Pharmacology | Galen College of Nursing |
2026/2027 Q&A Exam Prep PDF
NUR 210 - Exam 2: Autonomic Nervous System, Cardiovascular & Endocrine
Pharmacology
1. A patient with symptomatic bradycardia (heart rate 42 bpm) is about to receive atropine. The
nurse understands that this medication works by which mechanism?
A) Stimulating beta-1 adrenergic receptors directly
B) Blocking muscarinic receptors in the sinoatrial node
C) Inhibiting acetylcholinesterase
D) Stimulating nicotinic receptors in the autonomic ganglia
Correct Answer: B) Blocking muscarinic receptors in the sinoatrial node
Rationale: Atropine is a muscarinic antagonist (anticholinergic) that competitively blocks
acetylcholine at muscarinic receptors in the sinoatrial (SA) node. This reduces vagal tone,
allowing the SA node to fire more rapidly and increase heart rate. It does not stimulate beta
receptors or inhibit acetylcholinesterase.
,2. A patient with asthma is prescribed albuterol via metered-dose inhaler. The nurse explains
that this medication works by which mechanism?
A) Blocking beta-2 adrenergic receptors in bronchial smooth muscle
B) Stimulating beta-2 adrenergic receptors to cause bronchodilation
C) Blocking muscarinic receptors in the airways
D) Inhibiting mast cell degranulation
Correct Answer: B) Stimulating beta-2 adrenergic receptors to cause bronchodilation
Rationale: Albuterol is a beta-2 adrenergic agonist that stimulates beta-2 receptors in bronchial
smooth muscle, causing bronchodilation. It is a rescue medication for asthma. Beta blockers
(not agonists) block receptors; anticholinergics block muscarinic receptors; mast cell stabilizers
inhibit degranulation.
3. A patient with angina is prescribed nitroglycerin sublingually. Which instruction should the
nurse include?
A) "Swallow the tablet immediately."
B) "Place the tablet under your tongue and let it dissolve."
C) "Chew the tablet for faster absorption."
D) "Take the tablet with a full glass of water."
Correct Answer: B) "Place the tablet under your tongue and let it dissolve."
, Rationale: Sublingual nitroglycerin should be placed under the tongue and allowed to dissolve
for rapid absorption through the mucous membranes, bypassing first-pass metabolism. It should
not be swallowed, chewed, or taken with water.
4. A patient is prescribed digoxin for heart failure. Which finding indicates digoxin toxicity?
A) Heart rate of 72 beats per minute
B) Serum digoxin level of 1.2 ng/mL
C) Visual disturbances such as yellow-green halos
D) Serum potassium of 4.0 mEq/L
Correct Answer: C) Visual disturbances such as yellow-green halos
Rationale: Visual disturbances, including yellow-green halos around lights, are classic signs of
digoxin toxicity. Therapeutic range is 0.8-2.0 ng/mL; a level of 1.2 ng/mL is within range. A heart
rate of 72 and potassium of 4.0 are normal.
5. A patient with heart failure is prescribed furosemide (Lasix). The nurse should monitor for
which electrolyte imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hypermagnesemia
Correct Answer: B) Hypokalemia