NUR 2474 Exam 2: Pharmacology for
Professional Nursing Exam 2 (Latest 2024
/ 2025) Rasmussen
Cardiovascular & Diuretics
1. A patient is brought to the ER with shortness of breath, RR 30, intercostal
retractions, and frothy, pink sputum. Which drug does the nurse expect?
• A. Spironolactone
• B. Hydrochlorothiazide
• C. Mannitol
• D. Furosemide (Lasix)
o Rationale: Furosemide is a potent loop diuretic used for rapid
fluid mobilization in pulmonary edema. Thiazides are not strong
enough for this emergency .
2. A patient taking digoxin and furosemide has an irregular HR of 86 and a
potassium level of 3.5 mEq/L. Which lab value concerns the nurse most?
• A. Blood glucose 120 mg/dL
• B. Oxygen saturation 90%
• C. Potassium 3.5 mEq/L
• D. Sodium 140 mEq/L
o Rationale: Hypokalemia (3.5 is low-normal) increases the risk
of digoxin toxicity and fatal dysrhythmias.
3. A patient has 2+ pitting edema, crackles, and a potassium level of 6.0
mEq/L. Which diuretic order should the nurse question?
, • A. Bumetanide
• B. Furosemide
• C. Spironolactone (Aldactone)
• D. Hydrochlorothiazide
o Rationale: Spironolactone is potassium-sparing. Giving it to a
patient with hyperkalemia (K+ >5.0) is dangerous .
4. A patient on spironolactone asks about diet changes. What is the best
instruction?
• A. Increase your intake of oranges and bananas.
• B. Avoid salt substitutes.
• C. Restrict your fluid intake to 1 Liter/day.
• D. Take the medication with a glass of milk.
o Rationale: Salt substitutes are high in potassium. Combined with
a potassium-sparing diuretic, this can cause life-threatening
hyperkalemia .
5. A patient is on furosemide and digoxin. To prevent arrhythmias, the nurse
expects an order for which medication?
• A. Bumetanide
• B. Chlorothiazide
• C. Hydrochlorothiazide
• D. Spironolactone (Aldactone)
o Rationale: Furosemide causes potassium loss (hypokalemia),
which increases digoxin toxicity risk. Spironolactone is added
to conserve potassium .
6. A patient is prescribed captopril and spironolactone. Morning labs show K+
5.1 mEq/L. What is the priority action?
, • A. Administer both medications as ordered.
• B. Contact the provider to report the potassium level.
• C. Give the patient a potassium supplement.
• D. Request an order for furosemide immediately.
o Rationale: ACE inhibitors and spironolactone both raise
potassium. A level of 5.1 requires clarification before administering .
7. A patient starts nifedipine (CCB) and metoprolol (beta-blocker) for HTN.
Why was metoprolol added?
• A. To increase heart rate
• B. To reduce flushing
• C. To prevent reflex tachycardia
• D. To decrease pedal edema
o Rationale: CCBs cause vasodilation leading to flushing. Beta-
blockers help reduce this side effect .
8. A patient has a digoxin level of 0.7 ng/mL. What is the best action?
• A. Withhold the dose and notify the provider.
• B. Check the apical pulse; if >60, administer.
• C. Administer Digibind immediately.
• D. Hold the dose due to toxicity.
o Rationale: Therapeutic digoxin range is 0.5-0.9 ng/mL for HF. 0.7
is therapeutic. Always check the apical pulse before giving .
9. A patient taking warfarin reports black, tarry stools. What is the priority
action?
• A. Administer Vitamin K immediately.
• B. Hold the drug and check INR/aPTT.
, • C. Reassure the patient this is normal.
• D. Increase the dose to stop the bleeding.
o Rationale: Black tarry stools indicate internal bleeding. The
nurse must hold the anticoagulant and notify the provider .
10. A patient on heparin has an aPTT >90 seconds and reports lumbar pain.
Which order does the nurse expect?
• A. Vitamin K
• B. Protamine sulfate
• C. Enoxaparin
• D. Aminocaproic acid
o Rationale: Protamine sulfate is the specific antidote for heparin
overdose .
11. A patient starts atorvastatin. What statement indicates understanding?
• A. "I will see results in 2 days."
• B. "I will notify the HCP if I have muscle pain all over my body."
• C. "I can continue drinking grapefruit juice daily."
• D. "I should take this with an antacid."
o Rationale: Muscle pain (myopathy/rhabdomyolysis) is a serious
adverse effect of statins .
