Chapter 44 Drugs Used to Treat the Musculoskeletal System

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Chapter 44  Drugs Used to Treat the Musculoskeletal System

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE CHOICE

1. A patient who has undergone a lengthy surgical procedure under general anesthesia is unable to breathe on his own following the procedure. Which drug will the nurse expect to be administered as an antidote to the neuromuscular-blocking agent?
a.
Dantrolene (Dantrium)
b.
Neostigmine methylsulfate (Prostigmin)
c.
Ether
d.
Baclofen (Lioresal)

ANS: B
Neostigmine methylsulfate is an antidote to neuromuscular-blocking agents. Additional measures to implement include artificial respirations with oxygen and atropine sulfate for bradycardia and hypotension. Dantrolene is a direct-acting skeletal muscle relaxant given for the treatment of neuroleptic malignant syndrome associated with the use of antipsychotic agents. Ether is a general anesthetic. Baclofen is a skeletal muscle relaxant.

DIF: Cognitive Level: Application REF: Page 684 OBJ: 4
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety; Gas Exchange

2. What is the reason for a paraplegic patient to receive baclofen (Lioresal)?
a.
It interrupts reflexes at the level of the spinal cord.
b.
It acts directly on the skeletal muscles to reduce spasticity.
c.
It interrupts transmission of impulses from motor nerves to muscles at the skeletal neuromuscular junction.
d.
It produces generalized mild weakness of skeletal muscles and decreases the force of reflex muscle contractions.

ANS: A
Baclofen is a gamma aminobutyric acid derivative that interrupts polysynaptic reflexes at the level of the spinal cord. Baclofen does not appear to act directly on the skeletal muscles. Interrupting transmission of impulses from motor nerves to muscles at the skeletal neuromuscular junction is the mechanism of action of neuromuscular-blocking agents. Producing generalized mild weakness of skeletal muscles and decreasing the force of reflex muscle contractions is the mechanism of action of dantrolene.

DIF: Cognitive Level: Comprehension REF: Page 682 OBJ: 2 | 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment

3. A patient taking antipsychotic medication for schizophrenia is admitted with a temperature of 106° F. The admitting diagnosis is neuroleptic malignant syndrome resulting from antipsychotic medication. Which drug is indicated in treatment of this condition?
a.
Edrophonium (Tensilon)
b.
Dantrolene (Dantrium)
c.
Baclofen (Lioresal)
d.
Metaxalone (Skelaxin)

ANS: B
Dantrolene, a direct-acting skeletal muscle relaxant, is used to treat neuroleptic malignant syndrome associated with the use of antipsychotic agents. Edrophonium is an antidote for neuromuscular-blocking agents. Baclofen is a skeletal muscle relaxant used for the treatment of muscle spasticity resulting from multiple sclerosis (MS) and cerebral palsy. Metaxalone is used for muscle spasms.

DIF: Cognitive Level: Comprehension REF: Page 683 OBJ: 2 | 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety

4. In the intensive care unit, the nurse is taking care of a patient who is on a ventilator and is receiving succinylcholine (Anectine). Which is a priority nursing diagnosis for this patient?
a.
Pain
b.
Disturbed body image
c.
Risk for injury
d.
Self-care deficit

ANS: A
Pain is the highest priority, according to Maslow’s hierarchy of needs. Succinylcholine, a neuromuscular-blocking agent, is used to paralyze muscles while a patient is on a ventilator. Neuromuscular-blocking agents do not relieve pain. Disturbed body image is not a priority for this situation, although it does apply. Risk for injury and self-care deficit are not as great of priorities for this situation.

DIF: Cognitive Level: Application REF: Page 684 | Page 685
OBJ: 1 | 4 TOP: Nursing Process Step: Diagnosis
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Pain

5. The patient’s family asks why neuromuscular blocking agents are used before electroconvulsive therapy. Which explanation by the nurse is most accurate?
a.
“They stimulate respirations while therapy is delivered.”
b.
“They prevent aspiration of respiratory secretions during the therapy.”
c.
“They decrease intracranial pressure resulting from therapy.”
d.
“They reduce the risk of injury during therapy.”

ANS: D
Neuromuscular-blocking agents are used before electroconvulsive therapy to paralyze the skeletal muscles and reduce the risk of fractures during therapy. Neuromuscular-blocking agents do not stimulate respiration, prevent aspiration, or affect intracranial pressure.

DIF: Cognitive Level: Application REF: Page 684 OBJ: 4
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
NOT: CONCEPT(S): Clinical Judgment

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