1
NCLEX PN Exam Bank Antihypertensives and
Diuretic Use in Clinical Practice
Table of Contents
Subtopic 1: Classes of Antihypertensives – Mechanisms, Effects, and Indications ............. 2
Subtopic 2: Nursing Considerations and Monitoring Parameters for Antihypertensives and
Diuretics .................................................................................................................... 10
Subtopic 3: Patient Education and Compliance with Antihypertensive and Diuretic Therapy
.................................................................................................................................. 19
Subtopic 4: Adverse Effects and Drug Interactions of Antihypertensives and Diuretics ..... 27
Subtopic 5: Special Populations – Antihypertensives and Diuretics in Elderly, Pregnant
Women, and Children ................................................................................................. 36
Subtopic 6: Pharmacologic Interactions and Contraindications with Antihypertensives and
Diuretics .................................................................................................................... 44
Subtopic 7: Nursing Considerations and Patient Safety with Antihypertensives and
Diuretics .................................................................................................................... 53
Subtopic 8: Drug Interactions and Contraindications in Antihypertensive and Diuretic Use
.................................................................................................................................. 61
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Subtopic 1: Classes of Antihypertensives –
Mechanisms, Effects, and Indications
Question 1:
Which class of antihypertensive medications works by blocking the conversion of
angiotensin I to angiotensin II?
A. Beta-blockers
B. Calcium channel blockers
C. ACE inhibitors
D. Alpha-blockers
Correct Answer: C. ACE inhibitors
Rationale: ACE inhibitors inhibit the angiotensin-converting enzyme (ACE), which converts
angiotensin I to angiotensin II, a potent vasoconstrictor. This results in vasodilation and
reduced blood pressure.
Question 2:
A patient is started on a thiazide diuretic. Which electrolyte imbalance is most commonly
associated with this medication?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypocalcemia
Correct Answer: C. Hypokalemia
Rationale: Thiazide diuretics promote potassium loss in the urine, increasing the risk of
hypokalemia. Monitoring potassium levels is important during therapy.
, 3
Question 3:
Which beta-blocker is cardioselective and primarily affects beta-1 receptors in the heart?
A. Propranolol
B. Metoprolol
C. Labetalol
D. Carvedilol
Correct Answer: B. Metoprolol
Rationale: Metoprolol selectively blocks beta-1 receptors, reducing heart rate and
contractility with fewer respiratory side effects than non-selective beta-blockers.
Question 4:
Which antihypertensive class causes vasodilation by blocking calcium from entering
smooth muscle cells?
A. ACE inhibitors
B. ARBs
C. Calcium channel blockers
D. Diuretics
Correct Answer: C. Calcium channel blockers
Rationale: Calcium channel blockers relax blood vessels by inhibiting calcium entry into
vascular smooth muscle cells, leading to decreased peripheral resistance and blood
pressure.
Question 5:
Which medication is an example of an angiotensin II receptor blocker (ARB)?
A. Lisinopril
, 4
B. Amlodipine
C. Losartan
D. Atenolol
Correct Answer: C. Losartan
Rationale: Losartan is an ARB that blocks the effects of angiotensin II, leading to
vasodilation and decreased blood pressure.
Question 6:
Which of the following is a potassium-sparing diuretic?
A. Furosemide
B. Spironolactone
C. Hydrochlorothiazide
D. Bumetanide
Correct Answer: B. Spironolactone
Rationale: Spironolactone conserves potassium by antagonizing aldosterone in the distal
nephron, preventing potassium loss.
Question 7:
What is a common adverse effect of ACE inhibitors that may require discontinuation of the
drug?
A. Diarrhea
B. Rash
C. Dry cough
D. Constipation
NCLEX PN Exam Bank Antihypertensives and
Diuretic Use in Clinical Practice
Table of Contents
Subtopic 1: Classes of Antihypertensives – Mechanisms, Effects, and Indications ............. 2
Subtopic 2: Nursing Considerations and Monitoring Parameters for Antihypertensives and
Diuretics .................................................................................................................... 10
Subtopic 3: Patient Education and Compliance with Antihypertensive and Diuretic Therapy
.................................................................................................................................. 19
Subtopic 4: Adverse Effects and Drug Interactions of Antihypertensives and Diuretics ..... 27
Subtopic 5: Special Populations – Antihypertensives and Diuretics in Elderly, Pregnant
Women, and Children ................................................................................................. 36
Subtopic 6: Pharmacologic Interactions and Contraindications with Antihypertensives and
Diuretics .................................................................................................................... 44
Subtopic 7: Nursing Considerations and Patient Safety with Antihypertensives and
Diuretics .................................................................................................................... 53
Subtopic 8: Drug Interactions and Contraindications in Antihypertensive and Diuretic Use
.................................................................................................................................. 61
, 2
Subtopic 1: Classes of Antihypertensives –
Mechanisms, Effects, and Indications
Question 1:
Which class of antihypertensive medications works by blocking the conversion of
angiotensin I to angiotensin II?
A. Beta-blockers
B. Calcium channel blockers
C. ACE inhibitors
D. Alpha-blockers
Correct Answer: C. ACE inhibitors
Rationale: ACE inhibitors inhibit the angiotensin-converting enzyme (ACE), which converts
angiotensin I to angiotensin II, a potent vasoconstrictor. This results in vasodilation and
reduced blood pressure.
Question 2:
A patient is started on a thiazide diuretic. Which electrolyte imbalance is most commonly
associated with this medication?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypocalcemia
Correct Answer: C. Hypokalemia
Rationale: Thiazide diuretics promote potassium loss in the urine, increasing the risk of
hypokalemia. Monitoring potassium levels is important during therapy.
, 3
Question 3:
Which beta-blocker is cardioselective and primarily affects beta-1 receptors in the heart?
A. Propranolol
B. Metoprolol
C. Labetalol
D. Carvedilol
Correct Answer: B. Metoprolol
Rationale: Metoprolol selectively blocks beta-1 receptors, reducing heart rate and
contractility with fewer respiratory side effects than non-selective beta-blockers.
Question 4:
Which antihypertensive class causes vasodilation by blocking calcium from entering
smooth muscle cells?
A. ACE inhibitors
B. ARBs
C. Calcium channel blockers
D. Diuretics
Correct Answer: C. Calcium channel blockers
Rationale: Calcium channel blockers relax blood vessels by inhibiting calcium entry into
vascular smooth muscle cells, leading to decreased peripheral resistance and blood
pressure.
Question 5:
Which medication is an example of an angiotensin II receptor blocker (ARB)?
A. Lisinopril
, 4
B. Amlodipine
C. Losartan
D. Atenolol
Correct Answer: C. Losartan
Rationale: Losartan is an ARB that blocks the effects of angiotensin II, leading to
vasodilation and decreased blood pressure.
Question 6:
Which of the following is a potassium-sparing diuretic?
A. Furosemide
B. Spironolactone
C. Hydrochlorothiazide
D. Bumetanide
Correct Answer: B. Spironolactone
Rationale: Spironolactone conserves potassium by antagonizing aldosterone in the distal
nephron, preventing potassium loss.
Question 7:
What is a common adverse effect of ACE inhibitors that may require discontinuation of the
drug?
A. Diarrhea
B. Rash
C. Dry cough
D. Constipation
