NUR 210 Exams 2 Pharmacology (2026)
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1. A patient experiencing an acute asthma exacerbation is prescribed an
inhaled short-acting beta-2 agonist. The nurse knows the primary therapeutic
action of this drug class is to promote:
A. Vasoconstriction of pulmonary vessels
B. Bronchodilation by relaxing airway smooth muscle
C. Decreased heart rate and contractility
D. Increased mucociliary clearance in the upper airways
Correct Answer: B. Bronchodilation by relaxing airway smooth muscle
Expert Explanation: Short-acting beta-2 agonists (SABAs) like albuterol are
first-line rescue medications for bronchospasm. Beta-2 adrenergic receptors are
predominantly located on the smooth muscle of the bronchioles. When
stimulated by an agonist, these receptors activate a cascade that leads to
muscle relaxation and bronchodilation . This rapidly opens constricted airways,
relieving wheezing and shortness of breath. While beta-1 receptors increase
heart rate (a common side effect of non-selective agonists), the therapeutic goal
in asthma is pure beta-2-mediated bronchodilation.
2. The nurse is preparing to administer an ophthalmic solution of timolol to a
patient with glaucoma. Which of the following assessments should be
prioritized due to systemic absorption of this beta-blocker?
A. Monitoring for urinary retention
B. Auscultating breath sounds for wheezing
C. Assessing for visual halos and light sensitivity
D. Checking deep tendon reflexes
Correct Answer: B. Auscultating breath sounds for wheezing
Expert Explanation: Timolol is a non-selective beta-adrenergic antagonist
(beta-blocker). Even when administered as eye drops, a portion of the drug is
absorbed systemically via the nasolacrimal duct. Non-selective beta-blockers
antagonize both beta-1 (heart) and beta-2 (lung) receptors. Blockade of beta-2
,receptors in the bronchioles can precipitate bronchospasm, which is dangerous
in patients with asthma or COPD . Applying gentle pressure over the lacrimal
duct for 1-2 minutes after instillation can help minimize systemic absorption
and reduce this risk.
3. A patient with cardiogenic shock is receiving an IV infusion of dobutamine.
The nurse titrates the drip to achieve a therapeutic increase in cardiac output.
Dobutamine achieves this by selectively activating which receptor type?
A. Alpha-1 adrenergic receptors
B. Beta-1 adrenergic receptors
C. Beta-2 adrenergic receptors
D. Muscarinic cholinergic receptors
Correct Answer: B. Beta-1 adrenergic receptors
Expert Explanation: Dobutamine is a sympathomimetic agent with
predominant beta-1 adrenergic agonist activity. Beta-1 receptors are primarily
located in the heart (remember: Beta-1 = 1 Heart). Activation of these receptors
increases myocardial contractility (positive inotropy) and heart rate (positive
chronotropy), which collectively boost cardiac output. While it has minor beta-2
effects (vasodilation), its therapeutic utility in heart failure and shock stems
directly from its beta-1 agonism, which strengthens the force of the heart's
contractions .
4. A patient with benign prostatic hyperplasia (BPH) is prescribed tamsulosin.
The nurse educates the patient that this medication works by blocking alpha-1
receptors, which should relieve symptoms by:
A. Relaxing the detrusor muscle of the bladder wall
B. Relaxing smooth muscle in the bladder neck and prostate
C. Increasing the tone of the internal urethral sphincter
D. Reducing the overall production of prostatic fluid
Correct Answer: B. Relaxing smooth muscle in the bladder neck and prostate
Expert Explanation: Alpha-1 adrenergic receptors are abundant in the
smooth muscle of the bladder neck and prostatic capsule. When these receptors
are stimulated, the tissue contracts, constricting urine flow. Drugs like
tamsulosin (an alpha-1 selective antagonist) block these receptors, causing the
smooth muscle to relax. This widens the urethral channel and facilitates easier
urination and bladder emptying. Selective alpha-1 blockers are preferred for
BPH because they target the urinary tract with less effect on vascular alpha-1
receptors, reducing the risk of hypotension .
