NSG 533
EXAM 3
Advanced Pharmacology
Actual Questions with Verified Answers
Wilkes University
Pass the Exam with Confidence
What You Will Get:
➢100 Exam Questions w/ Answers
➢Expert Rationales included.
➢Exam 3 Comprehensive Study Guide
,Table of Contents
NSG 533 Exam 3 ................................................................................ 2
NSG 533 Exam 3 ............................................................................. 26
NSG 533 Exam 3 Focused Study Guide .............................. 49
NSG 533 Exam 3
Question 1
A 28-year-old patient with moderate persistent asthma is prescribed an inhaled
corticosteroid (ICS). Which of the following best describes the mechanism of action
of ICS?
A) Stimulate beta-2 adrenergic receptors causing bronchodilation
B) Inhibit acetylcholine on muscarinic receptors to prevent bronchoconstriction
C) Potent anti-inflammatory agents that decrease airway inflammation, attenuate airway
hyper-responsiveness, and minimize mucus production
D) Block leukotriene receptors to reduce bronchoconstriction
Correct Answer: C
Rationale: Inhaled corticosteroids (ICS) such as fluticasone, budesonide, beclomethasone,
and ciclesonide are the most potent anti-inflammatory agents for asthma. They work by
decreasing airway inflammation, attenuating airway hyper-responsiveness, and minimizing
mucus production and secretions. They also improve the actions of beta-agonists and target
the lungs directly. Option A describes LABA mechanism, Option B describes LAMA
mechanism, and Option D describes LTRA mechanism.
Question 2
Which of the following are examples of inhaled corticosteroids? (Select All That Apply)
,A) Fluticasone
B) Salmeterol
C) Budesonide
D) Tiotropium
E) Beclomethasone
F) Ciclesonide
Correct Answers: A, C, E, F
Rationale: Fluticasone, budesonide, beclomethasone, and ciclesonide are all inhaled
corticosteroids. Salmeterol (Option B) is a long-acting beta agonist (LABA), and tiotropium
(Option D) is a long-acting muscarinic antagonist (LAMA). It is critical to distinguish
between drug classes for safe prescribing.
Question 3
A patient with asthma not adequately controlled on an inhaled corticosteroid alone
is prescribed a long-acting beta agonist (LABA) as add-on therapy. What is the
primary mechanism of action of LABA?
A) Inhibit 5-lipoxygenase to reduce leukotriene production
B) Stimulate beta-2 adrenergic receptors in the lungs, resulting in relaxation of bronchial
smooth muscle (bronchodilation)
C) Block muscarinic receptors to prevent cholinergic bronchoconstriction
D) Stabilize mast cell membranes to prevent degranulation
Correct Answer: B
Rationale: Long-acting beta agonists (LABA) such as salmeterol and vilanterol work by
stimulating beta-2 adrenergic receptors in the lungs, resulting in relaxation of bronchial
smooth muscle (bronchodilation). Benefits include improved pulmonary function, more
symptom-free days, and decreased need for short-acting beta agonists (SABA). LABA
should NEVER be used as monotherapy for asthma—must always be combined with
ICS. Option A describes LTRA, Option C describes LAMA, and Option D describes
cromolyn/mast cell stabilizers.
Question 4
Which of the following are benefits of adding a long-acting beta agonist (LABA) to
inhaled corticosteroid therapy in asthma? (Select All That Apply)
, A) Improved pulmonary function
B) More symptom-free days
C) Decreased need for short-acting beta agonists (SABA)
D) Reduced airway inflammation independent of ICS
E) Replacement for inhaled corticosteroids
Correct Answers: A, B, C
Rationale: LABA add-on therapy to ICS provides improved pulmonary function, more
symptom-free days, and decreased need for SABA rescue inhalers. However, LABA does
NOT reduce airway inflammation independently (Option D)—that is the role of ICS. Most
importantly, LABA should NEVER replace ICS (Option E) due to safety concerns; LABA
monotherapy increases risk of asthma-related death.
Question 5
A patient with COPD is started on tiotropium. Which mechanism of action correctly
describes this medication?
A) Stimulates beta-2 receptors to increase cAMP and cause bronchodilation
B) Inhibits effects of acetylcholine on muscarinic receptors, protecting against cholinergic-
mediated bronchoconstriction
C) Blocks leukotriene D4 receptors to reduce inflammation
D) Inhibits phosphodiesterase to increase cAMP levels
Correct Answer: B
Rationale: Tiotropium is a long-acting muscarinic antagonist (LAMA). It inhibits the effects
of acetylcholine on muscarinic receptors, protecting against cholinergic-mediated
bronchoconstriction. This is particularly useful in COPD where cholinergic tone is
increased. Option A describes beta-agonists, Option C describes LTRA (montelukast), and
Option D describes phosphodiesterase inhibitors like roflumilast.
Question 6
A patient newly started on tiotropium reports dry mouth and difficulty urinating. The nurse
practitioner should recognize these as:
A) Signs of an allergic reaction requiring immediate discontinuation
B) Expected antimuscarinic side effects that may improve with continued use
C) Indications that the dose is too high
D) Symptoms unrelated to the medication
EXAM 3
Advanced Pharmacology
Actual Questions with Verified Answers
Wilkes University
Pass the Exam with Confidence
What You Will Get:
➢100 Exam Questions w/ Answers
➢Expert Rationales included.
