ORIGINAL EXAM-STYLE QUESTIONS • ANSWER KEY INCLUDED A+ VERIFIED
Pharmacology NURS 251 Module 5 Exam –
Portage Learning 2026/2027 – Questions
and Answers
| Neuropharmacology Mastery | Autonomic
Control – Pass Guaranteed – A+ Graded
50 QUESTIONS • 5 SECTIONS • BLOOM'S: APPLICATION/ANALYSIS
50 5 50
QUESTIONS SECTIONS RATIONALES
WHAT THIS COVERS
1 Autonomic Nervous System Pharmacology 2 Neuromuscular Pharmacology
3 Central Nervous System Pharmacology 4 Anesthetic Agents
5 Substance Use and Dependence Pharmacology
ABOUT THIS ASSESSMENT
This 50-item assessment is structured across 5 domains: Autonomic Nervous System Pharmacology; Neuromuscular
Pharmacology; Central Nervous System Pharmacology; Anesthetic Agents; Substance Use and Dependence Pharmacology.
Items are written at the Application/Analysis level and target intermediate learners. Each question includes four options, one
best answer, and a focused rationale that explains the clinical reasoning. Use this resource to reinforce prioritization, safe
practice, and application of core principles across the listed domains.
ANS Pharmacology Neuromuscular CNS Pharmacology Anesthetics Substance Use
PA S S I N G S C O R E D I F F I C U LT Y F O R M AT
80% Intermediate Multiple Choice
STUVIA ACTUAL EXAM
,Pharmacology NURS 251 Module 5 Exam – Portage Learning 2026/2027 Questions and Answers • A+ Verified
Pharmacology NURS 251 Module 5 Exam – Portage Learning
2026/2027 – Questions and Answers | Neuropharmacology Mastery
| Autonomic Control – Pass Guaranteed – A+ Graded
Total Questions: 50 Sections: 5 Passing Score: 80% Difficulty: Intermediate Bloom's: Application/Analysis
Section 1 — Autonomic Nervous System Pharmacology
1. A patient in septic shock remains hypotensive despite fluid resuscitation. The intensive care team
orders a continuous infusion of dobutamine. The nurse understands that this drug primarily acts on
which receptor site to improve cardiac output?
A. Alpha-1 receptors causing peripheral vasoconstriction
B. Beta-1 receptors in the myocardium increasing contractility
C. Beta-2 receptors causing bronchodilation
D. Dopamine receptors increasing renal perfusion
Concept: Beta-1 Selective Agonist - Cardiac Indication
Rationale: Dobutamine is a synthetic catecholamine with predominantly beta-1 adrenergic agonist activity,
increasing myocardial contractility and stroke volume. It is selected when the goal is to augment cardiac
output rather than to constrict vasculature (alpha-1) or dilate bronchi (beta-2). Renal-dose dopamine relies on
dopaminergic receptor stimulation, which is no longer recommended.
2. A 34-year-old with allergic rhinitis requests an over-the-counter phenylephrine nasal spray for
congestion. Which assessment finding should prompt the nurse to counsel against its use?
A. History of seasonal pollen allergy
B. Concurrent use of inhaled fluticasone
C. Repeated blood pressure readings of 168/98 mmHg
D. Daily oral loratadine 10 mg for allergies
Concept: Alpha-1 Agonist - Nasal Decongestant Caution
Rationale: Phenylephrine is a direct alpha-1 adrenergic agonist that produces vasoconstriction of nasal
mucosa to relieve congestion. Systemic absorption can worsen uncontrolled hypertension, so elevated blood
pressure readings are a caution. The other options do not represent contraindications to topical
sympathomimetic decongestants.
3. A patient with stage 2 hypertension wears a clonidine patch changed weekly. The patient calls the
clinic reporting side effects and asks to stop the medication immediately. What is the nurse's best
response?
