NR 545 Exam 3 – Pharm, Phys Assess & Pathophys
– Q&A (2026) PDF | Chamberlain
QUESTIONS 1–25 — CARDIOVASCULAR PHARMACOLOGY & PATHOPHYSIOLOGY
1. A patient with hypertension is prescribed lisinopril. Which mechanism best
explains the drug's antihypertensive effect?
A. Blocks beta-1 receptors
B. Inhibits angiotensin-converting enzyme
C. Blocks calcium channels
D. Increases sodium retention
Correct answer: B. Inhibits angiotensin-converting enzyme
Rationale: Lisinopril is an ACE inhibitor. It decreases conversion of angiotensin I to
angiotensin II, reducing vasoconstriction and aldosterone secretion. This lowers
systemic vascular resistance and blood pressure.
Normal vs. abnormal: A modest decrease in blood pressure is expected. Severe
hypotension, hyperkalemia, or angioedema is abnormal.
High-yield exam point: ACE inhibitors commonly end in “-pril.”
2. Which laboratory value is particularly important to monitor in a patient
taking an ACE inhibitor?
A. Calcium
B. Potassium
C. Hemoglobin
D. Platelets
Correct answer: B. Potassium
Rationale: ACE inhibition reduces aldosterone activity, which can decrease
potassium excretion. Hyperkalemia may occur, particularly in patients with renal
impairment or those taking potassium-sparing medications.
,Normal vs. abnormal: Normal serum potassium is approximately 3.5–5.0 mEq/L.
Significant elevation requires evaluation.
High-yield: ACE inhibitors → hyperkalemia + increased creatinine risk +
cough/angioedema.
3. A patient taking metoprolol has a heart rate of 48/min and reports dizziness.
What is the priority interpretation?
A. Expected therapeutic response
B. Possible excessive beta-blockade
C. Evidence of hyperthyroidism
D. Expected response to dehydration
Correct answer: B. Possible excessive beta-blockade
Rationale: Metoprolol decreases heart rate and myocardial contractility through
beta-1 blockade. Symptomatic bradycardia requires assessment and may warrant
holding the medication according to the clinical order/protocol.
Normal vs. abnormal: Mild reduction in HR may be expected; symptomatic
bradycardia is abnormal.
High-yield: Beta blockers → ↓ HR, ↓ contractility, ↓ BP.
4. Which assessment finding is most consistent with left-sided heart failure?
A. Ascites
B. Peripheral edema
C. Pulmonary crackles
D. Enlarged liver
Correct answer: C. Pulmonary crackles
Rationale: Left ventricular failure causes increased pulmonary venous pressure
and pulmonary congestion. Crackles, dyspnea, orthopnea, and pulmonary edema
may result.
,Normal: Clear bilateral lung sounds.
Abnormal: Crackles, hypoxemia, orthopnea, or acute respiratory distress.
High-yield:
Left HF → lungs.
Right HF → systemic venous congestion.
5. A patient with heart failure develops worsening orthopnea and bilateral
crackles. What pathophysiologic process is occurring?
A. Reduced pulmonary blood flow
B. Increased pulmonary capillary hydrostatic pressure
C. Reduced systemic venous pressure
D. Increased renal filtration
Correct answer: B. Increased pulmonary capillary hydrostatic pressure
Rationale: Left ventricular dysfunction causes blood to back up into pulmonary
circulation. Increased hydrostatic pressure drives fluid into pulmonary interstitial
and alveolar spaces.
High-yield: Pulmonary edema in left HF results primarily from elevated
hydrostatic pressure.
6. Which medication is a loop diuretic?
A. Furosemide
B. Spironolactone
C. Lisinopril
D. Losartan
Correct answer: A. Furosemide
Rationale: Furosemide inhibits sodium and chloride reabsorption in the thick
ascending limb of the loop of Henle, producing substantial diuresis.
, Normal vs. abnormal: Increased urine output is expected. Hypokalemia,
dehydration, hypotension, and electrolyte disturbances are possible adverse
effects.
High-yield: Furosemide → loop diuretic → potassium loss.
7. Which finding is most concerning after administration of furosemide?
A. Increased urine output
B. Mild thirst
C. Potassium of 2.8 mEq/L
D. Decreased ankle edema
Correct answer: C. Potassium of 2.8 mEq/L
Rationale: Significant hypokalemia increases the risk of cardiac dysrhythmias and
muscle weakness.
High-yield: Loop diuretics can cause hypokalemia.
8. A patient taking spironolactone should be monitored closely for:
A. Hypoglycemia
B. Hyperkalemia
C. Hypercalcemia
D. Neutropenia
Correct answer: B. Hyperkalemia
Rationale: Spironolactone is a potassium-sparing aldosterone antagonist.
Reduced potassium excretion can cause hyperkalemia.
High-yield: Spironolactone → potassium-sparing.
