Nokea
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.
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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.
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.
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.
Prior to administering bethanechol to a client, the nurse would assess which of the following?
- A. Palpation of the bladder
- B. Palpation of the thyroid
- C. Blood glucose
- D. Blood pressure
- E. Pulse rate
Correct Answer: A,D,E
Rationale: Bethanechol is used to treat urinary retentions. The nurse's preadministration assessment should include palpation of the bladder, blood pressure, and pulse rate prior to its administration to a client.
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.