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WorksheetsNSG2311 Exam 2 Content Review
Total questions: 102
Worksheet time: 51mins
A patient is prescribed neostigmine for myasthenia gravis. Which mechanism explains how neostigmine improves muscle strength?
It inhibits acetylcholinesterase at the synaptic cleft.
It increases the presynaptic release of acetylcholine.
It directly stimulates nicotinic receptors on skeletal muscle.
It blocks muscarinic receptors in the autonomic nervous system.
A patient with chronic obstructive pulmonary disease (COPD) is experiencing acute bronchospasm. Which medication would be most appropriate to administer to relieve this symptom?
Neostigmine
A beta2 receptor agonist
A beta1 receptor antagonist
A cholinergic (muscarinic) antagonist
A 60-year-old patient with hypertension and chronic heart failure is prescribed a beta-blocker. Which is a primary mechanism by which beta-blockers improve cardiovascular health in this patient?
Inhibition of beta1-adrenergic receptors, reducing heart rate and contractility.
Stimulation of alpha1 receptors to increase peripheral vascular resistance.
Activation of beta2 receptors to enhance bronchodilation and cardiac output.
Blockade of muscarinic receptors to increase sinoatrial node firing.
In the context of vagal stimulation, which interventions can be used to manage cholinergic toxicity? Select all that apply.
Administer atropine
Provide activated charcoal
Give epinephrine
Administer flumazenil
A patient presents with excessive salivation, diarrhea, and constricted pupils after exposure to an unknown substance. These symptoms are most consistent with:
Cholinergic toxicity
Sympathetic nervous system activation
Beta blocker overdose
Sedative-hypnotic toxicity
Which of the following symptoms would be expected from activation of the sympathetic nervous system during a stress response?
Decreased heart rate
Increased digestive activity
Dilated pupils
Constricted bronchi
A patient with a history of anxiety is prescribed a sedative-hypnotic medication. Which of the following is a nonbenzodiazepine sedative-hypnotic that could be considered for this patient?
Zolpidem
Diazepam
Temazepam
Ramelteon
In patients with asthma, which type of beta-blocker is preferred to minimize the risk of bronchospasm?
Non-selective beta-blockers
Selective beta-1 blockers
Alpha-1 blockers
Which nursing intervention is critical when administering bethanechol to a patient with urinary retention?
Monitor for bradycardia and hypotension.
Assess for signs of cholinergic toxicity such as dry mouth and pupil dilation.
Ensure the patient is positioned supine during administration.
Restrict fluid intake to prevent bladder distention.
Which of the following medications is most suitable as an antidote for cholinergic toxicity?
Atropine
Bethanechol
Beta blockers
Phenytoin
A patient is experiencing autonomic dysreflexia. What is the most immediate nursing intervention to take?
Elevate the head of the bed.
Administer beta-blockers.
Apply cold compresses.
Provide a sedative.
Which of the following adverse effects is commonly associated with the use of benzodiazepines in treating sleep disorders?
Daytime drowsiness
Hypertension
Increased appetite
Tachycardia
What is the priority intervention for a patient presenting with cholinergic toxicity?
Administer atropine immediately.
Provide intravenous fluids to maintain hydration.
Initiate gastric lavage to remove the toxin.
Administer beta-blockers to control heart rate.
Which neurotransmitter is primarily involved in cholinergic toxicity?
Acetylcholine
Dopamine
Norepinephrine
Gamma-aminobutyric acid (GABA)
A patient with a history of myocardial infarction is prescribed metoprolol. What is the primary benefit of metoprolol in this context?
Decreasing heart rate and myocardial oxygen demand
Increasing coronary artery perfusion
Direct vasodilation of coronary arteries
Increasing cardiac output
When initiating treatment with ramelteon, a patient should be advised about which potential side effect?
Dizziness
Increased heart rate
Weight gain
Constipation
How does pilocarpine exert its effects on the autonomic nervous system?
As a beta-blocker
As a muscarinic agonist
As a nicotinic antagonist
As an adrenergic antagonist
A patient is experiencing muscle twitching, bradycardia, and bronchospasm after taking an unknown medication. Which of the following is the most likely cause?
Neostigmine overdose
Beta blocker overdose
Sympathetic nervous system activation
Sedative-hypnotic overdose
A patient with glaucoma is prescribed pilocarpine drops. What is the primary therapeutic action of pilocarpine in this condition?
Increase aqueous humor outflow.
Decrease the production of aqueous humor.
