NUR 210 • PHARMACOLOGY PRACTICE SERIES
NUR 210 Cardiovascular & Respiratory Medications
2026–2027 • Study Guide + 110 Practice Questions with Rationales
High-yield guide and exam questions covering ACE inhibitors, ARBs, beta blockers, diuretics, anticoagulants, asthma/COPD
drugs and acute safety priorities.
USE & SCOPE
Independent practice questions, not an official test, answer key, or course syllabus. NUR 210 varies by school. Dose
calculations are educational examples, not prescribing directions. Verify medication orders, current labeling, facility policies,
monitoring thresholds and patient-specific factors in actual care.
HIGH-YIELD DRUG CLASS REVIEW
ACE inhibitors / ARBs: Lisinopril and losartan lower blood pressure through the renin–angiotensin system. Watch kidney
function, potassium and pregnancy risks. ACE inhibitors may cause cough and angioedema.
Beta blockers: Metoprolol can reduce heart rate and blood pressure. Check vital signs and symptoms; abrupt stopping may
cause rebound sympathetic effects.
Calcium channel blockers: Amlodipine can cause dependent edema; diltiazem may slow AV nodal conduction and reduce
heart rate.
Diuretics: Loop and thiazide diuretics can cause volume depletion and low electrolytes; spironolactone may cause
hyperkalemia.
Digoxin: Check pulse, symptoms, electrolyte abnormalities and kidney function. Nausea, visual symptoms and dysrhythmias
can suggest toxicity.
Antianginals and statins: Nitrates can cause hypotension; avoid dangerous PDE-5 inhibitor combinations. With statins,
urgently assess severe muscle symptoms and dark urine.
Anticoagulants and antiplatelets: Bleeding, interactions and procedure planning are priorities. Warfarin requires INR
monitoring; heparin may cause HIT; DOACs need patient-specific assessment.
Rescue versus controller therapy: Albuterol provides rapid relief. Inhaled corticosteroids and long-acting bronchodilators are
maintenance therapy; LABA should not be the sole asthma controller.
COPD antimuscarinics: Ipratropium is shorter acting; tiotropium is long acting and not rescue therapy. Dry mouth is a
common effect.
Severe allergy and anaphylaxis: IM epinephrine is first-line for anaphylaxis. Do not delay with controller medicines or
antihistamines.
Other respiratory agents: Theophylline toxicity may cause GI, neurologic and cardiac symptoms; montelukast has a boxed
warning for serious neuropsychiatric events.
PRACTICE EXAM: QUESTIONS, ANSWERS & RATIONALES
1. A patient taking lisinopril has new tongue swelling and a muffled voice. Which action is the priority?
A. Stop the medication and obtain emergency airway assessment
B. Give the next dose with food
C. Wait until the scheduled follow-up
D. Encourage extra potassium
Correct answer: A. Stop the medication and obtain emergency airway assessment
Detailed rationale: ACE-inhibitor angioedema can progress to airway obstruction and needs urgent evaluation.
Why other options are incorrect: Food and potassium do not treat angioedema; delayed evaluation may endanger the
airway.
2. Which laboratory findings require particular attention after initiation of an ACE inhibitor?
A. Thyroid stimulating hormone only
B. Hemoglobin A1c and ketones only
C. Calcium and serum amylase only
NUR 210 | Original educational practice resource • 2026–2027 | Page 1
, NUR 210 • PHARMACOLOGY PRACTICE SERIES
D. Potassium and kidney function
Correct answer: D. Potassium and kidney function
Detailed rationale: ACE inhibitors can increase potassium and affect renal function, particularly in vulnerable patients.
Why other options are incorrect: The other tests do not directly address the key ACE-inhibitor risks.
3. Which counseling point is essential for a patient starting losartan who may become pregnant?
A. Stop blood-pressure monitoring after one week
B. Take additional potassium routinely
C. Losartan is preferred for use throughout pregnancy
D. Contact the prescriber promptly regarding pregnancy because ARBs can injure a fetus
Correct answer: D. Contact the prescriber promptly regarding pregnancy because ARBs can injure a fetus
Detailed rationale: ARB therapy is contraindicated in pregnancy because of fetal toxicity risks.
Why other options are incorrect: The alternatives disregard pregnancy risk, hyperkalemia, or blood pressure follow-up.
4. A patient prescribed metoprolol has a new heart rate of 43/min and dizziness. What should the nurse do?
A. Withhold the scheduled dose pending prompt assessment and order clarification
B. Give twice the dose to correct the rate
C. Encourage strenuous exercise immediately
D. Ignore the symptoms as expected
Correct answer: A. Withhold the scheduled dose pending prompt assessment and order clarification
Detailed rationale: Symptomatic bradycardia is a safety concern with beta blockers and warrants assessment.
Why other options are incorrect: Giving more beta blocker can worsen bradycardia; exercise and inaction are unsafe.
5. Why should long-term beta-blocker treatment generally not be stopped abruptly?
A. Rebound tachycardia, hypertension or ischemia can occur
B. It becomes a permanent anticoagulant
C. It always causes severe hypoglycemia
D. It immediately causes antibiotic resistance
Correct answer: A. Rebound tachycardia, hypertension or ischemia can occur
Detailed rationale: Abrupt cessation may produce increased adrenergic activity; tapering is commonly directed by the
prescriber.
Why other options are incorrect: Antibiotic resistance, permanent anticoagulation and inevitable hypoglycemia are
unrelated.
6. Which adverse effect is common with amlodipine?
A. Severe cough from histamine release
B. Dependent ankle edema
C. Blue-gray vision in all users
D. Profound hypoglycemia as the expected effect
Correct answer: B. Dependent ankle edema
Detailed rationale: Amlodipine is a dihydropyridine calcium-channel blocker that can cause peripheral edema.
Why other options are incorrect: The alternatives are not characteristic routine amlodipine effects.
7. Which assessment is especially important before a dose of diltiazem?
A. Last dental cleaning date
B. Hair distribution
C. Visual acuity without other assessment
D. Heart rate, blood pressure and conduction history
Correct answer: D. Heart rate, blood pressure and conduction history
Detailed rationale: Diltiazem slows atrioventricular nodal conduction and can lower heart rate and blood pressure.
Why other options are incorrect: The other assessments do not address its principal hemodynamic effects.
8. A patient receiving furosemide becomes dizzy on standing and has reduced urine output. What is the priority?
A. Ignore because dehydration is desired
B. Assess volume status, blood pressure and electrolytes
NUR 210 | Original educational practice resource • 2026–2027 | Page 2
, NUR 210 • PHARMACOLOGY PRACTICE SERIES
C. Increase the dose automatically
D. Give a potassium-sparing supplement without an order
Correct answer: B. Assess volume status, blood pressure and electrolytes
Detailed rationale: Excess diuresis can lead to volume depletion, orthostasis and electrolyte abnormalities.
Why other options are incorrect: Unordered treatment and dose escalation can worsen harm.
9. What electrolyte imbalance is associated with spironolactone?
A. No electrolyte changes are possible
B. Hyperkalemia
C. Persistent low potassium by its usual mechanism
D. Isolated severe hypocalcemia in all patients
Correct answer: B. Hyperkalemia
Detailed rationale: Spironolactone reduces potassium excretion, increasing hyperkalemia risk.
Why other options are incorrect: The alternative effects conflict with potassium-sparing pharmacology.
10. Which patient statement about potassium supplements and spironolactone requires correction?
A. I can take extra potassium tablets whenever I feel tired
B. I will ask before using potassium-based salt substitutes
C. I will attend ordered laboratory checks
D. I will report weakness or palpitations
Correct answer: A. I can take extra potassium tablets whenever I feel tired
Detailed rationale: Combining potassium supplements with a potassium-sparing diuretic can cause dangerous
hyperkalemia.
Why other options are incorrect: The other statements reflect appropriate safety precautions.
11. A patient receiving hydrochlorothiazide reports dizziness after standing. Which problem should be considered?
A. Orthostatic hypotension and volume depletion
B. Acute opioid withdrawal
C. Serotonin syndrome as the expected effect
D. A reversal of all antihypertensive effects
Correct answer: A. Orthostatic hypotension and volume depletion
Detailed rationale: Thiazide diuretics can lower blood pressure and circulating volume.
Why other options are incorrect: The other choices are unrelated to thiazide-related dizziness.
12. A patient taking digoxin develops nausea, yellowish vision and new arrhythmia. What is most appropriate?
A. Give the next dose early
B. Hold the dose and promptly evaluate for digoxin toxicity
C. Add an antacid and disregard the heart rhythm
D. Administer a double dose with food
Correct answer: B. Hold the dose and promptly evaluate for digoxin toxicity
Detailed rationale: Visual disturbance, GI symptoms and arrhythmias can signal digoxin toxicity.
Why other options are incorrect: Additional digoxin and delayed evaluation can worsen toxicity.
13. Why is hypokalemia important in a patient receiving digoxin?
A. It guarantees digoxin will be ineffective
B. It eliminates the need for pulse assessment
C. Low potassium can increase susceptibility to digoxin toxicity
D. It prevents all dysrhythmias
Correct answer: C. Low potassium can increase susceptibility to digoxin toxicity
Detailed rationale: Hypokalemia can potentiate digoxin effects and contribute to dangerous dysrhythmias.
Why other options are incorrect: Low potassium does not protect against toxicity or remove monitoring needs.
14. Which combination requires special concern when a patient uses sublingual nitroglycerin?
A. Normal saline nasal spray
B. A moisturizer applied to dry skin
NUR 210 | Original educational practice resource • 2026–2027 | Page 3
NUR 210 Cardiovascular & Respiratory Medications
2026–2027 • Study Guide + 110 Practice Questions with Rationales
High-yield guide and exam questions covering ACE inhibitors, ARBs, beta blockers, diuretics, anticoagulants, asthma/COPD
drugs and acute safety priorities.
USE & SCOPE
Independent practice questions, not an official test, answer key, or course syllabus. NUR 210 varies by school. Dose
calculations are educational examples, not prescribing directions. Verify medication orders, current labeling, facility policies,
monitoring thresholds and patient-specific factors in actual care.
HIGH-YIELD DRUG CLASS REVIEW
ACE inhibitors / ARBs: Lisinopril and losartan lower blood pressure through the renin–angiotensin system. Watch kidney
function, potassium and pregnancy risks. ACE inhibitors may cause cough and angioedema.
Beta blockers: Metoprolol can reduce heart rate and blood pressure. Check vital signs and symptoms; abrupt stopping may
cause rebound sympathetic effects.
Calcium channel blockers: Amlodipine can cause dependent edema; diltiazem may slow AV nodal conduction and reduce
heart rate.
Diuretics: Loop and thiazide diuretics can cause volume depletion and low electrolytes; spironolactone may cause
hyperkalemia.
Digoxin: Check pulse, symptoms, electrolyte abnormalities and kidney function. Nausea, visual symptoms and dysrhythmias
can suggest toxicity.
Antianginals and statins: Nitrates can cause hypotension; avoid dangerous PDE-5 inhibitor combinations. With statins,
urgently assess severe muscle symptoms and dark urine.
Anticoagulants and antiplatelets: Bleeding, interactions and procedure planning are priorities. Warfarin requires INR
monitoring; heparin may cause HIT; DOACs need patient-specific assessment.
Rescue versus controller therapy: Albuterol provides rapid relief. Inhaled corticosteroids and long-acting bronchodilators are
maintenance therapy; LABA should not be the sole asthma controller.
COPD antimuscarinics: Ipratropium is shorter acting; tiotropium is long acting and not rescue therapy. Dry mouth is a
common effect.
Severe allergy and anaphylaxis: IM epinephrine is first-line for anaphylaxis. Do not delay with controller medicines or
antihistamines.
Other respiratory agents: Theophylline toxicity may cause GI, neurologic and cardiac symptoms; montelukast has a boxed
warning for serious neuropsychiatric events.
PRACTICE EXAM: QUESTIONS, ANSWERS & RATIONALES
1. A patient taking lisinopril has new tongue swelling and a muffled voice. Which action is the priority?
A. Stop the medication and obtain emergency airway assessment
B. Give the next dose with food
C. Wait until the scheduled follow-up
D. Encourage extra potassium
Correct answer: A. Stop the medication and obtain emergency airway assessment
Detailed rationale: ACE-inhibitor angioedema can progress to airway obstruction and needs urgent evaluation.
Why other options are incorrect: Food and potassium do not treat angioedema; delayed evaluation may endanger the
airway.
2. Which laboratory findings require particular attention after initiation of an ACE inhibitor?
A. Thyroid stimulating hormone only
B. Hemoglobin A1c and ketones only
C. Calcium and serum amylase only
NUR 210 | Original educational practice resource • 2026–2027 | Page 1
, NUR 210 • PHARMACOLOGY PRACTICE SERIES
D. Potassium and kidney function
Correct answer: D. Potassium and kidney function
Detailed rationale: ACE inhibitors can increase potassium and affect renal function, particularly in vulnerable patients.
Why other options are incorrect: The other tests do not directly address the key ACE-inhibitor risks.
3. Which counseling point is essential for a patient starting losartan who may become pregnant?
A. Stop blood-pressure monitoring after one week
B. Take additional potassium routinely
C. Losartan is preferred for use throughout pregnancy
D. Contact the prescriber promptly regarding pregnancy because ARBs can injure a fetus
Correct answer: D. Contact the prescriber promptly regarding pregnancy because ARBs can injure a fetus
Detailed rationale: ARB therapy is contraindicated in pregnancy because of fetal toxicity risks.
Why other options are incorrect: The alternatives disregard pregnancy risk, hyperkalemia, or blood pressure follow-up.
4. A patient prescribed metoprolol has a new heart rate of 43/min and dizziness. What should the nurse do?
A. Withhold the scheduled dose pending prompt assessment and order clarification
B. Give twice the dose to correct the rate
C. Encourage strenuous exercise immediately
D. Ignore the symptoms as expected
Correct answer: A. Withhold the scheduled dose pending prompt assessment and order clarification
Detailed rationale: Symptomatic bradycardia is a safety concern with beta blockers and warrants assessment.
Why other options are incorrect: Giving more beta blocker can worsen bradycardia; exercise and inaction are unsafe.
5. Why should long-term beta-blocker treatment generally not be stopped abruptly?
A. Rebound tachycardia, hypertension or ischemia can occur
B. It becomes a permanent anticoagulant
C. It always causes severe hypoglycemia
D. It immediately causes antibiotic resistance
Correct answer: A. Rebound tachycardia, hypertension or ischemia can occur
Detailed rationale: Abrupt cessation may produce increased adrenergic activity; tapering is commonly directed by the
prescriber.
Why other options are incorrect: Antibiotic resistance, permanent anticoagulation and inevitable hypoglycemia are
unrelated.
6. Which adverse effect is common with amlodipine?
A. Severe cough from histamine release
B. Dependent ankle edema
C. Blue-gray vision in all users
D. Profound hypoglycemia as the expected effect
Correct answer: B. Dependent ankle edema
Detailed rationale: Amlodipine is a dihydropyridine calcium-channel blocker that can cause peripheral edema.
Why other options are incorrect: The alternatives are not characteristic routine amlodipine effects.
7. Which assessment is especially important before a dose of diltiazem?
A. Last dental cleaning date
B. Hair distribution
C. Visual acuity without other assessment
D. Heart rate, blood pressure and conduction history
Correct answer: D. Heart rate, blood pressure and conduction history
Detailed rationale: Diltiazem slows atrioventricular nodal conduction and can lower heart rate and blood pressure.
Why other options are incorrect: The other assessments do not address its principal hemodynamic effects.
8. A patient receiving furosemide becomes dizzy on standing and has reduced urine output. What is the priority?
A. Ignore because dehydration is desired
B. Assess volume status, blood pressure and electrolytes
NUR 210 | Original educational practice resource • 2026–2027 | Page 2
, NUR 210 • PHARMACOLOGY PRACTICE SERIES
C. Increase the dose automatically
D. Give a potassium-sparing supplement without an order
Correct answer: B. Assess volume status, blood pressure and electrolytes
Detailed rationale: Excess diuresis can lead to volume depletion, orthostasis and electrolyte abnormalities.
Why other options are incorrect: Unordered treatment and dose escalation can worsen harm.
9. What electrolyte imbalance is associated with spironolactone?
A. No electrolyte changes are possible
B. Hyperkalemia
C. Persistent low potassium by its usual mechanism
D. Isolated severe hypocalcemia in all patients
Correct answer: B. Hyperkalemia
Detailed rationale: Spironolactone reduces potassium excretion, increasing hyperkalemia risk.
Why other options are incorrect: The alternative effects conflict with potassium-sparing pharmacology.
10. Which patient statement about potassium supplements and spironolactone requires correction?
A. I can take extra potassium tablets whenever I feel tired
B. I will ask before using potassium-based salt substitutes
C. I will attend ordered laboratory checks
D. I will report weakness or palpitations
Correct answer: A. I can take extra potassium tablets whenever I feel tired
Detailed rationale: Combining potassium supplements with a potassium-sparing diuretic can cause dangerous
hyperkalemia.
Why other options are incorrect: The other statements reflect appropriate safety precautions.
11. A patient receiving hydrochlorothiazide reports dizziness after standing. Which problem should be considered?
A. Orthostatic hypotension and volume depletion
B. Acute opioid withdrawal
C. Serotonin syndrome as the expected effect
D. A reversal of all antihypertensive effects
Correct answer: A. Orthostatic hypotension and volume depletion
Detailed rationale: Thiazide diuretics can lower blood pressure and circulating volume.
Why other options are incorrect: The other choices are unrelated to thiazide-related dizziness.
12. A patient taking digoxin develops nausea, yellowish vision and new arrhythmia. What is most appropriate?
A. Give the next dose early
B. Hold the dose and promptly evaluate for digoxin toxicity
C. Add an antacid and disregard the heart rhythm
D. Administer a double dose with food
Correct answer: B. Hold the dose and promptly evaluate for digoxin toxicity
Detailed rationale: Visual disturbance, GI symptoms and arrhythmias can signal digoxin toxicity.
Why other options are incorrect: Additional digoxin and delayed evaluation can worsen toxicity.
13. Why is hypokalemia important in a patient receiving digoxin?
A. It guarantees digoxin will be ineffective
B. It eliminates the need for pulse assessment
C. Low potassium can increase susceptibility to digoxin toxicity
D. It prevents all dysrhythmias
Correct answer: C. Low potassium can increase susceptibility to digoxin toxicity
Detailed rationale: Hypokalemia can potentiate digoxin effects and contribute to dangerous dysrhythmias.
Why other options are incorrect: Low potassium does not protect against toxicity or remove monitoring needs.
14. Which combination requires special concern when a patient uses sublingual nitroglycerin?
A. Normal saline nasal spray
B. A moisturizer applied to dry skin
NUR 210 | Original educational practice resource • 2026–2027 | Page 3
