UNIVERSITY OF SOUTH CAROLINA
C OL L EGE OF NU R S ING · GR A D U AT E P R OGR A M
NURS 711 · EXAM 2
Pharmacotherapies
Cardiovascular & Renal
An original graduate-level practice examination covering
antihypertensives, heart failure pharmacotherapy, antidysrhythmics,
anticoagulants, antiplatelets, lipid-lowering agents, diuretics, and renal
replacement adjuncts. Seventy multiple-choice items with full answer
key and rationales.
70 70 90 2026
Q U ES T I O N S T O TA L P O I N T S TIME LIMIT ED I T I O N
(MIN)
E X A M I N AT I O N I N S T R U C T I O N S
Each question has ONE best answer. Select a single option (A, B, C, or D).
Mark your answer on the line provided beneath each question stem.
There is no penalty for guessing; answer every question.
A basic non-programmable calculator is permitted for dosage calculations.
Answer key with rationales begins after Question 70.
P R A C T I C E E X A M I N AT I O N · OR I G I N AL I T EM S ·
N O T A F F I L I AT E D W I T H U S C
,NURS 711 · EXAM 2 · PHARMACOTHERAPIES (2026) 70 Questions · 90 Minutes · 70 Points
Cardiovascular & Renal Pharmacology · Practice Examination Page 1
INSTRUC This practice examination consists of 70 multiple-choice questions. Each question has
TIONS one best answer. Mark your answer on the line provided beneath each question stem.
There is no penalty for guessing. A non-programmable calculator is permitted. Time
limit: 90 minutes. The answer key with full rationales follows Question 70.
1. A 58-year-old man with newly diagnosed hypertension (BP 152/96) and type 2 diabetes
begins lisinopril 10 mg daily. Which laboratory value must the NP monitor most closely 1–2
weeks after initiation and again after any dose increase?
A. Fasting blood glucose
B. Serum creatinine and potassium
C. Liver function panel
D. Serum uric acid
Answer: ____
2. A 45-year-old woman is started on hydrochlorothiazide 25 mg daily for stage 1
hypertension. At her 4-week follow-up she reports muscle cramps and fatigue. The serum
potassium is 3.1 mEq/L. Which addition to her regimen is MOST appropriate to correct the
electrolyte disturbance while maintaining antihypertensive efficacy?
A. Switch to furosemide 20 mg daily
B. Add spironolactone 25 mg daily
C. Discontinue HCTZ and start amlodipine
D. Add oral potassium chloride 20 mEq daily
Answer: ____
3. A 67-year-old man with a history of angioedema after lisinopril requires add-on therapy for
resistant hypertension (BP 158/94 on amlodipine + HCTZ). Which antihypertensive is
CONTRAINDICATED in this patient?
A. Losartan
B. Carvedilol
C. Hydralazine
D. Clonidine
Answer: ____
4. A 72-year-old woman with osteoporosis, hypertension, and recurrent calcium oxalate
kidney stones is being evaluated for antihypertensive therapy. Which agent provides a unique
NON-cardiovascular benefit by reducing urinary calcium excretion, making it the preferred
option for this patient?
A. Lisinopril
B. Losartan
C. Chlorthalidone
D. Diltiazem
Answer: ____
Practice Examination · Original Items · Not Affiliated with USC Choose the BEST single answer.
,NURS 711 · EXAM 2 · PHARMACOTHERAPIES (2026) 70 Questions · 90 Minutes · 70 Points
Cardiovascular & Renal Pharmacology · Practice Examination Page 2
5. A 50-year-old African American man with stage 2 hypertension (BP 166/98) and no other
comorbidities is initiating monotherapy per JNC 8 / ACC-AHA guidance. Which drug class is
recommended FIRST-LINE for this demographic because of superior BP-lowering and stroke
reduction?
A. ACE inhibitor (lisinopril)
B. Beta-blocker (metoprolol)
C. Thiazide-type diuretic (chlorthalidone)
D. ARB (valsartan)
Answer: ____
6. A patient taking clonidine 0.2 mg twice daily for 6 months runs out of refills and abruptly
stops. Three days later she presents to the ED with BP 200/118, headache, diaphoresis, and
tremor. Which mechanism best explains this presentation?
