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Raus Respiratory Care Pharmacology 9th Edition By Gardenhire - Test Bank

Raus Respiratory Care Pharmacology 9th Edition By Gardenhire – Test Bank

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Raus Respiratory Care Pharmacology 9th Edition By Gardenhire – Test Bank

Chapter 05: Central and Peripheral Nervous Systems

Gardenhire: Rau’s Respiratory Care Pharmacology, 9th Edition

MULTIPLE CHOICE

1. The somatic portion of the nervous system controls which of the following?

a.

Heart muscle

b.

Glandular secretion

c.

Skeletal muscle

d.

Smooth airway muscle

ANS: C

Heart muscle is under autonomic control. Glandular secretion and smooth airway muscle are controlled by the autonomic nervous system. Skeletal muscle (used for such motor actions as lifting, walking, and breathing) is under conscious control by the somatic portion of the nervous system.

REF: p. 78

2. How is the neurotransmitter acetylcholine inactivated at the parasympathetic terminal receptor site?

a.

By the enzyme catechol O-methyltransferase (COMT)

b.

By the reuptake process

c.

By the enzyme cholinesterase

d.

By the enzyme monoamine oxidase (MAO)

ANS: C

The enzymes COMT and MAO inactivate catecholamines such as epinephrine. The reuptake process terminates norepinephrine and sympathetic transmission. Cholinesterase inactivates the neurotransmitter acetylcholine at the parasympathetic terminal receptor site.

REF: p. 77 | p. 80

3. You administer an inhaled bronchodilator that is known to have adrenergic side effects. What cardiovascular clinical effect should you watch for in your patient?

a.

Bradycardia

b.

Tachycardia

c.

Bradypnea

d.

Tachypnea

ANS: B

The adrenergic effect on the heart is excitatory, leading to an increase in heart rate. The muscles of respiration are under somatic control.

REF: p. 86

4. Following administration of a dose of atropine to your patient, which of the following effects are not likely to occur?

a.

Dry mouth

b.

Decreased mucus production

c.

Bronchial constriction

d.

Increased heart rate

ANS: C

As a parasympatholytic agent, atropine blocks salivary secretion and causes dry mouth. Atropine also blocks the parasympathetically maintained basal tone of bronchial smooth muscle and would produce an expected relaxation of bronchial smooth muscle. Atropine has a parasympatholytic effect on the mucous glands, decreasing mucus production, and blocks vagal innervation of the heart to produce an increased heart rate.

REF: p. 82

5. As a practitioner, you would expect which parts of the physical examination to be affected by a dose of atropine or other parasympatholytic agent?

a.

Gastrointestinal examination

b.

Neurologic examination

c.

Cardiac examination

d.

All of the above

ANS: D

Atropine decreases the tone and mobility of the gastrointestinal tract and causes pupillary dilation (mydriasis), which could lead an unknowing practitioner to suspect head injury, brain infarct, or some other type of detrimental process. Atropine increases the heart rate by blocking vagal innervation and may cause a patient to present with drug-induced tachycardia.

REF: p. 84 | p. 85

6. What is the adrenergic effect on bronchial smooth muscle?

a.

Constriction

b.

Dilation (relaxation)

c.

Both

d.

Neither

ANS: B

The effect of sympathetic (adrenergic) stimulation of the bronchi is relaxation and dilation of airway diameter.

REF: p. 85

7. Your patient is accidentally given a large dose of a parasympathomimetic drug. What side effects of parasympathetic overstimulation do you expect to see?

1. Salivation

2. Lacrimation

3. Urination

4. Defecation

a.

1 only

b.

1 and 2 only

c.

1, 2, and 3 only

d.

1, 2, 3, and 4

ANS: D

Overstimulation of the parasympathetic branch would render the body incapable of violent action and would result in what is termed the SLUD syndrome: salivation, lacrimation, urination, and defecation.

REF: p. 78 | p. 79

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