NCLEX-RN Cardiovascular Pharmacology
Practice Questions with Detailed Rationales |
20 Original NGN-Style MCQs |
ATI Pharmacology Made Easy Review |
Nursing Exam Prep PDF
Question 1
Clinical Scenario
A 67-year-old man is admitted with newly diagnosed
hypertension. His blood pressure is 168/94 mm Hg, heart rate is
84 beats/min, respiratory rate is 18 breaths/min, and oxygen
saturation is 98% on room air. His medical history includes type
2 diabetes mellitus and hyperlipidemia. The provider prescribes
lisinopril 10 mg orally once daily. Before administering the first
dose, the nurse reviews the patient's history.
Question Stem
,Which assessment finding is the highest priority for the nurse to
report before administering the medication?
A. History of hereditary angioedema
B. Blood glucose level of 148 mg/dL
C. Total cholesterol of 228 mg/dL
D. Heart rate of 84 beats/min
Correct Answer
Correct Answer: A. History of hereditary angioedema
Detailed Rationale
Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor
that lowers blood pressure by preventing the conversion of
angiotensin I to angiotensin II, resulting in vasodilation and
reduced aldosterone secretion. A history of hereditary
angioedema is a major contraindication because ACE inhibitors
increase bradykinin levels, significantly increasing the risk of
life-threatening airway edema. The nurse should withhold the
medication and notify the provider before administration.
Option B is incorrect because a blood glucose of 148 mg/dL
requires ongoing diabetic management but is not a
contraindication to lisinopril. In fact, ACE inhibitors provide
renal protection in many patients with diabetes.
,Option C is incorrect because elevated cholesterol contributes
to cardiovascular risk but does not prevent safe administration
of lisinopril.
Option D is incorrect because a heart rate of 84 beats/min is
within normal limits and does not require withholding the
medication.
Nursing priorities include assessing renal function, serum
potassium, blood pressure, and any history of angioedema
before initiating therapy. Patients should also be instructed to
seek emergency care immediately if facial, tongue, or throat
swelling develops.
Learning Objectives
After completing this question, the learner should be able to:
• Identify contraindications to ACE inhibitor therapy.
• Recognize angioedema as a medical emergency.
• Perform appropriate pre-administration assessments
before initiating lisinopril.
Medication Safety Focus
Contraindication
Question 2
, Clinical Scenario
A 74-year-old woman with chronic heart failure is receiving
furosemide 40 mg orally twice daily. During the morning
assessment, she reports increasing fatigue and leg cramps. Vital
signs are blood pressure 118/70 mm Hg, heart rate 88
beats/min, respiratory rate 18 breaths/min. Laboratory results
reveal:
• Potassium: 2.9 mEq/L
• Sodium: 138 mEq/L
• Creatinine: 1.0 mg/dL
Question Stem
Which nursing action is the priority?
A. Administer the scheduled dose of furosemide.
B. Notify the provider and anticipate potassium replacement.
C. Encourage increased fluid intake.
D. Restrict dietary potassium.
Correct Answer
Correct Answer: B. Notify the provider and anticipate
potassium replacement.
Detailed Rationale
Practice Questions with Detailed Rationales |
20 Original NGN-Style MCQs |
ATI Pharmacology Made Easy Review |
Nursing Exam Prep PDF
Question 1
Clinical Scenario
A 67-year-old man is admitted with newly diagnosed
hypertension. His blood pressure is 168/94 mm Hg, heart rate is
84 beats/min, respiratory rate is 18 breaths/min, and oxygen
saturation is 98% on room air. His medical history includes type
2 diabetes mellitus and hyperlipidemia. The provider prescribes
lisinopril 10 mg orally once daily. Before administering the first
dose, the nurse reviews the patient's history.
Question Stem
,Which assessment finding is the highest priority for the nurse to
report before administering the medication?
A. History of hereditary angioedema
B. Blood glucose level of 148 mg/dL
C. Total cholesterol of 228 mg/dL
D. Heart rate of 84 beats/min
Correct Answer
Correct Answer: A. History of hereditary angioedema
Detailed Rationale
Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor
that lowers blood pressure by preventing the conversion of
angiotensin I to angiotensin II, resulting in vasodilation and
reduced aldosterone secretion. A history of hereditary
angioedema is a major contraindication because ACE inhibitors
increase bradykinin levels, significantly increasing the risk of
life-threatening airway edema. The nurse should withhold the
medication and notify the provider before administration.
Option B is incorrect because a blood glucose of 148 mg/dL
requires ongoing diabetic management but is not a
contraindication to lisinopril. In fact, ACE inhibitors provide
renal protection in many patients with diabetes.
,Option C is incorrect because elevated cholesterol contributes
to cardiovascular risk but does not prevent safe administration
of lisinopril.
Option D is incorrect because a heart rate of 84 beats/min is
within normal limits and does not require withholding the
medication.
Nursing priorities include assessing renal function, serum
potassium, blood pressure, and any history of angioedema
before initiating therapy. Patients should also be instructed to
seek emergency care immediately if facial, tongue, or throat
swelling develops.
Learning Objectives
After completing this question, the learner should be able to:
• Identify contraindications to ACE inhibitor therapy.
• Recognize angioedema as a medical emergency.
• Perform appropriate pre-administration assessments
before initiating lisinopril.
Medication Safety Focus
Contraindication
Question 2
, Clinical Scenario
A 74-year-old woman with chronic heart failure is receiving
furosemide 40 mg orally twice daily. During the morning
assessment, she reports increasing fatigue and leg cramps. Vital
signs are blood pressure 118/70 mm Hg, heart rate 88
beats/min, respiratory rate 18 breaths/min. Laboratory results
reveal:
• Potassium: 2.9 mEq/L
• Sodium: 138 mEq/L
• Creatinine: 1.0 mg/dL
Question Stem
Which nursing action is the priority?
A. Administer the scheduled dose of furosemide.
B. Notify the provider and anticipate potassium replacement.
C. Encourage increased fluid intake.
D. Restrict dietary potassium.
Correct Answer
Correct Answer: B. Notify the provider and anticipate
potassium replacement.
Detailed Rationale