➢Exam 3 Comprehensive Study Guide
,Table of Contents
NSG 533 Exam 3 ................................................................................ 2
NSG 533 Exam 3 ............................................................................. 26
NSG 533 Exam 3 Focused Study Guide .............................. 49
NSG 533 Exam 3
Question 1
A 28-year-old patient with moderate persistent asthma is prescribed an inhaled
corticosteroid (ICS). Which of the following best describes the mechanism of action
of ICS?
A) Stimulate beta-2 adrenergic receptors causing bronchodilation
B) Inhibit acetylcholine on muscarinic receptors to prevent bronchoconstriction
C) Potent anti-inflammatory agents that decrease airway inflammation, attenuate airway
hyper-responsiveness, and minimize mucus production
D) Block leukotriene receptors to reduce bronchoconstriction
Correct Answer: C
Rationale: Inhaled corticosteroids (ICS) such as fluticasone, budesonide, beclomethasone,
and ciclesonide are the most potent anti-inflammatory agents for asthma. They work by
decreasing airway inflammation, attenuating airway hyper-responsiveness, and minimizing
mucus production and secretions. They also improve the actions of beta-agonists and target
the lungs directly. Option A describes LABA mechanism, Option B describes LAMA
mechanism, and Option D describes LTRA mechanism.
Question 2
Which of the following are examples of inhaled corticosteroids? (Select All That Apply)
,A) Fluticasone
B) Salmeterol
C) Budesonide
D) Tiotropium
E) Beclomethasone
F) Ciclesonide
Correct Answers: A, C, E, F
Rationale: Fluticasone, budesonide, beclomethasone, and ciclesonide are all inhaled
corticosteroids. Salmeterol (Option B) is a long-acting beta agonist (LABA), and tiotropium
(Option D) is a long-acting muscarinic antagonist (LAMA). It is critical to distinguish
between drug classes for safe prescribing.
Question 3
A patient with asthma not adequately controlled on an inhaled corticosteroid alone
is prescribed a long-acting beta agonist (LABA) as add-on therapy. What is the
primary mechanism of action of LABA?
A) Inhibit 5-lipoxygenase to reduce leukotriene production
B) Stimulate beta-2 adrenergic receptors in the lungs, resulting in relaxation of bronchial
smooth muscle (bronchodilation)
C) Block muscarinic receptors to prevent cholinergic bronchoconstriction
D) Stabilize mast cell membranes to prevent degranulation
Correct Answer: B
Rationale: Long-acting beta agonists (LABA) such as salmeterol and vilanterol work by
stimulating beta-2 adrenergic receptors in the lungs, resulting in relaxation of bronchial
smooth muscle (bronchodilation). Benefits include improved pulmonary function, more
symptom-free days, and decreased need for short-acting beta agonists (SABA). LABA
should NEVER be used as monotherapy for asthma—must always be combined with
ICS. Option A describes LTRA, Option C describes LAMA, and Option D describes
cromolyn/mast cell stabilizers.
Question 4
Which of the following are benefits of adding a long-acting beta agonist (LABA) to
inhaled corticosteroid therapy in asthma? (Select All That Apply)
, A) Improved pulmonary function
B) More symptom-free days
C) Decreased need for short-acting beta agonists (SABA)
D) Reduced airway inflammation independent of ICS
E) Replacement for inhaled corticosteroids
Correct Answers: A, B, C
Rationale: LABA add-on therapy to ICS provides improved pulmonary function, more
symptom-free days, and decreased need for SABA rescue inhalers. However, LABA does
NOT reduce airway inflammation independently (Option D)—that is the role of ICS. Most
importantly, LABA should NEVER replace ICS (Option E) due to safety concerns; LABA
monotherapy increases risk of asthma-related death.
Question 5
A patient with COPD is started on tiotropium. Which mechanism of action correctly
describes this medication?
A) Stimulates beta-2 receptors to increase cAMP and cause bronchodilation
B) Inhibits effects of acetylcholine on muscarinic receptors, protecting against cholinergic-
mediated bronchoconstriction
C) Blocks leukotriene D4 receptors to reduce inflammation
D) Inhibits phosphodiesterase to increase cAMP levels
Correct Answer: B
Rationale: Tiotropium is a long-acting muscarinic antagonist (LAMA). It inhibits the effects
of acetylcholine on muscarinic receptors, protecting against cholinergic-mediated
bronchoconstriction. This is particularly useful in COPD where cholinergic tone is
increased. Option A describes beta-agonists, Option C describes LTRA (montelukast), and
Option D describes phosphodiesterase inhibitors like roflumilast.
Question 6
A patient newly started on tiotropium reports dry mouth and difficulty urinating. The nurse
practitioner should recognize these as:
A) Signs of an allergic reaction requiring immediate discontinuation
B) Expected antimuscarinic side effects that may improve with continued use
C) Indications that the dose is too high
D) Symptoms unrelated to the medication
