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Rau’s Respiratory Care
Pharmacology 9th Edition by
Douglas S. Gardenhire –
Complete Test Bank with Exam
Questions and Answer Key
Chapter 01: Introduction to Respiratory Care Pharmacology: 10e
MULTIPLE CHOICE
1. What is the name of the receptor sites that are located in the peripheral vasculature, the heart, bronchial
muscle, and bronchial blood vessels?
a. Beta 2 receptors c. Alpha receptors
b. Gamma receptors d. Beta 1 receptors
ANS: C
Alpha receptors are located in the peripheral vasculature, the heart, bronchial muscle, and bronchial
blood vessels.
PTS: 1
2. Which receptor site results in tachycardia, an increased potential for arrhythmias, and an increased
cardiac output?
a. Beta 1 receptor c. Alpha receptor
b. Beta 2 receptor d. Delta receptor
ANS: A
Stimulation of the beta-1 receptors results in tachycardia, an increased potential for arrhythmias, and
an increased cardiac output. In administering drugs to the pulmonary system, stimulation of the beta-1
sites is not desired. However, most respiratory pharmacologic agents have some beta-1 stimulatory
effect.
PTS: 1
3. Stimulation of the beta 2 receptors causes
a. peripheral vasoconstriction and mild bronchoconstriction in the lungs.
b. tachycardia, an increased potential for arrhythmias, and an increased cardiac output.
c. bronchodilation.
d. peripheral vasodilation, bradycardia, and decreased cardiac output.
ANS: C
Stimulation of the beta-2 receptors in the lungs causes bronchodilation.
PTS: 1
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4. Acetylcholine stimulates
a. the Vagus nerve.
b. the adrenergic receptors.
c. the sympathetic nervous system.
d. the cholinergic receptors.
ANS: D
Acetylcholine stimulates the cholinergic receptors.
PTS: 1
5. What immunoglobulin antibody sensitizes the mast cell?
a. Leukotrienes c. Histamine
b. IgE d. Prostaglandins
ANS: B
The IgE (reagin) antibodies sensitize the mast cell. Repeated exposure to the antigen causes the
degranulation of the mast cell.
PTS: 1
6. Which of the following is caused by histamine release from the mast cells?
I. Bronchodilation
II. Increased bronchial gland secretion
III. Increased amount of mucus present in the airways
a. I and II only c. III only
b. II and III only d. I, II, III
ANS: B
Histamine is also a potent bronchoconstrictor. In addition to its bronchoconstrictive activity, histamine
II) increases bronchial gland secretion, causing III) an increase in the amount of mucus present
in the airways. Histamine may also have an effect on vascular permeability similar to the effect of-
SRS-A.
PTS: 1
7. A sympathomimetic drug would cause
a. bronchodilation. c. Histamine release.
b. bronchoconstriction. d. Vagus nerve stimulation.
ANS: A
A sympathomimetic drug would cause bronchodilation. Sympathomimetic agents are the drugs most
commonly used to reverse bronchospasm.
PTS: 1
8. Stimulation of the sympathetic nervous system causes
a. vascular permeability. c. bronchodilation.
b. decreased blood pressure. d. bronchoconstriction.
ANS: C
Sympathetic nervous system stimulation causes bronchodilation.
PTS: 1
9. Which of the following would NOT cause a bronchospasm or bronchoconstriction?
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a. Leukotrienes c. Histamine
b. Beta 1 receptors d. Prostaglandins
ANS: B
Beta-1 receptors would not cause a bronchospasm or bronchoconstriction. Leukotrienes are one of
many chemical mediators released by the mast cells. Leukotrienes cause a direct, strong
bronchoconstriction. Histamine is also a potent bronchoconstrictor. Prostaglandins cause a strong
bronchospasm, especially in asthmatic patients.
