BIOD351 / BIOD 351 Final Exam
| Latest Update |Newly Released
Pharmacology | Questions & Answers | Grade A
Guaranteed Pass | 100% Correct - Portage Learning
Q1: A 58-year-old patient with hypertension is prescribed lisinopril. The nurse should monitor
for which of the following side effects that is most characteristic of ACE inhibitors?
A. Peripheral edema
B. Dr y cough
C. Constipation
D. Bradycardia
Correct Answer: B
Rationale: Correct because ACE inhibitors block angiotensin-converting enzyme, leading to
accumulation of bradykinin, which causes a persistent dry cough in up to 20% of patients.
This side effect is the hallmark distinguishing feature of ACE inhibitors and is the most
common reason patients switch to an ARB. Peripheral edema is associated with
dihydropyridine CCBs, constipation with verapamil, and bradycardia with non-
dihydropyridine CCBs or beta-blockers.
Q2: A patient on losartan for hypertension reports no cough but develops hyperkalemia. The
nurse understands that ARBs differ from ACE inhibitors primarily because ARBs:
A. Inhibit angiotensin-converting enzyme directly
B. Block AT1 receptors and do not affect bradykinin metabolis m
C. Cause more angioedema than ACE inhibitors
D. Increase aldosterone secretion
Correct Answer: B
,Rationale: Correct because ARBs such as losartan block the AT1 receptor, preventing
angiotensin II from binding and exerting its vasoconstrictive and aldosterone-stimulating
effects, without inhibiting bradykinin breakdown. This is why ARBs cause significantly less dry
cough and less angioedema than ACE inhibitors. ARBs still cause hyperkalemia due to
decreased aldosterone, but they do not increase aldosterone secretion.
Q3: A patient is prescribed amlodipine for hypertension. The nurse should recognize that
amlodipine belongs to which subclass of calcium channel blockers, and what is its primary
side effect profile?
A. Non-dihydropyridine; causes bradycardia and constipation
B. Dihydropyridine; caus es peripheral edema, headache, and flus hing
C. Non-dihydropyridine; causes peripheral edema and flushing
D. Dihydropyridine; causes bradycardia and heart block
Correct Answer: B
Rationale: Correct because amlodipine is a dihydropyridine calcium channel blocker that is
vascular-selective, causing vasodilation without significant negative inotropic or chronotropic
effects on the heart. The most common side effects are peripheral edema (due to precapillary
vasodilation increasing capillary hydrostatic pressure), headache, and flushing. Non -
dihydropyridine CCBs such as verapamil and diltiazem cause bradycardia, constipation, and
heart block.
Q4: A patient's heart rate is 72 beats per minute and stroke volume is 75 mL. What is the
patient's cardiac output?
A. 5.4 L/min
B. 4.8 L/min
C. 6.0 L/min
D. 5.25 L/min
Correct Answer: A
Rationale: Correct because cardiac output is calculated using the formula CO = HR × SV.
Therefore, CO = 72 bpm × 75 mL = 5,400 mL/min, which converts to 5.4 L/min. This value
, falls within the normal cardiac output range of 4–8 L/min, indicating adequate cardiac
function at rest.
Q5: Arrange the following opioids in order from LEAST potent to MOST potent based on
equianalgesic dosing relative to morphine:
A. Morphine → Codeine → Fentanyl → Hydromorphone
B. Codeine → Tramadol → Hydrocodone → Morphine → Fentanyl
C. Fentanyl → Hydromorphone → Morphine → Codeine → Tramadol
D. Codeine → Morphine → Oxycodone → Hydromorphone → Fentanyl
Correct Answer: B
Rationale: Correct because the opioid potency ranking from least to most potent is: Codeine
(0.1× morphine) ≈ Tramadol (0.1×) → Hydrocodone (1×, equal to morphine) → Morphine (1×,
reference standard) → Oxycodone (1.5–2×) → Hydromorphone (5–7×) → Fentanyl (50–100×).
Potency refers to the dose required to produce an analgesic effect, not the maximum efficacy,
which is similar across mu-opioid receptor agonists.
Q6: A patient with seasonal allergic rhinitis is prescribed fluticasone. Which route of
administration and delivery form is correct for this medication?
A. Oral tablet, immediate-release
B. Intranas al s pray
C. Subcutaneous injection
D. Ophthalmic drops
Correct Answer: B
Rationale: Correct because fluticasone (Flonase) is an intranasal corticosteroid administered
as a nasal spray for the treatment of allergic rhinitis. Proper technique includes priming the
spray if new, shaking the bottle, aiming away from the nasal septum, and breathing in gently
without a deep sniff to minimize systemic absorption and local irritation.
| Latest Update |Newly Released
Pharmacology | Questions & Answers | Grade A
Guaranteed Pass | 100% Correct - Portage Learning
Q1: A 58-year-old patient with hypertension is prescribed lisinopril. The nurse should monitor
for which of the following side effects that is most characteristic of ACE inhibitors?
