NSG 318 UPDATED 2026 EXAM SCRIPT 2026 QUESTIONS
AND ANSWERS RATED A+
✔✔atenolol action - ✔✔blocks beta 1 adrenergic receptor sites (NE and Epinephrine),
depress SNS, suppress RAAS, dec workload and O2 demands of heart
✔✔what ethnicity may beta blockers not work for - ✔✔African Americans (unless paired
with diuretics)
✔✔Atenolol contraindications - ✔✔sinus bradycardia, heart block, pulm edema,
bronchospasm, pregnancy
✔✔atenolol drug interactions - ✔✔-Atropine/anticholinergics: inc absorption
-NSAIDs: dec effects
-Insulin and sulfonylureas: inc risk of hypoglycemia
✔✔Atenolol side effects/adverse effects - ✔✔ED, CNS effects, GI distress, cool
extremities, hypotension, bradycardia, dyspnea, bronchospasm, thrombocytopenia
✔✔atenolol interventions - ✔✔-teach pt to not stop taking abruptly to avoid rebound
HTN (wean off 1-2 weeks)
-warn male clients of dose related ED
-assist with ambulation (ortho hypotension)
✔✔Diltiazem class - ✔✔calcium channel blocker
✔✔diltiazem use - ✔✔tx hypertension and atrial dysrhythmias (brings more O2 to
myocardium and dec cardiac workload)
✔✔diltiazem action - ✔✔inhibits transport of Ca ions to myocardial cells
✔✔Diltiazem Contraindications - ✔✔hypotension, AV heart block, bleeding aneurysm
✔✔diltiazem drug interactions - ✔✔-Digoxin/beta blockers: partial/complete heart block,
HF, or dysrhythmias
-Digoxin: inc digoxin levels
-Beta blockers/antihypertensives: cause hypotension
✔✔diltiazem CAM interactions - ✔✔-St. Johns and ginseng: dec effectiveness
-Garlic and hawthorn: inc hypotensive effect
✔✔diltiazem side effects - ✔✔CNS effects, edema of ankles/feet, bradycardia,
hypotension
abrupt withdrawal may cause acute angina episode
,✔✔diltiazem overdose - ✔✔-atropine reverses bradycardia
-CaCl can reverse hypotension or heart block
✔✔diltiazem interventions - ✔✔-avoid use of extended release in elderly (promotes fluid
retention and exacerbates HF)
-Monitor BP and HR and EKG
-Monitor digoxin levels
✔✔Hydrochlorothiazide class - ✔✔thiazide
✔✔hydrochlorothiazide uses - ✔✔inc urine output and tx hypertension, edema, HF,
nephrotic syndrome, and ascites
✔✔hydrochlorothiazide action - ✔✔excretion of Na and H2O by inhibiting Na
reabsorption in distal tubule. promotes excretion of Na, Cl and H2O. dec BP and edema
✔✔hydrochlorothiazide contraindications - ✔✔renal failure, hypersensitivity
caution w/ gout and hypotension
✔✔hydrochlorothiazide side effects/adverse effects - ✔✔CNS and GI effects,
hypotension, hyperglycemia, photosensitivity, blurred vision, gout, Steven Johnson
✔✔hydrochlorothiazide drug interactions - ✔✔-inc digitalis toxicity if hypokalemia
present
-Aspirin: inc renal toxicity
-Steroids: inc K+ loss
-Antidiabetics: dec effects
-NSAIDs: dec absorption of thiazides
✔✔hydrochlorothiazide CAM interactions - ✔✔-Aloe: dec serum K+ level
-Gingko: inc BP
-Licorice: inc K+ loss
-Hawthorn: potentiate hypotension
✔✔hydrochlorothiazide interventions - ✔✔-assess daily weight (concerning if 2.2lbs
gained in one day- kidney failure)
-assess I&Os
-teach pt. to take in AM to avoid sleep disturbances from nocturia
-observe for hypokalemia
✔✔furosemide class - ✔✔loop diuretic
✔✔furosemide use - ✔✔tx HF, renal dysfunction, hypertension, nephrotic syndrome,
acute pulmonary and peripheral edema
