NUR2407: Pharmacology Exam 2 Actual Exam 2026/2027 –
Complete Exam-Style Questions with Detailed Rationales |
100% Verified | Pass Guaranteed – A+ Graded
SECTION 1: Cardiovascular Pharmacology – Antihypertensives, Antianginals,
Antidysrhythmics (Q1-Q20)
Q1: A 62-year-old male with hypertension and heart failure is prescribed lisinopril. The
nurse explains that this medication works by:
A. Blocking angiotensin II receptors directly
B. Inhibiting ACE, decreasing angiotensin II, causing vasodilation and decreased
preload/afterload [CORRECT]
C. Blocking calcium channels in vascular smooth muscle
D. Inhibiting the renin enzyme directly in the kidney
Correct Answer: B
Rationale: ACE inhibitors (lisinopril, enalapril, captopril) inhibit angiotensin-converting
enzyme (ACE), which decreases angiotensin II production. This results in vasodilation,
decreased preload and afterload, and reduced aldosterone secretion. ARBs (losartan)
block angiotensin II receptors directly. CCBs (amlodipine) block calcium channels.
Direct renin inhibitors (aliskiren) inhibit renin directly. [100% VERIFIED – Rasmussen
NUR2407]
Q2: A patient taking lisinopril reports a persistent dry cough. The nurse recognizes this
as:
A. An allergic reaction requiring immediate discontinuation
B. Bradykinin accumulation, a common adverse effect of ACE inhibitors [CORRECT]
C. A sign of worsening heart failure
D. An indication that the dose is too low
Correct Answer: B
Rationale: A dry, nonproductive cough is a common adverse effect of ACE inhibitors
caused by bradykinin accumulation (ACE normally degrades bradykinin). It is not an
allergic reaction or sign of heart failure worsening. If intolerable, switching to an ARB
,(which does not affect bradykinin) typically resolves the cough. Angioedema (swelling
of face, tongue, throat) is the serious allergic-type reaction requiring immediate
discontinuation. [100% VERIFIED – Rasmussen NUR2407]
Q3: A 55-year-old female on lisinopril develops swelling of the lips and tongue. Which
action should the nurse take first?
A. Administer diphenhydramine 25 mg PO
B. Discontinue lisinopril immediately and prepare for emergency airway management
[CORRECT]
C. Reduce the lisinopril dose by 50%
D. Switch to losartan without further assessment
Correct Answer: B
Rationale: Angioedema (swelling of lips, tongue, face, or airway) is a life-threatening
adverse effect of ACE inhibitors caused by bradykinin-mediated vasodilation and
increased vascular permeability. The medication must be stopped immediately, and
emergency airway management (epinephrine, intubation) may be needed. ARBs have a
lower but not zero risk of angioedema. Simply switching to an ARB without addressing
the acute airway emergency is dangerous. [100% VERIFIED – Rasmussen NUR2407]
Q4: A patient is switched from lisinopril to losartan due to persistent cough. Which
adverse effect is LESS likely with losartan compared to lisinopril?
A. Hyperkalemia
B. Angioedema
C. Dry cough [CORRECT]
D. Hypotension
Correct Answer: C
Rationale: ARBs (losartan, valsartan) do not inhibit bradykinin degradation, so dry cough
and angioedema are significantly less common compared to ACE inhibitors. However,
hyperkalemia, hypotension, and renal impairment occur with both drug classes. Both
ACE inhibitors and ARBs are Category D in pregnancy and contraindicated. [100%
VERIFIED – Rasmussen NUR2407]
Q5: A 68-year-old male with hypertension is prescribed amlodipine. The nurse should
monitor for which common adverse effect?
,A. Bradycardia and AV block
B. Peripheral edema in dependent areas [CORRECT]
C. Severe constipation
D. Bronchospasm
Correct Answer: B
Rationale: Dihydropyridine calcium channel blockers (amlodipine, nifedipine) cause
vasodilation of arteries more than veins, leading to peripheral edema in dependent
areas (ankles, feet). This is caused by increased hydrostatic pressure in capillary beds.
Non-dihydropyridine CCBs (verapamil, diltiazem) cause bradycardia, AV block, and
constipation. Beta-blockers cause bronchospasm. [100% VERIFIED – Rasmussen
NUR2407]
Q6: A patient on verapamil reports constipation. The nurse recognizes this as:
A. An indication of bowel obstruction requiring surgery
B. A common adverse effect of non-dihydropyridine CCBs [CORRECT]
C. A sign of calcium deficiency
D. An unrelated side effect that should be ignored
Correct Answer: B
Rationale: Verapamil (a non-dihydropyridine calcium channel blocker) commonly causes
constipation due to decreased smooth muscle contraction in the GI tract. This is a
well-documented adverse effect requiring management with increased fiber, fluids, and
possibly stool softeners. It is not related to calcium deficiency or bowel obstruction.
Dihydropyridine CCBs (amlodipine) do not typically cause constipation. [100% VERIFIED
– Rasmussen NUR2407]
Q7: A patient on metoprolol reports dizziness and fatigue. The nurse checks the
patient's pulse and finds it to be 52 bpm. Which action is most appropriate?