Constrict blood vessels in the eye.
Relax the iris sphincter muscle.
A patient is prescribed zolpidem for insomnia. What instruction should the nurse provide to minimize the risk of adverse effects?
Take the medication immediately before going to bed.
Take the medication with a large meal.
Use the medication only on weekends.
Take a double dose if sleep is not achieved within 30 minutes.
Which side effect should a nurse monitor for in a patient starting therapy with propranolol, a non-selective beta-blocker?
Bradycardia
Hyperkalemia
Hypoglycemia
Agranulocytosis
Which of the following mechanisms explains the toxicity associated with cholinergic drugs like pilocarpine?
Excessive activation of muscarinic receptors
Inhibition of acetylcholinesterase
Blockade of nicotinic receptors
Increased norepinephrine release
A nurse is assessing a client who has developed redness, discomfort, and blurred vision after using prescribed eye drops for glaucoma. Based on the scenario, determine the appropriate nursing actions in response to the client's symptoms.
Discontinue the eye drops.
Administer artificial tears to relieve discomfort.
Arrange for a prompt eye examination to assess severity and prevent complications.
Reassure the client and provide comfort measures.
In a patient with suspected autonomic nervous system dysfunction, which observation would most likely indicate sympathetic nervous system involvement?
Persistent hypotension.
Increased sweating.
Bradycardia.
Enhanced gastrointestinal motility.
An elderly patient with a history of COPD and hypertension is prescribed a beta-blocker. Which of the following beta-blockers is most appropriate for this patient?
Atenolol.
Propranolol.
Labetalol.
Carvedilol.
A patient on temazepam reports experiencing fatigue and confusion during the day. What is the most likely cause of these symptoms?
Residual sedation from the medication.
Medication-induced anxiety.
Inadequate sleep duration.
Increased caffeine intake.
A nurse is preparing to administer bethanechol to a postoperative patient. What condition would contraindicate its use?
Urinary retention.
Hypotension.
Constipation.
Postoperative ileus.
A patient is treated with atropine for cholinergic toxicity. What is the primary action of atropine in this situation?
Blocks muscarinic receptors to reduce acetylcholine effects
Inhibits acetylcholine release from nerve terminals
Enhances the metabolism of acetylcholine
Stimulates nicotinic receptors to counteract toxicity
A patient is prescribed a non‑selective beta‑blocker. What caution should the nurse advise regarding its effects on the autonomic nervous system?
Possible bronchoconstriction
Increased heart rate
Enhanced parasympathetic activity
Increased blood pressure
What is the most immediate treatment for organophosphate poisoning‑induced cholinergic toxicity?
Atropine and pralidoxime
Beta blockers and oxygen therapy
Neostigmine and supportive care
Activated charcoal
What is the role of cholinergic drugs in managing Alzheimer’s disease?
Increase acetylcholine levels in the brain
Reduce amyloid plaque formation
Stimulate dopamine release
Improve serotonin uptake
A patient with high blood pressure is being considered for beta‑blocker therapy. Which additional condition would make a beta‑blocker particularly beneficial for this patient?
Migraine headaches
Seasonal allergic rhinitis
Iron‑deficiency anemia
Osteoarthritis
A nurse is reviewing discharge instructions for a patient starting on nonbenzodiazepine sedative-hypnotics. Which statement should be included?
Avoid alcohol consumption while on this medication.
Take the medication in the morning to align with natural circadian rhythms.
Increase dose if sleep is not achieved within one hour.
Use this medication for long-term management of insomnia.
Which drug would be most appropriate to counteract cholinergic toxicity in an emergency setting?
Neostigmine
Atropine
Propranolol
Bethanechol
A patient develops bradycardia following vagal stimulation during a procedure. What is the most appropriate initial intervention?
Administer atropine to block vagal effects.
Provide intravenous fluids to improve circulation.
Apply defibrillation pads for immediate cardioversion.
Monitor the patient for spontaneous resolution.
Which symptom is least likely to be associated with cholinergic toxicity?
Dry mouth
Diarrhea
Miosis
Bronchospasm
Which clinical finding would indicate effective treatment of glaucoma with pilocarpine?
Reduced intraocular pressure.
Improved visual acuity.
A patient on beta-blockers is experiencing fatigue and bradycardia. What is the most appropriate nursing action?
Increase the dose of beta-blockers
Assess the patient's blood pressure and heart rate
Administer atropine
Advise the patient to stop taking the medication
A patient with heart failure is prescribed carvedilol. What is a key reason for choosing carvedilol over other beta-blockers in this situation?
