NR-567 ADVANCED
PHARMACOLOGY
FOR ADULT-
GERONTOLOGY
ACUTE CARE –
PRACTICE EXAM
Section 1: Receptor Pharmacology & Vasoactive Agents
1. A patient in septic shock requires vasopressor support. The AGACNP selects
phenylephrine. Which receptor does phenylephrine primarily stimulate?
A. Beta-1 receptors only
B. Alpha-1 receptors only
C. Alpha-1 and beta-1 receptors
D. Beta-2 receptors only
,Rationale: Phenylephrine is a selective alpha-1 adrenergic agonist. Stimulation of alpha-
1 receptors causes vasoconstriction of arteries and veins, elevating blood pressure. It has
no significant beta-receptor activity .
2. A patient with cardiogenic shock requires an inotropic agent that increases
cardiac contractility without excessive chronotropy. The AGACNP selects
dobutamine. Which receptors does dobutamine primarily stimulate?
A. Alpha-1 only
B. Beta-1 primarily, with some beta-2 activity
C. Alpha-1 and alpha-2
D. Dopamine receptors only
Rationale: Dobutamine is a synthetic catecholamine that primarily stimulates beta-1
receptors, producing positive inotropic effects (increased contractility) with less
chronotropic effect than other agents. It is commonly used in cardiogenic shock and
acute decompensated heart failure .
3. A patient with acute decompensated heart failure and hypotension requires an
agent that provides both inotropic support and vasoconstriction. The AGACNP
selects norepinephrine. Which receptors does norepinephrine stimulate?
A. Beta-2 receptors only
B. Alpha-1, alpha-2, and beta-1 receptors
C. Dopamine receptors only
D. Alpha-1 and beta-2 receptors
Rationale: Norepinephrine stimulates alpha-1, alpha-2, and beta-1 receptors. Alpha-1
stimulation causes vasoconstriction, while beta-1 stimulation increases cardiac
contractility and heart rate. This makes it a first-line vasopressor in septic shock .
,4. A patient requires an agent that stimulates alpha-1, alpha-2, beta-1, and beta-2
receptors. Which medication is the AGACNP most likely to select?
A. Phenylephrine
B. Epinephrine
C. Dobutamine
D. Isoproterenol
Rationale: Epinephrine is a non-selective adrenergic agonist that stimulates alpha-1,
alpha-2, beta-1, and beta-2 receptors. It is used in cardiac arrest, anaphylaxis, and severe
shock states .
5. A patient with symptomatic bradycardia requires pharmacologic support. The
AGACNP considers isoproterenol. Which receptors does isoproterenol stimulate?
A. Alpha-1 and beta-1
B. Beta-1 and beta-2
C. Alpha-1 only
D. Dopamine receptors only
Rationale: Isoproterenol is a non-selective beta-adrenergic agonist that stimulates both
beta-1 and beta-2 receptors. Beta-1 stimulation increases heart rate and contractility,
while beta-2 stimulation causes bronchodilation and peripheral vasodilation .
6. Which of the following correctly describes the effects of alpha-1 receptor
stimulation?
A. Vasoconstriction of arteries and veins with elevation of blood pressure
B. Bronchodilation and increased heart rate
C. Decreased sympathetic outflow and pain relief
D. Increased heart rate and contractility
Rationale: Alpha-1 receptor stimulation causes vasoconstriction of arteries and veins,
leading to elevation of blood pressure. This is the primary mechanism of action for
vasopressors like phenylephrine .
, 7. A patient in shock receives an agent that stimulates alpha-2 receptors. What
effect would the AGACNP expect?
A. Increased heart rate and contractility
B. Decreased sympathetic outflow to the heart and vessels, with pain relief
C. Vasoconstriction and increased blood pressure
D. Bronchodilation and increased heart rate
Rationale: Alpha-2 receptor stimulation opposes the effects of the sympathetic nervous
system, producing inhibitory effects. This decreases sympathetic outflow to the heart
and vessels and provides pain relief. Alpha-2 agonists like clonidine and
dexmedetomidine work through this mechanism .
8. Which of the following is a beta-1 receptor effect?
A. Bronchodilation
B. Vasoconstriction
C. Positive inotrope and chronotrope, increasing heart rate and contractility
D. Uterine relaxation
Rationale: Beta-1 receptor stimulation produces positive inotropic (increased
contractility) and chronotropic (increased heart rate) effects, increasing cardiac output
and tissue perfusion. This is the primary mechanism of dobutamine and
norepinephrine's cardiac effects .
9. A patient with hyperthyroid crisis requires a non-selective beta-blocker. Which
medication is most appropriate?
