The nurse is preparing to administer a first dose of benztropine (Cogentin) to a patient diagnosed with parkinsonism. The nurse would notify the patient’s provider if the patient had a history of which condition?

Irritable bowel disease

Glaucoma

Asthma

Hypertension

Answer and Explanation

The Correct Answer is B

A) Irritable bowel disease: Benztropine is an anticholinergic medication that can reduce gastrointestinal motility, which might exacerbate constipation. However, irritable bowel disease (IBD) is not a contraindication for using benztropine. The drug is more likely to cause concern in conditions where smooth muscle relaxation could worsen symptoms of constipation, but it is not typically withheld due to IBD alone.

B) Glaucoma: Glaucoma, particularly narrow-angle glaucoma, is a contraindication for benztropine use. Benztropine, as an anticholinergic agent, can cause pupil dilation (mydriasis), which can increase intraocular pressure and worsen glaucoma. This is a critical concern for patients with glaucoma, and the healthcare provider should be notified before administering the drug.

C) Asthma: While benztropine can have mild anticholinergic effects that may cause dryness of the respiratory tract, it is not a contraindication for asthma. Beta-agonist inhalers are more commonly prescribed to manage bronchospasm, but the use of benztropine in asthma is not typically harmful unless the patient is experiencing severe respiratory distress. Asthma would not be a primary concern when administering this medication.

D) Hypertension: Benztropine does not directly affect blood pressure in a way that would be a concern for someone with hypertension. While it may cause some mild autonomic changes (like dry mouth or dizziness), hypertension is not a contraindication for the medication. Therefore, there is no specific need to notify the healthcare provider due to a history of hypertension.

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Correct Answer is C

Explanation

A) Proteins:
Proteins are generally too large to diffuse freely across the cell membrane. They require specific transport mechanisms, such as endocytosis or transport proteins, to move in and out of cells. The hydrophilic nature of most proteins further complicates their passage across the lipid bilayer.

B) Enzymes:
Like proteins, enzymes are large molecules that do not freely diffuse across cell membranes. Enzymes, being proteins, also need specialized transport mechanisms or need to be secreted or endocytosed to enter or exit cells.

C) Hormones:
Many hormones, particularly lipid-soluble ones like steroid hormones, can diffuse freely across the cell membrane. These hormones pass through the lipid bilayer due to their hydrophobic nature and bind to intracellular receptors, initiating cellular responses. However, water-soluble hormones (e.g., insulin) typically do not diffuse freely but interact with receptors on the cell surface.

D) Electrolytes:
Electrolytes (such as sodium, potassium, calcium, and chloride ions) are charged particles that cannot pass freely through the lipid bilayer due to the hydrophobic interior of the cell membrane. They require specific ion channels or transporters to move in and out of the cell. Diffusion of electrolytes is facilitated through these channels, but it is not a simple diffusion process as seen with small, uncharged molecules.

A. Stop taking the medication immediately. B. Increase fluid intake. C. Request another antidepressant. D. Notify the provider.

Correct Answer is B

Explanation

A) Stop taking the medication immediately: Abruptly stopping amitriptyline without the guidance of a healthcare provider can cause withdrawal symptoms and other complications. Discontinuing this medication should only be done under medical supervision.

B) Increase fluid intake: Amitriptyline can cause anticholinergic side effects such as dry mouth and constipation. Increasing fluid intake helps manage dry mouth by stimulating salivation and helps alleviate constipation by promoting bowel regularity.

C) Request another antidepressant: While amitriptyline can cause side effects like dry mouth and constipation, switching medications should not be the first step. These side effects are often manageable with lifestyle modifications, such as increasing fluid and fiber intake, and adjustments to the treatment plan can be considered if the symptoms are severe or persistent.

D) Notify the provider: While it is important for the nurse to document and inform the provider about any significant side effects, this instruction alone does not provide immediate relief to the patient. It is more appropriate to first recommend increasing fluid intake, and then the nurse can discuss with the provider if the symptoms persist or worsen.

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The nurse is preparing to administer a first dose of benztropine (Cogentin) to a patient diagnosed with parkinsonism. The nurse would notify the patient’s provider if the patient had a history of which condition?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What substance move freely in and out of a cell by diffusion?

Correct Answer is C

Explanation

A patient who is taking amitriptyline (Elavil) reports constipation and dry mouth. The nurse will give the patient which instruction?

Correct Answer is B

Explanation

An older patient exhibits a shuffling gait, lack of facial expression, and tremors at rest. The nurse will expect the provider to order which medication for this patient?

The nurse is preparing to administer a first dose of benztropine (Cogentin) to a patient diagnosed with parkinsonism. The nurse would notify the patient’s provider if the patient had a history of which condition?

A patient reports weakness of the extremities and diplopia. The nurse knows that these symptoms are characteristic of which condition?

The nurse administers a drug that causes vasoconstriction, contracted piloerection muscles, pupil dilation, closure of salivary sphincter, and male sexual emission. What receptor is the drug stimulating?

The nurse administers a drug that stimulate the parasympathetic nervous system. What physiologic response would indicate that the drug is working?

A patient is admitted to the emergency department in shock. Isoproterenol (Isuprel) is admitted. What would the nurse expect the effect of this drug would be?

A patient is taking aspirin to help prevent myocardial infarction and is experiencing moderate gastrointestinal upset. The nurse will contact the patient’s provider to discuss changing from aspirin to which drug?

A client primary care provider prescribed a B-adrenergic receptor blocker. Which of the following therapeutic effects do the client and care provider likely seek?