Family Nurse Practitioner (FNP) Pharmacology
Assessment — Exam Questions with Correct
Answers (VerifiedAnswers) Plus Rationales
2026 Q&A Instant Download PDF
Question 1
A patient with newly diagnosed hypertension has no compelling
indication for a specific antihypertensive class. Which
medication class is generally considered an appropriate first-line
option?
A. Alpha-1 blocker
B. ACE inhibitor
C. Central alpha-2 agonist
D. Direct vasodilator
Correct answer: B. ACE inhibitor
Rationale: ACE inhibitors are established first-line
antihypertensive agents and are particularly useful when certain
comorbidities, such as chronic kidney disease with albuminuria,
are present. They reduce formation of angiotensin II and
decrease aldosterone secretion, producing vasodilation and
reduced sodium and water retention. Clinicians should monitor
,serum creatinine and potassium after initiation or dose
escalation. ACE inhibitors are contraindicated during pregnancy
and can cause cough, hyperkalemia, and, rarely, angioedema.
Question 2
A patient taking lisinopril develops a persistent dry cough.
Which mechanism best explains this adverse effect?
A. Increased histamine release
B. Accumulation of bradykinin
C. Increased aldosterone production
D. Blockade of beta-2 receptors
Correct answer: B. Accumulation of bradykinin
Rationale: ACE normally contributes to the breakdown of
bradykinin. ACE inhibition therefore increases bradykinin
concentrations, which can produce the characteristic persistent,
nonproductive cough associated with ACE inhibitors. If the
cough is troublesome, an angiotensin II receptor blocker may be
considered because ARBs do not inhibit bradykinin breakdown
to the same degree.
Question 3
,Which adverse effect is particularly associated with angiotensin-
converting enzyme inhibitors and warrants immediate
evaluation?
A. Mild constipation
B. Angioedema
C. Tinnitus
D. Photosensitivity
Correct answer: B. Angioedema
Rationale: ACE inhibitor–associated angioedema can involve
swelling of the lips, tongue, face, or upper airway and may
become life-threatening. It can occur even after prolonged
therapy. Airway assessment is the priority when significant
facial, tongue, or throat swelling occurs. Patients who develop
ACE inhibitor–associated angioedema generally should not be
rechallenged with an ACE inhibitor.
Question 4
Which laboratory abnormality is most important to monitor in a
patient receiving spironolactone?
A. Hypocalcemia
B. Hyperkalemia
C. Hypernatremia
D. Hypoglycemia
, Correct answer: B. Hyperkalemia
Rationale: Spironolactone is a potassium-sparing diuretic and
mineralocorticoid receptor antagonist. By reducing aldosterone-
mediated sodium reabsorption and potassium secretion in the
distal nephron, it can increase serum potassium. The risk is
higher in patients with renal impairment and in those taking
other medications that increase potassium. Renal function and
serum potassium should therefore be monitored appropriately.
Question 5
A patient taking hydrochlorothiazide develops muscle weakness
and an abnormal cardiac rhythm. Which electrolyte
abnormality should the FNP suspect?
A. Hyperkalemia
B. Hypokalemia
C. Hypermagnesemia
D. Hypernatremia
Correct answer: B. Hypokalemia
Rationale: Thiazide diuretics increase sodium and chloride
excretion and indirectly increase potassium excretion.
Hypokalemia may cause weakness, cramps, fatigue, and
potentially clinically significant cardiac arrhythmias. Periodic
electrolyte monitoring is appropriate, particularly after initiation
Assessment — Exam Questions with Correct
Answers (VerifiedAnswers) Plus Rationales
2026 Q&A Instant Download PDF
Question 1
A patient with newly diagnosed hypertension has no compelling
indication for a specific antihypertensive class. Which
medication class is generally considered an appropriate first-line
option?
A. Alpha-1 blocker
B. ACE inhibitor
C. Central alpha-2 agonist
D. Direct vasodilator
Correct answer: B. ACE inhibitor
Rationale: ACE inhibitors are established first-line
antihypertensive agents and are particularly useful when certain
comorbidities, such as chronic kidney disease with albuminuria,
are present. They reduce formation of angiotensin II and
decrease aldosterone secretion, producing vasodilation and
reduced sodium and water retention. Clinicians should monitor
,serum creatinine and potassium after initiation or dose
escalation. ACE inhibitors are contraindicated during pregnancy
and can cause cough, hyperkalemia, and, rarely, angioedema.
Question 2
A patient taking lisinopril develops a persistent dry cough.
Which mechanism best explains this adverse effect?
A. Increased histamine release
B. Accumulation of bradykinin
C. Increased aldosterone production
D. Blockade of beta-2 receptors
Correct answer: B. Accumulation of bradykinin
Rationale: ACE normally contributes to the breakdown of
bradykinin. ACE inhibition therefore increases bradykinin
concentrations, which can produce the characteristic persistent,
nonproductive cough associated with ACE inhibitors. If the
cough is troublesome, an angiotensin II receptor blocker may be
considered because ARBs do not inhibit bradykinin breakdown
to the same degree.
Question 3
,Which adverse effect is particularly associated with angiotensin-
converting enzyme inhibitors and warrants immediate
evaluation?
A. Mild constipation
B. Angioedema
C. Tinnitus
D. Photosensitivity
Correct answer: B. Angioedema
Rationale: ACE inhibitor–associated angioedema can involve
swelling of the lips, tongue, face, or upper airway and may
become life-threatening. It can occur even after prolonged
therapy. Airway assessment is the priority when significant
facial, tongue, or throat swelling occurs. Patients who develop
ACE inhibitor–associated angioedema generally should not be
rechallenged with an ACE inhibitor.
Question 4
Which laboratory abnormality is most important to monitor in a
patient receiving spironolactone?
A. Hypocalcemia
B. Hyperkalemia
C. Hypernatremia
D. Hypoglycemia
, Correct answer: B. Hyperkalemia
Rationale: Spironolactone is a potassium-sparing diuretic and
mineralocorticoid receptor antagonist. By reducing aldosterone-
mediated sodium reabsorption and potassium secretion in the
distal nephron, it can increase serum potassium. The risk is
higher in patients with renal impairment and in those taking
other medications that increase potassium. Renal function and
serum potassium should therefore be monitored appropriately.
Question 5
A patient taking hydrochlorothiazide develops muscle weakness
and an abnormal cardiac rhythm. Which electrolyte
abnormality should the FNP suspect?
A. Hyperkalemia
B. Hypokalemia
C. Hypermagnesemia
D. Hypernatremia
Correct answer: B. Hypokalemia
Rationale: Thiazide diuretics increase sodium and chloride
excretion and indirectly increase potassium excretion.
Hypokalemia may cause weakness, cramps, fatigue, and
potentially clinically significant cardiac arrhythmias. Periodic
electrolyte monitoring is appropriate, particularly after initiation
