NUR 2474 LATEST EXAM 2 2026 RASMUSSEN
COLLEGE ACTUAL QUESTIONS CORRECTLY
ANSWERED 100% WINTER SPRING QUARTER
A patient with diabetes develops hypertension. The nurse will anticipate
administering which type of medication to treat hypertension in this patient?
a.ACE inhibitors
b.Beta blockers
c.Direct-acting vasodilators
d.Thiazide diuretics
a.ACE inhibitors
ACE inhibitors slow the progression of kidney injury in diabetic patients with renal
damage. Beta blockers can mask signs of hypoglycemia and must be used with caution in
diabetics. Direct-acting vasodilators are third-line drugs for chronic hypertension. Thiazide
diuretics promote hyperglycemia.
A patient who does not consume alcohol or nicotine products reports a strong family
history of hypertension and cardiovascular disease. The patient has a blood pressure
of 126/82 and a normal weight and body mass index for height and age. The nurse
will expect to teach this patient about:
a.ACE inhibitors and calcium channel blocker medications.
b.the DASH diet, sodium restriction, and exercise.
c.increased calcium and potassium supplements.
d.thiazide diuretics and lifestyle changes.
b.the DASH diet, sodium restriction, and exercise.
This patient has prehypertension without other risk factors. Lifestyle changes are indicated
at this point. If blood pressure rises to hypertension levels, other measures, including drug
therapy, will be initiated. Calcium and potassium supplements are not indicated.
,A patient with hypertension with a blood pressure of 168/110 mm Hg begins taking
hydrochlorothiazide and verapamil. The patient returns to the clinic after 2 weeks of
drug therapy, and the nurse notes a blood pressure of 140/85 mm Hg and a heart
rate of 98 beats per minute. What will the nurse do?
a.Notify the provider and ask about adding a beta blocker medication.
b.Reassure the patient that the medications are working.
c.Remind the patient to move slowly from sitting to standing.
d.Request an order for an electrocardiogram.
a.Notify the provider and ask about adding a beta blocker medication.
Beta blockers are often added to drug regimens to treat reflex tachycardia, which is a
common side effect of lowering blood pressure, caused by the baroreceptor reflex. The
patient's blood pressure is responding to the medications, but the tachycardia warrants
treatment. Reminding the patient to move slowly from sitting to standing is appropriate
with any blood pressure medication, but this patient has reflex tachycardia, which must be
treated. An electrocardiogram is not indicated.
A nurse is discussing how beta blockers work to decrease blood pressure with a
nursing student. Which statement by the student indicates a need for further
teaching?
a."Beta blockers block the actions of angiotensin II."
b."Beta blockers decrease heart rate and contractility."
c."Beta blockers decrease peripheral vascular resistance."
d."Beta blockers decrease the release of renin."
a."Beta blockers block the actions of angiotensin II."
Beta blockers reduce the release of renin by blockade of beta1 receptors on
juxtaglomerular cells in the kidney, which reduces angiotensin II-mediated
vasoconstriction, but do not block the actions of angiotensin II directly. Beta blockers
decrease heart rate and cardiac contractility, decrease peripheral vascular resistance, and
decrease the release of renin.
A patient is taking enalapril (Vasotec). The nurse understands that patients taking
this type of drug for heart failure need to be monitored carefully for:
a.hypernatremia.
b.hypertension.
c.hyperkalemia.
d.hypokalemia.
,c.hyperkalemia.
One of the principal effects of angiotensin-converting enzyme (ACE) inhibitors is
hyperkalemia, which is due to decreased aldosterone release arising from blockage of
angiotensin II. There is no indication that careful monitoring of sodium for increased levels
is indicated. Vasotec is indicated for heart failure, not hypertension. The drug therapy
should be monitored to ascertain its effectiveness, but hyperkalemia is the main concern.
Hyperkalemia, not hypokalemia, is a concern because of the decreased aldosterone release
that occurs with blockage of angiotensin II.
A patient with chronic hypertension is admitted to the hospital. During the
admission assessment, the nurse notes a heart rate of 96 beats per minute, a blood
pressure of 150/90 mm Hg, bibasilar crackles, 2+ pitting edema of the ankles, and
distension of the jugular veins. The nurse will contact the provider to request an
order for which medication?
a.ACE inhibitor
b.Digoxin (Lanoxin)
c.Furosemide (Lasix)
d.Spironolactone (Aldactone)
c.Furosemide (Lasix)
This patient shows signs of fluid volume overload and needs a diuretic. Furosemide is a
high-ceiling (loop) diuretic, which can produce profound diuresis very quickly even when
the glomerular filtration rate (GFR) is low. An ACE inhibitor will not reduce fluid volume
overload. Digoxin has a positive inotropic effect on the heart, which may improve renal
perfusion, but this is not its primary effect. Spironolactone is a potassium-sparing diuretic
with weak diuresis effects; it is used in conjunction with other diuretics to improve
electrolyte balance.
A diabetic patient is recovering from a myocardial infarction but does not have
symptoms of heart failure. The nurse will expect to teach this patient about:
a.ACE inhibitors and beta blockers.
b.biventricular pacemakers.
c.dietary supplements and exercise.
d.diuretics and digoxin.
, a.ACE inhibitors and beta blockers.
This patient is classified as having Stage B heart failure with no current symptoms but with
structural heart disease strongly associated with the development of heart failure.
Treatment at this stage includes an ACE inhibitor and a beta blocker to help prevent the
progression of symptoms. Biventricular pacemakers are used for patients in Stage C heart
failure and have more advanced structural disease and symptoms. Dietary supplements
and exercise have not been proven to prevent structural heart disease. Diuretics and
digoxin are used for patients with Stage C heart failure.
A patient with heart failure who has been taking an ACE inhibitor, a thiazide diuretic,
and a beta blocker for several months comes to the clinic for evaluation. As part of
the ongoing assessment of this patient, the nurse will expect the provider to
evaluate:
a.complete blood count.
b.ejection fraction.
c.maximal exercise capacity.
d.serum electrolyte levels.
d.serum electrolyte levels.
Patients taking thiazide diuretics can develop hypokalemia, which can increase the risk for
dysrhythmias; therefore, the serum electrolyte levels should be monitored closely. A
complete blood count is not recommended. This patient is taking the drugs recommended
for patients with Stage C heart failure; although the patient's quality of life and ability to
participate in activities should be monitored, routine measurement of the ejection fraction
and maximal exercise capacity is not recommended.
A patient with Stage C heart failure (HF) who has been taking an ACE inhibitor, a beta
blocker, and a diuretic begins to have increased dyspnea, weight gain, and decreased
urine output. The provider orders spironolactone (Aldactone). The nurse will make
sure that the patient:
a.does not take potassium supplements.
b.monitors for a decreased heart rate.
c.takes extra fluids.
d.uses a salt substitute instead of salt.
COLLEGE ACTUAL QUESTIONS CORRECTLY
ANSWERED 100% WINTER SPRING QUARTER
A patient with diabetes develops hypertension. The nurse will anticipate
administering which type of medication to treat hypertension in this patient?
a.ACE inhibitors
b.Beta blockers
c.Direct-acting vasodilators
d.Thiazide diuretics
a.ACE inhibitors
ACE inhibitors slow the progression of kidney injury in diabetic patients with renal
damage. Beta blockers can mask signs of hypoglycemia and must be used with caution in
diabetics. Direct-acting vasodilators are third-line drugs for chronic hypertension. Thiazide
diuretics promote hyperglycemia.
A patient who does not consume alcohol or nicotine products reports a strong family
history of hypertension and cardiovascular disease. The patient has a blood pressure
of 126/82 and a normal weight and body mass index for height and age. The nurse
will expect to teach this patient about:
a.ACE inhibitors and calcium channel blocker medications.
b.the DASH diet, sodium restriction, and exercise.
c.increased calcium and potassium supplements.
d.thiazide diuretics and lifestyle changes.
b.the DASH diet, sodium restriction, and exercise.
This patient has prehypertension without other risk factors. Lifestyle changes are indicated
at this point. If blood pressure rises to hypertension levels, other measures, including drug
therapy, will be initiated. Calcium and potassium supplements are not indicated.
,A patient with hypertension with a blood pressure of 168/110 mm Hg begins taking
hydrochlorothiazide and verapamil. The patient returns to the clinic after 2 weeks of
drug therapy, and the nurse notes a blood pressure of 140/85 mm Hg and a heart
rate of 98 beats per minute. What will the nurse do?
a.Notify the provider and ask about adding a beta blocker medication.
b.Reassure the patient that the medications are working.
c.Remind the patient to move slowly from sitting to standing.
d.Request an order for an electrocardiogram.
a.Notify the provider and ask about adding a beta blocker medication.
Beta blockers are often added to drug regimens to treat reflex tachycardia, which is a
common side effect of lowering blood pressure, caused by the baroreceptor reflex. The
patient's blood pressure is responding to the medications, but the tachycardia warrants
treatment. Reminding the patient to move slowly from sitting to standing is appropriate
with any blood pressure medication, but this patient has reflex tachycardia, which must be
treated. An electrocardiogram is not indicated.
A nurse is discussing how beta blockers work to decrease blood pressure with a
nursing student. Which statement by the student indicates a need for further
teaching?
a."Beta blockers block the actions of angiotensin II."
b."Beta blockers decrease heart rate and contractility."
c."Beta blockers decrease peripheral vascular resistance."
d."Beta blockers decrease the release of renin."
a."Beta blockers block the actions of angiotensin II."
Beta blockers reduce the release of renin by blockade of beta1 receptors on
juxtaglomerular cells in the kidney, which reduces angiotensin II-mediated
vasoconstriction, but do not block the actions of angiotensin II directly. Beta blockers
decrease heart rate and cardiac contractility, decrease peripheral vascular resistance, and
decrease the release of renin.
A patient is taking enalapril (Vasotec). The nurse understands that patients taking
this type of drug for heart failure need to be monitored carefully for:
a.hypernatremia.
b.hypertension.
c.hyperkalemia.
d.hypokalemia.
,c.hyperkalemia.
One of the principal effects of angiotensin-converting enzyme (ACE) inhibitors is
hyperkalemia, which is due to decreased aldosterone release arising from blockage of
angiotensin II. There is no indication that careful monitoring of sodium for increased levels
is indicated. Vasotec is indicated for heart failure, not hypertension. The drug therapy
should be monitored to ascertain its effectiveness, but hyperkalemia is the main concern.
Hyperkalemia, not hypokalemia, is a concern because of the decreased aldosterone release
that occurs with blockage of angiotensin II.
A patient with chronic hypertension is admitted to the hospital. During the
admission assessment, the nurse notes a heart rate of 96 beats per minute, a blood
pressure of 150/90 mm Hg, bibasilar crackles, 2+ pitting edema of the ankles, and
distension of the jugular veins. The nurse will contact the provider to request an
order for which medication?
a.ACE inhibitor
b.Digoxin (Lanoxin)
c.Furosemide (Lasix)
d.Spironolactone (Aldactone)
c.Furosemide (Lasix)
This patient shows signs of fluid volume overload and needs a diuretic. Furosemide is a
high-ceiling (loop) diuretic, which can produce profound diuresis very quickly even when
the glomerular filtration rate (GFR) is low. An ACE inhibitor will not reduce fluid volume
overload. Digoxin has a positive inotropic effect on the heart, which may improve renal
perfusion, but this is not its primary effect. Spironolactone is a potassium-sparing diuretic
with weak diuresis effects; it is used in conjunction with other diuretics to improve
electrolyte balance.
A diabetic patient is recovering from a myocardial infarction but does not have
symptoms of heart failure. The nurse will expect to teach this patient about:
a.ACE inhibitors and beta blockers.
b.biventricular pacemakers.
c.dietary supplements and exercise.
d.diuretics and digoxin.
, a.ACE inhibitors and beta blockers.
This patient is classified as having Stage B heart failure with no current symptoms but with
structural heart disease strongly associated with the development of heart failure.
Treatment at this stage includes an ACE inhibitor and a beta blocker to help prevent the
progression of symptoms. Biventricular pacemakers are used for patients in Stage C heart
failure and have more advanced structural disease and symptoms. Dietary supplements
and exercise have not been proven to prevent structural heart disease. Diuretics and
digoxin are used for patients with Stage C heart failure.
A patient with heart failure who has been taking an ACE inhibitor, a thiazide diuretic,
and a beta blocker for several months comes to the clinic for evaluation. As part of
the ongoing assessment of this patient, the nurse will expect the provider to
evaluate:
a.complete blood count.
b.ejection fraction.
c.maximal exercise capacity.
d.serum electrolyte levels.
d.serum electrolyte levels.
Patients taking thiazide diuretics can develop hypokalemia, which can increase the risk for
dysrhythmias; therefore, the serum electrolyte levels should be monitored closely. A
complete blood count is not recommended. This patient is taking the drugs recommended
for patients with Stage C heart failure; although the patient's quality of life and ability to
participate in activities should be monitored, routine measurement of the ejection fraction
and maximal exercise capacity is not recommended.
A patient with Stage C heart failure (HF) who has been taking an ACE inhibitor, a beta
blocker, and a diuretic begins to have increased dyspnea, weight gain, and decreased
urine output. The provider orders spironolactone (Aldactone). The nurse will make
sure that the patient:
a.does not take potassium supplements.
b.monitors for a decreased heart rate.
c.takes extra fluids.
d.uses a salt substitute instead of salt.
