NCLEX-RN Pharmacology Cardiovascular
System Exam Questions & Answers |
20 Original ATI & NGN-Style Practice MCQs
with Rationales |
Nursing Pharmacology Study Guide
Question 11
Clinical Scenario
A 67-year-old man with chronic heart failure is admitted for
worsening dyspnea and peripheral edema. The provider prescribes
furosemide 40 mg IV. Thirty minutes after administration, the nurse
assesses the patient.
Assessment findings include:
• Blood pressure: 108/66 mm Hg
• Heart rate: 84 beats/min
• Urine output: 650 mL
• Respiratory rate: 18 breaths/min
• Oxygen saturation: 96% on room air
Morning laboratory results:
• Potassium: 3.1 mEq/L
, • Sodium: 136 mEq/L
• Creatinine: 1.0 mg/dL
Question Stem
Which finding requires the nurse's immediate intervention?
A. Urine output of 650 mL after medication administration
B. Blood pressure of 108/66 mm Hg
C. Potassium level of 3.1 mEq/L
D. Oxygen saturation of 96%
Correct Answer
Correct Answer: C. Potassium level of 3.1 mEq/L
Detailed Rationale
Furosemide is a loop diuretic that inhibits sodium and chloride
reabsorption in the loop of Henle, producing significant diuresis.
While effective for reducing fluid overload, it also increases urinary
potassium excretion. A potassium level of 3.1 mEq/L indicates
hypokalemia, which increases the risk for ventricular dysrhythmias,
particularly in patients with underlying cardiovascular disease or
those receiving medications such as digoxin.
The nurse should promptly notify the provider, anticipate potassium
replacement, continue cardiac monitoring if indicated, and reassess
electrolyte levels. Early recognition and treatment of hypokalemia
help prevent potentially life-threatening complications.
Option A is expected because increased urine output demonstrates
the desired therapeutic response.
, Option B reflects an acceptable blood pressure after diuresis.
Option D indicates adequate oxygenation and does not require
immediate intervention.
Patient teaching should include consuming potassium-rich foods if
appropriate, adhering to prescribed potassium supplements,
recognizing symptoms of hypokalemia (muscle weakness, fatigue,
palpitations), and attending routine laboratory appointments.
Learning Objectives
After completing this question, the learner should be able to:
• Recognize electrolyte abnormalities associated with loop
diuretics.
• Prioritize nursing interventions for hypokalemia.
• Evaluate therapeutic responses to diuretic therapy.
• Educate patients regarding electrolyte monitoring.
Medication Safety Focus
Laboratory Monitoring
Question 12
Clinical Scenario
A 62-year-old woman with hypertension is prescribed losartan 50
mg orally once daily after developing a persistent cough while
taking lisinopril. During a follow-up visit, the nurse evaluates her
understanding of the medication.
System Exam Questions & Answers |
20 Original ATI & NGN-Style Practice MCQs
with Rationales |
Nursing Pharmacology Study Guide
Question 11
Clinical Scenario
A 67-year-old man with chronic heart failure is admitted for
worsening dyspnea and peripheral edema. The provider prescribes
furosemide 40 mg IV. Thirty minutes after administration, the nurse
assesses the patient.
Assessment findings include:
• Blood pressure: 108/66 mm Hg
• Heart rate: 84 beats/min
• Urine output: 650 mL
• Respiratory rate: 18 breaths/min
• Oxygen saturation: 96% on room air
Morning laboratory results:
• Potassium: 3.1 mEq/L
, • Sodium: 136 mEq/L
• Creatinine: 1.0 mg/dL
Question Stem
Which finding requires the nurse's immediate intervention?
A. Urine output of 650 mL after medication administration
B. Blood pressure of 108/66 mm Hg
C. Potassium level of 3.1 mEq/L
D. Oxygen saturation of 96%
Correct Answer
Correct Answer: C. Potassium level of 3.1 mEq/L
Detailed Rationale
Furosemide is a loop diuretic that inhibits sodium and chloride
reabsorption in the loop of Henle, producing significant diuresis.
While effective for reducing fluid overload, it also increases urinary
potassium excretion. A potassium level of 3.1 mEq/L indicates
hypokalemia, which increases the risk for ventricular dysrhythmias,
particularly in patients with underlying cardiovascular disease or
those receiving medications such as digoxin.
The nurse should promptly notify the provider, anticipate potassium
replacement, continue cardiac monitoring if indicated, and reassess
electrolyte levels. Early recognition and treatment of hypokalemia
help prevent potentially life-threatening complications.
Option A is expected because increased urine output demonstrates
the desired therapeutic response.
, Option B reflects an acceptable blood pressure after diuresis.
Option D indicates adequate oxygenation and does not require
immediate intervention.
Patient teaching should include consuming potassium-rich foods if
appropriate, adhering to prescribed potassium supplements,
recognizing symptoms of hypokalemia (muscle weakness, fatigue,
palpitations), and attending routine laboratory appointments.
Learning Objectives
After completing this question, the learner should be able to:
• Recognize electrolyte abnormalities associated with loop
diuretics.
• Prioritize nursing interventions for hypokalemia.
• Evaluate therapeutic responses to diuretic therapy.
• Educate patients regarding electrolyte monitoring.
Medication Safety Focus
Laboratory Monitoring
Question 12
Clinical Scenario
A 62-year-old woman with hypertension is prescribed losartan 50
mg orally once daily after developing a persistent cough while
taking lisinopril. During a follow-up visit, the nurse evaluates her
understanding of the medication.