, 5. The nurse is preparing to administer bethanechol to a patient with
postoperative urinary retention. The nurse understands that this drug acts as a
direct cholinergic agonist, which carries a high risk of:
A. Tachycardia and hypertension
B. Bronchodilation and dry mouth
C. Bradycardia and increased bronchial secretions
D. Constipation and pupillary dilation
Correct Answer: C. Bradycardia and increased bronchial secretions
Expert Explanation: Bethanechol stimulates muscarinic cholinergic receptors,
mimicking the "rest and digest" parasympathetic nervous system. This action
increases detrusor muscle tone to promote bladder emptying. However,
cholinergic stimulation also affects other systems: it slows the heart rate
(bradycardia) , increases gastric acid and respiratory secretions, and causes
bronchoconstriction. Due to the risk of respiratory distress, bethanechol is
contraindicated in patients with asthma or COPD. Atropine is the antidote for
overdose .
6. Before administering a scheduled dose of atenolol, the nurse assesses the
patient's apical pulse. The nurse should hold the medication and notify the
provider if the heart rate is:
A. Above 100 beats per minute
B. Below 60 beats per minute
C. Irregularly irregular
D. Within 70-80 beats per minute
Correct Answer: B. Below 60 beats per minute
Expert Explanation: Atenolol is a cardioselective beta-1 blocker (remember:
A-M drugs like Atenolol/Metoprolol are cardio-selective). Its primary action is to
decrease heart rate, contractility, and cardiac workload. If the patient's heart
rate is already bradycardic (typically <60 bpm) , administering a beta-blocker
could suppress the heart rate further, leading to severe hypotension, heart
block, or cardiac arrest. This pre-administration assessment is a critical nursing
safety checkpoint for all negative chronotropic drugs .
7. A patient on an anticholinergic medication like oxybutynin for overactive
bladder should be prioritized for teaching regarding which common,
uncomfortable side effect?
A. Diarrhea and abdominal cramping
B. Dry mouth and constipation
C. Excessive salivation and lacrimation
PDF | Galen College of Nursing Questions
and Ansẉers with
Expert-Verified Explanation 2026\2027
update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
, Expert-Verified Explanation
Verified ẉith trusted textbooks
───────────────────────────────────────────────────────
─
1. A patient experiencing an acute asthma exacerbation is prescribed an
inhaled short-acting beta-2 agonist. The nurse knows the primary therapeutic
action of this drug class is to promote:
A. Vasoconstriction of pulmonary vessels
B. Bronchodilation by relaxing airway smooth muscle
C. Decreased heart rate and contractility
D. Increased mucociliary clearance in the upper airways
Correct Answer: B. Bronchodilation by relaxing airway smooth muscle
Expert Explanation: Short-acting beta-2 agonists (SABAs) like albuterol are
first-line rescue medications for bronchospasm. Beta-2 adrenergic receptors are
predominantly located on the smooth muscle of the bronchioles. When
stimulated by an agonist, these receptors activate a cascade that leads to
muscle relaxation and bronchodilation . This rapidly opens constricted airways,
relieving wheezing and shortness of breath. While beta-1 receptors increase
heart rate (a common side effect of non-selective agonists), the therapeutic goal
in asthma is pure beta-2-mediated bronchodilation.
2. The nurse is preparing to administer an ophthalmic solution of timolol to a
patient with glaucoma. Which of the following assessments should be
prioritized due to systemic absorption of this beta-blocker?
A. Monitoring for urinary retention
B. Auscultating breath sounds for wheezing
C. Assessing for visual halos and light sensitivity
D. Checking deep tendon reflexes
Correct Answer: B. Auscultating breath sounds for wheezing
Expert Explanation: Timolol is a non-selective beta-adrenergic antagonist
(beta-blocker). Even when administered as eye drops, a portion of the drug is
absorbed systemically via the nasolacrimal duct. Non-selective beta-blockers
antagonize both beta-1 (heart) and beta-2 (lung) receptors. Blockade of beta-2
,receptors in the bronchioles can precipitate bronchospasm, which is dangerous
in patients with asthma or COPD . Applying gentle pressure over the lacrimal
duct for 1-2 minutes after instillation can help minimize systemic absorption
and reduce this risk.
