Nokea
A client comes to the clinic for a follow-up visit. It is a hot July afternoon. The client has been prescribed a cholinergic blocking drug. Which of the following would lead the nurse to suspect that the client is experiencing heat prostration?
- A. Chills
- B. Flushing
- C. Bradycardia
- D. Cool, moist skin
- E. Mental confusion
Correct Answer: B,E
Rationale: Cholinergic blocking drugs can cause decreased sweating, increasing a client's risk for heat prostration. The signs of heat prostration include fever, tachycardia, flushing, warm, dry skin, and mental confusion.
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A nurse is assigned to care for a client with biliary colic in a health care facility. The client has been prescribed atropine. The nurse reviews the client's medical record and determines that the client should not receive this drug because the client has a history of which of the following?
- A. Hepatic disease
- B. Benign prostatic hypertrophy
- C. Myocardial infarction
- D. Urinary retention
Correct Answer: C
Rationale: The nurse should know that the use of atropine is contraindicated in clients with myocardial infarction. Other contraindications include myasthenia gravis, tachyarrhythmia, and congestive heart failure (unless bradycardia is present).
A nurse is caring for a client who has been prescribed belladonna for the treatment of prolonged diarrhea. Which of the following nursing interventions should the nurse perform before administering the drug?
- A. Check stools of the client.
- B. Monitor for abdominal pain.
- C. Assess weight of the client.
- D. Monitor vital signs every 2 hours.
Correct Answer: C
Rationale: The nurse should assess the client's weight when caring for this client with prolonged diarrhea.
A nurse is administering glycopyrrolate to a client with a peptic ulcer. The nurse would assess the client for which of the following as a possible GI system adverse reaction?
- A. Diarrhea
- B. Dry mouth
- C. Constipation
- D. Nausea
- E. Dysphagia
Correct Answer: B,C,D,E
Rationale: A nurse administering glycopyrrolate to a client with a peptic ulcer should monitor the client for dry mouth, nausea, vomiting, constipation, and dysphagia.
A nurse is providing care to a client with COPD. The nurse anticipates that which of the following would be appropriate to be prescribed for this client?
- A. Darifenacin (Enablex)
- B. Ipratropium (Atrovent)
- C. Benztropine (Cogentin)
- D. Biperiden (Akineton)
- E. Tiotropium (Spiriva)
Correct Answer: B,E
Rationale: Ipratropium (Atrovent) and tiotropium (Spiriva) are inhaled cholinergic blocking drugs used in the treatment of chronic obstructive pulmonary disease (COPD).
A client has a nursing diagnosis of Impaired Comfort related to xerostomia from the daily administration of a cholinergic blocking drug. When assessing the client, the nurse would be alert for which of the following?
- A. Dysphagia
- B. Tooth decay
- C. Gingivitis
- D. Impeded speech
- E. Gingival hyperplasia
Correct Answer: A,D
Rationale: Dry mouth caused by daily use of cholinergic blocking drugs can result in dysphagia and impeded, difficult-to-understand speech. Tooth decay, gingivitis, and gingival hyperplasia are not associated with dry mouth.