A. Instruct the patient to remove the patch now and discard it
B. Advise doubling fluids to flush the medication out
C. Recommend taking an extra oral dose immediately
D. Explain that abrupt discontinuation may precipitate severe rebound hypertension
Concept: Alpha-2 Agonist - Rebound Hypertension
Rationale: Clonidine is a central alpha-2 agonist that suppresses sympathetic outflow. Sudden
discontinuation causes reflex catecholamine surge and potentially life-threatening rebound hypertension
within 18 to 72 hours. The medication must be tapered under supervision rather than stopped abruptly.
STUVIA • ACTUAL EXAM • A+ VERIFIED Page 1
, Pharmacology NURS 251 Module 5 Exam – Portage Learning 2026/2027 Questions and Answers • A+ Verified
4. A 7-year-old with an acute asthma exacerbation receives albuterol via nebulizer. Fifteen minutes after
treatment, which finding best indicates that the medication has achieved its therapeutic effect?
A. Wheezing diminishes and peak expiratory flow increases
B. Heart rate decreases from 110 to 80 beats per minute
C. Oxygen saturation drops from 95% to 91%
D. Respiratory rate slows to 8 breaths per minute
Concept: Beta-2 Agonist - Bronchodilation Assessment
Rationale: Albuterol is a selective beta-2 adrenergic agonist that relaxes bronchial smooth muscle, producing
bronchodilation within minutes. Improved airflow is reflected by reduced wheezing and a higher peak
expiratory flow. A transient increase in heart rate from beta-1 cross-activation is expected rather than
bradycardia.
5. A 28-year-old performer with essential tremor is started on propranolol 20 mg three times daily.
Which instruction should the nurse prioritize during discharge teaching?
A. Take the medication with grapefruit juice to enhance absorption
B. Discontinue immediately if tremor resolves after one dose
C. Monitor for dizziness with position changes and report bradycardia
D. Expect a transient increase in blood pressure during the first week
Concept: Non-Selective Beta Blocker - Side Effect Teaching
Rationale: Propranolol is a non-selective beta-adrenergic antagonist that reduces sympathetic drive,
lowering heart rate and blood pressure and producing orthostatic hypotension. Patients should be taught to
change positions slowly and to report significant bradycardia. Grapefruit does not meaningfully alter
propranolol levels, and abrupt discontinuation risks tachycardia and rebound hypertension.
6. A postoperative patient has not voided for 10 hours and has a palpable bladder with no mechanical
obstruction on scan. The provider orders bethanechol. The nurse recognizes this medication works
by which mechanism?
A. Blocking parasympathetic input to the detrusor muscle
B. Stimulating muscarinic receptors to increase detrusor contraction
C. Inhibiting alpha-1 receptors at the bladder neck
D. Relaxing the internal urethral sphincter through nitric oxide release
Concept: Muscarinic Agonist - Postoperative Voiding
Rationale: Bethanechol is a direct-acting muscarinic cholinergic agonist that contracts the detrusor muscle
and relaxes the urinary sphincter, facilitating bladder emptying in non-obstructive retention. It is not an
alpha-1 antagonist nor a nitric oxide donor. Antimuscarinic action would worsen retention.
7. A patient develops symptomatic sinus bradycardia at 38 beats per minute after an inferior myocardial
infarction. Atropine 0.5 mg IV is administered. The nurse anticipates which primary therapeutic
response within minutes?
A. Heart rate increases to above 60 bpm via vagal blockade
B. Blood pressure rises through alpha-1 vasoconstriction
C. Ventricular ectopy resolves through sodium channel blockade
D. Coronary vasodilation increases myocardial oxygen delivery
Concept: Antimuscarinic - Symptomatic Bradycardia
Rationale: Atropine is a competitive muscarinic antagonist that blocks vagal input to the sinoatrial node,
raising heart rate in symptomatic bradycardia. It has no significant alpha-1 or sodium channel activity at
clinical doses, and coronary vasodilation is not its therapeutic mechanism. Excessive doses can paradoxically
slow the heart via central vagal stimulation.
