Answer to Question 1
B
The basic pharmacology of physostigmine is nearly identical to that of neostigmine, the exception being that physostigmine readily crosses membranes, including the blood-brain barrier. Neostigmine does not.
Physostigmine and neostigmine are both effective for treating poisoning by muscarinic blocking drugs.
Neither physostigmine nor neostigmine is devoid of side effects.
Physostigmine cannot reverse the effects of neuromuscular blockers.
Answer to Question 2
D
An overdose of a cholinesterase inhibitor can lead to respiratory depression, respiratory failure, and death secondary to neuromuscular blockade; therefore the nurse should prepare to place the patient on mechanical ventilation.
Physostigmine is not the primary treatment for cholinesterase overdose.
Succinylcholine is not the primary treatment for cholinesterase overdose.
Atropine can be used to reduce muscarinic stimulation after cholinesterase overdose, but it is not the first action the nurse should anticipate.