NUR 521 Exam 2 Study Guide | University of Alabama –
Capstone College of Nursing (2026) – Advanced Pharmacology
of Endocrine and Diabetic Agents
Question 1
Which medication is an angiotensin-converting enzyme (ACE) inhibitor
commonly used to treat hypertension and heart failure?
A. Losartan
B. Lisinopril
C. Amlodipine
D. Metoprolol
Correct Answer: B. Lisinopril
Rationale: Lisinopril is an ACE inhibitor that decreases conversion of
angiotensin I to angiotensin II. This reduces vasoconstriction and aldosterone
secretion, resulting in lower blood pressure and decreased cardiac workload.
Losartan is an ARB, amlodipine is a calcium-channel blocker, and metoprolol
is a beta blocker.
Question 2
A patient taking lisinopril reports swelling of the lips and tongue. What is the
nurse's priority action?
A. Administer the next dose with food
B. Place the patient in a supine position
C. Hold the medication and assess the airway
D. Encourage increased fluid intake
Correct Answer: C. Hold the medication and assess the airway
Rationale: Facial, lip, or tongue swelling can indicate angioedema, a
potentially life-threatening adverse effect of ACE inhibitors. Airway
compromise can develop rapidly. The medication should be withheld, the
airway assessed, and emergency treatment initiated as appropriate.
1|Page
,Question 3
Which laboratory value is particularly important to monitor in a patient
receiving an ACE inhibitor?
A. Potassium
B. Hemoglobin
C. Platelet count
D. Calcium
Correct Answer: A. Potassium
Rationale: ACE inhibitors decrease aldosterone secretion, which can reduce
potassium excretion and cause hyperkalemia. Renal function, especially
serum creatinine, should also be monitored because ACE inhibitors can affect
renal perfusion and kidney function.
Question 4
Which medication is an angiotensin II receptor blocker (ARB)?
A. Enalapril
B. Losartan
C. Diltiazem
D. Hydrochlorothiazide
Correct Answer: B. Losartan
Rationale: Losartan blocks angiotensin II receptors, preventing angiotensin II
from producing vasoconstriction and stimulating aldosterone release. ARBs
are commonly used when an ACE inhibitor causes troublesome cough. Like
ACE inhibitors, ARBs can cause hyperkalemia and are contraindicated during
pregnancy.
Question 5
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,A patient taking losartan asks why the medication is prescribed. Which
response is most appropriate?
A. “It increases heart rate to improve circulation.”
B. “It blocks the effects of angiotensin II and lowers blood pressure.”
C. “It directly increases sodium retention.”
D. “It increases blood volume to improve cardiac output.”
Correct Answer: B. “It blocks the effects of angiotensin II and lowers
blood pressure.”
Rationale: Losartan blocks the AT₁ receptor for angiotensin II. This promotes
vasodilation and decreases aldosterone-mediated sodium and water
retention, lowering blood pressure and reducing cardiac workload.
Question 6
Which adverse effect is commonly associated with amlodipine?
A. Severe hypoglycemia
B. Peripheral edema
C. Ototoxicity
D. Gingival bleeding
Correct Answer: B. Peripheral edema
Rationale: Amlodipine is a dihydropyridine calcium-channel blocker that
produces arterial vasodilation. Increased capillary hydrostatic pressure can
cause dependent peripheral edema, particularly around the ankles.
Dizziness and headache may also occur.
Question 7
Which medication is classified as a beta-1 selective beta blocker?
A. Metoprolol
B. Propranolol
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, C. Labetalol
D. Carvedilol
Correct Answer: A. Metoprolol
Rationale: Metoprolol primarily blocks beta-1 receptors at usual therapeutic
doses, reducing heart rate, myocardial contractility, and cardiac workload.
Propranolol is nonselective, while labetalol and carvedilol block both beta
receptors and alpha-1 receptors.
Question 8
Which finding in a patient receiving metoprolol requires the most immediate
attention?
A. Heart rate of 48/min
B. Mild fatigue
C. Occasional headache
D. Slight coldness of the hands
Correct Answer: A. Heart rate of 48/min
Rationale: Beta blockers decrease heart rate. Significant bradycardia can
impair cardiac output and may require withholding the medication depending
on the clinical situation and prescribed parameters. Mild fatigue and cold
extremities can occur but are generally less urgent.
Question 9
Why should a patient generally not abruptly discontinue a beta blocker?
