Chapter 18: Adrenergic Agonists and Adrenergic Blockers Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 18: Adrenergic Agonists and Adrenergic Blockers

Test Bank

MULTIPLE CHOICE

1. The drugs that mimic the effect of norepinephrine are called:

a.

sympathomimetics, or adrenergic agonists.

b.

sympatholytics, or adrenergic drugs.

c.

sympathomimetics, or adrenergic blockers.

d.

sympatholytics, or adrenergic blockers.

ANS: A

Drugs that stimulate the sympathetic nervous system are called adrenergic agonists.

DIF: Cognitive Level: Comprehension REF: pp. 258-259

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

2. The actions of the mixed-acting sympathomimetics are _____ the adrenergic receptor sites and _____ the release of norepinephrine.

a.

stimulating; inhibiting

b.

stimulating; stimulating

c.

inhibiting; inhibiting

d.

inhibiting; stimulating

ANS: B

Mixed-acting agents stimulate the release of norepinephrine and directly stimulate alpha and beta receptors.

DIF: Cognitive Level: Comprehension REF: p. 260

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

3. A client was stung by a bee. This is the third bee sting the client has received, and the client complains of shortness of breath. What is the adrenergic drug used in emergencies to combat a life-threatening allergic reaction?

a.

Norepinephrine (Levophed)

b.

Epinephrine (Adrenalin)

c.

Terbutaline (Brethine)

d.

Propranolol (Inderal)

ANS: B

Epinephrine has powerful beta2 action that dilates bronchial airways.

DIF: Cognitive Level: Application REF: p. 260

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

4. A client experiencing shortness of breath associated with asthma is given epinephrine (Adrenalin). This medication is considered a nonselective adrenergic drug because it innervates ________ receptor sites.

a.

alpha-adrenergic

b.

beta-adrenergic

c.

alpha-, beta1-, and beta2-adrenergic

d.

beta1 and beta2-adrenergic

ANS: C

Epinephrine has powerful beta2 action that dilates bronchial airways and works on all receptor sites.

DIF: Cognitive Level: Application REF: p. 260

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

5. A nurse receives an order to administer epinephrine (Adrenalin) orally to a client. What is the highest priority action on the part of the nurse?

a.

Call the physician to question the order.

b.

Administer the medication as ordered.

c.

Call the pharmacist for clarification of the order.

d.

Hold the order and continue to monitor the client.

ANS: A

Epinephrine is rapidly metabolized in the gastrointestinal tract and the liver and should not be given orally.

DIF: Cognitive Level: Application REF: p. 260

TOP: Nursing Process: Intervention/Implementation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

6. A client with asthma is given albuterol sulfate (Proventil), a selective adrenergic drug that stimulates the beta2-receptor site. Which response should the nurse expect to see in the client?

a.

Bronchoconstriction

b.

Bronchodilation

c.

Decreased heart rate

d.

Increased blood pressure

ANS: B

Albuterol sulfate is a bronchodilator.

DIF: Cognitive Level: Comprehension REF: p. 263

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

7. Albuterol sulfate (Proventil) has a short half-life and duration of action. Based on this information, what should the nurse select as an appropriate dosing schedule for this drug?

a.

Once a day

b.

Once every other day

c.

3 or 4 times a day

d.

2 times a day

ANS: C

A short half-life indicates that a medication must be given more frequently.

DIF: Cognitive Level: Application REF: p. 261

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

8. Alpha-adrenergic blockers promote vasodilation. The nurse anticipates what expected therapeutic response from the client taking alpha-adrenergic blockers?

a.

Increased blood pressure

b.

Decreased blood pressure

c.

Decreased pulse rate

d.

Rapid respiration

ANS: B

Vasodilation leads to a decrease in blood pressure.

DIF: Cognitive Level: Application REF: pp. 263, 265

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

9. The client has been ordered to receive a beta-adrenergic blocker. The nurse should anticipate that the client will exhibit:

a.

increased pulse rate and bronchoconstriction.

b.

decreased pulse rate and bronchodilation.

c.

increased pulse rate and bronchodilation.

d.

decreased pulse rate and bronchoconstriction.

ANS: D

A beta-adrenergic blocker should cause the client to exhibit decreased pulse rate and bronchoconstriction.

DIF: Cognitive Level: Application REF: p. 268

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

10. A client with asthma is receiving metoprolol (Lopressor), a beta blocker for hypertension. The client asks if metoprolol will affect her asthma. What is the best response from the nurse?

a.

Metoprolol may cause bronchoconstriction, and is questionable if it will help decrease blood pressure.

b.

Metoprolol decreases pulse rate and thus blood pressure, but it should not have an effect on the bronchioles.

c.

Metoprolol causes bronchodilation and increased pulse rate, so refuse the drug.

d.

Ill inform the healthcare provider that you should not take metoprolol.

ANS: B

Metoprolol is formulated to not cause bronchial constriction. Most other beta blockers cause bronchoconstriction and are contraindicated with asthma.

DIF: Cognitive Level: Application REF: pp. 268-269

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

11. Which instruction will the nurse include in a teaching plan for a client taking metoprolol (Lopressor) for treatment of hypertension?

a.