9. Which assessment finding suggests peripheral arterial disease?
A. Warm legs with bilateral edema
B. Bounding pedal pulses
– Q&A (2026) PDF | Chamberlain
QUESTIONS 1–25 — CARDIOVASCULAR PHARMACOLOGY & PATHOPHYSIOLOGY
1. A patient with hypertension is prescribed lisinopril. Which mechanism best
explains the drug's antihypertensive effect?
A. Blocks beta-1 receptors
B. Inhibits angiotensin-converting enzyme
C. Blocks calcium channels
D. Increases sodium retention
Correct answer: B. Inhibits angiotensin-converting enzyme
Rationale: Lisinopril is an ACE inhibitor. It decreases conversion of angiotensin I to
angiotensin II, reducing vasoconstriction and aldosterone secretion. This lowers
systemic vascular resistance and blood pressure.
Normal vs. abnormal: A modest decrease in blood pressure is expected. Severe
hypotension, hyperkalemia, or angioedema is abnormal.
High-yield exam point: ACE inhibitors commonly end in “-pril.”
2. Which laboratory value is particularly important to monitor in a patient
taking an ACE inhibitor?
A. Calcium
B. Potassium
C. Hemoglobin
D. Platelets
Correct answer: B. Potassium
Rationale: ACE inhibition reduces aldosterone activity, which can decrease
potassium excretion. Hyperkalemia may occur, particularly in patients with renal
impairment or those taking potassium-sparing medications.
,Normal vs. abnormal: Normal serum potassium is approximately 3.5–5.0 mEq/L.
Significant elevation requires evaluation.
High-yield: ACE inhibitors → hyperkalemia + increased creatinine risk +
cough/angioedema.
3. A patient taking metoprolol has a heart rate of 48/min and reports dizziness.
What is the priority interpretation?
A. Expected therapeutic response
B. Possible excessive beta-blockade
C. Evidence of hyperthyroidism
D. Expected response to dehydration
Correct answer: B. Possible excessive beta-blockade
Rationale: Metoprolol decreases heart rate and myocardial contractility through
beta-1 blockade. Symptomatic bradycardia requires assessment and may warrant
holding the medication according to the clinical order/protocol.
Normal vs. abnormal: Mild reduction in HR may be expected; symptomatic
bradycardia is abnormal.
High-yield: Beta blockers → ↓ HR, ↓ contractility, ↓ BP.
4. Which assessment finding is most consistent with left-sided heart failure?
A. Ascites
B. Peripheral edema
C. Pulmonary crackles
D. Enlarged liver
Correct answer: C. Pulmonary crackles
Rationale: Left ventricular failure causes increased pulmonary venous pressure
and pulmonary congestion. Crackles, dyspnea, orthopnea, and pulmonary edema
may result.
,Normal: Clear bilateral lung sounds.
Abnormal: Crackles, hypoxemia, orthopnea, or acute respiratory distress.
High-yield:
Left HF → lungs.
Right HF → systemic venous congestion.
5. A patient with heart failure develops worsening orthopnea and bilateral
crackles. What pathophysiologic process is occurring?
A. Reduced pulmonary blood flow
B. Increased pulmonary capillary hydrostatic pressure
C. Reduced systemic venous pressure
D. Increased renal filtration
Correct answer: B. Increased pulmonary capillary hydrostatic pressure
Rationale: Left ventricular dysfunction causes blood to back up into pulmonary
circulation. Increased hydrostatic pressure drives fluid into pulmonary interstitial
and alveolar spaces.
High-yield: Pulmonary edema in left HF results primarily from elevated
hydrostatic pressure.
6. Which medication is a loop diuretic?
A. Furosemide
B. Spironolactone
C. Lisinopril
D. Losartan
Correct answer: A. Furosemide
Rationale: Furosemide inhibits sodium and chloride reabsorption in the thick
ascending limb of the loop of Henle, producing substantial diuresis.
, Normal vs. abnormal: Increased urine output is expected. Hypokalemia,
dehydration, hypotension, and electrolyte disturbances are possible adverse
effects.
High-yield: Furosemide → loop diuretic → potassium loss.
7. Which finding is most concerning after administration of furosemide?
A. Increased urine output
B. Mild thirst
C. Potassium of 2.8 mEq/L
D. Decreased ankle edema
Correct answer: C. Potassium of 2.8 mEq/L
Rationale: Significant hypokalemia increases the risk of cardiac dysrhythmias and
muscle weakness.
High-yield: Loop diuretics can cause hypokalemia.
8. A patient taking spironolactone should be monitored closely for:
A. Hypoglycemia
B. Hyperkalemia
C. Hypercalcemia
D. Neutropenia
Correct answer: B. Hyperkalemia
Rationale: Spironolactone is a potassium-sparing aldosterone antagonist.
Reduced potassium excretion can cause hyperkalemia.
High-yield: Spironolactone → potassium-sparing.
9. Which assessment finding suggests peripheral arterial disease?
A. Warm legs with bilateral edema
B. Bounding pedal pulses