Carvedilol has both beta and alpha-blocking properties, which can improve heart failure outcomes.
Carvedilol selectively blocks only beta-1 receptors.
Carvedilol increases cardiac output more than other beta-blockers.
Carvedilol has a shorter half-life, allowing for easier dose adjustments.
Which of the following is most likely to cause cholinergic toxicity?
Organophosphate exposure
Beta blocker overdose
Zolpidem overdose
Sympathetic nervous system activation
Which adverse effect is most likely to occur with cholinergic drug overdose?
Diarrhea and excessive salivation.
Confusion and hallucinations.
Dry skin and decreased sweating.
Hypertension and tachycardia.
Which clinical finding is most indicative of cholinergic toxicity?
Bronchospasm and excessive salivation
Hypotension and tachycardia
What is the primary action of beta1 receptor antagonists on the autonomic nervous system?
Increase cardiac output
Decrease heart rate
Stimulate bronchial dilation
Enhance sympathetic activity
In the management of acute coronary syndrome, why might a beta-blocker be administered?
To decrease myocardial oxygen demand by reducing heart rate
To increase coronary artery dilation and improve blood flow
To eliminate arrhythmias by increasing vagal tone
To enhance platelet aggregation inhibition
A patient is experiencing dry mouth and blurred vision after starting a new medication. Which class of drugs is most likely responsible for these symptoms?
Beta-blockers
Cholinergic agonists
Anticholinergics
Sympathomimetics
A patient taking a beta-blocker for hypertension complains of cold extremities. What is a likely explanation for this side effect?
Decreased peripheral circulation due to beta-2 receptor blockade
Increased core body temperature
Enhanced sympathetic nervous system activity
Overactivation of the renin-angiotensin system
For a patient with both hypertension and benign prostatic hyperplasia (BPH), which beta-blocker might offer additional benefits?
Carvedilol
Propranolol
Labetalol
Nebivolol
A 45-year-old patient with a history of asthma presents with signs of autonomic dysregulation. Which of the following beta-blockers would be most appropriate to prescribe?
Propranolol
Atenolol
Nadolol
Sotalol
Which of the following interventions are appropriate for managing cholinergic toxicity? (Select all that apply)
Administer atropine
Provide supportive oxygen therapy
Administer a benzodiazepine to control seizures
Initiate beta-blocker therapy
Administer pilocarpine
A patient is prescribed zolpidem to treat insomnia. Which of the following is an important nursing consideration related to the administration of this medication?
Administer with food to enhance absorption
Advise the patient to avoid alcohol consumption while on this medication
Instruct the patient to take the medication in the morning
Monitor for signs of hypertension as a side effect
A 55-year-old patient with a history of asthma and hypertension is to be started on a beta-blocker. Which beta-blocker would be the most appropriate choice for this patient?
Propranolol
Atenolol
Labetalol
Nadolol
Which of the following medications is most appropriate for treating insomnia by mimicking melatonin function in the brain?
Zolpidem
Ramelteon
Temazepam
Phenobarbital
A patient is prescribed neostigmine for myasthenia gravis. Which effect should the nurse monitor for?
Increased muscle strength
Decreased heart rate
What is the primary effect of vagal stimulation on the heart?
Increase in heart rate
Decrease in heart rate
Which clinical signs indicate cholinergic toxicity that require immediate intervention? (Select all that apply)
Bradycardia
Excessive salivation
Hypotension
A patient with a history of COPD is prescribed temazepam for insomnia. What precaution should the nurse take?
Monitor for signs of respiratory depression
Advise the patient to avoid dairy products
Monitor the patient's blood glucose levels.
Which of the following beta-blockers is most likely to cause a significant reduction in heart rate at rest?
Metoprolol
Carvedilol
Propanolol
When administering bethanechol, what primary effect should the nurse anticipate in the patient?
Increased urinary output
Decreased salivation
During the administration of temazepam, a sedative-hypnotic, which of the following assessments is most critical?
Monitoring of respiratory status.
Regular blood glucose checks.
Assessment of liver function tests.
Frequent blood pressure measurements.
A patient is experiencing autonomic dysregulation following the administration of a non-selective beta-blocker. Which symptom is most likely to be exacerbated in this scenario?
Hypertension
Bronchospasm
Increased heart rate
Hyperglycemia
Which of the following is a nonbenzodiazepine sedative-hypnotic used for short-term management of insomnia?
