Arizona College of Nursing NUR 354 – Pharmacology II Exams 1, 2, 3, and
ARIZONA COLLEGE OF4 NURSING
Comprehensive Review Bundle
NUR 354 - PHARMACOLOGY II
EXAM 1 - 2026
Student Name:
Date: ____________________
__________________________________
Score: __________ / 50 Grade: __________________
1. An older adult is experiencing the expected effects of parasympathetic stimulation. Which
assessment finding best reflects the “rest and digest” response described in the review materials?
A. Increased blood pressure with pupil dilation and reduced bladder contraction
B. A lower heart rate with increased peristalsis and bladder contraction
C. Dilated pupils with increased heart rate and urine retention
D. Bronchodilation with decreased peristalsis and increased blood glucose
✓ Correct Answer: B. A lower heart rate with increased peristalsis and bladder contraction
Rationale: The review describes the parasympathetic response as rest and digest: pupils contract, heart rate
lowers, peristalsis increases, and the bladder contracts.
2. A postoperative client has nonobstructive urinary retention. Which medication should the nurse
expect to administer based on the Exam 1 materials?
A. Oxybutynin
B. Bethanechol
C. Dicyclomine
D. Benztropine
✓ Correct Answer: B. Bethanechol
Rationale: Bethanechol is identified as a direct-acting cholinergic medication that stimulates bladder smooth
muscle and is used for nonobstructive urinary retention, including after anesthesia.
3. A client receives bethanechol. Which finding should the nurse recognize as an expected adverse
effect that requires monitoring?
A. Urinary retention with constipation
B. Hypertension with dry mouth
C. Tachycardia with decreased bowel sounds
D. Hypotension with increased salivation and sweating
✓ Correct Answer: D. Hypotension with increased salivation and sweating
Rationale: The uploaded materials list increased salivation, sweating, abdominal cramping, and hypotension as
effects of bethanechol and direct the nurse to monitor blood pressure and heart rate.
4. A client taking a cholinergic medication develops bradycardia, muscle weakness, excessive
salivation, sweating, and abdominal cramping. Which complication is most consistent with these
findings?
A. Malignant hyperthermia
B. Cholinergic crisis
C. Anticholinergic toxicity
D. Neuroleptic malignant syndrome
✓ Correct Answer: B. Cholinergic crisis
Rationale: The review defines cholinergic crisis as too much acetylcholine and lists bradycardia, muscle
weakness or twitching, sweating or tearing, hypersalivation, and abdominal cramping among the manifestations.
,5. Which medication should the nurse anticipate for a client experiencing a cholinergic crisis?
A. Phentolamine
B. Physostigmine
C. Atropine
D. Flumazenil
✓ Correct Answer: C. Atropine
Rationale: The course materials repeatedly identify atropine, an anticholinergic, as the treatment or antidote for
cholinergic crisis.
6. A client with myasthenia gravis is prescribed a medication to improve skeletal muscle strength.
Which medication is emphasized in the Exam 1 materials?
A. Oxybutynin
B. Phenobarbital
C. Clonidine
D. Pyridostigmine
✓ Correct Answer: D. Pyridostigmine
Rationale: Pyridostigmine is listed as an acetylcholinesterase inhibitor used for myasthenia gravis that increases
acetylcholine and improves muscle strength.
7. A client develops delirium and other manifestations of anticholinergic toxicity after receiving an
anticholinergic medication. Which reversal agent should the nurse expect?
A. Dantrolene
B. Flumazenil
C. Atropine
D. Physostigmine
✓ Correct Answer: D. Physostigmine
Rationale: Physostigmine is identified in the uploaded reviews as an indirect cholinesterase inhibitor used to
reverse anticholinergic toxicity or delirium.
8. A client reports urinary urgency and frequent voiding from an overactive bladder. Which medication
from the review is most appropriate?
A. Bethanechol
B. Donepezil
C. Oxybutynin
D. Pyridostigmine
✓ Correct Answer: C. Oxybutynin
Rationale: The Exam 1 review specifically links oxybutynin, an anticholinergic, with treatment of overactive
bladder.
9. The nurse reviews a new prescription for dicyclomine. Which client condition in the uploaded
material supports this prescription?
A. Parkinson disease
B. Status epilepticus
C. Irritable bowel syndrome
D. Septic shock
✓ Correct Answer: C. Irritable bowel syndrome
Rationale: Dicyclomine (Bentyl) is listed in the Exam 1 materials as an anticholinergic medication used for IBS.
,10. Which assessment finding best reflects activation of the sympathetic, or “fight or flight,” system
described in the review?
