NCLEX-RN Cardiovascular Pharmacology Exam
Questions & Answers |
20 Original NGN/ATI-Style Practice MCQs with
Detailed Rationales |
Nursing Pharmacology Study Guide
Question 1
Clinical Scenario
A 68-year-old man with a history of hypertension, stable angina,
and chronic kidney disease (stage 3) is admitted for blood
pressure management. Current medications include lisinopril 20
mg daily, aspirin 81 mg daily, and atorvastatin 40 mg nightly. His
vital signs are: BP 168/94 mm Hg, HR 84/min, RR 18/min, SpO₂
98% on room air. Laboratory results reveal potassium 5.8
mEq/L, serum creatinine 2.1 mg/dL (baseline 1.8 mg/dL), and
BUN 34 mg/dL.
Question Stem
Which action should the nurse take first before administering
the scheduled lisinopril dose?
,A. Administer the medication as prescribed because elevated
blood pressure is the priority.
B. Hold the medication and notify the healthcare provider
about the elevated potassium level.
C. Encourage the client to increase dietary potassium intake.
D. Administer a potassium supplement before giving the
medication.
Correct Answer
Correct Answer: B. Hold the medication and notify the
healthcare provider about the elevated potassium level.
Detailed Rationale
Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor
that lowers blood pressure by decreasing angiotensin II
production and reducing aldosterone secretion. While effective
for hypertension, heart failure, and kidney protection in many
patients, ACE inhibitors can increase serum potassium and
worsen renal function. This client already has hyperkalemia (5.8
mEq/L) and impaired kidney function. Administering lisinopril
could further elevate potassium, increasing the risk of life-
threatening cardiac dysrhythmias. The priority nursing action is
to hold the medication and promptly notify the healthcare
provider for further evaluation and treatment.
,Option A is incorrect because medication safety takes
precedence over treating elevated blood pressure when serious
adverse effects are possible. Option C is unsafe because
additional potassium intake could worsen hyperkalemia. Option
D is contraindicated because potassium supplementation would
significantly increase the risk of dangerous cardiac
complications. Nurses should monitor renal function, serum
potassium, blood pressure, and signs of hypotension
throughout ACE inhibitor therapy. Patients should also be
taught to avoid potassium-containing salt substitutes unless
specifically prescribed.
Learning Objectives
After completing this question, the learner should be able to:
• Identify laboratory findings requiring an ACE inhibitor to be
withheld.
• Recognize the relationship between ACE inhibitors and
hyperkalemia.
• Prioritize nursing interventions using laboratory
assessment.
• Educate patients regarding potassium-containing products.
Medication Safety Focus: Monitoring—Hyperkalemia and renal
function during ACE inhibitor therapy.
, Question 2
Clinical Scenario
A 74-year-old woman is hospitalized with chronic heart failure.
She receives digoxin 0.125 mg orally every morning. Before
administering today's dose, the nurse assesses the client. Vital
signs are BP 118/70 mm Hg, HR 54/min, RR 18/min, SpO₂ 96%.
The client reports nausea, decreased appetite, and seeing
yellow halos around lights.
Question Stem
Which nursing action is most appropriate?
A. Administer the medication because the symptoms are
expected.
B. Hold the digoxin dose and notify the healthcare provider.
C. Administer the medication with food to reduce nausea.
D. Increase the client's fluid intake before administering the
medication.
Correct Answer
Correct Answer: B. Hold the digoxin dose and notify the
healthcare provider.
Detailed Rationale
Questions & Answers |
20 Original NGN/ATI-Style Practice MCQs with
Detailed Rationales |
Nursing Pharmacology Study Guide
Question 1
Clinical Scenario
A 68-year-old man with a history of hypertension, stable angina,
and chronic kidney disease (stage 3) is admitted for blood
pressure management. Current medications include lisinopril 20
mg daily, aspirin 81 mg daily, and atorvastatin 40 mg nightly. His
vital signs are: BP 168/94 mm Hg, HR 84/min, RR 18/min, SpO₂
98% on room air. Laboratory results reveal potassium 5.8
mEq/L, serum creatinine 2.1 mg/dL (baseline 1.8 mg/dL), and
BUN 34 mg/dL.
Question Stem
Which action should the nurse take first before administering
the scheduled lisinopril dose?
,A. Administer the medication as prescribed because elevated
blood pressure is the priority.
B. Hold the medication and notify the healthcare provider
about the elevated potassium level.
C. Encourage the client to increase dietary potassium intake.
D. Administer a potassium supplement before giving the
medication.
Correct Answer
Correct Answer: B. Hold the medication and notify the
healthcare provider about the elevated potassium level.
Detailed Rationale
Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor
that lowers blood pressure by decreasing angiotensin II
production and reducing aldosterone secretion. While effective
for hypertension, heart failure, and kidney protection in many
patients, ACE inhibitors can increase serum potassium and
worsen renal function. This client already has hyperkalemia (5.8
mEq/L) and impaired kidney function. Administering lisinopril
could further elevate potassium, increasing the risk of life-
threatening cardiac dysrhythmias. The priority nursing action is
to hold the medication and promptly notify the healthcare
provider for further evaluation and treatment.
,Option A is incorrect because medication safety takes
precedence over treating elevated blood pressure when serious
adverse effects are possible. Option C is unsafe because
additional potassium intake could worsen hyperkalemia. Option
D is contraindicated because potassium supplementation would
significantly increase the risk of dangerous cardiac
complications. Nurses should monitor renal function, serum
potassium, blood pressure, and signs of hypotension
throughout ACE inhibitor therapy. Patients should also be
taught to avoid potassium-containing salt substitutes unless
specifically prescribed.
Learning Objectives
After completing this question, the learner should be able to:
• Identify laboratory findings requiring an ACE inhibitor to be
withheld.
• Recognize the relationship between ACE inhibitors and
hyperkalemia.
• Prioritize nursing interventions using laboratory
assessment.
• Educate patients regarding potassium-containing products.
Medication Safety Focus: Monitoring—Hyperkalemia and renal
function during ACE inhibitor therapy.
, Question 2
Clinical Scenario
A 74-year-old woman is hospitalized with chronic heart failure.
She receives digoxin 0.125 mg orally every morning. Before
administering today's dose, the nurse assesses the client. Vital
signs are BP 118/70 mm Hg, HR 54/min, RR 18/min, SpO₂ 96%.
The client reports nausea, decreased appetite, and seeing
yellow halos around lights.
Question Stem
Which nursing action is most appropriate?
A. Administer the medication because the symptoms are
expected.
B. Hold the digoxin dose and notify the healthcare provider.
C. Administer the medication with food to reduce nausea.
D. Increase the client's fluid intake before administering the
medication.
Correct Answer
Correct Answer: B. Hold the digoxin dose and notify the
healthcare provider.
Detailed Rationale
