Page 1 of 48
NUR 2474 PHARM EXAM 2 NCLEX QUESTIONS NEWEST
2026 EXAM QUESTIONS LATEST VERSION SOLVED
QUESTIONS & ANSWERS VERIFIED
Questions
A patient who stops taking an ACE inhibitor because of its side effects will
begin taking an angiotensin II receptor blocker (ARB) medication. Which side
effect of ACE inhibitors will not occur with an ARB medication?
a.Angioedema
b.Cancer
c.Cough
d.Renal failure
c.Cough
ARBs do not promote the accumulation of bradykinin in the lungs and do not induce
cough. Angioedema may occur with ARBs, but the incidence is lower than with ACE
inhibitors. An increased risk of cancer may be a concern with ARBs but is not a
concern with ACE inhibitors. As with ACE inhibitors, renal failure can occur in
patients with bilateral renal artery stenosis or stenosis in the artery to a single
remaining kidney.
A female patient taking an ACE inhibitor learns that she is pregnant. What will
the nurse tell this patient?
a.The fetus most likely will have serious congenital defects.
b.The fetus must be monitored closely while the patient is taking this drug.
c.The patient's prescriber probably will change her medication to an ARB.
, Page 2 of 48
d.The patient should stop taking the medication and contact her provider
immediately.
d.The patient should stop taking the medication and contact her provider
immediately.
ACE inhibitors are known to cause serious fetal injury during the second and third
trimesters of pregnancy. Whether injury occurs earlier in pregnancy is unknown, and
the incidence probably is low. However, women should be counseled to stop taking
the drug if they become pregnant, and they should not take it if they are
contemplating becoming pregnant. Women who take ACE inhibitors in the first
trimester should be counseled that the risk to the fetus is probably low. Women
should stop taking the drug when pregnant. ARBs carry the same risk as ACE
inhibitors.
A nurse is caring for a patient who is receiving verapamil (Calan) for
hypertension and digoxin (Lanoxin) for heart failure. The nurse will observe
this patient for:
a.AV blockade.
b.gingival hyperplasia.
c.migraine headaches.
d.reflex tachycardia.
a.AV blockade.
Verapamil and digoxin both suppress impulse conduction through the AV node;
when the two drugs are used concurrently, the risk of AV blockade is increased.
Gingival hyperplasia can occur in rare cases with verapamil, but it is not an acute
symptom. Verapamil can be used to prevent migraine, and its use for this purpose is
under investigation. Verapamil and digoxin both suppress the heart rate. Nifedipine
causes reflex tachycardia.
A patient begins taking nifedipine (Procardia), along with a beta blocker, to
treat hypertension. The nurse understands that the beta blocker is used to:
a.reduce flushing.
b.minimize gingival hyperplasia.
, Page 3 of 48
c.prevent constipation.
d.prevent reflex tachycardia.
d.prevent reflex tachycardia.
Beta blockers are combined with nifedipine to prevent reflex tachycardia. Beta
blockers do not reduce flushing, minimize gingival hyperplasia, or prevent
constipation. Beta blockers can reduce the adverse cardiac effects of nifedipine.
A nurse is teaching a patient who will begin taking verapamil (Calan) for
hypertension about the drug's side effects. Which statement by the patient
indicates understanding of the teaching?
a."I may become constipated, so I should increase fluids and fiber."
b."I may experience a rapid heart rate as a result of taking this drug."
c."I may have swelling of my hands and feet, but this will subside."
d."I may need to increase my digoxin dose while taking this drug."
a."I may become constipated, so I should increase fluids and fiber."
Constipation is common with verapamil and can be minimized by increasing dietary
fiber and fluids. Verapamil lowers the heart rate. Peripheral edema may occur
secondary to vasodilation, and patients should notify their prescriber if this occurs,
because the prescriber may use diuretics to treat the condition. Verapamil and
digoxin have similar cardiac effects; also, verapamil may increase plasma levels of
digoxin by as much as 60%, so digoxin doses may need to be reduced.
