, NSG 318 Exam 2 – NGN Questions and
Case Scenarios (Guarantee Pass)
Table of Contents
NSG 318 EXAM 2
NSG 318 EXAM 2 STUDY GUIDE
NSG 318 EXAM 2
1. A patient is prescribed bethanechol for urinary retention. Which assessment
finding would contraindicate administration?
• A. Blood pressure 142/88 mmHg
• B. Heart rate 72 beats/min
• C. Blood pressure 98/62 mmHg
• D. Respiratory rate 16 breaths/min
Answer: C
Rationale: Bethanechol is contraindicated in patients with hypotension as it causes
vasodilation and can further decrease blood pressure. Other contraindications include
intestinal obstruction, peptic ulcer, asthma, and bradycardia .
2. The nurse is teaching a patient about bethanechol. Which statement by the
patient indicates understanding?
• A. "I should take this medication with meals to prevent stomach upset."
• B. "This medication will help me empty my bladder completely."
• C. "I can stop taking this medication when my symptoms improve."
• D. "This medication works by blocking nerve impulses to my bladder."
,Answer: B
Rationale: Bethanechol is a cholinergic agonist that stimulates the parasympathetic
nervous system, contracting the detrusor muscle and promoting bladder emptying. It
should be taken on an empty stomach to avoid nausea .
3. A patient receiving bethanechol reports wheezing and shortness of breath.
What is the nurse's priority action?
• A. Administer albuterol inhaler
• B. Discontinue the medication and notify the provider
• C. Slow the infusion rate
• D. Place the patient in high Fowler's position
Answer: B
Rationale: Bethanechol can cause bronchoconstriction by stimulating muscarinic
receptors in the lungs. Wheezing and shortness of breath indicate a severe adverse
reaction requiring immediate discontinuation and provider notification .
4. Pilocarpine is prescribed for a patient with glaucoma. What is the mechanism of
action of this medication?
• A. Blocks beta-adrenergic receptors in the eye
• B. Stimulates cholinergic receptors, causing pupil constriction
• C. Inhibits carbonic anhydrase to reduce aqueous humor production
• D. Blocks alpha-adrenergic receptors to reduce intraocular pressure
Answer: B
Rationale: Pilocarpine is a direct-acting cholinergic agonist that stimulates muscarinic
receptors in the eye, causing miosis (pupil constriction) and lowering intraocular
pressure by improving aqueous humor outflow .
, 5. A patient with myasthenia gravis is prescribed neostigmine. What is the
expected therapeutic effect?
• A. Decreased heart rate
• B. Increased muscle strength
• C. Increased urinary output
• D. Decreased salivation
Answer: B
Rationale: Neostigmine is a cholinesterase inhibitor that prevents the breakdown of
acetylcholine at the neuromuscular junction, increasing nerve transmission and skeletal
muscle activation, thereby improving muscle strength in myasthenia gravis .
6. A patient on neostigmine therapy reports excessive salivation, diarrhea, and
muscle cramps. What complication should the nurse suspect?
• A. Drug allergy
• B. Cholinergic crisis
• C. Myasthenic crisis
• D. Anaphylactic reaction
Answer: B
Rationale: Cholinergic crisis results from excessive stimulation of cholinergic receptors
due to cholinesterase inhibitor overdose. Symptoms include salivation, diarrhea, muscle
cramps, bradycardia, and respiratory distress. Atropine is the antidote .
7. The nurse is caring for a patient receiving bethanechol. Which side effect should
the nurse monitor for?
• A. Tachycardia
• B. Hypertension
• C. Bronchoconstriction
Case Scenarios (Guarantee Pass)
Table of Contents
NSG 318 EXAM 2
NSG 318 EXAM 2 STUDY GUIDE
NSG 318 EXAM 2
1. A patient is prescribed bethanechol for urinary retention. Which assessment
finding would contraindicate administration?
• A. Blood pressure 142/88 mmHg
• B. Heart rate 72 beats/min
• C. Blood pressure 98/62 mmHg
• D. Respiratory rate 16 breaths/min
Answer: C
Rationale: Bethanechol is contraindicated in patients with hypotension as it causes
vasodilation and can further decrease blood pressure. Other contraindications include
intestinal obstruction, peptic ulcer, asthma, and bradycardia .
2. The nurse is teaching a patient about bethanechol. Which statement by the
patient indicates understanding?
• A. "I should take this medication with meals to prevent stomach upset."
• B. "This medication will help me empty my bladder completely."
• C. "I can stop taking this medication when my symptoms improve."
• D. "This medication works by blocking nerve impulses to my bladder."
,Answer: B
Rationale: Bethanechol is a cholinergic agonist that stimulates the parasympathetic
nervous system, contracting the detrusor muscle and promoting bladder emptying. It
should be taken on an empty stomach to avoid nausea .
3. A patient receiving bethanechol reports wheezing and shortness of breath.
What is the nurse's priority action?
• A. Administer albuterol inhaler
• B. Discontinue the medication and notify the provider
• C. Slow the infusion rate
• D. Place the patient in high Fowler's position
Answer: B
Rationale: Bethanechol can cause bronchoconstriction by stimulating muscarinic
receptors in the lungs. Wheezing and shortness of breath indicate a severe adverse
reaction requiring immediate discontinuation and provider notification .
4. Pilocarpine is prescribed for a patient with glaucoma. What is the mechanism of
action of this medication?
• A. Blocks beta-adrenergic receptors in the eye
• B. Stimulates cholinergic receptors, causing pupil constriction
• C. Inhibits carbonic anhydrase to reduce aqueous humor production
• D. Blocks alpha-adrenergic receptors to reduce intraocular pressure
Answer: B
Rationale: Pilocarpine is a direct-acting cholinergic agonist that stimulates muscarinic
receptors in the eye, causing miosis (pupil constriction) and lowering intraocular
pressure by improving aqueous humor outflow .
, 5. A patient with myasthenia gravis is prescribed neostigmine. What is the
expected therapeutic effect?
• A. Decreased heart rate
• B. Increased muscle strength
• C. Increased urinary output
• D. Decreased salivation
Answer: B
Rationale: Neostigmine is a cholinesterase inhibitor that prevents the breakdown of
acetylcholine at the neuromuscular junction, increasing nerve transmission and skeletal
muscle activation, thereby improving muscle strength in myasthenia gravis .
6. A patient on neostigmine therapy reports excessive salivation, diarrhea, and
muscle cramps. What complication should the nurse suspect?
• A. Drug allergy
• B. Cholinergic crisis
• C. Myasthenic crisis
• D. Anaphylactic reaction
Answer: B
Rationale: Cholinergic crisis results from excessive stimulation of cholinergic receptors
due to cholinesterase inhibitor overdose. Symptoms include salivation, diarrhea, muscle
cramps, bradycardia, and respiratory distress. Atropine is the antidote .
7. The nurse is caring for a patient receiving bethanechol. Which side effect should
the nurse monitor for?
• A. Tachycardia
• B. Hypertension
• C. Bronchoconstriction
