NURS 635 COMPREHENSIVE EXAM 2025/2026 QUESTIONS
WITH ANSWERS GRADED A+
✔✔A patient with chronic congestive heart failure has repeated hospitalizations in spite
of ongoing treatment with hydrochlorothiazide [HydroDIURIL] and digoxin. The
prescriber has ordered spironolactone [Aldactone] to be added to this patient's drug
regimen, and the nurse provides education about this medication. Which statement by
the patient indicates understanding of the teaching? - ✔✔I need to stop taking
potassium supplements
✔✔A patient who stops taking an ACE inhibitor because of its side effects will begin
taking an angiotensin II receptor blocker (ARB) medication. Which side effect of ACE
inhibitors will not occur with an ARB medication? - ✔✔Hyperkalemia
✔✔A patient who is taking furosemide [Lasix] and digoxin will begin taking captopril
[Capoten]. The nurse is providing information about the drug. Which statement by the
patient indicates a need for further teaching? - ✔✔―I should take this medication on a
full stomach.
(Most oral formulations of ACE inhibitors may be given without regard for meals;
captopril and moexipril, however, should be given 1 hour before meals.)
✔✔A female patient who is not taking any other medications is prescribed aliskiren
[Tekturna], a direct renin inhibitor (DRI). The nurse reviews medication information with
the patient. Which statement by the patient indicates understanding of the teaching? -
✔✔I should take this medication 1 hour before sitting down to a meal.
✔✔A nurse administers an ACE inhibitor to a patient who is taking the drug for the first
time. What will the nurse do? - ✔✔Instruct the patient not to get up without assistance.
✔✔A provider has ordered captopril [Capoten] for a patient who has hypertension. The
patient reports a history of swelling of the tongue and lips after taking enalapril [Vasotec]
in the past. Which action by the nurse is correct? - ✔✔Hold the dose and notify the
provider.
✔✔A patient with hypertension is prescribed an angiotensin-converting enzyme (ACE)
inhibitor. The nurse reviewing this patient's chart before administering the medication
will be most concerned about which other disease process? - ✔✔Renal arterystenosis
✔✔A patient who has been taking an antihypertensive medication for several years is
recovering froma myocardial infarction. The prescriber changes the patient's medication
to an ACE inhibitor. The patient asks the nurse why a new drug is necessary. What is
the nurse's response? - ✔✔ACE inhibitors can prevent or reverse pathologic changes in
the heart's structure.
,✔✔A female patient who begins taking spironolactone [Aldactone] as an adjunct to
furosemide [Lasix] complains that her voice is deepening. What will the nurse do? -
✔✔Explain that this drug binds with receptors for steroid hormones, causing this effect.
✔✔A prescriber orders ramipril [Altace] for an obese patient with type 2 diabetes
mellitus who has developed hypertension. The nurse provides teaching before
dismissing the patient home. Which statement by the patient indicates understanding of
the teaching? - ✔✔Taking this medication helps reduce my risk of stroke and heart
attack.
✔✔A female patient taking an ACE inhibitor learns that she is pregnant. What will the
nurse tell this patient? - ✔✔The patient should stop taking the medication and contact
her provider immediately.
✔✔A nurse is reviewing a patient's medications before administration. Which drug-to-
drug interactions will most concern the nurse in a patient with a history of heart failure
and a potassium level of 5.5 mEq/L? - ✔✔Captopril [Capoten] and spironolactone
[Aldactone]
✔✔A patient begins taking an ACE inhibitor and complains of a dry cough. What does
the nurse correctly tell the patient about this symptom? - ✔✔It may be uncomfortable
enough that the drug will need to bediscontinued.
✔✔A nurse is caring for a patient who is receiving verapamil [Calan] for hypertension
and digoxin [Lanoxin] for heart failure. The nurse will observe this patient for: - ✔✔AV
blockade.
(Verapamil and digoxin both suppress impulse conduction through the AV node; when
the two drugs are used concurrently, the risk of AV blockade is increased.)
✔✔A nurse is teaching a patient who will begin taking verapamil [Calan] for
hypertension about the drug's side effects. Which statement bythe patient indicates
understanding of the teaching? - ✔✔I may become constipated, so I should increase
fluids and fiber
✔✔A patient who took an overdose of verapamil has been treated with gastric lavage
and a cathartic. The emergency department nurse assesses the patient and notes a
heart rate of 50 beats/minute and a blood pressure of 90/50 mm Hg. The nurse will
anticipate: - ✔✔administering intravenous norepinephrine (NE) and atropine and
glucagon.