A. Bronchoconstriction with bladder contraction
B. Decreased heart rate, constricted pupils, and increased peristalsis
C. Increased heart rate, dilated pupils, and decreased peristalsis
D. Decreased blood glucose with increased bowel activity
✓ Correct Answer: C. Increased heart rate, dilated pupils, and decreased peristalsis
Rationale: The review describes fight or flight as increased heart rate and glucose, dilated pupils,
bronchodilation, decreased peristalsis, and urine retention.
11. A medication selectively stimulates beta-2 adrenergic receptors. Which therapeutic response
should the nurse expect?
A. Increased bladder contraction
B. Bronchodilation
C. Slowed heart rate
D. Increased peristalsis
✓ Correct Answer: B. Bronchodilation
Rationale: The source materials locate beta-2 effects in the lungs and repeatedly associate beta-2 activation
with relaxation of airway smooth muscle and bronchodilation.
12. A medication activates alpha-1 adrenergic receptors. Which effect is most consistent with the
Exam 1 review?
A. Vasoconstriction with increased blood pressure
B. Decreased heart rate through beta-1 blockade
C. Bronchodilation with little vascular effect
D. Bladder contraction from muscarinic stimulation
✓ Correct Answer: A. Vasoconstriction with increased blood pressure
Rationale: The uploaded receptor table associates alpha-1 activation with vasoconstriction and an increase in
blood pressure.
13. A client takes clonidine for hypertension. Which effect best explains the medication’s action in the
review materials?
A. Increased acetylcholine at central receptors
B. Direct stimulation of bladder smooth muscle
C. Decreased sympathetic outflow resulting in lower heart rate and blood pressure
D. Increased beta-1 stimulation that raises heart rate
✓ Correct Answer: C. Decreased sympathetic outflow resulting in lower heart rate and blood pressure
Rationale: Clonidine is described as a centrally acting adrenergic antihypertensive that decreases sympathetic
outflow to the heart and blood vessels, lowering heart rate and blood pressure.
14. A client with benign prostatic hyperplasia is prescribed tamsulosin. Which outcome best indicates
the medication is working?
A. Reduced seizure activity
B. Improved urine flow
C. Increased skeletal muscle strength
D. Increased bronchial secretions
✓ Correct Answer: B. Improved urine flow
Rationale: The source states that tamsulosin antagonizes alpha receptors in the prostate, relaxes prostatic
smooth muscle, and improves urine flow.
, 15. Which teaching should the nurse emphasize to a client taking an adrenergic-blocking medication
such as a beta blocker?
A. Stop the drug when the blood pressure becomes normal
B. Do not stop the medication abruptly
C. Take the medication only when symptoms occur
D. Double the next dose if one dose is missed
✓ Correct Answer: B. Do not stop the medication abruptly
Rationale: The uploaded study guide repeatedly states that adrenergic blockers and beta blockers should not
be stopped abruptly.
16. A client receives albuterol for bronchospasm. Which finding is most consistent with the adverse
effects listed in the Exam 1 materials?
A. Bradycardia and excessive salivation
B. Constipation with urinary retention only
C. Severe muscle rigidity
D. Palpitations and tachycardia
✓ Correct Answer: D. Palpitations and tachycardia
Rationale: Albuterol is a short-acting beta-2 agonist; the review lists palpitations, tachycardia, nervousness,
restlessness, and headache among its effects.
17. A client develops a severe systemic allergic reaction with hypotension and airway restriction.
Which medication is identified as the priority first-line treatment?
A. Clonidine
B. Tamsulosin
C. Diphenhydramine alone
D. Epinephrine
✓ Correct Answer: D. Epinephrine
Rationale: The Exam 1 materials identify epinephrine as first-line and priority treatment for anaphylaxis because
it provides vasoconstriction and relieves bronchoconstriction.
18. A parent asks when an epinephrine auto-injector is needed rather than an antihistamine alone.
Which finding from the review most strongly supports epinephrine use?
A. A localized rash without breathing difficulty
B. Hives with normal blood pressure and normal breathing
C. Low blood pressure with a restricted airway and stridor
D. Mild itching with normal oxygenation
✓ Correct Answer: C. Low blood pressure with a restricted airway and stridor
Rationale: The review contrasts anaphylaxis requiring epinephrine—low blood pressure with restricted airway or
stridor—with hives and stable breathing or blood pressure that may be managed with an antihistamine.
19. A client is in septic shock and requires a vasopressor. Which medication is specifically
emphasized in the study guide?
A. Tamsulosin
B. Donepezil
C. Bethanechol
D. Norepinephrine
✓ Correct Answer: D. Norepinephrine
Rationale: The comprehensive review states that norepinephrine is used for septic shock and severe
hypotension and specifically identifies it as the vasopressor used during septic shock.
