,NU 136 — Exam 3 Comprehensive Questions &
Verified Answers | 2026 Edition
1. Which of the following best describes the mechanism of action of atorvastatin?
A) Inhibition of intestinal cholesterol absorption
B) Inhibition of HMG-CoA reductase
C) Activation of lipoprotein lipase
D) Binding of bile acids in the gut
Correct Answer: Inhibition of HMG-CoA reductase
Rationale: Atorvastatin blocks HMG-CoA reductase, the rate-limiting enzyme in hepatic cholesterol
synthesis, reducing intracellular cholesterol and upregulating LDL receptors. Bile acid binding and
cholesterol absorption are other lipid-lowering mechanisms, and lipoprotein lipase activation is a fibrate
effect.
2. The nurse is teaching a patient about captopril. Which statement indicates correct understanding?
A) “I will avoid salt substitutes that contain potassium.”
B) “I can stop the drug when my blood pressure is normal.”
C) “This drug will not cause a cough.”
D) “I should take it with meals.”
Correct Answer: “I will avoid salt substitutes that contain potassium.”
Rationale: ACE inhibitors can cause hyperkalemia, so potassium-based salt substitutes must be avoided.
A persistent dry cough is a common side effect, the drug should not be stopped abruptly, and food
decreases absorption.
3. A patient with heart failure is started on carvedilol. The nurse explains that this drug
A) increases heart rate
,B) blocks both alpha-1 and beta-adrenergic receptors
C) is only a beta-1 blocker
D) has no effect on blood pressure
Correct Answer: Blocks both alpha-1 and beta-adrenergic receptors
Rationale: Carvedilol is a non-selective beta-blocker with alpha-1 blocking activity, leading to
vasodilation and reduced afterload. It slows heart rate, lowers blood pressure, and improves survival in
heart failure.
4. The nurse is monitoring a patient receiving furosemide. Which adverse effect is most likely to occur?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hypoglycemia
Correct Answer: Hypokalemia
Rationale: Loop diuretics inhibit sodium-potassium-chloride cotransport, causing significant potassium
loss. Hypokalemia can lead to muscle weakness and cardiac arrhythmias. Hyperkalemia is associated
with potassium-sparing diuretics.
5. Which of the following is a nursing consideration when administering digoxin?
A) Check the apical pulse for one full minute; hold if below 60 bpm
B) Administer with a high-fiber meal
C) Give the drug at bedtime only
D) Monitor for hypokalemia as a sign of toxicity
Correct Answer: Check the apical pulse for one full minute; hold if below 60 bpm
, Rationale: Digoxin slows AV conduction; an apical pulse less than 60 bpm in adults may indicate toxicity.
Hypokalemia increases digoxin toxicity, but it is not itself a sign; visual disturbances and nausea are
common toxicity signs.
6. The nurse is teaching a patient about nitroglycerin sublingual tablets. Which instruction is correct?
A) “Take one tablet every 5 minutes up to three doses; call 911 if pain persists after the first dose.”
B) “Swallow the tablet with water.”
C) “Store the bottle in the refrigerator.”
D) “Take the medication only at bedtime.”
Correct Answer: “Take one tablet every 5 minutes up to three doses; call 911 if pain persists after the
first dose.”
Rationale: Sublingual nitroglycerin is placed under the tongue at the onset of angina. If pain is unrelieved
after 5 minutes, a second dose can be taken, but 911 should be called after the first dose if pain persists.
7. A patient is receiving warfarin. Which laboratory value should the nurse monitor to evaluate
therapeutic effect?
A) Activated partial thromboplastin time (aPTT)
B) International normalized ratio (INR)
C) Platelet count
D) Fibrinogen level
Correct Answer: International normalized ratio (INR)
Rationale: Warfarin affects the extrinsic pathway, monitored by prothrombin time and its standardized
INR. aPTT monitors heparin therapy. Platelet count and fibrinogen are not primary warfarin monitoring
tests.
