,NU 578 U2 Exam | Pharm for Adv Practice Nurses (2026/2027) Q&A | U South
Alabama
1. A patient is prescribed a medication that stimulates the parasympathetic nervous system.
Which expected effect should the nurse monitor for?
A) Increased heart rate
B) Pupillary dilation
C) Increased salivation
D) Bronchial relaxation
Correct Answer: Increased salivation
Rationale: Parasympathetic stimulation activates cholinergic receptors, leading to
increased salivation, lacrimation, urination, digestion, and defecation. Increased heart rate
and pupillary dilation are sympathetic effects. Bronchial relaxation is mediated by
sympathetic beta-2 receptors.
2. Which neurotransmitter is primarily responsible for transmission at all autonomic ganglia?
A) Norepinephrine
B) Acetylcholine
C) Dopamine
D) Serotonin
Correct Answer: Acetylcholine
Rationale: Acetylcholine is the neurotransmitter at all autonomic ganglia, both
sympathetic and parasympathetic. Norepinephrine is the primary neurotransmitter at most
sympathetic postganglionic nerve endings. Dopamine and serotonin are primarily central
nervous system neurotransmitters.
3. A patient receives atropine. Which anticipated effect should the nurse expect?
A) Bradycardia
,B) Dry mouth
C) Increased urination
D) Constricted pupils
Correct Answer: Dry mouth
Rationale: Atropine is a muscarinic antagonist that blocks parasympathetic effects, causing
dry mouth, tachycardia, mydriasis, and urinary retention. Bradycardia, increased urination,
and constricted pupils are parasympathomimetic effects.
4. Which receptor type is primarily responsible for sympathetic effects on the heart?
A) Alpha-1
B) Beta-1
C) Beta-2
D) Muscarinic
Correct Answer: Beta-1
Rationale: Beta-1 receptors are located primarily in the heart and mediate increased heart
rate, contractility, and conduction velocity. Alpha-1 receptors mediate vasoconstriction.
Beta-2 receptors mediate bronchodilation and uterine relaxation. Muscarinic receptors
mediate parasympathetic effects.
5. A patient is prescribed a beta-2 agonist. Which therapeutic effect should the nurse
anticipate?
A) Bronchoconstriction
B) Bronchodilation
C) Bradycardia
D) Hypertension
Correct Answer: Bronchodilation
, Rationale: Beta-2 agonists stimulate beta-2 receptors in the lungs, causing
bronchodilation. They are used to treat asthma and COPD. Bradycardia is a beta-1 antagonist
effect. Hypertension is an alpha-1 agonist effect.
6. Which medication is a direct-acting cholinergic agonist?
A) Bethanechol
B) Atropine
C) Propranolol
D) Phenylephrine
Correct Answer: Bethanechol
Rationale: Bethanechol directly stimulates muscarinic receptors and is used to treat
urinary retention. Atropine is a muscarinic antagonist. Propranolol is a beta-blocker.
Phenylephrine is an alpha-1 agonist.
7. A patient taking an anticholinergic medication reports constipation. Which instruction
should the nurse provide?
A) Increase dietary fiber and fluid intake.
B) Take the medication with food.
C) Decrease physical activity.
D) Restrict fluids to prevent bloating.
Correct Answer: Increase dietary fiber and fluid intake.
Rationale: Anticholinergic medications decrease gastrointestinal motility, leading to
constipation. Increasing dietary fiber and fluid intake helps prevent and manage
constipation. Decreasing activity and restricting fluids would worsen the condition.
8. Which adverse effect is most concerning for a patient receiving a beta-blocker?
A) Bradycardia
B) Hypertension
Alabama
1. A patient is prescribed a medication that stimulates the parasympathetic nervous system.
Which expected effect should the nurse monitor for?
A) Increased heart rate
B) Pupillary dilation
C) Increased salivation
D) Bronchial relaxation
Correct Answer: Increased salivation
Rationale: Parasympathetic stimulation activates cholinergic receptors, leading to
increased salivation, lacrimation, urination, digestion, and defecation. Increased heart rate
and pupillary dilation are sympathetic effects. Bronchial relaxation is mediated by
sympathetic beta-2 receptors.
2. Which neurotransmitter is primarily responsible for transmission at all autonomic ganglia?
A) Norepinephrine
B) Acetylcholine
C) Dopamine
D) Serotonin
Correct Answer: Acetylcholine
Rationale: Acetylcholine is the neurotransmitter at all autonomic ganglia, both
sympathetic and parasympathetic. Norepinephrine is the primary neurotransmitter at most
sympathetic postganglionic nerve endings. Dopamine and serotonin are primarily central
nervous system neurotransmitters.
3. A patient receives atropine. Which anticipated effect should the nurse expect?
A) Bradycardia
,B) Dry mouth
C) Increased urination
D) Constricted pupils
Correct Answer: Dry mouth
Rationale: Atropine is a muscarinic antagonist that blocks parasympathetic effects, causing
dry mouth, tachycardia, mydriasis, and urinary retention. Bradycardia, increased urination,
and constricted pupils are parasympathomimetic effects.
4. Which receptor type is primarily responsible for sympathetic effects on the heart?
A) Alpha-1
B) Beta-1
C) Beta-2
D) Muscarinic
Correct Answer: Beta-1
Rationale: Beta-1 receptors are located primarily in the heart and mediate increased heart
rate, contractility, and conduction velocity. Alpha-1 receptors mediate vasoconstriction.
Beta-2 receptors mediate bronchodilation and uterine relaxation. Muscarinic receptors
mediate parasympathetic effects.
5. A patient is prescribed a beta-2 agonist. Which therapeutic effect should the nurse
anticipate?
A) Bronchoconstriction
B) Bronchodilation
C) Bradycardia
D) Hypertension
Correct Answer: Bronchodilation
, Rationale: Beta-2 agonists stimulate beta-2 receptors in the lungs, causing
bronchodilation. They are used to treat asthma and COPD. Bradycardia is a beta-1 antagonist
effect. Hypertension is an alpha-1 agonist effect.
6. Which medication is a direct-acting cholinergic agonist?
A) Bethanechol
B) Atropine
C) Propranolol
D) Phenylephrine
Correct Answer: Bethanechol
Rationale: Bethanechol directly stimulates muscarinic receptors and is used to treat
urinary retention. Atropine is a muscarinic antagonist. Propranolol is a beta-blocker.
Phenylephrine is an alpha-1 agonist.
7. A patient taking an anticholinergic medication reports constipation. Which instruction
should the nurse provide?
A) Increase dietary fiber and fluid intake.
B) Take the medication with food.
C) Decrease physical activity.
D) Restrict fluids to prevent bloating.
Correct Answer: Increase dietary fiber and fluid intake.
Rationale: Anticholinergic medications decrease gastrointestinal motility, leading to
constipation. Increasing dietary fiber and fluid intake helps prevent and manage
constipation. Decreasing activity and restricting fluids would worsen the condition.
8. Which adverse effect is most concerning for a patient receiving a beta-blocker?
A) Bradycardia
B) Hypertension
