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NUR209 Final Medical Surgical Nursing 2
2026/2027 Comprehensive Test Bank with
Verified Answers and Detailed Rationales
1. The nurse is preparing to administer bethanechol (Urecholine) to a
patient who is experiencing urinary retention. The nurse notes that the
patient has a blood pressure of 90/60 mm Hg and a heart rate of 98
beats per minute. The nurse will perform which action?
A) Administer the drug and monitor urine output.
B) Administer the medication and monitor vital signs frequently.
C) Give the medication and notify the provider of the increased heart rate.
D) Hold the medication and notify the provider of the decreased blood
pressure.
Correct Answer: D) Hold the medication and notify the provider of the
decreased blood pressure.
Rationale:
1. Bethanechol is a cholinergic agonist that can cause hypotension and
bradycardia.
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2. The patient's blood pressure (90/60 mm Hg) is already low, and
administering bethanechol could worsen hypotension.
3. The nurse should hold the medication and notify the provider for further
instructions.
2. The nurse administers bethanechol (Urecholine) to a patient to treat
urinary retention. After 30 minutes, the patient voids 800 mL of urine
and reports having a loose stool but no cramping or gastrointestinal
pain. The patient's blood pressure is 110/70 mm Hg. The nurse will
perform which action?
A) Notify the provider of bethanechol adverse effects.
B) Record the urine output and the blood pressure and continue to monitor.
C) Request an order for intravenous atropine sulfate.
D) Suggest another dose of bethanechol to the provider.
Correct Answer: B) Record the urine output and the blood pressure and
continue to monitor.
Rationale:
1. The patient voided 800 mL (desired effect) and has stable blood pressure.
2. Loose stool without cramping or pain is a mild, expected side effect.
3. No intervention is needed; continue monitoring.
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3. The nurse is teaching a patient who will begin taking bethanechol
(Urecholine). Which statement by the patient indicates a need for
further teaching?
A) "Excessive sweating is a normal reaction to this medication."
B) "Excess salivation is a serious side effect."
C) "I should get out of bed slowly while taking this drug."
D) "I will not take the drug if my heart rate is less than 60 beats per minute."
Correct Answer: A) "Excessive sweating is a normal reaction to this
medication."
Rationale:
1. Excessive sweating is NOT a normal reaction; it may indicate overdose or
excessive cholinergic stimulation.
2. Excess salivation is a common side effect but not typically serious.
3. Getting out of bed slowly prevents orthostatic hypotension.
4. Holding the drug for heart rate <60 is appropriate (bradycardia risk).
4. A patient is receiving bethanechol (Urecholine). The nurse realizes
that the action of this drug is to treat which condition?
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A) Glaucoma
B) Urinary retention
C) Delayed gastric upset
D) Gastroesophageal reflux disease
Correct Answer: B) Urinary retention
Rationale:
1. Bethanechol is a cholinergic agonist that stimulates the detrusor muscle of the
bladder.
2. It is used for non-obstructive urinary retention.
3. It may also be used for neurogenic bladder.
5. The nurse is preparing to administer a drug and learns that it is an
indirect-acting cholinergic agonist. The nurse understands that this drug
A) acts on muscarinic receptors.
B) acts on nicotinic receptors.
C) inhibits cholinesterase.
D) inhibits cholinergic receptors.
Correct Answer: C) Inhibits cholinesterase
Rationale:
1. Indirect-acting cholinergic agonists (anticholinesterases) inhibit the
NUR209 Final Medical Surgical Nursing 2
2026/2027 Comprehensive Test Bank with
Verified Answers and Detailed Rationales
1. The nurse is preparing to administer bethanechol (Urecholine) to a
patient who is experiencing urinary retention. The nurse notes that the
patient has a blood pressure of 90/60 mm Hg and a heart rate of 98
beats per minute. The nurse will perform which action?
A) Administer the drug and monitor urine output.
B) Administer the medication and monitor vital signs frequently.
C) Give the medication and notify the provider of the increased heart rate.
D) Hold the medication and notify the provider of the decreased blood
pressure.
Correct Answer: D) Hold the medication and notify the provider of the
decreased blood pressure.
Rationale:
1. Bethanechol is a cholinergic agonist that can cause hypotension and
bradycardia.
,2|Page
2. The patient's blood pressure (90/60 mm Hg) is already low, and
administering bethanechol could worsen hypotension.
3. The nurse should hold the medication and notify the provider for further
instructions.
2. The nurse administers bethanechol (Urecholine) to a patient to treat
urinary retention. After 30 minutes, the patient voids 800 mL of urine
and reports having a loose stool but no cramping or gastrointestinal
pain. The patient's blood pressure is 110/70 mm Hg. The nurse will
perform which action?
A) Notify the provider of bethanechol adverse effects.
B) Record the urine output and the blood pressure and continue to monitor.
C) Request an order for intravenous atropine sulfate.
D) Suggest another dose of bethanechol to the provider.
Correct Answer: B) Record the urine output and the blood pressure and
continue to monitor.
Rationale:
1. The patient voided 800 mL (desired effect) and has stable blood pressure.
2. Loose stool without cramping or pain is a mild, expected side effect.
3. No intervention is needed; continue monitoring.
,3|Page
3. The nurse is teaching a patient who will begin taking bethanechol
(Urecholine). Which statement by the patient indicates a need for
further teaching?
A) "Excessive sweating is a normal reaction to this medication."
B) "Excess salivation is a serious side effect."
C) "I should get out of bed slowly while taking this drug."
D) "I will not take the drug if my heart rate is less than 60 beats per minute."
Correct Answer: A) "Excessive sweating is a normal reaction to this
medication."
Rationale:
1. Excessive sweating is NOT a normal reaction; it may indicate overdose or
excessive cholinergic stimulation.
2. Excess salivation is a common side effect but not typically serious.
3. Getting out of bed slowly prevents orthostatic hypotension.
4. Holding the drug for heart rate <60 is appropriate (bradycardia risk).
4. A patient is receiving bethanechol (Urecholine). The nurse realizes
that the action of this drug is to treat which condition?
, 4|Page
A) Glaucoma
B) Urinary retention
C) Delayed gastric upset
D) Gastroesophageal reflux disease
Correct Answer: B) Urinary retention
Rationale:
1. Bethanechol is a cholinergic agonist that stimulates the detrusor muscle of the
bladder.
2. It is used for non-obstructive urinary retention.
3. It may also be used for neurogenic bladder.
5. The nurse is preparing to administer a drug and learns that it is an
indirect-acting cholinergic agonist. The nurse understands that this drug
A) acts on muscarinic receptors.
B) acts on nicotinic receptors.
C) inhibits cholinesterase.
D) inhibits cholinergic receptors.
Correct Answer: C) Inhibits cholinesterase
Rationale:
1. Indirect-acting cholinergic agonists (anticholinesterases) inhibit the
