UNIVERSITY OF SOUTH ALABAMA · COLLEGE OF NURSING
NU 578 Advanced
Pharmacology
Controlled Substances
Unit 2
Exam-Style Practice Questions with Rationales
Topic Focus: Controlled Substances — Opioid Pharmacology
Edition 1 · July 2026
Table of Contents
1. Instructions for Use 2
2. Practice Questions with Answers & Rationales — Controlled Substances 2
University of South Alabama · College of Nursing Page 1
,NU 578 CONTROLLED SUBSTANCES PRACTICE GUIDE INSTRUCTIONS & PRACTICE QUESTIONS
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is. These questions are designed to reflect the NU 578 Advanced Pharmacology
exam style and content.
Category: Controlled Substances — Opioid Pharmacology
1 Morphine relieves pain by acting through which mechanisms?
A Actions through the CNS and periphery, causing respiratory depression,
constipation, urinary retention, orthostatic hypotension, emesis, miosis, cough
suppression, and biliary colic
B Actions through the CNS only, with no peripheral effects
C Actions through the periphery only, with no CNS effects
D Selective action on dopamine receptors only
Why A is correct: Morphine acts through both the CNS and periphery. It relieves pain
without affecting other senses or LOC. Large doses are effective against sharp pain. The
ability to cause mental clouding, sedation, euphoria, and anxiety reduction contributes to
pain relief.
B — Morphine acts through both CNS and peripheral mechanisms.
C — Morphine acts through both CNS and peripheral mechanisms.
D — Morphine acts on opioid receptors, not dopamine receptors.
, 2 Which of the following is an adverse effect of morphine related to the respiratory
system?
A Respiratory depression
B Bronchodilation
C Increased respiratory rate
D Hyperventilation
Why A is correct: Respiratory depression is a significant adverse effect of morphine.
Tolerance to respiratory depression can develop with long-term use. Morphine should not
be given to patients with a respiratory rate less than 12, and respiratory depression should
be reversed with Narcan (naloxone).
B — Morphine does not cause bronchodilation; it can cause respiratory depression.
C — Morphine decreases, not increases, respiratory rate.
D — Morphine does not cause hyperventilation.
3 Morphine is contraindicated in patients with which of the following conditions?
A History of respiratory disease (COPD/Asthma), head injury, and hypotension with
decreased blood volume
B History of hypertension
C History of diabetes mellitus
D History of gastrointestinal bleeding
Why A is correct: Morphine is contraindicated in patients with a history of respiratory
disease (COPD/asthma), head injury (due to increased ICP), concurrent use with CNS
depressants, and hypotension with decreased blood volume. Elderly and young patients
should be monitored closely.
B — Hypertension is not a contraindication for morphine.
C — Diabetes mellitus is not a contraindication for morphine.
D — GI bleeding is not a primary contraindication for morphine.
NU 578 Advanced
Pharmacology
Controlled Substances
Unit 2
Exam-Style Practice Questions with Rationales
Topic Focus: Controlled Substances — Opioid Pharmacology
Edition 1 · July 2026
Table of Contents
1. Instructions for Use 2
2. Practice Questions with Answers & Rationales — Controlled Substances 2
University of South Alabama · College of Nursing Page 1
,NU 578 CONTROLLED SUBSTANCES PRACTICE GUIDE INSTRUCTIONS & PRACTICE QUESTIONS
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is. These questions are designed to reflect the NU 578 Advanced Pharmacology
exam style and content.
Category: Controlled Substances — Opioid Pharmacology
1 Morphine relieves pain by acting through which mechanisms?
A Actions through the CNS and periphery, causing respiratory depression,
constipation, urinary retention, orthostatic hypotension, emesis, miosis, cough
suppression, and biliary colic
B Actions through the CNS only, with no peripheral effects
C Actions through the periphery only, with no CNS effects
D Selective action on dopamine receptors only
Why A is correct: Morphine acts through both the CNS and periphery. It relieves pain
without affecting other senses or LOC. Large doses are effective against sharp pain. The
ability to cause mental clouding, sedation, euphoria, and anxiety reduction contributes to
pain relief.
B — Morphine acts through both CNS and peripheral mechanisms.
C — Morphine acts through both CNS and peripheral mechanisms.
D — Morphine acts on opioid receptors, not dopamine receptors.
, 2 Which of the following is an adverse effect of morphine related to the respiratory
system?
A Respiratory depression
B Bronchodilation
C Increased respiratory rate
D Hyperventilation
Why A is correct: Respiratory depression is a significant adverse effect of morphine.
Tolerance to respiratory depression can develop with long-term use. Morphine should not
be given to patients with a respiratory rate less than 12, and respiratory depression should
be reversed with Narcan (naloxone).
B — Morphine does not cause bronchodilation; it can cause respiratory depression.
C — Morphine decreases, not increases, respiratory rate.
D — Morphine does not cause hyperventilation.
3 Morphine is contraindicated in patients with which of the following conditions?
A History of respiratory disease (COPD/Asthma), head injury, and hypotension with
decreased blood volume
B History of hypertension
C History of diabetes mellitus
D History of gastrointestinal bleeding
Why A is correct: Morphine is contraindicated in patients with a history of respiratory
disease (COPD/asthma), head injury (due to increased ICP), concurrent use with CNS
depressants, and hypotension with decreased blood volume. Elderly and young patients
should be monitored closely.
B — Hypertension is not a contraindication for morphine.
C — Diabetes mellitus is not a contraindication for morphine.
D — GI bleeding is not a primary contraindication for morphine.
