Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse understands that an anticholinergic drug will produce which of the following effects?
A. Dry mouth
This is correct. Dry mouth is a common side effect of anticholinergic drugs. It occurs because anticholinergic drugs block the action of acetylcholine, a neurotransmitter that stimulates the secretion of saliva and other fluids in the body. Dry mouth can cause discomfort, bad breath, and increased risk of dental problems¹.
B. Constricted bronchioles
This is incorrect. Constricted bronchioles are not a side effect of anticholinergic drugs. In fact, anticholinergic drugs can cause the opposite effect: dilated bronchioles. This is because anticholinergic drugs block the action of acetylcholine, a neurotransmitter that causes the smooth muscles of the airways to contract. Dilated bronchioles can improve breathing and reduce wheezing in people with respiratory disorders, such as asthma or COPD.
C. Increased heart rate
This is incorrect. Increased heart rate is not a side effect of anticholinergic drugs. In fact, anticholinergic drugs can cause the opposite effect: decreased heart rate. This is because anticholinergic drugs block the action of acetylcholine, a neurotransmitter that slows down the heart rate and lowers the blood pressure. Decreased heart rate can be beneficial for people with certain heart conditions, such as atrial fibrillation or tachycardia.
D. Dilated pupils
This is correct. Dilated pupils are a common side effect of anticholinergic drugs. It occurs because anticholinergic drugs block the action of acetylcholine, a neurotransmitter that controls the muscles of the iris, which regulate the size of the pupils. Dilated pupils can cause blurred vision, sensitivity to light, and difficulty focusing.
This question is an excerpt from Nurse Dive's nursing test bank - Ati Rn Pharmacology Proctored Exam. Take the full exam now
Full Explanation
Choice A reason: This is correct. Dry mouth is a common side effect of anticholinergic drugs. It occurs because anticholinergic drugs block the action of acetylcholine, a neurotransmitter that stimulates the secretion of saliva and other fluids in the body. Dry mouth can cause discomfort, bad breath, and increased risk of dental problems¹.
Choice B reason: This is incorrect. Constricted bronchioles are not a side effect of anticholinergic drugs. In fact, anticholinergic drugs can cause the opposite effect: dilated bronchioles. This is because anticholinergic drugs block the action of acetylcholine, a neurotransmitter that causes the smooth muscles of the airways to contract. Dilated bronchioles can improve breathing and reduce wheezing in people with respiratory disorders, such as asthma or COPD.
Choice C reason: This is incorrect. Increased heart rate is not a side effect of anticholinergic drugs. In fact, anticholinergic drugs can cause the opposite effect: decreased heart rate. This is because anticholinergic drugs block the action of acetylcholine, a neurotransmitter that slows down the heart rate and lowers the blood pressure. Decreased heart rate can be beneficial for people with certain heart conditions, such as atrial fibrillation or tachycardia.
Choice D reason: This is correct. Dilated pupils are a common side effect of anticholinergic drugs. It occurs because anticholinergic drugs block the action of acetylcholine, a neurotransmitter that controls the muscles of the iris, which regulate the size of the pupils. Dilated pupils can cause blurred vision, sensitivity to light, and difficulty focusing.
Similar Questions
A nurse is reviewing the medical record of a client who is to receive the first dose of a cephalosporin antibiotic via intermittent IV bolus. Which of the following findings should the nurse identify as a contraindication for the client to receive a cephalosporin and report to the provider?
A. A recent history of diarrhea for 3 days
This is incorrect. A recent history of diarrhea for 3 days is not a contraindication for receiving a cephalosporin antibiotic. However, the nurse should monitor the client for signs of dehydration and electrolyte imbalance, and advise the client to drink plenty of fluids and avoid caffeine and alcohol. The nurse should also be aware that cephalosporins can cause or worsen diarrhea in some people, especially if they disrupt the normal flora of the gut. In rare cases, cephalosporins can cause a serious infection called Clostridioides difficile (C. difficile) colitis, which is characterized by severe diarrhea, abdominal pain, fever, and blood or pus in the stool. The nurse should instruct the client to report any of these symptoms and to avoid taking antidiarrheal drugs without consulting the doctor.
