Chapter 31 Adrenergic Blocking Antagonists

Chapter 31  Adrenergic Blocking Antagonists

Complete Chapter Questions And Answers
 

Sample Questions

1.
The nurse administers an adrenergic blocking agent in order to prevent release of what neurotransmitter?
A)
Epinephrine
B)
Norepinephrine
C)
Serotonin
D)
Gamma-aminobutyric acid (GABA)
Ans:
B

Feedback:

Adrenergic blocking agents prevent norepinephrine from being released from the adrenal medulla or from the nerve terminal from activating the receptor, which blocks sympathetic nervous system effects. Epinephrine, serotonin, and GABA are not associated with this process.

2.
What medication, if ordered for an 8-year-old patient, should the nurse question? (Select all that apply.)
A)
Amiodarone (Cordarone) 400 mg orally per 24 hours
B)
Labetalol (Normodyne) 100 mg orally b.i.d.
C)
Phentolamine (Regitine) 1 mg intramuscularly 1 to 2 hours before surgery
D)
Prazosin (Minipress) 3 mg orally t.i.d.
E)
Carvedilol (Coreg) 6.25 mg orally b.i.d.
Ans:
A, B, E

Feedback:

Amiodarone, labetalol, and carvedilol are not indicated for pediatric use and do not have established pediatric dosages. Phentolamine and prazosin have established pediatric dosages and would not need to be questioned.

3.
A nurse is working with a patient who is taking an adrenergic blocking agent. While assessing the patient’s medication history, the nurse discovers that the patient takes several alternative therapies. What herb is the nurse concerned may interact with the adrenergic blocking agent and affect the patient’s blood glucose level?
A)
Ginseng
B)
Nightshade
C)
Di huang
D)
Saw Palmetto
Ans:
C

Feedback:

Di huang is an alternative therapy that can lower blood glucose when used in combination with adrenergic blocking agents. Ginseng increases antihypertensive effects; nightshade slows the heart rate; and saw palmetto increases the risk of urinary tract complications when used in combination with adrenergic blocking agents.

4.
A priority nursing assessment for a patient who is to receive an alpha- or beta-adrenergic blocking agent would be what?
A)
Monitoring respiratory rate
B)
Checking blood glucose level
C)
Measuring urine output
D)
Assessing heart rate
Ans:
D

Feedback:

The most serious adverse effect would be severe bradycardia, so the nurse’s priority would be assessing the heart rate. If the patient were identified as having diabetes, then monitoring blood glucose levels would become important because these drugs can aggravate diabetes by blocking sympathetic response including masking the usual signs and symptoms of hypoglycemia and hyperglycemia. Respiratory rate could be impacted if the patient was identified as having a condition causing bronchospasm and diabetes because the combination could worsen both conditions. Measuring urine output should be part of the patient’s care, but it is not the priority assessment.

5.
Bisoprolol (Zebeta) would be the drug of choice for which patient with a diagnosis of hypertension?
A)
A 7-year-old patient
B)
A 15-year-old patient
C)
A 37-year-old patient
D)
A 69-year-old patient
Ans:
D

Feedback:

Bisoprolol is the drug of choice for older adults. It is not associated with as many adverse effects in the elderly and regular dosing profiles can be used. This drug does not have an established pediatric dosage. Although the 37-year-old patient is an adult, there are additional choices for this patient, with a more favorable adverse effect profile.