NUR2407 / NUR 2407 ONLY: Pharmacology Exam 2
– Rasmussen Actual Exam Complete Questions &
Rationales | Detailed Drug Coverage | Pass
Guaranteed - A+ Graded
Cardiovascular & Antihypertensive Drugs
Q1: A patient newly diagnosed with hypertension is started on lisinopril. The nurse
knows this medication works primarily through which mechanism?
A. Blocking beta-1 receptors in the heart to reduce cardiac output
B. Inhibiting angiotensin-converting enzyme to decrease vasoconstriction [CORRECT]
C. Blocking calcium channels in vascular smooth muscle to cause vasodilation
D. Promoting sodium and water excretion through the kidneys to reduce blood volume
Correct Answer: B
Rationale: The best answer is B — lisinopril is an ACE inhibitor, and its whole job is to
block that angiotensin-converting enzyme so you don't get all that vasoconstriction and
aldosterone release. Here's what you need to remember: ACE inhibitors end in "-pril," and
they work on that renin-angiotensin-aldosterone system. On the NCLEX, you'll see this
presented as a first-line choice for patients with heart failure or diabetes because it also
protects the kidneys.
Q2: Your patient on metoprolol calls the clinic and says, "I feel really dizzy when I stand
up, and my heart rate is only 52." What is the nurse's priority response?
A. Tell the patient to take the next dose with food to reduce GI upset
B. Instruct the patient to hold the dose and notify the provider about the bradycardia
[CORRECT]
C. Reassure the patient that dizziness and bradycardia are expected with beta-blockers
D. Advise the patient to increase fluid intake and continue the medication as prescribed
,Correct Answer: B
Rationale: The best answer is B — a heart rate in the low 50s with symptomatic
dizziness is not something you brush off. This aligns with safe medication
administration because beta-blockers like metoprolol can drop that heart rate too low,
and you need to hold the dose and get the provider involved. Here's what you need to
remember: you always check apical pulse before giving a beta-blocker, and if it's under
60, you hold and call.
Q3: A 68-year-old patient with a history of heart failure is prescribed furosemide 40 mg
PO daily. Which laboratory value should the nurse monitor most closely during the first
week of therapy?
A. Serum creatinine
B. Serum potassium [CORRECT]
C. Hemoglobin and hematocrit
D. Serum albumin
Correct Answer: B
Rationale: The best answer is B — furosemide is a loop diuretic, and it will send
potassium right out the door with that fluid. This matches the expected teaching point
for loop diuretics: hypokalemia is your big worry, and you need to watch for muscle
weakness, irregular heart rhythms, and fatigue. On the NCLEX, you'll see this presented
as a patient on furosemide who needs potassium-rich foods or possibly a supplement.
Q4: A patient asks the nurse, "Why did my doctor switch me from hydrochlorothiazide to
spironolactone?" Which response by the nurse is most appropriate?
A. "Spironolactone works faster to lower your blood pressure than hydrochlorothiazide."
B. "Spironolactone is a potassium-sparing diuretic, so it helps protect your potassium
levels." [CORRECT]
C. "Spironolactone is stronger and will remove more fluid from your body."
D. "Spironolactone only works on your blood vessels, not your kidneys."
Correct Answer: B
Rationale: The best answer is B — spironolactone is your potassium-sparing diuretic,
and that's exactly why a provider might choose it, especially if the patient has been
running low on potassium. Here's what you need to remember: HCTZ is a thiazide that
, wastes potassium, while spironolactone actually hangs onto it, so you have to watch the
opposite problem — hyperkalemia.
Q5: The nurse is reviewing a patient's home medication list and sees amlodipine,
lisinopril, and hydrochlorothiazide. The patient reports swelling in the ankles and feet.
Which medication is most likely causing this side effect?
A. Lisinopril
B. Hydrochlorothiazide
C. Amlodipine [CORRECT]
D. The combination of all three is equally likely
Correct Answer: C
Rationale: The best answer is C — amlodipine is a calcium channel blocker, and
peripheral edema is basically its calling card. This aligns with safe medication
administration because you need to teach patients that ankle swelling is common with
this class, it's usually not dangerous, but it needs to be reported if it gets severe or is
accompanied by shortness of breath.
Q6: A patient with atrial fibrillation is started on diltiazem. The nurse understands that
the primary therapeutic effect of this drug in this patient is to:
A. Convert atrial fibrillation back to normal sinus rhythm
B. Slow ventricular response by delaying AV nodal conduction [CORRECT]
C. Increase myocardial contractility to improve cardiac output
D. Prevent thrombus formation in the atria
Correct Answer: B
Rationale: The best answer is B — diltiazem is a non-dihydropyridine calcium channel
blocker, and its main trick in A-fib is slowing down that electrical impulse through the AV
node so the ventricles don't race. Here's what you need to remember: it controls rate, it
does not fix the rhythm, and it does not prevent clots — that's what anticoagulants are
for.
Q7: During shift report, the nurse learns that a patient on digoxin has a serum potassium
of 2.8 mEq/L. What is the nurse's greatest concern?
