Nokea
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.
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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.
After teaching a group of nursing students about the parasympathetic nervous system, the instructor determines that the teaching was successful when the students identify which of the following as an action?
- A. Decreased salivary gland production
- B. Vasodilation
- C. Increased peristalsis
- D. Bronchodilation
- E. Pupillary constriction
Correct Answer: B,C,E
Rationale: Stimulation of the parasympathetic nervous system results in the opposite reactions to those triggered by the adrenergic system: blood vessels dilate, sending blood to the gastrointestinal (GI) tract; secretions and peristalsis are activated and salivary glands increase production; the heart slows and pulmonary bronchioles constrict; the smooth muscle of the bladder contracts; and the pupils of the eyes constrict.
The nurse would assess the client closely if the client has a history of which of the following?
- A. Diabetes
- B. Hypertension
- C. Tachycardia
- D. Epilepsy
- E. Megacolon
Correct Answer: B,D
Rationale: Cholinergic drugs, like ambenonium, are used cautiously in clients with hypertension, epilepsy, cardiac arrhythmias, bradycardia, recent coronary occlusion, and megacolon.
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.
When assessing a client receiving a cholinergic drug, the nurse would assess the client for increased neuromuscular blocking effects if the client is also receiving which of the following?
- A. Amoxicillin
- B. Tobramycin
- C. Cephalexin
- D. Neomycin
- E. Clarithromycin
Correct Answer: B,D
Rationale: Cholinergic drugs administered concomitantly with aminoglycoside antibiotics, like tobramycin and neomycin, can result in increased neuromuscular blocking effects.