NU 578 Exam 3 Mastery Guide: 200
Board-Style Questions Covering
Cardiovascular, Respiratory, CNS,
Endocrine, Anti-Infective, and GI
Pharmacology with Detailed
Rationales
SECTION 1: CARDIOVASCULAR PHARMACOLOGY – HYPERTENSION &
RAAS (Questions 1–25)
1. Which mechanism is responsible for primary hypertension?
A. Single gene mutation
B. Multifactorial interaction of genetics and environment
C. Infection
D. Trauma
Correct Answer: B
Rationale: Primary hypertension has no single cause; it results from a
complex interaction between genetic predisposition and environmental or
lifestyle factors such as diet, stress, and physical inactivity.
,2. The most important long-term regulator of blood pressure is the:
A. Heart
B. Kidneys
C. Brain
D. Lungs
Correct Answer: B
Rationale: The kidneys are central to long-term blood pressure control
because they regulate blood volume and sodium balance through the
renin-angiotensin-aldosterone system (RAAS).
3. Activation of the RAAS system results in:
A. Vasodilation
B. Sodium excretion
C. Vasoconstriction and fluid retention
D. Decreased blood pressure
Correct Answer: C
Rationale: RAAS increases blood pressure via vasoconstriction (angiotensin
II) and sodium/water retention (aldosterone-mediated).
4. ACE inhibitors work by:
A. Increasing angiotensin II
B. Blocking conversion of angiotensin I to angiotensin II
, C. Increasing aldosterone
D. Stimulating renin
Correct Answer: B
Rationale: ACE inhibitors block the conversion of angiotensin I to
angiotensin II, leading to vasodilation, decreased aldosterone, and reduced
blood pressure.
5. When comparing ACE inhibitors to Angiotensin Receptor Blockers
(ARBs), the NP knows that:
A. Both are equally likely to cause hyperkalemia
B. ARBs, but not ACE inhibitors, are considered safe to use throughout
pregnancy
C. Both ACE inhibitors and ARBs may cause renal failure in a patient
with bilateral renal stenosis
D. ACE inhibitors are less likely to cause angioedema than ARBs
Correct Answer: C
Rationale: Both drug classes inhibit the RAAS and can reduce glomerular
filtration pressure in patients with bilateral renal artery stenosis, leading to
acute renal failure. Neither is safe in pregnancy, and ACE inhibitors are
more likely than ARBs to cause angioedema.
6. A patient on lisinopril develops a persistent dry cough. The most
appropriate next step is to:
, A. Add a beta-blocker
B. Switch to an ARB
C. Increase the lisinopril dose
D. Add a diuretic
Correct Answer: B
Rationale: ACE inhibitors commonly cause a dry cough due to
accumulation of bradykinin. Switching to an ARB is appropriate because
ARBs do not affect bradykinin metabolism.
7. Which laboratory value should be monitored closely in patients
taking ACE inhibitors or ARBs?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B
Rationale: ACE inhibitors and ARBs can cause hyperkalemia by reducing
aldosterone secretion, which decreases potassium excretion.
8. Aliskiren is classified as a:
A. ACE inhibitor
B. ARB
Board-Style Questions Covering
Cardiovascular, Respiratory, CNS,
Endocrine, Anti-Infective, and GI
Pharmacology with Detailed
Rationales
SECTION 1: CARDIOVASCULAR PHARMACOLOGY – HYPERTENSION &
RAAS (Questions 1–25)
1. Which mechanism is responsible for primary hypertension?
A. Single gene mutation
B. Multifactorial interaction of genetics and environment
C. Infection
D. Trauma
Correct Answer: B
Rationale: Primary hypertension has no single cause; it results from a
complex interaction between genetic predisposition and environmental or
lifestyle factors such as diet, stress, and physical inactivity.
,2. The most important long-term regulator of blood pressure is the:
A. Heart
B. Kidneys
C. Brain
D. Lungs
Correct Answer: B
Rationale: The kidneys are central to long-term blood pressure control
because they regulate blood volume and sodium balance through the
renin-angiotensin-aldosterone system (RAAS).
3. Activation of the RAAS system results in:
A. Vasodilation
B. Sodium excretion
C. Vasoconstriction and fluid retention
D. Decreased blood pressure
Correct Answer: C
Rationale: RAAS increases blood pressure via vasoconstriction (angiotensin
II) and sodium/water retention (aldosterone-mediated).
4. ACE inhibitors work by:
A. Increasing angiotensin II
B. Blocking conversion of angiotensin I to angiotensin II
, C. Increasing aldosterone
D. Stimulating renin
Correct Answer: B
Rationale: ACE inhibitors block the conversion of angiotensin I to
angiotensin II, leading to vasodilation, decreased aldosterone, and reduced
blood pressure.
5. When comparing ACE inhibitors to Angiotensin Receptor Blockers
(ARBs), the NP knows that:
A. Both are equally likely to cause hyperkalemia
B. ARBs, but not ACE inhibitors, are considered safe to use throughout
pregnancy
C. Both ACE inhibitors and ARBs may cause renal failure in a patient
with bilateral renal stenosis
D. ACE inhibitors are less likely to cause angioedema than ARBs
Correct Answer: C
Rationale: Both drug classes inhibit the RAAS and can reduce glomerular
filtration pressure in patients with bilateral renal artery stenosis, leading to
acute renal failure. Neither is safe in pregnancy, and ACE inhibitors are
more likely than ARBs to cause angioedema.
6. A patient on lisinopril develops a persistent dry cough. The most
appropriate next step is to:
, A. Add a beta-blocker
B. Switch to an ARB
C. Increase the lisinopril dose
D. Add a diuretic
Correct Answer: B
Rationale: ACE inhibitors commonly cause a dry cough due to
accumulation of bradykinin. Switching to an ARB is appropriate because
ARBs do not affect bradykinin metabolism.
7. Which laboratory value should be monitored closely in patients
taking ACE inhibitors or ARBs?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B
Rationale: ACE inhibitors and ARBs can cause hyperkalemia by reducing
aldosterone secretion, which decreases potassium excretion.
8. Aliskiren is classified as a:
A. ACE inhibitor
B. ARB
