RASMUSSEN NUR 2474
PHARMACOLOGY FOR PROFESSIONAL NURSING
EXAM 2 STUDY SET
2026/2027 Edition
75 Questions | Verified Solutions | NGN-Aligned
Latest 2025-2026 Exam Update Content
Graded A+ | 100% Correct
Based on: Lehne's Pharmacology for Nursing Care | ATI Pharmacology Review Module | ACC/AHA
Guidelines | ADA Standards of Care | IDSA Guidelines | APA Practice Guidelines | CDC Opioid
Prescribing Guidelines | NCSBN CJMM Framework | FDA Drug Safety Communications
DOMAIN COVERAGE SUMMARY
Cardiovascular Pharmacology (Q1–Q15) — 15 Questions
Topics: Antihypertensives (ACEi/ARBs/CCBs/Diuretics/Beta-Blockers), Antianginals,
Anticoagulants/Antiplatelets, Heart Failure Agents (Digoxin/ARNIs/SGLT2i)
Respiratory Pharmacology (Q16–Q24) — 9 Questions
Topics: Bronchodilators (SABAs/LABAs/Anticholinergics), Inhaler Technique, Inhaled
Corticosteroids, Leukotriene Modifiers, Antitussives
Endocrine Pharmacology (Q25–Q35) — 11 Questions
Topics: Insulins (All Types), Oral Hypoglycemics (Metformin/Sulfonylureas/GLP-1/DPP-4/SGLT2),
Thyroid Agents, Hypoglycemia Management (15g Rule)
CNS & Psychiatric Pharmacology (Q36–Q44) — 9 Questions
Topics: Antidepressants (SSRIs/SNRIs), Antipsychotics (Typical/Atypical), Mood Stabilizers
(Lithium/Valproate), Anxiolytics (Benzodiazepines)
Pain Management & Opioid Stewardship (Q45–Q53) — 9 Questions
Topics: NSAIDs, Acetaminophen, Opioids (Morphine/Oxycodone/Fentanyl), Naloxone, Adjuvant
Analgesics, CDC Guidelines
Anti-Infective Pharmacology (Q54–Q62) — 9 Questions
,Topics: Penicillins/Cephalosporins, Vancomycin, Fluoroquinolones, Macrolides, C. difficile,
Antibiotic Stewardship
Gastrointestinal Pharmacology (Q63–Q68) — 6 Questions
Topics: PPIs, H2 Blockers, Antacids, Laxatives, Antiemetics, Antidiarrheals
Medication Safety & Nursing Process (Q69–Q72) — 4 Questions
Topics: High-Alert Medications, BCMA, Error Reporting, Patient Education (Teach-Back)
NGN Clinical Decision-Making (Q73–Q75) — 3 Questions
Topics: Ordered Response, Matrix, Scenario-Based Case Study (Multi-System Polypharmacy)
1. A client with hypertension is started on lisinopril (ACE inhibitor). Which instruction
should the nurse include in patient education?
A. Report persistent dry cough to the provider
B. Increase potassium-rich foods in the diet
C. Expect swelling of the lips and tongue as a normal side effect
D. Take the medication with antacids to reduce GI upset
Rationale: Lisinopril, an ACE inhibitor, commonly causes a persistent dry cough due to
bradykinin accumulation. The nurse should instruct the client to report this side effect, as it may
require switching to an ARB. ACE inhibitors decrease aldosterone, causing potassium retention;
therefore, clients should avoid potassium supplements and potassium-rich foods. Angioedema
(lip/tongue swelling) is a life-threatening reaction requiring emergency care, not an expected
side effect.
【Cardiovascular Pharmacology】 [MC]
2. A client receiving enalapril (ACE inhibitor) has a blood pressure of 88/52 mmHg and
reports dizziness. What is the nurse's priority action?
A. Administer the next scheduled dose on time
B. Hold the medication and notify the healthcare provider
C. Instruct the client to stand up slowly
D. Encourage increased fluid intake to 3 L/day
Rationale: Hypotension is a significant adverse effect of ACE inhibitors, especially after the
first dose (first-dose hypotension). A blood pressure of 88/52 mmHg with symptomatic dizziness
requires holding the medication and notifying the provider immediately. The provider may
adjust the dose, switch to a different antihypertensive class, or evaluate for volume depletion.