Rise slowly from a supine or sitting position.

b.

Limit fluid intake while taking this drug.

c.

Frequent ophthalmic exams are encouraged.

d.

Use lozenges if a dry cough occurs.

ANS: A

Beta blockers slow the pulse rate and decrease the blood pressure, which may cause orthostatic hypotension. The client should rise slowly from a supine or sitting position to prevent orthostatic hypotension. Fluids do not need to be restricted unless client has an underlying condition. Metoprolol does not adversely affect the eyes, so frequent ophthalmic examinations are not required. Metoprolol does not produce a dry cough.

DIF: Cognitive Level: Application REF: pp. 268-269

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

12. Client teaching for patients receiving beta blockers includes instructing the client:

a.

to take the beta blocker when symptoms occur.

b.

to have blood pressure and pulse rate checked monthly or quarterly.

c.

that GI upset is a common problem and if it occurs to stop the drug.

d.

not to abruptly stop taking the beta blocker because of the possible occurrence of rebound hypertension.

ANS: D

When taking beta blockers for a prolonged time, abrupt cessation of the medication may cause rebound hypertension.

DIF: Cognitive Level: Application REF: p. 263

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

13. A nurse is teaching a client how to use phenylephrine (Neo-Synephrine) nasal spray. To avoid systemic absorption, the nurse teaches the client to:

a.

apply pressure to the nose after spraying.

b.

administer the spray while in the supine position.

c.

insert the spray while sitting up.

d.

exhale deeply while injecting the nasal spray.

ANS: C

The client should insert the spray while sitting up to avoid it being absorbed systemically.

DIF: Cognitive Level: Application REF: p. 263

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

14. A client is discharged on beta blockers. Which skill is essential for the clients family to learn?

a.

How to prepare a low-sodium diet

b.

Assessments to detect fluid retention

c.

How to monitor heart rate and blood pressure

d.

Early signs of changing level of consciousness

ANS: C

Because of the action and side effects of beta blockers, heart rate and blood pressure should be monitored frequently.

DIF: Cognitive Level: Application REF: p. 269

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

15. A nurse is infusing dopamine (Intropin) intravenously. The nurse is aware that infiltration of this medication may lead to tissue necrosis. What is an early sign of intravenous infiltration?

a.

Red streak following the course of the vein

b.

Swelling at the IV site

c.

Warmth at the insertion site

d.

Bleeding at the insertion site

ANS: B

Swelling could indicate infiltration, along with coolness, tissue pallor, and local pain.

DIF: Cognitive Level: Application REF: p. 263

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

16. The client has been started on a treatment regimen that includes albuterol. The nurse should anticipate seeing a decrease in the clients serum _____ level.

a.

calcium

b.

potassium

c.

magnesium

d.

glucose

ANS: B

Albuterol can cause a decrease in the clients potassium level.

DIF: Cognitive Level: Application REF: p. 262

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

17. The client has been started on a treatment regimen that includes atenolol. She complains to the nurse of experiencing weakness. Which is the best response from the nurse?

a.

I will hold your next dose of the medication. You are reaching a toxic level.

b.

I will increase your next dose of the medication. Your level is too low.

c.

This is an adverse reaction to the medication. I will stop the drug.

d.

This is a side effect of the medication. I will notify your physician.

ANS: D

Weakness can be a side effect of atenolol.

DIF: Cognitive Level: Analysis REF: p. 266

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

18. The client comes to a health clinic asking for Sudafed. He tells the nurse that he has a history of diabetes mellitus. What is the most accurate response from the nurse?

a.

Sudafed is a safe drug to give to a client who is a diabetic.

b.

Sudafed should not be used by a client who is a diabetic.

c.

You can use Sudafed, but you must monitor your blood sugar very closely.

d.

You can use Sudafed, but you will probably experience hypoglycemia.

ANS: B

Sudafed is not recommended for a client who is a diagnosed diabetic.

DIF: Cognitive Level: Analysis REF: pp. 264-265

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

19. The client has been placed on a therapeutic regimen that includes Regitine. She tells the nurse that she routinely takes St. Johns wort for depression. What should the nurse expect to see as a result of the client taking these medications?

a.

Worsening of the hypotensive effects of the Regitine

b.

Client experiencing bradycardia

c.

Worsening of the hypertensive effects of the Regitine

d.

Client experiencing of tachycardia

ANS: A

The combination of St. Johns wort and Regitine will increase the hypotensive effects of Regitine.

DIF: Cognitive Level: Analysis REF: p. 268

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

MULTIPLE RESPONSE

1. Adrenergic agents have specific effects on the body. What are the actions of adrenergic medications? (Select all that apply.)

a.

Dilate pupils.

b.

Increase heart rate.

c.

Stimulate gastric muscle.

d.

Dilate blood vessels.

e.

Dilate bronchioles.

f.

Relax uterine muscles.

g.

Contract the bladder.

ANS: A, B, E, F

Adrenergic agents stimulate the sympathetic nervous system, evoking the fight or flight response. This response increases those functions needed to respond to stress while shunting blood away from the reproductive tract and GI organs.

DIF: Cognitive Level: Application REF: p. 265

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

Copyright 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

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