ATI PN PHARMACOLOGY PROCTORED EXAM
WITH ACTUAL CORRECT QUESTIONS AND
VERIFIED DETAILED COMPREHENSIVE
RATIONALES ANSWERS| CURRENTLY TESTING
VERSION | ALREADY GRADED A+|EXPERT
VERIFIED FOR GUARANTEED PASS
2026|NCLEX-PN REVIEW
Receptors
Norepinephrine-Adrenergic (adrenergic comes from the word adrenalin)
Alpha 1-all sympathetic target organs except the heart-constrict the blood vessels and
dilation of pupils
Alpha 2-Presynaptic adrenergic nerve terminal-inhibits the release of norepinephrine
Beta 1-Heart and Kidneys (BETA 1-ONE HEART)-increased heart rate and force of
contraction, release of renin
Beta 2-All sympathetic target organs-inhibits smooth muscle (BETA 2-TWO LUNGS)
Beta blockers/olol's
Beta-Adrenergic Blockers
Metoprolol/Lopressor ENDING OLOL
Beta Blockers are use with heart failure, hypertension, angina and with myocardial
infarctions.
Action = Blocks Beta-Receptors in the heart causing...
Decreases = HR, force of contraction, Rate of atrioventricular (AV) conduction
SE = Bradycardia, lethargy, GI disturbance, congestive heart failure, decrease BP,
depression
The beta blockers stop sympathetic nervous system stimulation of the heart. Does not
allow the heart rate and blood pressure to rise with stress thus lowering the oxygen
demand of the heart. It is very heart protective!
Will slow the heart rate and lower the blood pressure
Can have beta 2 blockage with larger doses-will constrict the bronchioles-watch for clients
with known COPD, Asthma
1|Page
,Nursing Interventions
Check pulse-needs to be 60 or above
Check blood pressure-if hypotensive do not give (Systolic below 100 is a good rule of
thumb I go by)
Monitor for sexual dysfunction-impotence for men-a good reason for non-compliance
Drowsiness/Fatigue-operating heavy machinery, driving could put client at risk
Insomnia-
Contraindicated with Heart Blocks, Bradycardia, Worsening Heart Failure
Increases Hypoglycemic effect of Insulin-monitor blood sugars and for hypoglycemia, may
need to lower insulin dosage
Beta Blockers have to be weaned slowly to prevent rebound hypertension and tachycardia-
if a client wants to stop his beta-blocker they need to contract their physician
CCB,/calcium channel blockers
Nifedipine/Adalat/Procardia/Norvasc-controls blood vessels
Diltiazem/Cardizem
Verapamil/Calan/Isoptin/Verelan-controls heart rate and blood vessels
Angina/Raynaud's/Vasospastic Angina/Atrial Arrhythmia's
Blocks calcium channels in the myocardial and vascular smooth muscles, decreases the
contraction of smooth muscle-relaxes the arteries-vasodilation. Blocking of calcium
channels in the SA and AV node-Slows conduction through the SA and AV node. Decreases
the force of contraction slows heart rate
Grapefruit juice may increase absorption of nifedipine
Side Effects: Relaxes smooth muscle and cardiac muscle-
Headache
Dizziness-Take lying, sitting and standing B/P, educate client to sit and stand slowly
Peripheral edema-assess for edema, monitor for worsening (diuretic)
Flushing
Reflex tachycardia-monitor for elevated heart rate (may need a BB)
Constipation-increase fibers and fluids (if not restricted) stool softener
Fatigue-Due to low heart rate-monitor EKG, pulse rate and rhythm
Weakness-Monitor B/P and Heart Rate
2|Page
,Impotence and sexual dysfunction-Discuss possibility with client-have client to call and
not just to stop medications
Hepatotoxicity-ALT, AST, ALK PHOS, Bilirubin
MI-Monitor for chest pain, dyspnea, increases fatigue, weakness
CHF-Monitor for chest pain, dyspnea, edema, increasing weight, decreasing output,
increasing HR and B/P
Angioedema-edema in face, throat, trouble swallowing, trouble breathing, thickened
tongue
Grapefruit juice may increase absorption of nifedipine
Acute Toxicity
With an overdose or overmedicated
Gastric lavage
Monitor EKG-bradycardia-widening QRS, hypotension
Norepinephrine to treat hypotension and decreased cardiac contractility
Atropine or Isoproterenol-Bradycardia and Cardiac Blocks
Verapamil (Calan, Covera, Isoptin Verelan)
Class IV antidysrhythmic
Calcium channel blocker
Inhi
Pril/ace inhibitors
Enalapril/Vasotec
PRIL-is the ending for ace's
Reduces Angiotensin 2 and aldosterone levels
Prevents Angiotensin 1 from converting to Angiotensin 2 in the lungs-leaves the Angiotensin
1 hanging in the lungs-creates irritation-cough
Vasodilation-mostly arteriole (decreases afterload)
Excretion of sodium and water-retention of K (decreases preload)
Treats hypertension and heart failure
Do not take 2nd and 3rd Trimester of pregnancy
SE = Angioedema-allergic reaction-swelling of tongue, throat-stop taking and notify md
Hyperkalemia-monitor for widening and slowing of pulse/qrs, weakness, fatigue, avoid high
K foods, AVOID SALT SUBSTITUTES-usually very high in K, avoid potassium sparing
diuretics, sport drinks are high in K also
Orthostatic Hypotension-teach client to sit and stand slowly, enact fall precautions
3|Page
, Neutropenia/Agranulocytosis-monitor CBC-WBC count, reoccurring infections
Renal Insufficiency-Monitor weight, edema, I/O, BUN, Cr, and GFR
Hepatic Insufficiency-Monitor AST, ALT, ALK PHOS, Bilirubin
Cough-Cough lozenges, hard candy, increase fluid intake, sleep with HOB elevated,
antihistamines
ACE Inhibitors
Discussed these medications with hypertension
Arb's-Angiotensin receptor blockers, sartan's
No Cough, same effects and side effects as Ace's-just not as potent
Sartan's/angiotension blockers/arb's
...
