NR-293 | Exam 2 | Original Practice Examination Page 1
, NR-293 EXAM 2
PHARMACOLOGY FOR NURSING PRACTICE
CHAMBERLAIN UNIVERSITY
100-Question Original Practice Examination
2026/2027 Edition
1. An adult with acute wheezing receives inhaled albuterol. Which finding best indicates the
intendedresponse?
A) Lower serum cholesterol
B) Decreased platelet count
C) Improved air movement and reduced wheezing
D) Increased urine output
Correct Answer: Improved air movement and reduced wheezing
Rationale: Albuterol stimulates beta-2 receptors to relax bronchial smooth muscle. Improved airflow is the
therapeutic target. Tachycardia or tremor can occur, but they are adverse effects rather than evidence of successful
bronchodilation.
2. Shortly after repeated albuterol treatments, a client reports palpitations. Which assessment is
mostrelevant?
A) Visual acuity
B) Heart rate and rhythm
C) Bowel sounds alone
D) Deep tendon reflexes only
Correct Answer: Heart rate and rhythm
Rationale: Beta-agonists may cause tachycardia and palpitations, especially with frequent dosing. Cardiac
assessment helps distinguish expected mild stimulation from a clinically significant reaction needing reassessment.
3. A client uses both albuterol and an inhaled corticosteroid. Which sequence is generally
usefulwhen both are due?
A) Skip the bronchodilator permanently
B) Swallow the corticosteroid powder
C) Mix both products into one mouthpiece
D) Use the prescribed bronchodilator first to improve airflow
Correct Answer: Use the prescribed bronchodilator first to improve airflow
Rationale: A fast-acting bronchodilator can improve airway opening before a controller medication is inhaled.
Device-specific instructions and the individualized prescription still govern administration.
4. Following an inhaled fluticasone dose, what self-care action should be taught?
A) Lie flat for two hours
NR-293 | Exam 2 | Original Practice Examination Page 2
, B) Rinse the mouth and spit out the water
C) Drink grapefruit juice with every dose
D) Stop all oral hygiene
Correct Answer: Rinse the mouth and spit out the water
Rationale: Inhaled corticosteroids can promote oral candidiasis and dysphonia. Rinsing and spitting after
administration reduces residual medication in the oropharynx without undermining the inhaled anti-inflammatory
benefit.
5. An asthma patient reaches for a daily montelukast tablet during sudden severe bronchospasm.
What teaching is essential?
A) Montelukast works faster than inhaled albuterol
B) Montelukast is not a rescue treatment for an acute attack
C) Double the maintenance dose for immediate relief
D) Avoid all prescribed rescue inhalers
Correct Answer: Montelukast is not a rescue treatment for an acute attack
Rationale: Montelukast modifies leukotriene-mediated inflammation and is used for control, not rapid reversal of
acute airway narrowing. A prescribed rescue strategy and emergency assessment are required for severe
symptoms.
6. A parent reports new agitation and disturbing dreams after a child starts montelukast. What
shouldthe nurse advise?
A) Assume the symptoms are unrelated
B) Contact the prescriber promptly about possible neuropsychiatric effects
C) Increase the dose without consultation
D) Continue indefinitely without monitoring
Correct Answer: Contact the prescriber promptly about possible neuropsychiatric effects
Rationale: Montelukast carries a boxed warning for serious neuropsychiatric events. Behavioral or mood changes
warrant prompt discussion with the prescriber and reassessment of therapy.
7. Before administering ipratropium by nebulizer, what should the nurse protect?
A) The patient's ankles from pressure
B) The medication from room light only
C) The client's hearing from noise
D) The patient's eyes from aerosol exposure
Correct Answer: The patient's eyes from aerosol exposure
Rationale: Ipratropium is an antimuscarinic bronchodilator. Aerosol reaching the eyes may trigger blurred vision or
worsen narrow-angle glaucoma; appropriate mask fit and technique help prevent exposure.
