NUR 354 Pharmacology II —Exam 1 Comprehensive Review | Full Questions and Answers with
Rationales | 2026/2027 Updated | 100% Correct - Arizona College of Nursing.
Arizona College of Nursing | Modules 1–2 | 60 Questions with Answers &
Rationales
1. A nurse is reviewing the pathophysiology of Parkinson’s disease. Which
neurotransmitter imbalance is most closely associated with the disorder?
A. Increased dopamine and decreased acetylcholine
B. Decreased dopamine with relative excess acetylcholine activity
C. Increased serotonin and decreased norepinephrine
D. Decreased GABA and increased glutamate
Answer: B
Rationale: Parkinson’s disease is associated with progressive loss of dopaminergic neurons,
producing decreased dopamine activity and a relative cholinergic predominance. Many
medications attempt to restore the functional balance between dopamine and acetylcholine. This
is a central theme of the NUR 354 Exam 1 material. [studocu.com] - NUR354- Exam 1 …
2. A client with Parkinson’s disease is prescribed benztropine. Which mechanism best
explains its therapeutic effect?
A. Increasing acetylcholine release
B. Blocking central cholinergic activity
C. Stimulating dopamine breakdown
D. Increasing GABA activity
Answer: B
Rationale: Benztropine is an anticholinergic medication. By decreasing central cholinergic
activity, it helps restore the dopamine–acetylcholine balance and can reduce tremor and rigidity.
[studocu.com] - NUR354- Exam 1 …
3. Which client history should cause the nurse to question a prescription for benztropine?
A. Seasonal allergies
B. Narrow-angle glaucoma
C. Controlled hypothyroidism
D. Migraine headaches
,Answer: B
Rationale: Anticholinergic medications can increase intraocular pressure and are problematic in
narrow-angle glaucoma. Urinary retention, severe constipation, and prostatic obstruction are
other important concerns.
4. A client taking benztropine reports dry mouth and constipation. Which interpretation is
most appropriate?
A. These findings suggest cholinergic crisis.
B. These are characteristic anticholinergic effects.
C. These indicate severe renal toxicity.
D. These indicate dopamine toxicity.
Answer: B
Rationale: Anticholinergic effects commonly include dry mouth, blurred vision, constipation,
urinary retention, and tachycardia. Your NUR 354 guide repeatedly emphasizes this cluster.
[studocu.com] - NUR354- Exam 1 …
5. What is the primary role of levodopa in carbidopa/levodopa therapy?
A. It blocks dopamine receptors.
B. It crosses the blood-brain barrier and is converted to dopamine.
C. It directly blocks acetylcholine receptors.
D. It inhibits dopamine release.
Answer: B
Rationale: Dopamine itself does not effectively cross the blood-brain barrier. Levodopa does
and is subsequently converted to dopamine in the brain. DailyMed
6. Why is carbidopa combined with levodopa?
A. Carbidopa increases acetylcholine.
B. Carbidopa prevents peripheral conversion of levodopa to dopamine.
C. Carbidopa activates dopamine receptors directly.
D. Carbidopa blocks GABA receptors.
Answer: B
, Rationale: Carbidopa inhibits peripheral decarboxylation of levodopa, allowing more levodopa
to reach the CNS and reducing some peripheral adverse effects. DailyMed
7. A client receiving carbidopa/levodopa reports dark-colored urine. Which response is
most appropriate?
A. “This automatically indicates renal failure.”
B. “This can occur with the medication and is not necessarily harmful.”
C. “This proves that the dose is too low.”
D. “This indicates cholinergic crisis.”
Answer: B
Rationale: Darkening of urine, sweat, or saliva can occur with levodopa therapy. It should be
distinguished from findings indicating significant organ dysfunction. Your course review
specifically emphasizes this expected effect. [studocu.com] - NUR354- Exam 1 …
8. Which dietary factor can interfere with the clinical response to levodopa in some clients?
A. Protein
B. Vitamin C
C. Simple carbohydrates
D. Soluble fiber
Answer: A
Rationale: Levodopa competes with certain amino acids for intestinal transport, so high-protein
intake can reduce absorption in some patients. DailyMed
9. Which finding best suggests that carbidopa/levodopa therapy is effective?
A. Complete cure of Parkinson’s disease
B. Improved movement and decreased rigidity
C. Increased salivation
D. Development of bradycardia
Answer: B
Rationale: Carbidopa/levodopa provides symptomatic improvement, particularly in bradykinesia
and rigidity. It does not cure the underlying neurodegenerative disease.
