NUR 100 Pharmacology Exam 3 | Fortis College 2026/2027 Complete Review Questions with Correct Answers
NUR 100 Pharmacology
Exam 3 - Fortis College 2026/2027
Review Questions and Correct Answers - Graded A+
80 Questions | Multiple Choice | Fortis College NUR 100 Exam 3 Format
Cognitive Levels: 30% Recall | 50% Application | 20% Analysis
Section 1: Cardiovascular Pharmacology (Q1 - Q25)
Q1: A nurse is administering lisinopril to a patient with hypertension. Which instruction should the nurse include in the discharge
teaching?
A. Increase potassium-rich foods in the diet
B. Monitor for a persistent dry cough [CORRECT]
C. Expect bradycardia within the first week
D. Take the medication with meals to reduce GI upset
Correct Answer: B
Rationale: Lisinopril is an ACE inhibitor that blocks the conversion of angiotensin I to angiotensin II, preventing bradykinin breakdown.
Accumulation of bradykinin in the lungs causes a persistent dry cough in up to 20% of patients, which is a well-documented adverse effect.
Increasing potassium-rich foods is incorrect because ACE inhibitors cause potassium retention, increasing the risk of hyperkalemia. Bradycardia is
not a typical adverse effect of ACE inhibitors. Lisinopril can be taken without regard to meals.
Q2: A patient prescribed losartan asks the nurse how this medication works. What is the best response by the nurse?
A. It blocks angiotensin-converting enzyme, reducing blood pressure
B. It selectively blocks angiotensin II receptors, causing vasodilation [CORRECT]
C. It prevents calcium from entering cardiac and smooth muscle cells
D. It slows the heart rate to decrease cardiac output and BP
Correct Answer: B
Rationale: Losartan is an angiotensin II receptor blocker (ARB) that selectively blocks the AT1 receptor, preventing angiotensin II from binding and
causing vasoconstriction. Blocking ACE is the mechanism of ACE inhibitors like lisinopril, not ARBs. Calcium channel blockade is the mechanism of
drugs like amlodipine. Slowing heart rate describes beta-blocker activity, such as metoprolol. ARBs are often prescribed when a patient develops an
ACE inhibitor cough.
Q3: A patient receiving amlodipine reports swelling in both ankles. What is the most appropriate nursing action?
A. Hold the medication and notify the provider immediately
B. Instruct the patient to elevate the legs and wear compression stockings [CORRECT]
C. Administer a dose of furosemide to reduce the edema
D. Document the finding as an expected side effect and continue monitoring
Correct Answer: B
Rationale: Amlodipine is a dihydropyridine calcium channel blocker (CCB) that causes peripheral vasodilation, leading to dose-dependent pedal
edema in approximately 10% of patients. This is not a sign of fluid overload but rather capillary leakage due to precapillary vasodilation. The nurse
should implement conservative measures such as leg elevation and compression stockings. Holding the medication and notifying the provider is
premature for a known, common side effect. Furosemide is not indicated for CCB-induced edema since the mechanism is not fluid retention.
Page 1
,NUR 100 Pharmacology Exam 3 | Fortis College 2026/2027 Complete Review Questions with Correct Answers
Q4: A nurse is caring for a patient who is taking metoprolol. Which finding requires immediate intervention?
A. Heart rate 58 bpm
B. Blood pressure 102/64 mmHg
C. Respiratory rate 10 breaths/min [CORRECT]
D. Blood glucose 90 mg/dL
Correct Answer: C
Rationale: Metoprolol is a cardioselective beta-1 blocker that reduces heart rate and myocardial contractility. A respiratory rate of 10 breaths/min
indicates bradypnea and possible respiratory depression, which requires immediate intervention, especially in patients with asthma or COPD because
beta-blockers can cause bronchoconstriction even with cardioselective agents at higher doses. A heart rate of 58 bpm and BP of 102/64 mmHg are
expected therapeutic effects. Blood glucose of 90 mg/dL is within normal limits.
Q5: A patient with angina is prescribed sublingual nitroglycerin. The nurse teaches the patient to take up to how many tablets, 5
minutes apart, before calling 911?
