NUR 354 Pharmacology II Exam 1 Practice
Questions (Updated 2026) Module 1: Diuretics,
Cardiovascular, and Endocrine Medications
Question 1: Which medication is classified as a loop diuretic?
• A) Hydrochlorothiazide
• B) Mannitol
• C) Spironolactone
• D) Furosemide
Answer & Rationale: The correct answer is D. Furosemide is a potent loop
diuretic that acts on the ascending limb of the loop of Henle. It inhibits sodium
and chloride reabsorption to promote diuresis. Nurses must monitor patients for
hypokalemia, and daily weights are essential to assess effectiveness.
Question 2: A patient is prescribed Lisinopril for hypertension. What common side
effect should the nurse monitor for?
• A) Peripheral edema
• B) Dry, nonproductive cough
• C) Hyperglycemia
• D) Constipation
Answer & Rationale: The correct answer is B. A dry, hacking cough is a common
side effect of ACE inhibitors like lisinopril, caused by bradykinin accumulation. This
often leads to medication discontinuation, and ARBs may be prescribed as an
alternative.
,Question 3: Which assessment is most important before administering Digoxin?
• A) Blood pressure
• B) Respiratory rate
• C) Temperature
• D) Apical pulse for one minute
Answer & Rationale: The correct answer is D. Apical pulse for one minute before
administration. Digoxin should be held if the adult heart rate is below 60 beats per
minute to prevent further slowing and digoxin toxicity.
Question 4: A nurse is providing discharge teaching for a client with pulmonary
edema starting furosemide. Which instruction should the nurse include?
• A) Take aspirin if headaches develop
• B) Eat foods containing plenty of potassium
• C) Expect swelling in hands and feet
• D) Take medication at bedtime
Answer & Rationale: The correct answer is B. Eat foods containing plenty of
potassium. Furosemide is a loop diuretic that causes potassium wasting,
increasing risk for hypokalemia. Patients should consume potassium-rich foods
like bananas and potatoes.
Question 5: A nurse is caring for a client with heart failure receiving IV
furosemide. The nurse should monitor for which electrolyte imbalance?
• A) Hypernatremia
• B) Hyperuricemia
, • C) Hypercalcemia
• D) Hyperchloremia
Answer & Rationale: The correct answer is B. Hyperuricemia. Loop diuretics can
increase uric acid levels by reducing uric acid excretion, potentially precipitating
gout in susceptible patients.
Question 6: A nurse is caring for a client whose serum potassium level is 5.3
mEq/L. Which scheduled medication should the nurse plan to administer?
• A) Lisinopril
• B) Digoxin
• C) Furosemide
• D) Potassium iodide
Answer & Rationale: The correct answer is B. Digoxin. A potassium level of 5.3
mEq/L is within normal range (3.5-5.0 mEq/L is typical; 5.3 is slightly elevated but
not critical). However, the nurse should monitor digoxin levels closely since
hyperkalemia can affect digoxin effectiveness.
Question 7: Where should sublingual Nitroglycerin be stored to maintain
potency?
• A) In the refrigerator
• B) In a clear plastic container
• C) In a bathroom medicine cabinet
• D) In its original dark glass bottle
Answer & Rationale: The correct answer is D. In its original dark glass bottle.
Nitroglycerin is highly sensitive to light and moisture and must be kept in its
original amber glass container to ensure effectiveness.
, Question 8: A patient taking Warfarin has an INR of 5.5 with active gingival
bleeding. Which reversal agent should the nurse anticipate?
• A) Vitamin K (Phytonadione)
• B) Protamine Sulfate
• C) Idarucizumab
• D) Glucagon
Answer & Rationale: The correct answer is A. Vitamin K is the specific antagonist
for warfarin, helping the liver synthesize clotting factors. An INR of 5.5 is
significantly above the therapeutic range (typically 2.0-3.0), placing the patient at
high risk for hemorrhage.
Question 9: Which medication is considered a rescue inhaler for acute asthma
attacks?
• A) Salmeterol
• B) Fluticasone
• C) Albuterol
• D) Tiotropium
Answer & Rationale: The correct answer is C. Albuterol is a short-acting beta-
agonist (SABA) used for immediate relief of bronchospasm. It is the drug of choice
for acute asthma symptoms because it works rapidly. Patients should carry this
inhaler at all times.
Question 10: A nurse is preparing to give Metoprolol. Which vital sign is the
priority to check?
