A nurse is assessing a client who has muscarinic agonist poisoning. Following administration of atropine, which of the following findings should indicate to the nurse that the treatment has been effective?

Hyperactive bowel sounds

Heart rate 90/min

Blood pressure 90/50 mm Hg

Increased salivation

Answer and Explanation

The Correct Answer is B

A.   Hyperactive bowel sounds: Muscarinic agonist poisoning typically results in increased gastrointestinal motility and hyperactive bowel sounds. Atropine, an anticholinergic medication, works by blocking muscarinic receptors and reducing gastrointestinal motility. Therefore, the presence of hyperactive bowel sounds may indicate ongoing muscarinic stimulation and inadequate treatment with atropine.
B.   Heart rate 90/min: Atropine is an anticholinergic medication that increases heart rate by blocking the parasympathetic effects of acetylcholine on the heart. Bradycardia is a common manifestation of muscarinic agonist poisoning, and an increase in heart rate following atropine administration indicates reversal of this effect and effective treatment.
C.   Blood pressure 90/50 mm Hg: Atropine administration may result in transient hypertension due to its effect on increasing heart rate and cardiac output. Hypotension is a common
manifestation of muscarinic agonist poisoning, and an increase in blood pressure following atropine administration may indicate improvement in cardiovascular function. Therefore, a blood pressure of 90/50 mm Hg may not necessarily indicate effective treatment with atropine.
D.   Increased salivation: Muscarinic agonist poisoning typically results in excessive salivation (sialorrhea) due to stimulation of muscarinic receptors in the salivary glands. Atropine administration works by blocking these muscarinic receptors and reducing salivation. Therefore, increased salivation would indicate ongoing muscarinic stimulation and inadequate treatment with atropine.

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Correct Answer is C

Explanation

A. This statement is incorrect. While it’s essential not to exceed the recommended dose, the

maximum daily limit for nicotine gum is 24 pieces, not 40. Using more than the recommended amount can lead to adverse effects
B. This information is not accurate. Nicotine gum is typically used for a shorter duration. The

treatment plan varies, but it’s essential to follow the recommended dosing and gradually reduce usage over time. The goal is to quit smoking successfully, not to use the gum for 9 months
C. This advice is correct. Nicotine gum is not used like ordinary chewing gum. You should chew it a few times and then “park” it between your cheek and the space below your teeth. The nicotine is absorbed mostly in your mouth. Chewing it slowly over 30 minutes allows for
effective absorption and helps control withdrawal symptoms

D. Drinking water before chewing nicotine gum is not a necessary instruction for its use.

A. Ringing in the ears B. Urinary retention C. Increased blood pressure D. Respiratory depression

Correct Answer is D

Explanation

A. Ringing in the ears (tinnitus) is not a common adverse effect of midazolam.

B. Urinary retention is not a common adverse effect of midazolam.

C. Midazolam typically causes decreased blood pressure, not increased blood pressure.

D. Respiratory depression is a potential adverse effect of midazolam, particularly when administered in higher doses or in combination with other central nervous system depressants.

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A nurse is assessing a client who has muscarinic agonist poisoning. Following administration of atropine, which of the following findings should indicate to the nurse that the treatment has been effective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

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Correct Answer is D

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