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NSG 124 – PHARMACOLOGY – EXAM 3 (NCLEX-STYLE)
2026/2027 COMPLETE CURRENT TESTING QUESTIONS
AND CORRECT ANSWERS WITH DETAILED RATIONALES.
PHARMACOLOGY
Prepare for NSG 124 Exam 3 with this focused Pharmacology NCLEX-style study
resource from Herzing University. It is designed to reinforce medication
classifications, pharmacologic principles, adverse effects, safety considerations, and
appropriate nursing interventions. The NCLEX-style format helps you practice
applying pharmacology knowledge to clinical scenarios while strengthening
prioritization and critical-thinking skills. Use this resource alongside your coursework
to review key concepts and build confidence for the exam.
MULTIPLE CHOICE.
Section 1: Cardiovascular Medications – RAA System & Antihypertensives
(Q1–Q25)
1. A client newly prescribed an ACE inhibitor asks the nurse how the
medication works. Which statement by the nurse is most accurate?
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."
Answer: A
Rationale: ACE inhibitors prevent the conversion of angiotensin I to
angiotensin II by inhibiting the angiotensin-converting enzyme, reducing
vasoconstriction and aldosterone secretion.
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.
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C. Advise the client to stop the medication immediately.
D. Schedule a chest X-ray to rule out pneumonia.
Answer: B
Rationale: A persistent dry cough is a common adverse effect of ACE
inhibitors related to bradykinin accumulation; the provider may switch to
an ARB.
3. Which laboratory value should the nurse monitor most closely in a
client taking an ACE inhibitor?
A. Serum sodium.
B. Serum potassium.
C. Serum calcium.
D. Serum magnesium.
Answer: B
Rationale: ACE inhibitors can cause hyperkalemia by reducing
aldosterone secretion, which decreases potassium excretion.
4. A nurse is teaching a client about lisinopril. Which statement by the
client indicates a need for further teaching?
A. "I should rise slowly from a sitting position."
B. "I can use a salt substitute with potassium."
C. "I should report swelling of my face or tongue."
D. "I should avoid taking this medication during pregnancy."
Answer: B
Rationale: Salt substitutes often contain potassium; combined with an
ACE inhibitor, this can cause dangerous hyperkalemia.
5. Which medication is an angiotensin II receptor blocker (ARB)?
A. Lisinopril.
B. Losartan.
C. Metoprolol.
D. Diltiazem.
Answer: B
Rationale: Losartan is an ARB that blocks angiotensin II at the receptor
site, reducing vasoconstriction and aldosterone secretion.
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6. A client on an ARB should be monitored for which adverse effect?
A. Dry cough.
B. Angioedema.
C. Hyperkalemia.
D. Both B and C.
Answer: D
Rationale: ARBs can cause angioedema and hyperkalemia, though the dry
cough is less common than with ACE inhibitors.
7. A nurse is administering the first dose of an ACE inhibitor to a client.
Which action is priority?
A. Monitor blood pressure closely for first-dose hypotension.
B. Administer the medication with a potassium supplement.
C. Encourage the client to increase sodium intake.
D. Hold the medication if the heart rate is below 60.
Answer: A
Rationale: First-dose hypotension is a significant risk with ACE inhibitors;
blood pressure should be monitored closely.
8. Which class of antihypertensive medications works by blocking
calcium channels in vascular smooth muscle?
A. ACE inhibitors.
B. ARBs.
C. Calcium channel blockers.
D. Beta-blockers.
Answer: C
Rationale: Calcium channel blockers (e.g., diltiazem, amlodipine) block
calcium channels, causing vasodilation and reduced blood pressure.
9. A client taking a beta-blocker should be taught to:
A. Stop the medication abruptly if feeling well.
B. Monitor heart rate and blood pressure.
C. Increase caffeine intake to counteract fatigue.
D. Take the medication only when symptomatic.
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Answer: B
Rationale: Beta-blockers can cause bradycardia and hypotension; clients
should monitor heart rate and blood pressure and never stop the
medication abruptly.
10. Which adverse effect is most common with beta-blockers?
A. Tachycardia.
B. Bradycardia.
C. Hypertension.
D. Hyperglycemia.
Answer: B
Rationale: Beta-blockers reduce heart rate and can cause bradycardia.
11. A nurse is teaching a client about metoprolol. Which statement by the
client indicates understanding?
A. "I should take this medication with food."
B. "I can stop taking this medication when my blood pressure is normal."
C. "I should monitor my heart rate before taking this medication."
D. "This medication will increase my heart rate."
Answer: C
Rationale: Metoprolol can cause bradycardia; clients should monitor
heart rate and report rates below 60 beats/min.
12. Which medication is a cardioselective beta-blocker?
A. Propranolol.
B. Metoprolol.
C. Carvedilol.
D. Labetalol.
Answer: B
Rationale: Metoprolol is cardioselective, primarily affecting beta-1
receptors in the heart.
13. A client on a calcium channel blocker should be monitored for which
adverse effect?
