Chapter 13 Drugs That Affect the Central Nervous System

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Chapter 13  Drugs That Affect the Central Nervous System

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE CHOICE

1. Which condition would alert the nurse of the need to use beta adrenergic blockers cautiously?
a.
Hypertension
b.
Raynaud’s phenomenon
c.
Emphysema
d.
Cardiac dysrhythmias

ANS: C
Beta adrenergic blockers can produce severe bronchoconstriction. Selective beta 1 antagonists are used to treat hypertension. Alpha adrenergic blocking agents are used to treat patients with Raynaud’s disease. Beta adrenergic blocking agents are indicated for patients with cardiac arrhythmias.

DIF: Cognitive Level: Application REF: p. 206 | p. 208
OBJ: 9 TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity

2. A patient with chronic obstructive pulmonary disease (COPD) reports having insomnia and a racing heart after starting terbutaline therapy. Which explanation by the nurse is most accurate?
a.
“The symptoms are typical and indicate that the medication is at a therapeutic level.”
b.
“The symptoms will tend to resolve with continued therapy.”
c.
“The symptoms are unusual and need to be reported to the health care provider immediately.”
d.
“The symptoms are indicative of toxicity.”

ANS: B
Terbutaline, an adrenergic agent effective for bronchodilation, can cause excessive central nervous system (CNS) stimulation. Adverse effects such as palpitations, tachycardia, flushed skin, dizziness, and tremors tend to be mild and resolve with continued therapy. The therapeutic level can only be determined by analyzing a blood sample. These are common symptoms and should only be reported if they persist. Symptoms of toxicity are chest pain, persistent palpitations, and tachycardia.

DIF: Cognitive Level: Application REF: p. 203 OBJ: 7
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity

3. What is the primary response to alpha 1 receptor stimulation?
a.
Bronchodilation
b.
Tachycardia
c.
Vasoconstriction
d.
Uterine relaxation

ANS: C
Stimulation of the alpha 1 receptors causes vasoconstriction of all blood vessels throughout the body. Alpha 1 receptor stimulation causes bronchoconstriction. Alpha 1 receptor stimulation does not cause tachycardia. Beta 2 receptor stimulation produces relaxation of smooth muscle tissue, such as the uterus.

DIF: Cognitive Level: Knowledge REF: p. 206 OBJ: 7
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity

4. Which category of medications is used for peripheral vascular diseases characterized by excessive vasoconstriction, such as Raynaud’s disease?
a.
Adrenergic agents
b.
Alpha adrenergic blocking agents
c.
Beta adrenergic blocking agents
d.
Cholinergic agents

ANS: B
Alpha adrenergic blocking agents interfere with the stimulation of alpha 1 and alpha 2 receptors. Because the primary action of alpha receptor stimulation is vasoconstriction, alpha adrenergic blocking agents are indicated for patients with diseases associated with vasoconstriction. Adrenergic drugs cause vasoconstriction. Beta adrenergic blocking agents are used to treat hypertension and dysrhythmias. Cholinergic drugs are used to treat ocular diseases such as glaucoma, respiratory tract disease, and urinary system diseases.

DIF: Cognitive Level: Comprehension REF: p. 206 OBJ: 8
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity

5. Why are beta blockers used cautiously in patients with respiratory conditions?
a.
They mask the signs and symptoms of acute hypoglycemia.
b.
They cause extensive vasodilation and cardiac overload.
c.
They may produce severe bronchoconstriction.
d.
They increase hypertensive episodes.

ANS: C
Nonselective beta blockers, such as Inderal, and larger doses of selective beta antagonists will readily affect the beta 2 receptors of the bronchi, causing bronchoconstriction. Therefore, beta blockers must be used with extreme caution in patients with respiratory conditions such as bronchitis, emphysema, asthma, or allergic rhinitis. Beta blockers affect blood glucose by inducing the hypoglycemic effects of insulin. Vasodilation relieves cardiac overload. Beta blockers induce hypotensive effects.

DIF: Cognitive Level: Comprehension REF: p. 206 OBJ: 9
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity

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