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  • August 11, 2024
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  • 2024/2025
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STUVIA 2024/2025
Chapter 16: Cholinergic Agonists and
Antagonists
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

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.

A patient who has irritable bowel syndrome would most likely receive which type of drug to treat this
condition?
a. An anticholinergic
b. A cholinergic esterase inhibitor
%


c. A muscarinic agent
d. A nicotinic agent - ✔✔ANS: A

Anticholinergic drugs are used to treat peptic ulcers and intestinal spasticity because of their actions
to decrease gastric secretions and gastrointestinal spasms.

A patient who has Parkinson disease will begin treatment with benztropine (Cogentin). Which
symptom of Parkinson disease would be a contraindication for this drug?
a. Drooling
b. Muscle rigidity
c. Muscle weakness
d. Myasthenia gravis - ✔✔ANS: D

Myasthenia gravis is a contraindication for this drug.

A patient who is intubated develops sinus bradycardia. Which medication will the nurse anticipate
administering to treat this symptom?
a. Atropine sulfate (Atropine)
b. Benztropine (Cogentin)
c. Bethanechol chloride (Urecholine)


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, STUVIA 2024/2025
d. Metoclopramide (Reglan) - ✔✔ANS: A

Atropine is most commonly used to decrease salivation and respiratory secretions preoperatively and
to treat sinus bradycardia by increasing the heart rate.

Cholinergic drugs have specific effects on the body. What are the actions of cholinergic medications?
(Select all that apply.)
a. Dilate pupils
b. Decrease heart rate
c. Stimulate gastric muscle
d. Dilate blood vessels
e. Dilate bronchioles
f. Increase salivation
g. Constrict pupils - ✔✔ANS: B, C, D, F, G

Decreasing heart rate, stimulating gastric muscles, dilating blood vessels, increasing salivation, and
constricting pupils are actions of the cholinergic drugs.

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
%

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 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




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