STUVIA • ACTUAL EXAM • A+ VERIFIED Page 2
Pharmacology NURS 251 Module 5 Exam –
Portage Learning 2026/2027 – Questions
and Answers
| Neuropharmacology Mastery | Autonomic
Control – Pass Guaranteed – A+ Graded
50 QUESTIONS • 5 SECTIONS • BLOOM'S: APPLICATION/ANALYSIS
50 5 50
QUESTIONS SECTIONS RATIONALES
WHAT THIS COVERS
1 Autonomic Nervous System Pharmacology 2 Neuromuscular Pharmacology
3 Central Nervous System Pharmacology 4 Anesthetic Agents
5 Substance Use and Dependence Pharmacology
ABOUT THIS ASSESSMENT
This 50-item assessment is structured across 5 domains: Autonomic Nervous System Pharmacology; Neuromuscular
Pharmacology; Central Nervous System Pharmacology; Anesthetic Agents; Substance Use and Dependence Pharmacology.
Items are written at the Application/Analysis level and target intermediate learners. Each question includes four options, one
best answer, and a focused rationale that explains the clinical reasoning. Use this resource to reinforce prioritization, safe
practice, and application of core principles across the listed domains.
ANS Pharmacology Neuromuscular CNS Pharmacology Anesthetics Substance Use
PA S S I N G S C O R E D I F F I C U LT Y F O R M AT
80% Intermediate Multiple Choice
STUVIA ACTUAL EXAM
,Pharmacology NURS 251 Module 5 Exam – Portage Learning 2026/2027 Questions and Answers • A+ Verified
Pharmacology NURS 251 Module 5 Exam – Portage Learning
2026/2027 – Questions and Answers | Neuropharmacology Mastery
| Autonomic Control – Pass Guaranteed – A+ Graded
Total Questions: 50 Sections: 5 Passing Score: 80% Difficulty: Intermediate Bloom's: Application/Analysis
Section 1 — Autonomic Nervous System Pharmacology
1. A patient in septic shock remains hypotensive despite fluid resuscitation. The intensive care team
orders a continuous infusion of dobutamine. The nurse understands that this drug primarily acts on
which receptor site to improve cardiac output?
A. Alpha-1 receptors causing peripheral vasoconstriction
B. Beta-1 receptors in the myocardium increasing contractility
C. Beta-2 receptors causing bronchodilation
D. Dopamine receptors increasing renal perfusion
Concept: Beta-1 Selective Agonist - Cardiac Indication
Rationale: Dobutamine is a synthetic catecholamine with predominantly beta-1 adrenergic agonist activity,
increasing myocardial contractility and stroke volume. It is selected when the goal is to augment cardiac
output rather than to constrict vasculature (alpha-1) or dilate bronchi (beta-2). Renal-dose dopamine relies on
dopaminergic receptor stimulation, which is no longer recommended.
2. A 34-year-old with allergic rhinitis requests an over-the-counter phenylephrine nasal spray for
congestion. Which assessment finding should prompt the nurse to counsel against its use?
A. History of seasonal pollen allergy
B. Concurrent use of inhaled fluticasone
C. Repeated blood pressure readings of 168/98 mmHg
D. Daily oral loratadine 10 mg for allergies
Concept: Alpha-1 Agonist - Nasal Decongestant Caution
Rationale: Phenylephrine is a direct alpha-1 adrenergic agonist that produces vasoconstriction of nasal
mucosa to relieve congestion. Systemic absorption can worsen uncontrolled hypertension, so elevated blood
pressure readings are a caution. The other options do not represent contraindications to topical
sympathomimetic decongestants.
3. A patient with stage 2 hypertension wears a clonidine patch changed weekly. The patient calls the
clinic reporting side effects and asks to stop the medication immediately. What is the nurse's best
response?