8. A client taking tiotropium complains of dry mouth. Which interpretation is most appropriate?
A) It proves bacterial infection
B) It may reflect an anticholinergic adverse effect
NR-293 | Exam 2 | Original Practice Examination Page 3
, NR-293 EXAM 2
PHARMACOLOGY FOR NURSING PRACTICE
CHAMBERLAIN UNIVERSITY
100-Question Original Practice Examination
2026/2027 Edition
1. An adult with acute wheezing receives inhaled albuterol. Which finding best indicates the
intendedresponse?
A) Lower serum cholesterol
B) Decreased platelet count
C) Improved air movement and reduced wheezing
D) Increased urine output
Correct Answer: Improved air movement and reduced wheezing
Rationale: Albuterol stimulates beta-2 receptors to relax bronchial smooth muscle. Improved airflow is the
therapeutic target. Tachycardia or tremor can occur, but they are adverse effects rather than evidence of successful
bronchodilation.
2. Shortly after repeated albuterol treatments, a client reports palpitations. Which assessment is
mostrelevant?
A) Visual acuity
B) Heart rate and rhythm
C) Bowel sounds alone
D) Deep tendon reflexes only
Correct Answer: Heart rate and rhythm
Rationale: Beta-agonists may cause tachycardia and palpitations, especially with frequent dosing. Cardiac
assessment helps distinguish expected mild stimulation from a clinically significant reaction needing reassessment.
3. A client uses both albuterol and an inhaled corticosteroid. Which sequence is generally
usefulwhen both are due?
A) Skip the bronchodilator permanently
B) Swallow the corticosteroid powder
C) Mix both products into one mouthpiece
D) Use the prescribed bronchodilator first to improve airflow
Correct Answer: Use the prescribed bronchodilator first to improve airflow
Rationale: A fast-acting bronchodilator can improve airway opening before a controller medication is inhaled.
Device-specific instructions and the individualized prescription still govern administration.
4. Following an inhaled fluticasone dose, what self-care action should be taught?
A) Lie flat for two hours
NR-293 | Exam 2 | Original Practice Examination Page 2
, B) Rinse the mouth and spit out the water
C) Drink grapefruit juice with every dose
D) Stop all oral hygiene
Correct Answer: Rinse the mouth and spit out the water
Rationale: Inhaled corticosteroids can promote oral candidiasis and dysphonia. Rinsing and spitting after
administration reduces residual medication in the oropharynx without undermining the inhaled anti-inflammatory
benefit.
5. An asthma patient reaches for a daily montelukast tablet during sudden severe bronchospasm.
What teaching is essential?
A) Montelukast works faster than inhaled albuterol
B) Montelukast is not a rescue treatment for an acute attack
C) Double the maintenance dose for immediate relief
D) Avoid all prescribed rescue inhalers
Correct Answer: Montelukast is not a rescue treatment for an acute attack
Rationale: Montelukast modifies leukotriene-mediated inflammation and is used for control, not rapid reversal of
acute airway narrowing. A prescribed rescue strategy and emergency assessment are required for severe
symptoms.
6. A parent reports new agitation and disturbing dreams after a child starts montelukast. What
shouldthe nurse advise?
A) Assume the symptoms are unrelated
B) Contact the prescriber promptly about possible neuropsychiatric effects
C) Increase the dose without consultation
D) Continue indefinitely without monitoring
Correct Answer: Contact the prescriber promptly about possible neuropsychiatric effects
Rationale: Montelukast carries a boxed warning for serious neuropsychiatric events. Behavioral or mood changes
warrant prompt discussion with the prescriber and reassessment of therapy.
7. Before administering ipratropium by nebulizer, what should the nurse protect?
A) The patient's ankles from pressure
B) The medication from room light only
C) The client's hearing from noise
D) The patient's eyes from aerosol exposure
Correct Answer: The patient's eyes from aerosol exposure
Rationale: Ipratropium is an antimuscarinic bronchodilator. Aerosol reaching the eyes may trigger blurred vision or
worsen narrow-angle glaucoma; appropriate mask fit and technique help prevent exposure.
8. A client taking tiotropium complains of dry mouth. Which interpretation is most appropriate?
A) It proves bacterial infection
B) It may reflect an anticholinergic adverse effect
NR-293 | Exam 2 | Original Practice Examination Page 3
