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A nurse is caring for a client with urinary retention who is receiving a cholinergic drug as part of the treatment plan. After administering the drug, the nurse would notify the primary health care provider if the assessment reveals which of the following?
- A. Failure to void after drug administration
- B. Frequent vomiting after drug administration
- C. Increase in abdominal pain after drug administration
- D. Occurrence of blood in urine after drug administration
Correct Answer: A
Rationale: The nurse should notify the primary health care provider if the client fails to void after drug administration. Frequent vomiting, increase in abdominal pain, and occurrence of blood in urine are not usually observed when urinary retention is treated with cholinergic therapy.
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The students demonstrate understanding of the information when they identify that which type of receptor is involved with stimulating smooth muscle in the parasympathetic nervous system?
- A. Nicotinic
- B. Muscarinic
- C. Alpha
- D. Beta
Correct Answer: B
Rationale: There are two types of receptors in the parasympathetic nervous branch: muscarinic receptors (which stimulate smooth muscle) and nicotinic receptors (which stimulate skeletal muscle). Alpha and beta receptors are found in the sympathetic nervous system.
A nurse would be alert for an increase in cholinergic effects if a client who is prescribed a cholinergic drug is also receiving which medication?
- A. Prednisone
- B. Oxycodone
- C. Diclofenac
- D. Dexamethasone
- E. Ibuprofen
Correct Answer: A,D
Rationale: Cholinergic drugs administered concomitantly with corticosteroids, like prednisone and dexamethasone, can result in increased adverse effects of the cholinergic drug.
Which condition, if found, would alert the nurse to a possible contraindication to the prescribed therapy?
- A. Pancreatitis
- B. Diabetes
- C. Asthma
- D. Hyperthyroidism
- E. Peptic ulcer disease
Correct Answer: C,D,E
Rationale: The use of cholinergic drugs is contraindicated in clients with known hypersensitivity to the drugs, asthma, peptic ulcer disease, coronary artery disease, and hyperthyroidism.
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.