PTS: 1
10. Place the following intracellular events of the Beta 2 receptor stimulation in order.
I. Phosphodiesterase breaks down cyclic 3’, 5’-AMP into 5’-AMP
II. Adenylate cyclase combines with magnesium and ATP to form cyclic 3’,5’-AMP
III. Cyclic 3’,5’-AMP results in bronchial smooth muscle relaxation
IV. Beta-2 stimulation causes the formation of adenylate cyclase
a. I, II, III, IV c. IV, II, III, I
b. III, IV, I, II d. IV, III, II, I
ANS: C
The following order is correct: IV) Beta-2 stimulation causes the formation of adenylate cyclase. II)
Adenylate cyclase combines with magnesium and ATP (adenosine triphosphate) to form cyclic 3’,5’-
AMP (adenosine monophosphate). III) Cyclic 3’,5’-AMP results in bronchial smooth muscle
relaxation and hence bronchodilation. Cyclic 3’,5’-AMP is not a long-lived agent. It is readily broken
down by another enzyme present in the lungs called phosphodiesterase. I) Phosphodiesterase breaks
3’,5’-AMP down into 5’-AMP, which no longer causes bronchodilation.
PTS: 1
11. Release of acetylcholine will cause
a. bronchodilation. c. stimulation of cyclic 3’5’ AMP.
b. Mast cell stabilization. d. bronchospasm.
ANS: D
Cholinergic receptors are cells that respond when stimulated by acetylcholine. Cholinergic receptors
cause profound bronchospasm in the lungs when stimulated. Cholinergic receptors are found in the
parasympathetic nervous system.
PTS: 1
12. Which of the following is NOT an example of a sympathomimetic drug?
a. Salmeterol Xinafoate c. Pirbuterol Acetate
b. Formoterol fumarate d. Atropine Sulfate
ANS: D
Atropine sulfate is a anti-cholinergic bronchodilator. Salmeterol, formoterol, and pirbuterol are all
sympathomimetic bronchodilators.
PTS: 1
13. Which of the following sympathomimetic drugs are intended for maintenance therapy only?
I. Levalbuterol
II. Salmeterol
III. Formoterol
IV. Pirbuterol
a. II, III, and IV c. II and III
b. I and IV d. I, II, III, and IV
ANS: C
II) Salmeterol and III) Formoterol are intended for maintenance therapy only.
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PTS: 1
14. A pediatric patient is admitted to the emergency department from a physician’s office with the
suspected diagnosis of croup. An inspiratory stridor is heard. Which aerosolized sympathomimetic
would you recommend to decrease the stridor?
a. Racemic epinephrine c. Levalbuterol
b. Albuterol d. Isoproterenol
ANS: A
Racemic epinephrine (Vaponephrine) is a sympathomimetic drug. However, its alpha effects are
strong and it is commonly used to relieve croup and epiglottitis symptoms in children.
PTS: 1
15. Aminophylline causes bronchodilation by
a. stimulating the production of cyclic 3’5’ AMP.
b. blocking the parasympathetic nervous system.
c. inhibiting the enzyme phosphodiesterase.
d. causing Mast cell degranulation.
ANS: C
Aminophylline is a phosphodiesterase inhibitor. It is an example of drugs in the xanthine group.
Common phosphodiesterase drugs are found in the methylxanthine group. Cyclic 3’,5’-AMP is broken
down into 5’-AMP by the enzyme phosphodiesterase. If the action of phosphodiesterase can be
blocked or inhibited, more 3’,5’-AMP will remain in the lungs, resulting in better bronchodilation.
Phosphodiesterase inhibitors act in this way.
PTS: 1
16. Inhibition of the sympathetic nervous system would cause
a. bronchoconstriction.
b. stridor.
c. bronchodilation.
d. relaxation of the bronchial smooth muscle.
ANS: A
If the sympathetic nervous system is inhibited, it would cause bronchoconstriction.
PTS: 1
17. Which of the following drugs cause bronchodilation by inhibiting the effects of the parasympathetic
nervous system?
I. Atropine sulfate
II. Ipratropium bromide
III. Tiotropium bromide
IV. Terbutaline sulfate
a. I and IV c. I, II, III
b. II and III d. IV only
ANS: C
I) Atropine, II) ipratropium, and III) tiotropium are all examples of antocholinergic
bronchodilators (bronchodilators that work by blocking the parasympathetic nervous system).
Anticholinergic drugs block the cholinergic receptor sites, preventing that route of bronchospasm.
PTS: 1
18. Corticosteroids:
a. cause brondilation directly.
