Nokea
A nurse should assess a patient taking a medication with anticholinergic properties for inhibition of what function?
- A. Parasympathetic nervous system
- B. Sympathetic nervous system
- C. Reticular activating system
- D. Medulla oblongata
Correct Answer: A
Rationale: Acetylcholine is the neurotransmitter found in high concentration in the parasympathetic nervous system. When acetylcholine action is inhibited by anticholinergic drugs, parasympathetic symptoms such as blurred vision, dry mouth, constipation, and urinary retention appear. The functions of the sympathetic nervous system, the reticular activating system, and the medulla oblongata are not affected by anticholinergic medications.
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On the basis of current knowledge of neurotransmitter effects, a nurse anticipates that the treatment plan for a patient with memory difficulties may include medications designed to do what?
- A. Inhibit GABA production.
- B. Increase dopamine sensitivity.
- C. Decrease dopamine at receptor sites.
- D. Prevent destruction of acetylcholine.
Correct Answer: D
Rationale: Increased acetylcholine plays a role in learning and memory. Preventing the destruction of acetylcholine by acetylcholinesterase results in higher levels of acetylcholine, with the potential for improved memory. GABA is known to affect anxiety level rather than memory. Increased dopamine causes symptoms associated with schizophrenia or mania rather than improves memory. Decreasing dopamine at receptor sites is associated with Parkinson disease rather than improving memory.
A nurse prepares to administer an antipsychotic medication to a patient diagnosed with schizophrenia. Additional monitoring of the medication's effects and side effects will be most important if the patient is also diagnosed with which health problem? (Select all that apply.)
- A. Parkinson disease
- B. Graves' disease
- C. Osteoarthritis
- D. Epilepsy
- E. Diabetes
Correct Answer: A,D,E
Rationale: Antipsychotic medications may produce weight gain, which complicates the care of a patient with diabetes, or lowers the seizure threshold (or both), which complicates the care of a patient with epilepsy. Parkinson disease involves changes in transmission of dopamine and acetylcholine; therefore, these drugs also complicate the care of a patient with the disorder. Osteoarthritis and Graves' disease should have no synergistic effect with this medication.
A patient prescribed a muscarinic-receptor blocker, will require assess for what side effect?
- A. Dry mouth
- B. Gynecomastia
- C. Pseudoparkinsonism
- D. Orthostatic hypotension
Correct Answer: A
Rationale: Muscarinic-receptor blockade includes atropine-like side effects such as dry mouth, blurred vision, and constipation. Gynecomastia is associated with decreased prolactin levels. Movement defects are associated with dopamine blockade. Orthostatic hypotension is associated with ?±??-receptor antagonism.
A patient demonstrates disorganized thinking associated related to a diagnosis of schizophrenia. Neuroimaging would most likely show dysfunction in which part of the brain?
- A. Brainstem
- B. Cerebellum
- C. Temporal lobe
- D. Prefrontal cortex
Correct Answer: D
Rationale: The prefrontal cortex is responsible for intellectual functioning. The temporal lobe is responsible for the sensation of hearing. The cerebellum regulates skeletal muscle coordination and equilibrium. The brainstem regulates internal organs.
A nurse administering psychotropic medications should be prepared to intervene when giving a drug that blocks the attachment of norepinephrine to ?±??-receptors because the patient may experience what effect?
- A. Increased psychotic symptoms
- B. Severe appetite disturbance
- C. Orthostatic hypotension
- D. Hypertensive crisis
Correct Answer: C
Rationale: Sympathetic-mediated vasoconstriction is essential for maintaining normal blood pressure in the uplink position. Blockage of ?±??-receptors leads to vasodilation and orthostatic hypotension. Orthostatic hypotension may cause fainting and falls. Patients should be taught ways of minimizing this phenomenon.