Zolpidem
Lorazepam
Ramelteon
Diphenhydramine
Which of the following is a primary mechanism of action for benzodiazepines like diazepam?
Inhibition of GABA receptors
Enhancement of GABA activity
Blockade of adrenergic receptors
Inhibition of dopamine synthesis
In the event of cholinergic toxicity, which medication should the nurse prepare to administer as an antidote?
Atropine
Physostigmine
Neostigmine
Propranolol
A patient with chronic obstructive pulmonary disease (COPD) requires a beta-blocker for heart failure management. Which beta-blocker is the safest option?
Sotalol
Bisoprolol
Timolol
Pindolol
A patient taking zolpidem for insomnia is advised to avoid alcohol. What is the primary reason for this instruction?
Alcohol can increase the risk of allergic reactions to zolpidem.
Alcohol can enhance the sedative effects of zolpidem, leading to increased CNS depression.
Alcohol reduces the effectiveness of zolpidem in treating insomnia.
Alcohol can cause zolpidem to be metabolized more quickly, reducing its duration of action.
A patient experiencing increased vagal stimulation is likely to exhibit which of the following symptoms?
Bradycardia
Hypertension
Tachycardia
Increased respiratory rate
In the management of hypertension, which beta-blocker should be avoided in patients with diabetes due to its potential effect on blood glucose levels?
Atenolol
Metoprolol
Carvedilol
A patient with Parkinson's disease is being treated with Carbidopa/Levodopa. They report experiencing increased autonomic dysregulation. What adjustment might help alleviate this symptom?
Increase the dose of Levodopa
Add Benztropine
Decrease Carbidopa
Switch to Pramipexole
Which medication is used in the management of sleep disorders and works by activating GABA receptors?
Ramelteon
Zolpidem
Modafinil
Melatonin
Which of the following medications is most likely to cause cholinergic toxicity when overdosed?
Neostigmine
Beta-blockers
Phenytoin
Ramelteon
Which of the following is a potential side effect of beta-blockers that nurses should monitor for in patients?
Bradycardia
Increased cardiac output
Hyperglycemia
Insomnia
Which beta-blocker is most appropriate for a patient with hypertension who also experiences frequent migraines?
Atenolol
Propranolol
Esmolol
A nurse is educating a patient about ramelteon, a melatonin receptor agonist. Which statement by the patient indicates a correct understanding of the medication?
I should take this medication with a glass of wine to help me relax.
This medication can be used for immediate relief of anxiety.
It may take a few days for the full effect to be noticeable.
I can take this medication anytime during the day.
A patient presents with orthostatic hypotension and autonomic nervous system dysregulation. Which intervention is most appropriate to manage this condition?
Initiate beta-blocker therapy
Increase fluid intake and sodium consumption
Prescribe diuretics
Advise strict bed rest
A patient with heart failure is prescribed a beta-blocker known for its antioxidant properties. Which medication is this likely to be?
Carvedilol
Metoprolol
Atenolol
Propranolol
A patient with glaucoma is prescribed pilocarpine. What mechanism of action should the nurse explain to the
patient?
Decreases intraocular pressure by increasing aqueous humor outflow
Increases aqueous humor production to relieve pressure
Blocks beta-adrenergic receptors to reduce fluid production
During a stress response, which neurotransmitter is primarily released by the sympathetic nervous system?
Acetylcholine
Norepinephrine
Dopamine
What is the primary action of benzodiazepines in the treatment of insomnia?
Inhibition of acetylcholine release.
Inhibition of serotonin reuptake.
Enhancement of GABAergic activity.
Blockade of dopamine receptors.
Which adverse effect is most associated with cholinergic agonists like bethanechol?
Diarrhea
Constipation
HTN
Dry Mouth
A patient with autonomic dysregulation is experiencing severe bradycardia. Which of the following medications
would be most effective in increasing heart rate?
Atropine
Propanolol
Atenolol
Epi
patient on beta-blocker therapy presents with symptoms of hypoglycemia. Which beta-blocker is most likely
responsible for masking these symptoms?
Atenolol
Metoprolol
Propanolol
Bisoprolol
Which of the following is a distinguishing feature of nonbenzodiazepine sedative-hypnotics compared to
benzodiazepines?
Higher risk of addiction
Lack of muscle relaxant properties
Longer half-life
Greater potential for tolerance
Which drug would be most appropriate for a patient with autonomic dysreflexia secondary to spinal cord injury?
