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Lehne's Pharmacotherapeutics for Nurse Practitioners and Physician Assistants 1st Edition By Jacqueline Burchum, Laura Rosenthal 9780323447836 Chapter 1-89 Complete Guide$17.99
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Lehne's Pharmacotherapeutics for Nurse Practitioners and Physician Assistants 1st Edition By Jacqueline Burchum, Laura Rosenthal 9780323447836 Chapter 1-89 Complete Guide
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Lehne's Pharmacotherapeutics for Nurse Practitioners and Physician Assistants 1st Edition By Jacqueline Burchum, Laura Rosenthal 9780323447836 Chapter 1-89 Complete Guide
Test Bank Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants 2nd Edition by Laura D. Rosenthal & Jacqueline Rosenjack Burchum 9780323554954 Chapter 1-92| Complete Gui...
Test Bank Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants 2nd Edition by Laura D. Rosenthal & Jacqueline Rosenjack Burchum 9780323554954 Chapter 1-92| Complete Gui...
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Test Bank For Lehne's Pharmacotherapeutics for Nurse
Practitioners and Physician Assistants 1st Edition By
Jacqueline Burchum, Laura Rosenthal 9780323447836 Chapter
1-89 Complete Guide
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
the force and rate of cardiac contraction, thus increasing cardiac output. ACh would increase
sweating. Bronchodilation occurs when epinephrine activates beta2 receptors on bronchial smooth
muscle. NE affects alpha1 receptorsto dilate the pupils.DIF: Cognitive Level: ApplicationREF: pp.
79TOP: Nursing Process: Planning MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
A nurse is teaching a patient about a medication that alters sympathetic nervous system functions. To
evaluate understanding, the nurse asks the patient to describe which functions the sympathetic
nervous system regulates. Which answer indicates the need for further teaching?
a. "The digestive functions of the body"
b. "The cardiovascular system"
c. "The fight-or-flight response"
d. "Body temperature" - ANSWER: ANS: A The sympathetic nervous system does not regulate
digestive functions of the body—the parasympathetic nervous system does; further education is
needed. The sympathetic nervous systemregulates the cardiovascular system, the fight-or-flight
response, and the body temperature; no further education is needed.DIF: Cognitive Level:
AnalysisREF: pp. 79TOP: Nursing Process: Diagnosis MSC: NCLEX Client Needs Category: Physiologic
Integrity: Pharmacologic and Parenteral Therapies
A patient is wheezing and short of breath. The nurse assesses a heart rate of 88 beats/minute, a
respiratory rate of 24 breaths/minute, and a blood pressure of 124/78 mm Hg. The prescriber orders
a nonspecific beta agonist medication. Besides evaluating the patient for a reduction in respiratory
distress, the nurse will monitor for which side effect? a. Hypotension
b. Tachycardia
c. Tachypnea
d. Urinary retention - ANSWER: ANS: B Beta agonists are used for asthma because of their beta2
effects on bronchial smooth muscle, causing dilation. Beta1 effects cause tachycardia and
, hypertension. Beta receptors do not exert effects on the bladder.DIF: Cognitive Level: ApplicationREF:
pp. 88TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic Integrity:
Pharmacologic and Parenteral Therapies
Many medications list side effects that include dry mouth, constipation, and urinary retention. What
kinds of effects are these?
a. Alpha adrenergic
b. Anticholinergic
c. Beta adrenergic
d. Sympathetic - ANSWER: ANS: B Cholinergic stimulation by ACh causes increased salivation,
increased gastrointestinal (GI) motility, and relaxation of the bladder trigone and sphincter.
Anticholinergic medications inhibit these responses, causing dry mouth, constipation, and urinary
retention. Alpha-adrenergic agents effect processes in the sympathetic nervous system, causing
peripheral vasoconstriction and pupil dilation, among other effects. The effects of beta-adrenergic
medications are seen mostly in the heart and blood vessels. The sympathetic nervous system has both
cholinergic and adrenergic transmitters.DIF: Cognitive Level: AnalysisREF: pp. 87TOP: Nursing Process:
Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral
Therapies
A patient is to receive a beta agonist. Before administration of this medication, which assessment
finding would most concern the nurse?
a. Pulse oximetry reading of 88%
b. Blood pressure of 100/60 mm Hg
c. Respiratory rate of 28 breaths/minute
d. Heart rate of 110 beats/minute - ANSWER: ANS: D A beta agonist dilates respiratory smooth
muscle, but as a side effect, it can stimulate the heart. A heart rate of 110 beats/minute is a concern,
because this medication may further increase the already elevated heart rate. A pulse oximetry
reading of 88% is a concern, but the medication causes bronchodilation and increased oxygenation;
this should increase the pulse oximetry reading. A blood pressure of 100/60 mm Hg is on the low side,
but this medication may actually cause an increase in blood pressure as a side effect; this should not
concern the nurse before administration of the medication. A respiratory rate of 28 breaths/minute is
elevated; however, this medication should increase oxygenation by bronchodilation, and the patient's
respiratory rate should decrease once oxygenation has improved. Therefore, this should not concern
the nurse. DIF: Cognitive Level: Application REF: pp. 88TOP: Nursing Process: Assessment MSC: NCLEX
Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
A nurse is explaining activation of beta2 receptorsto nursing students during a clinicalrotation at the
hospital. Which statement by a student demonstrates a need for further teaching?
a. "Beta2 activation results in bronchodilation."
b. "Beta2 activation results in contraction of uterine muscle."
c. "Beta2 activation results in glycogenolysis."
d. "Beta2 activation results in vasodilation of skeletal muscles." - ANSWER: ANS: B Beta2 activation
would result in relaxation of uterine smooth muscle, not contraction; this statement indicates a need
for further teaching. Bronchodilation is an effect of beta2 activation; no further teaching is needed.
Beta2 activation does result in glycogenolysis; no further teaching is needed. Beta2 activation does
result in vasodilation of skeletal muscle; no further teaching is needed.DIF: Cognitive Level:
AnalysisREF: pp. 88TOP: Nursing Process: Evaluation MSC: NCLEX Client Needs Category: Physiologic
Integrity: Pharmacologic and ParenteralTherapies
A pregnant patient is in premature labor. Which class of drug will she be given?
a. Alpha1 agonist
b. Anticholinergic
c. Beta2 agonist
d. Beta2 antagonist - ANSWER: ANS: C Beta2 agonists cause relaxation of uterine muscle, slowing or
stopping the contractions that precipitate labor. An alpha1 agonist would have effects on the heart
and arterioles. Anticholinergic drugs generally are given for their effects on the urinary and GI tracts
and do not affect uterine muscle. A beta2 antagonist would cause increased constriction of uterine
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