NUR 210 Exam 2 – Pharmacology – (2026/2027)
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1. A client is prescribed epinephrine for an anaphylactic reaction. Which
physiological effects should the nurse expect? (Select all that apply)
A. Vasoconstriction
B. Increased heart rate
C. Bronchodilation
D. Vasodilation
E. Pupil constriction
<details> <summary>See Answer & Rationale</summary> **Correct Answer: A,
B, C** **Rationale:** Epinephrine is a non-selective adrenergic agonist. It
stimulates alpha-1 receptors causing vasoconstriction (which increases blood
pressure), beta-1 receptors causing increased heart rate and contractility, and
beta-2 receptors causing bronchodilation. Epinephrine does not cause
vasodilation or pupil constriction[citation:1]. </details>
2. The nurse is caring for a patient with diabetes who receives epinephrine.
Which side effect is a high priority for the nurse to monitor?
A. Hypoglycemia
B. Hyperglycemia
C. Hypotension
D. Bradycardia
<details> <summary>See Answer & Rationale</summary> **Correct Answer: B.
Hyperglycemia** **Rationale:** Beta-2 stimulation by epinephrine activates liver
glycogenolysis, which releases glucose and leads to hyperglycemia[citation:1].
</details>
3. The nurse is teaching a client prescribed an EpiPen. Which statement
indicates that the client understands the instructions?
A. "I should store the EpiPen in the refrigerator."
B. "I should keep the EpiPen in a cool, dark place."
,C. "I should keep the EpiPen in a bright, warm place."
D. "I should store the EpiPen in the bathroom cabinet."
<details> <summary>See Answer & Rationale</summary> **Correct Answer: B. "I
should keep the EpiPen in a cool, dark place."** **Rationale:** EpiPens should be
stored at room temperature in a cool, dark place. Refrigeration can damage the
medication, and exposure to heat or light can degrade it[citation:1]. </details>
4. The nurse is preparing to administer atropine preoperatively. Which
assessment finding indicates the medication is having its desired effect?
A. Increased heart rate
B. Decreased respiratory secretions
C. Pupil dilation
D. All of the above
<details> <summary>See Answer & Rationale</summary> **Correct Answer: D.
All of the above** **Rationale:** Atropine is an anticholinergic agent that blocks
the parasympathetic nervous system. This results in an increased heart rate (to
treat bradycardia), decreased secretions (to prevent aspiration), and pupil
dilation. The classic mnemonic is "Hot as a hare, blind as a bat, dry as a bone, red
as a beet, mad as a hatter"[citation:4]. </details>
5. A patient on a cholinergic agent complains of diarrhea, frequent urination,
and blurred distance vision. The nurse recognizes these as:
A. Signs of an allergic reaction
B. Expected side effects of the medication
C. Signs of a cholinergic crisis
D. Signs of anticholinergic toxicity
<details> <summary>See Answer & Rationale</summary> **Correct Answer: B.
Expected side effects of the medication** **Rationale:** These are classic effects
of cholinergic stimulation (SLUDGE: Salivation, Lacrimation, Urination, Defecation,
GI upset, Emesis). When taking cholinergic agents, these are expected side effects
but should be monitored[citation:4]. </details>
6. A client with myasthenia gravis is prescribed pyridostigmine. The nurse
explains that this medication works by:
A. Suppressing the immune system.
,B. Blocking acetylcholine at the neuromuscular junction.
C. Increasing the amount of acetylcholine available.
D. Preventing the destruction of myelin sheaths.
<details> <summary>See Answer & Rationale</summary> **Correct Answer: C.
Increasing the amount of acetylcholine available.** **Rationale:**
Pyridostigmine is an acetylcholinesterase inhibitor. It prevents the breakdown of
acetylcholine, increasing its availability to improve neuromuscular transmission
and control muscle weakness[citation:2]. </details>
7. A client is prescribed carbidopa-levodopa for Parkinson's disease. Which
foods should the nurse instruct the client to avoid?
A. High-protein foods
B. High-carbohydrate foods
C. High-fat foods
D. High-fiber foods
<details> <summary>See Answer & Rationale</summary> **Correct Answer: A.
High-protein foods** **Rationale:** High-protein foods compete with levodopa
for absorption across the blood-brain barrier, which can significantly reduce its
effectiveness. It should be taken on an empty stomach or with a low-protein
snack[citation:2]. </details>
8. A nurse is caring for a client with Alzheimer's disease who is prescribed
rivastigmine. What is the primary mechanism of action for this drug?
