Pharmacology NCLEX UPDATED ACTUAL
Exam Questions and CORRECT Answers
ACE Inhibitor Drugs - CORRECT ANSWER - Captopril (Capoten), Enalapril (Vasotec),
Enalaprilat (Vasotec IV), Fosinopril (Monopril), Lisinopril (Prinivil)
ACE Inhibitors/ARBs Use - CORRECT ANSWER - Uses: Hypertension, HF, MI, diabetic
neuropathy. Precautions/interactions: caution with diuretic therapy, monitor potassium levels.
Side effects of ACE inhibitor/ARBs - CORRECT ANSWER - Persistent non-productive
cough with ACE. Angioedema (administer epinephrine), hypotension, should not be used in
second and third trimester of pregnancy
Captopril time to take - CORRECT ANSWER - 1 hour before meals
Calcium channel blocker drugs - CORRECT ANSWER - Nifedipine (Adalat, Procardia),
verapamil (Calan), Diltiazem (Cardizem), Amlodipine (Norvasc)
Ca++ channel blocker Use - CORRECT ANSWER - Angina, hypertension. Verapamil and
diltiazem used for a fib, atrial flutter, or SVT.
Use cautiously with digoxin and beta blockers, contraindicated for those with HF, heart block,
bradycardia. NO GRAPEFRUIT JUICE. IV injection over 2-3 minutes. Slowly taper if
discontinuing
Side effects of calcium channel blockers - CORRECT ANSWER - Constipation, reflex
tachycardia, peripheral edema, toxicity
Alpha Adrenergic Blockers (Sympatholytics) - CORRECT ANSWER - Selectively inhibit
alpha, adrenergic receptors, resulting in peripheral arterial and venous dilation that lowers BP.
Side effects: dizziness, fainting. Take at bed time to minimize effects of hypotension.
,Alpha Adrenergic Blockers Drugs - CORRECT ANSWER - Prazosin (Minipress),
Doxazosin mesylate (Cardura)
Centrally Acting Alpha2 Agonists - CORRECT ANSWER - Stimulate alpha-adrenergic
receptors in the brain to reduce peripheral vascular resistance, heart rate, and systolic and
diastolic blood pressure. Used for HTN, hypertensive crisis, severe cancer pain.
Centrally Acting Alpha2 Agonist Drugs - CORRECT ANSWER - Clonidine (Catapres),
Guanfacine HCl (Tenex), Methyldopa (Aldomet)
Centrally Acting Alpha2 Agonist Drug Precautions - CORRECT ANSWER -
Contraindicated with anticoagulant therapy, hepatic failure. Do not administer to clients taking
MAOIs. Do not administer methyldopa through IV line with barbiturates or sulfonamides. Use
cautiously in CVA, MI, DM, depression, or chronic renal failure. Do not use during lactation
Centrally Acting Alpha2 Agonist Drug Side Effects - CORRECT ANSWER - Dry mouth,
drowsiness, sedation, rebound HTN, black or sore tongue, leukopenia
Beta Adrenergic Blockers (Sympatholytics) - CORRECT ANSWER - Inhibit stimulation
of receptor sites, resulting in decreased cardiac excitability, cardiac output, myocardial oxygen
demand, lower BP by decreasing release of renin by kidney. Hypertension, angina,
tachydysrhythmias, HF, MI.
Beta Adrenergic Blocker Medications (Cardioselective Beta1 meds) - CORRECT
ANSWER - Metoprolol (Lopressor), atenolol (Tenormin), Metoprolol succinate (Toprol
XL)
Beta Adrenergic Blocker Medications (Nonselective beta1 and 2 meds) - CORRECT
ANSWER - Propranolol (Inderal), Nadolol (Corgard), Labetalol (Normodyne)
Beta Adrenergic Blocker Precautions - CORRECT ANSWER - Contraindicated in clients
who have AV block and sinus bradycardia, do not administer nonselective beta blockers to clients
who have asthma, bronchospasm, HF, propranolol may mask effects of hypoglycemia in DM, do
,not administer labetalol in same IV line with furosemide. Do not administer if systolic less than
100 and pulse less than 60.
Beta adrenergic blocker side effects - CORRECT ANSWER - Bradycardia, nasal
stuffiness, AV block, rebound myocardium excitation if stopped abruptly, bronchospasm
Vasodilators - CORRECT ANSWER - Direct vasodilation of arteries and veins resulting in
rapid reduction of BP (decreased preload and afterload). Used for hypertensive emergencies.
Precautions: clients who have hepatic or renal disease, older adults, electrolyte imbalances
Vasodilator medications - CORRECT ANSWER - Nitroglycerin (Nitrostat IV): Enalaprilat
(Vasotec IV), Nitroprusside (Nipride), Hydralazine (Apresoline).
Vasodilator Side Effects - CORRECT ANSWER - Dizziness, headache, profound
hypotension, cyanide toxicity, thiocyanate poisoning
Nitroprusside Interventions - CORRECT ANSWER - Should not be mixed with any
medication, apply protective cover to container, discard unused fluid after 24 hour, provide
continuous ECG and blood pressure monitoring
Cardiac Glycosides - CORRECT ANSWER - Used in the treatment of clients who have
cardiac failure or ineffective pumping mechanism of the heart muscle. Increase the force and
velocity of myocardial contractions to improve stroke volume and CO. Slow the conduction rate,
allowing for increased ventricular filling. Used for HF, a fib
Cardiac Glycoside Medication - CORRECT ANSWER - Digoxin (Lanoxin, Lanoxicaps,
Digitek)
Digoxin Precautions/interactions - CORRECT ANSWER - Thiazide or loop diuretics
increase risk of hypokalemia and precipitate digoxin toxicity. ACE and ARBs increase risk of
hyperkalemia. Verapamil (Calan) increases risk of toxicity
, Digoxin Toxicity - CORRECT ANSWER - GI effects (anorexia, n/v, abdominal pain),
CNS effects (fatigue, weakness, diplopia, blurred vision, yellow-green or white halos around
objects)
Digoxin interventions - CORRECT ANSWER - Assess apical pulse for 1 min prior to
administration. Notify HCP if HR less than 60 (adult), less than 70 (child), less than 90 (infant),
monitor for signs of digoxin toxicity, hypokalemia, and hypomagnesemia, notify provider of any
sudden increase in pulse rate that previously normal or low, maintain therapeutic level
Management of Digoxin Toxicity - CORRECT ANSWER - Discontinue digoxin and
potassium-wasting medications, treat dysrhythmias with phenytoin (Dilantin) or lidocaine, treat
bradycardia with atropine, for excess overdose, administer Digibind to prevent absorption
Antianginal Medications - CORRECT ANSWER - Organic nitrates, beta adrenergic-
blocking agents, and calcium channel blockers to treat pain related to imbalances between
myocardial oxygen supply and demand.
Organic Nitrates - CORRECT ANSWER - Relax peripheral vascular smooth muscles,
resulting in dilation of arteries and veins, thus reducing venous blood return (reduced preload) to
the heart, which leads to decreased oxygen demands on the heart. Increase myocardial oxygen
supply by dilating large coronary arteries and redistributing blood flow.
Organic Nitrates Meds - CORRECT ANSWER - Nitrostat (sublingual), nitrolingual
(translingual spray), nitro-bid (topical ointment), nitro-dur (transderm patch)
Organic Nitrate Precautions/interactions - CORRECT ANSWER - Contraindicated in
clients with head injury, hypotensive risk with antihypertensive meds, erectile dysfunction meds
may increase life-threatening hypotension
Organic Nitrates side effects - CORRECT ANSWER - Headache, orthostatic hypotension,
reflex tachycardia, tolerance
Exam Questions and CORRECT Answers
ACE Inhibitor Drugs - CORRECT ANSWER - Captopril (Capoten), Enalapril (Vasotec),
Enalaprilat (Vasotec IV), Fosinopril (Monopril), Lisinopril (Prinivil)
ACE Inhibitors/ARBs Use - CORRECT ANSWER - Uses: Hypertension, HF, MI, diabetic
neuropathy. Precautions/interactions: caution with diuretic therapy, monitor potassium levels.
Side effects of ACE inhibitor/ARBs - CORRECT ANSWER - Persistent non-productive
cough with ACE. Angioedema (administer epinephrine), hypotension, should not be used in
second and third trimester of pregnancy
Captopril time to take - CORRECT ANSWER - 1 hour before meals
Calcium channel blocker drugs - CORRECT ANSWER - Nifedipine (Adalat, Procardia),
verapamil (Calan), Diltiazem (Cardizem), Amlodipine (Norvasc)
Ca++ channel blocker Use - CORRECT ANSWER - Angina, hypertension. Verapamil and
diltiazem used for a fib, atrial flutter, or SVT.
Use cautiously with digoxin and beta blockers, contraindicated for those with HF, heart block,
bradycardia. NO GRAPEFRUIT JUICE. IV injection over 2-3 minutes. Slowly taper if
discontinuing
Side effects of calcium channel blockers - CORRECT ANSWER - Constipation, reflex
tachycardia, peripheral edema, toxicity
Alpha Adrenergic Blockers (Sympatholytics) - CORRECT ANSWER - Selectively inhibit
alpha, adrenergic receptors, resulting in peripheral arterial and venous dilation that lowers BP.
Side effects: dizziness, fainting. Take at bed time to minimize effects of hypotension.
,Alpha Adrenergic Blockers Drugs - CORRECT ANSWER - Prazosin (Minipress),
Doxazosin mesylate (Cardura)
Centrally Acting Alpha2 Agonists - CORRECT ANSWER - Stimulate alpha-adrenergic
receptors in the brain to reduce peripheral vascular resistance, heart rate, and systolic and
diastolic blood pressure. Used for HTN, hypertensive crisis, severe cancer pain.
