Page 1 of 60
GCU – NSG 318 – PHARMACOLOGY – 2026
EXAM 3 COMPLETE (160) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES|GRADED A+.
PHARMACOLOGY
Below is a comprehensive 160- practice questions exam for GCU NSG 318
Pharmacology Exam 3. (multiple-choice A-D, correct answer with letter
and text, and explanation). The exam covers autonomic nervous system
drugs, CNS drugs (sedative-hypnotics, antidepressants, antipsychotics,
anticonvulsants), cardiovascular drugs, respiratory drugs, and GI drugs,
which are typical for a third pharmacology exam.
Multiple choice.
Section 1: Autonomic Nervous System – Cholinergic &
Anticholinergic Drugs (Questions 1–20)
1. A patient with myasthenia gravis is prescribed pyridostigmine
(Mestinon). The nurse understands that this drug works by:
A) Blocking acetylcholine receptors at the neuromuscular junction
B) Inhibiting acetylcholinesterase, increasing acetylcholine
availability
C) Directly stimulating nicotinic receptors
D) Increasing the release of acetylcholine from nerve terminals
Answer: B. Inhibiting acetylcholinesterase, increasing acetylcholine
availability
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Explanation: Pyridostigmine is a cholinesterase inhibitor that
prolongs the action of acetylcholine at the neuromuscular junction,
improving muscle strength.
2. A patient receiving atropine (an anticholinergic) preoperatively.
The nurse expects which effect?
A) Increased salivation
B) Bradycardia
C) Drying of respiratory secretions
D) Diarrhea
Answer: C. Drying of respiratory secretions
Explanation: Atropine blocks muscarinic receptors, reducing
salivation and respiratory secretions, which helps prevent aspiration
during anesthesia.
3. Which finding indicates a cholinergic crisis (overdose of
acetylcholinesterase inhibitor) in a patient with myasthenia gravis?
A) Muscle strength improvement
B) Excessive salivation, miosis, and bradycardia
C) Dry mouth and constipation
D) Tachycardia and hypertension
Answer: B. Excessive salivation, miosis, and bradycardia
Explanation: Cholinergic crisis results from too much
acetylcholine, causing muscarinic effects (salivation, sweating,
miosis, bradycardia) and nicotinic effects (fasciculations,
weakness).
4. The nurse administers neostigmine to a patient with
postoperative urinary retention. This drug works by:
A) Blocking parasympathetic activity
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B) Increasing bladder muscle contraction via acetylcholinesterase
inhibition
C) Relaxing the bladder sphincter
D) Decreasing bladder tone
Answer: B. Increasing bladder muscle contraction via
acetylcholinesterase inhibition
Explanation: Neostigmine increases acetylcholine at muscarinic
receptors, promoting bladder contraction and emptying.
5. A patient accidentally ingests a large amount of an
organophosphate insecticide. The nurse expects the provider to
order:
A) Atropine and pralidoxime (2-PAM)
B) Neostigmine
C) Epinephrine
D) Naloxone
Answer: A. Atropine and pralidoxime (2-PAM)
Explanation: Atropine blocks muscarinic effects, and pralidoxime
reactivates acetylcholinesterase. Organophosphates cause
cholinergic excess.
6. A patient is prescribed ipratropium bromide (Atrovent) for COPD.
This drug is classified as:
A) Short-acting beta agonist
B) Long-acting muscarinic antagonist (LAMA)
C) Anticholinergic (short-acting)
D) Corticosteroid
Answer: C. Anticholinergic (short-acting)
Explanation: Ipratropium is a short-acting muscarinic antagonist
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used for bronchodilation in COPD and asthma. Tiotropium is a
LAMA.
7. Which adverse effect is most commonly associated with
anticholinergic drugs such as atropine or oxybutynin?
A) Diarrhea
B) Urinary incontinence
C) Dry mouth and constipation
D) Tachycardia
Answer: C. Dry mouth and constipation
Explanation: Anticholinergics block muscarinic receptors, leading
to dry mouth, constipation, urinary retention, blurred vision, and
tachycardia.
8. A patient with overactive bladder is prescribed oxybutynin
(Ditropan). The nurse should teach the patient to:
A) Increase fluid intake to prevent dehydration
B) Avoid activities requiring mental alertness if drowsiness occurs
C) Take the medication with grapefruit juice
D) Expect immediate improvement in symptoms
Answer: B. Avoid activities requiring mental alertness if drowsiness
occurs
Explanation: Oxybutynin can cause CNS effects (drowsiness,
dizziness). Improvement takes several weeks.
9. A patient with Alzheimer’s disease is prescribed donepezil
(Aricept). The mechanism of action is:
A) Central acetylcholinesterase inhibition
B) Dopamine receptor blockade
GCU – NSG 318 – PHARMACOLOGY – 2026
EXAM 3 COMPLETE (160) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES|GRADED A+.