3. A patient with cardiogenic shock is receiving an IV infusion of dobutamine.
The nurse titrates the drip to achieve a therapeutic increase in cardiac output.
Dobutamine achieves this by selectively activating which receptor type?
A. Alpha-1 adrenergic receptors
B. Beta-1 adrenergic receptors
C. Beta-2 adrenergic receptors
D. Muscarinic cholinergic receptors
Correct Answer: B. Beta-1 adrenergic receptors
Expert Explanation: Dobutamine is a sympathomimetic agent with
predominant beta-1 adrenergic agonist activity. Beta-1 receptors are primarily
located in the heart (remember: Beta-1 = 1 Heart). Activation of these receptors
increases myocardial contractility (positive inotropy) and heart rate (positive
chronotropy), which collectively boost cardiac output. While it has minor beta-2
effects (vasodilation), its therapeutic utility in heart failure and shock stems
directly from its beta-1 agonism, which strengthens the force of the heart's
contractions .
4. A patient with benign prostatic hyperplasia (BPH) is prescribed tamsulosin.
The nurse educates the patient that this medication works by blocking alpha-1
receptors, which should relieve symptoms by:
A. Relaxing the detrusor muscle of the bladder wall
B. Relaxing smooth muscle in the bladder neck and prostate
C. Increasing the tone of the internal urethral sphincter
D. Reducing the overall production of prostatic fluid
Correct Answer: B. Relaxing smooth muscle in the bladder neck and prostate
Expert Explanation: Alpha-1 adrenergic receptors are abundant in the
smooth muscle of the bladder neck and prostatic capsule. When these receptors
are stimulated, the tissue contracts, constricting urine flow. Drugs like
tamsulosin (an alpha-1 selective antagonist) block these receptors, causing the
smooth muscle to relax. This widens the urethral channel and facilitates easier
urination and bladder emptying. Selective alpha-1 blockers are preferred for
BPH because they target the urinary tract with less effect on vascular alpha-1
receptors, reducing the risk of hypotension .
, 5. The nurse is preparing to administer bethanechol to a patient with
postoperative urinary retention. The nurse understands that this drug acts as a
direct cholinergic agonist, which carries a high risk of:
A. Tachycardia and hypertension
B. Bronchodilation and dry mouth
C. Bradycardia and increased bronchial secretions
D. Constipation and pupillary dilation
Correct Answer: C. Bradycardia and increased bronchial secretions
Expert Explanation: Bethanechol stimulates muscarinic cholinergic receptors,
mimicking the "rest and digest" parasympathetic nervous system. This action
increases detrusor muscle tone to promote bladder emptying. However,
cholinergic stimulation also affects other systems: it slows the heart rate
(bradycardia) , increases gastric acid and respiratory secretions, and causes
bronchoconstriction. Due to the risk of respiratory distress, bethanechol is
contraindicated in patients with asthma or COPD. Atropine is the antidote for
overdose .
6. Before administering a scheduled dose of atenolol, the nurse assesses the
patient's apical pulse. The nurse should hold the medication and notify the
provider if the heart rate is:
A. Above 100 beats per minute
B. Below 60 beats per minute
C. Irregularly irregular
D. Within 70-80 beats per minute
Correct Answer: B. Below 60 beats per minute
Expert Explanation: Atenolol is a cardioselective beta-1 blocker (remember:
A-M drugs like Atenolol/Metoprolol are cardio-selective). Its primary action is to
decrease heart rate, contractility, and cardiac workload. If the patient's heart
rate is already bradycardic (typically <60 bpm) , administering a beta-blocker
could suppress the heart rate further, leading to severe hypotension, heart
block, or cardiac arrest. This pre-administration assessment is a critical nursing
safety checkpoint for all negative chronotropic drugs .
7. A patient on an anticholinergic medication like oxybutynin for overactive
bladder should be prioritized for teaching regarding which common,
uncomfortable side effect?
A. Diarrhea and abdominal cramping
B. Dry mouth and constipation
C. Excessive salivation and lacrimation
