Exam (elaborations)
Chapter 16 Cholinergic Agonists and Antagonists
Chapter 16 Cholinergic Agonists and Antagonists
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STUVIA 2024/2025Chapter 16: Cholinergic Agonists and
Antagonists
The nurse is preparing to administer a drug and learns that it is an indirect-acting cholinergic agonist.
The nurse understands that this drug:
a. acts on muscarinic receptors.
b. acts on nicotinic receptors.
c. inhibits cholinesterase.
d. inhibits cholinergic receptors. - ✔✔ANS: C
Agents that inhibit cholinesterase, which is the enzyme that breaks down acetylcholine, indirectly
enhance the actions of acetylcholine.
A nursing student asks why a direct-acting cholinergic agonist drug that is selective to muscarinic
receptors is described as being non-specific. The nurse will explain that this is because:
a. muscarinic receptors are present in many different tissues.
b. the action of cholinesterase alters the bioavailability at different sites.
c. these drugs can also affect nicotinic receptors.
d. they vary in their reversible and irreversible effects. - ✔✔ANS: A
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Although drugs classified as direct-acting cholinergic agonists are primarily selective for muscarinic
receptors, they are non-specific because muscarinic receptors are located in different sites, causing
actions in various organs. They are not affected differently by cholinesterase activity and have
negligible actions on nicotinic receptors.
The nurse is preparing to administer bethanechol (Urecholine) to a patient who is experiencing
urinary retention. The nurse notes that the patient has a blood pressure of 90/60 mm Hg. The nurse
will perform which action?
a. Administer the drug and monitor urine output.
b. Administer the medication and monitor vital signs frequently.
c. Give the medication and notify the provider of the increased heart rate.
d. Hold the medication and notify the provider of the decreased blood pressure. - ✔✔ANS: D
Bethanechol treatment can result in hypotension. The nurse should hold the drug and notify the
provider of the low blood pressure.
The nurse administers bethanechol (Urecholine) to a patient to treat urinary retention. After 30
minutes, the patient voids 800 mL of urine and reports having a loose stool but no cramping or
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, STUVIA 2024/2025
gastrointestinal pain. The patient's blood pressure is 110/70 mm Hg. The nurse will perform which
action?
a. Notify the provider of bethanechol adverse effects.
b. Record the urine output and the blood pressure and continue to monitor.
c. Request an order for intravenous atropine sulfate.
d. Suggest another dose of bethanechol to the provider. - ✔✔ANS: B
The patient is exhibiting desired effects and mild side effects of bethanechol, so the nurse should
record information and continue to monitor the patient. There is no need to notify the provider, give an
antidote, or repeat the dose.
The nurse is teaching a patient who will begin taking bethanechol (Urecholine). Which statement by
the patient indicates a need for further teaching?
a. "Excessive sweating is a normal reaction to this medication."
b. "Excess salivation is a serious side effect."
c. "I should get out of bed slowly while taking this drug."
d. "I will not take the drug if my heart rate is less than 60 beats per minute." - ✔✔ANS: A
Patients taking bethanechol should be instructed to report increased salivation and diaphoresis since
they can be early signs of overdosing. They should also be taught to rise slowly to avoid orthostatic
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hypotension and to hold the drug if their heart rate is low.
The nurse is caring for a male patient with myasthenia gravis who will begin taking neostigmine.
When performing a health history, the nurse will be concerned about a history of which condition in
this patient?
a. Benign prostatic hypertrophy
b. Chronic constipation
c. Erectile dysfunction
d. Upper respiratory infection - ✔✔ANS: A
This drug is a reversible cholinesterase inhibitor and is given to increase muscle strength.
Cholinesterase inhibitors are contraindicated in patients with urinary tract obstruction. The severity of
the benign prostatic hypertrophy would need to be investigated prior to administration.
The nurse is preparing to administer the anticholinergic medication benztropine (Cogentin) to a
patient who has Parkinson disease. The nurse understands that this drug is used primarily for which
purpose?
a. To decrease drooling and excessive salivation
b. To improve mobility and muscle strength
c. To prevent urinary retention
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