NSG 318 Exam 3 – GCU Pharmacology 2026: 165 Practice Q&A with Rationales – High-Yield Test Bank

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NSG 318 EXAM 3 – GCU PHARMACOLOGY
## 2026 ACTUAL QUESTIONS & ANSWERS | GRADED
A+ | FIRST-TIME PASS




## Table of Contents


| Section | Topic | Number of Questions |
|---------|-------|---------------------|
| 1 | Autonomic Nervous System Drugs (Cholinergic & Adrenergic) | 25 |
| 2 | Cardiovascular Pharmacology (Antihypertensives, Antiarrhythmics,
Anticoagulants) | 30 |
| 3 | Respiratory Pharmacology (Asthma, COPD, Allergies) | 20 |
| 4 | GI & Endocrine Pharmacology (Diabetes, Thyroid, GI disorders) | 25 |
| 5 | CNS Pharmacology (Sedatives, Antiepileptics, Anesthetics) | 20 |
| 6 | Pain Management (Opioids, NSAIDs, Adjuvants) | 15 |
| 7 | Antibiotics & Antimicrobials | 20 |
| 8 | Critical Care & Emergency Pharmacology | 10 |

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# SECTION 1: AUTONOMIC NERVOUS SYSTEM DRUGS (25 Questions)


**1. A patient receives atropine preoperatively. Which expected effect is due to
muscarinic receptor blockade?**
A) Miosis
B) Bradycardia
C) Salivation
D) Tachycardia


**Correct Answer: D**
*Rationale: Atropine is a muscarinic antagonist. Blocking M2 receptors in the
heart increases heart rate (tachycardia). Miosis, salivation, and bradycardia are
muscarinic agonist effects.*


**2. A patient with myasthenia gravis is taking neostigmine. Which adverse effect
indicates cholinergic crisis?**
A) Muscle weakness, salivation, bradycardia
B) Dry mouth, urinary retention, tachycardia
C) Hypertension, hyperthermia, mydriasis
D) Bronchodilation, constipation, anhidrosis


**Correct Answer: A**
*Rationale: Cholinergic crisis from excessive acetylcholinesterase inhibitor causes
muscarinic excess (SLUDGE: salivation, lacrimation, urination, diarrhea, GI upset,
emesis) + nicotinic effects (muscle weakness, fasciculations).*

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**3. A patient on metoprolol (beta-1 selective antagonist) reports fatigue and cold
hands. What is the mechanism?**
A) Beta-2 blockade in peripheral vessels
B) Beta-1 blockade reducing cardiac output
C) Alpha-1 blockade causing vasodilation
D) Central alpha-2 agonist effect


**Correct Answer: B**
*Rationale: Metoprolol is beta-1 selective at low doses but loses selectivity at
higher doses. Reduced cardiac output causes fatigue; unopposed alpha-mediated
vasoconstriction in periphery causes cold extremities.*


**4. Which adrenergic agonist is most likely to cause mydriasis (pupil dilation)?**
A) Norepinephrine
B) Phenylephrine
C) Isoproterenol
D) Dobutamine


**Correct Answer: B**
*Rationale: Phenylephrine is a pure alpha-1 agonist. Alpha-1 activation in radial
muscle of iris causes mydriasis (pupil dilation).*


**5. A patient on albuterol for asthma reports tremors and tachycardia. These are
due to:**
A) Beta-1 receptor activation
B) Alpha-1 receptor activation

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C) Beta-2 receptor activation
D) Muscarinic receptor activation


**Correct Answer: A**
*Rationale: Albuterol is beta-2 selective but at therapeutic doses causes some beta-
1 activation → tachycardia, tremors. Beta-2 activation causes bronchodilation.*


**6. A patient overdoses on organophosphate insecticide. Which medication is the
antidote?**
A) Atropine + pralidoxime
B) Naloxone
C) Flumazenil
D) Neostigmine


**Correct Answer: A**
*Rationale: Organophosphates cause cholinergic excess. Atropine blocks
muscarinic receptors; pralidoxime reactivates acetylcholinesterase.*


**7. Which statement about clonidine is correct?**
A) It is a peripheral alpha-1 blocker
B) It causes reflex tachycardia
C) It is a central alpha-2 agonist used for hypertension
D) It is a beta-blocker


**Correct Answer: C**