Arb's-Angiotensin receptor blockers, sartan's
No Cough, same effects and side effects as Ace's-just not as potent
Nitrates
Nitroglycerin/Nitrostat, Nitro-Bid, Nitro-Dur
Nitrates form nitric acid which is a relaxes smooth muscle and dilates venous and arterial
blood vessels
Open veins-blood pools in the legs-not as much blood returning to the heart-reduces
preload
Open arteries-heart does not have to work as hard to pump blood out of the heart-reduces
afterload
Opens the coronary arteries and helps supply blood to the heart tissue
Can be given sublingually, orally, topically, IV, buccal
Can be for acute or long term use
Nitroglycerin dilates any artery and vein-including yours if you touch it while administering
it-WEAR GLOVES
Nitroglycerin IV needs a glass bottle and covered from light-some hospitals still use special
tubing (nitro is absorbed in the tubing)
Short term-nitrostat-sublingually-1 tablet every 5 minutes x 3 for relief of chest pain-still
having chest pain call 911/physician
Long-term nitro-dur will last for up to 14 hours in the body
4|Page
WITH ACTUAL CORRECT QUESTIONS AND
VERIFIED DETAILED COMPREHENSIVE
RATIONALES ANSWERS| CURRENTLY TESTING
VERSION | ALREADY GRADED A+|EXPERT
VERIFIED FOR GUARANTEED PASS
2026|NCLEX-PN REVIEW
Receptors
Norepinephrine-Adrenergic (adrenergic comes from the word adrenalin)
Alpha 1-all sympathetic target organs except the heart-constrict the blood vessels and
dilation of pupils
Alpha 2-Presynaptic adrenergic nerve terminal-inhibits the release of norepinephrine
Beta 1-Heart and Kidneys (BETA 1-ONE HEART)-increased heart rate and force of
contraction, release of renin
Beta 2-All sympathetic target organs-inhibits smooth muscle (BETA 2-TWO LUNGS)
Beta blockers/olol's
Beta-Adrenergic Blockers
Metoprolol/Lopressor ENDING OLOL
Beta Blockers are use with heart failure, hypertension, angina and with myocardial
infarctions.
Action = Blocks Beta-Receptors in the heart causing...
Decreases = HR, force of contraction, Rate of atrioventricular (AV) conduction
SE = Bradycardia, lethargy, GI disturbance, congestive heart failure, decrease BP,
depression
The beta blockers stop sympathetic nervous system stimulation of the heart. Does not
allow the heart rate and blood pressure to rise with stress thus lowering the oxygen
demand of the heart. It is very heart protective!
