PHARMACOLOGY II BSN 315 REVIEW EXAM 300 – COMPREHENSIVE QUESTIONS
AND ANSWERS | VERIFIED AND WELLDETAILED ANSWERS | DETAILED EXPLANATIONS AND
RATIONALES | COMPLETE EXAM PREPARATION STUDY GUIDE | PRACTICE QUESTIONS |
LATEST EXAM UPDATE
• CORE DOMAINS *
•
• Cardiovascular Pharmacology
• Respiratory Pharmacology
• Neurologic and Psychiatric Pharmacology
• Endocrine and Metabolic Pharmacology
• Antimicrobial and Anti-Infective Pharmacology
• Gastrointestinal Pharmacology
• Hematologic and Immunologic Pharmacology
• Pain, Inflammation, and Musculoskeletal Pharmacology
• Oncology and Special-Population Pharmacology
• Medication Safety, Adverse Effects, Interactions, and Nursing Responsibilities
• INTRODUCTION *
•
This comprehensive assessment is designed to reinforce the knowledge and clinical reasoning
required in advanced pharmacology. The questions evaluate drug classifications,
mechanisms of action, therapeutic uses, adverse effects, contraindications, interactions,
monitoring requirements, and safe medication administration. Multiple-choice questions are
used to develop recognition, application, prioritization, and clinical decision-making skills.
Understanding why a medication produces a particular therapeutic or adverse effect is
essential for safe practice. Scenario-based questions encourage application of pharmacologic
principles to patient care, while conceptual questions strengthen foundational knowledge
and preparation for examination-style assessment.
SECTION ONE: QUESTIONS 1–100
Question 1. A patient is prescribed an angiotensin-converting enzyme (ACE) inhibitor. Which
mechanism best describes the therapeutic action of this medication?
A. Blocking aldosterone receptors in the distal nephron
B. Preventing conversion of angiotensin I to angiotensin II
C. Increasing calcium entry into vascular smooth muscle
D. Stimulating beta-1 adrenergic receptors
Correct Answer: B. Preventing conversion of angiotensin I to angiotensin II
,Explanation: ACE inhibitors reduce formation of angiotensin II, resulting in vasodilation and
decreased aldosterone secretion. This lowers systemic vascular resistance and blood volume,
reducing blood pressure and cardiac workload.
Question 2. Which adverse effect is particularly associated with ACE inhibitors?
A. Persistent dry cough
B. Severe constipation
C. Ototoxicity
D. Hypoglycemia
Correct Answer: A. Persistent dry cough
Explanation: ACE inhibitors increase bradykinin levels, which can produce a persistent,
nonproductive cough. Angioedema is another potentially serious adverse effect.
Question 3. A patient taking lisinopril develops swelling of the lips and tongue. What is the
nurse's priority action?
A. Administer the next dose with food
B. Document the expected adverse effect
C. Hold the medication and assess the airway
D. Encourage increased oral fluid intake
Correct Answer: C. Hold the medication and assess the airway
Explanation: Facial, lip, or tongue swelling may indicate ACE inhibitor–associated
angioedema, which can rapidly compromise the airway. The medication should be withheld
and emergency assessment initiated.
Question 4. Which medication class directly blocks the effects of angiotensin II at its
receptor?
A. ACE inhibitors
B. Angiotensin II receptor blockers
C. Thiazide diuretics
D. Calcium channel blockers
Correct Answer: B. Angiotensin II receptor blockers
Explanation: Angiotensin II receptor blockers (ARBs), such as losartan, prevent angiotensin II
from binding to AT1 receptors. They reduce vasoconstriction and aldosterone-mediated
sodium retention.
Question 5. Which electrolyte imbalance is most concerning in a patient receiving
spironolactone?
,A. Hypocalcemia
B. Hypokalemia
C. Hyperkalemia
D. Hypernatremia
Correct Answer: C. Hyperkalemia
Explanation: Spironolactone is a potassium-sparing diuretic and aldosterone antagonist.
Reduced potassium excretion can cause hyperkalemia, particularly in patients with renal
impairment or those taking other potassium-retaining medications.
Question 6. Which assessment finding is most important before administering a beta-
adrenergic blocker?
A. Respiratory rate and heart rate
B. Skin temperature
C. Bowel sounds
D. Visual acuity
Correct Answer: A. Respiratory rate and heart rate
Explanation: Beta blockers can decrease heart rate and myocardial contractility and may
cause bronchoconstriction, especially nonselective agents. Heart rate and respiratory status
are therefore important safety assessments.
