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, NUR 6130 Exam 1 | (2026) Nursing Exam
Questions | Practice III (PDF)
1. A patient with chronic HFrEF (LVEF 30%) is on
metoprolol succinate, lisinopril, and furosemide. Which
laboratory value requires immediate discontinuation of
lisinopril?
A) Serum potassium 5.1 mEq/L
B) Serum creatinine 1.8 mg/dL (baseline 1.2)
C) eGFR 55 mL/min
D) Serum sodium 132 mEq/L
Answer: B) Serum creatinine 1.8 mg/dL (baseline 1.2)
Rationale: A rise in creatinine >0.3 mg/dL or >50% from
baseline suggests ACE inhibitor-induced nephropathy or
renal artery stenosis; hold ACE inhibitor and evaluate.
2. Which clinical finding is most specific for acute
pericarditis?
A) Fever and leukocytosis
B) Pericardial friction rub
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,C) Chest pain relieved by leaning forward
D) Elevated troponin
Answer: C) Chest pain relieved by leaning forward
Rationale: Pericarditis pain is positional – worse supine,
relieved by sitting forward. A rub is specific but not
always present.
3. A patient presents with sudden-onset severe headache,
vomiting, and BP 220/120. No focal deficits. Which
medication is contraindicated?
A) Labetalol
B) Nicardipine
C) Nitroprusside
D) Oral nifedipine
Answer: D) Oral nifedipine
Rationale: Short-acting oral nifedipine causes rapid,
uncontrolled hypotension leading to cerebral ischemia or
MI. Avoid in hypertensive emergencies.
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, 4. What is the first-line rate control agent in a patient
k k k k k k k k k
k with acute atrial fibrillation and HFrEF?
k k k k k
A) Metoprolol tartrate k
B) Diltiazem
C) Digoxin
D) Amiodarone
Answer:C)Digoxin
k k k
Rationale: In HFrEF, non-dihydropyridine CCBs (diltiazem,
k k k k k
k verapamil) are contraindicated. Digoxin provides safe rate
k k k k k k
k control without negative inotropy.
k k k
5. Which murmur increases in intensity with handgrip?
k k k k k k
A) Aortic stenosis k
B) Hypertrophic cardiomyopathy k
C) Mitral regurgitation k
D) Mitral stenosis k
Answer: C) Mitral regurgitation
k k k
Rationale: Handgrip increases afterload → worsens MR
k k k k k k
k murmur. Decreases AS, HCM, MVP murmurs.
k k k k k
4
, NUR 6130 Exam 1 | (2026) Nursing Exam
Questions | Practice III (PDF)
1. A patient with chronic HFrEF (LVEF 30%) is on
metoprolol succinate, lisinopril, and furosemide. Which
laboratory value requires immediate discontinuation of
lisinopril?
A) Serum potassium 5.1 mEq/L
B) Serum creatinine 1.8 mg/dL (baseline 1.2)
C) eGFR 55 mL/min
D) Serum sodium 132 mEq/L
Answer: B) Serum creatinine 1.8 mg/dL (baseline 1.2)
Rationale: A rise in creatinine >0.3 mg/dL or >50% from
baseline suggests ACE inhibitor-induced nephropathy or
renal artery stenosis; hold ACE inhibitor and evaluate.
2. Which clinical finding is most specific for acute
pericarditis?
A) Fever and leukocytosis
B) Pericardial friction rub
2
,C) Chest pain relieved by leaning forward
D) Elevated troponin
Answer: C) Chest pain relieved by leaning forward
Rationale: Pericarditis pain is positional – worse supine,
relieved by sitting forward. A rub is specific but not
always present.
3. A patient presents with sudden-onset severe headache,
vomiting, and BP 220/120. No focal deficits. Which
medication is contraindicated?
A) Labetalol
B) Nicardipine
C) Nitroprusside
D) Oral nifedipine
Answer: D) Oral nifedipine
Rationale: Short-acting oral nifedipine causes rapid,
uncontrolled hypotension leading to cerebral ischemia or
MI. Avoid in hypertensive emergencies.
3
, 4. What is the first-line rate control agent in a patient
k k k k k k k k k
k with acute atrial fibrillation and HFrEF?
k k k k k
A) Metoprolol tartrate k
B) Diltiazem
C) Digoxin
D) Amiodarone
Answer:C)Digoxin
k k k
Rationale: In HFrEF, non-dihydropyridine CCBs (diltiazem,
k k k k k
k verapamil) are contraindicated. Digoxin provides safe rate
k k k k k k
k control without negative inotropy.
k k k
5. Which murmur increases in intensity with handgrip?
k k k k k k
A) Aortic stenosis k
B) Hypertrophic cardiomyopathy k
C) Mitral regurgitation k
D) Mitral stenosis k
Answer: C) Mitral regurgitation
k k k
Rationale: Handgrip increases afterload → worsens MR
k k k k k k
k murmur. Decreases AS, HCM, MVP murmurs.
k k k k k
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