ARIZONA COLLEGE OF NURSING NUR 354 PHARMACOLOGY II
EXAM 2 QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF.
Core Domains:
Renal Pharmacology and Diuretic Therapy
Hypertension Management and RAAS Agents
Cardiovascular Pharmacology: Angina and Heart Failure
Anticoagulation and Hematologic Agents
Endocrine Pharmacology: Diabetes and Thyroid
Autonomic Nervous System Pharmacology
Medication Safety and High-Alert Medications
Pharmacokinetics and Pharmacodynamics
Introduction
This examination assesses the nursing student’s mastery of
pharmacological principles essential for safe medication
administration in clinical practice. The test evaluates
comprehension of drug mechanisms, therapeutic applications,
adverse effects, and nursing responsibilities across major body
systems. Questions are structured as multiple-choice and scenario-
based items requiring clinical judgment, prioritization, and
application of evidence-based practice. Emphasis is placed on high-
alert medications, patient safety, and the nurse’s role in monitoring,
teaching, and evaluating therapeutic outcomes.
SECTION ONE: QUESTIONS 1–100
1. Which diuretic class remains effective in patients with
significant renal impairment?
,A. Thiazide diuretics
B. Loop diuretics
C. Potassium-sparing diuretics
D. Osmotic diuretics
🟢 B. Loop diuretics
🔴 RATIONALE: Loop diuretics such as furosemide and
bumetanide work in the thick ascending limb of the loop of Henle
and remain effective even when glomerular filtration rate is
significantly reduced. Thiazide diuretics lose efficacy in renal
impairment. Potassium-sparing and osmotic diuretics are not first-
line for this population.
2. A patient receiving furosemide intravenously reports ringing in
the ears. What is the nurse’s priority action?
A. Document the finding and continue the infusion
B. Stop the infusion and notify the provider
C. Administer an antiemetic
D. Reassure the patient that this is expected
🟢 B. Stop the infusion and notify the provider
🔴 RATIONALE: Tinnitus during intravenous loop diuretic
administration indicates ototoxicity, which can progress to
permanent hearing loss. The infusion should be stopped
immediately, and the provider notified. Documentation alone
without intervention is unsafe. Antiemetics and reassurance do
not address the adverse effect.
3. What is the primary mechanism of action of spironolactone?
A. Blocks sodium reabsorption in the distal convoluted tubule
B. Inhibits aldosterone receptors in the collecting duct
C. Inhibits sodium-potassium-chloride cotransporter in the loop
,of Henle
D. Increases osmotic pressure in the nephron
🟢 B. Inhibits aldosterone receptors in the collecting duct
🔴 RATIONALE: Spironolactone is a potassium-sparing diuretic
that acts as an aldosterone antagonist in the collecting duct,
reducing sodium and water retention while conserving potassium.
Thiazides block the distal convoluted tubule sodium-chloride
symporter. Loop diuretics inhibit the Na-K-2Cl cotransporter.
Osmotic diuretics work by increasing osmotic pressure.
4. A nurse is teaching a patient about furosemide. Which
statement indicates the patient understands the teaching?
A. “I will take this medication at bedtime.”
B. “I will increase my intake of potassium-rich foods.”
C. “I will avoid foods high in potassium.”
D. “I will take this medication with an antacid.”
🟢 B. “I will increase my intake of potassium-rich foods.”
🔴 RATIONALE: Furosemide causes potassium loss, so patients
should increase dietary potassium unless contraindicated. Taking
furosemide at bedtime would cause nocturia and disrupt sleep.
Foods high in potassium should be encouraged, not avoided.
Antacids can reduce absorption and are not recommended.
5. Which assessment finding should prompt the nurse to withhold
a scheduled dose of digoxin?
A. Heart rate of 88 beats per minute
B. Heart rate of 52 beats per minute
C. Blood pressure of 130/82 mmHg
D. Serum potassium of 4.2 mEq/L
, 🟢 B. Heart rate of 52 beats per minute
🔴 RATIONALE: Digoxin slows the heart rate through increased
vagal tone. The nurse should withhold digoxin if the apical pulse
is below 60 beats per minute in adults. A heart rate of 88 is within
normal limits. Blood pressure of 130/82 and potassium of 4.2 are
acceptable values.
6. A patient taking lisinopril develops a persistent dry cough.
What is the nurse’s best action?
A. Reassure the patient that this is a common side effect that will
resolve
B. Notify the provider; an ARB may be prescribed as an alternative
C. Administer an over-the-counter cough suppressant
D. Hold the next dose indefinitely without notifying the provider
🟢 B. Notify the provider; an ARB may be prescribed as an
alternative
🔴 RATIONALE: ACE inhibitor-induced cough results from
bradykinin accumulation and does not typically resolve.
Angiotensin receptor blockers (ARBs) are a common substitute
because they do not affect bradykinin metabolism. Reassurance is
incorrect as the cough often persists. Cough suppressants are
ineffective. Holding medication requires provider notification.
7. Which laboratory value should the nurse monitor most closely
in a patient receiving spironolactone?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum chloride
🟢 B. Serum potassium
EXAM 2 QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF.
