Test Bank for Core Concepts in Pharmacology, 2nd Edition: Leland N.

Holland

Test Bank for Core Concepts in Pharmacology, 2nd

Edition: Leland N. Holland

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MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.

1) The nervous system consists of which two divisions? Select all that apply.
A) Autonomic nervous system B) Central nervous system
C) Sympathetic nervous system D) Peripheral nervous system
Answer: B, D
Explanation: A) The nervous system consists of the Central Nervous System and the peripheral Nervous
System.
B) The nervous system consists of the Central Nervous System and the peripheral Nervous
System.
C) The nervous system consists of the Central Nervous System and the peripheral Nervous
System.
D) The nervous system consists of the Central Nervous System and the peripheral Nervous
System.
Cognitive Level: Knowledge
Client Need: Health Promotion and Maintenance
Nursing Process: Assessment

2) The autonomic nervous system consists of which two subsystems? Select all that apply.
A) Somatic nervous system B) Sympathetic nervous system
C) Parasympathetic nervous system D) Peripheral nervous system
Answer: B, C
Explanation: A) Somatic nervous system is incorrect because the somatic nervous system consists of nerves
that provide voluntary control over skeletal muscle.
B) The sympathetic nervous system and the parasympathetic nervous system make up the
autonomic nervous system.
C) The parasympathetic nervous system and the sympathetic nervous system make up the
autonomic nervous system.
D) Peripheral nervous system is incorrect because the peripheral nervous system is part of the
central nervous system.
Cognitive Level: Knowledge
Client Need: Health Promotion and Maintenance
Nursing Process: Assessment

3) The somatic nervous system consists of nerves that:

A) Provide involuntary control over smooth muscles.
B) Provide involuntary control over cardiac muscles.
C) Provide voluntary control of skeletal muscles.
D) Provide involuntary control of glands.
Answer: C
Explanation: A) This is a function of the autonomic nervous system.
B) This is a function of the autonomic nervous system.
C) Providing voluntary control of skeletal muscles is a function of the somatic nervous system.
D) This is a function of the autonomic nervous system.
Cognitive Level: Analysis
Client Need: Health Promotion and Maintenance
Nursing Process: Assessment
4) Flight-or-flight is part of the ________ nervous system.
A) Parasympathetic B) Sympathetic C) Somatic D) Peripheral
Answer: B
Explanation: A) The parasympathetic controls rest and digestion functions.
B) The sympathetic nervous system controls flight-or-fight.
C) The somatic nervous system consists of nerves that provide voluntary control over skeletal
muscle.
D) The peripheral nervous system is part of the central nervous system.
Cognitive Level: Application
Client Need: Health Promotion and Maintenance
Nursing Process: Assessment

5) Chemicals called ________ allow nerve impulses to cross the synaptic cleft.
A) Autonomic drugs B) Presynaptic neurons
C) Neurons D) Neurotransmitters
Answer: D
Explanation: A) The chemicals that allow nerve impulses to cross the synaptic cleft are neurotransmitters.
B) The neuron generating the original impulse is called the presynaptic neuron.
C) The basic functional cell of the nervous system is the neuron.
D) Neurotransmitters are chemicals that allow nerve impulses to cross the synaptic cleft.
Cognitive Level: Application
Client Need: Health Promotion and Maintenance
Nursing Process: Assessment

6) Two subtypes of norepinephrine receptors are which of the following? Select all that apply.
A) Alpha B) Beta C) Delta D) Epsilon
Answer: A, B
Explanation: A) Alpha is a subtype of norepinephrine receptor.
B) Beta is a subtype of norepinephrine receptor.
C) Alpha and beta are subtypes of norepinephrine receptors.
D) Alpha and beta are subtypes of norepinephrine receptors.
Cognitive Level: Application
Client Need: Health Promotion and Maintenance
Nursing Process: Assessment
7) A client has been diagnosed with myasthenia gravis, and is experiencing severe muscle weakness. The nurse
recognizes that myasthenia gravis is an autoimmune disorder characterized by the destruction of:
A) Norepinephrine (adrenergic) receptors found in smooth muscle.
B) Nicotinic (cholinergic) receptors found in skeletal muscles.
C) Norepinephrine (adrenergic) receptors found in skeletal muscle.
D) Muscarinic (cholinergic) receptors found in smooth muscle.
Answer: B
Explanation: A) Norepinephrine (adrenergic) receptors found in smooth muscle is incorrect because adrenergic
receptors constrict blood vessels, dilate pupils, inhibit release of norepinephrine, increase
heart rate and force of contractions, release renin, and inhibit smooth muscle.
B) Nicotinic (cholinergic) receptors found in skeletal muscles is correct because myasthenia gravis is
a disease characterized by destruction of nicotinic (cholinergic) receptors on skeletal
muscles.
C) Norepinephrine (adrenergic) receptors found in skeletal muscle is incorrect because adrenergic
receptors constrict blood vessels, dilate pupils, inhibit release of norepinephrine, increase
heart rate and force of contractions, release renin, and inhibit smooth muscle.
D) Muscarinic (cholinergic) receptors found in smooth muscle is incorrect because muscarinic
(cholinergic) receptors stimulate smooth muscle and gland secretion, and decrease the force
of contraction and rate of the heart.
Cognitive Level: Analysis
Client Need: Physiological Integrity
Nursing Process: Diagnosis

