NURS 521 Pharmacology Practice Questions and Correct Verified Answers Exam 2026/ 100% Pass

NURS 521 Pharmacology Practice Questions and Correct Verified Answers Exam 2026/ 100% Pass A drug that selectively stimulates muscarinic receptors is: Bethanechol The side effect(s) of muscarinic agonists could be: - diarrhea - bronchospasm - vasodilationc A drug that is topically used for treating glaucoma: carbachol (T/F) A selective muscarinic agonist can stimulate skeletal muscle contraction. False (T/F) A direct-acting cholinomimetic drug mimics the action of acetylcholine by inhibiting the activity of acetylcholinesterase (Ache). False Drug Y is an antagonist for muscarinic receptors. An effect of drug Y on heart can be: positive chronotropy Drug X blocks muscarinic receptors. An effect of drug X on eyes can be: mydriasis Drug Z is muscarinic blocker. The effects on most of the blood vessels can be: no effect WRONG options: vasodilation, vasoconstriction, atherosclerosis The least favorite antimuscarinic drug used in COPD: ipratropium A useful application for a muscarinic blocker can be: minor diarrhea Atropine blocks: all M1-M5 receptors The following muscarinic blocker can cross the blood brain barrier: scopolamine A patient with narrow anterior chamber angle needs a mydriatic drug for eye examination, we can give: tropicamide NURS 521 NURS 521 Darifenacin is effective in COPD because it: causes bronchorelaxation and decrease secretion A crop duster pilot has been accidentally exposed to a high concentration of a highly toxic agricultural organophosphate insecticide. If untreated, the cause of death from such exposure would probably be: respiratory failure Pyridostigmine and neostigmine may cause which one of the following in this patient? diarrhea (T/F) Atropine administration will strongly decrease gastric and pancreatic secretion. False Which of the following is incorrect about the parasympathetic NS? dilates pupils CORRECT options: - "rest and digest" - stimulates saliva and activity of GI system - contracts bladder What are the actions of the sympathetic system (select all that apply)? - increases heartbeat - inhibits activity of stomach and intestines - relaxes and opens airways Norepinephrine acts on all of the following receptors except? muscarinic 2 CORRECT options: - alpha 2 - beta 1 and 2 - alpha 1 Which of the following are incorrect about the actions of NE on different receptors? causes increase in heart rate when acting on beta 2 (should be beta 1) CORRECT options: - leads to bronchodilation (opening of airways) when acting on beta 2 - causes vasoconstriction in blood vessels when acting on alpha 1 - action at alpha 1 causes pupil dilation Direct acting cholinomimetic agents act by: activating both muscarinic and nicotinic receptors Which of the following is true about nicotinic receptors? they are ligand-gated Na+ channels M2 receptor stimulation causes ________ effects NURS 521 NURS 521 inhibitory Which of the following is true? Bethanechol chloride only has action at muscarinic receptors INCORRECT options: - Methacholine chloride has less muscarinic action than bethanechol chloride - Acetylcholine chloride is not susceptible to cholinesterase - Carbachol chloride has more muscarinic action than nicotinic action This drug is a direct-acting cholinoceptor stimulant and a non-choline ester pilocarpine Muscarinic agonists cause increase in gastric motility Which of the following is true regarding muscarinic agonist effects in the bladder? promotes voiding of bladder Which of the following is true regarding muscarinic agonist effects on the heart and blood vessels? negative chronotropy Select all that apply: What is a clinical use of muscarinic agonist? - atony of stomach following surgical manipulation - smoking cessation Which statement is true about antimuscarinics in general? tertiary agents reach high levels in brain quickly (true, reach CNS within 30 minutes to 1 hour) INCORRECT options: - all are well absorbed (not quaternary because they have low lipid solubility) - most act like non-competitive antagonists (false, are competitive) - they block receptors in variety of organs, including liver (false, liver does not have parasympathetic innervation) Select all that apply: Which of the following may be symptoms of atropine poisoning? - mydriasis (blind as a bat) - dry eyes and mouth (dry as a bone) - urinary retention (cannot urinate) - delirium (mad as a hatter) What are clinical indications for antimuscarinics? (select all that apply) - Parkinson's - motion sickness What does NOT describe the effect of antimuscarinics on the eyes? cause miosis and mydriasis NURS 521 NURS 521 CORRECT options: - block M3 receptor - cause mydriasis and cycloplegia - dry eyes - precipitate or induce glaucoma Which of the antimuscarinics used for eye examination would be least preferred in someone with narrow angle glaucoma? atropine (duration of action = 5-7 days) What drug is a non-selective muscarinic antagonist used in COPD and would be considered less effective for treating this specific disease state? ipratropium non-selective, can also be used in asthma Which of the following does NOT describe the effects of antimuscarinics