A. It increases dopamine levels in the brain.
B. It inhibits acetylcholinesterase, increasing acetylcholine levels.
C. It blocks glutamate receptors.
D. It acts as an NMDA receptor antagonist.
<details> <summary>See Answer & Rationale</summary> **Correct Answer: B. It
inhibits acetylcholinesterase, increasing acetylcholine levels.** **Rationale:**
Rivastigmine is a cholinesterase inhibitor. It works by blocking the enzyme
acetylcholinesterase, which breaks down acetylcholine. This leads to a higher
concentration of acetylcholine in the brain, which can temporarily improve or
stabilize cognitive symptoms in Alzheimer's disease[citation:2][citation:8].
</details>
, 9. The nurse is caring for a patient who takes digoxin for heart failure. The
patient's serum potassium level is 3.2 mEq/L. Which medication order should
the nurse question?
A. Digoxin
B. Furosemide
C. Potassium supplement
D. Enalapril
<details> <summary>See Answer & Rationale</summary> **Correct Answer: A.
Digoxin** **Rationale:** A low potassium level (hypokalemia) increases the risk
of digoxin toxicity. Digoxin should be held, and the healthcare provider should be
notified. The normal potassium range is 3.5-5 mEq/L[citation:5][citation:12].
</details>
10. A patient on warfarin has an INR of 4.5. What is the nurse's priority action?
A. Administer the next dose as scheduled.
B. Hold the next dose and notify the provider.
C. Administer Vitamin K as an antidote per protocol.
D. Monitor the patient for signs of bleeding.
<details> <summary>See Answer & Rationale</summary> **Correct Answer: C.
Administer Vitamin K as an antidote per protocol.** **Rationale:** A therapeutic
INR for most indications is between 2.0 and 3.0. An INR of 4.5 is significantly
elevated and indicates a high risk of bleeding. The priority is to reverse the
anticoagulation effect per protocol, usually with Vitamin K, and then notify the
provider. Holding the dose is not enough in this situation[citation:5]. </details>
11. The nurse is providing teaching to a client with a new prescription for
metoprolol. Which instruction is most important to include?
A. "This medication may cause a dry cough."
B. "Do not stop this medication abruptly."
C. "Take this medication with a high-fat meal."
D. "Monitor your blood glucose for hypoglycemia."
<details> <summary>See Answer & Rationale</summary> **Correct Answer: B.
"Do not stop this medication abruptly."** **Rationale:** Abrupt withdrawal of
beta-blockers can cause rebound hypertension, tachycardia, and an increased risk
Galen Actual Questions & Answers, 100%
Guarantee Pass
1. A client is prescribed epinephrine for an anaphylactic reaction. Which
physiological effects should the nurse expect? (Select all that apply)
A. Vasoconstriction
B. Increased heart rate
C. Bronchodilation
D. Vasodilation
E. Pupil constriction
<details> <summary>See Answer & Rationale</summary> **Correct Answer: A,
B, C** **Rationale:** Epinephrine is a non-selective adrenergic agonist. It
stimulates alpha-1 receptors causing vasoconstriction (which increases blood
pressure), beta-1 receptors causing increased heart rate and contractility, and
beta-2 receptors causing bronchodilation. Epinephrine does not cause
vasodilation or pupil constriction[citation:1]. </details>
2. The nurse is caring for a patient with diabetes who receives epinephrine.
Which side effect is a high priority for the nurse to monitor?
A. Hypoglycemia
B. Hyperglycemia
C. Hypotension
D. Bradycardia
<details> <summary>See Answer & Rationale</summary> **Correct Answer: B.
Hyperglycemia** **Rationale:** Beta-2 stimulation by epinephrine activates liver
glycogenolysis, which releases glucose and leads to hyperglycemia[citation:1].
</details>
3. The nurse is teaching a client prescribed an EpiPen. Which statement
indicates that the client understands the instructions?
A. "I should store the EpiPen in the refrigerator."
B. "I should keep the EpiPen in a cool, dark place."
,C. "I should keep the EpiPen in a bright, warm place."
D. "I should store the EpiPen in the bathroom cabinet."
<details> <summary>See Answer & Rationale</summary> **Correct Answer: B. "I
should keep the EpiPen in a cool, dark place."** **Rationale:** EpiPens should be
stored at room temperature in a cool, dark place. Refrigeration can damage the
medication, and exposure to heat or light can degrade it[citation:1]. </details>
4. The nurse is preparing to administer atropine preoperatively. Which
assessment finding indicates the medication is having its desired effect?
A. Increased heart rate
B. Decreased respiratory secretions
C. Pupil dilation
D. All of the above
<details> <summary>See Answer & Rationale</summary> **Correct Answer: D.
