,NU 160 Exam 2 | Comprehensive
Questions & Verified Answers | 2026
Edition | Galen College
1. Which of the following best describes the therapeutic action of digoxin in heart failure?
A) It decreases myocardial contractility and slows heart rate
B) It increases myocardial contractility and slows atrioventricular conduction
C) It blocks beta-1 receptors, reducing heart rate
D) It dilates peripheral vessels, reducing afterload
Correct Answer: It increases myocardial contractility and slows atrioventricular conduction
Rationale: Digoxin inhibits the sodium-potassium ATPase pump, increasing intracellular calcium and
improving cardiac contractility. It also enhances vagal tone, slowing conduction through the AV node
and reducing ventricular rate in atrial fibrillation. It does not block beta receptors or dilate vessels.
2. The nurse is teaching a patient prescribed diltiazem for hypertension. The patient should be
instructed to
A) take the medication on an empty stomach only
B) avoid grapefruit juice while taking this drug
C) stop the medication immediately if blood pressure is normal
D) increase potassium-rich foods in the diet
Correct Answer: Avoid grapefruit juice while taking this drug
Rationale: Diltiazem is metabolized by CYP3A4, and grapefruit juice inhibits this enzyme, leading to
increased drug levels and risk of bradycardia and hypotension. Patients should avoid grapefruit
products. The other instructions are not correct.
,3. The nurse is monitoring a patient receiving IV nitroprusside for a hypertensive emergency. The nurse
must
A) protect the solution from light with an opaque covering
B) administer the drug via a peripheral line without a filter
C) use only normal saline as the diluent
D) monitor blood glucose every hour
Correct Answer: Protect the solution from light with an opaque covering
Rationale: Nitroprusside is light-sensitive and degrades when exposed to light, forming toxic
thiocyanate. The IV bag and tubing must be wrapped. An inline filter is not required, and the diluent is
dextrose in water, not saline. Blood glucose is not directly affected.
4. A patient is prescribed rosuvastatin for hyperlipidemia. The nurse should instruct the patient to report
A) nasal congestion
B) unexplained muscle pain or dark urine
C) increased appetite
D) dry cough
Correct Answer: Unexplained muscle pain or dark urine
Rationale: Statins like rosuvastatin can cause myopathy and rhabdomyolysis, with muscle aches and
dark urine indicating myoglobinuria. These symptoms must be reported immediately to prevent acute
kidney injury. Dry cough is associated with ACE inhibitors.
5. The nurse is caring for a patient receiving enoxaparin subcutaneously. Which laboratory test is used to
monitor its anticoagulant effect?
A) Prothrombin time (PT)
B) International normalized ratio (INR)
C) Activated partial thromboplastin time (aPTT)
D) Routine monitoring is not required
, Correct Answer: Routine monitoring is not required
Rationale: Enoxaparin is a low-molecular-weight heparin with predictable pharmacokinetics. Unlike
unfractionated heparin, it does not require routine aPTT monitoring. Anti-factor Xa levels may be
measured in specific populations such as pregnancy or renal impairment.
6. Which of the following antiarrhythmic drugs is a class III potassium channel blocker that prolongs
repolarization?
A) Lidocaine
B) Amiodarone
C) Verapamil
D) Procainamide
Correct Answer: Amiodarone
Rationale: Amiodarone is a class III agent that blocks potassium channels, prolonging action potential
duration and refractory period. It also has class I, II, and IV properties. Lidocaine is class Ib; verapamil is
class IV; procainamide is class Ia.
