NR PHARM CH 13 . Drugs Affecting the Cardiovascular and
Renal Systems QUESTIONS WITH ANSWERS 2023 A+
1. Ray has been diagnosed with hypertension and it is determined that an angiotensin-converting enzyme
inhibitor is needed. Prior to prescribing this drug, the nurse practitioner (NP) should assess for:
1. Hypokalemia
2. Impotence
3. Decreased renal function
4. Inability to concentrate
2. Angiotensin-converting enzyme (ACE) inhibitors are the drug of choice in treating hypertension in diabetic
patients because they:
1. Improve insulin sensitivity
2. Improve renal hemodynamics
3. Reduce the production of angiotensin II
4. All of the above
3. A potentially life-threatening adverse response to an ACE inhibitor is angioedema. Which of the following
statements is true about this adverse response?
1. Swelling of the tongue and hoarseness are the most common symptoms.
2. It appears to be related to the decrease in aldosterone production.
3. Presence of a dry, hacking cough indicates a high risk for this adverse response.
4. Because it takes time to build up a blood level, it occurs after being on the drug for
about one week.
4. ACE inhibitors are useful in a variety of disorders. Which of the following statements is true about both their
usefulness in a particular disorder and the reason for their use?
1. They are useful to prevent stable angina because they decrease the thickening of
vascular walls due to decreased modified release.
2. They are useful to prevent heart failure because they reduce remodeling of injured
myocardial tissues.
3. Both 1 and 2 are true
4. Neither 1 nor 2 are true.
6. While taking an ARB, patients need to avoid certain over-the-counter drugs without first consulting the
provider because:
1. Cimetidine is metabolized by the CYP3A4 isoenzymes
2. Nonsteroidal anti-inflammatory drugs reduce prostaglandin levels
3. Both 1 and 2
4. Neither 1 nor 2
7. Laboratory monitoring for patients on ACE inhibitors or ARBs should include:
1. White blood cell counts with the drug dosage increased for elevations above 10,000 feet
2. Liver function tests with the drug dosage stopped for alanine aminotransferase
values twice that of normal
3. Serum creatinine levels with the drug dosage reduced for values greater than 2.5
mg/dL
4. Serum glucose levels with the drug dosage increased for levels greater than 120 mg/dL
, NR PHARM CH 13 . Drugs Affecting the Cardiovascular and
Renal Systems QUESTIONS WITH ANSWERS 2023 A+
8. Jacob has hypertension, for which a calcium channel blocker has been prescribed. This drug helps control
blood pressure because it:
1. Decreases the amount of calcium inside the cell
2. Reduces stroke volume
3. Increases the activity of the Na+/K+/ATPase pump indirectly
4. Decreases heart rate
9. Which of the following adverse effects may occur due to a dihydropyridine-type calcium channel blocker?
1. Bradycardia
2. Hepatic impairment
3. Increased contractility
4. Edema of the hands and feet
11. Vera, age 70, has isolated systolic hypertension. Calcium channel blocker dosages for her should be:
1. Started at about half the usual dosage
2. Not increased over the usual dosage for an adult
3. Given once daily because of memory issues in the older adult
4. Withheld if she experiences gastroesophageal reflux
12. Larry has heart failure, which is being treated with digoxin because it exhibits:
1. Negative inotropism
2. Positive chronotropism
3. Both 1 and 2
4. Neither 1 nor 2
13. Furosemide is added to a treatment regimen for heart failure that includes digoxin. Monitoring for this
combination includes:
1. Hemoglobin
2. Serum potassium
3. Blood urea nitrogen
4. Serum glucose
14. Which of the following create a higher risk for digoxin toxicity? Both the cause and the reason for it must be
correct.
1. Administration to older adults because of reduced renal function
2. Digoxin given with aldosterone antagonist diuretics because of decreased potassium levels
3. Taking an antacid for gastroesophageal reflux disease because it increases the absorption
of digoxin
4. Doses between 0.25 and 0.5 mg/day
15. Serum digoxin levels are monitored for potential toxicity. Monitoring should occur:
1. Within six hours of the last dose
2. Because a reference point is needed to adjust dosage
3. After three half-lives from the starting of the drug
4. When a patient has stable renal function
17. Which of the following is true about procainamide and its dosing schedule?
1. It produces bradycardia and should be used cautiously in patients with cardiac
conditions that a slower heart rate might worsen.
2. Gastrointestinal adverse effects are common so the drug should be taken with food.
3. Adherence can be improved by using a sustained release formulation that can be
given once daily.
4. Doses of this drug should be taken evenly spaced around the clock to keep an even
blood level.
