Nokea
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.
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When conducting client teaching with a client and his family about the prescribed cholinergic therapy for myasthenia gravis, which of the following would be most important to include?
- A. How to adjust dosage
- B. Indications of drug underdosage
- C. The need to monitor blood glucose levels
- D. How to keep a record of response to therapy
- E. The need to wear medical identification
Correct Answer: A,B,D,E
Rationale: Client and family teaching should include signs and symptoms associated with underand overdosage, instructions on how to adjust the dosage up or down, how to keep a record of the response to therapy, and the importance of wearing medical identification. There is no need for the client and family to monitor blood glucose levels.
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.
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.
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.
A nurse is caring for a client with urinary retention who is receiving a cholinergic drug as part of the treatment plan. After administering the drug, the nurse would notify the primary health care provider if the assessment reveals which of the following?
- A. Failure to void after drug administration
- B. Frequent vomiting after drug administration
- C. Increase in abdominal pain after drug administration
- D. Occurrence of blood in urine after drug administration
Correct Answer: A
Rationale: The nurse should notify the primary health care provider if the client fails to void after drug administration. Frequent vomiting, increase in abdominal pain, and occurrence of blood in urine are not usually observed when urinary retention is treated with cholinergic therapy.