,GCU NSG 318 Exam 3 | Introduction to Pharmacology | Grand
Canyon University | Q & A | 2026 Edition (PDF)
1. Which of the following best describes the mechanism of action of beta-2 adrenergic agonists used for
respiratory conditions?
A) They block muscarinic receptors in the bronchial smooth muscle
B) They stimulate beta-2 receptors, causing bronchial smooth muscle relaxation
C) They inhibit the release of inflammatory mediators from mast cells
D) They block leukotriene receptors in the airway epithelium
Correct Answer: They stimulate beta-2 receptors, causing bronchial smooth muscle relaxation
Rationale: Beta-2 adrenergic agonists, such as albuterol, stimulate beta-2 receptors located in bronchial
smooth muscle, leading to relaxation and bronchodilation. Anticholinergics block muscarinic receptors,
mast cell stabilizers inhibit inflammatory mediator release, and leukotriene modifiers block leukotriene
receptors.
2. A nurse is assessing a patient who has just received an albuterol nebulizer treatment. Which finding
demonstrates that the medication was effective?
A) Heart rate increased from 72 to 88 beats per minute
B) Respiratory rate decreased from 24 to 16 breaths per minute
C) Blood pressure increased from 110/70 to 130/80 mm Hg
D) Patient reports feeling jittery and anxious
Correct Answer: Respiratory rate decreased from 24 to 16 breaths per minute
Rationale: Effective bronchodilation from albuterol improves airflow, reducing the work of breathing
and allowing the respiratory rate to normalize. Tachycardia, elevated blood pressure, and jitteriness are
common side effects of beta-2 agonists, not indicators of therapeutic effectiveness.
3. What is the primary mechanism of action of ipratropium bromide in treating chronic obstructive
pulmonary disease (COPD)?
,A) Stimulation of beta-2 adrenergic receptors
B) Blockade of muscarinic cholinergic receptors
C) Inhibition of phosphodiesterase
D) Stabilization of mast cell membranes
Correct Answer: Blockade of muscarinic cholinergic receptors
Rationale: Ipratropium is an anticholinergic bronchodilator that blocks muscarinic receptors in the
airways, preventing bronchoconstriction caused by acetylcholine. This mechanism differs from beta-2
agonists, which stimulate adrenergic receptors, and from methylxanthines, which inhibit
phosphodiesterase.
4. Which assessment finding would indicate a complication of anticholinergic therapy with ipratropium?
A) Increased bronchial secretions
B) Urinary retention
C) Bradycardia
D) Diarrhea
Correct Answer: Urinary retention
Rationale: Anticholinergic drugs block muscarinic receptors, which can cause urinary retention,
constipation, dry mouth, and tachycardia. Increased secretions, bradycardia, and diarrhea are
cholinergic (parasympathetic) effects, not anticholinergic complications.
5. A patient with asthma is prescribed montelukast. Which statement accurately describes this
medication's mechanism of action?
A) It causes rapid bronchodilation for acute asthma attacks
B) It blocks leukotriene receptors, reducing inflammation and bronchoconstriction
C) It stimulates beta-2 receptors to relax bronchial smooth muscle
D) It inhibits the breakdown of cyclic AMP in mast cells
, Correct Answer: It blocks leukotriene receptors, reducing inflammation and bronchoconstriction
Rationale: Montelukast is a leukotriene receptor antagonist used for maintenance therapy in asthma. It
blocks the action of leukotrienes, which are inflammatory mediators that cause bronchoconstriction,
mucus secretion, and airway edema.
6. The nurse is teaching a patient about proper use of a metered-dose inhaler (MDI) with a spacer.
Which instruction should be included?
A) "Inhale rapidly and deeply after activating the inhaler."
B) "Wait 30 to 60 seconds between puffs if a second puff is prescribed."
C) "Exhale forcefully into the spacer before inhaling the medication."
D) "Store the inhaler in the refrigerator to preserve the medication."
Correct Answer: "Wait 30 to 60 seconds between puffs if a second puff is prescribed."
Rationale: Waiting 30 to 60 seconds between puffs allows the first dose to be absorbed and ensures the
second puff is delivered effectively. Patients should inhale slowly and deeply, not exhale into the spacer,
and store inhalers at room temperature.
7. Which drug classification is considered first-line therapy for maintenance treatment of persistent
asthma?
A) Short-acting beta-2 agonists
B) Inhaled corticosteroids
C) Leukotriene receptor antagonists
D) Anticholinergic bronchodilators
Correct Answer: Inhaled corticosteroids
Rationale: Inhaled corticosteroids (e.g., fluticasone, budesonide) are the most effective anti-
inflammatory agents for persistent asthma and are recommended as first-line maintenance therapy.
Short-acting beta-2 agonists are used for rescue, while leukotriene modifiers and anticholinergics are
alternative or adjunctive therapies.
