2025/2026 Questions and Elaborate Answers/ Fully covered/
100% Verified Grade A+
Drug Classes
Safe and Effective Medication Administration
Cardiovascular & Hemodynamic Medications
CNS Medications
Endocrine & Metabolic Drugs
Antibiotics & High-Risk Antimicrobials
Drug Classes
1. A nurse is reviewing medications for a patient with heart failure who is newly
prescribed a loop diuretic, and the nurse anticipates which laboratory value to be
monitored most closely due to the class-specific risk of electrolyte depletion that
can predispose the patient to dangerous ventricular dysrhythmias?
A. Potassium
B. Sodium
C. Hemoglobin
D. Calcium
Rationale: Loop diuretics such as furosemide cause significant potassium loss because they
inhibit sodium-potassium-chloride transport in the loop of Henle, leading to hypokalemia that
increases the risk for life-threatening arrhythmias; therefore potassium is the highest-priority lab
value to monitor.
2. The nurse is teaching a patient about beta-blockers, and the patient asks why
the medication can cause fatigue, so the nurse explains that this drug class slows
the heart rate and decreases myocardial oxygen demand, which can produce
reduced cardiac output and mild tiredness, especially when therapy is first
initiated.
A. Beta-blockers
B. ACE inhibitors
C. Anticoagulants
D. Antacids
Rationale: Beta-blockers decrease heart rate and contractility by blocking beta-1 receptors,
,which lowers cardiac output and may result in fatigue when therapy begins, making this a well-
known class effect.
3. A diabetic patient is prescribed a rapid-acting insulin, and the nurse
emphasizes the need to eat immediately after administration because the
medication reaches peak activity quickly and can cause sudden hypoglycemia if a
meal is delayed.
A. Insulin glargine
B. Regular insulin
C. Insulin lispro
D. NPH insulin
Rationale: Insulin lispro is a rapid-acting insulin that peaks within 30–90 minutes, creating a
high risk for hypoglycemia unless food is eaten soon after injection.
4. The nurse caring for a patient on an aminoglycoside antibiotic expects to
monitor for nephrotoxicity because this drug class accumulates in the renal
tubules, especially with prolonged use or elevated trough levels.
A. Macrolides
B. Aminoglycosides
C. Penicillins
D. Cephalosporins
Rationale: Aminoglycosides such as gentamicin have a narrow therapeutic range and can cause
kidney injury through accumulation in renal tissue, requiring close monitoring of creatinine and
urine output.
5. A patient receiving benzodiazepines for acute anxiety begins to demonstrate
excessive sedation, and the nurse anticipates which reversal agent may be needed
due to its specific action on benzodiazepine receptor sites?
A. Naloxone
B. Flumazenil
C. Protamine sulfate
D. Vitamin K
Rationale: Flumazenil competitively inhibits benzodiazepine receptors and is used to counteract
severe sedation or overdose, unlike naloxone which reverses opioids.
6. A patient is prescribed an ACE inhibitor, and the nurse explains that a
persistent dry cough is a common adverse effect caused by the accumulation of
bradykinin due to the drug class mechanism.
A. Calcium channel blockers
B. ACE inhibitors
,C. Beta-blockers
D. Thiazide diuretics
Rationale: ACE inhibitors block the breakdown of bradykinin, resulting in its accumulation,
which can stimulate the cough reflex in many patients.
7. When reviewing the medication profile of a patient starting warfarin therapy,
the nurse stresses the importance of regular INR testing because this
anticoagulant has a narrow therapeutic window and interacts with many drugs
and foods.
A. Aspirin
B. Heparin
C. Warfarin
D. Clopidogrel
Rationale: Warfarin requires INR monitoring due to variable metabolism and numerous
interactions that affect its anticoagulant effect.
8. A patient taking a calcium channel blocker reports ankle swelling, and the
nurse explains that this is a common class-related effect due to peripheral
vasodilation caused by the medication.
A. Loop diuretics
B. Calcium channel blockers
C. Beta-blockers
D. ACE inhibitors
Rationale: Calcium channel blockers like amlodipine dilate peripheral vessels, which can cause
fluid pooling and ankle edema.
9. A patient receiving vancomycin requires monitoring of trough levels because
this glycopeptide antibiotic carries risks for nephrotoxicity and ototoxicity,
especially if concentrations become excessively high.
A. Penicillins
B. Macrolides
C. Glycopeptides
D. Fluoroquinolones
Rationale: Vancomycin is a glycopeptide that can damage kidneys and hearing when trough
levels exceed safe parameters.
10. The nurse explains to a patient starting a selective serotonin reuptake
inhibitor that the medication may take several weeks to achieve full therapeutic
effect due to gradual increases in serotonin availability at synapses.
, A. Benzodiazepines
B. SSRIs
C. MAOIs
D. Tricyclic antidepressants
Rationale: SSRIs work by blocking serotonin reuptake but require time for synaptic changes to
produce mood improvement, typically 2–4 weeks.
11. A patient using an inhaled corticosteroid is taught to rinse the mouth after
each use because the medication suppresses local immunity and can lead to
fungal overgrowth resulting in oral thrush.
A. Beta-2 agonists
B. Anticholinergics
C. Inhaled corticosteroids
D. Leukotriene modifiers
Rationale: Inhaled corticosteroids reduce inflammatory responses but also weaken local immune
defenses, increasing the risk for oral candidiasis.
12. The nurse caring for a patient on spironolactone monitors for hyperkalemia
because this potassium-sparing diuretic inhibits aldosterone and reduces
potassium excretion.
A. Furosemide
B. Hydrochlorothiazide
C. Spironolactone
D. Mannitol
Rationale: Spironolactone retains potassium due to its aldosterone-blocking effects, increasing
hyperkalemia risk.
13. A patient taking opioids for postoperative pain is monitored closely for
respiratory depression because opioids depress the brainstem respiratory centers
by activating mu-receptors.
A. NSAIDs
B. Opioids
C. Anticonvulsants
D. Beta-blockers
Rationale: Opioids can slow respirations by acting on the central nervous system, making
respiratory monitoring essential.
14. A nurse instructs a patient on metformin that the medication reduces hepatic
glucose production and increases insulin sensitivity, which can improve glycemic
control without causing significant hypoglycemia when used alone.