ARIZONA COLLEGE OF4 NURSING
Comprehensive Review Bundle
NUR 354 - PHARMACOLOGY II
EXAM 1 - 2026
Student Name:
Date: ____________________
__________________________________
Score: __________ / 50 Grade: __________________
1. An older adult is experiencing the expected effects of parasympathetic stimulation. Which
assessment finding best reflects the “rest and digest” response described in the review materials?
A. Increased blood pressure with pupil dilation and reduced bladder contraction
B. A lower heart rate with increased peristalsis and bladder contraction
C. Dilated pupils with increased heart rate and urine retention
D. Bronchodilation with decreased peristalsis and increased blood glucose
✓ Correct Answer: B. A lower heart rate with increased peristalsis and bladder contraction
Rationale: The review describes the parasympathetic response as rest and digest: pupils contract, heart rate
lowers, peristalsis increases, and the bladder contracts.
2. A postoperative client has nonobstructive urinary retention. Which medication should the nurse
expect to administer based on the Exam 1 materials?
A. Oxybutynin
B. Bethanechol
C. Dicyclomine
D. Benztropine
✓ Correct Answer: B. Bethanechol
Rationale: Bethanechol is identified as a direct-acting cholinergic medication that stimulates bladder smooth
muscle and is used for nonobstructive urinary retention, including after anesthesia.
3. A client receives bethanechol. Which finding should the nurse recognize as an expected adverse
effect that requires monitoring?
A. Urinary retention with constipation
B. Hypertension with dry mouth
C. Tachycardia with decreased bowel sounds
D. Hypotension with increased salivation and sweating
✓ Correct Answer: D. Hypotension with increased salivation and sweating
Rationale: The uploaded materials list increased salivation, sweating, abdominal cramping, and hypotension as
effects of bethanechol and direct the nurse to monitor blood pressure and heart rate.
4. A client taking a cholinergic medication develops bradycardia, muscle weakness, excessive
salivation, sweating, and abdominal cramping. Which complication is most consistent with these
findings?
A. Malignant hyperthermia
B. Cholinergic crisis
C. Anticholinergic toxicity
D. Neuroleptic malignant syndrome
✓ Correct Answer: B. Cholinergic crisis
Rationale: The review defines cholinergic crisis as too much acetylcholine and lists bradycardia, muscle
weakness or twitching, sweating or tearing, hypersalivation, and abdominal cramping among the manifestations.
,5. Which medication should the nurse anticipate for a client experiencing a cholinergic crisis?
A. Phentolamine
B. Physostigmine
C. Atropine
D. Flumazenil
✓ Correct Answer: C. Atropine
Rationale: The course materials repeatedly identify atropine, an anticholinergic, as the treatment or antidote for
cholinergic crisis.
6. A client with myasthenia gravis is prescribed a medication to improve skeletal muscle strength.
Which medication is emphasized in the Exam 1 materials?
A. Oxybutynin
B. Phenobarbital
C. Clonidine
D. Pyridostigmine
✓ Correct Answer: D. Pyridostigmine
Rationale: Pyridostigmine is listed as an acetylcholinesterase inhibitor used for myasthenia gravis that increases
acetylcholine and improves muscle strength.
7. A client develops delirium and other manifestations of anticholinergic toxicity after receiving an
anticholinergic medication. Which reversal agent should the nurse expect?
A. Dantrolene
B. Flumazenil
C. Atropine
D. Physostigmine
✓ Correct Answer: D. Physostigmine
Rationale: Physostigmine is identified in the uploaded reviews as an indirect cholinesterase inhibitor used to
reverse anticholinergic toxicity or delirium.
8. A client reports urinary urgency and frequent voiding from an overactive bladder. Which medication
from the review is most appropriate?
A. Bethanechol
B. Donepezil
C. Oxybutynin
D. Pyridostigmine
✓ Correct Answer: C. Oxybutynin
Rationale: The Exam 1 review specifically links oxybutynin, an anticholinergic, with treatment of overactive
bladder.
9. The nurse reviews a new prescription for dicyclomine. Which client condition in the uploaded
material supports this prescription?
A. Parkinson disease
B. Status epilepticus
C. Irritable bowel syndrome
D. Septic shock
✓ Correct Answer: C. Irritable bowel syndrome
Rationale: Dicyclomine (Bentyl) is listed in the Exam 1 materials as an anticholinergic medication used for IBS.
,10. Which assessment finding best reflects activation of the sympathetic, or “fight or flight,” system
described in the review?
