NURS 251 Module 3 Exam V2 | NURS 251
Module 3 Exam – Pharmacology | Portage |
Q&A with Rationale (Portage NURS 251
Module 3 Exam)
1. A patient is prescribed Bethanechol (Urecholine) for postoperative urinary retention.
Which physiological response should the nurse anticipate?
A. Increased heart rate and force of contraction
B. Decreased gastric secretions and motility
C. Relaxation of the bladder trigone and sphincter muscles
D. Mydriasis (pupillary dilation)
Answer: C
Rationale: Bethanechol is a muscarinic agonist that acts directly on the parasympathetic
nervous system. It increases the tone of the detrusor muscle and causes relaxation of the
bladder sphincter, facilitating urination. The nurse must monitor for parasympathetic side
effects such as bradycardia and increased salivation.
2. A patient is receiving Atropine preoperatively to reduce secretions. Which condition in the
patient’s medical history would be a contraindication for this drug?
A. Gastroesophageal reflux disease (GERD)
B. Hypothyroidism
,C. Hypotension
D. Glaucoma (narrow-angle)
Answer: D
Rationale: Atropine is an anticholinergic medication that causes pupillary dilation
(mydriasis). In patients with narrow-angle glaucoma, this can lead to an acute increase in
intraocular pressure by blocking the outflow of aqueous humor. Therefore, Atropine and
other muscarinic antagonists are strictly contraindicated in these patients.
3. Which adrenergic receptor is primarily responsible for increasing the force and rate of
myocardial contraction?
A. Alpha-1
B. Beta-1
C. Alpha-2
D. Beta-2
Answer: B
Rationale: Beta-1 receptors are predominantly located in the heart and kidneys.
Stimulation of these receptors leads to increased heart rate (positive chronotropic effect)
and increased contractility (positive inotropic effect). This is a critical mechanism in the
treatment of heart failure and cardiogenic shock.
, 4. A patient arrives in the ER with anaphylactic shock. The nurse prepares to administer
Epinephrine. How does Epinephrine help treat anaphylaxis?
A. Alpha-1 mediated vasoconstriction helps increase blood pressure
B. Beta-2 mediated vasoconstriction in the lungs
C. Beta-1 mediated bronchodilation
D. Alpha-2 mediated increase in cardiac output
Answer: A
Rationale: Epinephrine is a non-selective adrenergic agonist that activates Alpha-1, Alpha-
2, Beta-1, and Beta-2 receptors. Alpha-1 activation causes vasoconstriction, which reverses
the severe hypotension seen in anaphylaxis. Simultaneously, Beta-2 activation causes
bronchodilation to relieve airway obstruction.
5. A patient with asthma requires a medication for hypertension. Which of the following
drugs would be the SAFEST choice?
A. Propranolol
B. Metoprolol
C. Nadolol
D. Timolol
Answer: B
Module 3 Exam – Pharmacology | Portage |
Q&A with Rationale (Portage NURS 251
Module 3 Exam)
1. A patient is prescribed Bethanechol (Urecholine) for postoperative urinary retention.
Which physiological response should the nurse anticipate?
A. Increased heart rate and force of contraction
B. Decreased gastric secretions and motility
C. Relaxation of the bladder trigone and sphincter muscles
D. Mydriasis (pupillary dilation)
Answer: C
Rationale: Bethanechol is a muscarinic agonist that acts directly on the parasympathetic
nervous system. It increases the tone of the detrusor muscle and causes relaxation of the
bladder sphincter, facilitating urination. The nurse must monitor for parasympathetic side
effects such as bradycardia and increased salivation.
2. A patient is receiving Atropine preoperatively to reduce secretions. Which condition in the
patient’s medical history would be a contraindication for this drug?
A. Gastroesophageal reflux disease (GERD)
B. Hypothyroidism
,C. Hypotension
D. Glaucoma (narrow-angle)
Answer: D
Rationale: Atropine is an anticholinergic medication that causes pupillary dilation
(mydriasis). In patients with narrow-angle glaucoma, this can lead to an acute increase in
intraocular pressure by blocking the outflow of aqueous humor. Therefore, Atropine and
other muscarinic antagonists are strictly contraindicated in these patients.
3. Which adrenergic receptor is primarily responsible for increasing the force and rate of
myocardial contraction?
A. Alpha-1
B. Beta-1
C. Alpha-2
D. Beta-2
Answer: B
Rationale: Beta-1 receptors are predominantly located in the heart and kidneys.
Stimulation of these receptors leads to increased heart rate (positive chronotropic effect)
and increased contractility (positive inotropic effect). This is a critical mechanism in the
treatment of heart failure and cardiogenic shock.
, 4. A patient arrives in the ER with anaphylactic shock. The nurse prepares to administer
Epinephrine. How does Epinephrine help treat anaphylaxis?
A. Alpha-1 mediated vasoconstriction helps increase blood pressure
B. Beta-2 mediated vasoconstriction in the lungs
C. Beta-1 mediated bronchodilation
D. Alpha-2 mediated increase in cardiac output
Answer: A
Rationale: Epinephrine is a non-selective adrenergic agonist that activates Alpha-1, Alpha-
2, Beta-1, and Beta-2 receptors. Alpha-1 activation causes vasoconstriction, which reverses
the severe hypotension seen in anaphylaxis. Simultaneously, Beta-2 activation causes
bronchodilation to relieve airway obstruction.
5. A patient with asthma requires a medication for hypertension. Which of the following
drugs would be the SAFEST choice?
A. Propranolol
B. Metoprolol
C. Nadolol
D. Timolol
Answer: B
