NURS 635 MIDTERM EXAM 2025/2026 QUESTIONS WITH
ANSWERS GRADED A+
✔✔beta 1 agonist - ✔✔adrenergic stimulation results in increased heart rate, increased
blood pressure, and increased cardiac output
examples: dobutamine, dopamine, norepinephrine
✔✔beta 1 antagonist - ✔✔adrenergic blockage results in reduced heart rate, reduced
blood pressure, and reduced cardiac output
examples: metroprolol (Lopressor), propranolol, esmolol, atenolol, nadolol
✔✔propranolol - ✔✔beta blocking agent that is nonselective and blocks beta 2
receptors in the lungs
✔✔atenolol and metoprolol - ✔✔selective beta blockers block beta 1 receptors in the
heart and vasculature
✔✔carvedilol - ✔✔not used in hypertensive emergencies, it is alpha and beta receptor
blocker
used as standard therapy for heart failure
✔✔first line therapy for HTN? - ✔✔ACE inhibitors, ARBs and Calcium channel blockers
✔✔Why are beta blockers not first line therapy in HTN? - ✔✔because of increased
morbidity and mortality
✔✔When to avoid using oral beta blocker in patients? - ✔✔If they are using beta
blocker ophthalmic drops for glaucoma
✔✔examples of dihydropyridine (DHP) calcium channel blockers - ✔✔amlodipine
nicardipine
isradipine
felodipine
nifedipine
✔✔How do calcium channel blockers work? - ✔✔reduce amount of intracellular calcium,
which reduces vascular rigidity and lowers blood pressure
✔✔left hear failure causes? - ✔✔reduced delivery of oxygenated blood to the body
tissues
✔✔right heart failure is associated with? - ✔✔pulmonary disease and increased
pulmonary vascular resistance
, ✔✔drug that relieves heart failure symptoms but does not reduce mortality -
✔✔furosemide (Lasix)
✔✔What type of drug is furosemide? - ✔✔loop diuretic, does not spare potassium,
can cause hyponatremia
works in ascending renal loop of Henle to prevent reabsorption of sodium, chloride and
water
✔✔2 potassium sparing diuretics - ✔✔spironolactone (Aldactone) and triamterene
(Dyrenium)
✔✔Medication that is antagonist of aldosterone? - ✔✔spironolactone (Aldactone)
✔✔Diuretic that should not be used when patient having anuria? - ✔✔Triamteren
(Dyrenium)
✔✔Drug that is a phosphodiesterase inhibitor used for acute heart failure? -
✔✔Milrinone
Milrinone is a PDE-III inhibitor with inotropic, lusitropic, and vasodilatory properties used
for the short-term treatment of acute decompensated heart failure.
✔✔What does digoxin do? - ✔✔Increases cardiac force of contraction, improves cardiac
function and HF symptoms
✔✔What medication to avoid while taking digoxin? - ✔✔Famotidine (Pepcid) because
digoxin needs acid in small intestine to be absorbed which famotidine eliminates
✔✔What does digoxin due to women? - ✔✔Increase mortality
✔✔When to use digoxin? - ✔✔When ACEIs, beta-blockers, and diuretics have not
improved function
✔✔Antidote to digoxin? - ✔✔Digibind
25% of pts get digoxin toxicity
✔✔What increases digoxin toxicity? - ✔✔Hypokalemia
*pt on albuterol can lower serum potassium level
✔✔Heart failure stage 1 drug choice - ✔✔ACEI
ARBs useful, but more expensive
Diuretics
✔✔Heart failure stage 2 drug choice - ✔✔ACEI or ARB if intolerant to ACEI
Beta-blocker
ANSWERS GRADED A+
✔✔beta 1 agonist - ✔✔adrenergic stimulation results in increased heart rate, increased
blood pressure, and increased cardiac output
examples: dobutamine, dopamine, norepinephrine
✔✔beta 1 antagonist - ✔✔adrenergic blockage results in reduced heart rate, reduced
blood pressure, and reduced cardiac output
examples: metroprolol (Lopressor), propranolol, esmolol, atenolol, nadolol
✔✔propranolol - ✔✔beta blocking agent that is nonselective and blocks beta 2
receptors in the lungs
✔✔atenolol and metoprolol - ✔✔selective beta blockers block beta 1 receptors in the
heart and vasculature
✔✔carvedilol - ✔✔not used in hypertensive emergencies, it is alpha and beta receptor
blocker
used as standard therapy for heart failure
✔✔first line therapy for HTN? - ✔✔ACE inhibitors, ARBs and Calcium channel blockers
✔✔Why are beta blockers not first line therapy in HTN? - ✔✔because of increased
morbidity and mortality
✔✔When to avoid using oral beta blocker in patients? - ✔✔If they are using beta
blocker ophthalmic drops for glaucoma
✔✔examples of dihydropyridine (DHP) calcium channel blockers - ✔✔amlodipine
nicardipine
isradipine
felodipine
nifedipine
✔✔How do calcium channel blockers work? - ✔✔reduce amount of intracellular calcium,
which reduces vascular rigidity and lowers blood pressure
✔✔left hear failure causes? - ✔✔reduced delivery of oxygenated blood to the body
tissues
✔✔right heart failure is associated with? - ✔✔pulmonary disease and increased
pulmonary vascular resistance
, ✔✔drug that relieves heart failure symptoms but does not reduce mortality -
✔✔furosemide (Lasix)
✔✔What type of drug is furosemide? - ✔✔loop diuretic, does not spare potassium,
can cause hyponatremia
works in ascending renal loop of Henle to prevent reabsorption of sodium, chloride and
water
✔✔2 potassium sparing diuretics - ✔✔spironolactone (Aldactone) and triamterene
(Dyrenium)
✔✔Medication that is antagonist of aldosterone? - ✔✔spironolactone (Aldactone)
✔✔Diuretic that should not be used when patient having anuria? - ✔✔Triamteren
(Dyrenium)
✔✔Drug that is a phosphodiesterase inhibitor used for acute heart failure? -
✔✔Milrinone
Milrinone is a PDE-III inhibitor with inotropic, lusitropic, and vasodilatory properties used
for the short-term treatment of acute decompensated heart failure.
✔✔What does digoxin do? - ✔✔Increases cardiac force of contraction, improves cardiac
function and HF symptoms
✔✔What medication to avoid while taking digoxin? - ✔✔Famotidine (Pepcid) because
digoxin needs acid in small intestine to be absorbed which famotidine eliminates
✔✔What does digoxin due to women? - ✔✔Increase mortality
✔✔When to use digoxin? - ✔✔When ACEIs, beta-blockers, and diuretics have not
improved function
✔✔Antidote to digoxin? - ✔✔Digibind
25% of pts get digoxin toxicity
✔✔What increases digoxin toxicity? - ✔✔Hypokalemia
*pt on albuterol can lower serum potassium level
✔✔Heart failure stage 1 drug choice - ✔✔ACEI
ARBs useful, but more expensive
Diuretics
✔✔Heart failure stage 2 drug choice - ✔✔ACEI or ARB if intolerant to ACEI
Beta-blocker
