Nokea
The nurse understands that the drug would be appropriate for which condition?
- A. Urinary retention
- B. Overactive bladder
- C. Myasthenia gravis
- D. Parkinson's disease
- E. Graves' disease
Correct Answer: A,C
Rationale: Cholinergic drugs can be used to treat urinary retention, myasthenia gravis, and glaucoma.
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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 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.
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.
When teaching the client about this drug, which of the following would the nurse include as a possible adverse reaction?
- A. Constipation
- B. Nausea
- C. Dry mouth
- D. Skin flushing
- E. Muscle rigidity
Correct Answer: B,D
Rationale: Pyridostigmine is an oral cholinergic medication used in the treatment of myasthenia gravis. General adverse reactions associated with oral administration include nausea, diarrhea, abdominal cramping, salivation, skin flushing, cardiac arrhythmias, and muscle weakness.