Question 7. A patient taking propranolol has a heart rate of 48 beats/minute and reports
dizziness. What should the nurse do first?
A. Administer the medication as scheduled
B. Hold the medication and notify the prescriber according to parameters
C. Give an additional dose to stabilize the rhythm
D. Encourage the patient to ambulate
Correct Answer: B. Hold the medication and notify the prescriber according to parameters
Explanation: Significant bradycardia accompanied by dizziness may indicate excessive beta
blockade and reduced cardiac output. The medication should be withheld when appropriate
parameters are met and the patient evaluated.
Question 8. Which medication is classified as a loop diuretic?
A. Hydrochlorothiazide
B. Spironolactone
C. Furosemide
D. Amiloride
Correct Answer: C. Furosemide
, Explanation: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in
the thick ascending limb of the loop of Henle. It produces potent diuresis.
Question 9. Which electrolyte disturbance is commonly associated with furosemide
therapy?
A. Hyperkalemia
B. Hypokalemia
C. Hypermagnesemia
D. Hyperphosphatemia
Correct Answer: B. Hypokalemia
Explanation: Loop diuretics increase urinary potassium excretion. Significant potassium loss
can contribute to muscle weakness and cardiac dysrhythmias.
Question 10. Which laboratory value should be closely monitored in a patient receiving
digoxin?
A. Serum potassium
B. Serum sodium only
C. Hemoglobin A1c
D. Serum amylase
Correct Answer: A. Serum potassium
Explanation: Hypokalemia increases myocardial sensitivity to digoxin and raises the risk of
digoxin toxicity. Potassium and renal function should be monitored closely.
Question 11. Which finding is most suggestive of digoxin toxicity?
A. Increased appetite
B. Yellow or blurred vision with nausea
C. Increased urinary output
D. Hypertension without symptoms
Correct Answer: B. Yellow or blurred vision with nausea
Explanation: Digoxin toxicity can cause gastrointestinal symptoms, neurologic changes, visual
disturbances such as yellow-green vision, and potentially dangerous dysrhythmias.
Question 12. A patient receiving digoxin has an apical pulse of 52 beats/minute. What is the
most appropriate nursing action?
A. Administer the dose immediately
B. Hold the dose and reassess according to prescribed parameters
C. Give the medication with potassium
D. Double the next dose
AND ANSWERS | VERIFIED AND WELLDETAILED ANSWERS | DETAILED EXPLANATIONS AND
RATIONALES | COMPLETE EXAM PREPARATION STUDY GUIDE | PRACTICE QUESTIONS |
LATEST EXAM UPDATE
• CORE DOMAINS *
•
• Cardiovascular Pharmacology
• Respiratory Pharmacology
• Neurologic and Psychiatric Pharmacology
• Endocrine and Metabolic Pharmacology
• Antimicrobial and Anti-Infective Pharmacology
• Gastrointestinal Pharmacology
• Hematologic and Immunologic Pharmacology
• Pain, Inflammation, and Musculoskeletal Pharmacology
• Oncology and Special-Population Pharmacology
• Medication Safety, Adverse Effects, Interactions, and Nursing Responsibilities
• INTRODUCTION *
•
This comprehensive assessment is designed to reinforce the knowledge and clinical reasoning
required in advanced pharmacology. The questions evaluate drug classifications,
mechanisms of action, therapeutic uses, adverse effects, contraindications, interactions,
monitoring requirements, and safe medication administration. Multiple-choice questions are
used to develop recognition, application, prioritization, and clinical decision-making skills.
Understanding why a medication produces a particular therapeutic or adverse effect is
essential for safe practice. Scenario-based questions encourage application of pharmacologic
principles to patient care, while conceptual questions strengthen foundational knowledge
and preparation for examination-style assessment.
SECTION ONE: QUESTIONS 1–100
Question 1. A patient is prescribed an angiotensin-converting enzyme (ACE) inhibitor. Which
mechanism best describes the therapeutic action of this medication?
A. Blocking aldosterone receptors in the distal nephron
B. Preventing conversion of angiotensin I to angiotensin II
C. Increasing calcium entry into vascular smooth muscle
D. Stimulating beta-1 adrenergic receptors
Correct Answer: B. Preventing conversion of angiotensin I to angiotensin II
,Explanation: ACE inhibitors reduce formation of angiotensin II, resulting in vasodilation and
decreased aldosterone secretion. This lowers systemic vascular resistance and blood volume,
reducing blood pressure and cardiac workload.