A. The patient is at increased risk for digoxin toxicity [CORRECT]
B. The patient will develop severe hypertension
C. The patient is likely to experience hyperglycemia
– Rasmussen Actual Exam Complete Questions &
Rationales | Detailed Drug Coverage | Pass
Guaranteed - A+ Graded
Cardiovascular & Antihypertensive Drugs
Q1: A patient newly diagnosed with hypertension is started on lisinopril. The nurse
knows this medication works primarily through which mechanism?
A. Blocking beta-1 receptors in the heart to reduce cardiac output
B. Inhibiting angiotensin-converting enzyme to decrease vasoconstriction [CORRECT]
C. Blocking calcium channels in vascular smooth muscle to cause vasodilation
D. Promoting sodium and water excretion through the kidneys to reduce blood volume
Correct Answer: B
Rationale: The best answer is B — lisinopril is an ACE inhibitor, and its whole job is to
block that angiotensin-converting enzyme so you don't get all that vasoconstriction and
aldosterone release. Here's what you need to remember: ACE inhibitors end in "-pril," and
they work on that renin-angiotensin-aldosterone system. On the NCLEX, you'll see this
presented as a first-line choice for patients with heart failure or diabetes because it also
protects the kidneys.
Q2: Your patient on metoprolol calls the clinic and says, "I feel really dizzy when I stand
up, and my heart rate is only 52." What is the nurse's priority response?
A. Tell the patient to take the next dose with food to reduce GI upset
B. Instruct the patient to hold the dose and notify the provider about the bradycardia
[CORRECT]
C. Reassure the patient that dizziness and bradycardia are expected with beta-blockers
D. Advise the patient to increase fluid intake and continue the medication as prescribed
,Correct Answer: B
Rationale: The best answer is B — a heart rate in the low 50s with symptomatic
dizziness is not something you brush off. This aligns with safe medication
administration because beta-blockers like metoprolol can drop that heart rate too low,
and you need to hold the dose and get the provider involved. Here's what you need to
remember: you always check apical pulse before giving a beta-blocker, and if it's under
60, you hold and call.
Q3: A 68-year-old patient with a history of heart failure is prescribed furosemide 40 mg
PO daily. Which laboratory value should the nurse monitor most closely during the first
week of therapy?
A. Serum creatinine
B. Serum potassium [CORRECT]
C. Hemoglobin and hematocrit
D. Serum albumin
Correct Answer: B
Rationale: The best answer is B — furosemide is a loop diuretic, and it will send
potassium right out the door with that fluid. This matches the expected teaching point
for loop diuretics: hypokalemia is your big worry, and you need to watch for muscle
weakness, irregular heart rhythms, and fatigue. On the NCLEX, you'll see this presented
as a patient on furosemide who needs potassium-rich foods or possibly a supplement.
Q4: A patient asks the nurse, "Why did my doctor switch me from hydrochlorothiazide to
spironolactone?" Which response by the nurse is most appropriate?
A. "Spironolactone works faster to lower your blood pressure than hydrochlorothiazide."
B. "Spironolactone is a potassium-sparing diuretic, so it helps protect your potassium
levels." [CORRECT]
C. "Spironolactone is stronger and will remove more fluid from your body."
D. "Spironolactone only works on your blood vessels, not your kidneys."
Correct Answer: B
Rationale: The best answer is B — spironolactone is your potassium-sparing diuretic,
and that's exactly why a provider might choose it, especially if the patient has been
running low on potassium. Here's what you need to remember: HCTZ is a thiazide that
, wastes potassium, while spironolactone actually hangs onto it, so you have to watch the
opposite problem — hyperkalemia.
Q5: The nurse is reviewing a patient's home medication list and sees amlodipine,
lisinopril, and hydrochlorothiazide. The patient reports swelling in the ankles and feet.
Which medication is most likely causing this side effect?
A. Lisinopril
B. Hydrochlorothiazide
C. Amlodipine [CORRECT]
D. The combination of all three is equally likely
Correct Answer: C
Rationale: The best answer is C — amlodipine is a calcium channel blocker, and
peripheral edema is basically its calling card. This aligns with safe medication
administration because you need to teach patients that ankle swelling is common with
this class, it's usually not dangerous, but it needs to be reported if it gets severe or is
accompanied by shortness of breath.
Q6: A patient with atrial fibrillation is started on diltiazem. The nurse understands that
the primary therapeutic effect of this drug in this patient is to:
A. Convert atrial fibrillation back to normal sinus rhythm
B. Slow ventricular response by delaying AV nodal conduction [CORRECT]
C. Increase myocardial contractility to improve cardiac output
D. Prevent thrombus formation in the atria
Correct Answer: B
Rationale: The best answer is B — diltiazem is a non-dihydropyridine calcium channel
blocker, and its main trick in A-fib is slowing down that electrical impulse through the AV
node so the ventricles don't race. Here's what you need to remember: it controls rate, it
does not fix the rhythm, and it does not prevent clots — that's what anticoagulants are
for.
Q7: During shift report, the nurse learns that a patient on digoxin has a serum potassium
of 2.8 mEq/L. What is the nurse's greatest concern?
A. The patient is at increased risk for digoxin toxicity [CORRECT]
B. The patient will develop severe hypertension
C. The patient is likely to experience hyperglycemia
