NUR 2474 Exam 2: Pharmacology for Professional Nursing Exam
2 – Rasmussen Actual Exam Complete Questions & Rationales |
Nursing Pharmacology | Pass Guaranteed - A+ Graded
Cardiovascular & Antihypertensive Drugs
Q1: A patient newly diagnosed with hypertension is started on lisinopril. The nurse
knows this medication works primarily through which mechanism?
A. Blocking beta-1 receptors in the heart to reduce cardiac output
B. Inhibiting angiotensin-converting enzyme to decrease vasoconstriction [CORRECT]
C. Blocking calcium channels in vascular smooth muscle to cause vasodilation
D. Promoting sodium and water excretion through the kidneys to reduce blood volume
Correct Answer: B
Rationale: The best answer is B — lisinopril is an ACE inhibitor, and its whole job is to
block that angiotensin-converting enzyme so you don't get all that vasoconstriction and
aldosterone release. In practice, you'd want to remember that ACE inhibitors end in
"-pril," and they work on that renin-angiotensin-aldosterone system. This aligns with safe
medication administration because you also need to watch potassium and that dry
cough some patients develop.
Q2: Your patient on metoprolol calls the clinic and says, "I feel really dizzy when I stand
up, and my heart rate is only 52." What is the nurse's priority response?
A. Tell the patient to take the next dose with food to reduce GI upset
B. Instruct the patient to hold the dose and notify the provider about the bradycardia
[CORRECT]
C. Reassure the patient that dizziness and bradycardia are expected with beta-blockers
D. Advise the patient to increase fluid intake and continue the medication as prescribed
Correct Answer: B
Rationale: The best answer is B — a heart rate in the low 50s with symptomatic
dizziness is not something you brush off. This aligns with safe medication
administration because beta-blockers like metoprolol can drop that heart rate too low,
and you need to hold the dose and get the provider involved. In practice, you'd want to
,remember that you always check apical pulse before giving a beta-blocker, and if it's
under 60, you hold and call.
Q3: A patient with a history of asthma is prescribed metoprolol for hypertension. The
nurse recognizes this as a potential concern because beta-blockers can:
A. Cause severe hyperglycemia in patients with asthma
B. Precipitate bronchospasm by blocking beta-2 receptors in the lungs [CORRECT]
C. Interact with albuterol to cause cardiac arrest
D. Increase the absorption of inhaled corticosteroids
Correct Answer: B
Rationale: The best answer is B — non-selective beta-blockers can block those beta-2
receptors in the lungs and cause bronchoconstriction, which is dangerous for anyone
with asthma or COPD. The key teaching point here is that even cardioselective
beta-blockers like metoprolol aren't perfectly selective at higher doses, so you need to
monitor respiratory status closely. In practice, you'd want to question this order and
make sure the provider knows about the asthma history.
Q4: A patient on amlodipine reports swelling in the ankles and feet that seems worse at
the end of the day. The nurse recognizes this as:
A. A sign of worsening heart failure requiring immediate intervention
B. A common side effect of calcium channel blockers due to vasodilation and capillary
pressure changes [CORRECT]
C. An allergic reaction that requires discontinuation of the medication
D. Evidence that the patient is nonadherent with sodium restriction
Correct Answer: B
Rationale: The best answer is B — peripheral edema is basically the calling card of
dihydropyridine calcium channel blockers like amlodipine, and it happens because of
precapillary vasodilation. This aligns with safe medication administration because you
need to teach patients that ankle swelling is common with this class, it's usually not
dangerous, but it needs to be reported if it gets severe or is accompanied by shortness
of breath. In practice, you'd want to make sure the patient knows the difference between
this expected effect and true fluid overload.
, Q5: A 72-year-old patient with heart failure is prescribed furosemide 40 mg PO daily.
Which laboratory value should the nurse monitor most closely during the first week of
therapy?
A. Serum creatinine
B. Serum potassium [CORRECT]
C. Hemoglobin and hematocrit
D. Serum albumin
Correct Answer: B
Rationale: The best answer is B — furosemide is a loop diuretic, and it will send
potassium right out the door with that fluid. The key teaching point here is that
hypokalemia is your big worry with loop diuretics, and you need to watch for muscle
weakness, irregular heart rhythms, and fatigue. In practice, you'd want to check those
electrolytes regularly and teach the patient about potassium-rich foods if the provider
approves.
Q6: A patient asks the nurse, "Why did my doctor switch me from hydrochlorothiazide to
spironolactone?" Which response by the nurse is most appropriate?
A. "Spironolactone works faster to lower your blood pressure than hydrochlorothiazide."
B. "Spironolactone is a potassium-sparing diuretic, so it helps protect your potassium
levels." [CORRECT]
C. "Spironolactone is stronger and will remove more fluid from your body."
D. "Spironolactone only works on your blood vessels, not your kidneys."
Correct Answer: B
Rationale: The best answer is B — spironolactone is your potassium-sparing diuretic,
and that's exactly why a provider might choose it, especially if the patient has been
running low on potassium. This aligns with safe medication administration because you
need to watch the opposite problem now — hyperkalemia — and teach the patient to
avoid salt substitutes and excessive potassium intake. In practice, you'd want to
remember that HCTZ wastes potassium while spironolactone hangs onto it.
