NSG 533 – Advanced Pharmacology 2 Exam Wilkes
University | 2026/2027 | Verified Study Guide with
Correct Concepts And Rtionales
Which of the following is a side effect commonly associated with the use of alpha-1 blockers such as
tamsulosin?
A. Dizziness
B. Hypertension
C. Diarrhea
D. Bradycardia - ANSWER---A. Dizziness
Rationale: Alpha-1 blockers can cause dizziness or orthostatic hypotension due to vasodilation,
especially when moving from a sitting or lying position to standing.
The provider is assessing an older adult male patient prior to beginning a prescribed anticholinergic
drug. Which question concerning preexisting conditions demonstrates the provider's understanding of
possible contraindications to this therapy?
A. "Do you have any vision problems that require a prescribed medication?"
B. "Would you say that diarrhea is a problem you deal with regularly?"
C. "Do you have problems with urinary incontinence?"
D. "Have you ever been treated for prostate cancer?" - ANSWER---A. "Do you have any vision problems
that require a prescribed medication?"
Rationale: Anticholinergic drugs have been designated as potentially inappropriate for use in geriatric
patients. They can cause confusion, blurred vision, tachycardia, urinary retention, and constipation.
Many of these complicate preexisting conditions (e.g., urinary retention secondary to benign prostatic
hyperplasia) and increase the risk for other conditions (e.g., narrow-angle glaucoma risk secondary to
pupil dilation and heat-related illness secondary to hyperthermia and impaired sweating
mechanisms).
Which of the following drugs is used in the management of glaucoma by reducing intraocular pressure
through muscarinic receptor activation?
, NSG 533 – Advanced Pharmacology 2 Exam Wilkes
University | 2026/2027 | Verified Study Guide with
Correct Concepts And Rtionales
A. Pilocarpine
B. Epinephrine
C. Atropine
D. Tropicamide - ANSWER---A. Pilocarpine
Rationale: Pilocarpine is a muscarinic agonist that stimulates the parasympathetic nervous system,
causing contraction of the ciliary muscle and improving drainage of aqueous humor to reduce
intraocular pressure in glaucoma.
A patient with asthma uses albuterol for wheezing. The provider notes current vital signs of HR, 96
beats/minute; RR, 18 breaths/minute; and BP, 116/78 mm Hg. The patient has clear breath sounds and
fine hand tremors. What action will the provider take initially to treat this patient effectively?
A. Check the patient's blood glucose level.
B. Substitute isoproterenol to minimize the tremors.
C. Prescribe isoproterenol to reduce side effects.
D. Ask how often the patient uses the inhaler. - ANSWER---D. Ask how often the patient uses the inhaler.
Rationale: Tachycardia is a response to activation of b1 receptors. It can occur when large doses of
albuterol are used and selectivity decreases. The nurse should question the patient about the number
of inhalations used. Isoproterenol can cause hyperglycemia in diabetic patients. Isoproterenol has
more side effects than albuterol. Tremors are an expected side effect and are not an indication for
stopping the drug.
Which of the following drugs is used to treat overactive bladder by blocking muscarinic receptors?
A. Neostigmine
B. Oxybutynin
C. Bethanechol
D. Pilocarpine - ANSWER---B. Oxybutynin
, NSG 533 – Advanced Pharmacology 2 Exam Wilkes
University | 2026/2027 | Verified Study Guide with
Correct Concepts And Rtionales
Rationale: Oxybutynin is an anticholinergic drug that blocks muscarinic receptors, reducing bladder
muscle spasms and helping control symptoms of overactive bladder.
A patient will begin taking propranolol for hypertension. Which statement made by the prescriber is
important when teaching this patient about the medication?
A. "Notify the clinic if you start waking at night with shortness of breath or have difficulty lying flat."
B. "It is safe to take this medication with your calcium channel blocker."
C. "Stop taking the drug if you become short of breath."
D. "Take your pulse and do not take the medication if your heart rate is fast." - ANSWER---A. "Notify the
clinic if you start waking at night with shortness of breath or have difficulty lying flat."
Rationale: Patients taking propranolol can develop heart failure because of the suppression in
myocardial contractility. Symptoms typically begin with left heart failure, so patients should be taught
to report onset of paroxysmal nocturnal dyspnea, orthopnea, and night coughs. Use of these agents
with calcium channel blockers is contraindicated, because the effects are identical and excessive
cardiosuppression can occur. Abrupt cessation of the drug can cause rebound cardiac excitability;
therefore, shortness of breath should be reported rather than stopping the drug. Propranolol reduces
the heart rate and should not be given if the pulse is less than 60 beats/minute.
A male patient with benign prostatic hyperplasia (BPH) has stopped taking his α-adrenergic antagonist
medication because of ejaculatory difficulties. Which medication will the provider to prescribe to best
address the BPH and the patient's concerns?
A. Tamsulosin
B. Alfuzosin
C. Prazosin
D. Silodosin - ANSWER---B. Alfuzosin
Rationale: Alfuzosin is used for BPH and does not interfere with ejaculation. All of the other drugs
have ejaculatory related side effects. Prazosin may be useful for BPH, but it is not approved for this
use.