✔✔A nurse is preparing to assist a nursing student to administer intravenous verapamil
to a patient who also receives a beta blocker. The nurse asks the nursing student to
discuss the plan of care for this patient. Which statement by the student indicates a
, need for further teaching? - ✔✔I will monitor the heart rate frequently to assess for
reflex tachycardia.‖
✔✔A patient who has been taking verapamil [Calan] for hypertension complains of
constipation. The patient will begin taking amlodipine [Norvasc] to avoid this side effect.
The nurse provides teaching about the difference between the two drugs. Which
statement by the patient indicates that further teaching is needed? - ✔✔I will need to
take a beta blocker to prevent reflex tachycardia.‖
✔✔Which are therapeutic uses for verapamil? Select all that apply. - ✔✔Angina of effort
Cardiac dysrhythmias Essential hypertension
✔✔A patient begins taking nifedipine [Procardia], along with metoprolol, to treat
hypertension. The nurse understands that metoprolol is used to: - ✔✔prevent reflex
tachycardia.
✔✔Which medications are most likely to cause postural hypotension? Select all that
apply. - ✔✔Prazosin [Minipress] Captopril [Capoten] Losartan [Cozaar]
✔✔The nurse is caring for a patient who is taking a vasodilator that dilates capacitance
vessels. The nurse will expect which effect in this patient? - ✔✔Decrease in cardiac
work
✔✔A nurse is obtaining a medication history on a newly admitted patient, who reports
taking minoxidil for hypertension. Admission vital signs reveal a heart rate of 78
beats/minute and a blood pressure of 120/80 mm Hg. What is an important part of the
initial assessment for this patient? - ✔✔Evaluating ankle edema
✔✔A female patient with essential hypertension is being treated with hydralazine 25 mg
twice daily. The nurse assesses the patient and notes a heart rate of 96 beats/minute
and a blood pressure of 110/72 mm Hg. The nurse will request an order to: -
✔✔administer a beta blocker.
✔✔A nurse is administering a vasodilator that dilates resistance vessels. The nurse
understands that this drug will have which effect on the patient? - ✔✔Increased tissue
perfusion
✔✔A patient is taking a vasodilator that relaxes smooth muscles in veins. To help
minimize drug side effects, the nurse caring for this patient will: - ✔✔caution the patient
not to get up abruptly
✔✔Which patients may receive hydralazine to treat hypertension? Select all that apply.
- ✔✔A 1-month-old infant A 5-year-old child
WITH ANSWERS GRADED A+
✔✔A patient with chronic congestive heart failure has repeated hospitalizations in spite
of ongoing treatment with hydrochlorothiazide [HydroDIURIL] and digoxin. The
prescriber has ordered spironolactone [Aldactone] to be added to this patient's drug
regimen, and the nurse provides education about this medication. Which statement by
the patient indicates understanding of the teaching? - ✔✔I need to stop taking
potassium supplements
✔✔A patient who stops taking an ACE inhibitor because of its side effects will begin
taking an angiotensin II receptor blocker (ARB) medication. Which side effect of ACE
inhibitors will not occur with an ARB medication? - ✔✔Hyperkalemia
✔✔A patient who is taking furosemide [Lasix] and digoxin will begin taking captopril
[Capoten]. The nurse is providing information about the drug. Which statement by the
patient indicates a need for further teaching? - ✔✔―I should take this medication on a
full stomach.
(Most oral formulations of ACE inhibitors may be given without regard for meals;
captopril and moexipril, however, should be given 1 hour before meals.)
✔✔A female patient who is not taking any other medications is prescribed aliskiren
[Tekturna], a direct renin inhibitor (DRI). The nurse reviews medication information with
the patient. Which statement by the patient indicates understanding of the teaching? -
✔✔I should take this medication 1 hour before sitting down to a meal.
✔✔A nurse administers an ACE inhibitor to a patient who is taking the drug for the first
time. What will the nurse do? - ✔✔Instruct the patient not to get up without assistance.
✔✔A provider has ordered captopril [Capoten] for a patient who has hypertension. The
patient reports a history of swelling of the tongue and lips after taking enalapril [Vasotec]
in the past. Which action by the nurse is correct? - ✔✔Hold the dose and notify the
provider.
✔✔A patient with hypertension is prescribed an angiotensin-converting enzyme (ACE)
inhibitor. The nurse reviewing this patient's chart before administering the medication
will be most concerned about which other disease process? - ✔✔Renal arterystenosis
✔✔A patient who has been taking an antihypertensive medication for several years is
recovering froma myocardial infarction. The prescriber changes the patient's medication
to an ACE inhibitor. The patient asks the nurse why a new drug is necessary. What is
the nurse's response? - ✔✔ACE inhibitors can prevent or reverse pathologic changes in
the heart's structure.