B. Serum creatinine 0.8 mg/dL
This is incorrect. Serum creatinine 0.8 mg/dL is not a contraindication for receiving a cephalosporin antibiotic. Serum creatinine is a measure of kidney function, and a normal range for adults is 0.6 to 1.2 mg/dL. A high serum creatinine level may indicate kidney damage or impairment, which can affect the clearance of cephalosporins and increase the risk of toxicity. Therefore, the dose of cephalosporins may need to be adjusted in people with kidney problems, except for ceftriaxone and cefoperazone, which are excreted mainly through the bile. The nurse should check the client's renal function tests and the doctor's orders before administering a cephalosporin antibiotic.
C. A history of phlebitis following an IV infusion of 0.9% sodium chloride with 10 mEq of potassium chloride
This is incorrect. A history of phlebitis following an IV infusion of 0.9% sodium chloride with 10 mEq of potassium chloride is not a contraindication for receiving a cephalosporin antibiotic. Phlebitis is the inflammation of a vein, which can be caused by mechanical, chemical, or infectious factors. Some IV solutions, such as potassium chloride, can irritate the vein and cause phlebitis. However, this does not mean that the client is allergic or intolerant to cephalosporins, which are usually well tolerated by the veins. The nurse should assess the client's IV site for signs of phlebitis, such as redness, swelling, pain, or warmth, and change the site if needed. The nurse should also dilute the cephalosporin antibiotic according to the manufacturer's instructions and administer it slowly over the recommended time to minimize the risk of phlebitis.
D. A severe allergy to penicillins
This is correct. A severe allergy to penicillins is a contraindication for receiving a cephalosporin antibiotic. Penicillins and cephalosporins belong to the same class of beta lactam antibiotics, which share a similar chemical structure. Therefore, people who are allergic to penicillins have a higher chance of being allergic to cephalosporins, especially the first and secondgeneration ones. An allergic reaction to cephalosporins can range from mild skin rashes to life-threatening anaphylaxis, which is a severe hypersensitivity reaction that causes difficulty breathing, low blood pressure, and shock. The nurse should ask the client about their allergy history and the type and severity of their reactions. The nurse should report any history of penicillin allergy to the doctor and avoid giving cephalosporins to the client unless the doctor confirms that it is safe to do so..
Full Explanation
Choice A reason: This is incorrect. A recent history of diarrhea for 3 days is not a contraindication for receiving a cephalosporin antibiotic. However, the nurse should monitor the client for signs of dehydration and electrolyte imbalance, and advise the client to drink plenty of fluids and avoid caffeine and alcohol. The nurse should also be aware that cephalosporins can cause or worsen diarrhea in some people, especially if they disrupt the normal flora of the gut. In rare cases, cephalosporins can cause a serious infection called Clostridioides difficile (C. difficile) colitis, which is characterized by severe diarrhea, abdominal pain, fever, and blood or pus in the stool. The nurse should instruct the client to report any of these symptoms and to avoid taking antidiarrheal drugs without consulting the doctor.
Choice B reason: This is incorrect. Serum creatinine 0.8 mg/dL is not a contraindication for receiving a cephalosporin antibiotic. Serum creatinine is a measure of kidney function, and a normal range for adults is 0.6 to 1.2 mg/dL. A high serum creatinine level may indicate kidney damage or impairment, which can affect the clearance of cephalosporins and increase the risk of toxicity. Therefore, the dose of cephalosporins may need to be adjusted in people with kidney problems, except for ceftriaxone and cefoperazone, which are excreted mainly through the bile. The nurse should check the client's renal function tests and the doctor's orders before administering a cephalosporin antibiotic.
Choice C reason: This is incorrect. A history of phlebitis following an IV infusion of 0.9% sodium chloride with 10 mEq of potassium chloride is not a contraindication for receiving a cephalosporin antibiotic. Phlebitis is the inflammation of a vein, which can be caused by mechanical, chemical, or infectious factors. Some IV solutions, such as potassium chloride, can irritate the vein and cause phlebitis. However, this does not mean that the client is allergic or intolerant to cephalosporins, which are usually well tolerated by the veins. The nurse should assess the client's IV site for signs of phlebitis, such as redness, swelling, pain, or warmth, and change the site if needed. The nurse should also dilute the cephalosporin antibiotic according to the manufacturer's instructions and administer it slowly over the recommended time to minimize the risk of phlebitis.