Phenobarbital
Nitroglycerin
Latanoprost
Temazepam
For a patient on carbidopa/levodopa therapy, which dietary advice is crucial to enhance drug efficacy?
Limit protein intake at meals
Increase calcium-rich foods
Avoid foods high in vitamin C
Consume more fiber-rich foods
A patient with sleep apnea is prescribed a sedative-hypnotic. What potential risk should the nurse prioritize when
monitoring this patient?
Increased risk of hypertension
Development of a dependence on the medication
Exacerbation of respiratory depression
In the context of sedative-hypnotic use, what is the major concern with abrupt discontinuation of benzodiazepines?
Risk of hypertensive crisis
Development of withdrawal seizures
Onset of severe depression
Increased risk of gastrointestinal bleeding
A patient is on a regimen of beta-blockers and benzodiazepines. What is the potential interaction to be most
concerned about?
Additive bradycardic effects
Increased risk of hyperglycemia
Enhanced hypertensive effects
Potential for renal impairment
A nurse is preparing to administer phenytoin (Dilantin) to a client with seizure disorder. Which instruction should the nurse include when teaching the client about this medication?
A. Take with milk to prevent GI upset
B. Stop taking immediately if seizures stop
C. Use a soft-bristle toothbrush
D. Take with antacids to reduce heartburn
The nurse reviews lab results for a client taking valproic acid (Depakote). Which finding should be reported to the provider immediately?
A. ALT 80 U/L
B. Sodium 138 mEq/L
C. Hemoglobin 13 g/dL
D. Glucose 90 mg/dL
A client taking carbamazepine (Tegretol) reports fever and sore throat. What is the nurse’s priority action?
A. Encourage increased fluids
B. Obtain a CBC
C. Administer acetaminophen
D. Reassure that this is an expected effect
he nurse monitors for hyponatremia in a client taking which anticonvulsant?
A. Phenytoin
Oxcarbazepine
Lamotrigine
Tiagabine
The nurse is reinforcing teaching about ophthalmic medication safety. Which statement by the client indicates understanding?
A. “I’ll touch the dropper to my eye to be sure it goes in.”
B. “I’ll wait at least 5 minutes between different eye drops.”
C. “I can share my eye drops with my spouse if we have similar symptoms.”
D. “I don’t need to wash my hands before applying the medication.”
A nurse suspects systemic absorption of ophthalmic beta-blocker drops. Which symptom supports this finding?
A. Tachycardia
B. Hypertension
Bradycardia
D. Dilated pupils
When administering dorzolamide (Trusopt) eye drops, the nurse should instruct the client to:
A. Close eyes tightly for 5 minutes after instillation
B. Apply pressure on the inner canthus for 30–60 seconds
C. Rinse eyes immediately after applying drops
D. Lie flat for 10 minutes after use
Acetazolamide (Diamox) may cause which electrolyte imbalance?
Hyperkalemia
B. Hyponatremia and hypokalemia
Hypernatremia
Hypocalcemia
A client prescribed latanoprost (Xalatan) should be taught which potential effect?
A. Temporary loss of vision
B. Darkening of the iris color
C. Dilated pupils
D. Eye pain indicating toxicity
A nurse is administering fluorescein during an eye exam. Which outcome is expected?
A. Temporary yellow discoloration of sclera
B. Visualization of corneal abrasions under blue light
C. Pupillary constriction
D. Increased intraocular pressure
The nurse should use caution giving timolol (a beta-blocker eye drop) to a client with which condition?
Hypertension
Glaucoma
Asthma
Cataracts
A nurse is reinforcing teaching for a client taking tiagabine (Gabitril) for partial seizures. Which statement shows correct understanding?
A. “I will avoid driving until I know how it affects me.”
B. “I should take this medication on an empty stomach.”
C. “I can stop this medication if I feel dizzy.”
D. “I can drink alcohol to help me relax.”
A client taking lamotrigine (Lamictal) reports a rash. What should the nurse do?
A. Advise use of a topical steroid cream
B. Encourage fluid intake
C. Report the finding to the provider immediately
D. Document and continue to monitor
The nurse monitors for hyponatremia in a client taking which anticonvulsant?
Phenytoin
Oxcarbazepine
Lamotrigine
Tiagabine
A client taking carbamazepine (Tegretol) reports fever and sore throat. What is the nurse’s priority action?
A. Encourage increased fluids
B. Obtain a CBC
C. Administer acetaminophen
D. Reassure that this is an expected effect
