NCLEX-RN Cardiovascular Pharmacology
Practice Questions |
20 NGN-Style Pharmacology MCQs with
Rationales
Question 1
Clinical Scenario
A 68-year-old male with hypertension is prescribed lisinopril 10 mg
orally daily. During a follow-up visit, he reports a persistent dry
cough that began several weeks after starting the medication. Vital
signs are stable, and his blood pressure is well controlled.
Question Stem
Which nursing action is most appropriate?
A. Instruct the client to discontinue the medication immediately.
B. Notify the provider that the cough may be an adverse effect of
lisinopril.
C. Recommend an over-the-counter cough suppressant.
D. Reassure the client that the symptom is unrelated to the
medication.
Correct Answer
,Correct Answer: B. Notify the provider that the cough may be an
adverse effect of lisinopril
Detailed Rationale
ACE inhibitors such as lisinopril commonly cause a persistent,
nonproductive cough due to accumulation of bradykinin in the
respiratory tract. Although not usually dangerous, the cough can
significantly affect adherence and quality of life. The nurse should
recognize this adverse effect and notify the provider, who may
consider switching the patient to an angiotensin II receptor blocker
(ARB) such as losartan.
Option A is incorrect because the client should not stop
antihypertensive therapy without provider guidance. Abrupt
discontinuation could result in uncontrolled hypertension.
Option C is incorrect because treating the symptom without
identifying the cause may delay appropriate medication
management.
Option D is incorrect because the cough is a well-known adverse
effect associated with ACE inhibitors.
Nurses should assess for additional adverse effects including
angioedema, hyperkalemia, hypotension, and renal dysfunction.
Monitoring blood pressure, potassium levels, and renal function is
essential.
Learning Objective
After completing this question, the learner should be able to:
• Identify common adverse effects of ACE inhibitors.
, • Recognize when provider notification is indicated.
• Differentiate medication-related symptoms from unrelated
complaints.
• Educate clients regarding ACE inhibitor therapy.
Medication Safety Focus
Adverse effect recognition
Question 2
Clinical Scenario
A 74-year-old female with heart failure receives furosemide 40 mg
IV. Four hours later, the nurse reviews laboratory results showing
potassium 2.9 mEq/L.
Question Stem
Which nursing action is the priority?
A. Administer the next scheduled dose of furosemide.
B. Encourage increased fluid intake.
C. Notify the provider of the potassium level.
D. Place the client in Trendelenburg position.
Correct Answer
Correct Answer: C. Notify the provider of the potassium level
Detailed Rationale
Practice Questions |
20 NGN-Style Pharmacology MCQs with
Rationales
Question 1
Clinical Scenario
A 68-year-old male with hypertension is prescribed lisinopril 10 mg
orally daily. During a follow-up visit, he reports a persistent dry
cough that began several weeks after starting the medication. Vital
signs are stable, and his blood pressure is well controlled.
Question Stem
Which nursing action is most appropriate?
A. Instruct the client to discontinue the medication immediately.
B. Notify the provider that the cough may be an adverse effect of
lisinopril.
C. Recommend an over-the-counter cough suppressant.
D. Reassure the client that the symptom is unrelated to the
medication.
Correct Answer
,Correct Answer: B. Notify the provider that the cough may be an
adverse effect of lisinopril
Detailed Rationale
ACE inhibitors such as lisinopril commonly cause a persistent,
nonproductive cough due to accumulation of bradykinin in the
respiratory tract. Although not usually dangerous, the cough can
significantly affect adherence and quality of life. The nurse should
recognize this adverse effect and notify the provider, who may
consider switching the patient to an angiotensin II receptor blocker
(ARB) such as losartan.
Option A is incorrect because the client should not stop
antihypertensive therapy without provider guidance. Abrupt
discontinuation could result in uncontrolled hypertension.
Option C is incorrect because treating the symptom without
identifying the cause may delay appropriate medication
management.
Option D is incorrect because the cough is a well-known adverse
effect associated with ACE inhibitors.
Nurses should assess for additional adverse effects including
angioedema, hyperkalemia, hypotension, and renal dysfunction.
Monitoring blood pressure, potassium levels, and renal function is
essential.
Learning Objective
After completing this question, the learner should be able to:
• Identify common adverse effects of ACE inhibitors.
, • Recognize when provider notification is indicated.
• Differentiate medication-related symptoms from unrelated
complaints.
• Educate clients regarding ACE inhibitor therapy.
Medication Safety Focus
Adverse effect recognition
Question 2
Clinical Scenario
A 74-year-old female with heart failure receives furosemide 40 mg
IV. Four hours later, the nurse reviews laboratory results showing
potassium 2.9 mEq/L.
Question Stem
Which nursing action is the priority?
A. Administer the next scheduled dose of furosemide.
B. Encourage increased fluid intake.
C. Notify the provider of the potassium level.
D. Place the client in Trendelenburg position.
Correct Answer
Correct Answer: C. Notify the provider of the potassium level
Detailed Rationale
