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Nondepolarizing NMJ blockers: A) Antagonize ACh to prevent depolarization of muscle cells B) Act as agonists of ACh, leading to depolarization of muscle cells C) Prevent the repolarization of muscle cells D) Are associated with painful muscle contractions on administration - ANS-A Curare is used as a poison on arrow tips in some cultures. Curare: A) Is a depolarizing NMJ blocker B) Causes muscle paralysis in the brain C) Is not affected by cooking D) Has no clinical use today - ANS-C Succinylcholine as a more rapid onset of action and a shorter duration of activity than the nondepolarizing NMJ blockers because it: A) Does not bind well to receptor sites B) Rapidly crosses the blood brain barrier and is lost C) Is broken down by acetylcholinesterase that is found in the plasma D) Is very unstable - ANS-C When planning the care of a pt who is to receive an NMJ blocker the nurse would expect which of the following about the pt? A) Transfer to an ICU would be essential B) Intubation would be necessary to maintain respirations C) He would have no memory of any events D) No adverse effects would occur after the drug is stopped - ANS-B Malignant hyperthermia can occur with any NMJ blocker, but it most often occurs with Succinylcholine. The nurse would expect to see which drug ordered? A) Phenobarbital B) Pancuronium C) Dantrolene D) Diazepam - ANS-C Pt recovery from an NMJ blocker: A) Is predictable, based on the drug given B) Can be affected by genetic enzyme deficiency C) Can always be ensured because of the drug half-life D) Can be shortened by administration of oxygen - ANS-B When preparing NMJ blockers for administration, it is important that they: A) Are not mixed in any alkaline solutions B) Are not exposed to light C) Are not mixed with any other drug D) Are not mixed with Heparin - ANS-A SATA. The nurse would expect to administration of an NMJ blocker as the drug of choice to accomplish which of the following? A) Facilitate endotracheal intubation B) Facilitate mechanical ventilation C) Prevent injury during electroconvulsive therapy D) Relieve pain during labor and delivery E) Treat myasthenia gravis F) Treat a pt with a history of malignant hyperthermia - ANS-A B C Which neuromuscular blocking agent would a nurse expect to have the shortest duration of action? A) Rocuronium B) Atracurium C) Succinylcholine D) Vecuronium - ANS-C The perioperative nurse ensures that a cholinesterase inhibitor is readily available for pts who are receiving an NMJ blocker. This will help the care team to: A) Treat malignant hyperthermia promptly B) Treat adverse effects of NMJ blockers as they arise C) Overcome excessive neuromuscular blockade, if needed D) Resolve the excessive sedation caused by NMJ blockers - ANS-C What drug, if taken by the pt, would indicate a need for a decrease in dosage of a nondepolarizing NMJ blocker? A) Cholinesterase inhibitor B) Aminoglycoside antibiotic C) Opioid analgesic D) Penicillin - ANS-B Based on the nurse's understanding of the adverse effects associated with Succinylcholine and the development of muscle pain, the nurse would expect what drug to be administered before administering Succinylcholine? A) Valium B) Nitrous oxide C) Hydromorphone D) Nondepolarizing NMJ blocker - ANS-D When reviewing the history of a pt who is to receive Succinylcholine, the nurse would expect a prolonged drug action if the pt has a history of what condition? A) Spinal cord injury B) Cesarean deliver C) Cirrhosis D) Fractures - ANS-C A pt is ambulating, which requires multiple coordinated muscle contractions. According to the sliding filament theory of muscle contraction, what action will take place during muscle contraction? A) Acetylcholine will interact with muscarinic receptors B) Calcium will combine with Troponin
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