University | 2026/2027 | Verified Study Guide with
Correct Concepts And Rtionales
Which of the following is a side effect commonly associated with the use of alpha-1 blockers such as
tamsulosin?
A. Dizziness
B. Hypertension
C. Diarrhea
D. Bradycardia - ANSWER---A. Dizziness
Rationale: Alpha-1 blockers can cause dizziness or orthostatic hypotension due to vasodilation,
especially when moving from a sitting or lying position to standing.
The provider is assessing an older adult male patient prior to beginning a prescribed anticholinergic
drug. Which question concerning preexisting conditions demonstrates the provider's understanding of
possible contraindications to this therapy?
A. "Do you have any vision problems that require a prescribed medication?"
B. "Would you say that diarrhea is a problem you deal with regularly?"
C. "Do you have problems with urinary incontinence?"
D. "Have you ever been treated for prostate cancer?" - ANSWER---A. "Do you have any vision problems
that require a prescribed medication?"
Rationale: Anticholinergic drugs have been designated as potentially inappropriate for use in geriatric
patients. They can cause confusion, blurred vision, tachycardia, urinary retention, and constipation.
Many of these complicate preexisting conditions (e.g., urinary retention secondary to benign prostatic
hyperplasia) and increase the risk for other conditions (e.g., narrow-angle glaucoma risk secondary to
pupil dilation and heat-related illness secondary to hyperthermia and impaired sweating
mechanisms).
Which of the following drugs is used in the management of glaucoma by reducing intraocular pressure
through muscarinic receptor activation?
, NSG 533 – Advanced Pharmacology 2 Exam Wilkes
University | 2026/2027 | Verified Study Guide with
Correct Concepts And Rtionales
A. Pilocarpine
B. Epinephrine
C. Atropine
D. Tropicamide - ANSWER---A. Pilocarpine
Rationale: Pilocarpine is a muscarinic agonist that stimulates the parasympathetic nervous system,
causing contraction of the ciliary muscle and improving drainage of aqueous humor to reduce
intraocular pressure in glaucoma.
A patient with asthma uses albuterol for wheezing. The provider notes current vital signs of HR, 96
beats/minute; RR, 18 breaths/minute; and BP, 116/78 mm Hg. The patient has clear breath sounds and
fine hand tremors. What action will the provider take initially to treat this patient effectively?
A. Check the patient's blood glucose level.
B. Substitute isoproterenol to minimize the tremors.
C. Prescribe isoproterenol to reduce side effects.
D. Ask how often the patient uses the inhaler. - ANSWER---D. Ask how often the patient uses the inhaler.
Rationale: Tachycardia is a response to activation of b1 receptors. It can occur when large doses of
albuterol are used and selectivity decreases. The nurse should question the patient about the number
of inhalations used. Isoproterenol can cause hyperglycemia in diabetic patients. Isoproterenol has
more side effects than albuterol. Tremors are an expected side effect and are not an indication for
stopping the drug.
Which of the following drugs is used to treat overactive bladder by blocking muscarinic receptors?
A. Neostigmine
B. Oxybutynin
C. Bethanechol
D. Pilocarpine - ANSWER---B. Oxybutynin
, NSG 533 – Advanced Pharmacology 2 Exam Wilkes
University | 2026/2027 | Verified Study Guide with
Correct Concepts And Rtionales
Rationale: Oxybutynin is an anticholinergic drug that blocks muscarinic receptors, reducing bladder
muscle spasms and helping control symptoms of overactive bladder.
A patient will begin taking propranolol for hypertension. Which statement made by the prescriber is
important when teaching this patient about the medication?
A. "Notify the clinic if you start waking at night with shortness of breath or have difficulty lying flat."
B. "It is safe to take this medication with your calcium channel blocker."
C. "Stop taking the drug if you become short of breath."
D. "Take your pulse and do not take the medication if your heart rate is fast." - ANSWER---A. "Notify the
clinic if you start waking at night with shortness of breath or have difficulty lying flat."
Rationale: Patients taking propranolol can develop heart failure because of the suppression in
myocardial contractility. Symptoms typically begin with left heart failure, so patients should be taught
to report onset of paroxysmal nocturnal dyspnea, orthopnea, and night coughs. Use of these agents
with calcium channel blockers is contraindicated, because the effects are identical and excessive
cardiosuppression can occur. Abrupt cessation of the drug can cause rebound cardiac excitability;
therefore, shortness of breath should be reported rather than stopping the drug. Propranolol reduces
the heart rate and should not be given if the pulse is less than 60 beats/minute.
A male patient with benign prostatic hyperplasia (BPH) has stopped taking his α-adrenergic antagonist
medication because of ejaculatory difficulties. Which medication will the provider to prescribe to best
address the BPH and the patient's concerns?
A. Tamsulosin
B. Alfuzosin
C. Prazosin
D. Silodosin - ANSWER---B. Alfuzosin
Rationale: Alfuzosin is used for BPH and does not interfere with ejaculation. All of the other drugs
have ejaculatory related side effects. Prazosin may be useful for BPH, but it is not approved for this
use.