A. One tablet
B. Two tablets
C. Three tablets [CORRECT]
D. Four tablets
Correct Answer: C
Rationale: The standard teaching for sublingual nitroglycerin is to take one tablet at the onset of chest pain, and if pain is not relieved after 5
minutes, call 911 immediately. However, current ACLS guidelines allow up to three tablets 5 minutes apart (for a total of three doses over 15
minutes) before activating emergency services. Taking only one or two tablets is insufficient per current evidence-based guidelines. Four tablets
exceeds the recommended maximum before seeking emergency care. Nitroglycerin causes venous and coronary vasodilation, reducing myocardial
oxygen demand.
Q6: A patient is receiving digoxin for heart failure. The nurse reviews the morning lab results and notes a serum digoxin level of 2.5
ng/mL and a serum potassium level of 3.0 mEq/L. Which action should the nurse take first?
A. Administer the next scheduled dose of digoxin
B. Give potassium supplements and hold digoxin
C. Prepare to administer digoxin immune Fab (Digibind) [CORRECT]
D. Check the apical pulse for a full 1 minute
Correct Answer: C
Rationale: The therapeutic range for digoxin is 0.5 to 2.0 ng/mL, so a level of 2.5 ng/mL indicates digoxin toxicity. The concurrent hypokalemia
(normal 3.5-5.0 mEq/L) further increases the risk of digoxin toxicity because potassium competes with digoxin at the Na+/K+-ATPase pump. With a
significantly elevated level and hypokalemia, the nurse should prepare to administer digoxin immune Fab (Digibind), which binds free digoxin and
prevents it from acting on cardiac tissue. Checking the apical pulse is important but not the first priority when the lab value clearly indicates toxicity.
Q7: Which adverse effect of diltiazem should the nurse prioritize when monitoring a patient receiving this medication?
A. Hypertension
B. Tachycardia
C. Bradycardia and AV block [CORRECT]
D. Hyperkalemia
Correct Answer: C
Rationale: Diltiazem is a non-dihydropyridine calcium channel blocker that primarily acts on cardiac tissue, slowing AV nodal conduction and
decreasing heart rate. The most significant adverse effects are bradycardia and atrioventricular (AV) block, which can progress to life-threatening
heart block. Diltiazem lowers blood pressure rather than causing hypertension. It decreases heart rate, not increases it. Diltiazem does not
significantly affect potassium levels. Nurses should monitor the ECG and heart rate closely during diltiazem therapy.
Page 2
, NUR 100 Pharmacology Exam 3 | Fortis College 2026/2027 Complete Review Questions with Correct Answers
Q8: A patient on warfarin therapy has an INR of 5.2. The patient is not actively bleeding. What is the most appropriate nursing
action?
A. Administer vitamin K intravenously immediately
B. Hold the next dose of warfarin and notify the provider [CORRECT]
C. Administer fresh frozen plasma
D. Increase the warfarin dose to achieve therapeutic range
Correct Answer: B
Rationale: The therapeutic INR range for most indications is 2.0-3.0, and an INR of 5.2 is significantly elevated but without active bleeding, the
priority is to hold the next dose of warfarin and notify the provider for further instructions. IV vitamin K and fresh frozen plasma are reserved for
actively bleeding patients or INR values above 10 with no bleeding. Increasing the warfarin dose would worsen the coagulopathy and is
contraindicated. The nurse should also assess for signs of bleeding such as bruising, hematuria, or melena.
Q9: A nurse is caring for a patient receiving a continuous heparin infusion. The aPTT result is 45 seconds. What should the nurse
anticipate?
A. The dose is therapeutic; continue current infusion
B. The dose is subtherapeutic; anticipate an increase in the infusion rate [CORRECT]
C. The dose is supratherapeutic; anticipate a decrease in the infusion rate
D. Discontinue the heparin infusion immediately
Correct Answer: B
Rationale: The therapeutic aPTT range for heparin therapy is typically 1.5 to 2.5 times the control value, which is approximately 60-80 seconds for
most institutions. An aPTT of 45 seconds is below the therapeutic range, meaning the patient is at risk for thrombus formation. The nurse should
anticipate that the provider will order an increase in the heparin infusion rate per the institutional weight-based protocol. Continuing the current dose
leaves the patient subtherapeutic. The dose is not supratherapeutic, so decreasing it is wrong. Discontinuing heparin is only indicated for severe
over-anticoagulation or bleeding.