A. Peripheral edema
B. Dr y cough
C. Constipation
D. Bradycardia
Correct Answer: B
Rationale: Correct because ACE inhibitors block angiotensin-converting enzyme, leading to
accumulation of bradykinin, which causes a persistent dry cough in up to 20% of patients.
This side effect is the hallmark distinguishing feature of ACE inhibitors and is the most
common reason patients switch to an ARB. Peripheral edema is associated with
dihydropyridine CCBs, constipation with verapamil, and bradycardia with non-
dihydropyridine CCBs or beta-blockers.
Q2: A patient on losartan for hypertension reports no cough but develops hyperkalemia. The
nurse understands that ARBs differ from ACE inhibitors primarily because ARBs:
A. Inhibit angiotensin-converting enzyme directly
B. Block AT1 receptors and do not affect bradykinin metabolis m
C. Cause more angioedema than ACE inhibitors
D. Increase aldosterone secretion
Correct Answer: B
,Rationale: Correct because ARBs such as losartan block the AT1 receptor, preventing
angiotensin II from binding and exerting its vasoconstrictive and aldosterone-stimulating
effects, without inhibiting bradykinin breakdown. This is why ARBs cause significantly less dry
cough and less angioedema than ACE inhibitors. ARBs still cause hyperkalemia due to
decreased aldosterone, but they do not increase aldosterone secretion.
Q3: A patient is prescribed amlodipine for hypertension. The nurse should recognize that
amlodipine belongs to which subclass of calcium channel blockers, and what is its primary
side effect profile?
A. Non-dihydropyridine; causes bradycardia and constipation
B. Dihydropyridine; caus es peripheral edema, headache, and flus hing
C. Non-dihydropyridine; causes peripheral edema and flushing
D. Dihydropyridine; causes bradycardia and heart block
Correct Answer: B
Rationale: Correct because amlodipine is a dihydropyridine calcium channel blocker that is
vascular-selective, causing vasodilation without significant negative inotropic or chronotropic
effects on the heart. The most common side effects are peripheral edema (due to precapillary
vasodilation increasing capillary hydrostatic pressure), headache, and flushing. Non -
dihydropyridine CCBs such as verapamil and diltiazem cause bradycardia, constipation, and
heart block.
Q4: A patient's heart rate is 72 beats per minute and stroke volume is 75 mL. What is the
patient's cardiac output?
A. 5.4 L/min
B. 4.8 L/min
C. 6.0 L/min
D. 5.25 L/min
Correct Answer: A
Rationale: Correct because cardiac output is calculated using the formula CO = HR × SV.
Therefore, CO = 72 bpm × 75 mL = 5,400 mL/min, which converts to 5.4 L/min. This value
, falls within the normal cardiac output range of 4–8 L/min, indicating adequate cardiac
function at rest.
Q5: Arrange the following opioids in order from LEAST potent to MOST potent based on
equianalgesic dosing relative to morphine:
A. Morphine → Codeine → Fentanyl → Hydromorphone
B. Codeine → Tramadol → Hydrocodone → Morphine → Fentanyl
C. Fentanyl → Hydromorphone → Morphine → Codeine → Tramadol
D. Codeine → Morphine → Oxycodone → Hydromorphone → Fentanyl
Correct Answer: B
Rationale: Correct because the opioid potency ranking from least to most potent is: Codeine
(0.1× morphine) ≈ Tramadol (0.1×) → Hydrocodone (1×, equal to morphine) → Morphine (1×,
reference standard) → Oxycodone (1.5–2×) → Hydromorphone (5–7×) → Fentanyl (50–100×).
Potency refers to the dose required to produce an analgesic effect, not the maximum efficacy,
which is similar across mu-opioid receptor agonists.
Q6: A patient with seasonal allergic rhinitis is prescribed fluticasone. Which route of
administration and delivery form is correct for this medication?
A. Oral tablet, immediate-release
B. Intranas al s pray
C. Subcutaneous injection
D. Ophthalmic drops
Correct Answer: B
Rationale: Correct because fluticasone (Flonase) is an intranasal corticosteroid administered
as a nasal spray for the treatment of allergic rhinitis. Proper technique includes priming the
spray if new, shaking the bottle, aiming away from the nasal septum, and breathing in gently
without a deep sniff to minimize systemic absorption and local irritation.
