,NUR100 Pharmacology Exam 2 Study Guide &
150 Practice Questions Fortis College
2026/2027
1. A nurse is reviewing the mechanism of action of ACE inhibitors. Which statement best
describes how these medications lower blood pressure?
A. They block calcium channels in vascular smooth muscle
B. They inhibit the conversion of angiotensin I to angiotensin II, reducing vasoconstriction and
aldosterone secretion
C. They block beta-1 receptors in the heart, reducing heart rate and contractility
D. They directly dilate peripheral arteries by relaxing smooth muscle
Correct Answer: B. They inhibit the conversion of angiotensin I to angiotensin II, reducing
vasoconstriction and aldosterone secretion
Rationale: ACE inhibitors (e.g., lisinopril, enalapril) block the angiotensin-converting enzyme,
preventing the conversion of angiotensin I to angiotensin II. This reduces vasoconstriction and
decreases aldosterone secretion, leading to lower blood pressure and reduced fluid retention.
2. A nurse is caring for a patient taking lisinopril who develops a persistent, dry cough. Which
action should the nurse take?
,A. Administer an antitussive and continue the medication
B. Notify the healthcare provider, as this is a common adverse effect of ACE inhibitors
C. Hold the medication and monitor for angioedema
D. Encourage the patient to increase fluid intake
Correct Answer: B. Notify the healthcare provider, as this is a common adverse effect of ACE
inhibitors
Rationale: A persistent, dry cough is a common adverse effect of ACE inhibitors, occurring in
approximately 5–20% of patients. It is caused by the accumulation of bradykinin. If the cough is
intolerable, the provider may switch to an ARB.
3. A nurse is teaching a patient about losartan (Cozaar). Which statement by the patient
indicates correct understanding?
A. "I should avoid potassium-rich foods while taking this medication."
B. "This medication may cause a dry cough, just like my previous ACE inhibitor."
C. "This medication blocks angiotensin II receptors, so it doesn't cause the cough that ACE
inhibitors do."
D. "I should take this medication only when my blood pressure is high."
, Correct Answer: C. "This medication blocks angiotensin II receptors, so it doesn't cause the
cough that ACE inhibitors do."
Rationale: ARBs (angiotensin II receptor blockers) such as losartan block the action of
angiotensin II at the receptor site. Unlike ACE inhibitors, they do not inhibit the breakdown of
bradykinin, so they are less likely to cause the dry cough associated with ACE inhibitors.
4. A nurse is assessing a patient who is prescribed metoprolol (Lopressor). Which assessment
finding requires immediate intervention?
A. Heart rate of 58 beats/min
B. Blood pressure of 110/70 mm Hg
C. Heart rate of 48 beats/min with dizziness
D. Respiratory rate of 16 breaths/min
Correct Answer: C. Heart rate of 48 beats/min with dizziness
Rationale: Metoprolol is a beta-1 selective blocker that reduces heart rate and blood pressure. A
heart rate below 50 beats/min with symptoms of dizziness indicates bradycardia and possible
hypotension, requiring immediate intervention. The nurse should hold the medication and
notify the provider.
150 Practice Questions Fortis College
2026/2027
1. A nurse is reviewing the mechanism of action of ACE inhibitors. Which statement best
describes how these medications lower blood pressure?
A. They block calcium channels in vascular smooth muscle
B. They inhibit the conversion of angiotensin I to angiotensin II, reducing vasoconstriction and
aldosterone secretion
C. They block beta-1 receptors in the heart, reducing heart rate and contractility
D. They directly dilate peripheral arteries by relaxing smooth muscle
Correct Answer: B. They inhibit the conversion of angiotensin I to angiotensin II, reducing
vasoconstriction and aldosterone secretion
Rationale: ACE inhibitors (e.g., lisinopril, enalapril) block the angiotensin-converting enzyme,
preventing the conversion of angiotensin I to angiotensin II. This reduces vasoconstriction and
decreases aldosterone secretion, leading to lower blood pressure and reduced fluid retention.
2. A nurse is caring for a patient taking lisinopril who develops a persistent, dry cough. Which
action should the nurse take?
,A. Administer an antitussive and continue the medication
B. Notify the healthcare provider, as this is a common adverse effect of ACE inhibitors
C. Hold the medication and monitor for angioedema
D. Encourage the patient to increase fluid intake
Correct Answer: B. Notify the healthcare provider, as this is a common adverse effect of ACE
inhibitors
Rationale: A persistent, dry cough is a common adverse effect of ACE inhibitors, occurring in
approximately 5–20% of patients. It is caused by the accumulation of bradykinin. If the cough is
intolerable, the provider may switch to an ARB.
3. A nurse is teaching a patient about losartan (Cozaar). Which statement by the patient
indicates correct understanding?
A. "I should avoid potassium-rich foods while taking this medication."
B. "This medication may cause a dry cough, just like my previous ACE inhibitor."
C. "This medication blocks angiotensin II receptors, so it doesn't cause the cough that ACE
inhibitors do."
D. "I should take this medication only when my blood pressure is high."
, Correct Answer: C. "This medication blocks angiotensin II receptors, so it doesn't cause the
cough that ACE inhibitors do."
Rationale: ARBs (angiotensin II receptor blockers) such as losartan block the action of
angiotensin II at the receptor site. Unlike ACE inhibitors, they do not inhibit the breakdown of
bradykinin, so they are less likely to cause the dry cough associated with ACE inhibitors.
4. A nurse is assessing a patient who is prescribed metoprolol (Lopressor). Which assessment
finding requires immediate intervention?
A. Heart rate of 58 beats/min
B. Blood pressure of 110/70 mm Hg
C. Heart rate of 48 beats/min with dizziness
D. Respiratory rate of 16 breaths/min
Correct Answer: C. Heart rate of 48 beats/min with dizziness
Rationale: Metoprolol is a beta-1 selective blocker that reduces heart rate and blood pressure. A
heart rate below 50 beats/min with symptoms of dizziness indicates bradycardia and possible
hypotension, requiring immediate intervention. The nurse should hold the medication and
notify the provider.