Centrally Acting Alpha2 Agonist Drugs - CORRECT ANSWER - Clonidine (Catapres),
Guanfacine HCl (Tenex), Methyldopa (Aldomet)
Centrally Acting Alpha2 Agonist Drug Precautions - CORRECT ANSWER -
Contraindicated with anticoagulant therapy, hepatic failure. Do not administer to clients taking
MAOIs. Do not administer methyldopa through IV line with barbiturates or sulfonamides. Use
cautiously in CVA, MI, DM, depression, or chronic renal failure. Do not use during lactation
Centrally Acting Alpha2 Agonist Drug Side Effects - CORRECT ANSWER - Dry mouth,
drowsiness, sedation, rebound HTN, black or sore tongue, leukopenia
Beta Adrenergic Blockers (Sympatholytics) - CORRECT ANSWER - Inhibit stimulation
of receptor sites, resulting in decreased cardiac excitability, cardiac output, myocardial oxygen
demand, lower BP by decreasing release of renin by kidney. Hypertension, angina,
tachydysrhythmias, HF, MI.
Beta Adrenergic Blocker Medications (Cardioselective Beta1 meds) - CORRECT
ANSWER - Metoprolol (Lopressor), atenolol (Tenormin), Metoprolol succinate (Toprol
XL)
Beta Adrenergic Blocker Medications (Nonselective beta1 and 2 meds) - CORRECT
ANSWER - Propranolol (Inderal), Nadolol (Corgard), Labetalol (Normodyne)
Beta Adrenergic Blocker Precautions - CORRECT ANSWER - Contraindicated in clients
who have AV block and sinus bradycardia, do not administer nonselective beta blockers to clients
who have asthma, bronchospasm, HF, propranolol may mask effects of hypoglycemia in DM, do
,not administer labetalol in same IV line with furosemide. Do not administer if systolic less than
100 and pulse less than 60.
Beta adrenergic blocker side effects - CORRECT ANSWER - Bradycardia, nasal
stuffiness, AV block, rebound myocardium excitation if stopped abruptly, bronchospasm
Vasodilators - CORRECT ANSWER - Direct vasodilation of arteries and veins resulting in
rapid reduction of BP (decreased preload and afterload). Used for hypertensive emergencies.
Precautions: clients who have hepatic or renal disease, older adults, electrolyte imbalances
Vasodilator medications - CORRECT ANSWER - Nitroglycerin (Nitrostat IV): Enalaprilat
(Vasotec IV), Nitroprusside (Nipride), Hydralazine (Apresoline).
Vasodilator Side Effects - CORRECT ANSWER - Dizziness, headache, profound
hypotension, cyanide toxicity, thiocyanate poisoning
Nitroprusside Interventions - CORRECT ANSWER - Should not be mixed with any
medication, apply protective cover to container, discard unused fluid after 24 hour, provide
continuous ECG and blood pressure monitoring
Cardiac Glycosides - CORRECT ANSWER - Used in the treatment of clients who have
cardiac failure or ineffective pumping mechanism of the heart muscle. Increase the force and
velocity of myocardial contractions to improve stroke volume and CO. Slow the conduction rate,
allowing for increased ventricular filling. Used for HF, a fib
Cardiac Glycoside Medication - CORRECT ANSWER - Digoxin (Lanoxin, Lanoxicaps,
Digitek)
Digoxin Precautions/interactions - CORRECT ANSWER - Thiazide or loop diuretics
increase risk of hypokalemia and precipitate digoxin toxicity. ACE and ARBs increase risk of
hyperkalemia. Verapamil (Calan) increases risk of toxicity
, Digoxin Toxicity - CORRECT ANSWER - GI effects (anorexia, n/v, abdominal pain),
CNS effects (fatigue, weakness, diplopia, blurred vision, yellow-green or white halos around
objects)
Digoxin interventions - CORRECT ANSWER - Assess apical pulse for 1 min prior to
administration. Notify HCP if HR less than 60 (adult), less than 70 (child), less than 90 (infant),
monitor for signs of digoxin toxicity, hypokalemia, and hypomagnesemia, notify provider of any
sudden increase in pulse rate that previously normal or low, maintain therapeutic level
Management of Digoxin Toxicity - CORRECT ANSWER - Discontinue digoxin and
potassium-wasting medications, treat dysrhythmias with phenytoin (Dilantin) or lidocaine, treat
bradycardia with atropine, for excess overdose, administer Digibind to prevent absorption
Antianginal Medications - CORRECT ANSWER - Organic nitrates, beta adrenergic-
blocking agents, and calcium channel blockers to treat pain related to imbalances between
myocardial oxygen supply and demand.
Organic Nitrates - CORRECT ANSWER - Relax peripheral vascular smooth muscles,
resulting in dilation of arteries and veins, thus reducing venous blood return (reduced preload) to
the heart, which leads to decreased oxygen demands on the heart. Increase myocardial oxygen
supply by dilating large coronary arteries and redistributing blood flow.
Organic Nitrates Meds - CORRECT ANSWER - Nitrostat (sublingual), nitrolingual
(translingual spray), nitro-bid (topical ointment), nitro-dur (transderm patch)
Organic Nitrate Precautions/interactions - CORRECT ANSWER - Contraindicated in
clients with head injury, hypotensive risk with antihypertensive meds, erectile dysfunction meds
may increase life-threatening hypotension
Organic Nitrates side effects - CORRECT ANSWER - Headache, orthostatic hypotension,
reflex tachycardia, tolerance