A. Unmasking of primary hyperaldosteronism
B. Rebound sympathetic overactivity from supersensitive alpha-2 receptors
C. Volume overload from sodium retention
D. Withdrawal-induced cortisol surge
Answer: ____
7. Which side effect, when occurring with minoxidil therapy, is the strongest indication for
adding a loop diuretic AND a beta-blocker as mandatory concomitant therapy?
A. Hypertrichosis
B. Reflex tachycardia with significant fluid retention
C. Orthostatic hypotension
D. Gingival hyperplasia
Answer: ____
8. A 60-year-old woman with HFpEF (EF 55%), hypertension, and asthma requires
antihypertensive therapy. Which beta-blocker is preferred because of its combined alpha-1
and beta-blockade plus antioxidant effects shown beneficial in HFpEF and HF animal
models?
A. Atenolol
B. Metoprolol succinate
C. Carvedilol
D. Nadolol
Answer: ____
9. Which statement about the combination of ACE inhibitors and angiotensin receptor
blockers (or ACEi + aliskiren, a direct renin inhibitor) is MOST accurate?
A. Dual RAAS blockade is recommended in resistant hypertension to enhance
nephroprotection.
B. Combination ACEi + ARB/DRI increases risk of hyperkalemia, hypotension, and renal
dysfunction without mortality benefit, and is generally avoided.
C. ACEi + ARB is preferred in heart failure with reduced ejection fraction for additive
reverse remodeling.
D. Dual therapy is safe in pregnancy for severe hypertension.
Answer: ____
Practice Examination · Original Items · Not Affiliated with USC Choose the BEST single answer.
, NURS 711 · EXAM 2 · PHARMACOTHERAPIES (2026) 70 Questions · 90 Minutes · 70 Points
Cardiovascular & Renal Pharmacology · Practice Examination Page 3
10. A 39-year-old pregnant patient at 32 weeks' gestation presents with severe preeclampsia
(BP 172/110, proteinuria 3+, headache). Which intravenous antihypertensive is FIRST-LINE for
acute severe hypertension in pregnancy per ACOG?
A. Lisinopril IV
B. Hydralazine IV or labetalol IV
C. Sodium nitroprusside IV
D. Clonidine IV
Answer: ____
11. A 68-year-old man with HFrEF (EF 32%, NYHA III) on furosemide 40 mg BID, lisinopril 20
mg daily, and metoprolol succinate 100 mg daily remains symptomatic. His potassium is 5.4
mEq/L and eGFR 38 mL/min. Per 2022 AHA/ACC/HFSA guidelines, which addition provides
the greatest mortality and HF hospitalization reduction in this patient?
A. Spironolactone 25 mg daily
B. Sacubitril/valsartan 97/103 mg BID
C. Digoxin 0.125 mg daily
D. Hydralazine/isosorbide dinitrate 37.5/20 mg TID
Answer: ____
12. A 74-year-old woman with HFrEF (EF 28%) and type 2 diabetes is started on dapagliflozin
10 mg daily. Which outcome is best supported by the DAPA-HF trial?
A. Improvement in HbA1c by 2.0%
B. Reduction in HF hospitalization and cardiovascular death regardless of diabetes status
C. Reversal of left ventricular remodeling
D. Reduction in all-cause mortality by 35%
Answer: ____
13. A patient with chronic HFrEF taking digoxin 0.25 mg daily presents with nausea,
vomiting, confusion, and visual disturbances (yellow halos). Serum digoxin level is 3.2 ng/mL,
potassium 3.0 mEq/L. Which intervention is MOST appropriate?
A. Increase dose to control symptoms; current level is subtherapeutic.
B. Hold digoxin, correct hypokalemia, and administer digoxin Fab antibody fragments if
life-threatening arrhythmias occur.
C. Administer intravenous calcium gluconate immediately.
D. Discontinue furosemide and observe.
Answer: ____
14. Which beta-blocker, when initiated for HFrEF, MUST be titrated slowly from a low
starting dose (e.g., 1.25 mg BID) and is contraindicated in severe decompensated heart failure
because of its intrinsic sympathomimetic activity at low doses?
A. Metoprolol succinate
B. Bisoprolol
C. Carvedilol
D. Nebivolol
Answer: ____
Practice Examination · Original Items · Not Affiliated with USC Choose the BEST single answer.
