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Which of the following would the nurse assess before administering ambenonium to a client?
- A. Palpation of the bladder
- B. Palpation of the thyroid
- C. Evidence of muscle weakness
- D. Signs of difficulty breathing
- E. Drooping of eyelids
Correct Answer: C,D,E
Rationale: Ambenonium is used to treat myasthenia gravis. The nurse's preadministration assessment should include assessment for signs of muscle weakness, such as drooling, inability to chew and swallow, drooping eyelids, inability to perform repetitive movements, difficulty breathing, and extreme fatigue.
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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.
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.
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.