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Rau’s Respiratory Care
Pharmacology 9th Edition by
Douglas S. Gardenhire –
Complete Test Bank with Exam
Questions and Answer Key
Chapter 01: Introduction to Respiratory Care Pharmacology: 10e
MULTIPLE CHOICE
1. What is the name of the receptor sites that are located in the peripheral vasculature, the heart, bronchial
muscle, and bronchial blood vessels?
a. Beta 2 receptors c. Alpha receptors
b. Gamma receptors d. Beta 1 receptors
ANS: C
Alpha receptors are located in the peripheral vasculature, the heart, bronchial muscle, and bronchial
blood vessels.
PTS: 1
2. Which receptor site results in tachycardia, an increased potential for arrhythmias, and an increased
cardiac output?
a. Beta 1 receptor c. Alpha receptor
b. Beta 2 receptor d. Delta receptor
ANS: A
Stimulation of the beta-1 receptors results in tachycardia, an increased potential for arrhythmias, and
an increased cardiac output. In administering drugs to the pulmonary system, stimulation of the beta-1
sites is not desired. However, most respiratory pharmacologic agents have some beta-1 stimulatory
effect.
PTS: 1
3. Stimulation of the beta 2 receptors causes
a. peripheral vasoconstriction and mild bronchoconstriction in the lungs.
b. tachycardia, an increased potential for arrhythmias, and an increased cardiac output.
c. bronchodilation.
d. peripheral vasodilation, bradycardia, and decreased cardiac output.
ANS: C
Stimulation of the beta-2 receptors in the lungs causes bronchodilation.
PTS: 1
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pharmacology
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4. Acetylcholine stimulates
a. the Vagus nerve.
b. the adrenergic receptors.
c. the sympathetic nervous system.
d. the cholinergic receptors.
ANS: D
Acetylcholine stimulates the cholinergic receptors.
PTS: 1
5. What immunoglobulin antibody sensitizes the mast cell?
a. Leukotrienes c. Histamine
b. IgE d. Prostaglandins
ANS: B
The IgE (reagin) antibodies sensitize the mast cell. Repeated exposure to the antigen causes the
degranulation of the mast cell.
PTS: 1
6. Which of the following is caused by histamine release from the mast cells?
I. Bronchodilation
II. Increased bronchial gland secretion
III. Increased amount of mucus present in the airways
a. I and II only c. III only
b. II and III only d. I, II, III
ANS: B
Histamine is also a potent bronchoconstrictor. In addition to its bronchoconstrictive activity, histamine
II) increases bronchial gland secretion, causing III) an increase in the amount of mucus present
in the airways. Histamine may also have an effect on vascular permeability similar to the effect of-
SRS-A.
PTS: 1
7. A sympathomimetic drug would cause
a. bronchodilation. c. Histamine release.
b. bronchoconstriction. d. Vagus nerve stimulation.
ANS: A
A sympathomimetic drug would cause bronchodilation. Sympathomimetic agents are the drugs most
commonly used to reverse bronchospasm.
PTS: 1
8. Stimulation of the sympathetic nervous system causes
a. vascular permeability. c. bronchodilation.
b. decreased blood pressure. d. bronchoconstriction.
ANS: C
Sympathetic nervous system stimulation causes bronchodilation.
PTS: 1
9. Which of the following would NOT cause a bronchospasm or bronchoconstriction?
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a. Leukotrienes c. Histamine
b. Beta 1 receptors d. Prostaglandins
ANS: B
Beta-1 receptors would not cause a bronchospasm or bronchoconstriction. Leukotrienes are one of
many chemical mediators released by the mast cells. Leukotrienes cause a direct, strong
bronchoconstriction. Histamine is also a potent bronchoconstrictor. Prostaglandins cause a strong
bronchospasm, especially in asthmatic patients.
