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Worksheetstry passing
Total questions: 63
Worksheet time: 32mins
Which statement best defines medication adherence in clinical practice?
Taking medications only when symptoms worsen
Taking medications correctly—right patient, right drug, right dose, right time, right route, right reason
Stopping medications when feeling better to avoid side effects
Taking double doses if a dose was missed
A practical strategy to improve adherence includes which action?
Skip doses when busy
Use alarms, pill boxes, or set routines
Double the next dose after a missed dose
Rely solely on memory without tools
In the sympathetic division of the ANS, the typical physiologic effect is:
Decreased heart rate and blood pressure, constricted pupils
Increased HR/BP, bronchodilation, pupil dilation, decreased digestion
Increased digestion and secretions
Bronchoconstriction and miosis
Which nickname correctly matches its ANS division?
Sympathetic—Rest & Digest
Parasympathetic—Fight or Flight
Sympathetic—Fight or Flight
Parasympathetic—Adrenaline = GO!
Adrenergic agonists (sympathomimetics) primarily:
Turn OFF the sympathetic system
Turn ON the sympathetic system
Turn ON the parasympathetic system
Block acetylcholine receptors
Which is a listed use of adrenergic agonists?
Migraine prevention
Asthma, shock, cardiac arrest, hypotension, allergic reaction
Bradycardia and fatigue
Hypertension and angina
A patient on epinephrine develops tremors and restlessness. These are best categorized as:
Expected side effects of adrenergic agonists
Signs of hypoglycemia only
Normal parasympathetic responses
Harmless placebo responses
Which interaction raises the risk of hypertensive crisis with adrenergic agonists?
Insulin
Calcium channel blockers
MAOIs and TCAs; caffeine
Alcohol and hot showers
Adrenergic blockers (sympatholytics) are used to treat which condition?
Allergic reactions
Asthma exacerbations
Hypertension, angina, arrhythmias, heart failure, migraine prevention
Anaphylaxis
Teaching for beta-blockers includes which instruction?
Hold if HR < 60 or BP < 100; rise slowly; never stop suddenly
Carry EpiPen and inject outer thigh; hold 3 sec; call 911
Increase caffeine intake to avoid fatigue
Skip pulse checks to prevent anxiety
Which statement best describes the action of cholinergic agonists (parasympathomimetics)?
Turn OFF "fight or flight"
Turn ON "rest & digest"
Block acetylcholine to make patients dry, fast, and alert
Increase beta-adrenergic receptor activity
A patient with urinary retention is most likely to receive which cholinergic agonist?
Atropine
Glycopyrrolate
Bethanechol
Scopolamine
Which side effect cluster is characteristic of cholinergic agonists and remembered by the acronym SLUDGE?
Dry mouth, constipation, blurred vision, confusion
Saliva, lacrimation, urination, diarrhea, GI cramps, emesis
Bradycardia, motion sickness, urinary urgency
Heat intolerance, urinary retention, tachycardia
What is the antidote for excessive cholinergic effects such as drooling and diarrhea?
Epinephrine
Atropine
Naloxone
Flumazenil
Which monitoring priority is emphasized for patients receiving cholinergic agonists?
Monitor HR, lungs, and secretions
Monitor liver enzymes only
Check serum potassium every 4 hours
Daily weight and ankle edema
Anticholinergics (parasympatholytics) primarily do which of the following?
Activate muscarinic receptors
Block acetylcholine leading to dry, fast, and alert
Increase gastrointestinal motility
Stimulate lacrimation and urination
Which interaction increases the risk of severe dryness in patients taking anticholinergics?
Concurrent antihistamines, TCAs, or antipsychotics
Beta blockers
ACE inhibitors
Loop diuretics
Which teaching point aligns with cholinergic agonists in patient education for ANS drugs?
Stay hydrated; avoid sun; manage constipation
Rise slowly; don’t stop suddenly; monitor HR/BP daily
Expect jittery feeling; avoid caffeine; report chest pain
Have bathroom access; stop if diarrhea or drooling
A patient with COPD develops bronchospasm after starting a new medication. Based on the safety table, what is the most likely cause and appropriate safety measure?
Cause: Anticholinergic; Measure: Cool environment, fluids
Cause: Nonselective beta blocker; Measure: Avoid in asthma/COPD
Cause: Beta blocker; Measure: Hold <60 HR/<100 BP
Cause: Adrenergic agonist; Measure: Monitor HR/BP closely
Which drug combination for Parkinson's disease increases dopamine or mimics dopamine and is associated with dyskinesia, nausea, and orthostatic hypotension?