Question 2. Which adverse effect is particularly associated with ACE inhibitors?
A. Persistent dry cough
B. Severe constipation
C. Ototoxicity
D. Hypoglycemia
Correct Answer: A. Persistent dry cough
Explanation: ACE inhibitors increase bradykinin levels, which can produce a persistent,
nonproductive cough. Angioedema is another potentially serious adverse effect.
Question 3. A patient taking lisinopril develops swelling of the lips and tongue. What is the
nurse's priority action?
A. Administer the next dose with food
B. Document the expected adverse effect
C. Hold the medication and assess the airway
D. Encourage increased oral fluid intake
Correct Answer: C. Hold the medication and assess the airway
Explanation: Facial, lip, or tongue swelling may indicate ACE inhibitor–associated
angioedema, which can rapidly compromise the airway. The medication should be withheld
and emergency assessment initiated.
Question 4. Which medication class directly blocks the effects of angiotensin II at its
receptor?
A. ACE inhibitors
B. Angiotensin II receptor blockers
C. Thiazide diuretics
D. Calcium channel blockers
Correct Answer: B. Angiotensin II receptor blockers
Explanation: Angiotensin II receptor blockers (ARBs), such as losartan, prevent angiotensin II
from binding to AT1 receptors. They reduce vasoconstriction and aldosterone-mediated
sodium retention.
Question 5. Which electrolyte imbalance is most concerning in a patient receiving
spironolactone?
,A. Hypocalcemia
B. Hypokalemia
C. Hyperkalemia
D. Hypernatremia
Correct Answer: C. Hyperkalemia
Explanation: Spironolactone is a potassium-sparing diuretic and aldosterone antagonist.
Reduced potassium excretion can cause hyperkalemia, particularly in patients with renal
impairment or those taking other potassium-retaining medications.
Question 6. Which assessment finding is most important before administering a beta-
adrenergic blocker?
A. Respiratory rate and heart rate
B. Skin temperature
C. Bowel sounds
D. Visual acuity
Correct Answer: A. Respiratory rate and heart rate
Explanation: Beta blockers can decrease heart rate and myocardial contractility and may
cause bronchoconstriction, especially nonselective agents. Heart rate and respiratory status
are therefore important safety assessments.
Question 7. A patient taking propranolol has a heart rate of 48 beats/minute and reports
dizziness. What should the nurse do first?
A. Administer the medication as scheduled
B. Hold the medication and notify the prescriber according to parameters
C. Give an additional dose to stabilize the rhythm
D. Encourage the patient to ambulate
Correct Answer: B. Hold the medication and notify the prescriber according to parameters
Explanation: Significant bradycardia accompanied by dizziness may indicate excessive beta
blockade and reduced cardiac output. The medication should be withheld when appropriate
parameters are met and the patient evaluated.
Question 8. Which medication is classified as a loop diuretic?
A. Hydrochlorothiazide
B. Spironolactone
C. Furosemide
D. Amiloride
Correct Answer: C. Furosemide
, Explanation: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in
the thick ascending limb of the loop of Henle. It produces potent diuresis.
Question 9. Which electrolyte disturbance is commonly associated with furosemide
therapy?
A. Hyperkalemia
B. Hypokalemia
C. Hypermagnesemia
D. Hyperphosphatemia
Correct Answer: B. Hypokalemia
Explanation: Loop diuretics increase urinary potassium excretion. Significant potassium loss
can contribute to muscle weakness and cardiac dysrhythmias.
Question 10. Which laboratory value should be closely monitored in a patient receiving
digoxin?
A. Serum potassium
B. Serum sodium only
C. Hemoglobin A1c
D. Serum amylase
Correct Answer: A. Serum potassium
Explanation: Hypokalemia increases myocardial sensitivity to digoxin and raises the risk of
digoxin toxicity. Potassium and renal function should be monitored closely.
Question 11. Which finding is most suggestive of digoxin toxicity?
A. Increased appetite
B. Yellow or blurred vision with nausea
C. Increased urinary output
D. Hypertension without symptoms
Correct Answer: B. Yellow or blurred vision with nausea
Explanation: Digoxin toxicity can cause gastrointestinal symptoms, neurologic changes, visual
disturbances such as yellow-green vision, and potentially dangerous dysrhythmias.
Question 12. A patient receiving digoxin has an apical pulse of 52 beats/minute. What is the
most appropriate nursing action?
A. Administer the dose immediately
B. Hold the dose and reassess according to prescribed parameters
C. Give the medication with potassium
D. Double the next dose