A. Constipation.
B. Diarrhea.
NSG 124 – PHARMACOLOGY – EXAM 3 (NCLEX-STYLE)
2026/2027 COMPLETE CURRENT TESTING QUESTIONS
AND CORRECT ANSWERS WITH DETAILED RATIONALES.
PHARMACOLOGY
Prepare for NSG 124 Exam 3 with this focused Pharmacology NCLEX-style study
resource from Herzing University. It is designed to reinforce medication
classifications, pharmacologic principles, adverse effects, safety considerations, and
appropriate nursing interventions. The NCLEX-style format helps you practice
applying pharmacology knowledge to clinical scenarios while strengthening
prioritization and critical-thinking skills. Use this resource alongside your coursework
to review key concepts and build confidence for the exam.
MULTIPLE CHOICE.
Section 1: Cardiovascular Medications – RAA System & Antihypertensives
(Q1–Q25)
1. A client newly prescribed an ACE inhibitor asks the nurse how the
medication works. Which statement by the nurse is most accurate?
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."
Answer: A
Rationale: ACE inhibitors prevent the conversion of angiotensin I to
angiotensin II by inhibiting the angiotensin-converting enzyme, reducing
vasoconstriction and aldosterone secretion.
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.
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C. Advise the client to stop the medication immediately.
D. Schedule a chest X-ray to rule out pneumonia.
Answer: B
Rationale: A persistent dry cough is a common adverse effect of ACE
inhibitors related to bradykinin accumulation; the provider may switch to
an ARB.
3. Which laboratory value should the nurse monitor most closely in a
client taking an ACE inhibitor?
A. Serum sodium.
B. Serum potassium.
C. Serum calcium.
D. Serum magnesium.
Answer: B
Rationale: ACE inhibitors can cause hyperkalemia by reducing
aldosterone secretion, which decreases potassium excretion.
4. A nurse is teaching a client about lisinopril. Which statement by the
client indicates a need for further teaching?
A. "I should rise slowly from a sitting position."
B. "I can use a salt substitute with potassium."
C. "I should report swelling of my face or tongue."
D. "I should avoid taking this medication during pregnancy."
Answer: B
Rationale: Salt substitutes often contain potassium; combined with an
ACE inhibitor, this can cause dangerous hyperkalemia.
5. Which medication is an angiotensin II receptor blocker (ARB)?
A. Lisinopril.
B. Losartan.
C. Metoprolol.
D. Diltiazem.
Answer: B
Rationale: Losartan is an ARB that blocks angiotensin II at the receptor
site, reducing vasoconstriction and aldosterone secretion.
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6. A client on an ARB should be monitored for which adverse effect?
A. Dry cough.
B. Angioedema.
C. Hyperkalemia.
D. Both B and C.
Answer: D
Rationale: ARBs can cause angioedema and hyperkalemia, though the dry
cough is less common than with ACE inhibitors.
7. A nurse is administering the first dose of an ACE inhibitor to a client.
Which action is priority?
A. Monitor blood pressure closely for first-dose hypotension.
B. Administer the medication with a potassium supplement.
C. Encourage the client to increase sodium intake.
D. Hold the medication if the heart rate is below 60.
Answer: A
Rationale: First-dose hypotension is a significant risk with ACE inhibitors;
blood pressure should be monitored closely.
8. Which class of antihypertensive medications works by blocking
calcium channels in vascular smooth muscle?
A. ACE inhibitors.
B. ARBs.
C. Calcium channel blockers.
D. Beta-blockers.
Answer: C
Rationale: Calcium channel blockers (e.g., diltiazem, amlodipine) block
calcium channels, causing vasodilation and reduced blood pressure.
9. A client taking a beta-blocker should be taught to:
A. Stop the medication abruptly if feeling well.
B. Monitor heart rate and blood pressure.
C. Increase caffeine intake to counteract fatigue.
D. Take the medication only when symptomatic.
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Answer: B
Rationale: Beta-blockers can cause bradycardia and hypotension; clients
should monitor heart rate and blood pressure and never stop the
medication abruptly.
10. Which adverse effect is most common with beta-blockers?
A. Tachycardia.
B. Bradycardia.
C. Hypertension.
D. Hyperglycemia.
Answer: B
Rationale: Beta-blockers reduce heart rate and can cause bradycardia.
11. A nurse is teaching a client about metoprolol. Which statement by the
client indicates understanding?
A. "I should take this medication with food."
B. "I can stop taking this medication when my blood pressure is normal."
C. "I should monitor my heart rate before taking this medication."
D. "This medication will increase my heart rate."
Answer: C
Rationale: Metoprolol can cause bradycardia; clients should monitor
heart rate and report rates below 60 beats/min.
12. Which medication is a cardioselective beta-blocker?
A. Propranolol.
B. Metoprolol.
C. Carvedilol.
D. Labetalol.
Answer: B
Rationale: Metoprolol is cardioselective, primarily affecting beta-1
receptors in the heart.
13. A client on a calcium channel blocker should be monitored for which
adverse effect?
A. Constipation.
B. Diarrhea.