Fluid intake of 3 L/day is excessive and not indicated without provider assessment.
【Cardiovascular Pharmacology】 [MC]
3. Which laboratory value requires the nurse to monitor most closely for a client taking
losartan (ARB)?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum chloride
Rationale: Losartan, an angiotensin II receptor blocker (ARB), blocks the angiotensin II
receptor, reducing aldosterone secretion and decreasing potassium excretion. Hyperkalemia is a
significant risk, especially in clients with renal impairment or those taking potassium-sparing
diuretics, potassium supplements, or NSAIDs concurrently. The nurse should monitor serum
potassium levels and assess for signs of hyperkalemia including muscle weakness, fatigue, and
cardiac arrhythmias.
【Cardiovascular Pharmacology】 [MC]
, 4. A client is prescribed amlodipine (calcium channel blocker) for hypertension. Which
side effect should the nurse instruct the client to report?
A. Mild headache during the first week
B. Peripheral edema of the ankles and feet
C. Slight decrease in heart rate
D. Transient dizziness when standing quickly
Rationale: Peripheral edema (swelling of ankles and feet) is a common adverse effect of
dihydropyridine calcium channel blockers like amlodipine, caused by precapillary vasodilation.
While mild headache, slight bradycardia, and transient dizziness may occur initially, peripheral
edema is the most clinically significant side effect that should be reported to the provider, as it
may require dose adjustment, addition of a diuretic, or switching to a different antihypertensive
class.
【Cardiovascular Pharmacology】 [MC]
5. A client with heart failure is started on furosemide (loop diuretic). Which finding
indicates the medication is effective?
A. Weight gain of 1 kg over 2 days
B. Decreased dyspnea and reduced peripheral edema
C. Blood pressure increase to 140/90 mmHg
D. Serum sodium level of 150 mEq/L
Rationale: Furosemide, a loop diuretic, promotes diuresis by inhibiting sodium and chloride
reabsorption in the ascending loop of Henle. Effectiveness in heart failure is evidenced by
decreased dyspnea (reduced pulmonary congestion), reduced peripheral edema, weight loss
from fluid removal, and improved exercise tolerance. Weight gain indicates worsening fluid
retention (treatment failure), blood pressure increase is not a desired outcome, and
hypernatremia (sodium 150 mEq/L) is an adverse electrolyte imbalance.
【Cardiovascular Pharmacology】 [MC]
6. A client taking metoprolol (beta-blocker) reports fatigue, bradycardia (HR 48 bpm),
and dizziness. Which action should the nurse take first?
A. Assess the client's blood pressure and hold the medication
B. Administer atropine intravenously
C. Encourage the client to increase physical activity
D. Document the findings and continue the medication as prescribed
Rationale: Metoprolol, a cardioselective beta-1 blocker, reduces heart rate, myocardial
contractility, and cardiac output. Fatigue, bradycardia (HR <60 bpm), and dizziness are signs
of excessive beta-blockade. The nurse should first assess blood pressure (as hypotension often
accompanies bradycardia) and hold the medication pending provider notification. Atropine is
reserved for severe symptomatic bradycardia and requires a provider order. Increasing
physical activity would worsen symptoms in the setting of bradycardia and decreased cardiac
output.
【Cardiovascular Pharmacology】 [MC]
7. A client with stable angina is prescribed sublingual nitroglycerin. Which instruction
is correct regarding administration?
A. Take one tablet every 10 minutes for up to 3 doses for chest pain
B. Swallow the tablet with a full glass of water for rapid absorption
C. Sit or lie down before taking the medication due to risk of hypotension
D. Store the tablets in the refrigerator to maintain potency
Rationale: Nitroglycerin causes rapid venous vasodilation, which can lead to significant
hypotension and syncope. The client should sit or lie down before taking sublingual
nitroglycerin. The correct dosing for angina is one tablet every 5 minutes (not 10 minutes) for up
to 3 doses; if chest pain persists after 3 doses, emergency services should be activated.