12. A patient takes metoprolol. Which finding indicates a therapeutic effect?
• A. Heart rate 110 bpm
• B. Blood pressure 128/80 mm Hg
• C. Respiratory rate 28
• D. Complaint of headache
Professional Nursing Exam 2 (Latest 2024
/ 2025) Rasmussen
Cardiovascular & Diuretics
1. A patient is brought to the ER with shortness of breath, RR 30, intercostal
retractions, and frothy, pink sputum. Which drug does the nurse expect?
• A. Spironolactone
• B. Hydrochlorothiazide
• C. Mannitol
• D. Furosemide (Lasix)
o Rationale: Furosemide is a potent loop diuretic used for rapid
fluid mobilization in pulmonary edema. Thiazides are not strong
enough for this emergency .
2. A patient taking digoxin and furosemide has an irregular HR of 86 and a
potassium level of 3.5 mEq/L. Which lab value concerns the nurse most?
• A. Blood glucose 120 mg/dL
• B. Oxygen saturation 90%
• C. Potassium 3.5 mEq/L
• D. Sodium 140 mEq/L
o Rationale: Hypokalemia (3.5 is low-normal) increases the risk
of digoxin toxicity and fatal dysrhythmias.
3. A patient has 2+ pitting edema, crackles, and a potassium level of 6.0
mEq/L. Which diuretic order should the nurse question?
, • A. Bumetanide
• B. Furosemide
• C. Spironolactone (Aldactone)
• D. Hydrochlorothiazide
o Rationale: Spironolactone is potassium-sparing. Giving it to a
patient with hyperkalemia (K+ >5.0) is dangerous .
4. A patient on spironolactone asks about diet changes. What is the best
instruction?
• A. Increase your intake of oranges and bananas.
• B. Avoid salt substitutes.
• C. Restrict your fluid intake to 1 Liter/day.
• D. Take the medication with a glass of milk.
o Rationale: Salt substitutes are high in potassium. Combined with
a potassium-sparing diuretic, this can cause life-threatening
hyperkalemia .
5. A patient is on furosemide and digoxin. To prevent arrhythmias, the nurse
expects an order for which medication?
• A. Bumetanide
• B. Chlorothiazide
• C. Hydrochlorothiazide
• D. Spironolactone (Aldactone)
o Rationale: Furosemide causes potassium loss (hypokalemia),
which increases digoxin toxicity risk. Spironolactone is added
to conserve potassium .
6. A patient is prescribed captopril and spironolactone. Morning labs show K+
5.1 mEq/L. What is the priority action?
, • A. Administer both medications as ordered.
• B. Contact the provider to report the potassium level.
• C. Give the patient a potassium supplement.
• D. Request an order for furosemide immediately.
o Rationale: ACE inhibitors and spironolactone both raise
potassium. A level of 5.1 requires clarification before administering .
7. A patient starts nifedipine (CCB) and metoprolol (beta-blocker) for HTN.
Why was metoprolol added?
• A. To increase heart rate
• B. To reduce flushing
• C. To prevent reflex tachycardia
• D. To decrease pedal edema
o Rationale: CCBs cause vasodilation leading to flushing. Beta-
blockers help reduce this side effect .
8. A patient has a digoxin level of 0.7 ng/mL. What is the best action?
• A. Withhold the dose and notify the provider.
• B. Check the apical pulse; if >60, administer.
• C. Administer Digibind immediately.
• D. Hold the dose due to toxicity.
o Rationale: Therapeutic digoxin range is 0.5-0.9 ng/mL for HF. 0.7
is therapeutic. Always check the apical pulse before giving .
9. A patient taking warfarin reports black, tarry stools. What is the priority
action?
• A. Administer Vitamin K immediately.
• B. Hold the drug and check INR/aPTT.
, • C. Reassure the patient this is normal.
• D. Increase the dose to stop the bleeding.
o Rationale: Black tarry stools indicate internal bleeding. The
nurse must hold the anticoagulant and notify the provider .
10. A patient on heparin has an aPTT >90 seconds and reports lumbar pain.
Which order does the nurse expect?
• A. Vitamin K
• B. Protamine sulfate
• C. Enoxaparin
• D. Aminocaproic acid
o Rationale: Protamine sulfate is the specific antidote for heparin
overdose .
11. A patient starts atorvastatin. What statement indicates understanding?
• A. "I will see results in 2 days."
• B. "I will notify the HCP if I have muscle pain all over my body."
• C. "I can continue drinking grapefruit juice daily."
• D. "I should take this with an antacid."
o Rationale: Muscle pain (myopathy/rhabdomyolysis) is a serious
adverse effect of statins .
12. A patient takes metoprolol. Which finding indicates a therapeutic effect?
• A. Heart rate 110 bpm
• B. Blood pressure 128/80 mm Hg
• C. Respiratory rate 28
• D. Complaint of headache