All of the above** **Rationale:** Atropine is an anticholinergic agent that blocks
the parasympathetic nervous system. This results in an increased heart rate (to
treat bradycardia), decreased secretions (to prevent aspiration), and pupil
dilation. The classic mnemonic is "Hot as a hare, blind as a bat, dry as a bone, red
as a beet, mad as a hatter"[citation:4]. </details>
5. A patient on a cholinergic agent complains of diarrhea, frequent urination,
and blurred distance vision. The nurse recognizes these as:
A. Signs of an allergic reaction
B. Expected side effects of the medication
C. Signs of a cholinergic crisis
D. Signs of anticholinergic toxicity
<details> <summary>See Answer & Rationale</summary> **Correct Answer: B.
Expected side effects of the medication** **Rationale:** These are classic effects
of cholinergic stimulation (SLUDGE: Salivation, Lacrimation, Urination, Defecation,
GI upset, Emesis). When taking cholinergic agents, these are expected side effects
but should be monitored[citation:4]. </details>
6. A client with myasthenia gravis is prescribed pyridostigmine. The nurse
explains that this medication works by:
A. Suppressing the immune system.
,B. Blocking acetylcholine at the neuromuscular junction.
C. Increasing the amount of acetylcholine available.
D. Preventing the destruction of myelin sheaths.
<details> <summary>See Answer & Rationale</summary> **Correct Answer: C.
Increasing the amount of acetylcholine available.** **Rationale:**
Pyridostigmine is an acetylcholinesterase inhibitor. It prevents the breakdown of
acetylcholine, increasing its availability to improve neuromuscular transmission
and control muscle weakness[citation:2]. </details>
7. A client is prescribed carbidopa-levodopa for Parkinson's disease. Which
foods should the nurse instruct the client to avoid?
A. High-protein foods
B. High-carbohydrate foods
C. High-fat foods
D. High-fiber foods
<details> <summary>See Answer & Rationale</summary> **Correct Answer: A.
High-protein foods** **Rationale:** High-protein foods compete with levodopa
for absorption across the blood-brain barrier, which can significantly reduce its
effectiveness. It should be taken on an empty stomach or with a low-protein
snack[citation:2]. </details>
8. A nurse is caring for a client with Alzheimer's disease who is prescribed
rivastigmine. What is the primary mechanism of action for this drug?
A. It increases dopamine levels in the brain.
B. It inhibits acetylcholinesterase, increasing acetylcholine levels.
C. It blocks glutamate receptors.
D. It acts as an NMDA receptor antagonist.
<details> <summary>See Answer & Rationale</summary> **Correct Answer: B. It
inhibits acetylcholinesterase, increasing acetylcholine levels.** **Rationale:**
Rivastigmine is a cholinesterase inhibitor. It works by blocking the enzyme
acetylcholinesterase, which breaks down acetylcholine. This leads to a higher
concentration of acetylcholine in the brain, which can temporarily improve or
stabilize cognitive symptoms in Alzheimer's disease[citation:2][citation:8].
</details>
, 9. The nurse is caring for a patient who takes digoxin for heart failure. The
patient's serum potassium level is 3.2 mEq/L. Which medication order should
the nurse question?
A. Digoxin
B. Furosemide
C. Potassium supplement
D. Enalapril
<details> <summary>See Answer & Rationale</summary> **Correct Answer: A.
Digoxin** **Rationale:** A low potassium level (hypokalemia) increases the risk
of digoxin toxicity. Digoxin should be held, and the healthcare provider should be
notified. The normal potassium range is 3.5-5 mEq/L[citation:5][citation:12].
</details>
10. A patient on warfarin has an INR of 4.5. What is the nurse's priority action?
A. Administer the next dose as scheduled.
B. Hold the next dose and notify the provider.
C. Administer Vitamin K as an antidote per protocol.
D. Monitor the patient for signs of bleeding.
<details> <summary>See Answer & Rationale</summary> **Correct Answer: C.
Administer Vitamin K as an antidote per protocol.** **Rationale:** A therapeutic
INR for most indications is between 2.0 and 3.0. An INR of 4.5 is significantly
elevated and indicates a high risk of bleeding. The priority is to reverse the
anticoagulation effect per protocol, usually with Vitamin K, and then notify the
provider. Holding the dose is not enough in this situation[citation:5]. </details>
11. The nurse is providing teaching to a client with a new prescription for
metoprolol. Which instruction is most important to include?
A. "This medication may cause a dry cough."
B. "Do not stop this medication abruptly."
C. "Take this medication with a high-fat meal."
D. "Monitor your blood glucose for hypoglycemia."
<details> <summary>See Answer & Rationale</summary> **Correct Answer: B.
"Do not stop this medication abruptly."** **Rationale:** Abrupt withdrawal of
beta-blockers can cause rebound hypertension, tachycardia, and an increased risk