Q10: A patient taking enoxaparin (Lovenox) asks why they cannot take it by mouth. What is the best explanation by the nurse?
A. It is destroyed by stomach acid
B. It is too large a molecule to be absorbed in the GI tract [CORRECT]
C. It is inactivated by first-pass metabolism in the liver
D. It causes severe GI irritation when taken orally
Correct Answer: B
Rationale: Enoxaparin is a low-molecular-weight heparin (LMWH) that cannot be administered orally because it is a large, highly polar molecule
that is not absorbed from the gastrointestinal tract. All heparin products, including unfractionated heparin and LMWHs, must be given parenterally
(subcutaneously or intravenously). Being destroyed by stomach acid or first-pass metabolism describes the fate of some other medications but not the
primary reason heparin cannot be given orally. GI irritation is not the relevant concern here.
Q11: A nurse is teaching a patient about apixaban (Eliquis). Which statement by the patient indicates an understanding of the
teaching?
A. I will need weekly blood tests to check my INR
B. I should take this medication with food to improve absorption
C. I will report any unusual bleeding or bruising to my provider [CORRECT]
D. I can stop taking this medication when I feel better
Correct Answer: C
Rationale: Apixaban is a direct oral anticoagulant (DOAC) that inhibits factor Xa. Unlike warfarin, DOACs do not require routine INR or aPTT
monitoring, making weekly blood tests unnecessary. Apixaban does not require food for absorption; in fact, bioavailability is decreased with high-fat
meals for some DOACs. The most critical teaching point is to report unusual bleeding or bruising, as all anticoagulants carry a bleeding risk.
Anticoagulants should never be discontinued abruptly without provider guidance, as this increases thrombotic risk.
Page 3
NUR 100 Pharmacology
Exam 3 - Fortis College 2026/2027
Review Questions and Correct Answers - Graded A+
80 Questions | Multiple Choice | Fortis College NUR 100 Exam 3 Format
Cognitive Levels: 30% Recall | 50% Application | 20% Analysis
Section 1: Cardiovascular Pharmacology (Q1 - Q25)
Q1: A nurse is administering lisinopril to a patient with hypertension. Which instruction should the nurse include in the discharge
teaching?
A. Increase potassium-rich foods in the diet
B. Monitor for a persistent dry cough [CORRECT]
C. Expect bradycardia within the first week
D. Take the medication with meals to reduce GI upset
Correct Answer: B
Rationale: Lisinopril is an ACE inhibitor that blocks the conversion of angiotensin I to angiotensin II, preventing bradykinin breakdown.
Accumulation of bradykinin in the lungs causes a persistent dry cough in up to 20% of patients, which is a well-documented adverse effect.
Increasing potassium-rich foods is incorrect because ACE inhibitors cause potassium retention, increasing the risk of hyperkalemia. Bradycardia is
not a typical adverse effect of ACE inhibitors. Lisinopril can be taken without regard to meals.
Q2: A patient prescribed losartan asks the nurse how this medication works. What is the best response by the nurse?
A. It blocks angiotensin-converting enzyme, reducing blood pressure
B. It selectively blocks angiotensin II receptors, causing vasodilation [CORRECT]
C. It prevents calcium from entering cardiac and smooth muscle cells
D. It slows the heart rate to decrease cardiac output and BP
Correct Answer: B
Rationale: Losartan is an angiotensin II receptor blocker (ARB) that selectively blocks the AT1 receptor, preventing angiotensin II from binding and
causing vasoconstriction. Blocking ACE is the mechanism of ACE inhibitors like lisinopril, not ARBs. Calcium channel blockade is the mechanism of
drugs like amlodipine. Slowing heart rate describes beta-blocker activity, such as metoprolol. ARBs are often prescribed when a patient develops an
ACE inhibitor cough.
