Page 1 of 62
CARDIOVASCULAR PHARMACOLOGY EXAM
WITH CORRECT ANSWERS,RATIONALES
NEWEST 2026 EXAM VERIFIED 100 %
Pharmacology-Cardiac
A patient is to be discharged home with a new prescription for prazosin
[Minipress]. Which statement is most important for the nurse to include in the
teaching plan?
A. "You should increase your intake of fresh fruits and vegetables."
B. "You should move slowly from a sitting to a standing position."
C. "Be sure to wear a Medic Alert bracelet while taking this medication."
D. "Take your first dose of this medication first thing in the morning."
B. Orthostatic hypotension is the most serious adverse effect of prazosin and other
alpha1 blockers. Patients should be taught to move slowly when changing from a
supine or sitting position to an upright position to avoid dizziness and prevent falls.
Fresh fruits and vegetables are good to include in the dietary teaching, but this is not
as important as preventing hypotension. A Medic Alert bracelet should not be
needed for this drug. This drug causes significant first-dose hypotension. The initial
dose should be taken at bedtime. Patients should avoid driving and other hazardous
activities for 12 to 24 hours after the first dose.
The nurse is caring for a patient receiving propranolol [Inderal]. Which clinical
finding is most indicative of an adverse effect of this drug?
A. A heart rate of 100 beats/min
B. Wheezing
C. A glucose level of 180 mg/dL
D. Urinary urgency
, Page 2 of 62
B. Beta blockers, such as propranolol, are known to cause bronchoconstriction,
which could manifest as wheezing. Other adverse effects could include bradycardia,
atrioventricular (AV) heart block, heart failure, rebound cardiac excitation, inhibition
of glycogenolysis, and potential central nervous system (CNS) effects.
The nurse is caring for several patients prescribed propranolol [Inderal]. In
which patient condition is propranolol [Inderal] contraindicated?
A. Cardiac dysrhythmias
B. Hypertension
C. Diabetes
D. Angina
B. Propranolol inhibits glycogenolysis and thus can produce hypoglycemia, which
can cause problems in patients with diabetes. It also suppresses tachycardia, which
is an important warning sign of hypoglycemia in patients with diabetes. It is safe to
use propranolol in dysrhythmias, hypertension, and angina.
Why does the nurse anticipate administering metoprolol [Lopressor] rather
than propranolol [Inderal] for diabetic patients who need a beta-blocking
agent?
A. Metoprolol is less likely to cause diabetic nephropathy.
B. Propranolol causes both beta1 and beta2 blockade.
C. Metoprolol helps prevent retinopathy in individuals with diabetes.
D. Propranolol is associated with a higher incidence of foot ulcers.
B. Metoprolol is a second-generation beta blocker and as such is more selective. At
therapeutic doses, it causes less bronchoconstriction and suppression of
glycogenolysis, which can cause problems in diabetic patients. Propranolol blocks
both beta1 and beta2 receptors.
A nurse is caring for a patient prescribed doxazosin [Cardura] for
hypertension. Safety is a priority because of which associated adverse effect?
A. Reflex tachycardia
B. Heart palpitations
C. Cardiac dysrhythmias
D. Orthostatic hypotension
D. Doxazosin is an alpha1 blocker and can cause orthostatic hypotension. Common
symptoms include dizziness or lightheadedness on standing, which may impair the
patient's balance and increase the risk of a fall.
, Page 3 of 62
The renin-angiotensin-aldosterone system plays an important role in
maintaining blood pressure. Which compound in this system is most powerful
at raising the blood pressure?
A. Angiotensin I
B. Angiotensin II
C. Angiotensin III
D. Renin
B. Angiotensin II is a potent vasoconstrictor. It participates in all the pathways
regulated by the renin-angiotensin-aldosterone system. Angiotensin I is a precursor
to angiotensin II; angiotensin III is formed by degradation of angiotensin II and is less
potent. Renin catalyzes the conversion of angiotensinogen to angiotensin I.
A patient is admitted to the hospital with a diagnosis of hypertension. The
nurse understands that which medication works by preventing angiotensin II
from binding with its receptor sites?
A. Quinapril [Accupril]
B. Aliskiren [Tekturna]
C. Eplerenone [Inspra]
D. Candesartan [Atacand]
C. Patients with bilateral renal artery stenosis are at increased risk for renal
insufficiency and failure with angiotensin-converting enzyme (ACE) inhibitors, such
as benazepril. ACE inhibitors do not typically cause hypokalemia, hyperglycemia, or
hyperuricemia.
The nurse has just administered the initial dose of enalapril [Vasotec] to a
newly admitted patient with hypertension. What is the priority nursing
intervention over the next several hours?
