Nokea
The nurse recognizes that adrenergic drugs cause relaxation of the bronchi and bronchodilation by stimulating which type of receptors?
- A. Dopaminergic
- B. Beta1 adrenergic
- C. Beta2 adrenergic
- D. Alpha1 adrenergic
Correct Answer: C
Rationale: Stimulation of beta2 adrenergic receptors results in bronchodilation. The other choices are incorrect.
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A patient is on a low-dose dobutamine drip for heart failure. She had been feeling better but now has a sense of tightness in her chest, palpitations, and a bit of anxiety. Her heart rate is up to 110 beats/min, and her blood pressure is 150/98 mm Hg (increased from previous readings of 86 beats/min and 120/80 mm Hg). What is the nurse's immediate concern for this patient?
- A. She is experiencing normal adverse effects of dobutamine therapy.
- B. She may be experiencing an allergic reaction to the dobutamine.
- C. The medication may be causing a worsening of a preexisting cardiac disorder.
- D. The dosage of the dobutamine needs to be increased to control the symptoms better.
Correct Answer: C
Rationale: Because dobutamine is a vasoactive adrenergic, it works by increasing the cardiac output in heart failure patients by increasing myocardial contractility and stroke volume. However, adrenergic drugs may worsen a preexisting cardiac disorder, such as causing a myocardial infarction in a patient with coronary artery disease. The other options are incorrect.
The nurse is to administer epinephrine 0.5 mg subcutaneously. The ampule contains 1 mL of medication and is labeled 1 mg/mL. Identify how many milliliters of epinephrine the nurse will give.
Correct Answer: 0.5 mL
Rationale: 1 mg : 1 mL :: 0.5 mg : x mL; (1 * x) = (1 * 0.5); x = 0.5 mL.
When a patient is taking an adrenergic agonist drug, the nurse expects to observe which effect?
- A. Decreased heart rate
- B. Bronchodilation
- C. Constricted pupils
- D. Increased intestinal peristalsis
Correct Answer: B
Rationale: Increased heart rate is one of the effects of adrenergic drugs. Sympathetic nervous system stimulation also results in bronchodilation, dilated pupils, and decreased gastrointestinal motility, depending upon which receptors are stimulated.
A 14-year-old patient has been treated for asthma for almost 4 months. Two weeks ago, she was given salmeterol as part of her medication regimen. However, her mother has called the clinic to report that it does not seem to work when her daughter is having an asthma attack. Which response by the nurse is appropriate?
- A. It takes time for a therapeutic response to develop.
- B. She is too young for this particular medication; it will be changed.
- C. She needs to take up to two puffs every 4 hours to ensure adequate blood levels.
- D. This medication is indicated for prevention of bronchospasms, not for relief of acute symptoms.
Correct Answer: D
Rationale: Salmeterol is indicated for the prevention of bronchospasms, not treatment of acute symptoms. The dosage is usually two puffs twice daily, 12 hours apart, for maintenance effects in patients older than 12 years of age. The other options are incorrect.
The nurse is presenting information to a class of students about adrenergic drugs. Which are the effects of drugs that stimulate the sympathetic nervous system?
- A. Dilation of bronchioles
- B. Constriction of bronchioles
- C. Decreased heart rate
- D. Increased heart rate
- E. Dilated pupils
- F. Constricted pupils
- G. Glycogenolysis
Correct Answer: A,D,E,G
Rationale: Stimulation of the sympathetic nervous system causes bronchodilation, increased heart rate, pupil dilation, and glycogenolysis as well as many other effects. The other responses are effects that occur as a result of the stimulation of the parasympathetic nervous system.