NUR 210 Exams 3 Pharmacology (2026)
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1. The nurse is preparing to administer metoprolol to a patient with
hypertension. Which assessment finding requires the nurse to hold the
medication and contact the provider?
A. Blood pressure of 138/82 mm Hg
B. Apical heart rate of 54 beats per minute
C. Respiratory rate of 18 breaths per minute
D. Temperature of 99.1°F (37.3°C)
Correct Answer: B. Apical heart rate of 54 beats per minute
Expert Explanation: Metoprolol is a cardioselective beta-1 adrenergic blocker
that decreases heart rate, contractility, and cardiac output. The suffix "-olol"
identifies beta blockers . A critical pre-administration assessment is the apical
pulse. If the heart rate is below 60 beats per minute, the medication should be
held to prevent further suppression of the heart rate, which could lead to
symptomatic bradycardia, heart block, or hypotension. This is a standard safety
checkpoint for all negative chronotropic medications.
2. A patient with hypertension and type 2 diabetes is prescribed metoprolol.
What important teaching point should the nurse include regarding diabetes
management?
A. "This medication will enhance the glucose-lowering effect of your insulin."
B. "This medication may mask the early warning signs of hypoglycemia, such as
tachycardia."
C. "You should discontinue this medication if your blood glucose exceeds 200
mg/dL."
D. "This medication has no effect on blood glucose regulation."
,Correct Answer: B. "This medication may mask the early warning signs of
hypoglycemia, such as tachycardia."
Expert Explanation: Beta blockers inhibit the sympathetic nervous system
response. When a diabetic patient experiences hypoglycemia, the body normally
releases epinephrine, causing tachycardia, tremors, and palpitations as warning
signals. Beta blockers suppress these adrenergic symptoms, masking the early
signs of low blood sugar . Patients may only experience diaphoresis (sweating)
as a warning sign, or they may progress directly to neuroglycopenic symptoms
(confusion, loss of consciousness). Diabetic patients on beta blockers must
monitor blood glucose more frequently.
3. A patient with a history of asthma is prescribed a beta blocker for
hypertension. The nurse should question which of the following orders?
A. Metoprolol
B. Atenolol
C. Propranolol
D. Bisoprolol
Correct Answer: C. Propranolol
Expert Explanation: Propranolol is a non-selective beta blocker, meaning it
antagonizes both beta-1 receptors (in the heart) and beta-2 receptors (in the
bronchial smooth muscle). Blockade of beta-2 receptors can precipitate
bronchospasm and is therefore contraindicated in patients with asthma or
COPD . Metoprolol, atenolol, and bisoprolol are cardioselective beta-1 blockers.
While high doses can lose selectivity, these agents are generally safer for
patients with reactive airway disease. However, even cardioselective agents
should be used with caution in severe asthmatics.
4. The nurse is educating a patient prescribed prazosin for hypertension. Which
instruction is most important to prevent a common adverse effect?
A. "Take this medication with food to prevent gastrointestinal upset."
B. "Take the first dose at bedtime to minimize dizziness upon standing."
C. "Increase your fluid intake to prevent dehydration."
D. "Avoid consuming dairy products while taking this medication."
Correct Answer: B. "Take the first dose at bedtime to minimize dizziness
upon standing."
, Expert Explanation: Prazosin is an alpha-1 adrenergic blocker (suffix "-sin" )
that causes vasodilation . A significant adverse effect is "first-dose
phenomenon" —a profound orthostatic hypotensive episode occurring within
30-90 minutes of the initial dose, which can cause syncope (fainting) and falls.
To mitigate this risk, the first dose should be taken at bedtime when the patient
is lying down and planning to remain recumbent for several hours. Patients
should also be taught to rise slowly from sitting or lying positions .
5. A patient taking prazosin reports swelling in their feet and ankles. The nurse
recognizes this as:
A. A sign of acute kidney injury requiring immediate intervention.
B. An expected side effect of alpha-1 blockade related to vasodilation.
C. A sign of heart failure exacerbation unrelated to the medication.
D. An allergic reaction requiring discontinuation of the drug.
Correct Answer: B. An expected side effect of alpha-1 blockade related to
vasodilation.
Expert Explanation: Peripheral edema is a known side effect of alpha-
adrenergic blockers like prazosin . The mechanism differs from calcium channel
blocker edema. Alpha blockade causes vasodilation, which can increase
capillary permeability and fluid shifts into the interstitial space. While the nurse
should document the finding and monitor for worsening symptoms, this is
generally not an emergency. If the edema becomes severe or is accompanied by
shortness of breath (suggesting heart failure), the provider should be notified.
6. The nurse is teaching a patient newly prescribed nifedipine for hypertension.
Which side effect should the patient be prepared to expect?
A. Persistent dry cough
B. Flushing, headache, and ankle edema
C. Increased urinary frequency
D. Metallic taste in the mouth
Correct Answer: B. Flushing, headache, and ankle edema
Expert Explanation: Nifedipine is a dihydropyridine calcium channel blocker
(suffix "-pine" ) that acts primarily on vascular smooth muscle to cause arterial
vasodilation . This rapid vasodilation produces common side effects including
PDF | Galen College of Nursing Questions
and Ansẉers with
Expert-Verified Explanation 2026\2027
update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
, Expert-Verified Explanation
Verified ẉith trusted textbooks
───────────────────────────────────────────────────────
─
1. The nurse is preparing to administer metoprolol to a patient with
hypertension. Which assessment finding requires the nurse to hold the
medication and contact the provider?