C OL L EGE OF NU R S ING · GR A D U AT E P R OGR A M
NURS 711 · EXAM 2
Pharmacotherapies
Cardiovascular & Renal
An original graduate-level practice examination covering
antihypertensives, heart failure pharmacotherapy, antidysrhythmics,
anticoagulants, antiplatelets, lipid-lowering agents, diuretics, and renal
replacement adjuncts. Seventy multiple-choice items with full answer
key and rationales.
70 70 90 2026
Q U ES T I O N S T O TA L P O I N T S TIME LIMIT ED I T I O N
(MIN)
E X A M I N AT I O N I N S T R U C T I O N S
Each question has ONE best answer. Select a single option (A, B, C, or D).
Mark your answer on the line provided beneath each question stem.
There is no penalty for guessing; answer every question.
A basic non-programmable calculator is permitted for dosage calculations.
Answer key with rationales begins after Question 70.
P R A C T I C E E X A M I N AT I O N · OR I G I N AL I T EM S ·
N O T A F F I L I AT E D W I T H U S C
,NURS 711 · EXAM 2 · PHARMACOTHERAPIES (2026) 70 Questions · 90 Minutes · 70 Points
Cardiovascular & Renal Pharmacology · Practice Examination Page 1
INSTRUC This practice examination consists of 70 multiple-choice questions. Each question has
TIONS one best answer. Mark your answer on the line provided beneath each question stem.
There is no penalty for guessing. A non-programmable calculator is permitted. Time
limit: 90 minutes. The answer key with full rationales follows Question 70.
1. A 58-year-old man with newly diagnosed hypertension (BP 152/96) and type 2 diabetes
begins lisinopril 10 mg daily. Which laboratory value must the NP monitor most closely 1–2
weeks after initiation and again after any dose increase?
A. Fasting blood glucose
B. Serum creatinine and potassium
C. Liver function panel
D. Serum uric acid
Answer: ____
2. A 45-year-old woman is started on hydrochlorothiazide 25 mg daily for stage 1
hypertension. At her 4-week follow-up she reports muscle cramps and fatigue. The serum
potassium is 3.1 mEq/L. Which addition to her regimen is MOST appropriate to correct the
electrolyte disturbance while maintaining antihypertensive efficacy?
A. Switch to furosemide 20 mg daily
B. Add spironolactone 25 mg daily
C. Discontinue HCTZ and start amlodipine
D. Add oral potassium chloride 20 mEq daily
Answer: ____
3. A 67-year-old man with a history of angioedema after lisinopril requires add-on therapy for
resistant hypertension (BP 158/94 on amlodipine + HCTZ). Which antihypertensive is
CONTRAINDICATED in this patient?
A. Losartan
B. Carvedilol
C. Hydralazine
D. Clonidine
Answer: ____
4. A 72-year-old woman with osteoporosis, hypertension, and recurrent calcium oxalate
kidney stones is being evaluated for antihypertensive therapy. Which agent provides a unique
NON-cardiovascular benefit by reducing urinary calcium excretion, making it the preferred
option for this patient?
A. Lisinopril
B. Losartan
C. Chlorthalidone
D. Diltiazem
Answer: ____
Practice Examination · Original Items · Not Affiliated with USC Choose the BEST single answer.
,NURS 711 · EXAM 2 · PHARMACOTHERAPIES (2026) 70 Questions · 90 Minutes · 70 Points
Cardiovascular & Renal Pharmacology · Practice Examination Page 2
5. A 50-year-old African American man with stage 2 hypertension (BP 166/98) and no other
comorbidities is initiating monotherapy per JNC 8 / ACC-AHA guidance. Which drug class is
recommended FIRST-LINE for this demographic because of superior BP-lowering and stroke
reduction?
A. ACE inhibitor (lisinopril)
B. Beta-blocker (metoprolol)
C. Thiazide-type diuretic (chlorthalidone)
D. ARB (valsartan)
Answer: ____
6. A patient taking clonidine 0.2 mg twice daily for 6 months runs out of refills and abruptly
stops. Three days later she presents to the ED with BP 200/118, headache, diaphoresis, and
tremor. Which mechanism best explains this presentation?
