NUR 2474 PHARMACOLOGY
FOR PROFESSIONAL NURSING
Exam 2 — Latest 2026/2027 Edition
75 Actual Exam Questions with Correct Answers
and Comprehensive Rationales
Rasmussen University NUR 2474 Curriculum Aligned
Cardiovascular • Respiratory • Gastrointestinal • Endocrine
Neurological/Psychiatric • NGN-Style Clinical Scenarios
Rasmussen University Pharmacology Examination
100% Correct Verified Answers with Detailed Rationales
,Section 1: Cardiovascular and Renal Pharmacology (Q1-Q25)
Q1: A patient with hypertension and diabetic nephropathy is started on lisinopril. Which statement by the patient indicates
the need for further teaching?
A. I will report any swelling of my face, lips, or tongue to my provider immediately
B. I should rise slowly from sitting or lying positions to avoid dizziness
C. I can take over-the-counter ibuprofen for my occasional headaches without checking with my provider [CORRECT]
D. I will report a persistent dry cough to my healthcare provider
Correct Answer: C
Rationale: NSAIDs such as ibuprofen decrease the antihypertensive effect of ACE inhibitors by inhibiting prostaglandin synthesis,
which reduces renal blood flow. Patients on ACE inhibitors should avoid NSAIDs or consult their provider before use. Reporting facial
swelling (angioedema), rising slowly (preventing orthostatic hypotension), and reporting dry cough (common ACE inhibitor side effect)
all demonstrate correct understanding.
Q2: A nurse is caring for a patient who is taking losartan for hypertension. The patient asks why they were switched from
lisinopril to losartan. Which response by the nurse is most accurate?
A. Losartan is more effective at lowering blood pressure than lisinopril
B. Losartan blocks angiotensin II receptors directly and does not cause the persistent dry cough associated with ACE
inhibitors [CORRECT]
C. Losartan has fewer drug interactions and can be taken with any medication
D. Losartan does not require monitoring of kidney function like lisinopril does
Correct Answer: B
Rationale: ARBs like losartan block angiotensin II at the receptor level rather than inhibiting ACE, which prevents the accumulation of
bradykinin that causes the dry cough seen with ACE inhibitors. Both drug classes are equally effective for hypertension, both require
renal function monitoring, and ARBs share many of the same drug interactions (potassium supplements, NSAIDs) as ACE inhibitors.
Q3: A patient with hypertension and angina is prescribed amlodipine. Which side effect should the nurse include in patient
teaching?
A. Constipation
B. Bradycardia
C. Peripheral edema [CORRECT]
D. Dry cough
Correct Answer: C
Rationale: Amlodipine is a dihydropyridine calcium channel blocker that causes peripheral vasodilation. Peripheral edema is the most
common side effect due to precapillary vasodilation. Constipation is associated with verapamil (a non-dihydropyridine). Bradycardia
and AV block are associated with non-dihydropyridines like verapamil and diltiazem. Dry cough is an ACE inhibitor side effect.
Q4: A patient with atrial fibrillation and heart failure with reduced ejection fraction is being evaluated for medication
therapy. Which calcium channel blocker should the nurse anticipate will be AVOIDED in this patient?
A. Amlodipine
B. Nifedipine
C. Verapamil [CORRECT]
D. All calcium channel blockers are contraindicated in heart failure
Correct Answer: C
, Rationale: Non-dihydropyridine calcium channel blockers (verapamil, diltiazem) are contraindicated in heart failure with reduced
ejection fraction because they cause cardiac depression through negative inotropic effects. Amlodipine and nifedipine are
dihydropyridines that primarily cause peripheral vasodilation without significant cardiac depression, so they are not contraindicated in
heart failure.
Q5: A nurse is teaching a patient with asthma who has been prescribed propranolol for migraine prevention. Which
statement by the nurse is most important?
A. Take this medication with food to reduce stomach upset
B. This medication may worsen your asthma because it blocks beta-2 receptors in the lungs [CORRECT]
C. Monitor your blood pressure daily and report any readings above 140/90
D. Do not stop taking this medication abruptly; taper gradually over 1-2 weeks
Correct Answer: B
Rationale: Propranolol is a non-selective beta-blocker that blocks both beta-1 (cardiac) and beta-2 (pulmonary) receptors. Blocking
beta-2 receptors in bronchial smooth muscle can cause bronchospasm, making propranolol contraindicated in patients with asthma.