, ✔✔furosemide action - ✔✔inhibits reabsorption of Na and H2O in the loop of Henle and
distal renal tubules. K+, Mg, and Ca may be excreted
✔✔Furosemide Contraindications - ✔✔hypovolemia, severe electrolyte imbalance,
anuria, hepatic coma, hypersensitivity to sulfa drugs
caution w patients w hearing impairment
✔✔Furosemide
Side effects/Adverse reactions - ✔✔CNS and GI effects, hyperglycemia, blurred vision,
hyperuricemia, hypokalemia, hyponatremia, hypomagnesemia, HEARING LOSS
✔✔Furosemide drug interactions - ✔✔-Alcohol: inc orthostatic hypotension
-Aminoglycosides: inc ototoxicity
-Steroids: inc K+ loss
-Digoxin and hypokalemia: inc digitalis toxicity and cardiac dysrhythmias
✔✔furosemide CAM interactions - ✔✔-Licorice: inc K+ loss
-Hawthorne: potentiate hypotension
-Ginseng: dec action of loop diuretics
✔✔furosemide interventions - ✔✔-VERY potent drug
-Admin IV slowly (to avoid hearing loss)
-Monitor K+ levels (especially pt taking digoxin)
-Consume foods high in K+
✔✔Spironolactone class - ✔✔potassium sparing diuretic
✔✔Spironolactone use - ✔✔tx hypokalemia, acne, peripheral/pulmonary edema,
circulatory overload, hypertension, HF
✔✔spironolactone action - ✔✔acts on distal renal tubules to promote Na and H2O
excretion and K+ retention
✔✔does spironolactone deplete K+ - ✔✔No, it holds on to it and can cause
hyperkalemia. shouldn't be combined with other drugs/foods that can inc K+ level
✔✔spironolactone contraindications - ✔✔renal failure, hyperkalemia
caution w renal/hepatic dysfunction
✔✔spironolactone drug interactions - ✔✔-K+ supplements: inc serum K+
-inc effects of anti-hypertensives and lithium
-ACE inhibitor: hyperkalemia (life threatening)
AND ANSWERS RATED A+
✔✔atenolol action - ✔✔blocks beta 1 adrenergic receptor sites (NE and Epinephrine),
depress SNS, suppress RAAS, dec workload and O2 demands of heart
✔✔what ethnicity may beta blockers not work for - ✔✔African Americans (unless paired
with diuretics)
✔✔Atenolol contraindications - ✔✔sinus bradycardia, heart block, pulm edema,
bronchospasm, pregnancy
✔✔atenolol drug interactions - ✔✔-Atropine/anticholinergics: inc absorption
-NSAIDs: dec effects
-Insulin and sulfonylureas: inc risk of hypoglycemia
✔✔Atenolol side effects/adverse effects - ✔✔ED, CNS effects, GI distress, cool
extremities, hypotension, bradycardia, dyspnea, bronchospasm, thrombocytopenia
✔✔atenolol interventions - ✔✔-teach pt to not stop taking abruptly to avoid rebound
HTN (wean off 1-2 weeks)
-warn male clients of dose related ED
-assist with ambulation (ortho hypotension)
✔✔Diltiazem class - ✔✔calcium channel blocker
✔✔diltiazem use - ✔✔tx hypertension and atrial dysrhythmias (brings more O2 to
myocardium and dec cardiac workload)
✔✔diltiazem action - ✔✔inhibits transport of Ca ions to myocardial cells
✔✔Diltiazem Contraindications - ✔✔hypotension, AV heart block, bleeding aneurysm
✔✔diltiazem drug interactions - ✔✔-Digoxin/beta blockers: partial/complete heart block,
HF, or dysrhythmias
-Digoxin: inc digoxin levels
-Beta blockers/antihypertensives: cause hypotension
✔✔diltiazem CAM interactions - ✔✔-St. Johns and ginseng: dec effectiveness
-Garlic and hawthorn: inc hypotensive effect
✔✔diltiazem side effects - ✔✔CNS effects, edema of ankles/feet, bradycardia,
hypotension
abrupt withdrawal may cause acute angina episode
,✔✔diltiazem overdose - ✔✔-atropine reverses bradycardia
-CaCl can reverse hypotension or heart block
✔✔diltiazem interventions - ✔✔-avoid use of extended release in elderly (promotes fluid
retention and exacerbates HF)
-Monitor BP and HR and EKG
-Monitor digoxin levels
✔✔Hydrochlorothiazide class - ✔✔thiazide
✔✔hydrochlorothiazide uses - ✔✔inc urine output and tx hypertension, edema, HF,
nephrotic syndrome, and ascites
✔✔hydrochlorothiazide action - ✔✔excretion of Na and H2O by inhibiting Na
reabsorption in distal tubule. promotes excretion of Na, Cl and H2O. dec BP and edema
✔✔hydrochlorothiazide contraindications - ✔✔renal failure, hypersensitivity
caution w/ gout and hypotension
✔✔hydrochlorothiazide side effects/adverse effects - ✔✔CNS and GI effects,
hypotension, hyperglycemia, photosensitivity, blurred vision, gout, Steven Johnson
✔✔hydrochlorothiazide drug interactions - ✔✔-inc digitalis toxicity if hypokalemia
present
-Aspirin: inc renal toxicity
-Steroids: inc K+ loss
-Antidiabetics: dec effects
-NSAIDs: dec absorption of thiazides
✔✔hydrochlorothiazide CAM interactions - ✔✔-Aloe: dec serum K+ level
-Gingko: inc BP
-Licorice: inc K+ loss
-Hawthorn: potentiate hypotension
✔✔hydrochlorothiazide interventions - ✔✔-assess daily weight (concerning if 2.2lbs
gained in one day- kidney failure)
-assess I&Os
-teach pt. to take in AM to avoid sleep disturbances from nocturia
-observe for hypokalemia
✔✔furosemide class - ✔✔loop diuretic
✔✔furosemide use - ✔✔tx HF, renal dysfunction, hypertension, nephrotic syndrome,
acute pulmonary and peripheral edema
, ✔✔furosemide action - ✔✔inhibits reabsorption of Na and H2O in the loop of Henle and
distal renal tubules. K+, Mg, and Ca may be excreted
✔✔Furosemide Contraindications - ✔✔hypovolemia, severe electrolyte imbalance,
anuria, hepatic coma, hypersensitivity to sulfa drugs
caution w patients w hearing impairment
✔✔Furosemide
Side effects/Adverse reactions - ✔✔CNS and GI effects, hyperglycemia, blurred vision,
hyperuricemia, hypokalemia, hyponatremia, hypomagnesemia, HEARING LOSS
✔✔Furosemide drug interactions - ✔✔-Alcohol: inc orthostatic hypotension
-Aminoglycosides: inc ototoxicity
-Steroids: inc K+ loss
-Digoxin and hypokalemia: inc digitalis toxicity and cardiac dysrhythmias
✔✔furosemide CAM interactions - ✔✔-Licorice: inc K+ loss
-Hawthorne: potentiate hypotension
-Ginseng: dec action of loop diuretics
✔✔furosemide interventions - ✔✔-VERY potent drug
-Admin IV slowly (to avoid hearing loss)
-Monitor K+ levels (especially pt taking digoxin)
-Consume foods high in K+
✔✔Spironolactone class - ✔✔potassium sparing diuretic
✔✔Spironolactone use - ✔✔tx hypokalemia, acne, peripheral/pulmonary edema,
circulatory overload, hypertension, HF
✔✔spironolactone action - ✔✔acts on distal renal tubules to promote Na and H2O
excretion and K+ retention
✔✔does spironolactone deplete K+ - ✔✔No, it holds on to it and can cause
hyperkalemia. shouldn't be combined with other drugs/foods that can inc K+ level
✔✔spironolactone contraindications - ✔✔renal failure, hyperkalemia
caution w renal/hepatic dysfunction
✔✔spironolactone drug interactions - ✔✔-K+ supplements: inc serum K+
-inc effects of anti-hypertensives and lithium
-ACE inhibitor: hyperkalemia (life threatening)