A nurse is preparing to assist a nursing student in administering intravenous
verapamil to a patient who also receives a beta blocker. The nurse asks the
nursing student to discuss the plan of care for this patient. Which statement
by the student indicates a need for further teaching?
a."I will check to see when the last dose of the beta blocker was given."
b."I will monitor vital signs closely to assess for hypotension."
c."I will monitor the heart rate frequently to assess for reflex tachycardia."
d."I will prepare to administer intravenous norepinephrine if necessary."
c."I will monitor the heart rate frequently to assess for reflex tachycardia."
, Page 4 of 48
Reflex tachycardia is not an expected effect; the greater risk is cardiosuppression
and bradycardia. Because beta blockers and verapamil have the same effects on the
heart, there is a risk of excessive cardiosuppression. To minimize this risk, the two
drugs should be given several hours apart. Hypotension may occur and should be
treated with IV norepinephrine.
A patient who has been taking verapamil (Calan) for hypertension complains
of constipation. The patient will begin taking amlodipine (Norvasc) to prevent
this side effect. The nurse provides teaching about the difference between the
two drugs. Which statement by the patient indicates that further teaching is
needed?
a."I can expect dizziness and facial flushing with nifedipine."
b."I should notify the provider if I have swelling of my hands and feet."
c."I will need to take a beta blocker to prevent reflex tachycardia."
d."I will need to take this drug once a day."
c."I will need to take a beta blocker to prevent reflex tachycardia."
Amlodipine produces selective blockade of calcium channels in blood vessels with
minimal effects on the heart. Reflex tachycardia is not common, so a beta blocker is
not indicated to prevent this effect. Dizziness and facial flushing may occur.
Peripheral edema may occur and should be reported to the provider. Amlodipine is
given once daily.
Which are therapeutic uses for verapamil? (Select all that apply.)
a.Angina of effort
b.Cardiac dysrhythmias
c.Essential hypertension
d.Sick sinus syndrome
e.Suppression of preterm labor
a.Angina of effort
b.Cardiac dysrhythmias
c.Essential hypertension
Verapamil is used to treat both vasospastic angina and angina of effort. It slows the
NUR 2474 PHARM EXAM 2 NCLEX QUESTIONS NEWEST
2026 EXAM QUESTIONS LATEST VERSION SOLVED
QUESTIONS & ANSWERS VERIFIED
Questions
A patient who stops taking an ACE inhibitor because of its side effects will
begin taking an angiotensin II receptor blocker (ARB) medication. Which side
effect of ACE inhibitors will not occur with an ARB medication?
a.Angioedema
b.Cancer
c.Cough
d.Renal failure
c.Cough
ARBs do not promote the accumulation of bradykinin in the lungs and do not induce
cough. Angioedema may occur with ARBs, but the incidence is lower than with ACE
inhibitors. An increased risk of cancer may be a concern with ARBs but is not a
concern with ACE inhibitors. As with ACE inhibitors, renal failure can occur in
patients with bilateral renal artery stenosis or stenosis in the artery to a single
remaining kidney.
A female patient taking an ACE inhibitor learns that she is pregnant. What will
the nurse tell this patient?
a.The fetus most likely will have serious congenital defects.
b.The fetus must be monitored closely while the patient is taking this drug.
c.The patient's prescriber probably will change her medication to an ARB.
, Page 2 of 48
d.The patient should stop taking the medication and contact her provider
immediately.
d.The patient should stop taking the medication and contact her provider
immediately.
ACE inhibitors are known to cause serious fetal injury during the second and third
trimesters of pregnancy. Whether injury occurs earlier in pregnancy is unknown, and
the incidence probably is low. However, women should be counseled to stop taking
the drug if they become pregnant, and they should not take it if they are
contemplating becoming pregnant. Women who take ACE inhibitors in the first
trimester should be counseled that the risk to the fetus is probably low. Women
should stop taking the drug when pregnant. ARBs carry the same risk as ACE
inhibitors.
A nurse is caring for a patient who is receiving verapamil (Calan) for
hypertension and digoxin (Lanoxin) for heart failure. The nurse will observe
this patient for:
a.AV blockade.
b.gingival hyperplasia.
c.migraine headaches.
d.reflex tachycardia.
a.AV blockade.