on the cardiovascular system? increase in blood pressure CORRECT options: - tachycardia - block M2 activation in heart by acetylcholine - increased conduction velocity Select all that apply: Antimuscarinics in the gastrointestinal tract... - may be used to treat IBS and diarrhea - include dicyclomine, glycopyrrolate, and hyoscyamine - decrease saliva and stomach motility In the urinary tract, antimuscarinics can be used to treat: - bladder spasm - urge incontinence Which of the following is true about cholinergic poisoning (select all that apply)? - atropine via parenteral route is preferred treatment - may be caused by chemical warfare or nerve gasses Which drug is an irreversible organophosphate? parathion Which is true about the pharmacokinetics of indirect-acting cholinomimetics? Distribution of indirect-acting cholinomimetic is negligible in CNS Which is NOT an effect of indirect-acting cholinomimetics at the neuromuscular junction? Paralysis will never occur with indirect-acting cholinomimetics (depolarizing Nm blockade → paralysis with marked inhibition of acetylcholinesterase) NURS 521 NURS 521 CORRECT options: - At low therapeutic doses, these agents cause muscle contraction - At high concentrations, these agents may cause paralysis Match the drug with its correct application Edrophonium is used as a diagnostic test for myasthenia gravis Select the drugs that are used for patients with Alzheimer's - tacrine - galantamine - donepezil - rivastigmine True or false: The cause of death from anticholinesterase agents is respiratory failure True Which drug is used to treat anticholinesterase toxicity? Pralidoxime (cholinesterase regenerator) Which of the following are clinical uses of neuromuscular blocking drugs? - endotracheal intubation - control of ventilation - surgical relaxation - treating convulsions ACTIVATION OF NICOTINIC RECEPTOR STIMULATES SKELETAL MUSCLE CONTRACTION Which of the following statements are FALSE concerning nondepolarizing NMJ blockers? At low and high doses, they can easily be revers TRUE options: - must be administered via intravenous route - vecuronium and rocuronium are more clinically common than pancuronium - curarine is no longer used due to adverse side effects What statement is true about depolarizing NMJ blockers? Succinylcholine is the only clinically useful drug in this class Which of the following are not matched correctly to their side effect? hypokalemia (succinylcholine) CORRECT options: - cardiac arrhythmias (succinylcholine) - pancuronium (tachycardia) - tubocurarine (hypotension) Which of the following drugs do NOT interact with NMJ blockers? NURS 521 NURS 521 dantrolene (do not interact, used to treat malignant hyperthermia caused by the interaction between succinylcholine with volatile anesthetics Increased intragastric pressure is a side effect of succinylcholine Drugs used to induce local vasoconstriction include - phenylephrine - epinephrine - oxymetazoline Drugs used for treating mild to moderate hypertension include alpha1 antagonist Side effect(s) of phenoxybenzamine include - orthostatic hypotension - miosis - nasal stuffiness A drug that can be used to induce sedation before anesthesia dexmedetomidine (T/F) The neuromuscular blockade by succinylcholine can be reversed by neostigmine. False Which of the following is a mixed-acting adrenergic agonist? ephedrine alpha1, alpha2, beta1, beta2 and releasing agent - both direct action and indirect action What receptor(s) does norepinephrine act at? - alpha 1 - alpha 2 - beta 1 - beta 2 (some) Which sympathomimetic has the highest selectivity at beta receptors? isoproterenol Which of the following is NOT an effect of alpha 1 adrenergic agonists? prostate relaxation cause prostate CONSTRICTION (why we use alpha antagonists for BPH) Which of the following is a cardiovascular effect of alpha-1 selective agonists? increase in blood pressure cause vasoconstriction -- increased peripherl arterial resistance -- dose dependent increase in BP used as hypotension treatment NURS 521 NURS 521 What is midodrine used for? orthostatic hypotension Which drug can be used in local anesthetics? epinephrine vasoconstricting effects that prolong duration of action of local anesthetics Which is/are a clinical application of alpha 2 selective agonists? - hypertension - sedation in ICU setting - glaucoma decrease sympathetic outflow -- decrease blood pressure Which drug is matched with its correct clinical application? xylometazoline - nasal decongestant Which of the following are ALPHA 1 selective antagonists? - prazosin - doxazosin - zosins Which of the following is a clinical application of ALPHA 1 blockers? urinary obstruction in BPH smooth muscle relaxation in enlarged prostate - also used for HYPERtension and hypertensive emergencies, not hypotension alpha2 blockers: relatively little clinical usefulness Which of the following is NOT true regarding non-selective ALPHA antagonists? are used to treat hypertension due to reflex tachycardia - phenoxybenzamine and phentolamine What happens when the ALPHA 1 receptor is blocked? - decreases blood pressure - vasodilation - reflex tachycardia baroreceptors are stimulated by drop in BP and causes reflex