Simple Nursing Pharmacology NCLEX
Questions and answers25/2026
ACE Inhibitors (-pril)
ARBs (-sartan)
(Antihypertensives: lower BP) - Answer Act to lower BP (not HR!)
S/E: Orthostatic Hypotension = SLOW position changes
Do we give ACE and ARBs if the HR < 60?
YES --> these have no affect on HR, only BP
Decreases Sodium and Water
INCREASES Potassium
Key notes:
- Avoid giving to pregnant patients
- ACE can cause angioedema, cough, elevates potassium (increased K+ > 5.0)
- ARBs used to decrease dry cough and they spare Potassium
Avoid food high in Potassium with ACE inhibitors (-prils) such as: - Answer - Green leafy
vegetables
- Oranges
- Bananas
- Avocado
- Melon
- Dried apricot
- Kidney beans
,Also salt substitutes and LIVER
Potassium > 5.0 EKG changes - Answer Peaked T waves, ST elevation
(muscle spasms)
**Any Potassium level high or low, fist action by the nurse is: CARDIAC MONITOR
Beta Blockers: Lowers HR & BP
(-lol) - Answer (Lowers HR & BP)
What are the three negative tropics for Beta Blockers?
1. Negative chronotropic (lower rate)
2. Negative Inotropic (less force)
3. Negative dromotropic (less beats)
The above tropics mean:
1. Decreases resistance
2. Decreases workload
3. Decreases cardiac output
DO NOT GIVE to COPD or ASTHMA pt's
----> causes bronchospasm
Most dangerous side effects of Beta blockers: - Answer 1. Bradycardia
---> HR < 60 and Systolic BP < 90 or < 100
(HOLD DRUG)
,2. Breathing problems (wheezing)
---> HOLD for COPD and Asthma pt's
3. BAD for Heart failures pt's!
---> can worsen heart failure
***---> New edema, worsening crackles in the lungs, rapid weight gain, new JVD***
All indicate worsening HR = PRIORITY report to HCP
4. Can mask/hide the signs and symptoms of Hypoglycemia (Low blood sugar)
---> Monitor blood sugar closely
< 70 question medication
Calcium Channel blockers: Calms the heart!
Nifedipine (only decreases BP)
Cardizem (decreases BP and HR
Verapamil (decreases BP and HR) - Answer Key nursing considerations:
- ALWAYS before giving the drug --> Assess HR and BP, HOLD drug if:
If BP systolic <100
HR < 60
(Except for Nifedipine! can give because it only decreases the BP)
- Change positions slowly
- Bad headaches - normal S/E
NCLEX: If on CCB drip, if the HR has a BIG drop like < 50 bpm, stop the drip and notify HCP
, Digoxin = Increases heart contractions = more forceful contractions and decreases the HR
(has no effect on BP) - Answer No orthostatic hypotension, so no slow position changes
TOXICITY:
- Check the apical pulse for a full 60 seconds*
(if HR < 60, HOLD the drug) (5th intercostal space left midclavicular)
- Digoxin level > 2.0 = BAD
--> NOTIFY HCP ASAP
--> Vision changes (fuzziness, difficulty reading, haziness, color changes), N/V, anorexia,
dizziness or lightheadedness
Big Test Tip:
- Older patients with decreased kidney function are at HIGHER risk for digoxin toxicity
- Monitor BUN and Creatinine (Cr is #1)
- Cr > 1.3 = huge risk for toxicity
**Low Potassium increases risk for Digoxin toxicity!! K+ < 3.5 (does not mean digoxin causes
low potassium, just means low potassium can cause digoxin toxicity)
Which pt is most at risk for DIgoxin toxicity?
- Pt on potassium wasting diuretics (furosemide or thiazide)
- Kidney failure (Cr > 1.3)
Vasodialtors --> Nitroglycerin
(Lowers preload and afterload) (lowers BP)
1. Nitroglycerin
2. Nitroprusside
3. Hydralazine
Questions and answers25/2026
ACE Inhibitors (-pril)
ARBs (-sartan)
(Antihypertensives: lower BP) - Answer Act to lower BP (not HR!)