Core Domains:
Renal Pharmacology and Diuretic Therapy
Hypertension Management and RAAS Agents
Cardiovascular Pharmacology: Angina and Heart Failure
Anticoagulation and Hematologic Agents
Endocrine Pharmacology: Diabetes and Thyroid
Autonomic Nervous System Pharmacology
Medication Safety and High-Alert Medications
Pharmacokinetics and Pharmacodynamics
Introduction
This examination assesses the nursing student’s mastery of
pharmacological principles essential for safe medication
administration in clinical practice. The test evaluates
comprehension of drug mechanisms, therapeutic applications,
adverse effects, and nursing responsibilities across major body
systems. Questions are structured as multiple-choice and scenario-
based items requiring clinical judgment, prioritization, and
application of evidence-based practice. Emphasis is placed on high-
alert medications, patient safety, and the nurse’s role in monitoring,
teaching, and evaluating therapeutic outcomes.
SECTION ONE: QUESTIONS 1–100
1. Which diuretic class remains effective in patients with
significant renal impairment?
,A. Thiazide diuretics
B. Loop diuretics
C. Potassium-sparing diuretics
D. Osmotic diuretics
🟢 B. Loop diuretics
🔴 RATIONALE: Loop diuretics such as furosemide and
bumetanide work in the thick ascending limb of the loop of Henle
and remain effective even when glomerular filtration rate is
significantly reduced. Thiazide diuretics lose efficacy in renal
impairment. Potassium-sparing and osmotic diuretics are not first-
line for this population.
2. A patient receiving furosemide intravenously reports ringing in
the ears. What is the nurse’s priority action?
A. Document the finding and continue the infusion
B. Stop the infusion and notify the provider
C. Administer an antiemetic
D. Reassure the patient that this is expected
🟢 B. Stop the infusion and notify the provider
🔴 RATIONALE: Tinnitus during intravenous loop diuretic
administration indicates ototoxicity, which can progress to
permanent hearing loss. The infusion should be stopped
immediately, and the provider notified. Documentation alone
without intervention is unsafe. Antiemetics and reassurance do
not address the adverse effect.
3. What is the primary mechanism of action of spironolactone?
A. Blocks sodium reabsorption in the distal convoluted tubule
B. Inhibits aldosterone receptors in the collecting duct
C. Inhibits sodium-potassium-chloride cotransporter in the loop
,of Henle
D. Increases osmotic pressure in the nephron
🟢 B. Inhibits aldosterone receptors in the collecting duct
🔴 RATIONALE: Spironolactone is a potassium-sparing diuretic
that acts as an aldosterone antagonist in the collecting duct,
reducing sodium and water retention while conserving potassium.
Thiazides block the distal convoluted tubule sodium-chloride
symporter. Loop diuretics inhibit the Na-K-2Cl cotransporter.
Osmotic diuretics work by increasing osmotic pressure.
4. A nurse is teaching a patient about furosemide. Which
statement indicates the patient understands the teaching?
A. “I will take this medication at bedtime.”
B. “I will increase my intake of potassium-rich foods.”
C. “I will avoid foods high in potassium.”
D. “I will take this medication with an antacid.”
🟢 B. “I will increase my intake of potassium-rich foods.”
🔴 RATIONALE: Furosemide causes potassium loss, so patients
should increase dietary potassium unless contraindicated. Taking
furosemide at bedtime would cause nocturia and disrupt sleep.
Foods high in potassium should be encouraged, not avoided.
Antacids can reduce absorption and are not recommended.
5. Which assessment finding should prompt the nurse to withhold
a scheduled dose of digoxin?
A. Heart rate of 88 beats per minute
B. Heart rate of 52 beats per minute
C. Blood pressure of 130/82 mmHg
D. Serum potassium of 4.2 mEq/L
, 🟢 B. Heart rate of 52 beats per minute
🔴 RATIONALE: Digoxin slows the heart rate through increased
vagal tone. The nurse should withhold digoxin if the apical pulse
is below 60 beats per minute in adults. A heart rate of 88 is within
normal limits. Blood pressure of 130/82 and potassium of 4.2 are
acceptable values.
6. A patient taking lisinopril develops a persistent dry cough.
What is the nurse’s best action?
A. Reassure the patient that this is a common side effect that will
resolve
B. Notify the provider; an ARB may be prescribed as an alternative
C. Administer an over-the-counter cough suppressant
D. Hold the next dose indefinitely without notifying the provider
🟢 B. Notify the provider; an ARB may be prescribed as an
alternative
🔴 RATIONALE: ACE inhibitor-induced cough results from
bradykinin accumulation and does not typically resolve.
Angiotensin receptor blockers (ARBs) are a common substitute
because they do not affect bradykinin metabolism. Reassurance is
incorrect as the cough often persists. Cough suppressants are
ineffective. Holding medication requires provider notification.
7. Which laboratory value should the nurse monitor most closely
in a patient receiving spironolactone?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum chloride
🟢 B. Serum potassium
