1
NUR 210 Principles of Pharmacology ACTUAL
EXAM QUESTIONS AND ANSWERS 2026/2027 |
Exam 2 | Galen College | 100% Correct Verified
Solutions Grade A | Pass Guaranteed - A+ Graded
Section 1: Autonomic Nervous System Drugs (Questions 1-15)
Q1: A patient with symptomatic bradycardia (heart rate 42 bpm) is about to receive atropine. The
nurse understands that this medication works by which mechanism?
A. Stimulating beta-1 adrenergic receptors directly
B. Blocking muscarinic receptors in the sinoatrial node [CORRECT]
C. Inhibiting acetylcholinesterase
D. Stimulating nicotinic receptors in the autonomic ganglia
Correct Answer: B
Rationale: Atropine is a muscarinic antagonist (anticholinergic) that competitively blocks
acetylcholine at muscarinic receptors in the sinoatrial (SA) node. This reduces vagal tone,
allowing the SA node to fire more rapidly and increase heart rate. It is the first-line drug for
symptomatic bradycardia per ACLS guidelines.
Distractor Analysis:
A: Incorrect - This describes direct beta-1 agonists like dobutamine or epinephrine, not atropine.
B: CORRECT - Atropine blocks muscarinic receptors, specifically M2 receptors in the heart.
C: Incorrect - This describes cholinesterase inhibitors like neostigmine or pyridostigmine, which
increase cholinergic activity and would worsen bradycardia.
D: Incorrect - Ganglionic stimulation would affect both sympathetic and parasympathetic
systems non-selectively; ganglionic blockers (not stimulants) are rarely used clinically.
Nursing Implications: Monitor heart rate response; atropine may cause tachycardia, dry mouth,
urinary retention, and pupillary dilation. Contraindicated in glaucoma.
,2
Q2: A patient with asthma is prescribed albuterol via metered-dose inhaler. The nurse explains
that this medication works by which mechanism?
A. Blocking beta-2 adrenergic receptors in bronchial smooth muscle
B. Stimulating beta-2 adrenergic receptors to cause bronchodilation [CORRECT]
C. Inhibiting acetylcholine release at parasympathetic nerve endings
D. Blocking histamine H1 receptors in the lungs
Correct Answer: B
Rationale: Albuterol is a selective beta-2 adrenergic agonist. Stimulation of beta-2 receptors in
bronchial smooth muscle activates adenyl cyclase, increasing cAMP and causing smooth muscle
relaxation (bronchodilation). It is a rescue medication for acute bronchospasm.
Distractor Analysis:
A: Incorrect - Beta-blockers would cause bronchoconstriction and are contraindicated in asthma.
B: CORRECT - Beta-2 agonism causes bronchodilation.
C: Incorrect - This describes anticholinergic mechanisms (ipratropium), not albuterol.
D: Incorrect - This describes antihistamines; while histamine contributes to asthma, albuterol
does not block H1 receptors.
Nursing Implications: Teach proper inhaler technique (spacer use), monitor for tachycardia and
tremors (beta-2 effects), and ensure patient understands this is a rescue medication, not controller
therapy.
Q3: A patient receiving pilocarpine eye drops for glaucoma reports excessive salivation,
sweating, and abdominal cramping. The nurse recognizes these as:
A. Expected therapeutic effects of the medication
B. Signs of cholinergic excess (muscarinic stimulation) [CORRECT]
C. Allergic reaction requiring immediate discontinuation
D. Indications that the medication is ineffective
Correct Answer: B
Rationale: Pilocarpine is a direct-acting cholinergic agonist (muscarinic agonist) used to treat
glaucoma by causing miosis and increasing aqueous humor outflow. Systemic absorption can
cause SLUDGE symptoms (Salivation, Lacrimation, Urination, Defecation, GI distress, Emesis)
due to muscarinic receptor stimulation.
Distractor Analysis:
,3
A: Incorrect - While miosis and decreased intraocular pressure are therapeutic, systemic
cholinergic effects are adverse effects.
B: CORRECT - These are classic muscarinic (parasympathetic) overstimulation effects.
C: Incorrect - These are pharmacological effects of the drug, not an allergic reaction (which
would involve rash, itching, anaphylaxis).
D: Incorrect - These symptoms indicate the drug is active systemically, not that it is ineffective.
Nursing Implications: Teach punctal occlusion technique (pressing inner corner of eye for 1-2
minutes after instillation) to minimize systemic absorption. Have atropine available as antidote if
severe.
Q4: The nurse is caring for a patient with urinary retention due to benign prostatic hyperplasia.
Which medication would be most appropriate to promote bladder emptying?
A. Atropine
B. Bethanechol [CORRECT]
C. Propranolol
D. Epinephrine
Correct Answer: B
Rationale: Bethanechol is a direct-acting cholinergic agonist (muscarinic agonist) that stimulates
the detrusor muscle of the bladder and relaxes the trigone sphincter, promoting urination. It is
used for non-obstructive urinary retention.