Q7: A patient with atrial fibrillation is started on diltiazem. The nurse understands that
the primary therapeutic effect of this drug in this patient is to:
A. Convert atrial fibrillation back to normal sinus rhythm
B. Slow ventricular response by delaying AV nodal conduction [CORRECT]
2 – Rasmussen Actual Exam Complete Questions & Rationales |
Nursing Pharmacology | Pass Guaranteed - A+ Graded
Cardiovascular & Antihypertensive Drugs
Q1: A patient newly diagnosed with hypertension is started on lisinopril. The nurse
knows this medication works primarily through which mechanism?
A. Blocking beta-1 receptors in the heart to reduce cardiac output
B. Inhibiting angiotensin-converting enzyme to decrease vasoconstriction [CORRECT]
C. Blocking calcium channels in vascular smooth muscle to cause vasodilation
D. Promoting sodium and water excretion through the kidneys to reduce blood volume
Correct Answer: B
Rationale: The best answer is B — lisinopril is an ACE inhibitor, and its whole job is to
block that angiotensin-converting enzyme so you don't get all that vasoconstriction and
aldosterone release. In practice, you'd want to remember that ACE inhibitors end in
"-pril," and they work on that renin-angiotensin-aldosterone system. This aligns with safe
medication administration because you also need to watch potassium and that dry
cough some patients develop.
Q2: Your patient on metoprolol calls the clinic and says, "I feel really dizzy when I stand
up, and my heart rate is only 52." What is the nurse's priority response?
A. Tell the patient to take the next dose with food to reduce GI upset
B. Instruct the patient to hold the dose and notify the provider about the bradycardia
[CORRECT]
C. Reassure the patient that dizziness and bradycardia are expected with beta-blockers
D. Advise the patient to increase fluid intake and continue the medication as prescribed
Correct Answer: B
Rationale: The best answer is B — a heart rate in the low 50s with symptomatic
dizziness is not something you brush off. This aligns with safe medication
administration because beta-blockers like metoprolol can drop that heart rate too low,
and you need to hold the dose and get the provider involved. In practice, you'd want to
,remember that you always check apical pulse before giving a beta-blocker, and if it's
under 60, you hold and call.
Q3: A patient with a history of asthma is prescribed metoprolol for hypertension. The
nurse recognizes this as a potential concern because beta-blockers can:
A. Cause severe hyperglycemia in patients with asthma
B. Precipitate bronchospasm by blocking beta-2 receptors in the lungs [CORRECT]
C. Interact with albuterol to cause cardiac arrest
D. Increase the absorption of inhaled corticosteroids
Correct Answer: B
Rationale: The best answer is B — non-selective beta-blockers can block those beta-2
receptors in the lungs and cause bronchoconstriction, which is dangerous for anyone
with asthma or COPD. The key teaching point here is that even cardioselective
beta-blockers like metoprolol aren't perfectly selective at higher doses, so you need to
monitor respiratory status closely. In practice, you'd want to question this order and
make sure the provider knows about the asthma history.
Q4: A patient on amlodipine reports swelling in the ankles and feet that seems worse at
the end of the day. The nurse recognizes this as:
A. A sign of worsening heart failure requiring immediate intervention
B. A common side effect of calcium channel blockers due to vasodilation and capillary
pressure changes [CORRECT]
C. An allergic reaction that requires discontinuation of the medication
D. Evidence that the patient is nonadherent with sodium restriction
Correct Answer: B
Rationale: The best answer is B — peripheral edema is basically the calling card of
dihydropyridine calcium channel blockers like amlodipine, and it happens because of
precapillary vasodilation. This aligns with safe medication administration because you
need to teach patients that ankle swelling is common with this class, it's usually not
dangerous, but it needs to be reported if it gets severe or is accompanied by shortness
of breath. In practice, you'd want to make sure the patient knows the difference between
this expected effect and true fluid overload.
, Q5: A 72-year-old patient with heart failure is prescribed furosemide 40 mg PO daily.
Which laboratory value should the nurse monitor most closely during the first week of
therapy?
A. Serum creatinine
B. Serum potassium [CORRECT]
C. Hemoglobin and hematocrit
D. Serum albumin
Correct Answer: B
Rationale: The best answer is B — furosemide is a loop diuretic, and it will send
potassium right out the door with that fluid. The key teaching point here is that
hypokalemia is your big worry with loop diuretics, and you need to watch for muscle
weakness, irregular heart rhythms, and fatigue. In practice, you'd want to check those
electrolytes regularly and teach the patient about potassium-rich foods if the provider
approves.
Q6: A patient asks the nurse, "Why did my doctor switch me from hydrochlorothiazide to
spironolactone?" Which response by the nurse is most appropriate?
A. "Spironolactone works faster to lower your blood pressure than hydrochlorothiazide."
B. "Spironolactone is a potassium-sparing diuretic, so it helps protect your potassium
levels." [CORRECT]
C. "Spironolactone is stronger and will remove more fluid from your body."
D. "Spironolactone only works on your blood vessels, not your kidneys."
Correct Answer: B
Rationale: The best answer is B — spironolactone is your potassium-sparing diuretic,
and that's exactly why a provider might choose it, especially if the patient has been
running low on potassium. This aligns with safe medication administration because you
need to watch the opposite problem now — hyperkalemia — and teach the patient to
avoid salt substitutes and excessive potassium intake. In practice, you'd want to
remember that HCTZ wastes potassium while spironolactone hangs onto it.
Q7: A patient with atrial fibrillation is started on diltiazem. The nurse understands that
the primary therapeutic effect of this drug in this patient is to:
A. Convert atrial fibrillation back to normal sinus rhythm
B. Slow ventricular response by delaying AV nodal conduction [CORRECT]
