Rasmussen University NUR 2474 Exam 2 (pdf) | 2026/2027 |
Pharmacology Q&A | Pharmacology
1. Which of the following best describes the mechanism of action of ACE
inhibitors in treating hypertension?
A) Blocking beta-1 receptors in the heart to decrease cardiac output
B) Inhibiting the conversion of angiotensin I to angiotensin II, reducing
vasoconstriction and aldosterone secretion
C) Blocking calcium channels in vascular smooth muscle to cause
vasodilation
D) Increasing the excretion of sodium and water by inhibiting sodium
reabsorption in the distal tubule
Correct Answer: Inhibiting the conversion of angiotensin I to angiotensin II,
reducing vasoconstriction and aldosterone secretion
Rationale: ACE inhibitors block the angiotensin-converting enzyme,
preventing the formation of angiotensin II. This leads to vasodilation and
decreased aldosterone release, lowering blood pressure. Beta-blockers
decrease cardiac output, calcium channel blockers cause vasodilation, and
diuretics increase sodium excretion.
2. A patient taking lisinopril reports a persistent, dry, nonproductive cough.
The nurse recognizes this as:
A) A sign of anaphylactic reaction requiring immediate epinephrine
B) A common side effect of ACE inhibitors due to bradykinin accumulation
C) An indication that the medication dosage needs to be increased
D) A psychosomatic response unrelated to the medication
Correct Answer: A common side effect of ACE inhibitors due to bradykinin
accumulation
,Rationale: ACE inhibitors cause a dry cough in 5–20% of patients due to
increased bradykinin levels. ARBs do not cause this cough and are a suitable
alternative. This is not anaphylactic, dose-related, or psychosomatic.
3. A patient with diabetes and hypertension would benefit most from which
antihypertensive class?
A) Beta-blockers
B) Thiazide diuretics
C) ACE inhibitors
D) Calcium channel blockers
Correct Answer: ACE inhibitors
Rationale: ACE inhibitors reduce intraglomerular pressure and slow the
progression of diabetic nephropathy, making them especially beneficial for
patients with diabetes and proteinuria. Beta-blockers, thiazides, and calcium
channel blockers do not offer this renal protective effect.
4. Beta-blockers lower blood pressure primarily through which mechanism?
A) Decreasing peripheral vascular resistance
B) Blocking calcium influx into vascular smooth muscle
C) Decreasing heart rate and myocardial contractility, reducing cardiac
output
D) Inhibiting the renin-angiotensin-aldosterone system
Correct Answer: Decreasing heart rate and myocardial contractility, reducing
cardiac output
Rationale: Beta-blockers lower blood pressure by decreasing heart rate and
myocardial contractility, which reduces cardiac output. They do not directly
,decrease peripheral vascular resistance—that is more characteristic of ACE
inhibitors, ARBs, or direct vasodilators.
5. A client begins taking nifedipine, a calcium channel blocker, along with
metoprolol, a beta-blocker, to treat hypertension. Why was metoprolol
added?
A) To increase the heart rate
B) To reduce the flushing caused by nifedipine
C) To prevent reflex tachycardia
D) To lower potassium levels
Correct Answer: To prevent reflex tachycardia
Rationale: Calcium channel blockers like nifedipine can cause reflex
tachycardia. Beta-blockers like metoprolol are added to blunt this
compensatory increase in heart rate. They do not increase heart rate, reduce
flushing, or lower potassium.
6. A patient with heart failure with reduced ejection fraction is prescribed
sacubitril/valsartan. Which laboratory value requires immediate notification
of the provider?
A) Serum potassium of 5.8 mEq/L
B) Serum sodium of 138 mEq/L
C) Blood urea nitrogen of 20 mg/dL
D) Serum creatinine of 1.0 mg/dL
Correct Answer: Serum potassium of 5.8 mEq/L
Rationale: Sacubitril/valsartan contains an ARB component that can cause
hyperkalemia. A potassium level of 5.8 mEq/L is elevated and requires
, immediate notification. Sodium of 138, BUN of 20, and creatinine of 1.0 are
within normal limits.
7. A patient is brought to the emergency department with shortness of
breath, respiratory rate of 30, intercostal retractions, and frothy pink sputum.
Which medication should the nurse expect to administer?
A) Hydrochlorothiazide
B) Spironolactone
C) Mannitol
D) Furosemide
Correct Answer: Furosemide
Rationale: Furosemide is a potent loop diuretic used when rapid mobilization
of fluid is needed, as in pulmonary edema. Hydrochlorothiazide and
spironolactone are not rapid enough. Mannitol is for increased intracranial
pressure.
8. A patient taking furosemide reports muscle cramps and weakness. The
nurse suspects which electrolyte imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hyponatremia
D) Hypercalcemia
Correct Answer: Hypokalemia
Rationale: Muscle cramps and weakness are classic symptoms of
hypokalemia. Furosemide is a potassium-wasting diuretic that can cause
Pharmacology Q&A | Pharmacology
1. Which of the following best describes the mechanism of action of ACE
inhibitors in treating hypertension?