Distractor Analysis:
A: Incorrect - Atropine (anticholinergic) would worsen urinary retention by relaxing the detrusor
and tightening the sphincter.
B: CORRECT - Bethanechol increases bladder contractility.
C: Incorrect - Propranolol (beta-blocker) has no significant effect on bladder function.
D: Incorrect - Epinephrine (alpha/beta agonist) causes internal sphincter contraction via alpha-1
receptors, potentially worsening retention.
Nursing Implications: Ensure no mechanical obstruction exists before administration
(bethanechol is contraindicated in obstructive disorders). Monitor for cholinergic side effects.
Q5: A patient with pheochromocytoma is scheduled for surgery. The nurse prepares which
medication to block catecholamine effects preoperatively?
, 4
A. Isoproterenol
B. Phentolamine [CORRECT]
C. Neostigmine
D. Atropine
Correct Answer: B
Rationale: Pheochromocytoma is a catecholamine-secreting tumor causing excessive
epinephrine/norepinephrine release. Phentolamine is a non-selective alpha-adrenergic antagonist
(alpha-blocker) used to control hypertension preoperatively by blocking catecholamine effects on
vascular smooth muscle.
Distractor Analysis:
A: Incorrect - Isoproterenol is a non-selective beta agonist that would worsen tachycardia and
hypertension.
B: CORRECT - Phentolamine blocks alpha receptors, preventing catecholamine-induced
vasoconstriction.
C: Incorrect - Neostigmine is a cholinesterase inhibitor; it has no role in pheochromocytoma
management.
D: Incorrect - Atropine is an anticholinergic; it does not block adrenergic receptors.
Nursing Implications: Monitor blood pressure closely; orthostatic hypotension is common.
Ensure adequate hydration. Beta-blockers may be added after alpha-blockade to control reflex
tachycardia (never give beta-blockers alone).
Q6: The nurse is teaching a patient about timolol eye drops for glaucoma. Which statement by
the patient indicates understanding of potential systemic effects?
A. "This medication may cause my heart rate to increase."
B. "I should check my pulse before taking this medication and report if it's below 60."
[CORRECT]
C. "This medication will cause my pupils to dilate."
D. "I can stop taking this medication once my eye pressure is normal."
Correct Answer: B
Rationale: Timolol is a non-selective beta-blocker administered as eye drops for glaucoma
(reduces aqueous humor production). Systemic absorption can cause bradycardia, hypotension,
bronchospasm, and heart block—especially in patients with cardiac disease.
Distractor Analysis:
NUR 210 Principles of Pharmacology ACTUAL
EXAM QUESTIONS AND ANSWERS 2026/2027 |
Exam 2 | Galen College | 100% Correct Verified
Solutions Grade A | Pass Guaranteed - A+ Graded
Section 1: Autonomic Nervous System Drugs (Questions 1-15)
Q1: A patient with symptomatic bradycardia (heart rate 42 bpm) is about to receive atropine. The
nurse understands that this medication works by which mechanism?
A. Stimulating beta-1 adrenergic receptors directly
B. Blocking muscarinic receptors in the sinoatrial node [CORRECT]
C. Inhibiting acetylcholinesterase
D. Stimulating nicotinic receptors in the autonomic ganglia
Correct Answer: B
Rationale: Atropine is a muscarinic antagonist (anticholinergic) that competitively blocks
acetylcholine at muscarinic receptors in the sinoatrial (SA) node. This reduces vagal tone,
allowing the SA node to fire more rapidly and increase heart rate. It is the first-line drug for
symptomatic bradycardia per ACLS guidelines.
Distractor Analysis:
A: Incorrect - This describes direct beta-1 agonists like dobutamine or epinephrine, not atropine.
B: CORRECT - Atropine blocks muscarinic receptors, specifically M2 receptors in the heart.
C: Incorrect - This describes cholinesterase inhibitors like neostigmine or pyridostigmine, which
increase cholinergic activity and would worsen bradycardia.
D: Incorrect - Ganglionic stimulation would affect both sympathetic and parasympathetic
systems non-selectively; ganglionic blockers (not stimulants) are rarely used clinically.
Nursing Implications: Monitor heart rate response; atropine may cause tachycardia, dry mouth,
urinary retention, and pupillary dilation. Contraindicated in glaucoma.
,2
Q2: A patient with asthma is prescribed albuterol via metered-dose inhaler. The nurse explains
that this medication works by which mechanism?
A. Blocking beta-2 adrenergic receptors in bronchial smooth muscle
B. Stimulating beta-2 adrenergic receptors to cause bronchodilation [CORRECT]
C. Inhibiting acetylcholine release at parasympathetic nerve endings
D. Blocking histamine H1 receptors in the lungs
Correct Answer: B
Rationale: Albuterol is a selective beta-2 adrenergic agonist. Stimulation of beta-2 receptors in
bronchial smooth muscle activates adenyl cyclase, increasing cAMP and causing smooth muscle
relaxation (bronchodilation). It is a rescue medication for acute bronchospasm.
