Pharm Exam study guide
A patient’s heart rate is found to be 72 beats per minute and regular. The nurse evaluates which
situation in the patient’s peripheral nervous system?
Standard Text: Select all that apply.
1. The sympathetic system is in control.
2. The parasympathetic system is dominating.
3. Both parasympathetic and sympathetic systems are influencing cardiac status.
4. The autonomic nervous system is affecting cardiac status.
5. The somatic nervous system is affecting cardiac status.
Correct Answer: 2,3,4
Rationale 2: Restful cardiac response indicates that the primary input is from the parasympathetic
system.
Rationale 3: These two systems work in tandem to regulate the cardiac response.
Rationale 4: Both the sympathetic and parasympathetic systems are part of the autonomic system.
2. A nurse is reading about the development of drugs that inhibit the parasympathetic nervous system.
The nurse would look for articles about which drug classes?
Standard Text: Select all that apply.
1. Anticholinergics
2. Parasympathomimetics
3. Parasympatholytics
4. Cholinergics
5. Muscarinic blockers
Correct Answer: 1,3,5
Rationale 1: Anticholinergics inhibit the parasympathetic nervous system.
Rationale 3: Parasympatholytic drugs inhibit the parasympathetic nervous system.
Rationale 5: Muscarinic blockers inhibit the parasympathetic nervous system.
,Question 3
Type: Hot Spot
Mark the site of the ganglionic synapse on this diagram.
1. A
2. B
3. C
4. D
Answer: 3
Rationale: The ganglionic synapse is the gap between the preganglionic neuron and the postganglionic
neuron.
Question 4
Type: MCMA
A patient has been prescribed an oral drug containing atropine. The nurse would hold the drug and
Contact the prescriber if which patient statements are made?
Standard Text: Select all that apply.
1. “I would like to wait a few minutes to take this as I just drank some aloe juice.”
2. “Can I take this at the same time as my procainamide?”
3. “I have had a headache this morning.”
4. “I am allergic to penicillin.”
,5. “My gallbladder surgery is scheduled for next week.”
Correct Answer: 1,2
Rationale 1: Atropine should be used with caution in those who use aloe.
Rationale 2: There is a drug–drug interaction between atropine and procainamide.
Question 5
Type: MCSA
The nurse has completed medication education about pyridostigmine (Mestinon), an indirect cholinergic
drug, for the patient with myasthenia gravis. The nurse determines that learning has occurred when the
patient makes which statement?
1. "My heart may beat slower while I am on this drug."
2. "I will need to increase my fluid intake with this medication."
3. "I must take this medication immediately before eating a full meal."
4. "It is really important to take my medication on time."
Correct Answer: 4
Rationale 4: Maintaining an optimum blood level of the drug is crucial in promoting muscle functioning,
so it is important for the patient to take his medication on time and as directed.
Question 6
Type: MCSA
The physician has ordered bethanechol (Urecholine), a cholinergic drug, for the patient with urinary
retention. The patient also has an enlarged prostate gland. What is the priority action by the nurse?
1. Hold the drug and prepare to catheterize the patient.
2. Administer the drug and measure urinary output.
3. Administer the drug and push fluids.
4. Hold the drug and contact the physician.
Correct Answer: 4.
Rationale 4: Bethanechol (Urecholine) relaxes the urinary sphincter and increases voiding pressure. It is
contraindicated with any physical obstruction of the urinary tract, such as an enlarged prostate gland.
, Question 7
Type: MCSA
The preop patient will be receiving glycopyrrolate (Robinul), an anticholinergic drug, and asks the nurse,
"Why do I need to have that shot?" What is the best response by the nurse?
1. "It will decrease your respiratory secretions during surgery."
2. "It will increase your urinary output during surgery."
3. "It will help you breathe better during surgery."
4. "It will help maintain your blood pressure during surgery."
Correct Answer: 1
Rationale 1: Anticholinergics dry secretions; a decrease in respiratory secretions is indicated prior to
surgery.
Question 8
Type: MCSA
The nurse is preparing to administer medications to a group of patients. One of the medications is
benztropine (Cogentin), an anticholinergic drug. This drug is contraindicated in which patient?
1. The patient with a fractured femur
2. The patient with tachycardia
3. The patient with an irritable colon
4. The patient with diarrhea
Correct Answer: 2
Rationale 2: Anticholinergic drugs increase the heart rate; a patient with tachycardia should not receive
benztropine (Cogentin).
Question 9
Type: MCSA
The nurse is preparing to administer medications to a group of patients. One of the medications is
atropine, an anticholinergic drug. This drug is contraindicated in which patient?