S/E: Orthostatic Hypotension = SLOW position changes
Do we give ACE and ARBs if the HR < 60?
YES --> these have no affect on HR, only BP
Decreases Sodium and Water
INCREASES Potassium
Key notes:
- Avoid giving to pregnant patients
- ACE can cause angioedema, cough, elevates potassium (increased K+ > 5.0)
- ARBs used to decrease dry cough and they spare Potassium
Avoid food high in Potassium with ACE inhibitors (-prils) such as: - Answer - Green leafy
vegetables
- Oranges
- Bananas
- Avocado
- Melon
- Dried apricot
- Kidney beans
,Also salt substitutes and LIVER
Potassium > 5.0 EKG changes - Answer Peaked T waves, ST elevation
(muscle spasms)
**Any Potassium level high or low, fist action by the nurse is: CARDIAC MONITOR
Beta Blockers: Lowers HR & BP
(-lol) - Answer (Lowers HR & BP)
What are the three negative tropics for Beta Blockers?
1. Negative chronotropic (lower rate)
2. Negative Inotropic (less force)
3. Negative dromotropic (less beats)
The above tropics mean:
1. Decreases resistance
2. Decreases workload
3. Decreases cardiac output
DO NOT GIVE to COPD or ASTHMA pt's
----> causes bronchospasm
Most dangerous side effects of Beta blockers: - Answer 1. Bradycardia
---> HR < 60 and Systolic BP < 90 or < 100
(HOLD DRUG)
,2. Breathing problems (wheezing)
---> HOLD for COPD and Asthma pt's
3. BAD for Heart failures pt's!
---> can worsen heart failure
***---> New edema, worsening crackles in the lungs, rapid weight gain, new JVD***
All indicate worsening HR = PRIORITY report to HCP
4. Can mask/hide the signs and symptoms of Hypoglycemia (Low blood sugar)
---> Monitor blood sugar closely
< 70 question medication
Calcium Channel blockers: Calms the heart!
Nifedipine (only decreases BP)
Cardizem (decreases BP and HR
Verapamil (decreases BP and HR) - Answer Key nursing considerations:
- ALWAYS before giving the drug --> Assess HR and BP, HOLD drug if:
If BP systolic <100
HR < 60
(Except for Nifedipine! can give because it only decreases the BP)
- Change positions slowly
- Bad headaches - normal S/E
NCLEX: If on CCB drip, if the HR has a BIG drop like < 50 bpm, stop the drip and notify HCP
, Digoxin = Increases heart contractions = more forceful contractions and decreases the HR
(has no effect on BP) - Answer No orthostatic hypotension, so no slow position changes
TOXICITY:
- Check the apical pulse for a full 60 seconds*
(if HR < 60, HOLD the drug) (5th intercostal space left midclavicular)
- Digoxin level > 2.0 = BAD
--> NOTIFY HCP ASAP
--> Vision changes (fuzziness, difficulty reading, haziness, color changes), N/V, anorexia,
dizziness or lightheadedness
Big Test Tip:
- Older patients with decreased kidney function are at HIGHER risk for digoxin toxicity
- Monitor BUN and Creatinine (Cr is #1)
- Cr > 1.3 = huge risk for toxicity
**Low Potassium increases risk for Digoxin toxicity!! K+ < 3.5 (does not mean digoxin causes
low potassium, just means low potassium can cause digoxin toxicity)
Which pt is most at risk for DIgoxin toxicity?
- Pt on potassium wasting diuretics (furosemide or thiazide)
- Kidney failure (Cr > 1.3)
Vasodialtors --> Nitroglycerin
(Lowers preload and afterload) (lowers BP)
1. Nitroglycerin
2. Nitroprusside
3. Hydralazine
