STUVIA 2024/2025
Chapter 15: Adrenergic Agonists and
Antagonists
The nurse is caring for a patient who has asthma and administers a selective beta2-adrenergic
agonist to treat bronchospasm. The nurse will expect this drug to also cause which side effect?
a. Increased blood glucose
b. Increased blood pressure
c. Increased heart rate
d. Increased gastrointestinal (GI) motility - ✔✔ANS: A
Drugs that act on beta2 receptors activate gluconeogenesis in the liver, causing increased blood
glucose. Selective beta2 drugs act on beta2 receptors only and not on beta1 receptors, so they do
not cause increased blood pressure or increased heart rate. Adrenergic agonists cause decreased GI
motility.
A patient who has asthma is diagnosed with hypertension. The nurse understands that which drug
will be the safest to give this patient?
a. Pindolol (Visken)
b. Metoprolol (Lopressor)
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c. Nadolol (Corgard)
d. Propranolol (Inderal) - ✔✔ANS: B
Metoprolol is a cardioselective adrenergic blocker that has a greater affinity for receptors that
decrease heart rate and blood pressure and is less likely to cause bronchospasm. The other
adrenergic blockers are not selective and can cause bronchoconstriction.
The nurse administers epinephrine to a patient who is experiencing an anaphylactic reaction. The
nurse should expect which of the following?
a. Bradycardia
b. Decreased urine output
c. Hypotension
d. Nausea and vomiting - ✔✔ANS: B
Epinephrine can cause renal vasoconstriction and thereby reduce renal perfusion and decrease
urinary output. Epinephrine causes tachycardia and elevates blood pressure. Nausea and vomiting
are not expected to occur.
An adult patient is brought to the emergency department for treatment of an asthma exacerbation.
The patient uses inhaled albuterol as needed to control wheezing. The nurse notes expiratory
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, STUVIA 2024/2025
wheezing, tremors, restlessness, and a heart rate of 120 beats per minute. The nurse suspects that
the patient has:
a. overused the albuterol.
b. not been using albuterol.
c. taken a beta-adrenergic blocker.
d. taken a monoamine oxidase (MAO) inhibitor. - ✔✔ANS: A
High doses of albuterol may affect beta1 receptors, causing an increase in heart rate. Patients having
an asthma exacerbation may overuse their albuterol inhalers when seeking relief. Patients may have
wheezing and increased heart rate during an untreated asthma exacerbation, but they will not have
tremors and restlessness.
The nurse is caring for a patient who is receiving intravenous dopamine (Intropin). The nurse notes
erythema and swelling at the IV insertion site. What is the nurse's initial action?
a. Apply warm soaks to the area.
b. Monitor the patient closely for hypertension.
c. Obtain an order for an electrocardiogram.
d. Notify the provider of a need for phentolamine mesylate (Regitine). - ✔✔ANS: D
Extravasation of dopamine causes tissue necrosis; if extravasation occurs, the antidote phentolamine
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mesylate should be infiltrated into the area.
The nurse is teaching a patient how to use phenylephrine HCl (Neo-Synephrine) nasal spray to treat
congestion from a viral upper respiratory infection. What instruction will the nurse give the patient?
a. Stop using the medication after 3 days.
b. Spray the medication into the nose while lying supine.
c. Use frequently since systemic side effects do not occur.
d. Use the medication with any other over-the-counter medications. - ✔✔ANS: A
Nurses should explain to patients that continuous use of nasal sprays containing adrenergic agonists
may result in rebound nasal congestion; these sprays should not be used more than 3 days. To avoid
systemic absorption, spray should be administered while the patient is in an upright position. The
medication may cause systemic side effects and should not be routinely used with other OTC cold
medications.
The nurse is caring for a patient who will begin taking atenolol (Tenormin). What information will the
nurse include when teaching the patient about taking this medication?
a. The drug must be taken twice daily.
b. The patient must rise slowly from a chair or bed.
c. The medication is safe to take during pregnancy.
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