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Pharmacology | Questions & Answers | Grade A
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Q1: A patient with hypertension and chronic kidney disease (CKD) is being initiated on
antihypertensive therapy. Which medication class is the most appropriate first-line choice to
provide both blood pressure control and renal protection?
A. Calcium Channel Blockers (CCBs)
B. Angiotens in -Converting Enzyme (ACE) Inhibitors
C. Beta-Blockers
D. Loop Diuretics
Correct Answer: B
Rationale: Correct because ACE inhibitors are preferred in patients with diabetes or CKD
because they dilate the efferent arteriole, reducing intraglomerular pressure and slowing the
progression of nephropathy. This mechanism provides renal protection that is not typically
found with CCBs, beta-blockers, or loop diuretics.
Q2: The nurse is calculating a patient's cardiac output. The patient has a heart rate of 75 beats
per minute and a stroke volume of 70 mL/beat. What is the cardiac output in liters per
minute?
A. 4.50 L/min
B. 5.25 L/min
C. 6.00 L/min
D. 5.75 L/min
Correct Answer: B
,Rationale: Correct because cardiac output is calculated as Heart Rate × Stroke Volume (75 ×
70 = 5,250 mL/min), which converts to 5.25 L/min. This calculation represents the volume of
blood pumped by the heart per minute, falling within the normal range of 4–8 L/min.
Q3: A patient diagnosed with hypertension reports a persistent, dry, non-productive cough
after starting a new medication. The nurse recognizes this adverse effect is characteristic of
which drug class?
A. Angiotensin II Receptor Blockers (ARBs)
B. Beta-Blockers
C. Angiotens in -Converting Enzyme (ACE) Inhibitors
D. Thiazide Diuretics
Correct Answer: C
Rationale: Correct because ACE inhibitors prevent the breakdown of bradykinin, leading to its
accumulation in the respiratory tract, which irritates the lungs and causes a dry cough. This
side effect is distinct to ACE inhibitors and typically resolves when the patient is switched to
an ARB.
Q4: Which mechanism explains how Calcium Channel Blockers (CCBs) primarily reduce blood
pressure?
A. Promoting the excretion of sodium and water by the kidneys
B. Blocking the reuptake of norepinephrine in the synaptic cleft
C. Inhibiting the entry of calcium into vas cular s mooth mus cle and cardiac myocytes
D. Blocking angiotensin II receptors on blood vessels
Correct Answer: C
Rationale: Correct because CCBs inhibit the influx of calcium through L-type channels,
causing vascular smooth muscle relaxation (vasodilation) and reducing myocardial
contractility. This reduction in peripheral vascular resistance and cardiac workload lowers
blood pressure.
, Q5: A patient presents to the emergency department with swelling of the lips and tongue
(angioedema) shortly after taking an antihypertensive dose. The nurse should question the
administration of which drug?
A. Lis inopril
B. Amlodipine
C. Hydrochlorothiazide
D. Metoprolol
Correct Answer: A
Rationale: Correct because angioedema is a rare but potentially life-threatening adverse
effect associated with ACE inhibitors, caused by increased bradykinin levels. Immediate
discontinuation of the ACE inhibitor is required, and alternative antihypertensives like ARBs or
CCBs are generally considered, though caution is still advised with ARBs.
Q6: When comparing opioid analgesics, which of the following lists the drugs in the correct
order from least potent to most potent?
A. Morphine → Oxycodone → Codeine → Fentanyl
B. Codeine → Morphine → Oxycodone → Fentanyl
C. Fentanyl → Morphine → Oxycodone → Codeine
D. Oxycodone → Morphine → Codeine → Fentanyl
Correct Answer: B
Rationale: Correct because codeine is the weakest (approximately 0.1x the potency of
morphine), followed by morphine (1x), oxycodone (1.5-2x), and finally fentanyl (50-100x).
Understanding this potency ranking is essential for safe dosing and preventing respiratory
depression.