Nokea
After teaching a group of nursing students about cholinergic drugs, the instructor determines a need for additional teaching when the students identify which drug as being administered orally?
- A. Ambenonium
- B. Bethanechol
- C. Pyndostigmine
- D. Edrophonium
Correct Answer: D
Rationale: Edrophonium is a cholinergic drug that is administered intravenously. Ambenonium, bethanechol, and pyridostigmine are administered orally.
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A client has been prescribed pyridostigmine for myasthenia gravis. The nurse would be alert for the development of which of the following?
- A. Seizure disorder
- B. Reduction of visual acuity
- C. Abdominal discomfort
- D. Cardiac arrhythmias
Correct Answer: D
Rationale: The nurse should monitor for cardiac arrhythmias as a general adverse reaction in the client. Seizure disorder, reduction of visual acuity, and abdominal discomfort are not pyridostigmine-related adverse reactions. Reduction of visual acuity is related to topical ophthalmics. When the client is receiving bethanechol chloride for urinary retention, the nurse needs to examine for abdominal discomfort, which is an adverse reaction of bethanechol chloride and not pyridostigmine.
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.
Based on the nurse's understanding of which body systems are affected by cholinergic drug adverse reactions, the nurse would be alert for adverse reactions involving which body system?
- A. Endocrine
- B. Circulatory
- C. Respiratory
- D. Gastrointestinal
- E. Central nervous
Correct Answer: B,C,D,E
Rationale: Cholinergic drug adverse reactions affect the circulatory, respiratory, gastrointestinal, and central nervous systems.
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.