Learning Q&A | Pharmacology
1. Which adrenergic receptor, when activated in the heart, is primarily
responsible for increasing both the rate and the force of contraction?
A) Alpha-1 receptor
B) Beta-1 receptor
C) Beta-2 receptor
D) Dopaminergic receptor
Correct Answer: Beta-1 receptor
Rationale: Beta-1 receptors are located predominantly in the heart. Their
stimulation increases cardiac output by raising the heart rate (chronotropy)
and the force of contraction (inotropy). Alpha-1 receptors cause
vasoconstriction, while Beta-2 receptors lead to bronchodilation and
peripheral vasodilation.
2. What is the primary clinical indication for administering a nonselective
beta-blocker like propranolol?
A) To treat acute bronchospasm in an asthma attack
B) To lower blood pressure and manage angina pectoris
C) To increase cardiac output in heart failure
D) To dilate the pupils for an ophthalmic exam
Correct Answer: To lower blood pressure and manage angina pectoris
Rationale: Beta-blockers decrease heart rate and contractility, reducing the
workload of the heart and lowering blood pressure. They are not used for
bronchospasm and are contraindicated in asthma, and they are not first-line
for increasing output in heart failure.
,3. How does the administration of a sympathomimetic drug like epinephrine
affect a patient’s blood glucose level?
A) It significantly decreases blood glucose by increasing insulin secretion
B) It mildly decreases blood glucose by improving peripheral uptake
C) It has no clinically significant effect on blood glucose levels
D) It increases blood glucose by promoting glycogenolysis and
gluconeogenesis
Correct Answer: It increases blood glucose by promoting glycogenolysis and
gluconeogenesis
Rationale: Epinephrine is a “fight or flight” hormone that prepares the body
for stress by increasing the availability of energy substrates. It stimulates the
liver to break down glycogen into glucose (glycogenolysis) and produce new
glucose (gluconeogenesis), leading to hyperglycemia.
4. Which combination of medication classes is most likely to be prescribed
for a patient with heart failure with reduced ejection fraction (HFrEF) to
decrease mortality and hospitalizations?
A) ACE inhibitor and beta-blocker
B) Beta-blocker and loop diuretic
C) Digoxin and loop diuretic
D) ACE inhibitor and potassium supplement
Correct Answer: ACE inhibitor and beta-blocker
Rationale: Both ACE inhibitors and beta-blockers have been shown in large
clinical trials to significantly reduce morbidity and mortality in patients with
, HFrEF. Loop diuretics control symptoms of fluid overload but do not improve
survival.
5. The nurse is preparing to administer a beta-2 adrenergic agonist, such as
albuterol. Which assessment finding would be the most concerning and
require the nurse to hold the medication and contact the provider?
A) Heart rate of 52 beats per minute
B) Blood pressure of 110/70 mm Hg
C) Heart rate of 120 beats per minute
D) Respiratory rate of 18 breaths per minute
Correct Answer: Heart rate of 120 beats per minute
Rationale: Beta-2 agonists, especially at higher doses, can cause significant
tachycardia by stimulating beta-1 receptors in the heart. A heart rate of 120
bpm is a sign of an adverse effect that could worsen cardiac ischemia or
cause dysrhythmias.
6. A patient is being treated for an acute asthma exacerbation with a
combination of albuterol and ipratropium bromide nebulizer treatments.
What is the primary rationale for this therapeutic drug combination?
A) Albuterol is an anticholinergic and ipratropium is a sympathomimetic
B) The drugs have an antagonistic effect that prevents toxicity
C) They work by different mechanisms to produce additive bronchodilation
D) Ipratropium prevents the rebound bronchospasm caused by albuterol
Correct Answer: They work by different mechanisms to produce additive
bronchodilation