• A) Temperature
Questions (Updated 2026) Module 1: Diuretics,
Cardiovascular, and Endocrine Medications
Question 1: Which medication is classified as a loop diuretic?
• A) Hydrochlorothiazide
• B) Mannitol
• C) Spironolactone
• D) Furosemide
Answer & Rationale: The correct answer is D. Furosemide is a potent loop
diuretic that acts on the ascending limb of the loop of Henle. It inhibits sodium
and chloride reabsorption to promote diuresis. Nurses must monitor patients for
hypokalemia, and daily weights are essential to assess effectiveness.
Question 2: A patient is prescribed Lisinopril for hypertension. What common side
effect should the nurse monitor for?
• A) Peripheral edema
• B) Dry, nonproductive cough
• C) Hyperglycemia
• D) Constipation
Answer & Rationale: The correct answer is B. A dry, hacking cough is a common
side effect of ACE inhibitors like lisinopril, caused by bradykinin accumulation. This
often leads to medication discontinuation, and ARBs may be prescribed as an
alternative.
,Question 3: Which assessment is most important before administering Digoxin?
• A) Blood pressure
• B) Respiratory rate
• C) Temperature
• D) Apical pulse for one minute
Answer & Rationale: The correct answer is D. Apical pulse for one minute before
administration. Digoxin should be held if the adult heart rate is below 60 beats per
minute to prevent further slowing and digoxin toxicity.
Question 4: A nurse is providing discharge teaching for a client with pulmonary
edema starting furosemide. Which instruction should the nurse include?
• A) Take aspirin if headaches develop
• B) Eat foods containing plenty of potassium
• C) Expect swelling in hands and feet
• D) Take medication at bedtime
Answer & Rationale: The correct answer is B. Eat foods containing plenty of
potassium. Furosemide is a loop diuretic that causes potassium wasting,
increasing risk for hypokalemia. Patients should consume potassium-rich foods
like bananas and potatoes.
Question 5: A nurse is caring for a client with heart failure receiving IV
furosemide. The nurse should monitor for which electrolyte imbalance?
• A) Hypernatremia
• B) Hyperuricemia
, • C) Hypercalcemia
• D) Hyperchloremia
Answer & Rationale: The correct answer is B. Hyperuricemia. Loop diuretics can
increase uric acid levels by reducing uric acid excretion, potentially precipitating
gout in susceptible patients.
Question 6: A nurse is caring for a client whose serum potassium level is 5.3
mEq/L. Which scheduled medication should the nurse plan to administer?
• A) Lisinopril
• B) Digoxin
• C) Furosemide
• D) Potassium iodide
Answer & Rationale: The correct answer is B. Digoxin. A potassium level of 5.3
mEq/L is within normal range (3.5-5.0 mEq/L is typical; 5.3 is slightly elevated but
not critical). However, the nurse should monitor digoxin levels closely since
hyperkalemia can affect digoxin effectiveness.
Question 7: Where should sublingual Nitroglycerin be stored to maintain
potency?
• A) In the refrigerator
• B) In a clear plastic container
• C) In a bathroom medicine cabinet
• D) In its original dark glass bottle
Answer & Rationale: The correct answer is D. In its original dark glass bottle.
Nitroglycerin is highly sensitive to light and moisture and must be kept in its
original amber glass container to ensure effectiveness.
, Question 8: A patient taking Warfarin has an INR of 5.5 with active gingival
bleeding. Which reversal agent should the nurse anticipate?
• A) Vitamin K (Phytonadione)
• B) Protamine Sulfate
• C) Idarucizumab
• D) Glucagon
Answer & Rationale: The correct answer is A. Vitamin K is the specific antagonist
for warfarin, helping the liver synthesize clotting factors. An INR of 5.5 is
significantly above the therapeutic range (typically 2.0-3.0), placing the patient at
high risk for hemorrhage.
Question 9: Which medication is considered a rescue inhaler for acute asthma
attacks?
• A) Salmeterol
• B) Fluticasone
• C) Albuterol
• D) Tiotropium
Answer & Rationale: The correct answer is C. Albuterol is a short-acting beta-
agonist (SABA) used for immediate relief of bronchospasm. It is the drug of choice
for acute asthma symptoms because it works rapidly. Patients should carry this
inhaler at all times.
Question 10: A nurse is preparing to give Metoprolol. Which vital sign is the
priority to check?
• A) Temperature