A. Bronchoconstriction with bladder contraction
B. Decreased heart rate, constricted pupils, and increased peristalsis
C. Increased heart rate, dilated pupils, and decreased peristalsis
D. Decreased blood glucose with increased bowel activity
✓ Correct Answer: C. Increased heart rate, dilated pupils, and decreased peristalsis
Rationale: The review describes fight or flight as increased heart rate and glucose, dilated pupils,
bronchodilation, decreased peristalsis, and urine retention.
11. A medication selectively stimulates beta-2 adrenergic receptors. Which therapeutic response
should the nurse expect?
A. Increased bladder contraction
B. Bronchodilation
C. Slowed heart rate
D. Increased peristalsis
✓ Correct Answer: B. Bronchodilation
Rationale: The source materials locate beta-2 effects in the lungs and repeatedly associate beta-2 activation
with relaxation of airway smooth muscle and bronchodilation.
12. A medication activates alpha-1 adrenergic receptors. Which effect is most consistent with the
Exam 1 review?
A. Vasoconstriction with increased blood pressure
B. Decreased heart rate through beta-1 blockade
C. Bronchodilation with little vascular effect
D. Bladder contraction from muscarinic stimulation
✓ Correct Answer: A. Vasoconstriction with increased blood pressure
Rationale: The uploaded receptor table associates alpha-1 activation with vasoconstriction and an increase in
blood pressure.
13. A client takes clonidine for hypertension. Which effect best explains the medication’s action in the
review materials?
A. Increased acetylcholine at central receptors
B. Direct stimulation of bladder smooth muscle
C. Decreased sympathetic outflow resulting in lower heart rate and blood pressure
D. Increased beta-1 stimulation that raises heart rate
✓ Correct Answer: C. Decreased sympathetic outflow resulting in lower heart rate and blood pressure
Rationale: Clonidine is described as a centrally acting adrenergic antihypertensive that decreases sympathetic
outflow to the heart and blood vessels, lowering heart rate and blood pressure.
14. A client with benign prostatic hyperplasia is prescribed tamsulosin. Which outcome best indicates
the medication is working?
A. Reduced seizure activity
B. Improved urine flow
C. Increased skeletal muscle strength
D. Increased bronchial secretions
✓ Correct Answer: B. Improved urine flow
Rationale: The source states that tamsulosin antagonizes alpha receptors in the prostate, relaxes prostatic
smooth muscle, and improves urine flow.
, 15. Which teaching should the nurse emphasize to a client taking an adrenergic-blocking medication
such as a beta blocker?
A. Stop the drug when the blood pressure becomes normal
B. Do not stop the medication abruptly
C. Take the medication only when symptoms occur
D. Double the next dose if one dose is missed
✓ Correct Answer: B. Do not stop the medication abruptly
Rationale: The uploaded study guide repeatedly states that adrenergic blockers and beta blockers should not
be stopped abruptly.
16. A client receives albuterol for bronchospasm. Which finding is most consistent with the adverse
effects listed in the Exam 1 materials?
A. Bradycardia and excessive salivation
B. Constipation with urinary retention only
C. Severe muscle rigidity
D. Palpitations and tachycardia
✓ Correct Answer: D. Palpitations and tachycardia
Rationale: Albuterol is a short-acting beta-2 agonist; the review lists palpitations, tachycardia, nervousness,
restlessness, and headache among its effects.
17. A client develops a severe systemic allergic reaction with hypotension and airway restriction.
Which medication is identified as the priority first-line treatment?
A. Clonidine
B. Tamsulosin
C. Diphenhydramine alone
D. Epinephrine
✓ Correct Answer: D. Epinephrine
Rationale: The Exam 1 materials identify epinephrine as first-line and priority treatment for anaphylaxis because
it provides vasoconstriction and relieves bronchoconstriction.
18. A parent asks when an epinephrine auto-injector is needed rather than an antihistamine alone.
Which finding from the review most strongly supports epinephrine use?
A. A localized rash without breathing difficulty
B. Hives with normal blood pressure and normal breathing
C. Low blood pressure with a restricted airway and stridor
D. Mild itching with normal oxygenation
✓ Correct Answer: C. Low blood pressure with a restricted airway and stridor
Rationale: The review contrasts anaphylaxis requiring epinephrine—low blood pressure with restricted airway or
stridor—with hives and stable breathing or blood pressure that may be managed with an antihistamine.
19. A client is in septic shock and requires a vasopressor. Which medication is specifically
emphasized in the study guide?
A. Tamsulosin
B. Donepezil
C. Bethanechol
D. Norepinephrine
✓ Correct Answer: D. Norepinephrine
Rationale: The comprehensive review states that norepinephrine is used for septic shock and severe
hypotension and specifically identifies it as the vasopressor used during septic shock.