8. The nurse is preparing to administer enoxaparin. The injection should be given
A) intramuscularly into the deltoid
Verified Answers | 2026 Edition
1. Which of the following best describes the mechanism of action of atorvastatin?
A) Inhibition of intestinal cholesterol absorption
B) Inhibition of HMG-CoA reductase
C) Activation of lipoprotein lipase
D) Binding of bile acids in the gut
Correct Answer: Inhibition of HMG-CoA reductase
Rationale: Atorvastatin blocks HMG-CoA reductase, the rate-limiting enzyme in hepatic cholesterol
synthesis, reducing intracellular cholesterol and upregulating LDL receptors. Bile acid binding and
cholesterol absorption are other lipid-lowering mechanisms, and lipoprotein lipase activation is a fibrate
effect.
2. The nurse is teaching a patient about captopril. Which statement indicates correct understanding?
A) “I will avoid salt substitutes that contain potassium.”
B) “I can stop the drug when my blood pressure is normal.”
C) “This drug will not cause a cough.”
D) “I should take it with meals.”
Correct Answer: “I will avoid salt substitutes that contain potassium.”
Rationale: ACE inhibitors can cause hyperkalemia, so potassium-based salt substitutes must be avoided.
A persistent dry cough is a common side effect, the drug should not be stopped abruptly, and food
decreases absorption.
3. A patient with heart failure is started on carvedilol. The nurse explains that this drug
A) increases heart rate
,B) blocks both alpha-1 and beta-adrenergic receptors
C) is only a beta-1 blocker
D) has no effect on blood pressure
Correct Answer: Blocks both alpha-1 and beta-adrenergic receptors
Rationale: Carvedilol is a non-selective beta-blocker with alpha-1 blocking activity, leading to
vasodilation and reduced afterload. It slows heart rate, lowers blood pressure, and improves survival in
heart failure.
4. The nurse is monitoring a patient receiving furosemide. Which adverse effect is most likely to occur?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hypoglycemia
Correct Answer: Hypokalemia
Rationale: Loop diuretics inhibit sodium-potassium-chloride cotransport, causing significant potassium
loss. Hypokalemia can lead to muscle weakness and cardiac arrhythmias. Hyperkalemia is associated
with potassium-sparing diuretics.
5. Which of the following is a nursing consideration when administering digoxin?
A) Check the apical pulse for one full minute; hold if below 60 bpm
B) Administer with a high-fiber meal
C) Give the drug at bedtime only
D) Monitor for hypokalemia as a sign of toxicity
Correct Answer: Check the apical pulse for one full minute; hold if below 60 bpm
, Rationale: Digoxin slows AV conduction; an apical pulse less than 60 bpm in adults may indicate toxicity.
Hypokalemia increases digoxin toxicity, but it is not itself a sign; visual disturbances and nausea are
common toxicity signs.
6. The nurse is teaching a patient about nitroglycerin sublingual tablets. Which instruction is correct?
A) “Take one tablet every 5 minutes up to three doses; call 911 if pain persists after the first dose.”
B) “Swallow the tablet with water.”
C) “Store the bottle in the refrigerator.”
D) “Take the medication only at bedtime.”
Correct Answer: “Take one tablet every 5 minutes up to three doses; call 911 if pain persists after the
first dose.”
Rationale: Sublingual nitroglycerin is placed under the tongue at the onset of angina. If pain is unrelieved
after 5 minutes, a second dose can be taken, but 911 should be called after the first dose if pain persists.
7. A patient is receiving warfarin. Which laboratory value should the nurse monitor to evaluate
therapeutic effect?
A) Activated partial thromboplastin time (aPTT)
B) International normalized ratio (INR)
C) Platelet count
D) Fibrinogen level
Correct Answer: International normalized ratio (INR)
Rationale: Warfarin affects the extrinsic pathway, monitored by prothrombin time and its standardized
INR. aPTT monitors heparin therapy. Platelet count and fibrinogen are not primary warfarin monitoring
tests.
8. The nurse is preparing to administer enoxaparin. The injection should be given
A) intramuscularly into the deltoid