Q3: A patient receiving amlodipine reports swelling in both ankles. What is the most appropriate nursing action?
A. Hold the medication and notify the provider immediately
B. Instruct the patient to elevate the legs and wear compression stockings [CORRECT]
C. Administer a dose of furosemide to reduce the edema
D. Document the finding as an expected side effect and continue monitoring
Correct Answer: B
Rationale: Amlodipine is a dihydropyridine calcium channel blocker (CCB) that causes peripheral vasodilation, leading to dose-dependent pedal
edema in approximately 10% of patients. This is not a sign of fluid overload but rather capillary leakage due to precapillary vasodilation. The nurse
should implement conservative measures such as leg elevation and compression stockings. Holding the medication and notifying the provider is
premature for a known, common side effect. Furosemide is not indicated for CCB-induced edema since the mechanism is not fluid retention.
Page 1
,NUR 100 Pharmacology Exam 3 | Fortis College 2026/2027 Complete Review Questions with Correct Answers
Q4: A nurse is caring for a patient who is taking metoprolol. Which finding requires immediate intervention?
A. Heart rate 58 bpm
B. Blood pressure 102/64 mmHg
C. Respiratory rate 10 breaths/min [CORRECT]
D. Blood glucose 90 mg/dL
Correct Answer: C
Rationale: Metoprolol is a cardioselective beta-1 blocker that reduces heart rate and myocardial contractility. A respiratory rate of 10 breaths/min
indicates bradypnea and possible respiratory depression, which requires immediate intervention, especially in patients with asthma or COPD because
beta-blockers can cause bronchoconstriction even with cardioselective agents at higher doses. A heart rate of 58 bpm and BP of 102/64 mmHg are
expected therapeutic effects. Blood glucose of 90 mg/dL is within normal limits.
Q5: A patient with angina is prescribed sublingual nitroglycerin. The nurse teaches the patient to take up to how many tablets, 5
minutes apart, before calling 911?
A. One tablet
B. Two tablets
C. Three tablets [CORRECT]
D. Four tablets
Correct Answer: C
Rationale: The standard teaching for sublingual nitroglycerin is to take one tablet at the onset of chest pain, and if pain is not relieved after 5
minutes, call 911 immediately. However, current ACLS guidelines allow up to three tablets 5 minutes apart (for a total of three doses over 15
minutes) before activating emergency services. Taking only one or two tablets is insufficient per current evidence-based guidelines. Four tablets
exceeds the recommended maximum before seeking emergency care. Nitroglycerin causes venous and coronary vasodilation, reducing myocardial
oxygen demand.
Q6: A patient is receiving digoxin for heart failure. The nurse reviews the morning lab results and notes a serum digoxin level of 2.5
ng/mL and a serum potassium level of 3.0 mEq/L. Which action should the nurse take first?
A. Administer the next scheduled dose of digoxin
B. Give potassium supplements and hold digoxin
C. Prepare to administer digoxin immune Fab (Digibind) [CORRECT]
D. Check the apical pulse for a full 1 minute
Correct Answer: C
Rationale: The therapeutic range for digoxin is 0.5 to 2.0 ng/mL, so a level of 2.5 ng/mL indicates digoxin toxicity. The concurrent hypokalemia
(normal 3.5-5.0 mEq/L) further increases the risk of digoxin toxicity because potassium competes with digoxin at the Na+/K+-ATPase pump. With a
significantly elevated level and hypokalemia, the nurse should prepare to administer digoxin immune Fab (Digibind), which binds free digoxin and
prevents it from acting on cardiac tissue. Checking the apical pulse is important but not the first priority when the lab value clearly indicates toxicity.
Q7: Which adverse effect of diltiazem should the nurse prioritize when monitoring a patient receiving this medication?
