ARIZONA COLLEGE OF NURSING
NUR 354 - PHARMACOLOGY II
EXAM 1 - 2026
Student Name:
Date: ____________________
__________________________________
Score: __________ / 50 Grade: __________________
1. An older adult is experiencing the expected effects of parasympathetic stimulation. Which
assessment finding best reflects the “rest and digest” response described in the review materials?
A. Increased blood pressure with pupil dilation and reduced bladder contraction
B. A lower heart rate with increased peristalsis and bladder contraction
C. Dilated pupils with increased heart rate and urine retention
D. Bronchodilation with decreased peristalsis and increased blood glucose
✓ Correct Answer: B. A lower heart rate with increased peristalsis and bladder contraction
Rationale: The review describes the parasympathetic response as rest and digest: pupils contract, heart rate
lowers, peristalsis increases, and the bladder contracts.
2. A postoperative client has nonobstructive urinary retention. Which medication should the nurse
expect to administer based on the Exam 1 materials?
A. Oxybutynin
B. Bethanechol
C. Dicyclomine
D. Benztropine
✓ Correct Answer: B. Bethanechol
Rationale: Bethanechol is identified as a direct-acting cholinergic medication that stimulates bladder smooth
muscle and is used for nonobstructive urinary retention, including after anesthesia.
3. A client receives bethanechol. Which finding should the nurse recognize as an expected adverse
effect that requires monitoring?
A. Urinary retention with constipation
B. Hypertension with dry mouth
C. Tachycardia with decreased bowel sounds
D. Hypotension with increased salivation and sweating
✓ Correct Answer: D. Hypotension with increased salivation and sweating
Rationale: The uploaded materials list increased salivation, sweating, abdominal cramping, and hypotension as
effects of bethanechol and direct the nurse to monitor blood pressure and heart rate.
4. A client taking a cholinergic medication develops bradycardia, muscle weakness, excessive
salivation, sweating, and abdominal cramping. Which complication is most consistent with these
findings?
A. Malignant hyperthermia
B. Cholinergic crisis
C. Anticholinergic toxicity
D. Neuroleptic malignant syndrome
✓ Correct Answer: B. Cholinergic crisis
Rationale: The review defines cholinergic crisis as too much acetylcholine and lists bradycardia, muscle
weakness or twitching, sweating or tearing, hypersalivation, and abdominal cramping among the manifestations.
, 5. Which medication should the nurse anticipate for a client experiencing a cholinergic crisis?
A. Phentolamine
B. Physostigmine
C. Atropine
D. Flumazenil
✓ Correct Answer: C. Atropine
Rationale: The course materials repeatedly identify atropine, an anticholinergic, as the treatment or antidote for
cholinergic crisis.
6. A client with myasthenia gravis is prescribed a medication to improve skeletal muscle strength.
Which medication is emphasized in the Exam 1 materials?
A. Oxybutynin
B. Phenobarbital
C. Clonidine
D. Pyridostigmine
✓ Correct Answer: D. Pyridostigmine
Rationale: Pyridostigmine is listed as an acetylcholinesterase inhibitor used for myasthenia gravis that increases
acetylcholine and improves muscle strength.
7. A client develops delirium and other manifestations of anticholinergic toxicity after receiving an
anticholinergic medication. Which reversal agent should the nurse expect?
A. Dantrolene
B. Flumazenil
C. Atropine
D. Physostigmine
✓ Correct Answer: D. Physostigmine
Rationale: Physostigmine is identified in the uploaded reviews as an indirect cholinesterase inhibitor used to
reverse anticholinergic toxicity or delirium.
8. A client reports urinary urgency and frequent voiding from an overactive bladder. Which medication
from the review is most appropriate?
A. Bethanechol
B. Donepezil
C. Oxybutynin
D. Pyridostigmine
✓ Correct Answer: C. Oxybutynin
Rationale: The Exam 1 review specifically links oxybutynin, an anticholinergic, with treatment of overactive
bladder.
9. The nurse reviews a new prescription for dicyclomine. Which client condition in the uploaded
material supports this prescription?
A. Parkinson disease
B. Status epilepticus
C. Irritable bowel syndrome
D. Septic shock
✓ Correct Answer: C. Irritable bowel syndrome
Rationale: Dicyclomine (Bentyl) is listed in the Exam 1 materials as an anticholinergic medication used for IBS.