A. Metoprolol
B. Propranolol
C. Labetalol
D. Carvedilol
PHARMACOLOGY
FOR ADULT-
GERONTOLOGY
ACUTE CARE –
PRACTICE EXAM
Section 1: Receptor Pharmacology & Vasoactive Agents
1. A patient in septic shock requires vasopressor support. The AGACNP selects
phenylephrine. Which receptor does phenylephrine primarily stimulate?
A. Beta-1 receptors only
B. Alpha-1 receptors only
C. Alpha-1 and beta-1 receptors
D. Beta-2 receptors only
,Rationale: Phenylephrine is a selective alpha-1 adrenergic agonist. Stimulation of alpha-
1 receptors causes vasoconstriction of arteries and veins, elevating blood pressure. It has
no significant beta-receptor activity .
2. A patient with cardiogenic shock requires an inotropic agent that increases
cardiac contractility without excessive chronotropy. The AGACNP selects
dobutamine. Which receptors does dobutamine primarily stimulate?
A. Alpha-1 only
B. Beta-1 primarily, with some beta-2 activity
C. Alpha-1 and alpha-2
D. Dopamine receptors only
Rationale: Dobutamine is a synthetic catecholamine that primarily stimulates beta-1
receptors, producing positive inotropic effects (increased contractility) with less
chronotropic effect than other agents. It is commonly used in cardiogenic shock and
acute decompensated heart failure .
3. A patient with acute decompensated heart failure and hypotension requires an
agent that provides both inotropic support and vasoconstriction. The AGACNP
selects norepinephrine. Which receptors does norepinephrine stimulate?
A. Beta-2 receptors only
B. Alpha-1, alpha-2, and beta-1 receptors
C. Dopamine receptors only
D. Alpha-1 and beta-2 receptors
Rationale: Norepinephrine stimulates alpha-1, alpha-2, and beta-1 receptors. Alpha-1
stimulation causes vasoconstriction, while beta-1 stimulation increases cardiac
contractility and heart rate. This makes it a first-line vasopressor in septic shock .
,4. A patient requires an agent that stimulates alpha-1, alpha-2, beta-1, and beta-2
receptors. Which medication is the AGACNP most likely to select?
A. Phenylephrine
B. Epinephrine
C. Dobutamine
D. Isoproterenol
Rationale: Epinephrine is a non-selective adrenergic agonist that stimulates alpha-1,
alpha-2, beta-1, and beta-2 receptors. It is used in cardiac arrest, anaphylaxis, and severe
shock states .
5. A patient with symptomatic bradycardia requires pharmacologic support. The
AGACNP considers isoproterenol. Which receptors does isoproterenol stimulate?
A. Alpha-1 and beta-1
B. Beta-1 and beta-2
C. Alpha-1 only
D. Dopamine receptors only
Rationale: Isoproterenol is a non-selective beta-adrenergic agonist that stimulates both
beta-1 and beta-2 receptors. Beta-1 stimulation increases heart rate and contractility,
while beta-2 stimulation causes bronchodilation and peripheral vasodilation .
6. Which of the following correctly describes the effects of alpha-1 receptor
stimulation?
A. Vasoconstriction of arteries and veins with elevation of blood pressure
B. Bronchodilation and increased heart rate
C. Decreased sympathetic outflow and pain relief
D. Increased heart rate and contractility
Rationale: Alpha-1 receptor stimulation causes vasoconstriction of arteries and veins,
leading to elevation of blood pressure. This is the primary mechanism of action for
vasopressors like phenylephrine .
, 7. A patient in shock receives an agent that stimulates alpha-2 receptors. What
effect would the AGACNP expect?
A. Increased heart rate and contractility
B. Decreased sympathetic outflow to the heart and vessels, with pain relief
C. Vasoconstriction and increased blood pressure
D. Bronchodilation and increased heart rate
Rationale: Alpha-2 receptor stimulation opposes the effects of the sympathetic nervous
system, producing inhibitory effects. This decreases sympathetic outflow to the heart
and vessels and provides pain relief. Alpha-2 agonists like clonidine and
dexmedetomidine work through this mechanism .
8. Which of the following is a beta-1 receptor effect?
A. Bronchodilation
B. Vasoconstriction
C. Positive inotrope and chronotrope, increasing heart rate and contractility
D. Uterine relaxation
Rationale: Beta-1 receptor stimulation produces positive inotropic (increased
contractility) and chronotropic (increased heart rate) effects, increasing cardiac output
and tissue perfusion. This is the primary mechanism of dobutamine and
norepinephrine's cardiac effects .
9. A patient with hyperthyroid crisis requires a non-selective beta-blocker. Which
medication is most appropriate?
A. Metoprolol
B. Propranolol
C. Labetalol
D. Carvedilol
