ACTUAL MARYVILLE NURS 615 PHARM EXAM 5 |2025-2026
LATEST UPDATED| REAL EXAM QUESTIONS AND ANSWERS
| 100% RATED CORRECT | 100% VERFIED | ALREADY
GRADED A+
What assessments should be made before prescribing any antihypertensive agent? - (answer)BP,
RF, and head to toe assessment. Assess diet, sodium intake, electrolytes, and potassium levels.
Prior to prescribing any antihypertensives, creatinine and BUN levels should be evaluated.
Confirmation of elevated BP at 3 different times. Children over 3 years old should be assessed at
least once at every visit-preferred method for children is by auscultation, the correct
measurement requires using a cuff that is appropriate to the child's upper arm. 12 lead EKG. UA,
albumin, albumin/creatinine ratio. Diabetics or those with renal disease should have the
albumin/creatinine ratio annually. The presence of albuminuria, micro albuminuria even in the
setting of normal GFR is associated with increased cardiovascular risk. Blood sugar, hct, serum
calcium, and lipid profile.
Why are ACE inhibitors the drug of choice in diabetic patients with hypertension? -
(answer)ACE-Is will improve insulin sensitivity, as well as reduce the effects of DM on the
kidneys. Protect the kidneys, watch for renal function, any creatinine >2.5 requires dose
reduction. Prevents diabetic nephropathy or slow its progression. Reduce albuminuria and BP.
ACEIs and ARBs should be used to treat the HTN. Renal protection, reduces the conversion of
AT II and improve the insulin sensitivity.
,What is the drug of choice to improve symptoms for patients taking propranolol? -
(answer)Ipratropium
What is the most common adverse effect of an ACE inhibitor? - (answer)Dry, hacking cough in
some patients. Can switch to an angiotensin blocker which won't cause cough. Reduce dose with
either of these if Cr >2.5. Most are associated with hypotension, dizziness, HA, fatigue,
orthostatic hypotension, tachyphylaxis.
What is the action of an ACE inhibitor? - (answer)Decreases angiotensin II and aldosterone.
Vasodilatation on the venous and arterial sides of the heart. Blocks the RAAS system leads to
rennin acts on angiotensinogen to angiotensin I to angiotensin II through ACE. Angiotensin II
stimulates aldosterone causing sodium and water while losing potassium via the kidney. ACE is
also involved in the inactivation of bradykinin a vasodilator. Bradykin is what causes the cough
(irritating the lungs).
What is the action of an Angiotensin Receptor Blocker? - (answer)Blocks the angiotensin II
receptor to leading to increasing vascular tone and stimulating vascular smooth muscle
contraction. One of the greatest advantages: doesn't produce the dry, hacking cough that ACE-Is
do. Similar to ACE-I except to bradykinin activity (no cough), lowers BP, decreases vascular
resistance, decreases pulmonary cap wedge pressure, decreases HR, increases cardiac index.
,What ethnic background should not be prescribed long-acting beta-agonists? - (answer)African
Americans, increased incidence of death in this population
What is tiotropium used to treat? - (answer)COPD, after patient stops smoking, this medication
slow the progression of COPD.
What is the action of a Calcium Channel Blocker? - (answer)Decrease the amount of calcium
inside the cell to control blood pressure. Dihydropyridine CCB: inhibits transmembrane influx of
extracellular calcium ions across myocardial and vascular smooth muscle cell membranes
without changing serum calcium concentrations. This results in inhibition of cardiac and vascular
smooth muscle contraction, thereby dilating main coronary and systemic arteries. Vasodilatation
with decreased peripheral resistance and increased heart rate. Nondihydropyridine CCB: inhibits
extracellular calcium ion influx across membranes of myocardial cells and vascular smooth
muscle cells. Resulting in inhibition of cardiac and vascular smooth muscle contraction and
thereby dilating main coronary and systemic arteries. No effect on serum calcium contractions.
Substantial inhibitory effects on cardiac conduction system, acting principally at AV node, with
some effects at sinus node.
What are the adverse effects of a dihydropyridine-type calcium channel blocker? -
(answer)Causes edema of the feet and hands, especially feet. Amlodipine and nifedipine. Type 2
, (dihydropyridine=vessel loving) = peripheral edema. Type 1 (non-dihydropyridine=heart
loving)=bradycardia, dizziness, hypotension.
A 70-year-old patient is admitted with peripheral edema. He is taking a calcium channel blocker
and metformin. What is the cause of his peripheral edema? - (answer)The edema is not related to
metformin. Type 1 CCB more commonly exhibit peripheral edema. Pts report swelling of the
hands, feet, ankles, and decreased urine output.
What special populations should not be prescribed pseudoephedrine? - (answer)Children under
the age of 4, first line treatment for coughs and colds is increased fluids and symptomatic
management. Schedule III- addictive personalities, HTN, CAD. Children under 4= Infants cause
sudden death, not recommended for children under 4. Anytime thinking of cough and cold
medications you should always think of the elderly, very young and HTN.
How is amlodipine metabolized? - (answer)All CCBs are metabolized by the liver in the CYP
3A4. Avoid, don't administer CCB with grapefruit juice, it will increase amlodipine level. Has a
half life of 30-50 hours (56hr in hepatic impairment), eliminated via urine.
A patient is prescribed amlodipine. She develops reflex tachycardia. What is the reason for the
development of bradycardia? - (answer)It increases the myocardial oxygen delivery in patients
with angina. Sub-peripheral vasodilatation causes such a dramatic drop in BP that baroreceptor
LATEST UPDATED| REAL EXAM QUESTIONS AND ANSWERS
| 100% RATED CORRECT | 100% VERFIED | ALREADY
GRADED A+
What assessments should be made before prescribing any antihypertensive agent? - (answer)BP,
RF, and head to toe assessment. Assess diet, sodium intake, electrolytes, and potassium levels.
Prior to prescribing any antihypertensives, creatinine and BUN levels should be evaluated.
Confirmation of elevated BP at 3 different times. Children over 3 years old should be assessed at
least once at every visit-preferred method for children is by auscultation, the correct
measurement requires using a cuff that is appropriate to the child's upper arm. 12 lead EKG. UA,
albumin, albumin/creatinine ratio. Diabetics or those with renal disease should have the
albumin/creatinine ratio annually. The presence of albuminuria, micro albuminuria even in the
setting of normal GFR is associated with increased cardiovascular risk. Blood sugar, hct, serum
calcium, and lipid profile.
Why are ACE inhibitors the drug of choice in diabetic patients with hypertension? -
(answer)ACE-Is will improve insulin sensitivity, as well as reduce the effects of DM on the
kidneys. Protect the kidneys, watch for renal function, any creatinine >2.5 requires dose
reduction. Prevents diabetic nephropathy or slow its progression. Reduce albuminuria and BP.
ACEIs and ARBs should be used to treat the HTN. Renal protection, reduces the conversion of
AT II and improve the insulin sensitivity.
,What is the drug of choice to improve symptoms for patients taking propranolol? -
(answer)Ipratropium
What is the most common adverse effect of an ACE inhibitor? - (answer)Dry, hacking cough in
some patients. Can switch to an angiotensin blocker which won't cause cough. Reduce dose with
either of these if Cr >2.5. Most are associated with hypotension, dizziness, HA, fatigue,
orthostatic hypotension, tachyphylaxis.
What is the action of an ACE inhibitor? - (answer)Decreases angiotensin II and aldosterone.
Vasodilatation on the venous and arterial sides of the heart. Blocks the RAAS system leads to
rennin acts on angiotensinogen to angiotensin I to angiotensin II through ACE. Angiotensin II
stimulates aldosterone causing sodium and water while losing potassium via the kidney. ACE is
also involved in the inactivation of bradykinin a vasodilator. Bradykin is what causes the cough
(irritating the lungs).
What is the action of an Angiotensin Receptor Blocker? - (answer)Blocks the angiotensin II
receptor to leading to increasing vascular tone and stimulating vascular smooth muscle
contraction. One of the greatest advantages: doesn't produce the dry, hacking cough that ACE-Is
do. Similar to ACE-I except to bradykinin activity (no cough), lowers BP, decreases vascular
resistance, decreases pulmonary cap wedge pressure, decreases HR, increases cardiac index.
,What ethnic background should not be prescribed long-acting beta-agonists? - (answer)African
Americans, increased incidence of death in this population
What is tiotropium used to treat? - (answer)COPD, after patient stops smoking, this medication
slow the progression of COPD.
What is the action of a Calcium Channel Blocker? - (answer)Decrease the amount of calcium
inside the cell to control blood pressure. Dihydropyridine CCB: inhibits transmembrane influx of
extracellular calcium ions across myocardial and vascular smooth muscle cell membranes
without changing serum calcium concentrations. This results in inhibition of cardiac and vascular
smooth muscle contraction, thereby dilating main coronary and systemic arteries. Vasodilatation
with decreased peripheral resistance and increased heart rate. Nondihydropyridine CCB: inhibits
extracellular calcium ion influx across membranes of myocardial cells and vascular smooth
muscle cells. Resulting in inhibition of cardiac and vascular smooth muscle contraction and
thereby dilating main coronary and systemic arteries. No effect on serum calcium contractions.
Substantial inhibitory effects on cardiac conduction system, acting principally at AV node, with
some effects at sinus node.
What are the adverse effects of a dihydropyridine-type calcium channel blocker? -
(answer)Causes edema of the feet and hands, especially feet. Amlodipine and nifedipine. Type 2
, (dihydropyridine=vessel loving) = peripheral edema. Type 1 (non-dihydropyridine=heart
loving)=bradycardia, dizziness, hypotension.
A 70-year-old patient is admitted with peripheral edema. He is taking a calcium channel blocker
and metformin. What is the cause of his peripheral edema? - (answer)The edema is not related to
metformin. Type 1 CCB more commonly exhibit peripheral edema. Pts report swelling of the
hands, feet, ankles, and decreased urine output.
What special populations should not be prescribed pseudoephedrine? - (answer)Children under
the age of 4, first line treatment for coughs and colds is increased fluids and symptomatic
management. Schedule III- addictive personalities, HTN, CAD. Children under 4= Infants cause
sudden death, not recommended for children under 4. Anytime thinking of cough and cold
medications you should always think of the elderly, very young and HTN.
How is amlodipine metabolized? - (answer)All CCBs are metabolized by the liver in the CYP
3A4. Avoid, don't administer CCB with grapefruit juice, it will increase amlodipine level. Has a
half life of 30-50 hours (56hr in hepatic impairment), eliminated via urine.
A patient is prescribed amlodipine. She develops reflex tachycardia. What is the reason for the
development of bradycardia? - (answer)It increases the myocardial oxygen delivery in patients
with angina. Sub-peripheral vasodilatation causes such a dramatic drop in BP that baroreceptor