NUR 354 - PHARMACOLOGY II
EXAM 1 - 2026
Student Name:
Date: ____________________
__________________________________
Score: __________ / 50 Grade: __________________
1. An older adult is experiencing the expected effects of parasympathetic stimulation. Which
assessment finding best reflects the “rest and digest” response described in the review materials?
A. Increased blood pressure with pupil dilation and reduced bladder contraction
B. A lower heart rate with increased peristalsis and bladder contraction
C. Dilated pupils with increased heart rate and urine retention
D. Bronchodilation with decreased peristalsis and increased blood glucose
✓ Correct Answer: B. A lower heart rate with increased peristalsis and bladder contraction
Rationale: The review describes the parasympathetic response as rest and digest: pupils contract, heart rate
lowers, peristalsis increases, and the bladder contracts.
2. A postoperative client has nonobstructive urinary retention. Which medication should the nurse
expect to administer based on the Exam 1 materials?
A. Oxybutynin
B. Bethanechol
C. Dicyclomine
D. Benztropine
✓ Correct Answer: B. Bethanechol
Rationale: Bethanechol is identified as a direct-acting cholinergic medication that stimulates bladder smooth
muscle and is used for nonobstructive urinary retention, including after anesthesia.
3. A client receives bethanechol. Which finding should the nurse recognize as an expected adverse
effect that requires monitoring?
A. Urinary retention with constipation
B. Hypertension with dry mouth
C. Tachycardia with decreased bowel sounds
D. Hypotension with increased salivation and sweating
✓ Correct Answer: D. Hypotension with increased salivation and sweating
Rationale: The uploaded materials list increased salivation, sweating, abdominal cramping, and hypotension as
effects of bethanechol and direct the nurse to monitor blood pressure and heart rate.
4. A client taking a cholinergic medication develops bradycardia, muscle weakness, excessive
salivation, sweating, and abdominal cramping. Which complication is most consistent with these
findings?
A. Malignant hyperthermia
B. Cholinergic crisis
C. Anticholinergic toxicity
D. Neuroleptic malignant syndrome
✓ Correct Answer: B. Cholinergic crisis
Rationale: The review defines cholinergic crisis as too much acetylcholine and lists bradycardia, muscle
weakness or twitching, sweating or tearing, hypersalivation, and abdominal cramping among the manifestations.
, 5. Which medication should the nurse anticipate for a client experiencing a cholinergic crisis?
A. Phentolamine
B. Physostigmine
C. Atropine
D. Flumazenil
✓ Correct Answer: C. Atropine
Rationale: The course materials repeatedly identify atropine, an anticholinergic, as the treatment or antidote for
cholinergic crisis.
6. A client with myasthenia gravis is prescribed a medication to improve skeletal muscle strength.
Which medication is emphasized in the Exam 1 materials?
A. Oxybutynin
B. Phenobarbital
C. Clonidine
D. Pyridostigmine
✓ Correct Answer: D. Pyridostigmine
Rationale: Pyridostigmine is listed as an acetylcholinesterase inhibitor used for myasthenia gravis that increases
acetylcholine and improves muscle strength.
7. A client develops delirium and other manifestations of anticholinergic toxicity after receiving an
anticholinergic medication. Which reversal agent should the nurse expect?
A. Dantrolene
B. Flumazenil
C. Atropine
D. Physostigmine
✓ Correct Answer: D. Physostigmine
Rationale: Physostigmine is identified in the uploaded reviews as an indirect cholinesterase inhibitor used to
reverse anticholinergic toxicity or delirium.
8. A client reports urinary urgency and frequent voiding from an overactive bladder. Which medication
from the review is most appropriate?
A. Bethanechol
B. Donepezil
C. Oxybutynin
D. Pyridostigmine
✓ Correct Answer: C. Oxybutynin
Rationale: The Exam 1 review specifically links oxybutynin, an anticholinergic, with treatment of overactive
bladder.
9. The nurse reviews a new prescription for dicyclomine. Which client condition in the uploaded
material supports this prescription?
A. Parkinson disease
B. Status epilepticus
C. Irritable bowel syndrome
D. Septic shock
✓ Correct Answer: C. Irritable bowel syndrome
Rationale: Dicyclomine (Bentyl) is listed in the Exam 1 materials as an anticholinergic medication used for IBS.