A. Monitor blood pressure.
B. Check the heart rate.
C. Auscultate lung sounds.
D. Draw a potassium level.
B. ACE inhibitors, such as captopril, can cause lithium accumulation. Lithium levels
should be monitored on a regular basis. ACE inhibitors can cause hyperkalemia,
renal insufficiency in some patients, and hypotension. However, the combination of
lithium and captopril would not increase the risk of these effects.
, Page 4 of 62
The nurse is evaluating the teaching done with a patient who has a new
prescription for fosinopril [Monopril]. Which statement by the patient indicates
a need for further teaching?
A. "I can take this medicine with breakfast each morning."
B. "I will call if I notice a rash or wheals on my skin."
C. "I will use a salt substitute to lower my sodium intake."
D. "I will call if I develop a bothersome cough."
C. Salt substitutes contain potassium and may increase the risk of hyperkalemia with
ACE inhibitors, such as fosinopril. The patient should not take potassium
supplements or use salt substitutes. The other statements are appropriate for this
patient.
The nurse is caring for a patient prescribed aliskiren [Tekturna]. How does this
medication lower blood pressure?
A. It blocks the conversion of angiotensin I to angiotensin II.
B. It prevents angiotensin II from binding to its receptors.
C. It inhibits the conversion of angiotensinogen into angiotensin I.
D. It selectively blocks aldosterone receptors in the kidneys.
C. Aliskiren is the first direct renin inhibitor on the market. It binds with renin and thus
inhibits the conversion of angiotensinogen to angiotensin I. The other items describe
ACE inhibitors, ARBs, and selective aldosterone receptor blockers.
A patient is prescribed lisinopril [Prinvil] as part of the treatment plan for heart
failure. Which finding indicates the patient is experiencing the therapeutic
effect of this drug?
A. + 2 edema of the lower extremities
B. Potassium level of 3.5 mEq/L
C. Crackles in the lungs are no longer heard
D. Jugular vein distention
C. Because ACE inhibitors promote venous dilation, they provide the therapeutic
effect of reducing pulmonary congestion and peripheral edema. Absence of
previously heard crackles would be an indicator of effectiveness. Edema and jugular
vein distention are manifestations of heart failure. A potassium level of 3.5 mEq/L is
a normal value.
A patient is prescribed lisinopril [Prinivil] 40 mg by mouth once a day for
hypertension. For which therapeutic effect will the nurse monitor?
CARDIOVASCULAR PHARMACOLOGY EXAM
WITH CORRECT ANSWERS,RATIONALES
NEWEST 2026 EXAM VERIFIED 100 %
Pharmacology-Cardiac
A patient is to be discharged home with a new prescription for prazosin
[Minipress]. Which statement is most important for the nurse to include in the
teaching plan?
A. "You should increase your intake of fresh fruits and vegetables."
B. "You should move slowly from a sitting to a standing position."
C. "Be sure to wear a Medic Alert bracelet while taking this medication."
D. "Take your first dose of this medication first thing in the morning."
B. Orthostatic hypotension is the most serious adverse effect of prazosin and other
alpha1 blockers. Patients should be taught to move slowly when changing from a
supine or sitting position to an upright position to avoid dizziness and prevent falls.
Fresh fruits and vegetables are good to include in the dietary teaching, but this is not
as important as preventing hypotension. A Medic Alert bracelet should not be
needed for this drug. This drug causes significant first-dose hypotension. The initial
dose should be taken at bedtime. Patients should avoid driving and other hazardous
activities for 12 to 24 hours after the first dose.
The nurse is caring for a patient receiving propranolol [Inderal]. Which clinical
finding is most indicative of an adverse effect of this drug?
A. A heart rate of 100 beats/min
B. Wheezing
C. A glucose level of 180 mg/dL
D. Urinary urgency
, Page 2 of 62
B. Beta blockers, such as propranolol, are known to cause bronchoconstriction,
which could manifest as wheezing. Other adverse effects could include bradycardia,
atrioventricular (AV) heart block, heart failure, rebound cardiac excitation, inhibition
of glycogenolysis, and potential central nervous system (CNS) effects.
The nurse is caring for several patients prescribed propranolol [Inderal]. In
which patient condition is propranolol [Inderal] contraindicated?
A. Cardiac dysrhythmias
B. Hypertension
C. Diabetes
D. Angina
B. Propranolol inhibits glycogenolysis and thus can produce hypoglycemia, which
can cause problems in patients with diabetes. It also suppresses tachycardia, which
is an important warning sign of hypoglycemia in patients with diabetes. It is safe to
use propranolol in dysrhythmias, hypertension, and angina.
Why does the nurse anticipate administering metoprolol [Lopressor] rather
than propranolol [Inderal] for diabetic patients who need a beta-blocking
agent?
