NCLEX-RN Cardiovascular Pharmacology
Practice Questions with Rationales |
ATI & NGN Style Nursing Exam Review PDF
NCLEX-Style Cardiovascular Pharmacology Practice Question
Clinical Scenario
A 72-year-old woman with chronic heart failure and
hypertension is admitted for worsening shortness of breath and
bilateral ankle edema. She takes furosemide, lisinopril, and
metoprolol. Morning assessment reveals:
• Blood pressure: 110/68 mm Hg
• Heart rate: 62/min
• Respiratory rate: 18/min
• Oxygen saturation: 96% on room air
Laboratory results:
• Potassium: 3.0 mEq/L
• Sodium: 138 mEq/L
, • Creatinine: 1.2 mg/dL
She is scheduled to receive her morning medications.
Question
Which nursing action is most appropriate?
A. Administer all scheduled medications as prescribed.
B. Hold the furosemide and notify the healthcare provider
about the potassium level.
C. Encourage the patient to restrict oral fluids before
administering medications.
D. Administer the metoprolol first because heart rate is within
the prescribed range.
Correct Answer
B. Hold the furosemide and notify the healthcare provider
about the potassium level.
Rationale
The patient's potassium level of 3.0 mEq/L indicates
hypokalemia. Loop diuretics such as furosemide increase
urinary potassium excretion and may worsen electrolyte
depletion if administered without further evaluation. Significant
hypokalemia increases the risk of ventricular dysrhythmias,
,muscle weakness, and enhanced toxicity from medications such
as digoxin. The nurse should notify the healthcare provider and
anticipate potassium replacement or adjustments to the
medication regimen before administering additional doses of
the diuretic.
• Option A: Incorrect. Administering furosemide without
addressing hypokalemia may increase the patient's risk of
serious complications.
• Option C: Incorrect. Fluid restriction does not correct
hypokalemia and is not the immediate priority.
• Option D: Incorrect. Although the heart rate is acceptable
for metoprolol administration, correcting the clinically
significant electrolyte abnormality takes precedence.
Nursing care should include ongoing monitoring of electrolytes,
renal function, daily weights, intake and output, blood pressure,
and symptoms of worsening heart failure. Patients should also
receive education regarding foods containing potassium (when
appropriate) and the importance of routine laboratory
monitoring.
Learning Objectives
After completing this question, the learner should be able to:
, • Recognize clinically significant hypokalemia in patients
receiving loop diuretics.
• Prioritize nursing interventions based on laboratory
findings.
• Identify appropriate monitoring parameters for diuretic
therapy.
Medication Safety Focus
Electrolyte monitoring during loop diuretic therapy
Cardiovascular Pharmacology Clinical Case 1: Managing Heart
Failure Medications
Patient Scenario
Mr. Johnson is a 69-year-old man admitted with worsening
heart failure. His medical history includes hypertension, type 2
diabetes mellitus, and chronic kidney disease (Stage 3).
Current Medications
• Lisinopril 20 mg orally once daily
• Metoprolol succinate 100 mg orally once daily
• Furosemide 40 mg IV twice daily
Practice Questions with Rationales |
ATI & NGN Style Nursing Exam Review PDF
NCLEX-Style Cardiovascular Pharmacology Practice Question
Clinical Scenario
A 72-year-old woman with chronic heart failure and
hypertension is admitted for worsening shortness of breath and
bilateral ankle edema. She takes furosemide, lisinopril, and
metoprolol. Morning assessment reveals:
• Blood pressure: 110/68 mm Hg
• Heart rate: 62/min
• Respiratory rate: 18/min
• Oxygen saturation: 96% on room air
Laboratory results:
• Potassium: 3.0 mEq/L
• Sodium: 138 mEq/L
, • Creatinine: 1.2 mg/dL
She is scheduled to receive her morning medications.
Question
Which nursing action is most appropriate?
A. Administer all scheduled medications as prescribed.
B. Hold the furosemide and notify the healthcare provider
about the potassium level.
C. Encourage the patient to restrict oral fluids before
administering medications.
D. Administer the metoprolol first because heart rate is within
the prescribed range.
Correct Answer
B. Hold the furosemide and notify the healthcare provider
about the potassium level.
Rationale
The patient's potassium level of 3.0 mEq/L indicates
hypokalemia. Loop diuretics such as furosemide increase
urinary potassium excretion and may worsen electrolyte
depletion if administered without further evaluation. Significant
hypokalemia increases the risk of ventricular dysrhythmias,
,muscle weakness, and enhanced toxicity from medications such
as digoxin. The nurse should notify the healthcare provider and
anticipate potassium replacement or adjustments to the
medication regimen before administering additional doses of
the diuretic.
• Option A: Incorrect. Administering furosemide without
addressing hypokalemia may increase the patient's risk of
serious complications.
• Option C: Incorrect. Fluid restriction does not correct
hypokalemia and is not the immediate priority.
• Option D: Incorrect. Although the heart rate is acceptable
for metoprolol administration, correcting the clinically
significant electrolyte abnormality takes precedence.
Nursing care should include ongoing monitoring of electrolytes,
renal function, daily weights, intake and output, blood pressure,
and symptoms of worsening heart failure. Patients should also
receive education regarding foods containing potassium (when
appropriate) and the importance of routine laboratory
monitoring.
Learning Objectives
After completing this question, the learner should be able to:
, • Recognize clinically significant hypokalemia in patients
receiving loop diuretics.
• Prioritize nursing interventions based on laboratory
findings.
• Identify appropriate monitoring parameters for diuretic
therapy.
Medication Safety Focus
Electrolyte monitoring during loop diuretic therapy
Cardiovascular Pharmacology Clinical Case 1: Managing Heart
Failure Medications
Patient Scenario
Mr. Johnson is a 69-year-old man admitted with worsening
heart failure. His medical history includes hypertension, type 2
diabetes mellitus, and chronic kidney disease (Stage 3).
Current Medications
• Lisinopril 20 mg orally once daily
• Metoprolol succinate 100 mg orally once daily
• Furosemide 40 mg IV twice daily
