,NU 578 U3 Exam | Pharm for Adv Practice Nurses (2026/2027) Q&A | U South
Alabama
1. A patient is prescribed a medication that blocks the conversion of angiotensin I to
angiotensin II. Which class of medication is this?
A) Angiotensin receptor blocker (ARB)
B) Angiotensin-converting enzyme (ACE) inhibitor
C) Direct renin inhibitor
D) Calcium channel blocker
Correct Answer: Angiotensin-converting enzyme (ACE) inhibitor
Rationale: ACE inhibitors block the conversion of angiotensin I to angiotensin II, leading to
vasodilation, decreased aldosterone secretion, and reduced blood pressure. ARBs block the
receptor directly, direct renin inhibitors block renin, and calcium channel blockers inhibit
calcium influx. ACE inhibitors are first-line for hypertension with albuminuria.
2. Which adverse effect is most characteristic of ACE inhibitors?
A) Dry cough
B) Peripheral edema
C) Bradycardia
D) Hyperkalemia
Correct Answer: Dry cough
Rationale: A persistent dry cough occurs in 5-20% of patients taking ACE inhibitors due to
accumulation of bradykinin and substance P in the lungs. It often requires switching to an
ARB. Peripheral edema is associated with calcium channel blockers, bradycardia with beta-
blockers, and hyperkalemia can occur with ACE inhibitors but is less characteristic than
cough.
3. A patient taking lisinopril develops angioedema. What is the priority nursing action?
,A) Administer the next dose as scheduled
B) Hold the medication and notify the provider immediately
C) Apply a cold compress to the swollen area
D) Document the finding and reassess in one hour
Correct Answer: Hold the medication and notify the provider immediately
Rationale: Angioedema is a medical emergency that can cause airway obstruction. The
medication must be held immediately, and the provider notified. ACE inhibitors are
contraindicated in patients with a history of angioedema. Airway assessment and emergency
intervention may be required.
4. Which laboratory value should be monitored in a patient taking an ACE inhibitor?
A) Serum potassium and creatinine
B) Serum sodium and calcium
C) Serum magnesium and phosphorus
D) Serum chloride and bicarbonate
Correct Answer: Serum potassium and creatinine
Rationale: ACE inhibitors can cause hyperkalemia and acute kidney injury, especially in
patients with renal artery stenosis or chronic kidney disease. Potassium and creatinine
should be monitored at baseline and periodically. The nurse should also monitor for
hypotension.
5. A patient is prescribed valsartan. Which statement by the patient indicates understanding
of the medication?
A) I should avoid potassium supplements while taking this medication.
B) This medication will cure my hypertension permanently.
C) I can stop taking this medication if my blood pressure is normal.
D) This medication works immediately within 24 hours.
Correct Answer: I should avoid potassium supplements while taking this medication.
, Rationale: ARBs can increase potassium levels, so potassium supplements should be
avoided unless prescribed. Hypertension is a chronic condition requiring long-term
management. ARBs do not cure hypertension and require several weeks for full effect.
Patients should not stop medications without provider guidance.
6. Which medication is a loop diuretic?
A) Hydrochlorothiazide
B) Spironolactone
C) Furosemide
D) Mannitol
Correct Answer: Furosemide
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in
the ascending loop of Henle. Hydrochlorothiazide is a thiazide diuretic, spironolactone is a
potassium-sparing diuretic, and mannitol is an osmotic diuretic.
7. A patient taking furosemide should be monitored for which electrolyte imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypercalcemia
Correct Answer: Hypokalemia
Rationale: Loop diuretics cause increased excretion of potassium, leading to hypokalemia.
Patients should be monitored for muscle weakness, cramping, and cardiac dysrhythmias.
Potassium supplements or potassium-sparing diuretics may be prescribed. Loop diuretics
also cause hypomagnesemia and hypocalcemia.
8. Which diuretic is a potassium-sparing agent?
Alabama
1. A patient is prescribed a medication that blocks the conversion of angiotensin I to
angiotensin II. Which class of medication is this?
A) Angiotensin receptor blocker (ARB)
B) Angiotensin-converting enzyme (ACE) inhibitor
C) Direct renin inhibitor
D) Calcium channel blocker
Correct Answer: Angiotensin-converting enzyme (ACE) inhibitor
Rationale: ACE inhibitors block the conversion of angiotensin I to angiotensin II, leading to
vasodilation, decreased aldosterone secretion, and reduced blood pressure. ARBs block the
receptor directly, direct renin inhibitors block renin, and calcium channel blockers inhibit
calcium influx. ACE inhibitors are first-line for hypertension with albuminuria.
2. Which adverse effect is most characteristic of ACE inhibitors?
A) Dry cough
B) Peripheral edema
C) Bradycardia
D) Hyperkalemia
Correct Answer: Dry cough
Rationale: A persistent dry cough occurs in 5-20% of patients taking ACE inhibitors due to
accumulation of bradykinin and substance P in the lungs. It often requires switching to an
ARB. Peripheral edema is associated with calcium channel blockers, bradycardia with beta-
blockers, and hyperkalemia can occur with ACE inhibitors but is less characteristic than
cough.
3. A patient taking lisinopril develops angioedema. What is the priority nursing action?
,A) Administer the next dose as scheduled
B) Hold the medication and notify the provider immediately
C) Apply a cold compress to the swollen area
D) Document the finding and reassess in one hour
Correct Answer: Hold the medication and notify the provider immediately
Rationale: Angioedema is a medical emergency that can cause airway obstruction. The
medication must be held immediately, and the provider notified. ACE inhibitors are
contraindicated in patients with a history of angioedema. Airway assessment and emergency
intervention may be required.
4. Which laboratory value should be monitored in a patient taking an ACE inhibitor?
A) Serum potassium and creatinine
B) Serum sodium and calcium
C) Serum magnesium and phosphorus
D) Serum chloride and bicarbonate
Correct Answer: Serum potassium and creatinine
Rationale: ACE inhibitors can cause hyperkalemia and acute kidney injury, especially in
patients with renal artery stenosis or chronic kidney disease. Potassium and creatinine
should be monitored at baseline and periodically. The nurse should also monitor for
hypotension.
5. A patient is prescribed valsartan. Which statement by the patient indicates understanding
of the medication?
A) I should avoid potassium supplements while taking this medication.
B) This medication will cure my hypertension permanently.
C) I can stop taking this medication if my blood pressure is normal.
D) This medication works immediately within 24 hours.
Correct Answer: I should avoid potassium supplements while taking this medication.
, Rationale: ARBs can increase potassium levels, so potassium supplements should be
avoided unless prescribed. Hypertension is a chronic condition requiring long-term
management. ARBs do not cure hypertension and require several weeks for full effect.
Patients should not stop medications without provider guidance.
6. Which medication is a loop diuretic?
A) Hydrochlorothiazide
B) Spironolactone
C) Furosemide
D) Mannitol
Correct Answer: Furosemide
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in
the ascending loop of Henle. Hydrochlorothiazide is a thiazide diuretic, spironolactone is a
potassium-sparing diuretic, and mannitol is an osmotic diuretic.
7. A patient taking furosemide should be monitored for which electrolyte imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypercalcemia
Correct Answer: Hypokalemia
Rationale: Loop diuretics cause increased excretion of potassium, leading to hypokalemia.
Patients should be monitored for muscle weakness, cramping, and cardiac dysrhythmias.
Potassium supplements or potassium-sparing diuretics may be prescribed. Loop diuretics
also cause hypomagnesemia and hypocalcemia.
8. Which diuretic is a potassium-sparing agent?
