Chapter 28 - Neuromuscular Junction Blocking Agents |Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
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Focus on Nursing Pharmacology
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Focus On Nursing Pharmacology
1. According to the sliding filament theory, what is the initial action in a muscle contraction?
a. Troponin is freed and prevents actin and myosin from reacting with each other.
b. Calcium binds to troponin, which causes the release of actin and myosin binding sites.
c. Actin and myosin molecu...
Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
1. According to the sliding filament theory, what is the initial action in a muscle
contraction?
a. Troponin is freed and prevents actin and myosin from reacting with each
other.
b. Calcium binds to troponin, which causes the release of actin and myosin
binding sites.
c. Actin and myosin molecules react with each other sliding along the
filament and making it shorter.
d. Muscle filament relaxes or slides back to the resting position.
Ans: C
Feedback:
Actin and myosin molecules react with each other again and again, sliding along the
filament and making it shorter. This is a contraction of the muscle fiber according to
the sliding filament theory. As the calcium is removed from the cell during
repolarization of the muscle membrane, the troponin is freed and once again prevents
the actin and myosin from reacting with each other. The muscle filament then relaxes
or slides back to the resting position. Muscle tone results from a dynamic balance
between excitatory and inhibitory impulses to the muscle.
2. When causing depolarization of the muscle membranes, what neurotransmitter
interacts with the nicotinic cholinergic receptors leading to the release of calcium
ions?
a. Acetylcholine
b. Serotonin
c. D-gluconamidoethyl methacrylate (GAMA)
d. Epinephrine
Ans: A
Feedback:
At the acetylcholine receptor site on the effector’s side of the synapse, the
acetylcholine interacts with the nicotinic cholinergic receptors causing the
depolarization. Serotonin, GAMA, and epinephrine are not part of muscle contraction
and relaxation.
3. The nurse, working in the preoperative holding area, is caring for a 70-year-old
patient who is scheduled to receive succinylcholine as part of general anesthesia.
, When collecting the nursing history, what condition would require the nurse to
notify the anesthesiologist of the need for caution?
a. Bone fracture
b. Malnutrition
c. Fluid volume overload
d. Narrow-angle glaucoma
e. Pregnancy
Ans: A, B, D
Feedback:
Succinylcholine should be used with caution in patients with fractures because the
muscle contractions it causes might lead to additional trauma; in patients with narrow-
angle glaucoma or penetrating eye injuries because intraocular pressure increases.
Extreme caution is necessary in the presence of genetic or disease-related conditions
causing low plasma cholinesterase levels (e.g., cirrhosis, metabolic disorders,
carcinoma, burns, dehydration, malnutrition, hyperpyrexia, thyroid toxicosis, collagen
diseases, exposure to neurotoxic insecticides).
4. The nurse is caring for a patient who received succinylcholine during surgery. The
nurse would expect the patient to spend more time in the postanesthesia care unit
due to prolonged paralysis and inability to breathe if the patient was from what
ethnic group?
a. American Japanese
b. Alaskan Eskimos
c. Native Americans
d. Hawaiian natives
Ans: B
Feedback:
Alaskan Eskimos belong to a genetic group that is predisposed to low plasma
cholinesterase levels, making them susceptible to prolonged paralysis after
succinylcholine use. The other ethnic groups do not have this genetic predisposition.
5. A patient scheduled for surgery is to have a nondepolarizing neuromuscular
junction (NMJ) blocker as adjunctive anesthesia. The nurse will have cause for
concern about prolonged paralysis if the patient has been taking what medication?
a. An aminoglycoside
b. Aminophylline
c. A barbiturate anesthetic
d. A cephalosporin
Ans: A
Feedback:
Combining nondepolarizing NMJ blockers with aminoglycosides can result in
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