PHARMACOLOGY FOR PROFESSIONAL NURSING
EXAM 2 STUDY SET
2026/2027 Edition
75 Questions | Verified Solutions | NGN-Aligned
Latest 2025-2026 Exam Update Content
Graded A+ | 100% Correct
Based on: Lehne's Pharmacology for Nursing Care | ATI Pharmacology Review Module | ACC/AHA
Guidelines | ADA Standards of Care | IDSA Guidelines | APA Practice Guidelines | CDC Opioid
Prescribing Guidelines | NCSBN CJMM Framework | FDA Drug Safety Communications
DOMAIN COVERAGE SUMMARY
Cardiovascular Pharmacology (Q1–Q15) — 15 Questions
Topics: Antihypertensives (ACEi/ARBs/CCBs/Diuretics/Beta-Blockers), Antianginals,
Anticoagulants/Antiplatelets, Heart Failure Agents (Digoxin/ARNIs/SGLT2i)
Respiratory Pharmacology (Q16–Q24) — 9 Questions
Topics: Bronchodilators (SABAs/LABAs/Anticholinergics), Inhaler Technique, Inhaled
Corticosteroids, Leukotriene Modifiers, Antitussives
Endocrine Pharmacology (Q25–Q35) — 11 Questions
Topics: Insulins (All Types), Oral Hypoglycemics (Metformin/Sulfonylureas/GLP-1/DPP-4/SGLT2),
Thyroid Agents, Hypoglycemia Management (15g Rule)
CNS & Psychiatric Pharmacology (Q36–Q44) — 9 Questions
Topics: Antidepressants (SSRIs/SNRIs), Antipsychotics (Typical/Atypical), Mood Stabilizers
(Lithium/Valproate), Anxiolytics (Benzodiazepines)
Pain Management & Opioid Stewardship (Q45–Q53) — 9 Questions
Topics: NSAIDs, Acetaminophen, Opioids (Morphine/Oxycodone/Fentanyl), Naloxone, Adjuvant
Analgesics, CDC Guidelines
Anti-Infective Pharmacology (Q54–Q62) — 9 Questions
,Topics: Penicillins/Cephalosporins, Vancomycin, Fluoroquinolones, Macrolides, C. difficile,
Antibiotic Stewardship
Gastrointestinal Pharmacology (Q63–Q68) — 6 Questions
Topics: PPIs, H2 Blockers, Antacids, Laxatives, Antiemetics, Antidiarrheals
Medication Safety & Nursing Process (Q69–Q72) — 4 Questions
Topics: High-Alert Medications, BCMA, Error Reporting, Patient Education (Teach-Back)
NGN Clinical Decision-Making (Q73–Q75) — 3 Questions
Topics: Ordered Response, Matrix, Scenario-Based Case Study (Multi-System Polypharmacy)
1. A client with hypertension is started on lisinopril (ACE inhibitor). Which instruction
should the nurse include in patient education?
A. Report persistent dry cough to the provider
B. Increase potassium-rich foods in the diet
C. Expect swelling of the lips and tongue as a normal side effect
D. Take the medication with antacids to reduce GI upset
Rationale: Lisinopril, an ACE inhibitor, commonly causes a persistent dry cough due to
bradykinin accumulation. The nurse should instruct the client to report this side effect, as it may
require switching to an ARB. ACE inhibitors decrease aldosterone, causing potassium retention;
therefore, clients should avoid potassium supplements and potassium-rich foods. Angioedema
(lip/tongue swelling) is a life-threatening reaction requiring emergency care, not an expected
side effect.
【Cardiovascular Pharmacology】 [MC]
2. A client receiving enalapril (ACE inhibitor) has a blood pressure of 88/52 mmHg and
reports dizziness. What is the nurse's priority action?
A. Administer the next scheduled dose on time
B. Hold the medication and notify the healthcare provider
C. Instruct the client to stand up slowly
D. Encourage increased fluid intake to 3 L/day
Rationale: Hypotension is a significant adverse effect of ACE inhibitors, especially after the
first dose (first-dose hypotension). A blood pressure of 88/52 mmHg with symptomatic dizziness
requires holding the medication and notifying the provider immediately. The provider may
adjust the dose, switch to a different antihypertensive class, or evaluate for volume depletion.
