NR 293 EXAM 3 — PHARMACOLOGY FOR NURSING PRACTICE
2026 PRACTICE EXAM — 190 ORIGINAL QUESTIONS WITH ANSWERS &
RATIONALES
1.
A client taking lisinopril reports a persistent dry cough. Which medication-related adverse
effect should the nurse recognize?
A. Hyperglycemia
B. Dry cough
C. Constipation
D. Urinary retention
Answer: B. Dry cough
RATIONALE: ACE inhibitors such as lisinopril increase bradykinin, which can produce a
persistent dry cough.
2.
A client receiving an ACE inhibitor develops swelling of the lips and tongue. What is the
nurse’s priority action?
A. Give the next dose with food
B. Encourage oral fluids
C. Hold the medication and obtain emergency assistance
D. Place the client in a supine position
Answer: C. Hold the medication and obtain emergency assistance
RATIONALE: Facial or tongue swelling can indicate angioedema, a potentially life-
threatening reaction requiring immediate intervention.
3.
Which electrolyte imbalance is particularly important to monitor in a client taking
spironolactone?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
, Answer: A. Hyperkalemia
RATIONALE: Spironolactone is a potassium-sparing diuretic and can increase serum
potassium.
4.
Which assessment finding is most concerning in a client receiving propranolol?
A. Heart rate of 48/min
B. Temperature of 37°C
C. Respiratory rate of 18/min
D. Blood pressure of 128/76 mm Hg
Answer: A. Heart rate of 48/min
RATIONALE: Beta blockers can cause clinically significant bradycardia.
5.
A nurse is teaching a client prescribed clonidine. Which instruction is most important?
A. Stop the medication when blood pressure normalizes
B. Double the next dose if one is missed
C. Avoid abruptly discontinuing the medication
D. Take it only when experiencing hypertension
Answer: C. Avoid abruptly discontinuing the medication
RATIONALE: Abrupt withdrawal of clonidine can cause rebound hypertension.
6.
Which adverse effect is commonly associated with alpha-1 blockers such as prazosin?
A. Severe constipation
B. First-dose orthostatic hypotension
C. Hyperkalemia
D. Hearing loss
Answer: B. First-dose orthostatic hypotension
RATIONALE: Alpha-1 blockade causes vasodilation and can produce significant orthostatic
hypotension, particularly after the first dose.
,7.
Which medication is commonly used to reduce preload in clients with fluid overload?
A. Furosemide
B. Atorvastatin
C. Warfarin
D. Digoxin
Answer: A. Furosemide
RATIONALE: Furosemide is a loop diuretic that promotes sodium and water excretion,
reducing fluid volume.
8.
Which laboratory value should the nurse monitor closely in a client receiving furosemide?
A. Potassium
B. Hemoglobin A1c
C. Platelet count only
D. Bilirubin
Answer: A. Potassium
RATIONALE: Loop diuretics can cause potassium loss and hypokalemia.
9.
Which instruction is appropriate for a client taking hydrochlorothiazide?
A. Expect potassium levels to increase
B. Change positions slowly
C. Avoid all fluids
D. Take the medication immediately before bedtime
Answer: B. Change positions slowly
RATIONALE: Diuresis and vasodilation can contribute to orthostatic hypotension.
10.
Which medication is a calcium channel blocker?
, A. Enalapril
B. Metoprolol
C. Amlodipine
D. Losartan
Answer: C. Amlodipine
RATIONALE: Amlodipine is a dihydropyridine calcium channel blocker used primarily for
hypertension and angina.
11.
A client taking amlodipine reports swollen ankles. How should the nurse interpret this
finding?
A. Expected peripheral edema
B. Evidence of hypoglycemia
C. Sign of ototoxicity
D. Evidence of neutropenia
Answer: A. Expected peripheral edema
RATIONALE: Peripheral edema is a recognized adverse effect of dihydropyridine calcium
channel blockers.
12.
Which medication should the nurse recognize as an angiotensin II receptor blocker?
A. Losartan
B. Captopril
C. Furosemide
D. Diltiazem
Answer: A. Losartan
RATIONALE: Losartan is an ARB that blocks angiotensin II receptors.
13.
Which medication should generally be avoided during pregnancy because of fetal renal
toxicity?