While all the other statements are valid teaching points for beta-blockers, the asthma contraindication is the most critical safety concern
for this specific patient.
Q6: A patient taking metoprolol for heart failure reports feeling dizzy and their heart rate is 52 bpm. What is the priority
nursing action?
A. Administer the next dose as scheduled and reassess in the morning
B. Hold the medication, notify the provider, and document the assessment findings [CORRECT]
C. Give the medication with a full glass of water and encourage ambulation
D. Instruct the patient to increase their fluid intake to raise blood pressure
Correct Answer: B
Rationale: Beta-blockers like metoprolol reduce heart rate and blood pressure. A heart rate of 52 bpm in an adult is below the standard
hold parameter of 60 bpm for beta-blockers. The nurse should hold the medication, notify the provider of the bradycardia and
dizziness, and document the findings. Administering the dose could worsen bradycardia and hypotension.
Q7: A patient has been taking metoprolol for 6 months for hypertension. At a follow-up visit, the patient tells the nurse they
stopped taking the medication 3 days ago because they felt better. Which response by the nurse is most appropriate?
A. It is fine to stop the medication if your blood pressure has normalized
B. Abrupt discontinuation of metoprolol can cause rebound hypertension, tachycardia, and angina exacerbation; you must
taper gradually over 1-2 weeks [CORRECT]
C. You should restart the medication at double the dose to make up for the missed days
D. Since you stopped 3 days ago, the medication is out of your system and restarting will require a new prescription
Correct Answer: B
Rationale: Abrupt discontinuation of beta-blockers can cause rebound hypertension, reflex tachycardia, and exacerbation of angina
due to upregulation of beta receptors during chronic therapy. Beta-blockers must be tapered gradually over 1-2 weeks under medical
supervision. Stopping abruptly is dangerous regardless of whether symptoms have improved.
Q8: A patient with heart failure is receiving digoxin. Which finding should the nurse recognize as an early sign of digoxin
toxicity?
A. Blurred vision with yellow-green halos around objects
B. Anorexia, nausea, and vomiting [CORRECT]
C. Atrial fibrillation with a rapid ventricular response
D. Severe bradycardia with heart rate below 40 bpm
Correct Answer: B
FOR PROFESSIONAL NURSING
Exam 2 — Latest 2026/2027 Edition
75 Actual Exam Questions with Correct Answers
and Comprehensive Rationales
Rasmussen University NUR 2474 Curriculum Aligned
Cardiovascular • Respiratory • Gastrointestinal • Endocrine
Neurological/Psychiatric • NGN-Style Clinical Scenarios
Rasmussen University Pharmacology Examination
100% Correct Verified Answers with Detailed Rationales
,Section 1: Cardiovascular and Renal Pharmacology (Q1-Q25)
Q1: A patient with hypertension and diabetic nephropathy is started on lisinopril. Which statement by the patient indicates
the need for further teaching?
A. I will report any swelling of my face, lips, or tongue to my provider immediately
B. I should rise slowly from sitting or lying positions to avoid dizziness
C. I can take over-the-counter ibuprofen for my occasional headaches without checking with my provider [CORRECT]
D. I will report a persistent dry cough to my healthcare provider
Correct Answer: C
Rationale: NSAIDs such as ibuprofen decrease the antihypertensive effect of ACE inhibitors by inhibiting prostaglandin synthesis,
which reduces renal blood flow. Patients on ACE inhibitors should avoid NSAIDs or consult their provider before use. Reporting facial
swelling (angioedema), rising slowly (preventing orthostatic hypotension), and reporting dry cough (common ACE inhibitor side effect)
all demonstrate correct understanding.
Q2: A nurse is caring for a patient who is taking losartan for hypertension. The patient asks why they were switched from
lisinopril to losartan. Which response by the nurse is most accurate?
A. Losartan is more effective at lowering blood pressure than lisinopril
B. Losartan blocks angiotensin II receptors directly and does not cause the persistent dry cough associated with ACE
inhibitors [CORRECT]
C. Losartan has fewer drug interactions and can be taken with any medication
D. Losartan does not require monitoring of kidney function like lisinopril does
Correct Answer: B
Rationale: ARBs like losartan block angiotensin II at the receptor level rather than inhibiting ACE, which prevents the accumulation of
bradykinin that causes the dry cough seen with ACE inhibitors. Both drug classes are equally effective for hypertension, both require
renal function monitoring, and ARBs share many of the same drug interactions (potassium supplements, NSAIDs) as ACE inhibitors.
Q3: A patient with hypertension and angina is prescribed amlodipine. Which side effect should the nurse include in patient
teaching?
A. Constipation
B. Bradycardia
C. Peripheral edema [CORRECT]
D. Dry cough
Correct Answer: C
Rationale: Amlodipine is a dihydropyridine calcium channel blocker that causes peripheral vasodilation. Peripheral edema is the most
common side effect due to precapillary vasodilation. Constipation is associated with verapamil (a non-dihydropyridine). Bradycardia
and AV block are associated with non-dihydropyridines like verapamil and diltiazem. Dry cough is an ACE inhibitor side effect.
Q4: A patient with atrial fibrillation and heart failure with reduced ejection fraction is being evaluated for medication
therapy. Which calcium channel blocker should the nurse anticipate will be AVOIDED in this patient?
A. Amlodipine
B. Nifedipine
C. Verapamil [CORRECT]
D. All calcium channel blockers are contraindicated in heart failure
Correct Answer: C
, Rationale: Non-dihydropyridine calcium channel blockers (verapamil, diltiazem) are contraindicated in heart failure with reduced
ejection fraction because they cause cardiac depression through negative inotropic effects. Amlodipine and nifedipine are
dihydropyridines that primarily cause peripheral vasodilation without significant cardiac depression, so they are not contraindicated in
heart failure.
Q5: A nurse is teaching a patient with asthma who has been prescribed propranolol for migraine prevention. Which
statement by the nurse is most important?
A. Take this medication with food to reduce stomach upset
B. This medication may worsen your asthma because it blocks beta-2 receptors in the lungs [CORRECT]
C. Monitor your blood pressure daily and report any readings above 140/90
D. Do not stop taking this medication abruptly; taper gradually over 1-2 weeks
Correct Answer: B
Rationale: Propranolol is a non-selective beta-blocker that blocks both beta-1 (cardiac) and beta-2 (pulmonary) receptors. Blocking
beta-2 receptors in bronchial smooth muscle can cause bronchospasm, making propranolol contraindicated in patients with asthma.
While all the other statements are valid teaching points for beta-blockers, the asthma contraindication is the most critical safety concern
for this specific patient.
Q6: A patient taking metoprolol for heart failure reports feeling dizzy and their heart rate is 52 bpm. What is the priority
nursing action?
A. Administer the next dose as scheduled and reassess in the morning
B. Hold the medication, notify the provider, and document the assessment findings [CORRECT]
C. Give the medication with a full glass of water and encourage ambulation
D. Instruct the patient to increase their fluid intake to raise blood pressure
Correct Answer: B
Rationale: Beta-blockers like metoprolol reduce heart rate and blood pressure. A heart rate of 52 bpm in an adult is below the standard
hold parameter of 60 bpm for beta-blockers. The nurse should hold the medication, notify the provider of the bradycardia and
dizziness, and document the findings. Administering the dose could worsen bradycardia and hypotension.
Q7: A patient has been taking metoprolol for 6 months for hypertension. At a follow-up visit, the patient tells the nurse they
stopped taking the medication 3 days ago because they felt better. Which response by the nurse is most appropriate?
A. It is fine to stop the medication if your blood pressure has normalized
B. Abrupt discontinuation of metoprolol can cause rebound hypertension, tachycardia, and angina exacerbation; you must
taper gradually over 1-2 weeks [CORRECT]
C. You should restart the medication at double the dose to make up for the missed days
D. Since you stopped 3 days ago, the medication is out of your system and restarting will require a new prescription
Correct Answer: B
Rationale: Abrupt discontinuation of beta-blockers can cause rebound hypertension, reflex tachycardia, and exacerbation of angina
due to upregulation of beta receptors during chronic therapy. Beta-blockers must be tapered gradually over 1-2 weeks under medical
supervision. Stopping abruptly is dangerous regardless of whether symptoms have improved.
Q8: A patient with heart failure is receiving digoxin. Which finding should the nurse recognize as an early sign of digoxin
toxicity?
A. Blurred vision with yellow-green halos around objects
B. Anorexia, nausea, and vomiting [CORRECT]
C. Atrial fibrillation with a rapid ventricular response
D. Severe bradycardia with heart rate below 40 bpm
Correct Answer: B
