the treatment. The nurse
should assess the medical hist ory of the client before administration of the
drug as part of the pre -administration assessment. The vital signs of the
client should be monitored every shift. The nurse need not observe for
behavioral changes in the client based on the client's diagnosis and condition.
Question format: Multiple Choice
Chapter: 26
Learning Objective: 2
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Reduction of Risk Potential
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 318, Ongoing Assessment
4. The nurse has administered dicyclomine to an elderl y client. Which finding on
the ongoing assessment should the nurse prioritize?
A) Disorientation
B) Light-headedness
C) Blurred vision
D) M ydriasis
Answer: C
Rationale: The nurse should monitor for blurred vision in the client after
administration of dicyclomine. The other conditions observed are drowsiness,
tachycardia, dry mouth, and urinary hesitancy. Disorientation, light -
headedness, and m ydriasis are adverse reactions ass ociated with the
administration of trihex yphenidyl.
Question format: Multiple Choice
, Chapter: 26
Learning Objective: 2
Cognitive Level: Appl y
Client Needs: Physiological Integrit y: Reduction of Risk Potential
Integrated Process: Clinical Problem -solving Process (Nursing Process)
Reference: p. 321, Summary Drug Table
5. A nurse is conducting a teaching session with a client who is prescribed
scopolamine during the summer. The nurse determines the session is successful
when the client correctl y chooses which sign to report immediatel y to the health
care provider which may indicate the client is experiencing heat prostration?
A) Dry mouth
B) Fever
C) Skin rash
D) Urinary retention
Answer: B
Rationale: During hot summer months, clients receiving a cholinergic
blocking drug such as scopolamine should be instructed on the risk of heat
prostration due to decreased sweating effect related to these medications.
Signs of heat prostration include fever; tachycardia; flushing; warm, dry
skin; and mental confusion. A dr y mouth is an adverse reaction to these
drugs. A skin rash is a potential adverse reaction related to a hypersensitivit y
to the medication. Urinary retention is an adverse reaction to scopolamine,
gl ycopyrrolate, and propantheline.
Question format: Multip le Choice
Chapter: 26
Learning Objective: 1
Cognitive Level: Anal yze
Client Needs: Physiological Integrit y: Pharmacological Therapies
Integrated Process: Teaching/Learning
Reference: p. 317, Other Reactions