A. ACE inhibitors
B. Calcium supplements
2026 PRACTICE EXAM — 190 ORIGINAL QUESTIONS WITH ANSWERS &
RATIONALES
1.
A client taking lisinopril reports a persistent dry cough. Which medication-related adverse
effect should the nurse recognize?
A. Hyperglycemia
B. Dry cough
C. Constipation
D. Urinary retention
Answer: B. Dry cough
RATIONALE: ACE inhibitors such as lisinopril increase bradykinin, which can produce a
persistent dry cough.
2.
A client receiving an ACE inhibitor develops swelling of the lips and tongue. What is the
nurse’s priority action?
A. Give the next dose with food
B. Encourage oral fluids
C. Hold the medication and obtain emergency assistance
D. Place the client in a supine position
Answer: C. Hold the medication and obtain emergency assistance
RATIONALE: Facial or tongue swelling can indicate angioedema, a potentially life-
threatening reaction requiring immediate intervention.
3.
Which electrolyte imbalance is particularly important to monitor in a client taking
spironolactone?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
, Answer: A. Hyperkalemia
RATIONALE: Spironolactone is a potassium-sparing diuretic and can increase serum
potassium.
4.
Which assessment finding is most concerning in a client receiving propranolol?
A. Heart rate of 48/min
B. Temperature of 37°C
C. Respiratory rate of 18/min
D. Blood pressure of 128/76 mm Hg
Answer: A. Heart rate of 48/min
RATIONALE: Beta blockers can cause clinically significant bradycardia.
5.
A nurse is teaching a client prescribed clonidine. Which instruction is most important?
A. Stop the medication when blood pressure normalizes
B. Double the next dose if one is missed
C. Avoid abruptly discontinuing the medication
D. Take it only when experiencing hypertension
Answer: C. Avoid abruptly discontinuing the medication
RATIONALE: Abrupt withdrawal of clonidine can cause rebound hypertension.
6.
Which adverse effect is commonly associated with alpha-1 blockers such as prazosin?
A. Severe constipation
B. First-dose orthostatic hypotension
C. Hyperkalemia
D. Hearing loss
Answer: B. First-dose orthostatic hypotension
RATIONALE: Alpha-1 blockade causes vasodilation and can produce significant orthostatic
hypotension, particularly after the first dose.
,7.
Which medication is commonly used to reduce preload in clients with fluid overload?
A. Furosemide
B. Atorvastatin
C. Warfarin
D. Digoxin
Answer: A. Furosemide
RATIONALE: Furosemide is a loop diuretic that promotes sodium and water excretion,
reducing fluid volume.
8.
Which laboratory value should the nurse monitor closely in a client receiving furosemide?
A. Potassium
B. Hemoglobin A1c
C. Platelet count only
D. Bilirubin
Answer: A. Potassium
RATIONALE: Loop diuretics can cause potassium loss and hypokalemia.
9.
Which instruction is appropriate for a client taking hydrochlorothiazide?
A. Expect potassium levels to increase
B. Change positions slowly
C. Avoid all fluids
D. Take the medication immediately before bedtime
Answer: B. Change positions slowly
RATIONALE: Diuresis and vasodilation can contribute to orthostatic hypotension.
10.
Which medication is a calcium channel blocker?
, A. Enalapril
B. Metoprolol
C. Amlodipine
D. Losartan
Answer: C. Amlodipine
RATIONALE: Amlodipine is a dihydropyridine calcium channel blocker used primarily for
hypertension and angina.
11.
A client taking amlodipine reports swollen ankles. How should the nurse interpret this
finding?
A. Expected peripheral edema
B. Evidence of hypoglycemia
C. Sign of ototoxicity
D. Evidence of neutropenia
Answer: A. Expected peripheral edema
RATIONALE: Peripheral edema is a recognized adverse effect of dihydropyridine calcium
channel blockers.
12.
Which medication should the nurse recognize as an angiotensin II receptor blocker?
A. Losartan
B. Captopril
C. Furosemide
D. Diltiazem
Answer: A. Losartan
RATIONALE: Losartan is an ARB that blocks angiotensin II receptors.
13.
Which medication should generally be avoided during pregnancy because of fetal renal
toxicity?
A. ACE inhibitors
B. Calcium supplements