Choice D reason: This is correct. A severe allergy to penicillins is a contraindication for receiving a cephalosporin antibiotic. Penicillins and cephalosporins belong to the same class of beta lactam antibiotics, which share a similar chemical structure. Therefore, people who are allergic to penicillins have a higher chance of being allergic to cephalosporins, especially the first and secondgeneration ones. An allergic reaction to cephalosporins can range from mild skin rashes to life-threatening anaphylaxis, which is a severe hypersensitivity reaction that causes difficulty breathing, low blood pressure, and shock. The nurse should ask the client about their allergy history and the type and severity of their reactions. The nurse should report any history of penicillin allergy to the doctor and avoid giving cephalosporins to the client unless the doctor confirms that it is safe to do so..
A nurse is teaching a client who has a new prescription for an antacid to treat a gastric ulcer. Which of the following statements by the client indicates an understanding of the teaching?
A. I will take this medication with an antacid.
This is incorrect. Taking an antacid with another antacid is redundant and unnecessary. Antacids are medicines that neutralize the acid in the stomach and relieve symptoms of heartburn, indigestion, and gastric ulcers. Taking too much antacid can cause side effects such as diarrhea, constipation, or electrolyte imbalance¹.
B. I will take this medication as needed to reduce pain.
This is incorrect. Taking an antacid as needed to reduce pain is not a good practice. Antacids are not painkillers and do not address the underlying cause of gastric ulcers. Gastric ulcers are sores in the lining of the stomach that can be caused by infection, inflammation, or erosion. Taking an antacid may temporarily relieve the pain, but it does not heal the ulcer or prevent complications. Antacids should be taken regularly as prescribed by the doctor, along with other medicines that treat the cause of the ulcer.
C. I will take this medication after I take my proton pump inhibitor (Protonix).
This is correct. Taking an antacid after taking a proton pump inhibitor (PPI) is a good practice. PPIs are medicines that reduce the production of acid in the stomach and help heal gastric ulcers. However, PPIs may take several hours to work and may not provide immediate relief of symptoms. Taking an antacid after a PPI can help neutralize any remaining acid in the stomach and provide faster symptom relief. However, the antacid should be taken at least 2 hours after the PPI, as the antacid can interfere with the absorption of the PPI.
D. I will reduce my fluid intake with this medication.
This is incorrect. Reducing fluid intake with an antacid is not a good practice. Fluid intake is important for hydration, digestion, and elimination. Reducing fluid intake can cause dehydration, constipation, or kidney problems. Fluid intake does not affect the effectiveness of antacids, as long as the antacid is taken with a glass of water to help dissolve and flush it down the esophagus and into the stomach.
Full Explanation
Choice A reason: This is incorrect. Taking an antacid with another antacid is redundant and unnecessary. Antacids are medicines that neutralize the acid in the stomach and relieve symptoms of heartburn, indigestion, and gastric ulcers. Taking too much antacid can cause side effects such as diarrhea, constipation, or electrolyte imbalance¹.
Choice B reason: This is incorrect. Taking an antacid as needed to reduce pain is not a good practice. Antacids are not painkillers and do not address the underlying cause of gastric ulcers. Gastric ulcers are sores in the lining of the stomach that can be caused by infection, inflammation, or erosion. Taking an antacid may temporarily relieve the pain, but it does not heal the ulcer or prevent complications. Antacids should be taken regularly as prescribed by the doctor, along with other medicines that treat the cause of the ulcer.
Choice C reason: This is correct. Taking an antacid after taking a proton pump inhibitor (PPI) is a good practice. PPIs are medicines that reduce the production of acid in the stomach and help heal gastric ulcers. However, PPIs may take several hours to work and may not provide immediate relief of symptoms. Taking an antacid after a PPI can help neutralize any remaining acid in the stomach and provide faster symptom relief. However, the antacid should be taken at least 2 hours after the PPI, as the antacid can interfere with the absorption of the PPI.
Choice D reason: This is incorrect. Reducing fluid intake with an antacid is not a good practice. Fluid intake is important for hydration, digestion, and elimination. Reducing fluid intake can cause dehydration, constipation, or kidney problems. Fluid intake does not affect the effectiveness of antacids, as long as the antacid is taken with a glass of water to help dissolve and flush it down the esophagus and into the stomach.
