Chapter 21: Cholinergic-Blocking Drugs

Test Bank

MULTIPLE CHOICE

1. The nurse is about to administer a stat dose of intravenous atropine sulfate to a patient who is

experiencing a symptomatic cardiac dysrhythmia. During administration of this drug, the nurse will monitor

the patient closely for which adverse effect?

a. Tachycardia

b. Bradycardia

c. Ectopic beats

d. Cardiac standstill

2. A patient has a prescription for oxybutynin (Ditropan), an anticholinergic drug. When reviewing the

patients medical history, which condition, if present, would be considered a contraindication to therapy

with this drug?

a. Diarrhea

b. Hypertension

c. Neurogenic bladder

d. Uncontrolled angle-closure glaucoma

3. The nurse is reviewing the use of anticholinergic drugs. Anticholinergic drugs block the effects of which

nervous system?

a. Central nervous system

b. Somatic nervous system

c. Sympathetic nervous system

d. Parasympathetic nervous system

4. A patient has received an accidental overdose of intravenous atropine. Which drug will the nurse prepare

to administer?

a. atenolol (Tenormin)

b. bethanechol (Urecholine)

c. dicyclomine (Bentyl)

d. physostigmine (Antilirium)

5. A 72-year-old man has a new prescription for an anticholinergic drug. He is an active man and enjoys

outdoor activities, such as golfing and doing his own yard work. What will the nurse emphasize to him

during the teaching session about his drug therapy?

a. Drowsiness may interfere with his outdoor activities.

b. Increased salivation may occur during exercise and outside activities.

c. Fluid volume deficits may occur as a result of an increased incidence of diarrhea.

d. He will need to take measures to reduce the occurrence of heat stroke during his activities.

6. The nurse will monitor for which adverse effect when administering an anticholinergic drug?

a. Excessive urination

b. Diaphoresis

c. Dry mouth

d. Pupillary constriction

7. The nurse is reviewing a patients medication history and notes that the patient is taking the cholinergic

blocker tolterodine (Detrol). Which is an indication for this medication?

a. Irritable bowel disease

b. Induction of mydriasis

c. Urge incontinence

d. Reduction of secretions preoperatively

8. A patient has been taking tolterodine (Detrol), but today her prescriber changed her to a newer drug,

darifenacin (Enablex). What advantage does darifenacin have over the tolterodine?

a. The newer cholinergic-blocker drugs are more effective.

b. It helps reduce urinary retention.

c. It can be used in patients with narrow-angle glaucoma.

d. The incidence of dry mouth is much lower with darifenacin.

9. The nurse working in a preoperative admitting unit administers an anticholinergic medication to a patient

before surgery. What is the purpose of this drug in the preoperative setting?

a. Control the heart rate

b. Relax the patient

c. Reduce urinary frequency

d. Reduce oral and gastrointestinal secretions

10. In preparation for eye surgery, the nurse monitors for which desired drug effect in a patient who is

receiving a cholinergic-blocking eyedrop medication?

a. Miosis

b. Mydriasis

c. Increased intraocular fluid production

d. Enhanced tear production

11. A patient has a new prescription for the transdermal form of scopolamine. The nurse knows that this form

of scopolamine is used for which condition?

a. Angina

b. Chronic pain

c. Hypertension

d. Motion sickness

MULTIPLE RESPONSE

1. The nurse is reviewing the indications for atropine sulfate. Atropine is appropriate for which of these

patients? (Select all that apply.)

a. A patient who has suddenly developed symptomatic bradycardia with a heart rate of 32

beats/minute

b. A patient who has suddenly developed symptomatic tachycardia with a heart rate of 180

beats/minute

c. A patient with severe narrow-angle glaucoma

d. A patient who is about to have surgery

e. A patient newly diagnosed with myasthenia gravis

f. A patient with anticholinesterase inhibitor poisoning

OTHER

1. A patient is to receive glycopyrrolate (Robinul) 4 mcg/kg IM 30 minutes before a procedure. The patient

weighs 110 pounds; the medication is available in a strength of 0.2 mg/mL. How many milliliters of

medication will the nurse draw up into the syringe?

ANS:

1 mL

110 lbs 2.2 = 50 kg

To calculate mcg/kg, multiply 4 mcg/kg by 50 kg (4 mcg/kg 50 kg = 200 mcg).

The patient will receive 200 mcg, or 0.2 mg.

The medication is available in a strength of 0.2 mg/mL; therefore, the patient will receive 1 mL.

DIF: COGNITIVE LEVEL: Applying (Application) REF: p. N/A

TOP: NURSING PROCESS: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies