NUR210 / NUR 210 EXAM 3 | PRINCIPLES OF
PHARMACOLOGY COMPREHENSIVE PRACTICE
ASSESSMENT
CORE DOMAINS
• Cardiovascular Pharmacology: Diuretics, Antihypertensives, and Antianginal
Agents
• Respiratory Pharmacology: Upper and Lower Respiratory Agents,
Antitubercular Drugs
• Endocrine Pharmacology: Antidiabetic Agents, Thyroid, Parathyroid, and
Adrenal Drugs
• Gastrointestinal Pharmacology: Antiemetics, Antidiarrheals, and Laxatives
• Neurological and Psychiatric Pharmacology: Antiepileptics, Antiparkinson
Agents, and Anxiolytics
• Anti-Infective Pharmacology: Antibiotics, Antivirals, and Antifungals
• Nursing Process and Patient Education in Pharmacology
• Safe Medication Administration and Adverse Effect Monitoring
INTRODUCTION
This comprehensive assessment is designed to evaluate mastery of
pharmacological principles for NUR 210 Exam 3. It measures knowledge of drug
classifications, mechanisms of action, therapeutic uses, adverse effects, nursing
considerations, and patient education across major body systems. The exam
employs a multiple-choice and scenario-based structure reflecting real-world
clinical decision-making. Emphasis is placed on safe medication administration,
prioritization, and evidence-based nursing practice. Candidates must demonstrate
,competency in identifying prototype drugs, anticipating adverse effects, and
applying the nursing process to medication management. This assessment
prepares students for the rigor of the Galen College of Nursing pharmacology
curriculum.
SECTION ONE: QUESTIONS 1–200
Question 1
A nurse is reviewing the medication history of a client prescribed
hydrochlorothiazide. The nurse should recognize that this medication belongs to
which drug classification?
A. Loop diuretic
B. Thiazide diuretic
C. Potassium-sparing diuretic
D. Osmotic diuretic
B. Thiazide diuretic
RATIONALE: Hydrochlorothiazide is the prototype thiazide diuretic. Thiazide
diuretics act on the distal convoluted tubule to inhibit sodium and chloride
reabsorption, promoting diuresis. Loop diuretics such as furosemide act on the
ascending loop of Henle, potassium-sparing diuretics such as spironolactone act
on the collecting duct, and osmotic diuretics such as mannitol act in the proximal
tubule and descending loop of Henle. Recognizing the classification is essential for
anticipating therapeutic effects and adverse reactions.
Question 2
A client is prescribed furosemide for the treatment of heart failure. The nurse
should monitor the client for which of the following electrolyte imbalances as a
priority?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
, B. Hypokalemia
RATIONALE: Furosemide is a loop diuretic that inhibits sodium and chloride
reabsorption in the ascending loop of Henle, leading to increased excretion of
potassium. Hypokalemia is a common and potentially dangerous adverse effect.
The nurse should monitor serum potassium levels closely and educate the client
about potassium-rich foods. Hyperkalemia is more commonly associated with
potassium-sparing diuretics such as spironolactone.
Question 3
A nurse is providing education to a client prescribed spironolactone. Which of the
following statements by the client indicates an understanding of the teaching?
A. "I should increase my intake of potassium-rich foods."
B. "I should avoid salt substitutes that contain potassium."
C. "I should expect to urinate less frequently."
D. "I should take this medication on an empty stomach."
B. "I should avoid salt substitutes that contain potassium."
RATIONALE: Spironolactone is a potassium-sparing diuretic that retains
potassium while excreting sodium and water. Clients should avoid potassium
supplements and salt substitutes containing potassium to prevent hyperkalemia.
Increasing potassium-rich foods is not recommended. Spironolactone increases
urine output, not decreases it. Taking the medication with food reduces
gastrointestinal upset.
Question 4
A client with increased intracranial pressure is prescribed mannitol. The nurse
should recognize that this medication is classified as which type of diuretic?
