1. A patient is started out on a low dose level of dopamine hydrochloride (Intropin) IV. Which of the following can the nurse expect?
a. A decrease in glomerular filtration rate
b. A decrease in the force of myocardial contractions
c. An increase in urine output
d. An increase in tactile sensation
C - Dopamine at low doses causes dilation of renal and mesenteric arteries, which in turn causes increased urine output.
2. Which nursing action is NOT appropriate for a patient receiving IV Dopamine hydrochloride (Intropin)?
a. The nurse will monitor V/S frequently
b. The nurse will check the IV infusion site frequently for extravasation
c. The nurse will infuse the drug via macrodrip tubing and will adjust the rate manually
d. The nurse will check client extremities for temperature and color
C - Dopamine needs to be infused via a minidrip tubing and attached to an infusion pump for accurate administration.
3. The patient experiences extravasation at the insertion site of dopamine hydrochloride (Intropin) IV. The infusion is stopped. What should be done next?
a. Warm compresses should be applied to the IV site
b. An ice pack should be applied to the IV site
c. The extremity with the IV site should be elevated on two pillows
d. The IV site should be infiltrated with phentolamine (Regitine).
D - If extravasation occurs with dopamine administration, the IV site should be infiltrated with phentolamine (Regitine) immediately after discontinuing the infusion.
4. When high doses of dopamine hydrochloride are given IV for treatment of shock, what effect would the nurse be looking for?
a. Increased BP
b. Decreased HR
c. Increased RR
d. Elevated body temperature
A - High doses of dopamine hydrochloride stimulate alpha-adrenergic activity, which causes increased BP.
5. Which drug produces effects that closely mimic high doses of dopamine hydrochloride (Intropin)?
a. Atropine sulfate
b. Ephedrine
c. Isoproterenol (Isuprel)
d. Norepinephrine (Levophed)
D - Dopamine given in high doses has effects that closely mimic norepinephrine (Levophed)
6. A woman calls the physician's office and states that she has vomited each time she has taken ergotamine tartrate (Ergomar). The nurse's best response is:
a. "Vomiting is a common A/E. Tell the physician so he can prescribe an anti-emetic for you."
b. "Stop taking the drug immediately. Vomiting is a toxic drug effect."
c. "You must be allergic to the drug. Notify the physician."
d. "Vomiting is a transient effect and it will eventually go away."
A - Ergotamine has emetic effects; vomiting is a common side effect. The client needs an antiemetic to help control this problem.
7. Which group of individuals should not receive ergotamine tartrate (Ergomar)?
a. Diabetic clients
b. Asthmatic clients
c. Alcoholic clients
d. Pregnant women
D - Ergotamine has an oxytoxic effect; it is C/I in pregnant women.
8. The nurse should relate all of the following information about ergotamine tartrate to a patient receiving the medication EXCEPT:
a. take the drug as soon as you feel a migraine headache coming on
b. have your blood pressure checked routinely when taking this drug
c. increase the dose as needed to help control your migraines
d. tell the physician if you have any numbness or tingling in your toes and fingers
C - Ergotamine tartrate is a drug that is abused by clients by altering dosage amount. Only the physician should change the dose of the drug.
9. When preparing the drug bethanechol chloride (Urecholine) the nurse knows that:
a. IM or IV is the preferred route
b. bethanecol chloride should be given with food
c. breath sounds should be monitored
d. constipation is a frequent A/E
C - Breath sounds should be monitored to assess for wheezing and bronchospasm.
10. Which drug would be given to treat neostigmine (Prostigmine) overdose?
a. Acetylcholine acetate (Miochol)
b. Atropine sulfate
c. Bethanicol (Urecholine)
d. Lidocaine (Xylocaine)
B - Atropine sulfate, an anti-cholinergic is the antidote for neostigmine (Prostigmine).
11. Which of the following effects of atropine sulfate would the nurse expect a patient having this medication exhibit?
a. Dry mouth
b. Increased bronchial secretions
c. Tachycardia
d. Miosis
A - Atropine sulfate causes dry mouth and decreases secretions, which is why it is given as a pre-anesthetic.
12. Which statement indicates that the client needs more teaching concerning the use of atropine sulfate?
a. "I will brush my teeth and see my dentist regularly."
b. "I will eat low-residue foods to prevent diarrhea."
c. "I will take my medication at least a half hour before meals."
d. "I will stay in my air conditioned house on hot and humid days."
B - Atropine can cause constipation; high-fiber foods and fluids should be encouraged.
13. Which adverse effect would the nurse NOT expect to see with trihexyphenidyl HCl (Artane) therapy?
a. Dizziness
b. Dry mouth
c. Diarrhea
d. Suppression of sweating
C - Artane is an anti-cholinergic that can cause constipation, not diarrhea.
14. A patient has symptoms that are not improving, so the physician starts her on levodopa (Larodopa) as an adjunct with trihexyohenidyl HCl (Artane). Which statement by the patient indicates understanding of proper use of levodopa (Larodopa)?
a. "If symptoms get worse I will stop taking this drug."
b. "I will not eat liver or boxed cereals."
c. "If I have a cold I will take aspirin or a cold remedy."
d. "I will eat eat foods low in residue to prevent diarrhea."
B - Vitamin B6 (pyridoxine) reverses the therapeutic effects of levodopa (Larodopa); clients should restrict their intake of foods high in vitamin B, such as whole-grain cereals, fortified cereals, liver and green vegetables.
15. Which instruction should the nurse give to clients taking bromocriptine (Parlodel)?
a. "Take one hour before meals."
b. "Do not use birth control pills as contraceptives."
c. "This drug causes infertility and use of contraceptives will not be necessary."
d. "Adverse effects will be reduced if taken during the day."
B - Oral contraceptives antagonize the effects of bromocriptine (Parlodel). Another method of birth control should be used.