A. Continue metoprolol and reassess in 24 hours
B. Hold the dose and notify the provider [CORRECT]
C. Administer atropine 0.5 mg IV
D. Switch to propranolol immediately
Correct Answer: B
Rationale: Beta-blockers (metoprolol) decrease heart rate and contractility. A pulse of
52 bpm is below the typical threshold for holding beta-blockers (usually <50-60 bpm
, depending on provider orders). The nurse should hold the dose and notify the provider
to evaluate for dose reduction or discontinuation. Atropine is for symptomatic
bradycardia in emergency settings. Propranolol is a non-selective beta-blocker and
would worsen bradycardia. [100% VERIFIED – Rasmussen NUR2407]
Q8: A patient with diabetes on metoprolol experiences sweating, tremors, and confusion
but denies feeling hypoglycemic. The nurse recognizes that:
A. The patient is experiencing hyperglycemia from metoprolol
B. Beta-blockers mask the adrenergic symptoms (tachycardia, tremors) of
hypoglycemia [CORRECT]
C. Metoprolol causes diabetes to worsen permanently
D. The patient needs a higher dose of metoprolol
Correct Answer: B
Rationale: Beta-blockers mask the adrenergic warning signs (tachycardia, palpitations,
tremors, sweating) of hypoglycemia by blocking beta-2 receptors. Patients with
diabetes on beta-blockers must monitor blood glucose closely and recognize that
sweating may still occur (mediated by cholinergic pathways), but other warning signs
may be absent. This does not mean hypoglycemia is prevented—only the symptoms are
masked. [100% VERIFIED – Rasmussen NUR2407]
Q9: A patient on clonidine for hypertension states they will stop the medication because
they feel drowsy. Which response by the nurse is most appropriate?
A. "You can stop the medication whenever you feel ready"
B. "Do not stop abruptly; clonidine can cause rebound hypertension" [CORRECT]
C. "Drowsiness is not a side effect of this medication"
D. "Switch to hydralazine immediately without consulting your provider"
Correct Answer: B
Rationale: Clonidine (alpha-2 agonist) must not be stopped abruptly due to risk of
rebound hypertension, which can be severe and life-threatening. The dose should be
tapered gradually over several days. Drowsiness and dry mouth are common adverse
effects of clonidine. Any medication changes should be discussed with the provider.
Hydralazine is a vasodilator with different adverse effects (reflex tachycardia, lupus-like
syndrome). [100% VERIFIED – Rasmussen NUR2407]
Complete Exam-Style Questions with Detailed Rationales |
100% Verified | Pass Guaranteed – A+ Graded
SECTION 1: Cardiovascular Pharmacology – Antihypertensives, Antianginals,
Antidysrhythmics (Q1-Q20)
Q1: A 62-year-old male with hypertension and heart failure is prescribed lisinopril. The
nurse explains that this medication works by:
A. Blocking angiotensin II receptors directly
B. Inhibiting ACE, decreasing angiotensin II, causing vasodilation and decreased
preload/afterload [CORRECT]
C. Blocking calcium channels in vascular smooth muscle
D. Inhibiting the renin enzyme directly in the kidney
Correct Answer: B
Rationale: ACE inhibitors (lisinopril, enalapril, captopril) inhibit angiotensin-converting
enzyme (ACE), which decreases angiotensin II production. This results in vasodilation,
decreased preload and afterload, and reduced aldosterone secretion. ARBs (losartan)
block angiotensin II receptors directly. CCBs (amlodipine) block calcium channels.
Direct renin inhibitors (aliskiren) inhibit renin directly. [100% VERIFIED – Rasmussen
NUR2407]
Q2: A patient taking lisinopril reports a persistent dry cough. The nurse recognizes this
as:
A. An allergic reaction requiring immediate discontinuation
B. Bradykinin accumulation, a common adverse effect of ACE inhibitors [CORRECT]
C. A sign of worsening heart failure
D. An indication that the dose is too low
Correct Answer: B
Rationale: A dry, nonproductive cough is a common adverse effect of ACE inhibitors
caused by bradykinin accumulation (ACE normally degrades bradykinin). It is not an
allergic reaction or sign of heart failure worsening. If intolerable, switching to an ARB
,(which does not affect bradykinin) typically resolves the cough. Angioedema (swelling
of face, tongue, throat) is the serious allergic-type reaction requiring immediate
discontinuation. [100% VERIFIED – Rasmussen NUR2407]
Q3: A 55-year-old female on lisinopril develops swelling of the lips and tongue. Which
action should the nurse take first?
A. Administer diphenhydramine 25 mg PO
B. Discontinue lisinopril immediately and prepare for emergency airway management
[CORRECT]
C. Reduce the lisinopril dose by 50%
D. Switch to losartan without further assessment
Correct Answer: B
Rationale: Angioedema (swelling of lips, tongue, face, or airway) is a life-threatening
adverse effect of ACE inhibitors caused by bradykinin-mediated vasodilation and
increased vascular permeability. The medication must be stopped immediately, and
emergency airway management (epinephrine, intubation) may be needed. ARBs have a
lower but not zero risk of angioedema. Simply switching to an ARB without addressing
the acute airway emergency is dangerous. [100% VERIFIED – Rasmussen NUR2407]
Q4: A patient is switched from lisinopril to losartan due to persistent cough. Which
adverse effect is LESS likely with losartan compared to lisinopril?
A. Hyperkalemia
B. Angioedema
C. Dry cough [CORRECT]
D. Hypotension
Correct Answer: C
Rationale: ARBs (losartan, valsartan) do not inhibit bradykinin degradation, so dry cough
and angioedema are significantly less common compared to ACE inhibitors. However,
hyperkalemia, hypotension, and renal impairment occur with both drug classes. Both
ACE inhibitors and ARBs are Category D in pregnancy and contraindicated. [100%
VERIFIED – Rasmussen NUR2407]
Q5: A 68-year-old male with hypertension is prescribed amlodipine. The nurse should
monitor for which common adverse effect?
,A. Bradycardia and AV block
B. Peripheral edema in dependent areas [CORRECT]
C. Severe constipation
D. Bronchospasm
Correct Answer: B
Rationale: Dihydropyridine calcium channel blockers (amlodipine, nifedipine) cause
vasodilation of arteries more than veins, leading to peripheral edema in dependent
areas (ankles, feet). This is caused by increased hydrostatic pressure in capillary beds.
Non-dihydropyridine CCBs (verapamil, diltiazem) cause bradycardia, AV block, and
constipation. Beta-blockers cause bronchospasm. [100% VERIFIED – Rasmussen
NUR2407]
Q6: A patient on verapamil reports constipation. The nurse recognizes this as:
A. An indication of bowel obstruction requiring surgery
B. A common adverse effect of non-dihydropyridine CCBs [CORRECT]
C. A sign of calcium deficiency
D. An unrelated side effect that should be ignored
Correct Answer: B
Rationale: Verapamil (a non-dihydropyridine calcium channel blocker) commonly causes
constipation due to decreased smooth muscle contraction in the GI tract. This is a
well-documented adverse effect requiring management with increased fiber, fluids, and
possibly stool softeners. It is not related to calcium deficiency or bowel obstruction.
Dihydropyridine CCBs (amlodipine) do not typically cause constipation. [100% VERIFIED
– Rasmussen NUR2407]
Q7: A patient on metoprolol reports dizziness and fatigue. The nurse checks the
patient's pulse and finds it to be 52 bpm. Which action is most appropriate?
A. Continue metoprolol and reassess in 24 hours
B. Hold the dose and notify the provider [CORRECT]
C. Administer atropine 0.5 mg IV
D. Switch to propranolol immediately
Correct Answer: B
Rationale: Beta-blockers (metoprolol) decrease heart rate and contractility. A pulse of
52 bpm is below the typical threshold for holding beta-blockers (usually <50-60 bpm
, depending on provider orders). The nurse should hold the dose and notify the provider
to evaluate for dose reduction or discontinuation. Atropine is for symptomatic
bradycardia in emergency settings. Propranolol is a non-selective beta-blocker and
would worsen bradycardia. [100% VERIFIED – Rasmussen NUR2407]
Q8: A patient with diabetes on metoprolol experiences sweating, tremors, and confusion
but denies feeling hypoglycemic. The nurse recognizes that:
A. The patient is experiencing hyperglycemia from metoprolol
B. Beta-blockers mask the adrenergic symptoms (tachycardia, tremors) of
hypoglycemia [CORRECT]
C. Metoprolol causes diabetes to worsen permanently
D. The patient needs a higher dose of metoprolol
Correct Answer: B
Rationale: Beta-blockers mask the adrenergic warning signs (tachycardia, palpitations,
tremors, sweating) of hypoglycemia by blocking beta-2 receptors. Patients with
diabetes on beta-blockers must monitor blood glucose closely and recognize that
sweating may still occur (mediated by cholinergic pathways), but other warning signs
may be absent. This does not mean hypoglycemia is prevented—only the symptoms are
masked. [100% VERIFIED – Rasmussen NUR2407]
Q9: A patient on clonidine for hypertension states they will stop the medication because
they feel drowsy. Which response by the nurse is most appropriate?
A. "You can stop the medication whenever you feel ready"
B. "Do not stop abruptly; clonidine can cause rebound hypertension" [CORRECT]
C. "Drowsiness is not a side effect of this medication"
D. "Switch to hydralazine immediately without consulting your provider"
Correct Answer: B
Rationale: Clonidine (alpha-2 agonist) must not be stopped abruptly due to risk of
rebound hypertension, which can be severe and life-threatening. The dose should be
tapered gradually over several days. Drowsiness and dry mouth are common adverse
effects of clonidine. Any medication changes should be discussed with the provider.
Hydralazine is a vasodilator with different adverse effects (reflex tachycardia, lupus-like
syndrome). [100% VERIFIED – Rasmussen NUR2407]