Donepezil–Rivastigmine
Levodopa–Carbidopa (Sinemet)
Memantine–Galantamine
Dantrolene (Dantrium)
A patient on Parkinson's medication should avoid high-protein meals because:
Protein enhances drug absorption leading to toxicity
Protein competes with levodopa transport and reduces effectiveness
Protein increases orthostatic hypotension risk
Protein causes dark urine to become lighter
Which of the following is a teaching point for Parkinson's medications listed in the material?
Take at bedtime to reduce agitation
Avoid alcohol and opioids
Rise slowly to prevent orthostatic hypotension
Stop baclofen abruptly if dizziness occurs
For Alzheimer's disease, which medication class acts to increase acetylcholine or block NMDA/glutamate?
Dopamine agonists
Anticholinergics
Cholinesterase inhibitors and memantine
Benzodiazepines
Which centrally acting muscle relaxant teaching point is correct?
Driving is acceptable once sedation resolves
Avoid alcohol; opioids and benzos can increase CNS depression
Report constipation immediately
Abruptly stop baclofen to prevent weakness
What is the primary action of centrally acting muscle relaxants such as cyclobenzaprine and tizanidine?
Directly relax skeletal muscle
Increase dopamine in the CNS
Cause CNS depression leading to decreased muscle spasm
Block NMDA/glutamate receptors
Which serious adverse effect is noted for centrally acting muscle relaxants?
Renal failure
Liver toxicity and blood disorders
Malignant hyperthermia
Orthostatic hypotension
Dantrolene (Dantrium) is indicated for which condition among its uses?
Orthostatic hypotension
Malignant hyperthermia
Alzheimer's agitation
Parkinsonian tremor
Which teaching point is specific to dantrolene?
Combine therapy cautiously; caregiver safety emphasized
Avoid sun and alcohol; monitor liver function tests
Take at bedtime only
No driving restrictions; report constipation
Which interaction increases CNS depression when using centrally acting muscle relaxants?
Anticholinesterase drugs
Alcohol, opioids, benzodiazepines
Levodopa–carbidopa
Memantine
Which adverse effect is shared by centrally acting muscle relaxants and should be communicated to patients?
Sedation
Bradycardia
Photosensitivity
Dark urine
Which best describes the primary action of neuromuscular blocking agents listed (e.g., succinylcholine, vecuronium)?
Analgesia with sedation
Paralysis with no pain relief or sedation
Anti-inflammatory effect
Anticonvulsant effect
A patient receiving rocuronium for intubation develops apnea and respiratory failure due to the drug. Which reversal agent is specifically indicated for certain aminosteroid neuromuscular blockers?
Naloxone
Flumazenil
Sugammadex
Atropine
Key safety measure after administering a neuromuscular blocking agent includes monitoring respirations for how long?
4 hours
12 hours
24 hours
48 hours
Which medication is used for prevention of uric acid buildup in gout rather than acute pain relief?
Colchicine
Allopurinol (Zyloprim)
Ibuprofen
Morphine
Which of the Six Rights of Medication Administration is missing from the following list: Right patient, Right drug, Right dose, Right route, Right time?
Right documentation
Right prescriber
Right storage
Right diagnosis
Before giving medications, which action is recommended regarding autonomic nervous system (ANS) drugs?
Crush extended-release tablets for faster absorption
Verify heart rate and blood pressure
Skip baseline labs to avoid delays
Avoid checking allergies
After administering a medication, which step is part of safe practice?
Recheck vital signs and document time, route, and effect
Encourage alcohol to reduce sedation
Do not report shortness of breath if transient
Avoid documenting to save time
For neuro/musculo patients, which precaution helps prevent falls related to sedation?
Remove call light to reduce confusion
Keep call light within reach
Encourage abrupt withdrawal from baclofen
Withhold hydration in gout
Which prevention strategy aligns with the complication of hepatotoxicity during medication therapy?
Rise slowly and hydrate
Avoid alcohol and monitor liver function tests (LFTs)
CBC checks and report fever or bruising
Monitor respiratory rate and have antidote ready
Under what condition should beta blockers be held?
Respiratory rate < 12
Temperature > 38°C
Heart rate < 60 or blood pressure < 100
Oxygen saturation < 92%
Which statement best describes evaluating outcomes after medication administration?
