Cholinergic-Blocking Drugs Test Bank 2025 | NCLEX Pharmacology Questions with Answers & Rationales | A+ Study Resource | Guaranteed Pass

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Cholinergic-Blocking Drugs Test Bank:
NCLEX-Style Questions with Answers
& Rationales




Chapter 21: Cholinergic-Blocking Drugs
Test Bank


MULTIPLE CHOICE

1. The nurse is about to administer a stat dose of intravenous atropine sulfate to a patient who is
experiencing a symptomatic cardiac dysrhythmia. During administration of this drug, the
nurse will monitor the patient closely for which adverse effect?
a.
Tachycardia
b.
Bradycardia
c.
Ectopic beats
d.
Cardiac standstill
ANS: A
Cardiovascular effects of cholinergic blockers include increased heart rate and dysrhythmias.
One indication for use is the treatment of sinus bradycardia accompanied by hemodynamic
compromise. The other options are incorrect.

DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 337
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

2. A patient has a prescription for oxybutynin (Ditropan), an anticholinergic drug. When
reviewing the patient’s medical history, which condition, if present, would be considered
a contraindication to therapy with this drug?
a.
Diarrhea
b.
Hypertension
c.
Neurogenic bladder
d.
Uncontrolled angle-closure glaucoma
ANS: D
Contraindications include drug allergy, urinary or gastric retention, and uncontrolled angle-
closure glaucoma. Neurogenic bladder is an indication for oxybutynin. The other options are
incorrect.

DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 339
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

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3. The nurse is reviewing the use of anticholinergic drugs. Anticholinergic drugs block
the effects of which nervous system?
a.
Central nervous system
b.
Somatic nervous system
c.
Sympathetic nervous system
d.
Parasympathetic nervous system
ANS: D
Anticholinergic drugs block or inhibit the actions of acetylcholine in the parasympathetic
nervous system. The other options are incorrect.

DIF: COGNITIVE LEVEL: Remembering (Knowledge) REF: p. 335

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TOP: NURSING PROCESS: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

4. A patient has received an accidental overdose of intravenous atropine. Which drug will the
nurse prepare to administer?
a.
atenolol (Tenormin)
b.
bethanechol (Urecholine)
c.
dicyclomine (Bentyl)
d.
physostigmine (Antilirium)
ANS: D
Physostigmine salicylate is the antidote to an atropine overdose in patients who show extreme
delirium or agitation and could inflict injury to themselves. Its routine use as an antidote for
cholinergic-blocker overdose is controversial, however. The other options are incorrect
choices.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 337
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

5. A 72-year-old man has a new prescription for an anticholinergic drug. He is an active man and
enjoys outdoor activities, such as golfing and doing his own yard work. What will the nurse
emphasize to him during the teaching session about his drug therapy?
a.
Drowsiness may interfere with his outdoor activities.
b.
Increased salivation may occur during exercise and outside activities.
c.
Fluid volume deficits may occur as a result of an increased incidence of diarrhea.
d.
He will need to take measures to reduce the occurrence of heat stroke during his
activities.
ANS: D
Elderly patients who take an anticholinergic drug need to be reminded that they are at a
greater risk for suffering heat stroke because of decreased sweating and loss of normal heat-
regulating mechanisms.

DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 342
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential

6. The nurse will monitor for which adverse effect when administering an anticholinergic drug?
a.
Excessive urination
b.
Diaphoresis
c.
Dry mouth
d.
Pupillary constriction
ANS: C
Anticholinergic drugs commonly cause the adverse effects of dry mouth, blurred vision,
constipation, and urinary retention. They also cause mydriasis (pupillary dilation).

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 341
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

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7. The nurse is reviewing a patient’s medication history and notes that the patient is taking
the cholinergic blocker tolterodine (Detrol). Which is an indication for this medication?
a.
Irritable bowel disease
b.
Induction of mydriasis
c.
Urge incontinence
d.
Reduction of secretions preoperatively
ANS: C
Tolterodine (Detrol) is used for urinary frequency, urgency, and urge incontinence caused by
bladder (detrusor) overactivity. The conditions in the other options are not indications.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 336
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

8. A patient has been taking tolterodine (Detrol), but today her prescriber changed her to a newer
drug, darifenacin (Enablex). What advantage does darifenacin have over the tolterodine?
a.
The newer cholinergic-blocker drugs are more effective.
b.
It helps reduce urinary retention.
c.
It can be used in patients with narrow-angle glaucoma.
d.
The incidence of dry mouth is much lower with darifenacin.
ANS: D
The incidence of dry mouth is much lower with use of the newer cholinergic-blocker drugs,
such as darifenacin, because the actions of these drugs are more specific for the bladder as
opposed to the salivary glands. These drugs are contraindicated if narrow-angle glaucoma or
urinary retention is present. The newer cholinergic-blocker drugs are not necessarily more
effective.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 339
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

9. The nurse working in a preoperative admitting unit administers an anticholinergic
medication to a patient before surgery. What is the purpose of this drug in the preoperative
setting?
a.
Control the heart rate
b.
Relax the patient
c.
Reduce urinary frequency
d.
Reduce oral and gastrointestinal secretions
ANS: D
Anticholinergic drugs are given preoperatively to control oral and gastrointestinal secretions
during surgery. The other options are incorrect.

DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 336
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

10. In preparation for eye surgery, the nurse monitors for which desired drug effect in a
patient who is receiving a cholinergic-blocking eyedrop medication?
a.
Miosis
b.
Mydriasis