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A nurse is caring for a client with urinary retention who is prescribed bethanechol. The nurse would administer this drug cautiously if the client has which of the following?
- A. Raynaud's disease
- B. Bradycardia
- C. Coronary artery disease
- D. Hyperthyroidism
Correct Answer: B
Rationale: The nurse should administer bethanechol cautiously if a client has bradycardia, hypertension, epilepsy, cardiac arrhythmias, recent coronary occlusion, or megacolon. Cautious use is not necessary if the client has Raynaud's disease, coronary artery disease, or hyperthyroidism.
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The nurse administers a prescribed oral dose of bethanechol to a client with urinary retention at 9:30 a.m. The nurse would notify the primary health care provider if the client has not voided by which time?
- A. 9:45 a.m.
- B. 10 a.m.
- C. 10:30 a.m.
- D. 11 a.m.
Correct Answer: D
Rationale: When bethanechol is administered orally, the client should void within 30 to 90 minutes. Therefore, if the client has not yet voided by 11 a.m., the nurse should notify the primary health care provider.
A nurse is providing care to a client who is receiving an ophthalmic cholinergic drug. When reviewing the client's medical history, which of the following, if found, would the nurse identify as a contraindication?
- A. Cataracts
- B. Diabetic retinopathy
- C. Megacolon
- D. Corneal abrasion
Correct Answer: D
Rationale: The nurse should know that ophthalmic cholinergic drugs are contraindicated in clients with corneal abrasions. The use of ophthalmic cholinergic drugs is not contraindicated in clients with cataracts, diabetic retinopathy, or megacolon. Cholinergic drugs are used cautiously in clients with megacolon.
A nurse is administering cholinergic eye drops to a client. The nurse would be alert for which of the following as a possible adverse reaction?
- A. Nausea
- B. Headache
- C. Nasal congestion
- D. Decreased visual acuity
- E. Decreased auditory acuity
Correct Answer: B,D
Rationale: Cholinergic eye drops are used to treat glaucoma. Topical administration usually produces few adverse reactions, but a temporary reduction of visual acuity and headache may occur.
When describing the enzyme acetylcholinesterase, which of the following would the instructor most likely include about this enzyme?
- A. Makes the parasympathetic nervous system function differently
- B. Inactivates the neurotransmitter serotonin
- C. Activates the neurotransmitter acetylcholine
- D. Inactivates the neurotransmitter norepinephrine
- E. Results in the prevention of nerve synapses to continue nerve impulses
Correct Answer: A,E
Rationale: Acetylcholinesterase makes the parasympathetic nervous system function differently by inactivating the neurotransmitter acetylcholine, thereby preventing the nerve synapse from continuing the nerve impulse.
A nurse is caring for a client with myasthenia gravis at a health care facility. The client is receiving ambenonium. The nurse suspects that the dosage is insufficient based on assessment of which of the following?
- A. Clenching of the jaw
- B. Muscle spasms
- C. Difficulty breathing
- D. Abdominal cramping
Correct Answer: C
Rationale: The nurse should monitor for difficulty breathing as a symptom of drug underdosage. Clenching of the jaw and muscle spasms are symptoms of drug overdosage. Abdominal cramping may occur in the client who is receiving guanidine.