8) A client with asthma is using ipratropium (Atrovent). The nurse advises the client to:
A) Monitor serum glucose. B) Limit outside activity.
C) Increase outside activity. D) Decrease fluid intake.
Answer: B
Explanation: A) Monitoring serum glucose does not apply to this medication.
B) Instruction to limit outside activity should be given to the client because ipratropium
(Atrovent) is an anticholinergic, and can therefore inhibit sweat gland secretions due to
direct blockade of the muscarinic receptors on the sweat glands. By limiting outside
activity, especially when the weather is hot, the client avoids possible heatstroke. Sweating
is necessary for clients to cool down, so this inhibition of sweating can increase their risk for
hypothermia.
C) Ipratropium (Atrovent) is an anticholinergic, and can therefore inhibit sweat gland
secretions due to direct blockade of the muscarinic receptors on the sweat glands. By
limiting outside activity, especially when the weather is hot, the client avoids possible
heatstroke. Sweating is necessary for clients to cool down, so this inhibition of sweating can
increase their risk for hypothermia.
D) A client taking anticholinergics should increase fluid intake.
Cognitive Level: Application
Client Need: Physiological Integrity
Nursing Process: Implementation
 9) When teaching a client about beta blockers, the nurse informs the client that abrupt discontinuation can
result in:
A) Dry mouth and painful urination. B) Cramping and constipation.
C) Dizziness and coma. D) Chest pain and rebound hypertension
Answer: D
Explanation: A) Dry mouth and painful urination are not signs and symptoms of beta blocker side effects or
abrupt discontinuation.
B) Cramping and constipation are not signs and symptoms of beta blocker side effects or
abrupt discontinuation.
C) Dizziness and coma are not signs and symptoms of beta blocker side effects or abrupt
discontinuation.
D) Chest pain and rebound hypertension can be caused by withdrawal from some
antihypertensive medications, which can cause a syndrome of apparent sympathetic
hyperactivity, especially in beta blockers. Do not discontinue beta blockers abruptly, as this
can result in chest pain or rebound hypertension.
Cognitive Level: Application
Client Need: Physiological Integrity
Nursing Process: Implementation

10) A client with benign prostatic hypertrophy (BPH) is started on the alpha blocker, alfuzosin (Uroxatral). The
nurse knows it is important to inform the client of which possible side effect?
A) Constipation B) Diaphoresis C) Impotence D) Dental caries
Answer: C
Explanation: A) Constipation is not a side effect of alpha blockers.
B) Diaphoresis is not a side effect of alpha blockers.
C) Impotence can be caused by alpha blockers.
D) Dental caries is not a side effect of alpha blockers.
Cognitive Level: Application
Client Need: Physiological Integrity
Nursing Process: Implementation

11) During discharge education, a nurse tells her client prescribed an adrenergic blocker to notify a health care
provider before taking over-the-counter cold, cough, or sinus medication. Which of the following conditions
would you suspect this client to have?
A) Severe cold B) Gastritis C) Hypertension D) Seizures
Answer: C
Explanation: A) Adrenergic blockers are not used to treat severe colds, gastritis, or seizures.
B) Adrenergic blockers are not used to treat severe colds, gastritis, or seizures.
C) Hypertension is treated with adrenergic blockers. Adrenergic blockers relax vascular
smooth muscle in small arteries, causing vasodilation, which results in decreased blood
pressure. Over-the-counter medications likely contain autonomic agents that can
potentiate the effects of the adrenergic blocker, causing severe hypotension, dizziness,
fainting, dry mouth, shortness of breath, palpitations, or chest pain.
D) Adrenergic blockers are not used to treat severe colds, gastritis, or seizures.
Cognitive Level: Application
Client Need: Physiological Integrity
Nursing Process: Implementation
12) The nurse knows some sympathomimetic drugs stimulate which type of receptors that makes these drugs
useful in treating asthma?
A) Alpha 1 B) Alpha 2 C) Beta 1 D) Beta 2
Answer: D
Explanation: A) Beta 2 receptors are stimulated in the treatment of asthma.
B) Beta 2 receptors are stimulated in the treatment of asthma.
C) Beta 2 receptors are stimulated in the treatment of asthma.
D) Beta 2 receptors are stimulated in the treatment of asthma.
Cognitive Level: Application
Client Need: Physiological Integrity
Nursing Process: Implementation

