NSG 318 Exam 2 – GCU Pharmacology – 2026 Actual Questions & Answers.
NSG 318 Exam 2 – GCU Pharmacology – 2026 Actual Questions & Answers
Each question includes the correct answer and a detailed rationale to reinforce
understanding and clinical application.
Exam 2 Blueprint Topics
Autonomic Nervous System Drugs (Cholinergic & Adrenergic
Agonists/Antagonists)
Central Nervous System Agents (Analgesics, Sedatives, Hypnotics,
Anticonvulsants)
Anti-infective Agents (Antibiotics, Antivirals, Antifungals)
Anti-inflammatory & Immunomodulating Drugs
Medication Administration & Safety
Adverse Effects & Drug Interactions
,Lifespan Considerations (Pediatric, Pregnancy, Geriatric)
Questions 1-20: Autonomic Nervous System – Cholinergic Agonists
Question 1
A patient has been prescribed bethanechol (Urecholine) for postoperative urinary
retention. The nurse understands that this drug works by:
A) Blocking adrenergic receptors in the bladder
B) Stimulating nicotinic receptors in skeletal muscle
C) Directly activating muscarinic receptors on the detrusor muscle
D) Inhibiting acetylcholinesterase to increase acetylcholine levels
Answer: C
Rationale: Bethanechol is a direct-acting cholinergic agonist that selectively
stimulates muscarinic receptors, particularly on the detrusor muscle of the
bladder, causing contraction and promoting voiding . It does not act on nicotinic
receptors, nor is it an anticholinesterase (indirect-acting) or adrenergic blocker.
Question 2
,A nurse is assessing a patient receiving a cholinergic agonist. Which finding
indicates a therapeutic effect?
A) Increased heart rate
B) Decreased urinary output
C) Increased gastrointestinal motility
D) Dilated pupils
Answer: C
Rationale: Cholinergic agonists stimulate the parasympathetic nervous system
("rest and digest"), which increases GI motility and peristalsis . Therapeutic effects
include treating urinary retention, gastric atony, and glaucoma. Tachycardia,
urinary retention, and mydriasis (dilated pupils) are anticholinergic effects, not
cholinergic effects.
Question 3
A patient with myasthenia gravis is prescribed neostigmine. The nurse explains
that this medication works by:
A) Directly stimulating nicotinic receptors at the neuromuscular junction
B) Blocking acetylcholine receptors to prevent overstimulation
C) Inhibiting acetylcholinesterase to increase acetylcholine availability
D) Promoting the release of norepinephrine from nerve terminals
, Answer: C
Rationale: Neostigmine is an indirect-acting cholinergic agonist (cholinesterase
inhibitor) that prevents the breakdown of acetylcholine, making more
acetylcholine available at nicotinic receptors . This improves neuromuscular
transmission and muscle strength in myasthenia gravis.
Question 4
A nurse should question the use of bethanechol in which patient?
A) A patient with postoperative urinary retention
B) A patient with neurogenic bladder
C) A patient with peptic ulcer disease
D) A patient with urinary obstruction from an enlarged prostate
Answer: D
Rationale: Bethanechol is contraindicated in patients with urinary obstruction
(e.g., BPH) because increased bladder contractions could worsen obstruction and
cause bladder rupture . It is also contraindicated in peptic ulcer disease (can
exacerbate ulcers) and asthma (can cause bronchoconstriction).
Question 5
NSG 318 Exam 2 – GCU Pharmacology – 2026 Actual Questions & Answers
Each question includes the correct answer and a detailed rationale to reinforce
understanding and clinical application.
Exam 2 Blueprint Topics
Autonomic Nervous System Drugs (Cholinergic & Adrenergic
Agonists/Antagonists)
Central Nervous System Agents (Analgesics, Sedatives, Hypnotics,
Anticonvulsants)
Anti-infective Agents (Antibiotics, Antivirals, Antifungals)
Anti-inflammatory & Immunomodulating Drugs
Medication Administration & Safety
Adverse Effects & Drug Interactions
,Lifespan Considerations (Pediatric, Pregnancy, Geriatric)
Questions 1-20: Autonomic Nervous System – Cholinergic Agonists
Question 1
A patient has been prescribed bethanechol (Urecholine) for postoperative urinary
retention. The nurse understands that this drug works by:
A) Blocking adrenergic receptors in the bladder
B) Stimulating nicotinic receptors in skeletal muscle
C) Directly activating muscarinic receptors on the detrusor muscle
D) Inhibiting acetylcholinesterase to increase acetylcholine levels
Answer: C
Rationale: Bethanechol is a direct-acting cholinergic agonist that selectively
stimulates muscarinic receptors, particularly on the detrusor muscle of the
bladder, causing contraction and promoting voiding . It does not act on nicotinic
receptors, nor is it an anticholinesterase (indirect-acting) or adrenergic blocker.
Question 2
,A nurse is assessing a patient receiving a cholinergic agonist. Which finding
indicates a therapeutic effect?
A) Increased heart rate
B) Decreased urinary output
C) Increased gastrointestinal motility
D) Dilated pupils
Answer: C
Rationale: Cholinergic agonists stimulate the parasympathetic nervous system
("rest and digest"), which increases GI motility and peristalsis . Therapeutic effects
include treating urinary retention, gastric atony, and glaucoma. Tachycardia,
urinary retention, and mydriasis (dilated pupils) are anticholinergic effects, not
cholinergic effects.
Question 3
A patient with myasthenia gravis is prescribed neostigmine. The nurse explains
that this medication works by:
A) Directly stimulating nicotinic receptors at the neuromuscular junction
B) Blocking acetylcholine receptors to prevent overstimulation
C) Inhibiting acetylcholinesterase to increase acetylcholine availability
D) Promoting the release of norepinephrine from nerve terminals
, Answer: C
Rationale: Neostigmine is an indirect-acting cholinergic agonist (cholinesterase
inhibitor) that prevents the breakdown of acetylcholine, making more
acetylcholine available at nicotinic receptors . This improves neuromuscular
transmission and muscle strength in myasthenia gravis.
Question 4
A nurse should question the use of bethanechol in which patient?
A) A patient with postoperative urinary retention
B) A patient with neurogenic bladder
C) A patient with peptic ulcer disease
D) A patient with urinary obstruction from an enlarged prostate
Answer: D
Rationale: Bethanechol is contraindicated in patients with urinary obstruction
(e.g., BPH) because increased bladder contractions could worsen obstruction and
cause bladder rupture . It is also contraindicated in peptic ulcer disease (can
exacerbate ulcers) and asthma (can cause bronchoconstriction).
Question 5