PTS: 1
10. Place the following intracellular events of the Beta 2 receptor stimulation in order.
I. Phosphodiesterase breaks down cyclic 3’, 5’-AMP into 5’-AMP
II. Adenylate cyclase combines with magnesium and ATP to form cyclic 3’,5’-AMP
III. Cyclic 3’,5’-AMP results in bronchial smooth muscle relaxation
IV. Beta-2 stimulation causes the formation of adenylate cyclase
a. I, II, III, IV c. IV, II, III, I
b. III, IV, I, II d. IV, III, II, I
ANS: C
The following order is correct: IV) Beta-2 stimulation causes the formation of adenylate cyclase. II)
Adenylate cyclase combines with magnesium and ATP (adenosine triphosphate) to form cyclic 3’,5’-
AMP (adenosine monophosphate). III) Cyclic 3’,5’-AMP results in bronchial smooth muscle
relaxation and hence bronchodilation. Cyclic 3’,5’-AMP is not a long-lived agent. It is readily broken
down by another enzyme present in the lungs called phosphodiesterase. I) Phosphodiesterase breaks
3’,5’-AMP down into 5’-AMP, which no longer causes bronchodilation.
PTS: 1
11. Release of acetylcholine will cause
a. bronchodilation. c. stimulation of cyclic 3’5’ AMP.
b. Mast cell stabilization. d. bronchospasm.
ANS: D
Cholinergic receptors are cells that respond when stimulated by acetylcholine. Cholinergic receptors
cause profound bronchospasm in the lungs when stimulated. Cholinergic receptors are found in the
parasympathetic nervous system.
PTS: 1
12. Which of the following is NOT an example of a sympathomimetic drug?
a. Salmeterol Xinafoate c. Pirbuterol Acetate
b. Formoterol fumarate d. Atropine Sulfate
ANS: D
Atropine sulfate is a anti-cholinergic bronchodilator. Salmeterol, formoterol, and pirbuterol are all
sympathomimetic bronchodilators.
PTS: 1
13. Which of the following sympathomimetic drugs are intended for maintenance therapy only?
I. Levalbuterol
II. Salmeterol
III. Formoterol
IV. Pirbuterol
a. II, III, and IV c. II and III
b. I and IV d. I, II, III, and IV
ANS: C
II) Salmeterol and III) Formoterol are intended for maintenance therapy only.
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PTS: 1
14. A pediatric patient is admitted to the emergency department from a physician’s office with the
suspected diagnosis of croup. An inspiratory stridor is heard. Which aerosolized sympathomimetic
would you recommend to decrease the stridor?
a. Racemic epinephrine c. Levalbuterol
b. Albuterol d. Isoproterenol
ANS: A
Racemic epinephrine (Vaponephrine) is a sympathomimetic drug. However, its alpha effects are
strong and it is commonly used to relieve croup and epiglottitis symptoms in children.
PTS: 1
15. Aminophylline causes bronchodilation by
a. stimulating the production of cyclic 3’5’ AMP.
b. blocking the parasympathetic nervous system.
c. inhibiting the enzyme phosphodiesterase.
d. causing Mast cell degranulation.
ANS: C
Aminophylline is a phosphodiesterase inhibitor. It is an example of drugs in the xanthine group.
Common phosphodiesterase drugs are found in the methylxanthine group. Cyclic 3’,5’-AMP is broken
down into 5’-AMP by the enzyme phosphodiesterase. If the action of phosphodiesterase can be
blocked or inhibited, more 3’,5’-AMP will remain in the lungs, resulting in better bronchodilation.
Phosphodiesterase inhibitors act in this way.
PTS: 1
16. Inhibition of the sympathetic nervous system would cause
a. bronchoconstriction.
b. stridor.
c. bronchodilation.
d. relaxation of the bronchial smooth muscle.
ANS: A
If the sympathetic nervous system is inhibited, it would cause bronchoconstriction.
PTS: 1
17. Which of the following drugs cause bronchodilation by inhibiting the effects of the parasympathetic
nervous system?
I. Atropine sulfate
II. Ipratropium bromide
III. Tiotropium bromide
IV. Terbutaline sulfate
a. I and IV c. I, II, III
b. II and III d. IV only
ANS: C
I) Atropine, II) ipratropium, and III) tiotropium are all examples of antocholinergic
bronchodilators (bronchodilators that work by blocking the parasympathetic nervous system).
Anticholinergic drugs block the cholinergic receptor sites, preventing that route of bronchospasm.
PTS: 1
18. Corticosteroids:
a. cause brondilation directly.
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