The nurse is caring for a client who is refusing to take their prescribed metformin (Glucophage). The nurse understands that the most common side effects of metformin are:
A. Nausea, vomiting, diarrhea
This is correct. Nausea, vomiting, and diarrhea are the most common side effects of metformin, especially when the drug is started or the dose is increased. These side effects occur because metformin can interfere with the absorption of glucose and other nutrients in the intestines, causing osmotic diarrhea. The nurse should advise the client to take metformin with food, start with a low dose and gradually increase it, and drink plenty of fluids to prevent dehydration. The nurse should also monitor the client for signs of lactic acidosis, a rare but serious complication of metformin that causes severe diarrhea, abdominal pain, muscle cramps, and difficulty breathing.
B. Palpitations
This is incorrect. Palpitations are not a common side effect of metformin. Palpitations are the sensation of a rapid, irregular, or pounding heartbeat, which can be caused by various factors, such as stress, anxiety, caffeine, nicotine, or heart problems. Metformin does not affect the heart rate or rhythm directly, but it can lower the blood sugar levels, which can trigger the release of adrenaline, a hormone that can cause palpitations. The nurse should check the client's blood sugar levels and advise the client to eat regular meals and snacks, avoid alcohol and caffeine, and report any chest pain or shortness of breath.
C. Headaches
This is incorrect. Headaches are not a common side effect of metformin. Headaches are the pain or discomfort in the head, scalp, or neck, which can be caused by various factors, such as stress, dehydration, or sinus infection. Metformin does not cause headaches directly, but it can lower the blood sugar levels, which can cause headaches as a symptom of hypoglycemia. The nurse should check the client's blood sugar levels and advise the client to eat regular meals and snacks, drink plenty of water, and take painkillers as needed.
D. Heartburn
This is incorrect. Heartburn is not a common side effect of metformin. Heartburn is the burning sensation in the chest or throat, which is caused by the reflux of stomach acid into the esophagus. Metformin does not cause heartburn directly, but it can worsen it if the client already has gastroesophageal reflux disease (GERD), a condition where the lower esophageal sphincter is weak or relaxed and allows the acid to flow back. The nurse should advise the client to take metformin with food, avoid spicy or fatty foods, elevate the head of the bed, and take antacids as needed.
Full Explanation
Choice A reason: This is correct. Nausea, vomiting, and diarrhea are the most common side effects of metformin, especially when the drug is started or the dose is increased. These side effects occur because metformin can interfere with the absorption of glucose and other nutrients in the intestines, causing osmotic diarrhea. The nurse should advise the client to take metformin with food, start with a low dose and gradually increase it, and drink plenty of fluids to prevent dehydration. The nurse should also monitor the client for signs of lactic acidosis, a rare but serious complication of metformin that causes severe diarrhea, abdominal pain, muscle cramps, and difficulty breathing.
Choice B reason: This is incorrect. Palpitations are not a common side effect of metformin. Palpitations are the sensation of a rapid, irregular, or pounding heartbeat, which can be caused by various factors, such as stress, anxiety, caffeine, nicotine, or heart problems. Metformin does not affect the heart rate or rhythm directly, but it can lower the blood sugar levels, which can trigger the release of adrenaline, a hormone that can cause palpitations. The nurse should check the client's blood sugar levels and advise the client to eat regular meals and snacks, avoid alcohol and caffeine, and report any chest pain or shortness of breath.
Choice C reason: This is incorrect. Headaches are not a common side effect of metformin. Headaches are the pain or discomfort in the head, scalp, or neck, which can be caused by various factors, such as stress, dehydration, or sinus infection. Metformin does not cause headaches directly, but it can lower the blood sugar levels, which can cause headaches as a symptom of hypoglycemia. The nurse should check the client's blood sugar levels and advise the client to eat regular meals and snacks, drink plenty of water, and take painkillers as needed.
Choice D reason: This is incorrect. Heartburn is not a common side effect of metformin. Heartburn is the burning sensation in the chest or throat, which is caused by the reflux of stomach acid into the esophagus. Metformin does not cause heartburn directly, but it can worsen it if the client already has gastroesophageal reflux disease (GERD), a condition where the lower esophageal sphincter is weak or relaxed and allows the acid to flow back. The nurse should advise the client to take metformin with food, avoid spicy or fatty foods, elevate the head of the bed, and take antacids as needed.