13) The client asks the nurse which of the following medications is a beta-adrenergic blocker?
A) Doxazosin (Cardura) B) Prazosin (Minipress)
C) Atenolol (Tenormin) D) Terazosin (Hytrin)
Answer: C
Explanation: A) Doxazosin (Cardura) is incorrect because this medication is an alpha-adrenergic blocker.
B) Prazosin (Minipress) is incorrect because this medication is an alpha-adrenergic blocker.
C) Atenolol (Tenormin) is a beta-adrenergic blocker.
D) Terazosin (Hytrin) is incorrect because this medication is an alpha-adrenergic blocker.
Cognitive Level: Analysis
Client Need: Physiological Integrity
Nursing Process: Implementation

14) A client has been prescribed a beta blocker. The nurse knows this medication is most often used to treat:
A) Hypertension. B) Hypotension.
C) Urinary retention. D) Increased intraocular pressure.
Answer: A
Explanation: A) Hypertension is the most common use for beta blockers.
B) Hypotension is incorrect because beta blockers lower blood pressure.
C) Urinary retention is incorrect because beta blockers are used to treat hypertension.
D) Increased intraocular pressure is incorrect because beta blockers are used to treat
hypertension.
Cognitive Level: Application
Client Need: Physiological Integrity
Nursing Process: Implementation

15) The nurse is caring for a client with chronic nasal congestion. The client is being treated with phenylephrine
(Neo-Synephrine). What are some possible nursing diagnoses for this client? Select all that apply.
A) Ineffective breathing pattern B) Urinary retention
C) Constipation D) Knowledge deficit, related to drug therapy
Answer: A, D
Explanation: A) Ineffective breathing pattern is related to chronic nasal congestion, and is appropriate for
this client.
B) Urinary retention is incorrect because it is not related to the medical condition or
medication.
C) Constipation is incorrect because it is not related to the medical condition or medication.
D) Knowledge deficit, related to drug therapy is related to chronic nasal congestion, and is
appropriate for this client.
Cognitive Level: Application
Client Need: Physiological Integrity
Nursing Process: Diagnosis
16) Stimulation of the sympathetic nervous system is caused by which type(s) of drug? Select all that apply.
A) Parasympathomimetics B) Sympathomimetics
C) Cholinergic agents D) Adrenergic agents
Answer: B, D
Explanation: A) Parasympathomimetics is incorrect because parasympathomimetics stimulate the
parasympathetic nervous system.
B) Sympathomimetics stimulate the sympathetic nervous system.
C) Cholinergic agents is incorrect because cholinergic agents stimulate the parasympathetic
nervous system.
D) Adrenergic agents stimulate the sympathetic nervous system.
Cognitive Level: Application
Client Need: Health Promotion and Maintenance
Nursing Process: Assessment

17) A client with chronic sinusitis complains of heart palpitations and nervousness following the use of Afrin
(pseudoephedrine) nasal spray. The nurse recognizes that this is a common side effect of:
A) Sympathomimetics. B) Histamines.
C) Adrenergic blockers. D) Parasympathomimetics.
Answer: A
Explanation: A) Sympathomimetics, or adrenergic agents, have actions similar to activation of the
sympathetic nervous system. They will produce responses characteristic of the
fight-or-flight response (accelerated heart rate, palpitations, constricted blood vessels, and
raised blood pressure).
B) Histamines contribute to an inflammatory response and constrict smooth muscle.
C) Adrenergic blockers and parasympathomimetics are associated with the rest-and-digest
response (slowed heart rate, decreased blood pressure, increased intestinal and gland
activity, and relaxed sphincter muscles).
D) Adrenergic blockers and parasympathomimetics are associated with the rest-and-digest
response (slowed heart rate, decreased blood pressure, increased intestinal and gland
activity, and relaxed sphincter muscles).
Cognitive Level: Analysis
Client Need: Physiological Integrity
Nursing Process: Assessment

18) Stimulation of the parasympathetic nervous system is caused by which type(s) of drug? Select all that apply.
A) Parasympathomimetics B) Sympathomimetics
C) Cholinergic agents D) Adrenergic agents
Answer: A, C
Explanation: A) Parasympathomimetics stimulate the parasympathetic nervous system.
B) Sympathomimetics stimulate the sympathetic nervous system.
C) Cholinergic agents stimulate the parasympathetic nervous system.
D) Adrenergic agents stimulate the sympathetic nervous system.
Cognitive Level: Application
Client Need: Health Promotion and Maintenance
Nursing Process: Assessment
19) While providing comfort to a client on anticholinergics, the nurse knows to avoid:
A) Alcohol-containing mouthwash. B) Hard candy.
C) Oral rinses. D) Frequent oral hygiene.
Answer: A
Explanation: A) Alcohol-containing mouthwash should be avoided because it can increase dryness of the
mouth.
B) Hard candy can help with dry mouth.
C) Oral rinses can help with dry mouth.
D) Frequent oral hygiene can help with dry mouth.
Cognitive Level: Application
Client Need: Physiological Integrity
Nursing Process: Implementation