A. Thiazide diuretic
B. Loop diuretic
C. Osmotic diuretic
D. Potassium-sparing diuretic
C. Osmotic diuretic
RATIONALE: Mannitol is an osmotic diuretic that creates an osmotic gradient
, in the renal tubules, pulling water into the tubules and promoting diuresis. It is
used to reduce intracranial pressure and intraocular pressure. Thiazide, loop, and
potassium-sparing diuretics work through different mechanisms. Mannitol must
be administered through a filter to remove crystals and should be monitored for
fluid and electrolyte imbalances.
Question 5
A nurse is reviewing the mechanism of action of metoprolol. The nurse should
identify that this medication works by which of the following mechanisms?
A. Blocking beta-1 receptors, reducing heart rate and blood pressure
B. Blocking alpha-1 receptors, causing vasodilation
C. Inhibiting angiotensin-converting enzyme
D. Blocking calcium channels in vascular smooth muscle
A. Blocking beta-1 receptors, reducing heart rate and blood pressure
RATIONALE: Metoprolol is a cardioselective beta-1 adrenergic blocker. It
works by blocking beta-1 receptors in the heart, which decreases heart rate,
contractility, and cardiac output, thereby reducing blood pressure and myocardial
oxygen demand. Alpha-1 blockers such as prazosin cause vasodilation. ACE
inhibitors such as lisinopril inhibit angiotensin-converting enzyme. Calcium
channel blockers such as nifedipine block calcium channels.
Question 6
A client is prescribed prazosin for hypertension. The nurse should include which of
the following instructions to prevent orthostatic hypotension?
A. "Take the medication with a high-protein meal."
B. "Rise slowly from sitting or lying positions."
C. "Increase your intake of potassium-rich foods."
D. "Avoid drinking fluids while taking this medication."
B. "Rise slowly from sitting or lying positions."
RATIONALE: Prazosin is an alpha-1 adrenergic blocker that causes
vasodilation, which can lead to orthostatic hypotension, especially with the first
dose (first-dose phenomenon). Clients should be instructed to rise slowly from
PHARMACOLOGY COMPREHENSIVE PRACTICE
ASSESSMENT
CORE DOMAINS
• Cardiovascular Pharmacology: Diuretics, Antihypertensives, and Antianginal
Agents
• Respiratory Pharmacology: Upper and Lower Respiratory Agents,
Antitubercular Drugs
• Endocrine Pharmacology: Antidiabetic Agents, Thyroid, Parathyroid, and
Adrenal Drugs
• Gastrointestinal Pharmacology: Antiemetics, Antidiarrheals, and Laxatives
• Neurological and Psychiatric Pharmacology: Antiepileptics, Antiparkinson
Agents, and Anxiolytics
• Anti-Infective Pharmacology: Antibiotics, Antivirals, and Antifungals
• Nursing Process and Patient Education in Pharmacology
• Safe Medication Administration and Adverse Effect Monitoring
INTRODUCTION
This comprehensive assessment is designed to evaluate mastery of
pharmacological principles for NUR 210 Exam 3. It measures knowledge of drug
classifications, mechanisms of action, therapeutic uses, adverse effects, nursing
considerations, and patient education across major body systems. The exam
employs a multiple-choice and scenario-based structure reflecting real-world
clinical decision-making. Emphasis is placed on safe medication administration,
prioritization, and evidence-based nursing practice. Candidates must demonstrate
,competency in identifying prototype drugs, anticipating adverse effects, and
applying the nursing process to medication management. This assessment
prepares students for the rigor of the Galen College of Nursing pharmacology
curriculum.
SECTION ONE: QUESTIONS 1–200
Question 1
A nurse is reviewing the medication history of a client prescribed
hydrochlorothiazide. The nurse should recognize that this medication belongs to
which drug classification?