Rationales | 2026/2027 Updated | 100% Correct - Arizona College of Nursing.
Arizona College of Nursing | Modules 1–2 | 60 Questions with Answers &
Rationales
1. A nurse is reviewing the pathophysiology of Parkinson’s disease. Which
neurotransmitter imbalance is most closely associated with the disorder?
A. Increased dopamine and decreased acetylcholine
B. Decreased dopamine with relative excess acetylcholine activity
C. Increased serotonin and decreased norepinephrine
D. Decreased GABA and increased glutamate
Answer: B
Rationale: Parkinson’s disease is associated with progressive loss of dopaminergic neurons,
producing decreased dopamine activity and a relative cholinergic predominance. Many
medications attempt to restore the functional balance between dopamine and acetylcholine. This
is a central theme of the NUR 354 Exam 1 material. [studocu.com] - NUR354- Exam 1 …
2. A client with Parkinson’s disease is prescribed benztropine. Which mechanism best
explains its therapeutic effect?
A. Increasing acetylcholine release
B. Blocking central cholinergic activity
C. Stimulating dopamine breakdown
D. Increasing GABA activity
Answer: B
Rationale: Benztropine is an anticholinergic medication. By decreasing central cholinergic
activity, it helps restore the dopamine–acetylcholine balance and can reduce tremor and rigidity.
[studocu.com] - NUR354- Exam 1 …
3. Which client history should cause the nurse to question a prescription for benztropine?
A. Seasonal allergies
B. Narrow-angle glaucoma
C. Controlled hypothyroidism
D. Migraine headaches
,Answer: B
Rationale: Anticholinergic medications can increase intraocular pressure and are problematic in
narrow-angle glaucoma. Urinary retention, severe constipation, and prostatic obstruction are
other important concerns.
4. A client taking benztropine reports dry mouth and constipation. Which interpretation is
most appropriate?
A. These findings suggest cholinergic crisis.
B. These are characteristic anticholinergic effects.
C. These indicate severe renal toxicity.
D. These indicate dopamine toxicity.
Answer: B
Rationale: Anticholinergic effects commonly include dry mouth, blurred vision, constipation,
urinary retention, and tachycardia. Your NUR 354 guide repeatedly emphasizes this cluster.
[studocu.com] - NUR354- Exam 1 …
5. What is the primary role of levodopa in carbidopa/levodopa therapy?
A. It blocks dopamine receptors.
B. It crosses the blood-brain barrier and is converted to dopamine.
C. It directly blocks acetylcholine receptors.
D. It inhibits dopamine release.
Answer: B
Rationale: Dopamine itself does not effectively cross the blood-brain barrier. Levodopa does
and is subsequently converted to dopamine in the brain. DailyMed
6. Why is carbidopa combined with levodopa?
A. Carbidopa increases acetylcholine.
B. Carbidopa prevents peripheral conversion of levodopa to dopamine.
C. Carbidopa activates dopamine receptors directly.
D. Carbidopa blocks GABA receptors.
Answer: B
, Rationale: Carbidopa inhibits peripheral decarboxylation of levodopa, allowing more levodopa
to reach the CNS and reducing some peripheral adverse effects. DailyMed
7. A client receiving carbidopa/levodopa reports dark-colored urine. Which response is
most appropriate?
A. “This automatically indicates renal failure.”
B. “This can occur with the medication and is not necessarily harmful.”
C. “This proves that the dose is too low.”
D. “This indicates cholinergic crisis.”
Answer: B
Rationale: Darkening of urine, sweat, or saliva can occur with levodopa therapy. It should be
distinguished from findings indicating significant organ dysfunction. Your course review
specifically emphasizes this expected effect. [studocu.com] - NUR354- Exam 1 …
8. Which dietary factor can interfere with the clinical response to levodopa in some clients?
A. Protein
B. Vitamin C
C. Simple carbohydrates
D. Soluble fiber
Answer: A
Rationale: Levodopa competes with certain amino acids for intestinal transport, so high-protein
intake can reduce absorption in some patients. DailyMed
9. Which finding best suggests that carbidopa/levodopa therapy is effective?
A. Complete cure of Parkinson’s disease
B. Improved movement and decreased rigidity
C. Increased salivation
D. Development of bradycardia
Answer: B
Rationale: Carbidopa/levodopa provides symptomatic improvement, particularly in bradykinesia
and rigidity. It does not cure the underlying neurodegenerative disease.
