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ATI LEHNE’S PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE NURSES AND PHYSICIAN ASSISTANTS GRADED A+ YEAR 2024 / 2025

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ATI LEHNE’S PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE NURSES AND PHYSICIAN ASSISTANTS GRADED A+ YEAR 2024 / 2025

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  • May 23, 2024
  • 122
  • 2023/2024
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  • ati lehnes pharmacotherapeutics for advanced pra
  • ati lehnes pharmacotherapeutics for advanced pr
  • ati lehnes pharmacotherapeutics for advanced p

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ATI LEHNE’S PHARMACOTHERAPEUTICS FOR
ADVANCED PRACTICE NURSES AND PHYSICIAN
ASSISTANTS GRADED A+ YEAR

A nursing student asks about drugs that interfere with the termination of transmitter action. Which
statement by the nurse is correct?

a. "Drugs act on this process by altering the diffusion of the transmitter away from the synaptic gap."

b. "Drugs can interfere with termination by either increasing or decreasing reuptake of the transmitter."

c. "Drugs in this category lead to decreased activation by the transmitter in the synapse."

d. "These drugs reduce either reuptake or degradation of the transmitter, causing an increase in
receptor activation." - ANSWER-ANS: D Drugs that interfere with termination of transmitter action do so
by blocking transmitter reuptake or inhibiting transmitter degradation, resulting in increased receptor
activation, because more of the transmitter remains available. Diffusion of the transmitter occurs
naturally, but it is a slow process with little clinical significance. Drugs that alter this process cause a
decrease in reuptake, not an increase. The effect of drugsthat interfere with termination oftransmitter
action is increased activation.DIF: Cognitive Level: ApplicationREF: p. 76TOP: Nursing Process:
Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies



A nurse is teaching a group of nursing students about neuropharmacology. Which statement by a
student about peripheral nervous system (PNS) drugs indicates a need for further teaching?

a. "Drugs affecting axonal conduction have a variety of uses."

b. "Drugs that alter synaptic transmission can be highly selective."

c. "Many PNS drugs act by altering synaptic transmission."

d. "These drugs work by influencing receptor activity." - ANSWER-ANS: A Local anesthetics are drugs
that work by altering axonal conduction. Any drug affecting axonal conduction would be nonselective,
because axonal conduction of impulses is essentially the same in all neurons. In contrast, drugs that
affect synaptic transmission can be highlyselective, because each transmitter has different effects on
receptor sites. Most PNS drugs work on synaptic transmission processes. Through their effects on
transmitters, they influence receptor activity.DIF: Cognitive Level: AnalysisREF: pp. 73-74TOP: Nursing
Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and
Parenteral Therapies

,A nurse is preparing to administer a medication and learns that it is a nonselective agonist drug. What
does the nurse understand about this drug?

a. It directly activates receptors to affect many physiologic processes.

b. It directly activates receptors to affect a specific physiologic process.

c. It prevents receptor activation to affect many physiologic processes.

d. It prevents receptor activation to affect a specific physiologic processes. - ANSWER-ANS: A Drugs that
directly activate receptors are called agonists, so this drug will directly activate the receptor site. Drugs
that are nonselective activate a variety of receptor sites. A selective agonist would directly activate
specific receptorsto affect a specific process. An antagonist would prevent receptor activation.DIF:
Cognitive Level: AnalysisREF: p. 76TOP: Nursing Process: Assessment MSC: NCLEX Client Needs Category:
Physiologic Integrity: Pharmacologic and Parenteral Therapies



A patient has allergies and takes an antihistamine. The patient wants to know how the drug works. The
nurse understands that antihistamines work because they are what?

a. Activators

b. Agonists

c. Antagonists

d. Antidotes - ANSWER-ANS: C Antihistamines bind to receptors to prevent activation by histamine; this
makes antihistamines antagonist drugs. Antihistamines do not activate receptors. Agonist drugs activate
receptors; they are not antidotes.DIF: Cognitive Level: ApplicationREF: p. 76TOP: Nursing Process:
Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies



A patient receiving botulinum toxin injections to control muscle spasticity asks how the drug works. The
nurse knows that this drug affects the transmitter acetylcholine by:

a. inhibiting its release.

b. interfering with its storage.

c. preventing its reuptake.

d. promoting its synthesis. - ANSWER-ANS: A Acetylcholine is a neurotransmitter that activates receptors
that increase skeletal muscle contraction. Botulinum toxin inhibits the release of this transmitter. It does
not interfere with storage, reuptake, or synthesis of acetylcholine.DIF: Cognitive Level: ApplicationREF:
p. 76TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies

,A nurse is administering drug X to a patient. The drug information states that the drug acts by activating
receptors in the peripheral nervous system by increasing transmitter synthesis. The nurse understands
that the effect of this drug is to:

a. activate axonal conduction.

b. enhance transmitter storage.

c. increase receptor activation.

d. synthesize supertransmitters. - ANSWER-ANS: C Drugs that increase transmitter synthesis increase
receptor activation. Other drugs that alter transmitter synthesis can decrease synthesis and would cause
decreased receptor activation. Drugs that affect transmitter production do not exert their effects on
axonal conduction. The amount of transmitter produced does not directly affect transmitter storage.
Some drugs that alter transmitter synthesis cause the synthesis of transmitter molecules that are more
effective than the transmitter itself; however, this is not accomplished by increasing transmitter
synthesis.DIF: Cognitive Level: ApplicationREF: p. 77TOP: Nursing Process: Implementation MSC: NCLEX
Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies



A patient receives morphine and shows signs of toxicity. The prescriber orders naloxone [Narcan] to
reverse the effects of the morphine. The nurse understands that the naloxone reverses morphine
toxicity by which action on morphine receptor sites?

a. Blocking transmitter reuptake

b. Inhibiting transmitter release

c. Interfering with transmitter storage

d. Preventing activation of receptors - ANSWER-ANS: D Morphine and its antagonist, naloxone, act
directly at the same receptors. Morphine causes activation, and naloxone prevents activation. Neither
morphine nor naloxone acts to alter transmitter reuptake, release, or storage.DIF: Cognitive Level:
ComprehensionREF: p. 76TOP: Nursing Process: Diagnosis MSC: NCLEX Client Needs Category:
Physiologic Integrity: Pharmacologic and Parenteral Therapies



A nurse learns about a drug that interferes with transmitter storage in the PNS. The transmitter affected
by this drug causes an increased heart rate. What response will the nurse expect to see when this drug is
administered?

a. Bradycardia

b. Positive inotropic effects

c. Prolonged receptor activation

d. Tachycardia - ANSWER-ANS: A Drugs that interfere with transmitter storage reduce receptor
activation, because disruption of storage decreasesthe amount oftransmitter available for release.

, Because thistransmitter increases the heart rate, the result will be a decrease in the heart rate. Inotropic
effects control the force of contraction, not the rate of contraction. Decreased transmitter storage
would result in decreased receptor activation. Tachycardia would occur if transmitter availability were
increased.DIF: Cognitive Level: ApplicationREF: p. 77TOP: Nursing Process: Evaluation MSC: NCLEX Client
Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies



What is the target organ when a beta1 agonist is administered?

a. Heart

b. Kidney

c. Respiratory

d. Liver - ANSWER-ANS: A A beta1 agonist increases the patient's heart rate and blood pressure and is
used in heart failure. Beta1 agonists would not be used for kidney, respiratory, or liver failure. DIF:
Cognitive Level: Knowledge REF: pp. 88TOP: Nursing Process: Diagnosis MSC: NCLEX Client Needs
Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies



A nurse is teaching a group of nursing students about neurotransmitters. Which statement by a student
about acetylcholine indicates a need for further teaching?

a. "It activates three cholinergic receptor subtypes." b. "It has effects in the parasympathetic,
sympathetic, and somatic nervous systems."

c. "It is used at most junctions of the peripheral nervous system."

d. "Its transmission is terminated by reuptake into the cholinergic nerve terminal." - ANSWER-ANS: D
Acetylcholine (ACh) is destroyed by acetylcholinesterase, an enzyme that degrades ACh into two inactive
products: acetate and choline. Choline is taken up into the nerve terminal. ACh activates three receptor
sites: nicotinicN, nicotinicM, and muscarinic. ACh has effects throughout the peripheral nervous system
(PNS) and is used at most junctions in the PNS.DIF: Cognitive Level: AnalysisREF: pp. 90TOP: Nursing
Process: Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and
Parenteral Therapies



A nurse is administering an agonist drug that acts on postganglionic neurons ofthe sympathetic nervous
system. Which response will the nurse expect to see? a. Decreased sweating

b. Bronchodilation

c. Increased cardiac output

d. Pinpoint pupils - ANSWER-ANS: C Norepinephrine (NE) is the most common neurotransmitter
released by allpostganglionic neurons of the sympathetic nervous system except those going to sweat
glands where ACh is the neurotransmitter. NE acts on alpha1, alpha2, and beta1 receptors to increase

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