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IHP310-Adrenergic Agonists and Antagonists
IHP310-Adrenergic Agonists and Antagonists
Chapter 15: Adrenergic Agonists and Antagonists
McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach, 9th Edition
MULTIPLE CHOICE
- The nurse is caring for a patient who has asthma and administers a selective beta2-adrenergic agonist to treat bronchospasm. The nurse will expect this drug to also cause which side effect?
| a. | Increased blood glucose |
| b. | Increased blood pressure |
| c. | Increased heart rate |
| d. | Increased gastrointestinal (GI) motility |
ANS: A
Drugs that act on beta2 receptors activate gluconeogenesis in the liver, causing increased blood glucose. Selective beta2 drugs act on beta2 receptors only and not on beta1 receptors, so they do not cause increased blood pressure or increased heart rate. Adrenergic agonists cause decreased GI motility.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 200
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- A patient who has asthma is diagnosed with hypertension. The nurse understands that which drug will be safe to give this patient?
| a. | Pindolol (Visken) |
| b. | Metoprolol (Lopressor) |
| c. | Nadolol (Corgard) |
| d. | Propranolol (Inderal) |
ANS:
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 208
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- The nurse administers subcutaneous epinephrine to a patient who is experiencing an anaphylactic reaction. The nurse should expect to monitor the patient for which symptom?
| a. | Bradycardia |
| b. | Decreased urine output |
| c. | Hypotension |
| d. | Nausea and vomiting |
ANS:
DIF: Cognitive Level: Applying (Application) REF: p. 202
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
IHP310-Adrenergic Agonists and Antagonists
- An adult patient is brought to the emergency department for treatment of an asthma exacerbation. The patient uses inhaled albuterol as needed to control wheezing. The nurse notes expiratory wheezing, tremors, restlessness, and a heart rate of 120 beats per minute. The nurse suspects that the patient has
| a. | overused the albuterol. |
| b. | not been using albuterol. |
| c. | taken a beta-adrenergic blocker. |
| d. | taken a monoamine oxidase (MAO) inhibitor. |
ANS:
DIF: Cognitive Level: Applying (Application) REF: p. 203
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- The nurse is caring for a patient who is receiving intravenous dopamine (Intropin). The nurse notes erythema and swelling at the IV insertion site. What is the nurse’s initial action?
| a. | Apply warm soaks to the area. |
| b. | Monitor the patient closely for hypertension. |
| c. | Obtain an order for an electrocardiogram. |
| d. | Notify the provider of a need for phentolamine mesylate (Regitine). |
ANS:
DIF: Cognitive Level: Applying (Application) REF: p. 203
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- The nurse is teaching a patient how to use phenylephrine HCl (Neo-Synephrine) nasal spray to treat congestion from a viral upper respiratory infection. What instruction will the nurse give the patient?
| a. | Stop using the medication after 3 days. |
| b. | Spray the medication into the nose while lying supine. |
| c. | Use frequently since systemic side effects do not occur. |
| d. | Use the medication with any other over-the-counter medications. |
ANS:
DIF: Cognitive Level: Applying (Application) REF: p. 204
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- The nurse is caring for a patient who will begin taking atenolol (Tenormin). What information will the nurse include when teaching the patient about taking this medication?
| a. | The drug must be taken twice daily. |
| b. | The patient must rise slowly from a chair or bed. |
| c. | The medication is safe to take during pregnancy. |
| d. | Use NSAIDs as needed for mild to moderate pain. |
ANS:
DIF: Cognitive Level: Applying (Application) REF: p. 207
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- The nurse is caring for a patient who has recently begun taking atenolol (Tenormin) to treat hypertension. The patient reports dizziness, nausea, vomiting, and decreased libido since beginning the medication. What will the nurse do?
| a. | Hold the next dose until the provider can be notified of these side effects. |
| b. | Reassure the patient that these symptoms are common and not worrisome. |
| c. | Recommend that the patient discuss these effects with the provider. |
| d. | Suggest that the patient request a different beta-adrenergic blocker. |
ANS:
DIF: Cognitive Level: Applying (Application) REF: p. 207
TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- A patient will begin taking albuterol (Proventil) to treat asthma. When teaching the patient about this drug, the nurse will make which recommendation?
| a. | Report rapid or irregular heart rate. |
| b. | Drink 8 to 16 extra ounces of fluid each day. |
| c. | Monitor serum glucose daily. |
| d. | Take a calcium supplement. |
ANS:
DIF: Cognitive Level: Applying (Application) REF: p. 204
TOP: Nursing Process: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- A patient is taking doxazosin mesylate (Cardura) 1 mg/day to treat hypertension. The nurse notes a blood pressure of 110/72 mm Hg and a heart rate of 92 beats per minute. The nurse will contact the provider to discuss which change to the drug regimen?
| a. | Changing to a beta-adrenergic blocker |
| b. | Decreasing the drug dose |
| c. | Increasing the drug dose |
| d. | Adding a diuretic |
ANS:
DIF: Cognitive Level: Applying (Application) REF: p. 206
TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
IHP310-Adrenergic Agonists and Antagonists
- A patient who has Raynaud’s disease will begin taking an alpha-adrenergic blocker. The patient asks the nurse how the drug works to treat symptoms. The nurse explains that alpha-adrenergic blockers treat Raynaud’s disease by causing
| a. | decreased peripheral vascular resistance. |
| b. | orthostatic hypotension. |
| c. | reflex tachycardia. |
| d. | vasodilation. |
ANS:
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 206
TOP: Nursing Process: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
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- A nurse is teaching a patient how to use phenylephrine (Neo-Synephrine) nasal spray. To avoid systemic absorption, the nurse teaches the patient to perform which action?
| 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:
DIF: Cognitive Level: Applying (Application) REF: p. 204
TOP: Nursing Process: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- A patient will be discharged on beta blockers. Which skill is essential for the nurse to teach the patient’s family?
| 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:
DIF: Cognitive Level: Applying (Application) REF: p. 206
TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- The nurse is caring for a patient whose provider has just ordered a switch from atenolol (Tenormin) to reserpine. When preparing the patient to take this medication, what will the nurse do?
| a. | Ask about herbal supplements. |
| b. | Counsel that NSAIDs are safe to take with reserpine. |
| c. | Teach about potential side effects of mood elevation and euphoria. |
| d. | Tell the patient to expect immediate therapeutic effects. |
ANS:
DIF: Cognitive Level: Applying (Application) REF: p. 209
TOP: Nursing Process: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- The patient has been started on a treatment regimen that includes atenolol (Tenormin) and complains to the nurse of feeling weak. Which is the best response from the nurse?
| a. | “I will hold your next dose of the medication.” |
| b. | “You may need an increase in your next dose of the medication.” |
| 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:
DIF: Cognitive Level: Applying (Application) REF: p. 207
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- The nurse is performing an admission assessment on a patient who has recently begun taking reserpine. The patient reports using St. John’s wort. The nurse anticipates that the patient will have
| a. | hypotension. |
| b. | hypertension. |
| c. | bradycardia. |
| d. | tachycardia. |
ANS:
DIF: Cognitive Level: Applying (Application) REF: p. 209
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
- The patient has been ordered to receive Sudafed to treat nasal congestion. The nurse performing an admission assessment learns that the patient has diabetes mellitus. What action is appropriate for the nurse to take?
| a. | Administer the medication as ordered. |
| b. | Contact the provider to discuss a lower dose. |
| c. | Give the medication and monitor serum glucose closely. |
| d. | Hold the medication and contact the provider. |
ANS:
DIF: Cognitive Level: Applying (Application) REF: p. 204
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
IHP310-Adrenergic Agonists and Antagonists
MULTIPLE RESPONSE
- The nurse caring for a patient who is taking an adrenergic agent will expect which side effects? (Select all that apply.)
| a. | Dilated pupils |
| b. | Increased heart rate |
| c. | Increase gastrointestinal motility |
| d. | Vasodilation |
| e. | Bronchospasm |
| f. | Relaxed uterine muscles |
ANS: A, B, F
Adrenergic agents stimulate the sympathetic nervous system, evoking the “fight or flight” response. This response increases those functions needed to respond to stress (increased heart rate to perfuse muscles, bronchodilation to increase oxygen exchange). Adrenergic drugs shunt blood away from the reproductive tract and gastrointestinal organs, as these functions are not needed during a fight or flight response.
DIF: Cognitive Level: Applying (Application) REF: p. 197
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies