NR293 Pharmacology Midterm Exam
2025/2026 – Verified Questions &
Correct Answers | Graded A+
Section 1: Autonomic Nervous System Agents (Questions 1–
20)
1. A client is prescribed atropine for bradycardia. What is the primary mechanism of
action? A. Beta-1 agonist B. Muscarinic receptor antagonist C. Alpha-1 blocker D. Dopamine
agonist
Rationale: Atropine blocks muscarinic receptors, increasing heart rate via parasympathetic
inhibition; monitor for dry mouth and tachycardia as nursing implications; avoid in glaucoma
due to mydriasis interaction.
2. Which adverse effect is most associated with beta-blockers like propranolol? A.
Hypertension B. Bradycardia C. Tachycardia D. Hyperglycemia
Rationale: Beta-blockers reduce cardiac output and AV conduction, causing bradycardia;
nursing implications include apical pulse check before dosing; caution in diabetics due to
masked hypoglycemia symptoms.
3. Epinephrine is administered for anaphylaxis. Its primary action is: A. Vasoconstriction
only B. Alpha and beta adrenergic stimulation C. Muscarinic blockade D. Calcium channel block
Rationale: Epinephrine activates alpha-1 (vasoconstriction) and beta-2 (bronchodilation)
receptors; IM administration preferred; monitor for rebound hypertension and teach EpiPen use
as nursing implication.
4. A client on pilocarpine for glaucoma should be monitored for: A. Mydriasis B. Miosis and
sweating C. Dry mouth D. Urinary retention
Rationale: Pilocarpine, a cholinergic agonist, contracts ciliary muscle for miosis; increases
salivation/sweating; nursing implications: assess IOP and avoid in asthma due to
bronchoconstriction risk.
5. Bethanechol is used for postoperative urinary retention. Its action is: A. Anticholinergic
B. Cholinergic agonist C. Adrenergic blocker D. Sympathomimetic
Rationale: Bethanechol stimulates muscarinic receptors to promote bladder contraction;
contraindicated in obstruction; nursing: monitor for hypotension and diarrhea.
, 6. Which interaction occurs with MAOIs and tyramine-rich foods? A. Hypotension B.
Hypertensive crisis C. Bradycardia D. Hypoglycemia
Rationale: MAOIs prevent catecholamine breakdown, leading to tyramine-induced pressor
response; nursing: educate on low-tyramine diet; monitor BP closely.
7. Dobutamine is indicated for: A. Hypotension B. Cardiogenic shock C. Asthma D. Urinary
retention
Rationale: Dobutamine, a beta-1 agonist, increases cardiac contractility; IV infusion; nursing
implications: continuous ECG monitoring for arrhythmias.
8. Scopolamine transdermal patch is used for motion sickness. Monitor for: A. Salivation B.
Dry mouth and drowsiness C. Diarrhea D. Bradycardia
Rationale: Anticholinergic action reduces vestibular stimulation; side effects include
xerostomia; nursing: apply behind ear, avoid driving due to sedation.
9. Albuterol, a beta-2 agonist, primarily causes: A. Vasodilation B. Bronchodilation C. Miosis
D. Urinary retention
Rationale: Selective beta-2 stimulation relaxes bronchial smooth muscle; MDI use; nursing:
teach spacer technique, monitor for tachycardia in overuse.
10. Phenylephrine nasal spray risks: A. Rebound congestion with prolonged use B. Rebound
congestion with prolonged use C. Hypotension D. Bradycardia
Rationale: Alpha-1 agonist vasoconstricts mucosa; limit to 3 days; nursing: educate on rhinitis
medicamentosa prevention.
11. A client on neostigmine for myasthenia gravis may experience: A. Weakness worsening
B. Muscarinic side effects like diarrhea C. Tachycardia D. Dry eyes
Rationale: Acetylcholinesterase inhibitor increases ACh; cholinergic crisis risk; nursing:
monitor for SLUDGE symptoms, have atropine available.
12. Clonidine, an alpha-2 agonist, is used for: A. Tachycardia B. Hypertension C. Glaucoma
D. Urinary retention
Rationale: Central alpha-2 stimulation reduces sympathetic outflow; withdrawal hypertension
risk; nursing: taper dose, monitor rebound.
