NCLEX-RN Cardiovascular Pharmacology Exam
Questions |
5 Original NCLEX-Style MCQs with Rationales |
ATI Pharmacology Made Easy Review |
Nursing Pharmacology Test Bank Study Guide
Question 1
Clinical Scenario
A 58-year-old man with newly diagnosed hypertension is
prescribed lisinopril. During a follow-up visit 2 weeks later, his
blood pressure is 132/78 mm Hg. He reports a persistent dry
cough that began after starting the medication.
Question Stem
Which nursing response is most appropriate?
A. Advise the client to stop the medication immediately and
avoid all antihypertensives.
B. Explain that a dry cough is a common adverse effect of
lisinopril and notify the provider.
C. Instruct the client to take the medication with milk to reduce
,the cough.
D. Tell the client the cough indicates heart failure progression.
Correct Answer
B. Explain that a dry cough is a common adverse effect of
lisinopril and notify the provider.
Detailed Rationale
ACE inhibitors such as lisinopril commonly cause a persistent
dry cough due to increased bradykinin levels. Although not
usually dangerous, the cough may affect adherence and often
prompts consideration of an alternative medication such as an
angiotensin II receptor blocker (ARB). The nurse should educate
the client and communicate the finding to the provider.
Option A is incorrect because abrupt discontinuation without
provider guidance may worsen blood pressure control. Option C
is incorrect because taking lisinopril with milk does not prevent
ACE inhibitor-induced cough. Option D is incorrect because a
dry cough related to lisinopril is not evidence of worsening
heart failure.
Nurses should also monitor renal function, serum potassium,
and blood pressure during ACE inhibitor therapy. Patients
should be instructed to report facial swelling or difficulty
breathing, which may indicate angioedema.
Learning Objective
,After completing this question, the learner should be able to:
• Recognize common adverse effects of ACE inhibitors.
• Differentiate medication side effects from disease
progression.
• Identify appropriate nursing interventions for medication-
related complaints.
• Educate patients regarding ACE inhibitor therapy.
Medication Safety Focus
Adverse effect monitoring
Question 2
Clinical Scenario
A 76-year-old woman with chronic atrial fibrillation takes
warfarin daily. Morning laboratory results reveal an INR of 5.8.
She reports bleeding gums when brushing her teeth.
Question Stem
Which action should the nurse take first?
A. Administer the scheduled warfarin dose.
B. Encourage increased intake of leafy green vegetables.
C. Hold the medication and notify the provider.
D. Document the findings and reassess in 24 hours.
, Correct Answer
C. Hold the medication and notify the provider.
Detailed Rationale
An INR of 5.8 is significantly above the therapeutic range for
most indications and increases the risk of serious bleeding.
Bleeding gums further suggest excessive anticoagulation. The
nurse should withhold warfarin and notify the provider
immediately. Additional interventions may include repeat INR
testing or administration of vitamin K depending on the clinical
situation.
Option A would increase bleeding risk. Option B may eventually
lower INR but is not the priority intervention. Option D delays
treatment of a potentially dangerous situation.
Warfarin is a high-alert medication requiring careful monitoring
of INR values, bleeding signs, drug interactions, and dietary
consistency.
Learning Objective
After completing this question, the learner should be able to:
• Interpret INR values during warfarin therapy.
• Identify signs of excessive anticoagulation.
• Prioritize nursing actions for abnormal laboratory results.
• Recognize bleeding risks associated with warfarin.
Questions |
5 Original NCLEX-Style MCQs with Rationales |
ATI Pharmacology Made Easy Review |
Nursing Pharmacology Test Bank Study Guide
Question 1
Clinical Scenario
A 58-year-old man with newly diagnosed hypertension is
prescribed lisinopril. During a follow-up visit 2 weeks later, his
blood pressure is 132/78 mm Hg. He reports a persistent dry
cough that began after starting the medication.
Question Stem
Which nursing response is most appropriate?
A. Advise the client to stop the medication immediately and
avoid all antihypertensives.
B. Explain that a dry cough is a common adverse effect of
lisinopril and notify the provider.
C. Instruct the client to take the medication with milk to reduce
,the cough.
D. Tell the client the cough indicates heart failure progression.
Correct Answer
B. Explain that a dry cough is a common adverse effect of
lisinopril and notify the provider.
Detailed Rationale
ACE inhibitors such as lisinopril commonly cause a persistent
dry cough due to increased bradykinin levels. Although not
usually dangerous, the cough may affect adherence and often
prompts consideration of an alternative medication such as an
angiotensin II receptor blocker (ARB). The nurse should educate
the client and communicate the finding to the provider.
Option A is incorrect because abrupt discontinuation without
provider guidance may worsen blood pressure control. Option C
is incorrect because taking lisinopril with milk does not prevent
ACE inhibitor-induced cough. Option D is incorrect because a
dry cough related to lisinopril is not evidence of worsening
heart failure.
Nurses should also monitor renal function, serum potassium,
and blood pressure during ACE inhibitor therapy. Patients
should be instructed to report facial swelling or difficulty
breathing, which may indicate angioedema.
Learning Objective
,After completing this question, the learner should be able to:
• Recognize common adverse effects of ACE inhibitors.
• Differentiate medication side effects from disease
progression.
• Identify appropriate nursing interventions for medication-
related complaints.
• Educate patients regarding ACE inhibitor therapy.
Medication Safety Focus
Adverse effect monitoring
Question 2
Clinical Scenario
A 76-year-old woman with chronic atrial fibrillation takes
warfarin daily. Morning laboratory results reveal an INR of 5.8.
She reports bleeding gums when brushing her teeth.
Question Stem
Which action should the nurse take first?
A. Administer the scheduled warfarin dose.
B. Encourage increased intake of leafy green vegetables.
C. Hold the medication and notify the provider.
D. Document the findings and reassess in 24 hours.
, Correct Answer
C. Hold the medication and notify the provider.
Detailed Rationale
An INR of 5.8 is significantly above the therapeutic range for
most indications and increases the risk of serious bleeding.
Bleeding gums further suggest excessive anticoagulation. The
nurse should withhold warfarin and notify the provider
immediately. Additional interventions may include repeat INR
testing or administration of vitamin K depending on the clinical
situation.
Option A would increase bleeding risk. Option B may eventually
lower INR but is not the priority intervention. Option D delays
treatment of a potentially dangerous situation.
Warfarin is a high-alert medication requiring careful monitoring
of INR values, bleeding signs, drug interactions, and dietary
consistency.
Learning Objective
After completing this question, the learner should be able to:
• Interpret INR values during warfarin therapy.
• Identify signs of excessive anticoagulation.
• Prioritize nursing actions for abnormal laboratory results.
• Recognize bleeding risks associated with warfarin.