,✔✔A female patient who begins taking spironolactone [Aldactone] as an adjunct to
furosemide [Lasix] complains that her voice is deepening. What will the nurse do? -
✔✔Explain that this drug binds with receptors for steroid hormones, causing this effect.
✔✔A prescriber orders ramipril [Altace] for an obese patient with type 2 diabetes
mellitus who has developed hypertension. The nurse provides teaching before
dismissing the patient home. Which statement by the patient indicates understanding of
the teaching? - ✔✔Taking this medication helps reduce my risk of stroke and heart
attack.
✔✔A female patient taking an ACE inhibitor learns that she is pregnant. What will the
nurse tell this patient? - ✔✔The patient should stop taking the medication and contact
her provider immediately.
✔✔A nurse is reviewing a patient's medications before administration. Which drug-to-
drug interactions will most concern the nurse in a patient with a history of heart failure
and a potassium level of 5.5 mEq/L? - ✔✔Captopril [Capoten] and spironolactone
[Aldactone]
✔✔A patient begins taking an ACE inhibitor and complains of a dry cough. What does
the nurse correctly tell the patient about this symptom? - ✔✔It may be uncomfortable
enough that the drug will need to bediscontinued.
✔✔A nurse is caring for a patient who is receiving verapamil [Calan] for hypertension
and digoxin [Lanoxin] for heart failure. The nurse will observe this patient for: - ✔✔AV
blockade.
(Verapamil and digoxin both suppress impulse conduction through the AV node; when
the two drugs are used concurrently, the risk of AV blockade is increased.)
✔✔A nurse is teaching a patient who will begin taking verapamil [Calan] for
hypertension about the drug's side effects. Which statement bythe patient indicates
understanding of the teaching? - ✔✔I may become constipated, so I should increase
fluids and fiber
✔✔A patient who took an overdose of verapamil has been treated with gastric lavage
and a cathartic. The emergency department nurse assesses the patient and notes a
heart rate of 50 beats/minute and a blood pressure of 90/50 mm Hg. The nurse will
anticipate: - ✔✔administering intravenous norepinephrine (NE) and atropine and
glucagon.
✔✔A nurse is preparing to assist a nursing student to administer intravenous verapamil
to a patient who also receives a beta blocker. The nurse asks the nursing student to
discuss the plan of care for this patient. Which statement by the student indicates a
, need for further teaching? - ✔✔I will monitor the heart rate frequently to assess for
reflex tachycardia.‖
✔✔A patient who has been taking verapamil [Calan] for hypertension complains of
constipation. The patient will begin taking amlodipine [Norvasc] to avoid this side effect.
The nurse provides teaching about the difference between the two drugs. Which
statement by the patient indicates that further teaching is needed? - ✔✔I will need to
take a beta blocker to prevent reflex tachycardia.‖
✔✔Which are therapeutic uses for verapamil? Select all that apply. - ✔✔Angina of effort
Cardiac dysrhythmias Essential hypertension
✔✔A patient begins taking nifedipine [Procardia], along with metoprolol, to treat
hypertension. The nurse understands that metoprolol is used to: - ✔✔prevent reflex
tachycardia.
✔✔Which medications are most likely to cause postural hypotension? Select all that
apply. - ✔✔Prazosin [Minipress] Captopril [Capoten] Losartan [Cozaar]
✔✔The nurse is caring for a patient who is taking a vasodilator that dilates capacitance
vessels. The nurse will expect which effect in this patient? - ✔✔Decrease in cardiac
work
✔✔A nurse is obtaining a medication history on a newly admitted patient, who reports
taking minoxidil for hypertension. Admission vital signs reveal a heart rate of 78
beats/minute and a blood pressure of 120/80 mm Hg. What is an important part of the
initial assessment for this patient? - ✔✔Evaluating ankle edema
✔✔A female patient with essential hypertension is being treated with hydralazine 25 mg
twice daily. The nurse assesses the patient and notes a heart rate of 96 beats/minute
and a blood pressure of 110/72 mm Hg. The nurse will request an order to: -
✔✔administer a beta blocker.
✔✔A nurse is administering a vasodilator that dilates resistance vessels. The nurse
understands that this drug will have which effect on the patient? - ✔✔Increased tissue
perfusion
✔✔A patient is taking a vasodilator that relaxes smooth muscles in veins. To help
minimize drug side effects, the nurse caring for this patient will: - ✔✔caution the patient
not to get up abruptly
✔✔Which patients may receive hydralazine to treat hypertension? Select all that apply.
- ✔✔A 1-month-old infant A 5-year-old child