A. Blood pressure of 138/82 mm Hg
B. Apical heart rate of 54 beats per minute
C. Respiratory rate of 18 breaths per minute
D. Temperature of 99.1°F (37.3°C)
Correct Answer: B. Apical heart rate of 54 beats per minute
Expert Explanation: Metoprolol is a cardioselective beta-1 adrenergic blocker
that decreases heart rate, contractility, and cardiac output. The suffix "-olol"
identifies beta blockers . A critical pre-administration assessment is the apical
pulse. If the heart rate is below 60 beats per minute, the medication should be
held to prevent further suppression of the heart rate, which could lead to
symptomatic bradycardia, heart block, or hypotension. This is a standard safety
checkpoint for all negative chronotropic medications.
2. A patient with hypertension and type 2 diabetes is prescribed metoprolol.
What important teaching point should the nurse include regarding diabetes
management?
A. "This medication will enhance the glucose-lowering effect of your insulin."
B. "This medication may mask the early warning signs of hypoglycemia, such as
tachycardia."
C. "You should discontinue this medication if your blood glucose exceeds 200
mg/dL."
D. "This medication has no effect on blood glucose regulation."
,Correct Answer: B. "This medication may mask the early warning signs of
hypoglycemia, such as tachycardia."
Expert Explanation: Beta blockers inhibit the sympathetic nervous system
response. When a diabetic patient experiences hypoglycemia, the body normally
releases epinephrine, causing tachycardia, tremors, and palpitations as warning
signals. Beta blockers suppress these adrenergic symptoms, masking the early
signs of low blood sugar . Patients may only experience diaphoresis (sweating)
as a warning sign, or they may progress directly to neuroglycopenic symptoms
(confusion, loss of consciousness). Diabetic patients on beta blockers must
monitor blood glucose more frequently.
3. A patient with a history of asthma is prescribed a beta blocker for
hypertension. The nurse should question which of the following orders?
A. Metoprolol
B. Atenolol
C. Propranolol
D. Bisoprolol
Correct Answer: C. Propranolol
Expert Explanation: Propranolol is a non-selective beta blocker, meaning it
antagonizes both beta-1 receptors (in the heart) and beta-2 receptors (in the
bronchial smooth muscle). Blockade of beta-2 receptors can precipitate
bronchospasm and is therefore contraindicated in patients with asthma or
COPD . Metoprolol, atenolol, and bisoprolol are cardioselective beta-1 blockers.
While high doses can lose selectivity, these agents are generally safer for
patients with reactive airway disease. However, even cardioselective agents
should be used with caution in severe asthmatics.
4. The nurse is educating a patient prescribed prazosin for hypertension. Which
instruction is most important to prevent a common adverse effect?
A. "Take this medication with food to prevent gastrointestinal upset."
B. "Take the first dose at bedtime to minimize dizziness upon standing."
C. "Increase your fluid intake to prevent dehydration."
D. "Avoid consuming dairy products while taking this medication."
Correct Answer: B. "Take the first dose at bedtime to minimize dizziness
upon standing."
, Expert Explanation: Prazosin is an alpha-1 adrenergic blocker (suffix "-sin" )
that causes vasodilation . A significant adverse effect is "first-dose
phenomenon" —a profound orthostatic hypotensive episode occurring within
30-90 minutes of the initial dose, which can cause syncope (fainting) and falls.
To mitigate this risk, the first dose should be taken at bedtime when the patient
is lying down and planning to remain recumbent for several hours. Patients
should also be taught to rise slowly from sitting or lying positions .
5. A patient taking prazosin reports swelling in their feet and ankles. The nurse
recognizes this as:
A. A sign of acute kidney injury requiring immediate intervention.
B. An expected side effect of alpha-1 blockade related to vasodilation.
C. A sign of heart failure exacerbation unrelated to the medication.
D. An allergic reaction requiring discontinuation of the drug.
Correct Answer: B. An expected side effect of alpha-1 blockade related to
vasodilation.
Expert Explanation: Peripheral edema is a known side effect of alpha-
adrenergic blockers like prazosin . The mechanism differs from calcium channel
blocker edema. Alpha blockade causes vasodilation, which can increase
capillary permeability and fluid shifts into the interstitial space. While the nurse
should document the finding and monitor for worsening symptoms, this is
generally not an emergency. If the edema becomes severe or is accompanied by
shortness of breath (suggesting heart failure), the provider should be notified.
6. The nurse is teaching a patient newly prescribed nifedipine for hypertension.
Which side effect should the patient be prepared to expect?
A. Persistent dry cough
B. Flushing, headache, and ankle edema
C. Increased urinary frequency
D. Metallic taste in the mouth
Correct Answer: B. Flushing, headache, and ankle edema
Expert Explanation: Nifedipine is a dihydropyridine calcium channel blocker
(suffix "-pine" ) that acts primarily on vascular smooth muscle to cause arterial
vasodilation . This rapid vasodilation produces common side effects including