13. Ipratropium bromide is a(n): A. Beta agonist B. Anticholinergic bronchodilator C.
Cholinergic D. MAOI
2025/2026 – Verified Questions &
Correct Answers | Graded A+
Section 1: Autonomic Nervous System Agents (Questions 1–
20)
1. A client is prescribed atropine for bradycardia. What is the primary mechanism of
action? A. Beta-1 agonist B. Muscarinic receptor antagonist C. Alpha-1 blocker D. Dopamine
agonist
Rationale: Atropine blocks muscarinic receptors, increasing heart rate via parasympathetic
inhibition; monitor for dry mouth and tachycardia as nursing implications; avoid in glaucoma
due to mydriasis interaction.
2. Which adverse effect is most associated with beta-blockers like propranolol? A.
Hypertension B. Bradycardia C. Tachycardia D. Hyperglycemia
Rationale: Beta-blockers reduce cardiac output and AV conduction, causing bradycardia;
nursing implications include apical pulse check before dosing; caution in diabetics due to
masked hypoglycemia symptoms.
3. Epinephrine is administered for anaphylaxis. Its primary action is: A. Vasoconstriction
only B. Alpha and beta adrenergic stimulation C. Muscarinic blockade D. Calcium channel block
Rationale: Epinephrine activates alpha-1 (vasoconstriction) and beta-2 (bronchodilation)
receptors; IM administration preferred; monitor for rebound hypertension and teach EpiPen use
as nursing implication.
4. A client on pilocarpine for glaucoma should be monitored for: A. Mydriasis B. Miosis and
sweating C. Dry mouth D. Urinary retention
Rationale: Pilocarpine, a cholinergic agonist, contracts ciliary muscle for miosis; increases
salivation/sweating; nursing implications: assess IOP and avoid in asthma due to
bronchoconstriction risk.
5. Bethanechol is used for postoperative urinary retention. Its action is: A. Anticholinergic
B. Cholinergic agonist C. Adrenergic blocker D. Sympathomimetic
Rationale: Bethanechol stimulates muscarinic receptors to promote bladder contraction;
contraindicated in obstruction; nursing: monitor for hypotension and diarrhea.
, 6. Which interaction occurs with MAOIs and tyramine-rich foods? A. Hypotension B.
Hypertensive crisis C. Bradycardia D. Hypoglycemia
Rationale: MAOIs prevent catecholamine breakdown, leading to tyramine-induced pressor
response; nursing: educate on low-tyramine diet; monitor BP closely.
7. Dobutamine is indicated for: A. Hypotension B. Cardiogenic shock C. Asthma D. Urinary
retention
Rationale: Dobutamine, a beta-1 agonist, increases cardiac contractility; IV infusion; nursing
implications: continuous ECG monitoring for arrhythmias.
8. Scopolamine transdermal patch is used for motion sickness. Monitor for: A. Salivation B.
Dry mouth and drowsiness C. Diarrhea D. Bradycardia
Rationale: Anticholinergic action reduces vestibular stimulation; side effects include
xerostomia; nursing: apply behind ear, avoid driving due to sedation.
9. Albuterol, a beta-2 agonist, primarily causes: A. Vasodilation B. Bronchodilation C. Miosis
D. Urinary retention
Rationale: Selective beta-2 stimulation relaxes bronchial smooth muscle; MDI use; nursing:
teach spacer technique, monitor for tachycardia in overuse.
10. Phenylephrine nasal spray risks: A. Rebound congestion with prolonged use B. Rebound
congestion with prolonged use C. Hypotension D. Bradycardia
Rationale: Alpha-1 agonist vasoconstricts mucosa; limit to 3 days; nursing: educate on rhinitis
medicamentosa prevention.
11. A client on neostigmine for myasthenia gravis may experience: A. Weakness worsening
B. Muscarinic side effects like diarrhea C. Tachycardia D. Dry eyes
Rationale: Acetylcholinesterase inhibitor increases ACh; cholinergic crisis risk; nursing:
monitor for SLUDGE symptoms, have atropine available.
12. Clonidine, an alpha-2 agonist, is used for: A. Tachycardia B. Hypertension C. Glaucoma
D. Urinary retention
Rationale: Central alpha-2 stimulation reduces sympathetic outflow; withdrawal hypertension
risk; nursing: taper dose, monitor rebound.
13. Ipratropium bromide is a(n): A. Beta agonist B. Anticholinergic bronchodilator C.
Cholinergic D. MAOI