7. The nurse is teaching a patient about the use of sublingual nitroglycerin for angina. The patient should
be instructed to
A) swallow the tablet with water
B) take the tablet every 5 minutes up to three doses, and call 911 if pain persists after the first dose
C) take one tablet and wait 15 minutes before taking another
D) store the tablets in a pill organizer
Correct Answer: Take the tablet every 5 minutes up to three doses, and call 911 if pain persists after the
first dose
Questions & Verified Answers | 2026
Edition | Galen College
1. Which of the following best describes the therapeutic action of digoxin in heart failure?
A) It decreases myocardial contractility and slows heart rate
B) It increases myocardial contractility and slows atrioventricular conduction
C) It blocks beta-1 receptors, reducing heart rate
D) It dilates peripheral vessels, reducing afterload
Correct Answer: It increases myocardial contractility and slows atrioventricular conduction
Rationale: Digoxin inhibits the sodium-potassium ATPase pump, increasing intracellular calcium and
improving cardiac contractility. It also enhances vagal tone, slowing conduction through the AV node
and reducing ventricular rate in atrial fibrillation. It does not block beta receptors or dilate vessels.
2. The nurse is teaching a patient prescribed diltiazem for hypertension. The patient should be
instructed to
A) take the medication on an empty stomach only
B) avoid grapefruit juice while taking this drug
C) stop the medication immediately if blood pressure is normal
D) increase potassium-rich foods in the diet
Correct Answer: Avoid grapefruit juice while taking this drug
Rationale: Diltiazem is metabolized by CYP3A4, and grapefruit juice inhibits this enzyme, leading to
increased drug levels and risk of bradycardia and hypotension. Patients should avoid grapefruit
products. The other instructions are not correct.
,3. The nurse is monitoring a patient receiving IV nitroprusside for a hypertensive emergency. The nurse
must
A) protect the solution from light with an opaque covering
B) administer the drug via a peripheral line without a filter
C) use only normal saline as the diluent
D) monitor blood glucose every hour
Correct Answer: Protect the solution from light with an opaque covering
Rationale: Nitroprusside is light-sensitive and degrades when exposed to light, forming toxic
thiocyanate. The IV bag and tubing must be wrapped. An inline filter is not required, and the diluent is
dextrose in water, not saline. Blood glucose is not directly affected.
4. A patient is prescribed rosuvastatin for hyperlipidemia. The nurse should instruct the patient to report
A) nasal congestion
B) unexplained muscle pain or dark urine
C) increased appetite
D) dry cough
Correct Answer: Unexplained muscle pain or dark urine
Rationale: Statins like rosuvastatin can cause myopathy and rhabdomyolysis, with muscle aches and
dark urine indicating myoglobinuria. These symptoms must be reported immediately to prevent acute
kidney injury. Dry cough is associated with ACE inhibitors.
5. The nurse is caring for a patient receiving enoxaparin subcutaneously. Which laboratory test is used to
monitor its anticoagulant effect?
A) Prothrombin time (PT)
B) International normalized ratio (INR)
C) Activated partial thromboplastin time (aPTT)
D) Routine monitoring is not required
, Correct Answer: Routine monitoring is not required
Rationale: Enoxaparin is a low-molecular-weight heparin with predictable pharmacokinetics. Unlike
unfractionated heparin, it does not require routine aPTT monitoring. Anti-factor Xa levels may be
measured in specific populations such as pregnancy or renal impairment.
6. Which of the following antiarrhythmic drugs is a class III potassium channel blocker that prolongs
repolarization?
A) Lidocaine
B) Amiodarone
C) Verapamil
D) Procainamide
Correct Answer: Amiodarone
Rationale: Amiodarone is a class III agent that blocks potassium channels, prolonging action potential
duration and refractory period. It also has class I, II, and IV properties. Lidocaine is class Ib; verapamil is
class IV; procainamide is class Ia.
7. The nurse is teaching a patient about the use of sublingual nitroglycerin for angina. The patient should
be instructed to
A) swallow the tablet with water
B) take the tablet every 5 minutes up to three doses, and call 911 if pain persists after the first dose
C) take one tablet and wait 15 minutes before taking another
D) store the tablets in a pill organizer
Correct Answer: Take the tablet every 5 minutes up to three doses, and call 911 if pain persists after the
first dose