PHARMACOLOGY
Below is a comprehensive 160- practice questions exam for GCU NSG 318
Pharmacology Exam 3. (multiple-choice A-D, correct answer with letter
and text, and explanation). The exam covers autonomic nervous system
drugs, CNS drugs (sedative-hypnotics, antidepressants, antipsychotics,
anticonvulsants), cardiovascular drugs, respiratory drugs, and GI drugs,
which are typical for a third pharmacology exam.
Multiple choice.
Section 1: Autonomic Nervous System – Cholinergic &
Anticholinergic Drugs (Questions 1–20)
1. A patient with myasthenia gravis is prescribed pyridostigmine
(Mestinon). The nurse understands that this drug works by:
A) Blocking acetylcholine receptors at the neuromuscular junction
B) Inhibiting acetylcholinesterase, increasing acetylcholine
availability
C) Directly stimulating nicotinic receptors
D) Increasing the release of acetylcholine from nerve terminals
Answer: B. Inhibiting acetylcholinesterase, increasing acetylcholine
availability
, Page 2 of 60
Explanation: Pyridostigmine is a cholinesterase inhibitor that
prolongs the action of acetylcholine at the neuromuscular junction,
improving muscle strength.
2. A patient receiving atropine (an anticholinergic) preoperatively.
The nurse expects which effect?
A) Increased salivation
B) Bradycardia
C) Drying of respiratory secretions
D) Diarrhea
Answer: C. Drying of respiratory secretions
Explanation: Atropine blocks muscarinic receptors, reducing
salivation and respiratory secretions, which helps prevent aspiration
during anesthesia.
3. Which finding indicates a cholinergic crisis (overdose of
acetylcholinesterase inhibitor) in a patient with myasthenia gravis?
A) Muscle strength improvement
B) Excessive salivation, miosis, and bradycardia
C) Dry mouth and constipation
D) Tachycardia and hypertension
Answer: B. Excessive salivation, miosis, and bradycardia
Explanation: Cholinergic crisis results from too much
acetylcholine, causing muscarinic effects (salivation, sweating,
miosis, bradycardia) and nicotinic effects (fasciculations,
weakness).
4. The nurse administers neostigmine to a patient with
postoperative urinary retention. This drug works by:
A) Blocking parasympathetic activity
, Page 3 of 60
B) Increasing bladder muscle contraction via acetylcholinesterase
inhibition
C) Relaxing the bladder sphincter
D) Decreasing bladder tone
Answer: B. Increasing bladder muscle contraction via
acetylcholinesterase inhibition
Explanation: Neostigmine increases acetylcholine at muscarinic
receptors, promoting bladder contraction and emptying.
5. A patient accidentally ingests a large amount of an
organophosphate insecticide. The nurse expects the provider to
order:
A) Atropine and pralidoxime (2-PAM)
B) Neostigmine
C) Epinephrine
D) Naloxone
Answer: A. Atropine and pralidoxime (2-PAM)
Explanation: Atropine blocks muscarinic effects, and pralidoxime
reactivates acetylcholinesterase. Organophosphates cause
cholinergic excess.
6. A patient is prescribed ipratropium bromide (Atrovent) for COPD.
This drug is classified as:
A) Short-acting beta agonist
B) Long-acting muscarinic antagonist (LAMA)
C) Anticholinergic (short-acting)
D) Corticosteroid
Answer: C. Anticholinergic (short-acting)
Explanation: Ipratropium is a short-acting muscarinic antagonist
, Page 4 of 60
used for bronchodilation in COPD and asthma. Tiotropium is a
LAMA.
7. Which adverse effect is most commonly associated with
anticholinergic drugs such as atropine or oxybutynin?
A) Diarrhea
B) Urinary incontinence
C) Dry mouth and constipation
D) Tachycardia
Answer: C. Dry mouth and constipation
Explanation: Anticholinergics block muscarinic receptors, leading
to dry mouth, constipation, urinary retention, blurred vision, and
tachycardia.
8. A patient with overactive bladder is prescribed oxybutynin
(Ditropan). The nurse should teach the patient to:
A) Increase fluid intake to prevent dehydration
B) Avoid activities requiring mental alertness if drowsiness occurs
C) Take the medication with grapefruit juice
D) Expect immediate improvement in symptoms
Answer: B. Avoid activities requiring mental alertness if drowsiness
occurs
Explanation: Oxybutynin can cause CNS effects (drowsiness,
dizziness). Improvement takes several weeks.
9. A patient with Alzheimer’s disease is prescribed donepezil
(Aricept). The mechanism of action is:
A) Central acetylcholinesterase inhibition
B) Dopamine receptor blockade