Verapamil and digoxin both suppress impulse conduction through the AV node;
when the two drugs are used concurrently, the risk of AV blockade is increased.
Gingival hyperplasia can occur in rare cases with verapamil, but it is not an acute
symptom. Verapamil can be used to prevent migraine, and its use for this purpose is
under investigation. Verapamil and digoxin both suppress the heart rate. Nifedipine
causes reflex tachycardia.
A patient begins taking nifedipine (Procardia), along with a beta blocker, to
treat hypertension. The nurse understands that the beta blocker is used to:
a.reduce flushing.
b.minimize gingival hyperplasia.
, Page 3 of 48
c.prevent constipation.
d.prevent reflex tachycardia.
d.prevent reflex tachycardia.
Beta blockers are combined with nifedipine to prevent reflex tachycardia. Beta
blockers do not reduce flushing, minimize gingival hyperplasia, or prevent
constipation. Beta blockers can reduce the adverse cardiac effects of nifedipine.
A nurse is teaching a patient who will begin taking verapamil (Calan) for
hypertension about the drug's side effects. Which statement by the patient
indicates understanding of the teaching?
a."I may become constipated, so I should increase fluids and fiber."
b."I may experience a rapid heart rate as a result of taking this drug."
c."I may have swelling of my hands and feet, but this will subside."
d."I may need to increase my digoxin dose while taking this drug."
a."I may become constipated, so I should increase fluids and fiber."
Constipation is common with verapamil and can be minimized by increasing dietary
fiber and fluids. Verapamil lowers the heart rate. Peripheral edema may occur
secondary to vasodilation, and patients should notify their prescriber if this occurs,
because the prescriber may use diuretics to treat the condition. Verapamil and
digoxin have similar cardiac effects; also, verapamil may increase plasma levels of
digoxin by as much as 60%, so digoxin doses may need to be reduced.
A nurse is preparing to assist a nursing student in administering intravenous
verapamil to a patient who also receives a beta blocker. The nurse asks the
nursing student to discuss the plan of care for this patient. Which statement
by the student indicates a need for further teaching?
a."I will check to see when the last dose of the beta blocker was given."
b."I will monitor vital signs closely to assess for hypotension."
c."I will monitor the heart rate frequently to assess for reflex tachycardia."
d."I will prepare to administer intravenous norepinephrine if necessary."
c."I will monitor the heart rate frequently to assess for reflex tachycardia."
, Page 4 of 48
Reflex tachycardia is not an expected effect; the greater risk is cardiosuppression
and bradycardia. Because beta blockers and verapamil have the same effects on the
heart, there is a risk of excessive cardiosuppression. To minimize this risk, the two
drugs should be given several hours apart. Hypotension may occur and should be
treated with IV norepinephrine.
A patient who has been taking verapamil (Calan) for hypertension complains
of constipation. The patient will begin taking amlodipine (Norvasc) to prevent
this side effect. The nurse provides teaching about the difference between the
two drugs. Which statement by the patient indicates that further teaching is
needed?
a."I can expect dizziness and facial flushing with nifedipine."
b."I should notify the provider if I have swelling of my hands and feet."
c."I will need to take a beta blocker to prevent reflex tachycardia."
d."I will need to take this drug once a day."
c."I will need to take a beta blocker to prevent reflex tachycardia."
Amlodipine produces selective blockade of calcium channels in blood vessels with
minimal effects on the heart. Reflex tachycardia is not common, so a beta blocker is
not indicated to prevent this effect. Dizziness and facial flushing may occur.
Peripheral edema may occur and should be reported to the provider. Amlodipine is
given once daily.
Which are therapeutic uses for verapamil? (Select all that apply.)
a.Angina of effort
b.Cardiac dysrhythmias
c.Essential hypertension
d.Sick sinus syndrome
e.Suppression of preterm labor
a.Angina of effort
b.Cardiac dysrhythmias
c.Essential hypertension
Verapamil is used to treat both vasospastic angina and angina of effort. It slows the