A. Unmasking of primary hyperaldosteronism
B. Rebound sympathetic overactivity from supersensitive alpha-2 receptors
C. Volume overload from sodium retention
D. Withdrawal-induced cortisol surge
Answer: ____
7. Which side effect, when occurring with minoxidil therapy, is the strongest indication for
adding a loop diuretic AND a beta-blocker as mandatory concomitant therapy?
A. Hypertrichosis
B. Reflex tachycardia with significant fluid retention
C. Orthostatic hypotension
D. Gingival hyperplasia
Answer: ____
8. A 60-year-old woman with HFpEF (EF 55%), hypertension, and asthma requires
antihypertensive therapy. Which beta-blocker is preferred because of its combined alpha-1
and beta-blockade plus antioxidant effects shown beneficial in HFpEF and HF animal
models?
A. Atenolol
B. Metoprolol succinate
C. Carvedilol
D. Nadolol
Answer: ____
9. Which statement about the combination of ACE inhibitors and angiotensin receptor
blockers (or ACEi + aliskiren, a direct renin inhibitor) is MOST accurate?
A. Dual RAAS blockade is recommended in resistant hypertension to enhance
nephroprotection.
B. Combination ACEi + ARB/DRI increases risk of hyperkalemia, hypotension, and renal
dysfunction without mortality benefit, and is generally avoided.
C. ACEi + ARB is preferred in heart failure with reduced ejection fraction for additive
reverse remodeling.
D. Dual therapy is safe in pregnancy for severe hypertension.
Answer: ____
Practice Examination · Original Items · Not Affiliated with USC Choose the BEST single answer.
, NURS 711 · EXAM 2 · PHARMACOTHERAPIES (2026) 70 Questions · 90 Minutes · 70 Points
Cardiovascular & Renal Pharmacology · Practice Examination Page 3
10. A 39-year-old pregnant patient at 32 weeks' gestation presents with severe preeclampsia
(BP 172/110, proteinuria 3+, headache). Which intravenous antihypertensive is FIRST-LINE for
acute severe hypertension in pregnancy per ACOG?
A. Lisinopril IV
B. Hydralazine IV or labetalol IV
C. Sodium nitroprusside IV
D. Clonidine IV
Answer: ____
11. A 68-year-old man with HFrEF (EF 32%, NYHA III) on furosemide 40 mg BID, lisinopril 20
mg daily, and metoprolol succinate 100 mg daily remains symptomatic. His potassium is 5.4
mEq/L and eGFR 38 mL/min. Per 2022 AHA/ACC/HFSA guidelines, which addition provides
the greatest mortality and HF hospitalization reduction in this patient?
A. Spironolactone 25 mg daily
B. Sacubitril/valsartan 97/103 mg BID
C. Digoxin 0.125 mg daily
D. Hydralazine/isosorbide dinitrate 37.5/20 mg TID
Answer: ____
12. A 74-year-old woman with HFrEF (EF 28%) and type 2 diabetes is started on dapagliflozin
10 mg daily. Which outcome is best supported by the DAPA-HF trial?
A. Improvement in HbA1c by 2.0%
B. Reduction in HF hospitalization and cardiovascular death regardless of diabetes status
C. Reversal of left ventricular remodeling
D. Reduction in all-cause mortality by 35%
Answer: ____
13. A patient with chronic HFrEF taking digoxin 0.25 mg daily presents with nausea,
vomiting, confusion, and visual disturbances (yellow halos). Serum digoxin level is 3.2 ng/mL,
potassium 3.0 mEq/L. Which intervention is MOST appropriate?
A. Increase dose to control symptoms; current level is subtherapeutic.
B. Hold digoxin, correct hypokalemia, and administer digoxin Fab antibody fragments if
life-threatening arrhythmias occur.
C. Administer intravenous calcium gluconate immediately.
D. Discontinue furosemide and observe.
Answer: ____
14. Which beta-blocker, when initiated for HFrEF, MUST be titrated slowly from a low
starting dose (e.g., 1.25 mg BID) and is contraindicated in severe decompensated heart failure
because of its intrinsic sympathomimetic activity at low doses?
A. Metoprolol succinate
B. Bisoprolol
C. Carvedilol
D. Nebivolol
Answer: ____
Practice Examination · Original Items · Not Affiliated with USC Choose the BEST single answer.