Canyon University | Q & A | 2026 Edition (PDF)
1. Which of the following best describes the mechanism of action of beta-2 adrenergic agonists used for
respiratory conditions?
A) They block muscarinic receptors in the bronchial smooth muscle
B) They stimulate beta-2 receptors, causing bronchial smooth muscle relaxation
C) They inhibit the release of inflammatory mediators from mast cells
D) They block leukotriene receptors in the airway epithelium
Correct Answer: They stimulate beta-2 receptors, causing bronchial smooth muscle relaxation
Rationale: Beta-2 adrenergic agonists, such as albuterol, stimulate beta-2 receptors located in bronchial
smooth muscle, leading to relaxation and bronchodilation. Anticholinergics block muscarinic receptors,
mast cell stabilizers inhibit inflammatory mediator release, and leukotriene modifiers block leukotriene
receptors.
2. A nurse is assessing a patient who has just received an albuterol nebulizer treatment. Which finding
demonstrates that the medication was effective?
A) Heart rate increased from 72 to 88 beats per minute
B) Respiratory rate decreased from 24 to 16 breaths per minute
C) Blood pressure increased from 110/70 to 130/80 mm Hg
D) Patient reports feeling jittery and anxious
Correct Answer: Respiratory rate decreased from 24 to 16 breaths per minute
Rationale: Effective bronchodilation from albuterol improves airflow, reducing the work of breathing
and allowing the respiratory rate to normalize. Tachycardia, elevated blood pressure, and jitteriness are
common side effects of beta-2 agonists, not indicators of therapeutic effectiveness.
3. What is the primary mechanism of action of ipratropium bromide in treating chronic obstructive
pulmonary disease (COPD)?
,A) Stimulation of beta-2 adrenergic receptors
B) Blockade of muscarinic cholinergic receptors
C) Inhibition of phosphodiesterase
D) Stabilization of mast cell membranes
Correct Answer: Blockade of muscarinic cholinergic receptors
Rationale: Ipratropium is an anticholinergic bronchodilator that blocks muscarinic receptors in the
airways, preventing bronchoconstriction caused by acetylcholine. This mechanism differs from beta-2
agonists, which stimulate adrenergic receptors, and from methylxanthines, which inhibit
phosphodiesterase.
4. Which assessment finding would indicate a complication of anticholinergic therapy with ipratropium?
A) Increased bronchial secretions
B) Urinary retention
C) Bradycardia
D) Diarrhea
Correct Answer: Urinary retention
Rationale: Anticholinergic drugs block muscarinic receptors, which can cause urinary retention,
constipation, dry mouth, and tachycardia. Increased secretions, bradycardia, and diarrhea are
cholinergic (parasympathetic) effects, not anticholinergic complications.
5. A patient with asthma is prescribed montelukast. Which statement accurately describes this
medication's mechanism of action?
A) It causes rapid bronchodilation for acute asthma attacks
B) It blocks leukotriene receptors, reducing inflammation and bronchoconstriction
C) It stimulates beta-2 receptors to relax bronchial smooth muscle
D) It inhibits the breakdown of cyclic AMP in mast cells
, Correct Answer: It blocks leukotriene receptors, reducing inflammation and bronchoconstriction
Rationale: Montelukast is a leukotriene receptor antagonist used for maintenance therapy in asthma. It
blocks the action of leukotrienes, which are inflammatory mediators that cause bronchoconstriction,
mucus secretion, and airway edema.
6. The nurse is teaching a patient about proper use of a metered-dose inhaler (MDI) with a spacer.
Which instruction should be included?
A) "Inhale rapidly and deeply after activating the inhaler."
B) "Wait 30 to 60 seconds between puffs if a second puff is prescribed."
C) "Exhale forcefully into the spacer before inhaling the medication."
D) "Store the inhaler in the refrigerator to preserve the medication."
Correct Answer: "Wait 30 to 60 seconds between puffs if a second puff is prescribed."
Rationale: Waiting 30 to 60 seconds between puffs allows the first dose to be absorbed and ensures the
second puff is delivered effectively. Patients should inhale slowly and deeply, not exhale into the spacer,
and store inhalers at room temperature.
7. Which drug classification is considered first-line therapy for maintenance treatment of persistent
asthma?
A) Short-acting beta-2 agonists
B) Inhaled corticosteroids
C) Leukotriene receptor antagonists
D) Anticholinergic bronchodilators
Correct Answer: Inhaled corticosteroids
Rationale: Inhaled corticosteroids (e.g., fluticasone, budesonide) are the most effective anti-
inflammatory agents for persistent asthma and are recommended as first-line maintenance therapy.
Short-acting beta-2 agonists are used for rescue, while leukotriene modifiers and anticholinergics are
alternative or adjunctive therapies.