Will slow the heart rate and lower the blood pressure
Can have beta 2 blockage with larger doses-will constrict the bronchioles-watch for clients
with known COPD, Asthma
1|Page
,Nursing Interventions
Check pulse-needs to be 60 or above
Check blood pressure-if hypotensive do not give (Systolic below 100 is a good rule of
thumb I go by)
Monitor for sexual dysfunction-impotence for men-a good reason for non-compliance
Drowsiness/Fatigue-operating heavy machinery, driving could put client at risk
Insomnia-
Contraindicated with Heart Blocks, Bradycardia, Worsening Heart Failure
Increases Hypoglycemic effect of Insulin-monitor blood sugars and for hypoglycemia, may
need to lower insulin dosage
Beta Blockers have to be weaned slowly to prevent rebound hypertension and tachycardia-
if a client wants to stop his beta-blocker they need to contract their physician
CCB,/calcium channel blockers
Nifedipine/Adalat/Procardia/Norvasc-controls blood vessels
Diltiazem/Cardizem
Verapamil/Calan/Isoptin/Verelan-controls heart rate and blood vessels
Angina/Raynaud's/Vasospastic Angina/Atrial Arrhythmia's
Blocks calcium channels in the myocardial and vascular smooth muscles, decreases the
contraction of smooth muscle-relaxes the arteries-vasodilation. Blocking of calcium
channels in the SA and AV node-Slows conduction through the SA and AV node. Decreases
the force of contraction slows heart rate
Grapefruit juice may increase absorption of nifedipine
Side Effects: Relaxes smooth muscle and cardiac muscle-
Headache
Dizziness-Take lying, sitting and standing B/P, educate client to sit and stand slowly
Peripheral edema-assess for edema, monitor for worsening (diuretic)
Flushing
Reflex tachycardia-monitor for elevated heart rate (may need a BB)
Constipation-increase fibers and fluids (if not restricted) stool softener
Fatigue-Due to low heart rate-monitor EKG, pulse rate and rhythm
Weakness-Monitor B/P and Heart Rate
2|Page
,Impotence and sexual dysfunction-Discuss possibility with client-have client to call and
not just to stop medications
Hepatotoxicity-ALT, AST, ALK PHOS, Bilirubin
MI-Monitor for chest pain, dyspnea, increases fatigue, weakness
CHF-Monitor for chest pain, dyspnea, edema, increasing weight, decreasing output,
increasing HR and B/P
Angioedema-edema in face, throat, trouble swallowing, trouble breathing, thickened
tongue
Grapefruit juice may increase absorption of nifedipine
Acute Toxicity
With an overdose or overmedicated
Gastric lavage
Monitor EKG-bradycardia-widening QRS, hypotension
Norepinephrine to treat hypotension and decreased cardiac contractility
Atropine or Isoproterenol-Bradycardia and Cardiac Blocks
Verapamil (Calan, Covera, Isoptin Verelan)
Class IV antidysrhythmic
Calcium channel blocker
Inhi
Pril/ace inhibitors
Enalapril/Vasotec
PRIL-is the ending for ace's
Reduces Angiotensin 2 and aldosterone levels
Prevents Angiotensin 1 from converting to Angiotensin 2 in the lungs-leaves the Angiotensin
1 hanging in the lungs-creates irritation-cough
Vasodilation-mostly arteriole (decreases afterload)
Excretion of sodium and water-retention of K (decreases preload)
Treats hypertension and heart failure
Do not take 2nd and 3rd Trimester of pregnancy
SE = Angioedema-allergic reaction-swelling of tongue, throat-stop taking and notify md
Hyperkalemia-monitor for widening and slowing of pulse/qrs, weakness, fatigue, avoid high
K foods, AVOID SALT SUBSTITUTES-usually very high in K, avoid potassium sparing
diuretics, sport drinks are high in K also
Orthostatic Hypotension-teach client to sit and stand slowly, enact fall precautions
3|Page
, Neutropenia/Agranulocytosis-monitor CBC-WBC count, reoccurring infections
Renal Insufficiency-Monitor weight, edema, I/O, BUN, Cr, and GFR
Hepatic Insufficiency-Monitor AST, ALT, ALK PHOS, Bilirubin
Cough-Cough lozenges, hard candy, increase fluid intake, sleep with HOB elevated,
antihistamines
ACE Inhibitors
Discussed these medications with hypertension
Arb's-Angiotensin receptor blockers, sartan's
No Cough, same effects and side effects as Ace's-just not as potent
Sartan's/angiotension blockers/arb's
...
Arb's-Angiotensin receptor blockers, sartan's
No Cough, same effects and side effects as Ace's-just not as potent
Nitrates
Nitroglycerin/Nitrostat, Nitro-Bid, Nitro-Dur
Nitrates form nitric acid which is a relaxes smooth muscle and dilates venous and arterial
blood vessels
Open veins-blood pools in the legs-not as much blood returning to the heart-reduces
preload
Open arteries-heart does not have to work as hard to pump blood out of the heart-reduces
afterload
Opens the coronary arteries and helps supply blood to the heart tissue
Can be given sublingually, orally, topically, IV, buccal
Can be for acute or long term use
Nitroglycerin dilates any artery and vein-including yours if you touch it while administering
it-WEAR GLOVES
Nitroglycerin IV needs a glass bottle and covered from light-some hospitals still use special
tubing (nitro is absorbed in the tubing)
Short term-nitrostat-sublingually-1 tablet every 5 minutes x 3 for relief of chest pain-still
having chest pain call 911/physician
Long-term nitro-dur will last for up to 14 hours in the body
4|Page
