Cholinergic Agonists and Antagonists

NCLEX Practice Questions: Cholinergic Drugs

1. A nurse is preparing to administer Bethanechol Chloride to a patient with post-operative urinary retention. Which type of cholinergic drug is Bethanechol categorized as?

   • A) Indirect-acting cholinergic agonist
   • B) Direct-acting cholinergic agonist
   • C) Muscarinic antagonist
   • D) Acetylcholinesterase inhibitor
   • Answer: B. Bethanechol acts directly on cholinergic receptors to produce a tissue response, specifically stimulating the bladder to treat urinary retention.

2. A patient is receiving an indirect-acting cholinergic drug. The nurse understands that the mechanism of action for this medication is to:

   • A) Bind directly to nicotinic receptors to stimulate skeletal muscle.
   • B) Block the parasympathetic nervous system via muscarinic receptors.
   • C) Inhibit the enzyme cholinesterase, preventing the breakdown of acetylcholine.
   • D) Act as a sympathomimetic to increase heart rate.
   • Answer: C. Indirect-acting drugs inhibit cholinesterase, allows acetylcholine to accumulate in the synaptic cleft and continue binding to receptors.

3. Which physiological effect is a result of stimulating muscarinic receptors?

   • A) Relaxation of skeletal muscles
   • B) Contraction of skeletal muscles
   • C) Stimulation of smooth muscle in various organ systems
   • D) Inhibition of the parasympathetic nervous system
   • Answer: C. Muscarinic receptors are primarily responsible for stimulating smooth muscle tissues across various organ systems.

4. The nurse is teaching a student about parasympathomimetic drugs. Which statement by the student indicates a need for further teaching?

   • A) "These drugs mimic the actions of the parasympathetic nervous system."
   • B) "These drugs are also known as cholinergic agonists."
   • C) "These drugs inhibit the action of the neurotransmitter acetylcholine."
   • D) "These drugs can be classified as muscarinic agonists."
   • Answer: C. Parasympathomimetics mimic or stimulate the actions of acetylcholine; they do not inhibit it.

5. Which receptor type would a nurse expect a drug to target if the goal is to primary affect voluntary skeletal muscle movement?

   • A) Muscarinic receptors
   • B) Beta-2 receptors
   • C) Alpha-1 receptors
   • D) Nicotinic receptors
   • Answer: D. Nicotinic receptors primarily affect skeletal muscles, leading to muscular contraction.