A) Blocking beta-1 receptors in the heart to decrease cardiac output
B) Inhibiting the conversion of angiotensin I to angiotensin II, reducing
vasoconstriction and aldosterone secretion
C) Blocking calcium channels in vascular smooth muscle to cause
vasodilation
D) Increasing the excretion of sodium and water by inhibiting sodium
reabsorption in the distal tubule
Correct Answer: Inhibiting the conversion of angiotensin I to angiotensin II,
reducing vasoconstriction and aldosterone secretion
Rationale: ACE inhibitors block the angiotensin-converting enzyme,
preventing the formation of angiotensin II. This leads to vasodilation and
decreased aldosterone release, lowering blood pressure. Beta-blockers
decrease cardiac output, calcium channel blockers cause vasodilation, and
diuretics increase sodium excretion.
2. A patient taking lisinopril reports a persistent, dry, nonproductive cough.
The nurse recognizes this as:
A) A sign of anaphylactic reaction requiring immediate epinephrine
B) A common side effect of ACE inhibitors due to bradykinin accumulation
C) An indication that the medication dosage needs to be increased
D) A psychosomatic response unrelated to the medication
Correct Answer: A common side effect of ACE inhibitors due to bradykinin
accumulation
,Rationale: ACE inhibitors cause a dry cough in 5–20% of patients due to
increased bradykinin levels. ARBs do not cause this cough and are a suitable
alternative. This is not anaphylactic, dose-related, or psychosomatic.
3. A patient with diabetes and hypertension would benefit most from which
antihypertensive class?
A) Beta-blockers
B) Thiazide diuretics
C) ACE inhibitors
D) Calcium channel blockers
Correct Answer: ACE inhibitors
Rationale: ACE inhibitors reduce intraglomerular pressure and slow the
progression of diabetic nephropathy, making them especially beneficial for
patients with diabetes and proteinuria. Beta-blockers, thiazides, and calcium
channel blockers do not offer this renal protective effect.
4. Beta-blockers lower blood pressure primarily through which mechanism?
A) Decreasing peripheral vascular resistance
B) Blocking calcium influx into vascular smooth muscle
C) Decreasing heart rate and myocardial contractility, reducing cardiac
output
D) Inhibiting the renin-angiotensin-aldosterone system
Correct Answer: Decreasing heart rate and myocardial contractility, reducing
cardiac output
Rationale: Beta-blockers lower blood pressure by decreasing heart rate and
myocardial contractility, which reduces cardiac output. They do not directly
,decrease peripheral vascular resistance—that is more characteristic of ACE
inhibitors, ARBs, or direct vasodilators.
5. A client begins taking nifedipine, a calcium channel blocker, along with
metoprolol, a beta-blocker, to treat hypertension. Why was metoprolol
added?
A) To increase the heart rate
B) To reduce the flushing caused by nifedipine
C) To prevent reflex tachycardia
D) To lower potassium levels
Correct Answer: To prevent reflex tachycardia
Rationale: Calcium channel blockers like nifedipine can cause reflex
tachycardia. Beta-blockers like metoprolol are added to blunt this
compensatory increase in heart rate. They do not increase heart rate, reduce
flushing, or lower potassium.
6. A patient with heart failure with reduced ejection fraction is prescribed
sacubitril/valsartan. Which laboratory value requires immediate notification
of the provider?
A) Serum potassium of 5.8 mEq/L
B) Serum sodium of 138 mEq/L
C) Blood urea nitrogen of 20 mg/dL
D) Serum creatinine of 1.0 mg/dL
Correct Answer: Serum potassium of 5.8 mEq/L
Rationale: Sacubitril/valsartan contains an ARB component that can cause
hyperkalemia. A potassium level of 5.8 mEq/L is elevated and requires
, immediate notification. Sodium of 138, BUN of 20, and creatinine of 1.0 are
within normal limits.
7. A patient is brought to the emergency department with shortness of
breath, respiratory rate of 30, intercostal retractions, and frothy pink sputum.
Which medication should the nurse expect to administer?
A) Hydrochlorothiazide
B) Spironolactone
C) Mannitol
D) Furosemide
Correct Answer: Furosemide
Rationale: Furosemide is a potent loop diuretic used when rapid mobilization
of fluid is needed, as in pulmonary edema. Hydrochlorothiazide and
spironolactone are not rapid enough. Mannitol is for increased intracranial
pressure.
8. A patient taking furosemide reports muscle cramps and weakness. The
nurse suspects which electrolyte imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hyponatremia
D) Hypercalcemia
Correct Answer: Hypokalemia
Rationale: Muscle cramps and weakness are classic symptoms of
hypokalemia. Furosemide is a potassium-wasting diuretic that can cause
