ORIGINAL EXAM-STYLE QUESTIONS • ANSWER KEY INCLUDED A+ VERIFIED
Pharmacology NURS 251 Module 6 Exam –
Portage Learning 2026/2027 – Questions
and Answers
| Cardiopulmonary Mastery | Safe Dosing –
Pass Guaranteed – A+ Graded
50 QUESTIONS • 5 SECTIONS • BLOOM'S: APPLICATION/ANALYSIS
50 5 50
QUESTIONS SECTIONS RATIONALES
WHAT THIS COVERS
1 Cardiovascular Pharmacology 2 Respiratory Pharmacology
3 Renal and Fluid-Electrolyte Pharmacology 4 Hematologic Pharmacology
5 Anti-Inflammatory and Analgesic Agents
ABOUT THIS ASSESSMENT
This 50-item assessment is structured across 5 domains: Cardiovascular Pharmacology; Respiratory Pharmacology; Renal
and Fluid-Electrolyte Pharmacology; Hematologic Pharmacology; Anti-Inflammatory and Analgesic Agents. Items are written
at the Application/Analysis level and target intermediate learners. Each question includes four options, one best answer, and a
focused rationale that explains the clinical reasoning. Use this resource to reinforce prioritization, safe practice, and
application of core principles across the listed domains.
Cardiovascular Respiratory Renal / Urinary Hematologic Anti-Inflammatory
PA S S I N G S C O R E D I F F I C U LT Y F O R M AT
80% Intermediate Multiple Choice
STUVIA ACTUAL EXAM
,Pharmacology NURS 251 Module 6 Exam – Portage Learning 2026/2027 Questions and Answers • A+ Verified
Pharmacology NURS 251 Module 6 Exam – Portage Learning
2026/2027 – Questions and Answers | Cardiopulmonary Mastery |
Safe Dosing – Pass Guaranteed – A+ Graded
Total Questions: 50 Sections: 5 Passing Score: 80% Difficulty: Intermediate Bloom's: Application/Analysis
Section 1 — Cardiovascular Pharmacology
1. A 62-year-old male starts lisinopril 10 mg daily for hypertension. Three weeks later he reports a
persistent dry cough that disrupts sleep. Which explanation and action by the nurse is most
appropriate?
A. Recommend an OTC cough suppressant; the cough is unrelated to therapy
B. Explain that ACE inhibitors increase bradykinin, causing cough; notify the prescriber to consider an
ARB
C. Discontinue the lisinopril immediately and recheck blood pressure in 48 hours
D. Reassure the patient that the cough resolves after the first month of therapy
Concept: ACE Inhibitor - Cough Adverse Effect
Rationale: ACE inhibitors block the degradation of bradykinin, which accumulates in the lungs and triggers a
dry, persistent cough in up to 20% of patients. The cough does not typically resolve over time, and switching
to an angiotensin receptor blocker (ARB) is the recommended action. Simply suppressing symptoms or
discontinuing abruptly without prescriber input is inappropriate.
2. A 58-year-old woman with type 2 diabetes and chronic kidney disease is prescribed losartan 50 mg
daily. Which laboratory value is most important for the nurse to monitor during the first week of
therapy?
A. Serum sodium
B. Fasting blood glucose
C. Serum potassium
D. Platelet count
Concept: ARB - Hyperkalemia Monitoring
Rationale: Angiotensin II receptor blockers like losartan inhibit aldosterone secretion, which can lead to
potassium retention and hyperkalemia. Patients with chronic kidney disease and diabetes are at higher risk
for this complication. Serum potassium should be checked within the first week and periodically thereafter,
especially in vulnerable populations.
3. A nurse is preparing to administer metoprolol 50 mg PO twice daily to a patient with hypertension.
The patient's apical pulse is 52 beats/min and blood pressure is 118/74 mmHg. Which action is
most appropriate?
A. Hold the dose and notify the prescriber of the bradycardia
B. Administer the dose as ordered and recheck vital signs in 30 minutes
C. Administer half the dose and document the heart rate
D. Administer atropine 0.5 mg IV to raise the heart rate
Concept: Beta-Blocker - Heart Rate Hold Parameter
Rationale: Beta-blockers reduce heart rate, contractility, and AV node conduction; the general guideline is to
hold the dose if the apical pulse is below 60 beats/min. Administering the dose could worsen bradycardia and
precipitate symptomatic hypotension. Atropine is reserved for symptomatic bradycardia, not asymptomatic
bradycardia requiring dose withholding.
STUVIA • ACTUAL EXAM • A+ VERIFIED Page 1
, Pharmacology NURS 251 Module 6 Exam – Portage Learning 2026/2027 Questions and Answers • A+ Verified
4. A 70-year-old patient taking verapamil 120 mg daily for atrial fibrillation reports new-onset dizziness
and fatigue. The ECG shows a heart rate of 44 beats/min with a first-degree AV block. Which
instruction should the nurse anticipate from the prescriber?
A. Increase the verapamil dose to improve atrial fibrillation control
B. Add a beta-blocker to enhance rate control
C. Discontinue the verapamil and start digoxin immediately
D. Reduce the verapamil dose or switch to an agent with less AV nodal effect
Concept: Calcium Channel Blocker - AV Nodal Depression
Rationale: Non-dihydropyridine calcium channel blockers such as verapamil and diltiazem depress AV nodal
conduction and can cause bradycardia and AV block, particularly in older adults. The appropriate response is
to reduce the dose or change therapy rather than adding another negative chronotrope. Increasing the dose
or adding a beta-blocker would worsen the conduction abnormality.
5. A 78-year-old woman taking digoxin 0.25 mg daily and furosemide 40 mg daily for heart failure
reports nausea, vomiting, and seeing yellow halos around lights. The serum digoxin level is 2.8
ng/mL (therapeutic 0.5-2.0). Which action should the nurse take first?
A. Administer the next digoxin dose and increase the furosemide dose
B. Hold the digoxin, check serum potassium, and notify the prescriber
C. Give ondansetron for nausea and continue digoxin
D. Discontinue furosemide and administer potassium
Concept: Digoxin - Toxicity Recognition
Rationale: The patient is exhibiting classic digoxin toxicity with GI symptoms and visual disturbances (yellow
halos), and the serum level is above the therapeutic range. Hypokalemia from loop diuretics potentiates
digoxin toxicity, so serum potassium must be evaluated. The first action is to hold the drug and notify the
prescriber for further management such as digoxin Fab fragments if severe.
6. A patient with chronic stable angina is started on isosorbide mononitrate 60 mg daily. Which
instruction is most important to prevent nitrate tolerance?
A. Maintain a nitrate-free interval of 10-12 hours each day
B. Take the medication with a high-fat meal to slow absorption
C. Alternate the dose every other day
D. Take an extra dose only when chest pain occurs at night
Concept: Nitrates - Tolerance Prevention
Rationale: Continuous nitrate exposure leads to tolerance and loss of antianginal effect; a daily nitrate-free
interval of 10-12 hours restores vascular responsiveness. The interval is typically scheduled overnight, such
as removing a transdermal patch for 10-12 hours or timing oral doses to allow a gap. Alternate-day dosing
does not provide consistent angina protection.
7. A 55-year-old man taking simvastatin 40 mg daily reports new muscle aches and dark-colored urine.
Which laboratory test is most important for the nurse to anticipate?
A. Serum troponin
B. Creatinine clearance
C. Creatine kinase (CK)
D. Liver function panel only
Concept: Statins - Myopathy and CK Monitoring
Rationale: Statin-associated myopathy can progress to rhabdomyolysis, characterized by muscle pain and
dark urine from myoglobinuria. Creatine kinase (CK) is the key marker for muscle injury and should be
measured when these symptoms occur. While liver enzymes are monitored with statins, CK is the priority
given the presentation of muscle breakdown.
STUVIA • ACTUAL EXAM • A+ VERIFIED Page 2
Pharmacology NURS 251 Module 6 Exam –
Portage Learning 2026/2027 – Questions
and Answers
| Cardiopulmonary Mastery | Safe Dosing –
Pass Guaranteed – A+ Graded
50 QUESTIONS • 5 SECTIONS • BLOOM'S: APPLICATION/ANALYSIS
50 5 50
QUESTIONS SECTIONS RATIONALES
WHAT THIS COVERS
1 Cardiovascular Pharmacology 2 Respiratory Pharmacology
3 Renal and Fluid-Electrolyte Pharmacology 4 Hematologic Pharmacology
5 Anti-Inflammatory and Analgesic Agents
ABOUT THIS ASSESSMENT
This 50-item assessment is structured across 5 domains: Cardiovascular Pharmacology; Respiratory Pharmacology; Renal
and Fluid-Electrolyte Pharmacology; Hematologic Pharmacology; Anti-Inflammatory and Analgesic Agents. Items are written
at the Application/Analysis level and target intermediate learners. Each question includes four options, one best answer, and a
focused rationale that explains the clinical reasoning. Use this resource to reinforce prioritization, safe practice, and
application of core principles across the listed domains.
Cardiovascular Respiratory Renal / Urinary Hematologic Anti-Inflammatory
PA S S I N G S C O R E D I F F I C U LT Y F O R M AT
80% Intermediate Multiple Choice
STUVIA ACTUAL EXAM
,Pharmacology NURS 251 Module 6 Exam – Portage Learning 2026/2027 Questions and Answers • A+ Verified
Pharmacology NURS 251 Module 6 Exam – Portage Learning
2026/2027 – Questions and Answers | Cardiopulmonary Mastery |
Safe Dosing – Pass Guaranteed – A+ Graded
Total Questions: 50 Sections: 5 Passing Score: 80% Difficulty: Intermediate Bloom's: Application/Analysis
Section 1 — Cardiovascular Pharmacology
1. A 62-year-old male starts lisinopril 10 mg daily for hypertension. Three weeks later he reports a
persistent dry cough that disrupts sleep. Which explanation and action by the nurse is most
appropriate?
A. Recommend an OTC cough suppressant; the cough is unrelated to therapy
B. Explain that ACE inhibitors increase bradykinin, causing cough; notify the prescriber to consider an
ARB
C. Discontinue the lisinopril immediately and recheck blood pressure in 48 hours
D. Reassure the patient that the cough resolves after the first month of therapy
Concept: ACE Inhibitor - Cough Adverse Effect
Rationale: ACE inhibitors block the degradation of bradykinin, which accumulates in the lungs and triggers a
dry, persistent cough in up to 20% of patients. The cough does not typically resolve over time, and switching
to an angiotensin receptor blocker (ARB) is the recommended action. Simply suppressing symptoms or
discontinuing abruptly without prescriber input is inappropriate.
2. A 58-year-old woman with type 2 diabetes and chronic kidney disease is prescribed losartan 50 mg
daily. Which laboratory value is most important for the nurse to monitor during the first week of
therapy?
A. Serum sodium
B. Fasting blood glucose
C. Serum potassium
D. Platelet count
Concept: ARB - Hyperkalemia Monitoring
Rationale: Angiotensin II receptor blockers like losartan inhibit aldosterone secretion, which can lead to
potassium retention and hyperkalemia. Patients with chronic kidney disease and diabetes are at higher risk
for this complication. Serum potassium should be checked within the first week and periodically thereafter,
especially in vulnerable populations.
3. A nurse is preparing to administer metoprolol 50 mg PO twice daily to a patient with hypertension.
The patient's apical pulse is 52 beats/min and blood pressure is 118/74 mmHg. Which action is
most appropriate?
A. Hold the dose and notify the prescriber of the bradycardia
B. Administer the dose as ordered and recheck vital signs in 30 minutes
C. Administer half the dose and document the heart rate
D. Administer atropine 0.5 mg IV to raise the heart rate
Concept: Beta-Blocker - Heart Rate Hold Parameter
Rationale: Beta-blockers reduce heart rate, contractility, and AV node conduction; the general guideline is to
hold the dose if the apical pulse is below 60 beats/min. Administering the dose could worsen bradycardia and
precipitate symptomatic hypotension. Atropine is reserved for symptomatic bradycardia, not asymptomatic
bradycardia requiring dose withholding.
STUVIA • ACTUAL EXAM • A+ VERIFIED Page 1
, Pharmacology NURS 251 Module 6 Exam – Portage Learning 2026/2027 Questions and Answers • A+ Verified
4. A 70-year-old patient taking verapamil 120 mg daily for atrial fibrillation reports new-onset dizziness
and fatigue. The ECG shows a heart rate of 44 beats/min with a first-degree AV block. Which
instruction should the nurse anticipate from the prescriber?
A. Increase the verapamil dose to improve atrial fibrillation control
B. Add a beta-blocker to enhance rate control
C. Discontinue the verapamil and start digoxin immediately
D. Reduce the verapamil dose or switch to an agent with less AV nodal effect
Concept: Calcium Channel Blocker - AV Nodal Depression
Rationale: Non-dihydropyridine calcium channel blockers such as verapamil and diltiazem depress AV nodal
conduction and can cause bradycardia and AV block, particularly in older adults. The appropriate response is
to reduce the dose or change therapy rather than adding another negative chronotrope. Increasing the dose
or adding a beta-blocker would worsen the conduction abnormality.
5. A 78-year-old woman taking digoxin 0.25 mg daily and furosemide 40 mg daily for heart failure
reports nausea, vomiting, and seeing yellow halos around lights. The serum digoxin level is 2.8
ng/mL (therapeutic 0.5-2.0). Which action should the nurse take first?
A. Administer the next digoxin dose and increase the furosemide dose
B. Hold the digoxin, check serum potassium, and notify the prescriber
C. Give ondansetron for nausea and continue digoxin
D. Discontinue furosemide and administer potassium
Concept: Digoxin - Toxicity Recognition
Rationale: The patient is exhibiting classic digoxin toxicity with GI symptoms and visual disturbances (yellow
halos), and the serum level is above the therapeutic range. Hypokalemia from loop diuretics potentiates
digoxin toxicity, so serum potassium must be evaluated. The first action is to hold the drug and notify the
prescriber for further management such as digoxin Fab fragments if severe.
6. A patient with chronic stable angina is started on isosorbide mononitrate 60 mg daily. Which
instruction is most important to prevent nitrate tolerance?
A. Maintain a nitrate-free interval of 10-12 hours each day
B. Take the medication with a high-fat meal to slow absorption
C. Alternate the dose every other day
D. Take an extra dose only when chest pain occurs at night
Concept: Nitrates - Tolerance Prevention
Rationale: Continuous nitrate exposure leads to tolerance and loss of antianginal effect; a daily nitrate-free
interval of 10-12 hours restores vascular responsiveness. The interval is typically scheduled overnight, such
as removing a transdermal patch for 10-12 hours or timing oral doses to allow a gap. Alternate-day dosing
does not provide consistent angina protection.
7. A 55-year-old man taking simvastatin 40 mg daily reports new muscle aches and dark-colored urine.
Which laboratory test is most important for the nurse to anticipate?
A. Serum troponin
B. Creatinine clearance
C. Creatine kinase (CK)
D. Liver function panel only
Concept: Statins - Myopathy and CK Monitoring
Rationale: Statin-associated myopathy can progress to rhabdomyolysis, characterized by muscle pain and
dark urine from myoglobinuria. Creatine kinase (CK) is the key marker for muscle injury and should be
measured when these symptoms occur. While liver enzymes are monitored with statins, CK is the priority
given the presentation of muscle breakdown.
STUVIA • ACTUAL EXAM • A+ VERIFIED Page 2