A. Instruct the patient to remove the patch now and discard it
B. Advise doubling fluids to flush the medication out
C. Recommend taking an extra oral dose immediately
D. Explain that abrupt discontinuation may precipitate severe rebound hypertension
Concept: Alpha-2 Agonist - Rebound Hypertension
Rationale: Clonidine is a central alpha-2 agonist that suppresses sympathetic outflow. Sudden
discontinuation causes reflex catecholamine surge and potentially life-threatening rebound hypertension
within 18 to 72 hours. The medication must be tapered under supervision rather than stopped abruptly.
STUVIA • ACTUAL EXAM • A+ VERIFIED Page 1
, Pharmacology NURS 251 Module 5 Exam – Portage Learning 2026/2027 Questions and Answers • A+ Verified
4. A 7-year-old with an acute asthma exacerbation receives albuterol via nebulizer. Fifteen minutes after
treatment, which finding best indicates that the medication has achieved its therapeutic effect?
A. Wheezing diminishes and peak expiratory flow increases
B. Heart rate decreases from 110 to 80 beats per minute
C. Oxygen saturation drops from 95% to 91%
D. Respiratory rate slows to 8 breaths per minute
Concept: Beta-2 Agonist - Bronchodilation Assessment
Rationale: Albuterol is a selective beta-2 adrenergic agonist that relaxes bronchial smooth muscle, producing
bronchodilation within minutes. Improved airflow is reflected by reduced wheezing and a higher peak
expiratory flow. A transient increase in heart rate from beta-1 cross-activation is expected rather than
bradycardia.
5. A 28-year-old performer with essential tremor is started on propranolol 20 mg three times daily.
Which instruction should the nurse prioritize during discharge teaching?
A. Take the medication with grapefruit juice to enhance absorption
B. Discontinue immediately if tremor resolves after one dose
C. Monitor for dizziness with position changes and report bradycardia
D. Expect a transient increase in blood pressure during the first week
Concept: Non-Selective Beta Blocker - Side Effect Teaching
Rationale: Propranolol is a non-selective beta-adrenergic antagonist that reduces sympathetic drive,
lowering heart rate and blood pressure and producing orthostatic hypotension. Patients should be taught to
change positions slowly and to report significant bradycardia. Grapefruit does not meaningfully alter
propranolol levels, and abrupt discontinuation risks tachycardia and rebound hypertension.
6. A postoperative patient has not voided for 10 hours and has a palpable bladder with no mechanical
obstruction on scan. The provider orders bethanechol. The nurse recognizes this medication works
by which mechanism?
A. Blocking parasympathetic input to the detrusor muscle
B. Stimulating muscarinic receptors to increase detrusor contraction
C. Inhibiting alpha-1 receptors at the bladder neck
D. Relaxing the internal urethral sphincter through nitric oxide release
Concept: Muscarinic Agonist - Postoperative Voiding
Rationale: Bethanechol is a direct-acting muscarinic cholinergic agonist that contracts the detrusor muscle
and relaxes the urinary sphincter, facilitating bladder emptying in non-obstructive retention. It is not an
alpha-1 antagonist nor a nitric oxide donor. Antimuscarinic action would worsen retention.
7. A patient develops symptomatic sinus bradycardia at 38 beats per minute after an inferior myocardial
infarction. Atropine 0.5 mg IV is administered. The nurse anticipates which primary therapeutic
response within minutes?
A. Heart rate increases to above 60 bpm via vagal blockade
B. Blood pressure rises through alpha-1 vasoconstriction
C. Ventricular ectopy resolves through sodium channel blockade
D. Coronary vasodilation increases myocardial oxygen delivery
Concept: Antimuscarinic - Symptomatic Bradycardia
Rationale: Atropine is a competitive muscarinic antagonist that blocks vagal input to the sinoatrial node,
raising heart rate in symptomatic bradycardia. It has no significant alpha-1 or sodium channel activity at
clinical doses, and coronary vasodilation is not its therapeutic mechanism. Excessive doses can paradoxically
slow the heart via central vagal stimulation.
STUVIA • ACTUAL EXAM • A+ VERIFIED Page 2