1. The patient with glaucoma
A patient’s heart rate is found to be 72 beats per minute and regular. The nurse evaluates which
situation in the patient’s peripheral nervous system?
Standard Text: Select all that apply.
1. The sympathetic system is in control.
2. The parasympathetic system is dominating.
3. Both parasympathetic and sympathetic systems are influencing cardiac status.
4. The autonomic nervous system is affecting cardiac status.
5. The somatic nervous system is affecting cardiac status.
Correct Answer: 2,3,4
Rationale 2: Restful cardiac response indicates that the primary input is from the parasympathetic
system.
Rationale 3: These two systems work in tandem to regulate the cardiac response.
Rationale 4: Both the sympathetic and parasympathetic systems are part of the autonomic system.
2. A nurse is reading about the development of drugs that inhibit the parasympathetic nervous system.
The nurse would look for articles about which drug classes?
Standard Text: Select all that apply.
1. Anticholinergics
2. Parasympathomimetics
3. Parasympatholytics
4. Cholinergics
5. Muscarinic blockers
Correct Answer: 1,3,5
Rationale 1: Anticholinergics inhibit the parasympathetic nervous system.
Rationale 3: Parasympatholytic drugs inhibit the parasympathetic nervous system.
Rationale 5: Muscarinic blockers inhibit the parasympathetic nervous system.
,Question 3
Type: Hot Spot
Mark the site of the ganglionic synapse on this diagram.
1. A
2. B
3. C
4. D
Answer: 3
Rationale: The ganglionic synapse is the gap between the preganglionic neuron and the postganglionic
neuron.
Question 4
Type: MCMA
A patient has been prescribed an oral drug containing atropine. The nurse would hold the drug and
Contact the prescriber if which patient statements are made?
Standard Text: Select all that apply.
1. “I would like to wait a few minutes to take this as I just drank some aloe juice.”
2. “Can I take this at the same time as my procainamide?”
3. “I have had a headache this morning.”
4. “I am allergic to penicillin.”
,5. “My gallbladder surgery is scheduled for next week.”
Correct Answer: 1,2
Rationale 1: Atropine should be used with caution in those who use aloe.
Rationale 2: There is a drug–drug interaction between atropine and procainamide.
Question 5
Type: MCSA
The nurse has completed medication education about pyridostigmine (Mestinon), an indirect cholinergic
drug, for the patient with myasthenia gravis. The nurse determines that learning has occurred when the
patient makes which statement?
1. "My heart may beat slower while I am on this drug."
2. "I will need to increase my fluid intake with this medication."
3. "I must take this medication immediately before eating a full meal."
4. "It is really important to take my medication on time."
Correct Answer: 4
Rationale 4: Maintaining an optimum blood level of the drug is crucial in promoting muscle functioning,
so it is important for the patient to take his medication on time and as directed.
Question 6
Type: MCSA
The physician has ordered bethanechol (Urecholine), a cholinergic drug, for the patient with urinary
retention. The patient also has an enlarged prostate gland. What is the priority action by the nurse?
1. Hold the drug and prepare to catheterize the patient.
2. Administer the drug and measure urinary output.
3. Administer the drug and push fluids.
4. Hold the drug and contact the physician.
Correct Answer: 4.
Rationale 4: Bethanechol (Urecholine) relaxes the urinary sphincter and increases voiding pressure. It is
contraindicated with any physical obstruction of the urinary tract, such as an enlarged prostate gland.
, Question 7
Type: MCSA
The preop patient will be receiving glycopyrrolate (Robinul), an anticholinergic drug, and asks the nurse,
"Why do I need to have that shot?" What is the best response by the nurse?
1. "It will decrease your respiratory secretions during surgery."
2. "It will increase your urinary output during surgery."
3. "It will help you breathe better during surgery."
4. "It will help maintain your blood pressure during surgery."
Correct Answer: 1
Rationale 1: Anticholinergics dry secretions; a decrease in respiratory secretions is indicated prior to
surgery.
Question 8
Type: MCSA
The nurse is preparing to administer medications to a group of patients. One of the medications is
benztropine (Cogentin), an anticholinergic drug. This drug is contraindicated in which patient?
1. The patient with a fractured femur
2. The patient with tachycardia
3. The patient with an irritable colon
4. The patient with diarrhea
Correct Answer: 2
Rationale 2: Anticholinergic drugs increase the heart rate; a patient with tachycardia should not receive
benztropine (Cogentin).
Question 9
Type: MCSA
The nurse is preparing to administer medications to a group of patients. One of the medications is
atropine, an anticholinergic drug. This drug is contraindicated in which patient?
1. The patient with glaucoma