A. Metoprolol is less likely to cause diabetic nephropathy.
B. Propranolol causes both beta1 and beta2 blockade.
C. Metoprolol helps prevent retinopathy in individuals with diabetes.
D. Propranolol is associated with a higher incidence of foot ulcers.
B. Metoprolol is a second-generation beta blocker and as such is more selective. At
therapeutic doses, it causes less bronchoconstriction and suppression of
glycogenolysis, which can cause problems in diabetic patients. Propranolol blocks
both beta1 and beta2 receptors.
A nurse is caring for a patient prescribed doxazosin [Cardura] for
hypertension. Safety is a priority because of which associated adverse effect?
A. Reflex tachycardia
B. Heart palpitations
C. Cardiac dysrhythmias
D. Orthostatic hypotension
D. Doxazosin is an alpha1 blocker and can cause orthostatic hypotension. Common
symptoms include dizziness or lightheadedness on standing, which may impair the
patient's balance and increase the risk of a fall.
, Page 3 of 62
The renin-angiotensin-aldosterone system plays an important role in
maintaining blood pressure. Which compound in this system is most powerful
at raising the blood pressure?
A. Angiotensin I
B. Angiotensin II
C. Angiotensin III
D. Renin
B. Angiotensin II is a potent vasoconstrictor. It participates in all the pathways
regulated by the renin-angiotensin-aldosterone system. Angiotensin I is a precursor
to angiotensin II; angiotensin III is formed by degradation of angiotensin II and is less
potent. Renin catalyzes the conversion of angiotensinogen to angiotensin I.
A patient is admitted to the hospital with a diagnosis of hypertension. The
nurse understands that which medication works by preventing angiotensin II
from binding with its receptor sites?
A. Quinapril [Accupril]
B. Aliskiren [Tekturna]
C. Eplerenone [Inspra]
D. Candesartan [Atacand]
C. Patients with bilateral renal artery stenosis are at increased risk for renal
insufficiency and failure with angiotensin-converting enzyme (ACE) inhibitors, such
as benazepril. ACE inhibitors do not typically cause hypokalemia, hyperglycemia, or
hyperuricemia.
The nurse has just administered the initial dose of enalapril [Vasotec] to a
newly admitted patient with hypertension. What is the priority nursing
intervention over the next several hours?
A. Monitor blood pressure.
B. Check the heart rate.
C. Auscultate lung sounds.
D. Draw a potassium level.
B. ACE inhibitors, such as captopril, can cause lithium accumulation. Lithium levels
should be monitored on a regular basis. ACE inhibitors can cause hyperkalemia,
renal insufficiency in some patients, and hypotension. However, the combination of
lithium and captopril would not increase the risk of these effects.
, Page 4 of 62
The nurse is evaluating the teaching done with a patient who has a new
prescription for fosinopril [Monopril]. Which statement by the patient indicates
a need for further teaching?
A. "I can take this medicine with breakfast each morning."
B. "I will call if I notice a rash or wheals on my skin."
C. "I will use a salt substitute to lower my sodium intake."
D. "I will call if I develop a bothersome cough."
C. Salt substitutes contain potassium and may increase the risk of hyperkalemia with
ACE inhibitors, such as fosinopril. The patient should not take potassium
supplements or use salt substitutes. The other statements are appropriate for this
patient.
The nurse is caring for a patient prescribed aliskiren [Tekturna]. How does this
medication lower blood pressure?
A. It blocks the conversion of angiotensin I to angiotensin II.
B. It prevents angiotensin II from binding to its receptors.
C. It inhibits the conversion of angiotensinogen into angiotensin I.
D. It selectively blocks aldosterone receptors in the kidneys.
C. Aliskiren is the first direct renin inhibitor on the market. It binds with renin and thus
inhibits the conversion of angiotensinogen to angiotensin I. The other items describe
ACE inhibitors, ARBs, and selective aldosterone receptor blockers.
A patient is prescribed lisinopril [Prinvil] as part of the treatment plan for heart
failure. Which finding indicates the patient is experiencing the therapeutic
effect of this drug?
A. + 2 edema of the lower extremities
B. Potassium level of 3.5 mEq/L
C. Crackles in the lungs are no longer heard
D. Jugular vein distention
C. Because ACE inhibitors promote venous dilation, they provide the therapeutic
effect of reducing pulmonary congestion and peripheral edema. Absence of
previously heard crackles would be an indicator of effectiveness. Edema and jugular
vein distention are manifestations of heart failure. A potassium level of 3.5 mEq/L is
a normal value.
A patient is prescribed lisinopril [Prinivil] 40 mg by mouth once a day for
hypertension. For which therapeutic effect will the nurse monitor?