Check whether side effects are present
Confirm relief of symptoms indicates the medication is working
Measure lab values only
Ask the patient if the pill tasted bitter
Which finding requires immediate reporting after medication administration?
Mild nausea
Jaundice, rash, confusion, or bleeding
Dry mouth
Transient dizziness upon standing
A patient appears weak, sedated, or spastic after receiving medication. What is the primary safety concern?
Electrolyte imbalance
Fall risk
Hyperglycemia
Dehydration
Combining an adrenergic drug with an MAOI most likely leads to which result?
Respiratory depression
Hypotensive shock
Hypertensive crisis
Serotonin syndrome
What nursing action is recommended when a patient is taking a beta blocker and insulin?
Hold insulin
Monitor blood glucose closely because hypoglycemia may be masked
Increase beta blocker dose
Encourage high-carbohydrate foods
Which combination is associated with severe dryness/confusion, warranting special monitoring in the elderly?
Cholinergic + parasympathomimetic
Anticholinergic + antihistamine
Levodopa + MAOI
Relaxant + opioid/benzo
A patient on cholinergic medication is also prescribed a parasympathomimetic. What crisis should the nurse anticipate and be prepared to manage?
Serotonin crisis
Cholinergic crisis; keep atropine ready
Addisonian crisis; start steroids
Thyroid storm; give propranolol
Which interaction reduces the effectiveness of levodopa and should be avoided?
Levodopa + MAOI
Levodopa + vitamin B6
Selegiline + tyramine-rich foods
Levodopa + opioid
For a patient on selegiline, which dietary teaching prevents a serious reaction?
Increase green leafy vegetables
Avoid aged cheese and wine to prevent hypertensive crisis
Limit salt intake
Increase fluid intake to 3 L/day
What is the priority nursing action when a muscle relaxant is combined with an opioid or benzodiazepine?
Encourage ambulation
Ensure airway safety due to risk of respiratory depression
Administer diuretics
Monitor for hypertension
A patient taking allopurinol with amoxicillin develops a rash suspicious for Stevens–Johnson syndrome. What should the nurse do?
Apply topical steroids and continue therapy
Report immediately
Stop amoxicillin only
Reassure the patient it will resolve spontaneously
Which combination increases liver toxicity and should be avoided?
Dantrolene + alcohol
Levodopa + vitamin B6
Beta blocker + insulin
Anticholinergic + antihistamine
A provider orders 100 mg PO of a medication. You have 50 mg tablets available. How many tablets should you administer?
1 tablet
2 tablets
3 tablets
4 tablets
Calculate the infusion rate: 500 mL to be delivered over 4 hours via IV. What is the mL/hr rate?
100 mL/hr
125 mL/hr
250 mL/hr
500 mL/hr
Which conversion is correct according to the table?
1 mg = 100 mg
1 L = 1000 mL
1 tsp = 15 mL
1 oz = 15 mL
A patient weighs 4.4 lb. Approximately how many kilograms is this?
1 kg
2 kg
0.5 kg
10 kg
Which benzodiazepine is listed as an example used for sleep disorders and is classified as a CNS depressant?
Zolpidem
Ramelteon
Lorazepam
Flumazenil
Which teaching point is most appropriate for non-benzodiazepine sleep aids like zolpidem or eszopiclone?
Use long-term; minimal risk
Take before bed only; can cause sleepwalking
Keep available if respiratory rate decreases
Short-term use due to dependence risk
Which agent regulates the sleep cycle and is considered safe for long-term use?
Temazepam
Zaleplon
Ramelteon
Flumazenil
What is the primary action of flumazenil in the context of sleep disorder pharmacology?
Enhances melatonin receptors
Provides sleep aid effects
Reverses benzodiazepine overdose
Prevents sleepwalking
According to the memory tricks, which statement is accurate?
Agonist = Brake; turns system OFF
Agonist = Accelerate; turns system ON
Blocker = Accelerate; turns system ON
Blocker has no effect on system state
Which mnemonic correctly links a cholinergic profile to its characteristic effects?
Cholinergic = Wet (SLUDGE effects)
Cholinergic = Dry (can’t see, pee, spit, or poop)
Cholinergic = Brake brain (sedation)
Cholinergic = Fixes Benzo (antidote)
Which pairing matches the mnemonic with its meaning for gout management?
Colchicine = Crampy tummy — GI upset warning
Allopurinol = Always hydrate — antidote to benzodiazepines
Dantrolene = Direct on muscle — prevents uric acid stones
Benzo = Brake brain — SLUDGE effects
