,NSG 124 Pharmacology Exam 3 | Herzing
University | Latest 2026/2027 Actual(PDF)
1. A client newly prescribed an ACE inhibitor asks the nurse how the medication works. Which
statement by the nurse is most accurate regarding the mechanism of action?
A) "It blocks the conversion of angiotensin I to angiotensin II."
B) "It blocks the actions of angiotensin II at the receptor site."
C) "It promotes vasodilation by blocking calcium channels."
D) "It inhibits the reabsorption of sodium in the distal tubule."
Correct Answer: "It blocks the conversion of angiotensin I to angiotensin II."
Rationale: ACE inhibitors (e.g., lisinopril, enalapril) prevent the conversion of angiotensin I to
angiotensin II by inhibiting the angiotensin-converting enzyme. This reduces vasoconstriction and
aldosterone secretion, lowering blood pressure. ARBs block angiotensin II at the receptor site, CCBs
block calcium channels, and diuretics inhibit sodium reabsorption.
2. A client taking an ACE inhibitor reports a persistent, dry, nonproductive cough. Which nursing
action is most appropriate?
A) Instruct the client to take an over-the-counter cough suppressant
B) Reassure the client that this is a common side effect and may require a medication change
C) Advise the client to stop the medication immediately
D) Schedule a chest X-ray to rule out pneumonia
Correct Answer: Reassure the client that this is a common side effect and may require a medication
change
Rationale: A persistent dry cough is a common adverse effect of ACE inhibitors, thought to be related
to bradykinin accumulation. The cough is not harmful but can be bothersome; the provider may
switch to an ARB if it becomes intolerable. The client should not stop the medication abruptly without
provider guidance.
,3. A client is prescribed an ARB (angiotensin II receptor blocker) for hypertension. Which medication is
classified as an ARB?
A) Lisinopril
B) Losartan
C) Amlodipine
D) Metoprolol
Correct Answer: Losartan
Rationale: Losartan is an ARB that blocks the actions of angiotensin II at the receptor site. Lisinopril is
an ACE inhibitor, amlodipine is a calcium channel blocker, and metoprolol is a beta-blocker. ARBs are
often used as an alternative for clients who cannot tolerate ACE inhibitors due to cough.
4. A nurse is monitoring a client taking an ACE inhibitor. Which laboratory value should be reported to
the provider immediately?
A) Serum potassium of 5.8 mEq/L
B) Serum sodium of 140 mEq/L
C) BUN of 12 mg/dL
D) Creatinine of 0.8 mg/dL
Correct Answer: Serum potassium of 5.8 mEq/L
Rationale: ACE inhibitors can cause hyperkalemia by reducing aldosterone secretion. Normal
potassium is 3.5-5.0 mEq/L; 5.8 mEq/L is elevated and requires provider notification. The other values
are within normal limits.
5. A client prescribed verapamil for angina pectoris reports swelling in the lower legs. Which action
should the nurse take?
A) Administer a diuretic as prescribed
B) Reassure the client that peripheral edema is a common side effect of this medication
C) Discontinue the medication immediately
, D) Elevate the client's legs and apply compression stockings
Correct Answer: Reassure the client that peripheral edema is a common side effect of this medication
Rationale: Peripheral edema (swelling in the legs) is a common side effect of calcium channel blockers
such as verapamil. The nurse should educate the client about this expected effect and encourage
reporting if it becomes severe. Discontinuing the medication without provider guidance is unsafe.
6. A nurse is teaching a client prescribed verapamil. Which statement by the client indicates correct
understanding?
A) "I should take this medication with grapefruit juice to enhance absorption."
B) "I should avoid grapefruit juice while taking this medication."
C) "I can take this medication with any over-the-counter cold medication."
D) "This medication will increase my heart rate."
Correct Answer: "I should avoid grapefruit juice while taking this medication."
Rationale: Grapefruit juice inhibits CYP450 enzymes and can increase serum levels of verapamil,
leading to toxicity. Clients should be advised to avoid grapefruit juice. Cold medications containing
sympathomimetics may interact, and verapamil decreases heart rate, not increases it.
7. A client is prescribed diltiazem (Cardizem) for atrial fibrillation. The nurse understands that this
medication is classified as which type of drug?