Fluid intake of 3 L/day is excessive and not indicated without provider assessment.
【Cardiovascular Pharmacology】 [MC]
3. Which laboratory value requires the nurse to monitor most closely for a client taking
losartan (ARB)?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum chloride
Rationale: Losartan, an angiotensin II receptor blocker (ARB), blocks the angiotensin II
receptor, reducing aldosterone secretion and decreasing potassium excretion. Hyperkalemia is a
significant risk, especially in clients with renal impairment or those taking potassium-sparing
diuretics, potassium supplements, or NSAIDs concurrently. The nurse should monitor serum
potassium levels and assess for signs of hyperkalemia including muscle weakness, fatigue, and
cardiac arrhythmias.
【Cardiovascular Pharmacology】 [MC]
, 4. A client is prescribed amlodipine (calcium channel blocker) for hypertension. Which
side effect should the nurse instruct the client to report?
A. Mild headache during the first week
B. Peripheral edema of the ankles and feet
C. Slight decrease in heart rate
D. Transient dizziness when standing quickly
Rationale: Peripheral edema (swelling of ankles and feet) is a common adverse effect of
dihydropyridine calcium channel blockers like amlodipine, caused by precapillary vasodilation.
While mild headache, slight bradycardia, and transient dizziness may occur initially, peripheral
edema is the most clinically significant side effect that should be reported to the provider, as it
may require dose adjustment, addition of a diuretic, or switching to a different antihypertensive
class.
【Cardiovascular Pharmacology】 [MC]
5. A client with heart failure is started on furosemide (loop diuretic). Which finding
indicates the medication is effective?
A. Weight gain of 1 kg over 2 days
B. Decreased dyspnea and reduced peripheral edema
C. Blood pressure increase to 140/90 mmHg
D. Serum sodium level of 150 mEq/L
Rationale: Furosemide, a loop diuretic, promotes diuresis by inhibiting sodium and chloride
reabsorption in the ascending loop of Henle. Effectiveness in heart failure is evidenced by
decreased dyspnea (reduced pulmonary congestion), reduced peripheral edema, weight loss
from fluid removal, and improved exercise tolerance. Weight gain indicates worsening fluid
retention (treatment failure), blood pressure increase is not a desired outcome, and
hypernatremia (sodium 150 mEq/L) is an adverse electrolyte imbalance.
【Cardiovascular Pharmacology】 [MC]
6. A client taking metoprolol (beta-blocker) reports fatigue, bradycardia (HR 48 bpm),
and dizziness. Which action should the nurse take first?
A. Assess the client's blood pressure and hold the medication
B. Administer atropine intravenously
C. Encourage the client to increase physical activity
D. Document the findings and continue the medication as prescribed
Rationale: Metoprolol, a cardioselective beta-1 blocker, reduces heart rate, myocardial
contractility, and cardiac output. Fatigue, bradycardia (HR <60 bpm), and dizziness are signs
of excessive beta-blockade. The nurse should first assess blood pressure (as hypotension often
accompanies bradycardia) and hold the medication pending provider notification. Atropine is
reserved for severe symptomatic bradycardia and requires a provider order. Increasing
physical activity would worsen symptoms in the setting of bradycardia and decreased cardiac
output.
【Cardiovascular Pharmacology】 [MC]
7. A client with stable angina is prescribed sublingual nitroglycerin. Which instruction
is correct regarding administration?
A. Take one tablet every 10 minutes for up to 3 doses for chest pain
B. Swallow the tablet with a full glass of water for rapid absorption
C. Sit or lie down before taking the medication due to risk of hypotension
D. Store the tablets in the refrigerator to maintain potency
Rationale: Nitroglycerin causes rapid venous vasodilation, which can lead to significant
hypotension and syncope. The client should sit or lie down before taking sublingual
nitroglycerin. The correct dosing for angina is one tablet every 5 minutes (not 10 minutes) for up
to 3 doses; if chest pain persists after 3 doses, emergency services should be activated.