A. It causes severe hypoglycemia
B. It can produce rebound tachycardia and hypertension
C. It causes permanent renal failure
D. It causes immediate hyperkalemia
4|Page
Capstone College of Nursing (2026) – Advanced Pharmacology
of Endocrine and Diabetic Agents
Question 1
Which medication is an angiotensin-converting enzyme (ACE) inhibitor
commonly used to treat hypertension and heart failure?
A. Losartan
B. Lisinopril
C. Amlodipine
D. Metoprolol
Correct Answer: B. Lisinopril
Rationale: Lisinopril is an ACE inhibitor that decreases conversion of
angiotensin I to angiotensin II. This reduces vasoconstriction and aldosterone
secretion, resulting in lower blood pressure and decreased cardiac workload.
Losartan is an ARB, amlodipine is a calcium-channel blocker, and metoprolol
is a beta blocker.
Question 2
A patient taking lisinopril reports swelling of the lips and tongue. What is the
nurse's priority action?
A. Administer the next dose with food
B. Place the patient in a supine position
C. Hold the medication and assess the airway
D. Encourage increased fluid intake
Correct Answer: C. Hold the medication and assess the airway
Rationale: Facial, lip, or tongue swelling can indicate angioedema, a
potentially life-threatening adverse effect of ACE inhibitors. Airway
compromise can develop rapidly. The medication should be withheld, the
airway assessed, and emergency treatment initiated as appropriate.
1|Page
,Question 3
Which laboratory value is particularly important to monitor in a patient
receiving an ACE inhibitor?
A. Potassium
B. Hemoglobin
C. Platelet count
D. Calcium
Correct Answer: A. Potassium
Rationale: ACE inhibitors decrease aldosterone secretion, which can reduce
potassium excretion and cause hyperkalemia. Renal function, especially
serum creatinine, should also be monitored because ACE inhibitors can affect
renal perfusion and kidney function.
Question 4
Which medication is an angiotensin II receptor blocker (ARB)?
A. Enalapril
B. Losartan
C. Diltiazem
D. Hydrochlorothiazide
Correct Answer: B. Losartan
Rationale: Losartan blocks angiotensin II receptors, preventing angiotensin II
from producing vasoconstriction and stimulating aldosterone release. ARBs
are commonly used when an ACE inhibitor causes troublesome cough. Like
ACE inhibitors, ARBs can cause hyperkalemia and are contraindicated during
pregnancy.
Question 5
2|Page
,A patient taking losartan asks why the medication is prescribed. Which
response is most appropriate?
A. “It increases heart rate to improve circulation.”
B. “It blocks the effects of angiotensin II and lowers blood pressure.”
C. “It directly increases sodium retention.”
D. “It increases blood volume to improve cardiac output.”
Correct Answer: B. “It blocks the effects of angiotensin II and lowers
blood pressure.”
Rationale: Losartan blocks the AT₁ receptor for angiotensin II. This promotes
vasodilation and decreases aldosterone-mediated sodium and water
retention, lowering blood pressure and reducing cardiac workload.
Question 6
Which adverse effect is commonly associated with amlodipine?
A. Severe hypoglycemia
B. Peripheral edema
C. Ototoxicity
D. Gingival bleeding
Correct Answer: B. Peripheral edema
Rationale: Amlodipine is a dihydropyridine calcium-channel blocker that
produces arterial vasodilation. Increased capillary hydrostatic pressure can
cause dependent peripheral edema, particularly around the ankles.
Dizziness and headache may also occur.
Question 7
Which medication is classified as a beta-1 selective beta blocker?
A. Metoprolol
B. Propranolol
3|Page
, C. Labetalol
D. Carvedilol
Correct Answer: A. Metoprolol
Rationale: Metoprolol primarily blocks beta-1 receptors at usual therapeutic
doses, reducing heart rate, myocardial contractility, and cardiac workload.
Propranolol is nonselective, while labetalol and carvedilol block both beta
receptors and alpha-1 receptors.
Question 8
Which finding in a patient receiving metoprolol requires the most immediate
attention?
A. Heart rate of 48/min
B. Mild fatigue
C. Occasional headache
D. Slight coldness of the hands
Correct Answer: A. Heart rate of 48/min
Rationale: Beta blockers decrease heart rate. Significant bradycardia can
impair cardiac output and may require withholding the medication depending
on the clinical situation and prescribed parameters. Mild fatigue and cold
extremities can occur but are generally less urgent.
Question 9
Why should a patient generally not abruptly discontinue a beta blocker?
A. It causes severe hypoglycemia
B. It can produce rebound tachycardia and hypertension
C. It causes permanent renal failure
D. It causes immediate hyperkalemia
4|Page
