NUR 138 EXAM 3 QUESTIONS AND ANSWERS | NUR 138 STUDY GUIDE
& PRACTICE TEST 2026/2027
ACE: - ANS ✔✔-peril
Calcium channel blockers: - ANS ✔✔-dipine, -pamil, zed;
Benzodiazepine: - ANS ✔✔-pam, -lam;
Antilipidemic: - ANS ✔✔-statin
Beta blocker: - ANS ✔✔-Ollo
Antiviral: - ANS ✔✔-vir
Anticoagulant: - ANS ✔✔-Arin
ARB inhibitor: - ANS ✔✔-artan
Teaching points for new prescription of an adrenergic drug for hypertension - ANS ✔✔(Stimulate alpha 2
-adrenergic receptors in the brain that reduce renin activity which decreases BP
because it slows down the work of the kidneys)
● Adverse effects: bradycardia with reflex tachycardia, postural and postexercise
hypotension, dry mouth, drowsiness, dizziness, depression, edema, constipation, and
sexual dysfunction. Other effects include: headache, sleep disturbances, nausea, rash, and
palpitations.
● Change positions slowly: high incidence of orthostatic hypotension in pts taking alpha
blockers
● Don't stop abruptly: abrupt discontinuation of the centrally acting alpha2 receptor
agonists can result in rebound hypertension, which is characterized by a sudden and very
high elevation of blood pressure
● any change in the dosing regimen should be undertaken gradually and with appropriate pt
monitoring and follow-up
● Some meds can cause disruptions in blood count as well as in serum electrolyte levels
and renal function. Periodic monitoring of WBC, serum potassium, sodium, and
creatinine levels is necessary
● Can cause additive CNS depression when taking with alcohol, benzodiazepines, and
opioids
● monitor BP during therapy; instruct pts to keep a journal of regular BP checks
● Men taking these drugs may not be aware that importance is an expected effect. This may
influence compliance with drug therapy
● Never double dose up on doses if a dose is missed
● ALWAYS stay by the bedside to assess the patient for big side effects on NEW DRUG
ex. huge decrease in BP.
● Usually used after other drugs have failed because of adverse effects
● Clonidine is useful in the management of withdrawal symptoms in opioid-
, dependent persons, alcohol withdrawal
● number 1 side effect is orthostatic hypotension
Why do we use Captopril for patients with liver disease? - ANS ✔✔Captopril has the shortest half-life. It
may be best to start with a drug that has a short half-life in
a pt who is critically ill, so if problems arise they will be short-lived. Captopril and lisinopril are the only
two ACE inhibitors that are not prodrugs. A prodrug is a drug that is inactive in its administered form and
must be metabolized to its active form in the body, generally by the liver, to be inactive. This
characteristic of captopril and lisinopril is an important advantage in treating
pt with liver dysfunction; all other ACE inhibitors are prodrugs, and their transformation to
active form is dependent upon liver function to reveal the active drug
Why do men decide not to take their anti-hypertensives? - ANS ✔✔Sexual dysfunction is a common
adverse effect
How long do people stay on antihypertensives? - ANS ✔✔Lifelong therapy is usually required
Why do diabetics take ACE inhibitors? - ANS ✔✔ACE inhibitors have been shown to have a protective
effect on the kidneys because
they reduce glomerular filtration pressure. This property makes them the cardiovascular
drug of choice for diabetic patients.
-It is also approved for treatment of diabetic nephropathy, in which the renal artery is being
damaged by diabetes. It is thought that decreased in stimulation of angiotensin receptors in the
kidney will slow down the damage in the renal artery
What does Digoxin toxicity look like and what should you do? - ANS ✔✔Toxicity: Bradycardia, dizziness,
loss of consciousness, colder extremity, nausea, vomiting,
people report seeing color yellow, headache, diaphoresis,
-Therapeutic level: 0.5-2, therapeutic effects of digoxin: Positive inotropic, negative chronotropic, and
negative dromotropic. Digoxin increases cardiac contractility (positive inotropic effect), decreases
heart rate (negative chronotropic effect), and decreases conductivity (negative dromotropic effect).
● Weight, I&O measures
● ECG
● Serum labs: potassium, sodium, magnesium, calcium, renal, and liver function studies
● Before giving any dose, count apical pulse for 1 full minute
● For apical pulse less than 60 or greater than 100 beats/min
○ Hold dose
○ Notify prescriber
● Hold dose and notify prescriber if patient experiences signs/symptoms of toxicity
○ Anorexia, nausea, vomiting, diarrhea
○ Visual disturbances (blurred vision, seeing green or yellow halos around objects)
● Check dosage forms carefully, and follow instructions for administering
● Avoid giving digoxin with high-fiber foods (fiber binds with digitalis)
● Patients should immediately report a weight gain of 2 lb or more in 1 day or 5 lb or more
in 1 week
● Monitor for therapeutic effects
○ Increased urinary output
○ Decreased edema, shortness of breath, dyspnea, crackles, fatigue
& PRACTICE TEST 2026/2027
ACE: - ANS ✔✔-peril
Calcium channel blockers: - ANS ✔✔-dipine, -pamil, zed;
Benzodiazepine: - ANS ✔✔-pam, -lam;
Antilipidemic: - ANS ✔✔-statin
Beta blocker: - ANS ✔✔-Ollo
Antiviral: - ANS ✔✔-vir
Anticoagulant: - ANS ✔✔-Arin
ARB inhibitor: - ANS ✔✔-artan
Teaching points for new prescription of an adrenergic drug for hypertension - ANS ✔✔(Stimulate alpha 2
-adrenergic receptors in the brain that reduce renin activity which decreases BP
because it slows down the work of the kidneys)
● Adverse effects: bradycardia with reflex tachycardia, postural and postexercise
hypotension, dry mouth, drowsiness, dizziness, depression, edema, constipation, and
sexual dysfunction. Other effects include: headache, sleep disturbances, nausea, rash, and
palpitations.
● Change positions slowly: high incidence of orthostatic hypotension in pts taking alpha
blockers
● Don't stop abruptly: abrupt discontinuation of the centrally acting alpha2 receptor
agonists can result in rebound hypertension, which is characterized by a sudden and very
high elevation of blood pressure
● any change in the dosing regimen should be undertaken gradually and with appropriate pt
monitoring and follow-up
● Some meds can cause disruptions in blood count as well as in serum electrolyte levels
and renal function. Periodic monitoring of WBC, serum potassium, sodium, and
creatinine levels is necessary
● Can cause additive CNS depression when taking with alcohol, benzodiazepines, and
opioids
● monitor BP during therapy; instruct pts to keep a journal of regular BP checks
● Men taking these drugs may not be aware that importance is an expected effect. This may
influence compliance with drug therapy
● Never double dose up on doses if a dose is missed
● ALWAYS stay by the bedside to assess the patient for big side effects on NEW DRUG
ex. huge decrease in BP.
● Usually used after other drugs have failed because of adverse effects
● Clonidine is useful in the management of withdrawal symptoms in opioid-
, dependent persons, alcohol withdrawal
● number 1 side effect is orthostatic hypotension
Why do we use Captopril for patients with liver disease? - ANS ✔✔Captopril has the shortest half-life. It
may be best to start with a drug that has a short half-life in
a pt who is critically ill, so if problems arise they will be short-lived. Captopril and lisinopril are the only
two ACE inhibitors that are not prodrugs. A prodrug is a drug that is inactive in its administered form and
must be metabolized to its active form in the body, generally by the liver, to be inactive. This
characteristic of captopril and lisinopril is an important advantage in treating
pt with liver dysfunction; all other ACE inhibitors are prodrugs, and their transformation to
active form is dependent upon liver function to reveal the active drug
Why do men decide not to take their anti-hypertensives? - ANS ✔✔Sexual dysfunction is a common
adverse effect
How long do people stay on antihypertensives? - ANS ✔✔Lifelong therapy is usually required
Why do diabetics take ACE inhibitors? - ANS ✔✔ACE inhibitors have been shown to have a protective
effect on the kidneys because
they reduce glomerular filtration pressure. This property makes them the cardiovascular
drug of choice for diabetic patients.
-It is also approved for treatment of diabetic nephropathy, in which the renal artery is being
damaged by diabetes. It is thought that decreased in stimulation of angiotensin receptors in the
kidney will slow down the damage in the renal artery
What does Digoxin toxicity look like and what should you do? - ANS ✔✔Toxicity: Bradycardia, dizziness,
loss of consciousness, colder extremity, nausea, vomiting,
people report seeing color yellow, headache, diaphoresis,
-Therapeutic level: 0.5-2, therapeutic effects of digoxin: Positive inotropic, negative chronotropic, and
negative dromotropic. Digoxin increases cardiac contractility (positive inotropic effect), decreases
heart rate (negative chronotropic effect), and decreases conductivity (negative dromotropic effect).
● Weight, I&O measures
● ECG
● Serum labs: potassium, sodium, magnesium, calcium, renal, and liver function studies
● Before giving any dose, count apical pulse for 1 full minute
● For apical pulse less than 60 or greater than 100 beats/min
○ Hold dose
○ Notify prescriber
● Hold dose and notify prescriber if patient experiences signs/symptoms of toxicity
○ Anorexia, nausea, vomiting, diarrhea
○ Visual disturbances (blurred vision, seeing green or yellow halos around objects)
● Check dosage forms carefully, and follow instructions for administering
● Avoid giving digoxin with high-fiber foods (fiber binds with digitalis)
● Patients should immediately report a weight gain of 2 lb or more in 1 day or 5 lb or more
in 1 week
● Monitor for therapeutic effects
○ Increased urinary output
○ Decreased edema, shortness of breath, dyspnea, crackles, fatigue
