Maryville NURS 615 Pharm Exam 2 with complete solutions
2025 Graded A+
Question 1
A nurse practitioner is prescribing an ACE inhibitor to a client with
hypertension and diabetes. Which of the following adverse effects should the
NP specifically counsel the client about?
A) Hyperkalemia and persistent dry cough
B) Hypoglycemia and weight gain
C) Bradycardia and constipation
D) Peripheral edema and flushing
E) Tachycardia and headache
Correct Answer: A) Hyperkalemia and persistent dry cough
Rationale: ACE inhibitors can cause hyperkalemia by inhibiting
aldosterone secretion and a persistent dry cough due to the
accumulation of bradykinin.
Question 2
Which of the following classes of antihypertensive medications is generally
contraindicated in clients with a history of asthma or chronic obstructive
pulmonary disease (COPD)?
A) ACE inhibitors
B) Angiotensin Receptor Blockers (ARBs)
C) Calcium Channel Blockers (CCBs)
D) Non-selective Beta-blockers
E) Thiazide diuretics
Correct Answer: D) Non-selective Beta-blockers
Rationale: Non-selective beta-blockers block beta-2 adrenergic
receptors in the lungs, which can cause bronchoconstriction and
worsen symptoms in clients with reactive airway diseases like
asthma or COPD.
Question 3
A client with Type 2 Diabetes Mellitus is prescribed metformin. Which of the
,following is the primary mechanism of action of metformin?
A) Stimulates insulin secretion from pancreatic beta cells.
B) Decreases hepatic glucose production and increases peripheral insulin
sensitivity.
C) Delays carbohydrate absorption in the gut.
D) Increases urinary glucose excretion.
E) Provides exogenous insulin.
Correct Answer: B) Decreases hepatic glucose production and
increases peripheral insulin sensitivity.
Rationale: Metformin, a biguanide, primarily acts by reducing glucose
production by the liver and improving the sensitivity of body tissues
to insulin, leading to lower blood glucose levels.
Question 4
Which of the following antiarrhythmic medications is classified as a Class III
agent and works by blocking potassium channels to prolong repolarization?
A) Lidocaine
B) Verapamil
C) Amiodarone
D) Adenosine
E) Digoxin
Correct Answer: C) Amiodarone
Rationale: Amiodarone is a Class III antiarrhythmic drug that blocks
potassium channels (and to a lesser extent, sodium and calcium
channels and beta receptors), prolonging the action potential
duration and refractoriness.
Question 5
A client is taking warfarin for anticoagulation. The nurse should instruct the
client to monitor for and report which of the following?
A) White stools
B) Muscle cramps
,C) Headache and blurred vision
D) Unusual bleeding or bruising
E) Diarrhea
Correct Answer: D) Unusual bleeding or bruising
Rationale: Warfarin is an anticoagulant that increases the risk of
bleeding. Clients should be instructed to report any signs of
bleeding (e.g., nosebleeds, gum bleeding, hematuria, excessive
bruising) immediately.
Question 6
Which of the following is a common adverse effect associated with the use of
statins (HMG-CoA reductase inhibitors)?
A) Hyperkalemia
B) Rhabdomyolysis and myalgia
C) Peripheral edema
D) Photosensitivity
E) Hypoglycemia
Correct Answer: B) Rhabdomyolysis and myalgia
Rationale: Statins can cause muscle pain (myalgia) and, in rare but
severe cases, rhabdomyolysis (muscle breakdown), which can lead
to kidney damage. Liver enzyme elevation is also a concern.
Question 7
A client with a history of heart failure is prescribed furosemide. The nurse
should monitor which of the following electrolyte levels closely?
A) Sodium
B) Calcium
C) Magnesium
D) Potassium
E) Phosphate
Correct Answer: D) Potassium
Rationale: Furosemide is a loop diuretic, which acts on the loop of
, Henle to inhibit sodium and chloride reabsorption, leading to
increased excretion of potassium and a risk of hypokalemia.
Question 8
Which of the following medications is a first-line treatment for an acute
asthma exacerbation due to its rapid bronchodilatory effects?
A) Salmeterol
B) Fluticasone
C) Montelukast
D) Albuterol
E) Tiotropium
Correct Answer: D) Albuterol
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that
provides rapid bronchodilation and is the primary "rescue"
medication for acute asthma symptoms.
Question 9
A client is taking a non-steroidal anti-inflammatory drug (NSAID) for chronic
pain. The NP should counsel the client about the increased risk of which
adverse effect?
A) Hypokalemia
B) Gastrointestinal bleeding and renal impairment
C) Hyperglycemia
D) Bronchoconstriction in all clients
E) Blurred vision
Correct Answer: B) Gastrointestinal bleeding and renal impairment
Rationale: NSAIDs inhibit prostaglandin synthesis, which can reduce
the protective gastric mucus layer (leading to GI bleeding) and
impair renal perfusion (leading to kidney damage), especially with
long-term use or in vulnerable clients.
Question 10
Which of the following medications is indicated for the treatment of opioid
2025 Graded A+
Question 1
A nurse practitioner is prescribing an ACE inhibitor to a client with
hypertension and diabetes. Which of the following adverse effects should the
NP specifically counsel the client about?
A) Hyperkalemia and persistent dry cough
B) Hypoglycemia and weight gain
C) Bradycardia and constipation
D) Peripheral edema and flushing
E) Tachycardia and headache
Correct Answer: A) Hyperkalemia and persistent dry cough
Rationale: ACE inhibitors can cause hyperkalemia by inhibiting
aldosterone secretion and a persistent dry cough due to the
accumulation of bradykinin.
Question 2
Which of the following classes of antihypertensive medications is generally
contraindicated in clients with a history of asthma or chronic obstructive
pulmonary disease (COPD)?
A) ACE inhibitors
B) Angiotensin Receptor Blockers (ARBs)
C) Calcium Channel Blockers (CCBs)
D) Non-selective Beta-blockers
E) Thiazide diuretics
Correct Answer: D) Non-selective Beta-blockers
Rationale: Non-selective beta-blockers block beta-2 adrenergic
receptors in the lungs, which can cause bronchoconstriction and
worsen symptoms in clients with reactive airway diseases like
asthma or COPD.
Question 3
A client with Type 2 Diabetes Mellitus is prescribed metformin. Which of the
,following is the primary mechanism of action of metformin?
A) Stimulates insulin secretion from pancreatic beta cells.
B) Decreases hepatic glucose production and increases peripheral insulin
sensitivity.
C) Delays carbohydrate absorption in the gut.
D) Increases urinary glucose excretion.
E) Provides exogenous insulin.
Correct Answer: B) Decreases hepatic glucose production and
increases peripheral insulin sensitivity.
Rationale: Metformin, a biguanide, primarily acts by reducing glucose
production by the liver and improving the sensitivity of body tissues
to insulin, leading to lower blood glucose levels.
Question 4
Which of the following antiarrhythmic medications is classified as a Class III
agent and works by blocking potassium channels to prolong repolarization?
A) Lidocaine
B) Verapamil
C) Amiodarone
D) Adenosine
E) Digoxin
Correct Answer: C) Amiodarone
Rationale: Amiodarone is a Class III antiarrhythmic drug that blocks
potassium channels (and to a lesser extent, sodium and calcium
channels and beta receptors), prolonging the action potential
duration and refractoriness.
Question 5
A client is taking warfarin for anticoagulation. The nurse should instruct the
client to monitor for and report which of the following?
A) White stools
B) Muscle cramps
,C) Headache and blurred vision
D) Unusual bleeding or bruising
E) Diarrhea
Correct Answer: D) Unusual bleeding or bruising
Rationale: Warfarin is an anticoagulant that increases the risk of
bleeding. Clients should be instructed to report any signs of
bleeding (e.g., nosebleeds, gum bleeding, hematuria, excessive
bruising) immediately.
Question 6
Which of the following is a common adverse effect associated with the use of
statins (HMG-CoA reductase inhibitors)?
A) Hyperkalemia
B) Rhabdomyolysis and myalgia
C) Peripheral edema
D) Photosensitivity
E) Hypoglycemia
Correct Answer: B) Rhabdomyolysis and myalgia
Rationale: Statins can cause muscle pain (myalgia) and, in rare but
severe cases, rhabdomyolysis (muscle breakdown), which can lead
to kidney damage. Liver enzyme elevation is also a concern.
Question 7
A client with a history of heart failure is prescribed furosemide. The nurse
should monitor which of the following electrolyte levels closely?
A) Sodium
B) Calcium
C) Magnesium
D) Potassium
E) Phosphate
Correct Answer: D) Potassium
Rationale: Furosemide is a loop diuretic, which acts on the loop of
, Henle to inhibit sodium and chloride reabsorption, leading to
increased excretion of potassium and a risk of hypokalemia.
Question 8
Which of the following medications is a first-line treatment for an acute
asthma exacerbation due to its rapid bronchodilatory effects?
A) Salmeterol
B) Fluticasone
C) Montelukast
D) Albuterol
E) Tiotropium
Correct Answer: D) Albuterol
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that
provides rapid bronchodilation and is the primary "rescue"
medication for acute asthma symptoms.
Question 9
A client is taking a non-steroidal anti-inflammatory drug (NSAID) for chronic
pain. The NP should counsel the client about the increased risk of which
adverse effect?
A) Hypokalemia
B) Gastrointestinal bleeding and renal impairment
C) Hyperglycemia
D) Bronchoconstriction in all clients
E) Blurred vision
Correct Answer: B) Gastrointestinal bleeding and renal impairment
Rationale: NSAIDs inhibit prostaglandin synthesis, which can reduce
the protective gastric mucus layer (leading to GI bleeding) and
impair renal perfusion (leading to kidney damage), especially with
long-term use or in vulnerable clients.
Question 10
Which of the following medications is indicated for the treatment of opioid