A. Hypertension
B. Tachycardia
C. Bradycardia and AV block [CORRECT]
D. Hyperkalemia
Correct Answer: C
Rationale: Diltiazem is a non-dihydropyridine calcium channel blocker that primarily acts on cardiac tissue, slowing AV nodal conduction and
decreasing heart rate. The most significant adverse effects are bradycardia and atrioventricular (AV) block, which can progress to life-threatening
heart block. Diltiazem lowers blood pressure rather than causing hypertension. It decreases heart rate, not increases it. Diltiazem does not
significantly affect potassium levels. Nurses should monitor the ECG and heart rate closely during diltiazem therapy.
Page 2
, NUR 100 Pharmacology Exam 3 | Fortis College 2026/2027 Complete Review Questions with Correct Answers
Q8: A patient on warfarin therapy has an INR of 5.2. The patient is not actively bleeding. What is the most appropriate nursing
action?
A. Administer vitamin K intravenously immediately
B. Hold the next dose of warfarin and notify the provider [CORRECT]
C. Administer fresh frozen plasma
D. Increase the warfarin dose to achieve therapeutic range
Correct Answer: B
Rationale: The therapeutic INR range for most indications is 2.0-3.0, and an INR of 5.2 is significantly elevated but without active bleeding, the
priority is to hold the next dose of warfarin and notify the provider for further instructions. IV vitamin K and fresh frozen plasma are reserved for
actively bleeding patients or INR values above 10 with no bleeding. Increasing the warfarin dose would worsen the coagulopathy and is
contraindicated. The nurse should also assess for signs of bleeding such as bruising, hematuria, or melena.
Q9: A nurse is caring for a patient receiving a continuous heparin infusion. The aPTT result is 45 seconds. What should the nurse
anticipate?
A. The dose is therapeutic; continue current infusion
B. The dose is subtherapeutic; anticipate an increase in the infusion rate [CORRECT]
C. The dose is supratherapeutic; anticipate a decrease in the infusion rate
D. Discontinue the heparin infusion immediately
Correct Answer: B
Rationale: The therapeutic aPTT range for heparin therapy is typically 1.5 to 2.5 times the control value, which is approximately 60-80 seconds for
most institutions. An aPTT of 45 seconds is below the therapeutic range, meaning the patient is at risk for thrombus formation. The nurse should
anticipate that the provider will order an increase in the heparin infusion rate per the institutional weight-based protocol. Continuing the current dose
leaves the patient subtherapeutic. The dose is not supratherapeutic, so decreasing it is wrong. Discontinuing heparin is only indicated for severe
over-anticoagulation or bleeding.
Q10: A patient taking enoxaparin (Lovenox) asks why they cannot take it by mouth. What is the best explanation by the nurse?
A. It is destroyed by stomach acid
B. It is too large a molecule to be absorbed in the GI tract [CORRECT]
C. It is inactivated by first-pass metabolism in the liver
D. It causes severe GI irritation when taken orally
Correct Answer: B
Rationale: Enoxaparin is a low-molecular-weight heparin (LMWH) that cannot be administered orally because it is a large, highly polar molecule
that is not absorbed from the gastrointestinal tract. All heparin products, including unfractionated heparin and LMWHs, must be given parenterally
(subcutaneously or intravenously). Being destroyed by stomach acid or first-pass metabolism describes the fate of some other medications but not the
primary reason heparin cannot be given orally. GI irritation is not the relevant concern here.
Q11: A nurse is teaching a patient about apixaban (Eliquis). Which statement by the patient indicates an understanding of the
teaching?
A. I will need weekly blood tests to check my INR
B. I should take this medication with food to improve absorption
C. I will report any unusual bleeding or bruising to my provider [CORRECT]
D. I can stop taking this medication when I feel better
Correct Answer: C
Rationale: Apixaban is a direct oral anticoagulant (DOAC) that inhibits factor Xa. Unlike warfarin, DOACs do not require routine INR or aPTT
monitoring, making weekly blood tests unnecessary. Apixaban does not require food for absorption; in fact, bioavailability is decreased with high-fat
meals for some DOACs. The most critical teaching point is to report unusual bleeding or bruising, as all anticoagulants carry a bleeding risk.
Anticoagulants should never be discontinued abruptly without provider guidance, as this increases thrombotic risk.
Page 3
