NCLEX-RN Cardiovascular Pharmacology Exam
|
20 NGN-Style Practice Questions with Detailed
Rationales |
ATI Pharmacology Made Easy Inspired |
Nursing Pharmacology Study Guide |
RN Exam Prep PDF
Question 1
Clinical Scenario
A 67-year-old man with hypertension, stable angina, and a
history of myocardial infarction is admitted for routine follow-
up. His current medications include aspirin, atorvastatin,
lisinopril, and metoprolol. Before administering the morning
medications, the nurse obtains the following assessment:
• Blood pressure: 118/72 mm Hg
• Heart rate: 48 beats/min
, • Respiratory rate: 16 breaths/min
• Oxygen saturation: 98% on room air
• The client reports feeling dizzy when standing but denies
chest pain or shortness of breath.
Question Stem
Which nursing action is most appropriate?
A. Administer the metoprolol as prescribed and reassess in 30
minutes.
B. Hold the metoprolol and notify the healthcare provider.
C. Administer metoprolol with food to minimize dizziness.
D. Encourage the client to ambulate before taking the
medication.
Correct Answer
Correct Answer: B. Hold the metoprolol and notify the
healthcare provider.
Detailed Rationale
Metoprolol is a cardioselective beta₁-adrenergic blocker that
decreases heart rate, myocardial contractility, and blood
pressure, reducing cardiac workload and oxygen demand.
Before administration, nurses must assess heart rate and blood
pressure because excessive beta blockade may result in
,symptomatic bradycardia. This client has a heart rate of 48
beats/min accompanied by dizziness, indicating inadequate
cardiac output. Holding the medication and notifying the
provider is the safest intervention to prevent worsening
bradycardia, hypotension, syncope, or reduced organ perfusion.
Option A is incorrect because administering metoprolol despite
symptomatic bradycardia may further slow the heart rate and
increase the risk for hemodynamic instability.
Option C is incorrect because taking metoprolol with food may
improve absorption consistency but does not address clinically
significant bradycardia.
Option D is incorrect because ambulating a dizzy patient before
evaluating the cause increases the risk of falls and injury.
The nurse should continue monitoring vital signs, assess for
signs of poor perfusion (confusion, chest pain, cool extremities),
review concurrent medications that may lower heart rate, and
educate the client never to discontinue beta blockers abruptly
because rebound hypertension, angina, or myocardial infarction
may occur.
Learning Objectives
After completing this question, the learner should be able to:
• Recognize when beta blockers should be withheld.
• Assess for manifestations of symptomatic bradycardia.
, • Prioritize nursing interventions before medication
administration.
• Apply safe medication administration principles.
Medication Safety Focus
Monitoring
Question 2
Clinical Scenario
A 58-year-old woman with newly diagnosed hypertension is
prescribed lisinopril. During discharge teaching, the nurse
reviews common adverse effects, home monitoring, and follow-
up care. The client asks which symptoms should prompt
immediate notification of the healthcare provider.
Question Stem
Which client statement indicates the need for immediate
medical evaluation?
A. "I notice a dry cough that started after taking the
medication."
B. "My blood pressure has gradually improved."
C. "My lips suddenly became swollen this morning."
D. "I occasionally feel tired after taking the medication."
|
20 NGN-Style Practice Questions with Detailed
Rationales |
ATI Pharmacology Made Easy Inspired |
Nursing Pharmacology Study Guide |
RN Exam Prep PDF
Question 1
Clinical Scenario
A 67-year-old man with hypertension, stable angina, and a
history of myocardial infarction is admitted for routine follow-
up. His current medications include aspirin, atorvastatin,
lisinopril, and metoprolol. Before administering the morning
medications, the nurse obtains the following assessment:
• Blood pressure: 118/72 mm Hg
• Heart rate: 48 beats/min
, • Respiratory rate: 16 breaths/min
• Oxygen saturation: 98% on room air
• The client reports feeling dizzy when standing but denies
chest pain or shortness of breath.
Question Stem
Which nursing action is most appropriate?
A. Administer the metoprolol as prescribed and reassess in 30
minutes.
B. Hold the metoprolol and notify the healthcare provider.
C. Administer metoprolol with food to minimize dizziness.
D. Encourage the client to ambulate before taking the
medication.
Correct Answer
Correct Answer: B. Hold the metoprolol and notify the
healthcare provider.
Detailed Rationale
Metoprolol is a cardioselective beta₁-adrenergic blocker that
decreases heart rate, myocardial contractility, and blood
pressure, reducing cardiac workload and oxygen demand.
Before administration, nurses must assess heart rate and blood
pressure because excessive beta blockade may result in
,symptomatic bradycardia. This client has a heart rate of 48
beats/min accompanied by dizziness, indicating inadequate
cardiac output. Holding the medication and notifying the
provider is the safest intervention to prevent worsening
bradycardia, hypotension, syncope, or reduced organ perfusion.
Option A is incorrect because administering metoprolol despite
symptomatic bradycardia may further slow the heart rate and
increase the risk for hemodynamic instability.
Option C is incorrect because taking metoprolol with food may
improve absorption consistency but does not address clinically
significant bradycardia.
Option D is incorrect because ambulating a dizzy patient before
evaluating the cause increases the risk of falls and injury.
The nurse should continue monitoring vital signs, assess for
signs of poor perfusion (confusion, chest pain, cool extremities),
review concurrent medications that may lower heart rate, and
educate the client never to discontinue beta blockers abruptly
because rebound hypertension, angina, or myocardial infarction
may occur.
Learning Objectives
After completing this question, the learner should be able to:
• Recognize when beta blockers should be withheld.
• Assess for manifestations of symptomatic bradycardia.
, • Prioritize nursing interventions before medication
administration.
• Apply safe medication administration principles.
Medication Safety Focus
Monitoring
Question 2
Clinical Scenario
A 58-year-old woman with newly diagnosed hypertension is
prescribed lisinopril. During discharge teaching, the nurse
reviews common adverse effects, home monitoring, and follow-
up care. The client asks which symptoms should prompt
immediate notification of the healthcare provider.
Question Stem
Which client statement indicates the need for immediate
medical evaluation?
A. "I notice a dry cough that started after taking the
medication."
B. "My blood pressure has gradually improved."
C. "My lips suddenly became swollen this morning."
D. "I occasionally feel tired after taking the medication."