Renal Systems QUESTIONS WITH ANSWERS 2023 A+
1. Ray has been diagnosed with hypertension and it is determined that an angiotensin-converting enzyme
inhibitor is needed. Prior to prescribing this drug, the nurse practitioner (NP) should assess for:
1. Hypokalemia
2. Impotence
3. Decreased renal function
4. Inability to concentrate
2. Angiotensin-converting enzyme (ACE) inhibitors are the drug of choice in treating hypertension in diabetic
patients because they:
1. Improve insulin sensitivity
2. Improve renal hemodynamics
3. Reduce the production of angiotensin II
4. All of the above
3. A potentially life-threatening adverse response to an ACE inhibitor is angioedema. Which of the following
statements is true about this adverse response?
1. Swelling of the tongue and hoarseness are the most common symptoms.
2. It appears to be related to the decrease in aldosterone production.
3. Presence of a dry, hacking cough indicates a high risk for this adverse response.
4. Because it takes time to build up a blood level, it occurs after being on the drug for
about one week.
4. ACE inhibitors are useful in a variety of disorders. Which of the following statements is true about both their
usefulness in a particular disorder and the reason for their use?
1. They are useful to prevent stable angina because they decrease the thickening of
vascular walls due to decreased modified release.
2. They are useful to prevent heart failure because they reduce remodeling of injured
myocardial tissues.
3. Both 1 and 2 are true
4. Neither 1 nor 2 are true.
6. While taking an ARB, patients need to avoid certain over-the-counter drugs without first consulting the
provider because:
1. Cimetidine is metabolized by the CYP3A4 isoenzymes
2. Nonsteroidal anti-inflammatory drugs reduce prostaglandin levels
3. Both 1 and 2
4. Neither 1 nor 2
7. Laboratory monitoring for patients on ACE inhibitors or ARBs should include:
1. White blood cell counts with the drug dosage increased for elevations above 10,000 feet
2. Liver function tests with the drug dosage stopped for alanine aminotransferase
values twice that of normal
3. Serum creatinine levels with the drug dosage reduced for values greater than 2.5
mg/dL
4. Serum glucose levels with the drug dosage increased for levels greater than 120 mg/dL
, NR PHARM CH 13 . Drugs Affecting the Cardiovascular and
Renal Systems QUESTIONS WITH ANSWERS 2023 A+
8. Jacob has hypertension, for which a calcium channel blocker has been prescribed. This drug helps control
blood pressure because it:
1. Decreases the amount of calcium inside the cell
2. Reduces stroke volume
3. Increases the activity of the Na+/K+/ATPase pump indirectly
4. Decreases heart rate
9. Which of the following adverse effects may occur due to a dihydropyridine-type calcium channel blocker?
1. Bradycardia
2. Hepatic impairment
3. Increased contractility
4. Edema of the hands and feet
11. Vera, age 70, has isolated systolic hypertension. Calcium channel blocker dosages for her should be:
1. Started at about half the usual dosage
2. Not increased over the usual dosage for an adult
3. Given once daily because of memory issues in the older adult
4. Withheld if she experiences gastroesophageal reflux
12. Larry has heart failure, which is being treated with digoxin because it exhibits:
1. Negative inotropism
2. Positive chronotropism
3. Both 1 and 2
4. Neither 1 nor 2
13. Furosemide is added to a treatment regimen for heart failure that includes digoxin. Monitoring for this
combination includes:
1. Hemoglobin
2. Serum potassium
3. Blood urea nitrogen
4. Serum glucose
14. Which of the following create a higher risk for digoxin toxicity? Both the cause and the reason for it must be
correct.
1. Administration to older adults because of reduced renal function
2. Digoxin given with aldosterone antagonist diuretics because of decreased potassium levels
3. Taking an antacid for gastroesophageal reflux disease because it increases the absorption
of digoxin
4. Doses between 0.25 and 0.5 mg/day
15. Serum digoxin levels are monitored for potential toxicity. Monitoring should occur:
1. Within six hours of the last dose
2. Because a reference point is needed to adjust dosage
3. After three half-lives from the starting of the drug
4. When a patient has stable renal function
17. Which of the following is true about procainamide and its dosing schedule?
1. It produces bradycardia and should be used cautiously in patients with cardiac
conditions that a slower heart rate might worsen.
2. Gastrointestinal adverse effects are common so the drug should be taken with food.
3. Adherence can be improved by using a sustained release formulation that can be
given once daily.
4. Doses of this drug should be taken evenly spaced around the clock to keep an even
blood level.