Distractor Analysis:
A: Incorrect - Beta-blockers would cause bronchoconstriction and are contraindicated in asthma.
B: CORRECT - Beta-2 agonism causes bronchodilation.
C: Incorrect - This describes anticholinergic mechanisms (ipratropium), not albuterol.
D: Incorrect - This describes antihistamines; while histamine contributes to asthma, albuterol
does not block H1 receptors.
Nursing Implications: Teach proper inhaler technique (spacer use), monitor for tachycardia and
tremors (beta-2 effects), and ensure patient understands this is a rescue medication, not controller
therapy.
Q3: A patient receiving pilocarpine eye drops for glaucoma reports excessive salivation,
sweating, and abdominal cramping. The nurse recognizes these as:
A. Expected therapeutic effects of the medication
B. Signs of cholinergic excess (muscarinic stimulation) [CORRECT]
C. Allergic reaction requiring immediate discontinuation
D. Indications that the medication is ineffective
Correct Answer: B
Rationale: Pilocarpine is a direct-acting cholinergic agonist (muscarinic agonist) used to treat
glaucoma by causing miosis and increasing aqueous humor outflow. Systemic absorption can
cause SLUDGE symptoms (Salivation, Lacrimation, Urination, Defecation, GI distress, Emesis)
due to muscarinic receptor stimulation.
Distractor Analysis:
,3
A: Incorrect - While miosis and decreased intraocular pressure are therapeutic, systemic
cholinergic effects are adverse effects.
B: CORRECT - These are classic muscarinic (parasympathetic) overstimulation effects.
C: Incorrect - These are pharmacological effects of the drug, not an allergic reaction (which
would involve rash, itching, anaphylaxis).
D: Incorrect - These symptoms indicate the drug is active systemically, not that it is ineffective.
Nursing Implications: Teach punctal occlusion technique (pressing inner corner of eye for 1-2
minutes after instillation) to minimize systemic absorption. Have atropine available as antidote if
severe.
Q4: The nurse is caring for a patient with urinary retention due to benign prostatic hyperplasia.
Which medication would be most appropriate to promote bladder emptying?
A. Atropine
B. Bethanechol [CORRECT]
C. Propranolol
D. Epinephrine
Correct Answer: B
Rationale: Bethanechol is a direct-acting cholinergic agonist (muscarinic agonist) that stimulates
the detrusor muscle of the bladder and relaxes the trigone sphincter, promoting urination. It is
used for non-obstructive urinary retention.
Distractor Analysis:
A: Incorrect - Atropine (anticholinergic) would worsen urinary retention by relaxing the detrusor
and tightening the sphincter.
B: CORRECT - Bethanechol increases bladder contractility.
C: Incorrect - Propranolol (beta-blocker) has no significant effect on bladder function.
D: Incorrect - Epinephrine (alpha/beta agonist) causes internal sphincter contraction via alpha-1
receptors, potentially worsening retention.
Nursing Implications: Ensure no mechanical obstruction exists before administration
(bethanechol is contraindicated in obstructive disorders). Monitor for cholinergic side effects.
Q5: A patient with pheochromocytoma is scheduled for surgery. The nurse prepares which
medication to block catecholamine effects preoperatively?
, 4
A. Isoproterenol
B. Phentolamine [CORRECT]
C. Neostigmine
D. Atropine
Correct Answer: B
Rationale: Pheochromocytoma is a catecholamine-secreting tumor causing excessive
epinephrine/norepinephrine release. Phentolamine is a non-selective alpha-adrenergic antagonist
(alpha-blocker) used to control hypertension preoperatively by blocking catecholamine effects on
vascular smooth muscle.
Distractor Analysis:
A: Incorrect - Isoproterenol is a non-selective beta agonist that would worsen tachycardia and
hypertension.
B: CORRECT - Phentolamine blocks alpha receptors, preventing catecholamine-induced
vasoconstriction.
C: Incorrect - Neostigmine is a cholinesterase inhibitor; it has no role in pheochromocytoma
management.
D: Incorrect - Atropine is an anticholinergic; it does not block adrenergic receptors.
Nursing Implications: Monitor blood pressure closely; orthostatic hypotension is common.
Ensure adequate hydration. Beta-blockers may be added after alpha-blockade to control reflex
tachycardia (never give beta-blockers alone).
Q6: The nurse is teaching a patient about timolol eye drops for glaucoma. Which statement by
the patient indicates understanding of potential systemic effects?
A. "This medication may cause my heart rate to increase."
B. "I should check my pulse before taking this medication and report if it's below 60."
[CORRECT]
C. "This medication will cause my pupils to dilate."
D. "I can stop taking this medication once my eye pressure is normal."
Correct Answer: B
Rationale: Timolol is a non-selective beta-blocker administered as eye drops for glaucoma
(reduces aqueous humor production). Systemic absorption can cause bradycardia, hypotension,
bronchospasm, and heart block—especially in patients with cardiac disease.
Distractor Analysis:
