1
HESI Cardiac Pharmacology Exam
Bank: Antiarrhythmic,
Antihypertensive & Anticoagulant
Q&A
Table of Contents
Subtopic 1: Classification and Mechanism of Cardiac Drugs............................2
Subtopic 2: Clinical Application of Antiarrhythmic Medications.......................8
Subtopic 3: Antihypertensive Agents—Types and Nursing Considerations....14
Subtopic 4: Anticoagulants—Clinical Use, Lab Monitoring & Reversal...........21
Subtopic 5: Cardiac Drug Interactions and Patient Safety Considerations.....27
, 2
Subtopic 1: Classification and Mechanism of
Cardiac Drugs
Q1. Which class of antiarrhythmic drugs primarily works by blocking sodium
channels in cardiac cells?
A. Beta blockers
B. Class I antiarrhythmics
C. Calcium channel blockers
D. Potassium-sparing diuretics
Rationale: Class I antiarrhythmic drugs, such as lidocaine and procainamide,
block sodium channels, which slows impulse conduction in the atria,
ventricles, and His-Purkinje system, thereby helping correct arrhythmias.
Q2. Which of the following medications is a Class III antiarrhythmic that
delays repolarization by blocking potassium channels?
A. Propranolol
B. Verapamil
C. Amiodarone
D. Digoxin
Rationale: Amiodarone is a Class III antiarrhythmic that prolongs action
potential duration and refractory period by blocking potassium channels,
stabilizing cardiac rhythm.
Q3. ACE inhibitors lower blood pressure primarily by:
A. Increasing heart rate
B. Blocking calcium influx
C. Inhibiting conversion of angiotensin I to angiotensin II
D. Promoting sodium retention
, 3
Rationale: ACE inhibitors, such as enalapril, prevent the conversion of
angiotensin I to angiotensin II, a potent vasoconstrictor, thereby reducing
blood pressure.
Q4. Which of the following is classified as a beta-1 selective blocker used in
hypertension and angina?
A. Metoprolol
B. Propranolol
C. Labetalol
D. Carvedilol
Rationale: Metoprolol is a cardioselective beta-1 blocker that reduces heart
rate and myocardial oxygen demand, useful in treating hypertension and
angina.
Q5. Which anticoagulant acts by inhibiting vitamin K-dependent clotting
factors?
A. Heparin
B. Enoxaparin
C. Warfarin
D. Dabigatran
Rationale: Warfarin works by inhibiting the synthesis of vitamin K-dependent
clotting factors (II, VII, IX, X), thereby prolonging clotting time.
Q6. What is the mechanism of action of calcium channel blockers in the
treatment of hypertension?
A. Enhancing sodium reabsorption
B. Blocking beta-adrenergic receptors
C. Preventing calcium entry into vascular smooth muscle
D. Stimulating aldosterone secretion
, 4
Rationale: Calcium channel blockers reduce blood pressure by inhibiting
calcium influx into vascular smooth muscle cells, leading to vasodilation.
Q7. Which of the following drugs is classified as a direct thrombin inhibitor?
A. Warfarin
B. Heparin
C. Dabigatran
D. Clopidogrel
Rationale: Dabigatran directly inhibits thrombin (factor IIa), preventing
conversion of fibrinogen to fibrin and inhibiting clot formation.
Q8. What is the therapeutic class of the drug atenolol?
A. Alpha-adrenergic agonist
B. Beta-1 selective blocker
C. Calcium channel blocker
D. Angiotensin receptor blocker
Rationale: Atenolol is a beta-1 selective blocker that reduces cardiac output
and suppresses renin activity to manage hypertension and angina.
Q9. Which class of antihypertensive drugs may cause a persistent dry cough
due to bradykinin accumulation?
A. ARBs
B. ACE inhibitors
C. Beta blockers
D. Diuretics
Rationale: ACE inhibitors increase bradykinin levels, which may lead to a dry,
persistent cough in some patients.
HESI Cardiac Pharmacology Exam
Bank: Antiarrhythmic,
Antihypertensive & Anticoagulant
Q&A
Table of Contents
Subtopic 1: Classification and Mechanism of Cardiac Drugs............................2
Subtopic 2: Clinical Application of Antiarrhythmic Medications.......................8
Subtopic 3: Antihypertensive Agents—Types and Nursing Considerations....14
Subtopic 4: Anticoagulants—Clinical Use, Lab Monitoring & Reversal...........21
Subtopic 5: Cardiac Drug Interactions and Patient Safety Considerations.....27
, 2
Subtopic 1: Classification and Mechanism of
Cardiac Drugs
Q1. Which class of antiarrhythmic drugs primarily works by blocking sodium
channels in cardiac cells?
A. Beta blockers
B. Class I antiarrhythmics
C. Calcium channel blockers
D. Potassium-sparing diuretics
Rationale: Class I antiarrhythmic drugs, such as lidocaine and procainamide,
block sodium channels, which slows impulse conduction in the atria,
ventricles, and His-Purkinje system, thereby helping correct arrhythmias.
Q2. Which of the following medications is a Class III antiarrhythmic that
delays repolarization by blocking potassium channels?
A. Propranolol
B. Verapamil
C. Amiodarone
D. Digoxin
Rationale: Amiodarone is a Class III antiarrhythmic that prolongs action
potential duration and refractory period by blocking potassium channels,
stabilizing cardiac rhythm.
Q3. ACE inhibitors lower blood pressure primarily by:
A. Increasing heart rate
B. Blocking calcium influx
C. Inhibiting conversion of angiotensin I to angiotensin II
D. Promoting sodium retention
, 3
Rationale: ACE inhibitors, such as enalapril, prevent the conversion of
angiotensin I to angiotensin II, a potent vasoconstrictor, thereby reducing
blood pressure.
Q4. Which of the following is classified as a beta-1 selective blocker used in
hypertension and angina?
A. Metoprolol
B. Propranolol
C. Labetalol
D. Carvedilol
Rationale: Metoprolol is a cardioselective beta-1 blocker that reduces heart
rate and myocardial oxygen demand, useful in treating hypertension and
angina.
Q5. Which anticoagulant acts by inhibiting vitamin K-dependent clotting
factors?
A. Heparin
B. Enoxaparin
C. Warfarin
D. Dabigatran
Rationale: Warfarin works by inhibiting the synthesis of vitamin K-dependent
clotting factors (II, VII, IX, X), thereby prolonging clotting time.
Q6. What is the mechanism of action of calcium channel blockers in the
treatment of hypertension?
A. Enhancing sodium reabsorption
B. Blocking beta-adrenergic receptors
C. Preventing calcium entry into vascular smooth muscle
D. Stimulating aldosterone secretion
, 4
Rationale: Calcium channel blockers reduce blood pressure by inhibiting
calcium influx into vascular smooth muscle cells, leading to vasodilation.
Q7. Which of the following drugs is classified as a direct thrombin inhibitor?
A. Warfarin
B. Heparin
C. Dabigatran
D. Clopidogrel
Rationale: Dabigatran directly inhibits thrombin (factor IIa), preventing
conversion of fibrinogen to fibrin and inhibiting clot formation.
Q8. What is the therapeutic class of the drug atenolol?
A. Alpha-adrenergic agonist
B. Beta-1 selective blocker
C. Calcium channel blocker
D. Angiotensin receptor blocker
Rationale: Atenolol is a beta-1 selective blocker that reduces cardiac output
and suppresses renin activity to manage hypertension and angina.
Q9. Which class of antihypertensive drugs may cause a persistent dry cough
due to bradykinin accumulation?
A. ARBs
B. ACE inhibitors
C. Beta blockers
D. Diuretics
Rationale: ACE inhibitors increase bradykinin levels, which may lead to a dry,
persistent cough in some patients.