A) Beta-blocker
B) Calcium channel blocker
C) ACE inhibitor
D) Antiarrhythmic
Correct Answer: Calcium channel blocker
University | Latest 2026/2027 Actual(PDF)
1. A client newly prescribed an ACE inhibitor asks the nurse how the medication works. Which
statement by the nurse is most accurate regarding the mechanism of action?
A) "It blocks the conversion of angiotensin I to angiotensin II."
B) "It blocks the actions of angiotensin II at the receptor site."
C) "It promotes vasodilation by blocking calcium channels."
D) "It inhibits the reabsorption of sodium in the distal tubule."
Correct Answer: "It blocks the conversion of angiotensin I to angiotensin II."
Rationale: ACE inhibitors (e.g., lisinopril, enalapril) prevent the conversion of angiotensin I to
angiotensin II by inhibiting the angiotensin-converting enzyme. This reduces vasoconstriction and
aldosterone secretion, lowering blood pressure. ARBs block angiotensin II at the receptor site, CCBs
block calcium channels, and diuretics inhibit sodium reabsorption.
2. A client taking an ACE inhibitor reports a persistent, dry, nonproductive cough. Which nursing
action is most appropriate?
A) Instruct the client to take an over-the-counter cough suppressant
B) Reassure the client that this is a common side effect and may require a medication change
C) Advise the client to stop the medication immediately
D) Schedule a chest X-ray to rule out pneumonia
Correct Answer: Reassure the client that this is a common side effect and may require a medication
change
Rationale: A persistent dry cough is a common adverse effect of ACE inhibitors, thought to be related
to bradykinin accumulation. The cough is not harmful but can be bothersome; the provider may
switch to an ARB if it becomes intolerable. The client should not stop the medication abruptly without
provider guidance.
,3. A client is prescribed an ARB (angiotensin II receptor blocker) for hypertension. Which medication is
classified as an ARB?
A) Lisinopril
B) Losartan
C) Amlodipine
D) Metoprolol
Correct Answer: Losartan
Rationale: Losartan is an ARB that blocks the actions of angiotensin II at the receptor site. Lisinopril is
an ACE inhibitor, amlodipine is a calcium channel blocker, and metoprolol is a beta-blocker. ARBs are
often used as an alternative for clients who cannot tolerate ACE inhibitors due to cough.
4. A nurse is monitoring a client taking an ACE inhibitor. Which laboratory value should be reported to
the provider immediately?
A) Serum potassium of 5.8 mEq/L
B) Serum sodium of 140 mEq/L
C) BUN of 12 mg/dL
D) Creatinine of 0.8 mg/dL
Correct Answer: Serum potassium of 5.8 mEq/L
Rationale: ACE inhibitors can cause hyperkalemia by reducing aldosterone secretion. Normal
potassium is 3.5-5.0 mEq/L; 5.8 mEq/L is elevated and requires provider notification. The other values
are within normal limits.
5. A client prescribed verapamil for angina pectoris reports swelling in the lower legs. Which action
should the nurse take?
A) Administer a diuretic as prescribed
B) Reassure the client that peripheral edema is a common side effect of this medication
C) Discontinue the medication immediately
, D) Elevate the client's legs and apply compression stockings
Correct Answer: Reassure the client that peripheral edema is a common side effect of this medication
Rationale: Peripheral edema (swelling in the legs) is a common side effect of calcium channel blockers
such as verapamil. The nurse should educate the client about this expected effect and encourage
reporting if it becomes severe. Discontinuing the medication without provider guidance is unsafe.
6. A nurse is teaching a client prescribed verapamil. Which statement by the client indicates correct
understanding?
A) "I should take this medication with grapefruit juice to enhance absorption."
B) "I should avoid grapefruit juice while taking this medication."
C) "I can take this medication with any over-the-counter cold medication."
D) "This medication will increase my heart rate."
Correct Answer: "I should avoid grapefruit juice while taking this medication."
Rationale: Grapefruit juice inhibits CYP450 enzymes and can increase serum levels of verapamil,
leading to toxicity. Clients should be advised to avoid grapefruit juice. Cold medications containing
sympathomimetics may interact, and verapamil decreases heart rate, not increases it.
7. A client is prescribed diltiazem (Cardizem) for atrial fibrillation. The nurse understands that this
medication is classified as which type of drug?
A) Beta-blocker
B) Calcium channel blocker
C) ACE inhibitor
D) Antiarrhythmic
Correct Answer: Calcium channel blocker
