A 73-year-old male with Parkinson's disease, emphysema, and benign prostatic hyperplasia presents to the clinic for routine care. Following detailed assessment, the provider has prescribed an anticholinergic drug for the client. What is the nurse's priority teaching point to the client in regard to his new medication?

Do slow position changes to avoid falls from lowering blood pressure."

if you feel short of breath, use a rescue inhaler.

"If possible, try to avoid rooms that are cold."

"Make sure to seek care immediately if you're not able to urinate."

Answer and Explanation

The Correct Answer is D

A.   Do slow position changes to avoid falls from lowering blood pressure: This is not the priority teaching point for an anticholinergic medication. While some anticholinergics can cause orthostatic hypotension, the risk of urinary retention is a more significant concern.
B.   If you feel short of breath, use a rescue inhaler: This instruction is unrelated to the use of anticholinergic medication and may be more relevant for patients with emphysema.
C.   "If possible, try to avoid rooms that are cold.": Avoiding cold rooms is not directly related to the use of anticholinergic medication. The priority teaching point should address potential adverse effects specific to the medication.
D.   "Make sure to seek care immediately if you're not able to urinate.": Anticholinergic medications can exacerbate urinary retention, particularly in older adults with benign prostatic hyperplasia. It's crucial for the patient to understand the importance of seeking medical attention if they experience difficulty urinating.

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Correct Answer is D

Explanation

A. "I know that I cannot switch brands of this medication." - This statement indicates an understanding of the importance of consistency in medication use. Phenytoin requires consistent dosing and should not be switched between different brands without consulting a healthcare provider.
B. "I have made an appointment to see my dentist next week." - This statement shows awareness of the need for dental care while taking phenytoin. Phenytoin can cause gum hyperplasia, so regular dental check-ups are recommended.

C. "I will notify my doctor before taking any other medications." - This statement demonstrates understanding of the potential for drug interactions with phenytoin. Phenytoin can interact with many other medications, so it's crucial to consult a doctor before starting any new medications.
D. "I'll be glad when I can stop taking this medicine." - This statement indicates a

misunderstanding about the management of epilepsy. Phenytoin is typically a long-term medication used to control seizures, and it's not usually discontinued unless directed by a healthcare provider. Further teaching is needed to address this misconception.

A. Dobutamine B. Atropine sulfate C. Atenolol D. Bethanechol

Correct Answer is B

Explanation

A. Dobutamine is a sympathomimetic drug used to increase cardiac output in conditions such as heart failure. It is not an antidote for cholinergic drug overdose.
B. Atropine sulfate is the antidote for cholinergic drug overdose. It acts as a competitive antagonist to acetylcholine at muscarinic receptors, counteracting the effects of excessive cholinergic stimulation.
C. Atenolol is a beta-blocker used to manage hypertension and certain cardiac conditions. It is not an antidote for cholinergic drug overdose.
D. Bethanechol is a cholinergic agonist used to stimulate bladder contractions in urinary retention. It is not an antidote for cholinergic drug overdose; in fact, it would exacerbate cholinergic effects.

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Naxlex Comprehensive Predictor Exams

A nurse is performing discharge teaching for a client who has seizures and a new prescription for phenytoin. Which of the following statements by the client indicates a need for further teaching?

Correct Answer is D

Explanation

A patient has had an overdose of an intravenous cholinergic drug. The nurse expects to administer which drug as an antidote?

Correct Answer is B

Explanation

A patient has been taking phenobarbital for 2 weeks as part of his therapy for epilepsy. He tells the nurse that he feels tense and that the least little thing bothers him now. Which is the correct explanation for this problem?

A nurse is preparing to administer meperidine 35 mg IM to a client every 6 hr PRN for pain. Available is meperidine injection 75 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

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?

When a patient is taking an adrenergic agonist drug, the nurse expects to observe which effect?

A patient has been taking donepezil for 2 weeks as part of the treatment for early stages of Alzheimer's disease. Her daughter calls the prescriber's office and is upset because "Mother has not improved one bit!" Which response by the nurse is appropriate?

The teaching for a patient who is taking tamsulosin to reduce urinary obstruction due to benign prostatic hyperplasia will include which of these?

A nurse is preparing to administer amantadine 150 mg PO every 12 hr. Available is amantadine 50 mg/5 mL syrup. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)