20) Inhibition of the sympathetic nervous system is caused by which type(s) of drug? Select all that apply
A) Parasympathomimetics B) Sympathomimetics
C) Cholinergic agents D) Adrenergic blockers
Answer: D
Explanation: A) Parasympathomimetics is incorrect because these stimulate the parasympathetic nervous
system.
B) Sympathomimetics is incorrect because these stimulate the sympathetic nervous system.
C) Cholinergic agents is incorrect because cholinergic agents stimulate the parasympathetic
nervous system.
D) Adrenergic blockers inhibit the sympathetic nervous system.
Cognitive Level: Application
Client Need: Health Promotion and Maintenance
Nursing Process: Assessment

21) Inhibition of the parasympathetic nervous system is caused by which type(s) of drug? Select all that apply.
A) Parasympathomimetics B) Sympathomimetics
C) Cholinergic blockers D) Anticholinergics
Answer: C, D
Explanation: A) Parasympathomimetics is incorrect because parasympathomimetics stimulate the
parasympathetic nervous system.
B) Sympathomimetics is incorrect is incorrect because these stimulate the sympathetic nervous
system.
C) Cholinergic blockers inhibit the parasympathetic nervous system.
D) Anticholinergics inhibit the parasympathetic nervous system.
Cognitive Level: Application
Client Need: Health Promotion and Maintenance
Nursing Process: Assessment
22) Bethanechol (Urecholine) has been prescribed for a client, who asks the nurse what the side effects of this
drug are. Select all side effects related to this drug.
A) Increased salivation B) Hypertension
C) Hypotension D) Abdominal cramping
Answer: A, C, D
Explanation: A) Increased salivation is a side effect of parasympathomimetics.
B) Hypertension is not a side effect of parasympathomimetics.
C) Hypotension is a side effect of parasympathomimetics.
D) Abdominal cramping is a side effect of parasympathomimetics.
Cognitive Level: Application
Client Need: Physiological Integrity
Nursing Process: Implementation

23) The physician states that an anticholinergic drug has been prescribed for a client. The nurse anticipates
which of the following to be ordered?
A) Bethanechol (Urecholine) B) Neostigmine (Prostigmin)
C) Ipratropium (Atrovent) D) Pyridostigmine (Mestinon)
Answer: C
Explanation: A) Bethanechol (Urecholine) is incorrect because this medication is a parasympathomimetic.
B) Neostigmine (Prostigmin) is incorrect because this medication is a parasympathomimetic.
C) Ipratropium (Atrovent) is an anticholinergic drug.
D) Pyridostigmine (Mestinon) is incorrect because this medication is a parasympathomimetic.
Cognitive Level: Application
Client Need: Physiological Integrity
Nursing Process: Implementation

24) Side effects that limit the usefulness of anticholinergics include which of the following? Select all that apply.
A) Increased salivation B) Hypotension
C) Tachycardia D) Urinary retention
Answer: C, D
Explanation: A) Increased salivation is incorrect because it is a side effect of parasympathomimetics.
B) Hypotension is incorrect because it is a side effect of parasympathomimetics.
C) Tachycardia is a side effect of anticholinergics.
D) Urinary retention is a side effect of anticholinergics.
Cognitive Level: Application
Client Need: Physiological Integrity
Nursing Process: Implementation
Test Bank for Core Concepts in Pharmacology, 2nd Edition: Leland N. Holland

25) Following a chemical explosion, a client presents to the Emergency Department with muscle twitching, loss
of bowel and bladder control, and confusion. The nurse recognizes that the client has been in contact with a
nerve agent, and knows to give:
A) Atropine (Atropine). B) Ethosuximide (Zarontin).
C) Ritodrine (Yutopar). D) Pridostigmine (Mestinon).
Answer: A
Explanation: A) Nerve agents are chemicals that inhibit acetylcholinesterase in the synaptic space and can
cause toxic parasympathomimetic effects. Atropine or related anticholinergic medications
block the attachment of acetylcholine to receptor sites, causing symptoms of the
fight-or-flight response, preventing overstimulation caused by harmful nerve agents.
B) Ethosuximide (Zarontin) is an anticonvulsant.
C) Ritodrine (Yutopar) is a sympathomimetic commonly used to slow uterine contractions.
D) Pridostigmine (Mestinon) is a parasympathomimetic commonly used for myasthenia
gravis.
Cognitive Level: Application
Client Need: Physiological Integrity
Nursing Process: Assessment

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