A. Loop diuretic
B. Thiazide diuretic
C. Potassium-sparing diuretic
D. Osmotic diuretic
B. Thiazide diuretic
RATIONALE: Hydrochlorothiazide is the prototype thiazide diuretic. Thiazide
diuretics act on the distal convoluted tubule to inhibit sodium and chloride
reabsorption, promoting diuresis. Loop diuretics such as furosemide act on the
ascending loop of Henle, potassium-sparing diuretics such as spironolactone act
on the collecting duct, and osmotic diuretics such as mannitol act in the proximal
tubule and descending loop of Henle. Recognizing the classification is essential for
anticipating therapeutic effects and adverse reactions.
Question 2
A client is prescribed furosemide for the treatment of heart failure. The nurse
should monitor the client for which of the following electrolyte imbalances as a
priority?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
, B. Hypokalemia
RATIONALE: Furosemide is a loop diuretic that inhibits sodium and chloride
reabsorption in the ascending loop of Henle, leading to increased excretion of
potassium. Hypokalemia is a common and potentially dangerous adverse effect.
The nurse should monitor serum potassium levels closely and educate the client
about potassium-rich foods. Hyperkalemia is more commonly associated with
potassium-sparing diuretics such as spironolactone.
Question 3
A nurse is providing education to a client prescribed spironolactone. Which of the
following statements by the client indicates an understanding of the teaching?
A. "I should increase my intake of potassium-rich foods."
B. "I should avoid salt substitutes that contain potassium."
C. "I should expect to urinate less frequently."
D. "I should take this medication on an empty stomach."
B. "I should avoid salt substitutes that contain potassium."
RATIONALE: Spironolactone is a potassium-sparing diuretic that retains
potassium while excreting sodium and water. Clients should avoid potassium
supplements and salt substitutes containing potassium to prevent hyperkalemia.
Increasing potassium-rich foods is not recommended. Spironolactone increases
urine output, not decreases it. Taking the medication with food reduces
gastrointestinal upset.
Question 4
A client with increased intracranial pressure is prescribed mannitol. The nurse
should recognize that this medication is classified as which type of diuretic?
A. Thiazide diuretic
B. Loop diuretic
C. Osmotic diuretic
D. Potassium-sparing diuretic
C. Osmotic diuretic
RATIONALE: Mannitol is an osmotic diuretic that creates an osmotic gradient
, in the renal tubules, pulling water into the tubules and promoting diuresis. It is
used to reduce intracranial pressure and intraocular pressure. Thiazide, loop, and
potassium-sparing diuretics work through different mechanisms. Mannitol must
be administered through a filter to remove crystals and should be monitored for
fluid and electrolyte imbalances.
Question 5
A nurse is reviewing the mechanism of action of metoprolol. The nurse should
identify that this medication works by which of the following mechanisms?
A. Blocking beta-1 receptors, reducing heart rate and blood pressure
B. Blocking alpha-1 receptors, causing vasodilation
C. Inhibiting angiotensin-converting enzyme
D. Blocking calcium channels in vascular smooth muscle
A. Blocking beta-1 receptors, reducing heart rate and blood pressure
RATIONALE: Metoprolol is a cardioselective beta-1 adrenergic blocker. It
works by blocking beta-1 receptors in the heart, which decreases heart rate,
contractility, and cardiac output, thereby reducing blood pressure and myocardial
oxygen demand. Alpha-1 blockers such as prazosin cause vasodilation. ACE
inhibitors such as lisinopril inhibit angiotensin-converting enzyme. Calcium
channel blockers such as nifedipine block calcium channels.
Question 6
A client is prescribed prazosin for hypertension. The nurse should include which of
the following instructions to prevent orthostatic hypotension?
A. "Take the medication with a high-protein meal."
B. "Rise slowly from sitting or lying positions."
C. "Increase your intake of potassium-rich foods."
D. "Avoid drinking fluids while taking this medication."
B. "Rise slowly from sitting or lying positions."
RATIONALE: Prazosin is an alpha-1 adrenergic blocker that causes
vasodilation, which can lead to orthostatic hypotension, especially with the first
dose (first-dose phenomenon). Clients should be instructed to rise slowly from
