1. A patient is taking aminophylline for their Monitor the patient very
COPD. The patient is about to undergo emer- closely for sign of early
gency surgery and will receive a neuromus- arousal and return of muscle
cular junction (NMJ) blocker as part of the function.
procedure. It is important for the nurse to
take what action?
2. The nurse is caring for a patient who is be- Bradycardia
ing maintained on a mechanical ventilator.
Atracurium is administered to limit the re-
sistance to mechanical ventilation. What is
the nurse's priority assessment?
3. The nurse is preparing a patient for surgery Calcium channel blockers
who will receive a neuromuscular junction
blocker during the procedure. It is important
for the nurse to review the patient's medica-
tion history for concurrent use of what?
4. An elderly patient has received a neuromus- Risk for impaired skin integri-
cular junction blocker during surgery, What ty
would be an appropriate nursing diagnosis
for this patient?
5. What are the primary uses of neuromuscu- To facilitate endotracheal in-
lar junction blockers (NMJ blockers)? tubation
To prevent injury during elec-
troconvulsive therapy
To facilitate mechanical ven-
tilation
6. The pharmacology instructor is discussing Acts like Ach then prevents
nondepolarizing neuromuscular junction repolarization
blockers (NMJ blockers) with the nursing
class. How would the instructor explain the
action on nondepolarizing NMJ blockers?
7. Actin and myosin molecules
react with each other sliding
, NR567 Advanced Pharmacology
According to the sliding filament theory, along the filament and mak-
what is the initial action in a muscle contrac- ing it shorter.
tion?
8. A patient is to have surgery and it is planned Acts as an antagonist to
that atracurium (Tracrium) is to be used as acetylcholine
an adjunct to general anesthesia. How will
the atracurium work?
9. The nurse is caring for a patient who is re- If given together, a precipi-
ceiving pancuronium (Pavulon) to facilitate tate may form.
mechanical ventilation. The patient is also
receiving a barbiturate. How will the nurse
administer these two medications?
10. The nurse is caring for a patient who is This drug is associated with
scheduled for abdominal surgery in the pulmonary hypertension
morning and is scheduled to receive rocuro-
nium (Zemuron). The patient asks the nurse
to describe the adverse effects of rocuroni-
um. What would the nurse describe for the
patient?
11. The PACU nurse is caring for a patient that Temperature
had succinylcholine (Anectine) as an ad-
junct to anesthesia. What is the nurse's pri-
ority assessment while caring for this pa-
tient?
12. The nurse is caring for a patient scheduled Fear related to paralysis
for abdominal surgery in the morning. The
patient confides that they watched a movie
last week about someone who had surgery
and the anesthetic did not work but no one
knew because that patient could not move,
What nursing diagnosis will the nurse in-
clude in this patient's plan of care?
13. The nurse is caring for a patient in the inten- -The patient's muscles need
sive care unit who has been receiving neu- to get their strength back
, NR567 Advanced Pharmacology
romuscular junction (NMJ) blockers, seda- again.
tives, and analgesics for the past 2 weeks. -This is a common occur-
The NMJ blocker therapy has been discon- rence in situations like this.
tinued and the other medications have been -He is likely to breathe better
reduced gradually. The patient is now alert each day.
and awake, communicating with family by -He will not be takne off
using paper and pencil. The family asks why the mechanical ventilator un-
the patient cannot sustain normal respira- til he is ready.
tions. What is the nurse's best response?
14. The nurse is caring for a very anxious 30 to 60 seconds
33-year-old female patient scheduled for
abdominal surgery today. The patient said
the anesthesiologist said she would receive
succinylcholine (anactine) during surgery
and asks the nurse how long it will take
before the medication starts to work. What
is the nurse's best response?
15. The patient returns from surgery complain- Aspirin
ing about muscle pain after receiving suc-
cinylcholine during the procedure After re-
viewing the postoperative orders, which of
these ordered analgesics will the nurse ad-
minister to treat this pain?
16. A student asks the pharmacology instruc- Succinylcholine is not bro-
tor how succinylcholine differs from acetyl- ken down instantly.
choline (Ach). What should the instructor
respond?
17. The CRNA documents the anesthesia plan Succinylcholine (Anectine,
as using a depolarizing NMJ blocker as ad- Quelicin)
junct to other anesthetics on the patient
when they go to surgery. The nurse would
understand from this note that the patient
will receive what drug?
18. The nurse administers pancuronium to the Bronchospasm
mechanically ventilated patient in the pedi-
, NR567 Advanced Pharmacology
atric ventilated patient in the pediatric in-
tensive care unit. What assessment finding
would the nurse suspect is an adverse effect
resulting from the drug?
19. The nursing student asks the mental health To reduce the intensity of
nurse why pancuronium was administered muscle contractions.
to the patient before electroconvulsive ther-
apy was performed. What is the mental
health nurse's best response?
20. When a nondepolarizing neuromuscular Xanthines
junction blocker is used as an adjunct to
surgery, what classification of medications
could reverse the neuromuscular blockage
leading to early arousal and return of mus-
cle function?
21. When causing depolarization of the mus- Acetylcholine
cle membranes, what neurotransmitter in-
teracts with the nicotinic cholinergic recep-
tors leading to the release of calcium ions?
22. The nurse, working in the preoperative hold- Bone fracture
ing area, is caring for a 70-year-old pa- Malnutrition
tient who is scheduled to receive succinyl- Narrow-angle glaucoma
choline as part of general anesthesia. When
collecting the nursing history, what condi-
tion would require the nurse to notify the
anesthesiologist of the need for caution?
23. The nurse is caring for a patient who re- Alaskan Eskimos
ceived succinylcholine during surgery. The
nurse would expect the patient to spend
more time in the post anesthesia care unit
due to prolonged paralysis and inability to
breathe if the patient was from what ethnic
group?
24. An aminoglycoside
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