Chapter 18: Adrenergic Drugs
Test Bank
MULTIPLE CHOICE
1. The nurse is aware that adrenergic drugs produce effects similar to which of these nervous
systems?
a. Central nervous system
b. Somatic nervous system
c. Sympathetic nervous system
d. Parasympathetic nervous system
ANS: C
Adrenergic drugs mimic the effects of the sympathetic nervous system.
DIF: COGNITIVE LEVEL: Remembering (Knowledge) REF: p. 300
TOP: NURSING PROCESS: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. When an adrenergic drug stimulates beta1-adrenergic receptors, the result is an increased force
of contraction, which is known as what type of effect?
a. Positive inotropic
b. Anti-adrenergic
c. Negative dromotropic
d. Positive chronotropic
ANS: A
An increased force of contraction is known as a positive inotropic effect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 302
TOP: NURSING PROCESS: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. When a patient is taking an adrenergic drug, the nurse expects to observe which effect?
a. Increased heart rate
b. Bronchial constriction
c. Constricted pupils
d. Increased intestinal peristalsis
ANS: A
Increased heart rate is one of the effects of adrenergic drugs. Sympathetic nervous system
stimulation also results in bronchodilation, dilated pupils, and decreased gastrointestinal
mobility, depending upon which receptors are stimulated.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 300
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
4. An adrenergic agonist is ordered for a patient in shock. The nurse will note that this drug has
had its primary intended effect if which expected outcome occurs?
a. Volume restoration
b. Increased blood pressure
c. Decreased urine output
d. Reduced anxiety
ANS: B
For a patient in shock, a primary benefit of an adrenergic agonist drug is to increase blood
pressure. A drug in this category should not be used in place of volume restoration, nor does it
provide volume restoration (IV fluids do this). Adrenergic agonists may enhance urine output if
cardiac output and perfusion to the kidneys increase. These drugs do not reduce anxiety.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 310
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. The nurse is administering a stat dose of epinephrine. Epinephrine is appropriate for which
situation?
a. Severe hypertension
b. Angina
c. Cardiac arrest
d. Tachycardia
ANS: C
Treatment of cardiac arrest is an indication for the use of epinephrine. The other options are not
indications for epinephrine.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 305
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. A patient is on a low-dose dobutamine drip for heart failure. She had been feeling better but
now has a sense of tightness in her chest, palpitations, and a bit of anxiety. Her heart rate is up to
110 per minute, and her blood pressure is 150/98 mm Hg (increased from previous readings of
86 per minute and 120/80 mm Hg). What is the nurse’s immediate concern for this patient?
a. She is experiencing normal adverse effects of dobutamine therapy.
b. She may be experiencing an allergic reaction to the dobutamine.
c. The medication may be causing a worsening of a preexisting cardiac disorder.
d. The dosage of the dobutamine needs to be increased to control the symptoms better.
ANS: C
Because dobutamine is a vasoactive adrenergic, it works by increasing the cardiac output in heart
failure patients by increasing myocardial contractility and stroke volume. However, adrenergic
drugs may worsen a preexisting cardiac disorder, such as causing a myocardial infarction in a
patient with coronary artery disease. The other options are incorrect.
DIF: COGNITIVE LEVEL: Analyzing (Analysis) REF: pp. 305-306
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
7. A 14-year-old patient has been treated for asthma for almost 4 months. Two weeks ago, she
was given salmeterol as part of her medication regimen. However, her mother has called the
clinic to report that it does not seem to work when her daughter is having an asthma attack.
Which response by the nurse is appropriate?
a. “It takes time for a therapeutic response to develop.”
b. “She is too young for this particular medication; it will be changed.”
c. “She needs to take up to two puffs every 4 hours to ensure adequate blood levels.”
“This medication is indicated for prevention of bronchospasms, not for relief of acute
d. symptoms.”
ANS: D
Salmeterol is indicated for the prevention of bronchospasms, not treatment of acute symptoms.
The dosage is usually two puffs twice daily, 12 hours apart, for maintenance effects in patients
older than 12 years of age. The other options are incorrect.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 309
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
8. A hospitalized patient is experiencing a severe anaphylactic reaction to a dose of intravenous
penicillin. Which drug will the nurse expect to use to treat this condition?
a. Ephedra
b. Epinephrine
c. Phenylephrine
d. Pseudoephedrine
ANS: B
Epinephrine is the drug of choice for the treatment of anaphylaxis. The other drugs listed are
incorrect choices.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 305
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
9. The nurse recognizes that adrenergic drugs cause relaxation of the bronchi and
bronchodilation by stimulating which type of receptors?
a. Dopaminergic
b. Beta1-adrenergic
c. Beta2-adrenergic
d. Alpha1-adrenergic
ANS: C
Stimulation of beta2-adrenergic receptors results in bronchodilation. The other choices are
incorrect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 300
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
10. A patient is receiving a moderate-level dose of dobutamine for shock and is complaining of
feeling more “skipping beats” than yesterday. What is the nurse’s next action?
a. Assess the patient’s vital signs and cardiac rhythm.
b. Discontinue the dobutamine immediately.
c. Titrate the rate to a higher dose to reduce the palpitations.
d. Monitor for other signs of a therapeutic response to the drug.
ANS: B
During the administration of adrenergic drugs, adverse effects such as cardiac irregularities,
hypertension, and tachycardia may occur. Stopping the drug should cause the toxic symptoms to
subside quickly because of the drug’s short half-life.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 303
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
11. The nurse is preparing to administer dopamine. Which is the correct technique for
administering dopamine?
a. Orally
b. Intravenous (IV) push injection
c. Intermittent IV infusions (IV piggyback)
d. Continuous IV infusion with an infusion pump
ANS: D
Dopamine is available only as an IV injectable drug and is given by continuous infusion, using
an infusion pump. The other options are incorrect.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 305
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
MULTIPLE RESPONSE
1. The nurse is presenting information to a class of students about adrenergic drugs. Which are
effects of drugs that stimulate the sympathetic nervous system? (Select all that apply.)
a. Dilation of bronchioles
b. Constriction of bronchioles
c. Decreased heart rate
d. Increased heart rate
e. Dilated pupils
f. Constricted pupils
g. Glycogenolysis
ANS: A, D, E, G
Stimulation of the sympathetic nervous system causes bronchodilation, increased heart rate,
pupil dilation, and glycogenolysis as well as many other effects (see Table 18-1). The other
responses are effects that occur as a result of the stimulation of the parasympathetic nervous
system.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 300
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
OTHER
1. The nurse is to administer epinephrine 0.3 mg subcutaneously. The ampule contains 1 mL of
medication and is labeled “Epinephrine 1:1000.” How many milliliters of epinephrine will the
nurse give?
ANS:
0.3 mL
Note that 1:1000 indicates 1 gram per 1000 mL or 1000 mg per 1000 mL, which is a
concentration of 1 mg/mL.
1 mg : 1 mL :: 0.3 mg : x mL
(1 ´ x) = (1 ´ 0.3); 1x = 0.3; x = 0.3; give 0.3 mL
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TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies