PHARM - Cardiovascular Exam 2025–2026
Accurate Real Exam Questions and Verified
Correct Answers
The nurse has completed client teaching about heart failure and prescribed
medications that include digoxin and furosemide. The nurse documents that the
teaching goals have been met if the client states knowing to report which
symptom?
Weight gain of 2 to 3 pounds in a few days
Rationale: Clients with heart failure should immediately report weight gain, loss of
appetite, shortness of breath with activity, edema, persistent cough, and nocturia.
A high urine output is expected with these medications. A cough that
accompanies a cold is normal. A sudden increase in appetite is insignificant.
The nurse is preparing to administer digoxin to an adult client. The nurse checks
which important item before administering the medication?
Apical pulse rate
Rationale:Digoxin is a cardiac glycoside that is used to manage and treat heart
failure and to control ventricular rates in clients with atrial fibrillation. Before
administering the medication, the nurse needs to assess the apical heart rate for
60 seconds. If the pulse rate is less than 60 beats per minute in an adult client,
the nurse would withhold the medication and contact the health care provider
because a low pulse rate may be an indication of toxicity. Blood pressure,
Neurological signs, and level of consciousness may be a component of the
assessment depending on the client's diagnosis. However, these assessments are
not specifically associated with the use of digoxin.
Vasopressin is prescribed for the client with diabetes insipidus. During data
collection, the nurse is particularly cautious in checking the client for which
preexisting condition?
1|Page
,Coronary artery disease
Rationale: Because of its powerful vasoconstrictive actions, vasopressin can cause
adverse cardiovascular effects. By constricting arteries of the heart, vasopressin
can cause angina pectoris and even myocardial infarction, especially if
administered to clients with coronary artery disease. In addition, vasopressin may
cause gangrene by decreasing blood flow in the periphery.
A client has taken his first dose of lisinopril about 2 hours ago and begins to
develop fullness in his face and hoarseness. Which action should the nurse take
first?
Determine the client's ability to breathe effectively.
Rationale: The client is experiencing angioedema, an adverse effect of the
medication, which involves facial swelling and hoarseness. Assessing the ability to
breathe effectively takes priority over assessing the blood pressure, preventing
dizziness, or determining how long the client has been hoarse.
A client takes digoxin 0.25 mg by prescription every day. When the nurse enters
the client's room with the medication, the client's meal tray is untouched and the
client says he has no appetite. Which action is the most appropriate?
Listen to the client's apical pulse. If it is less than 60 beats per minute, withhold
the medication.
Rationale: Anorexia is a common early sign of digoxin toxicity. Another sign of
digoxin toxicity is an apical pulse rate of less than 60 beats per minute. If the
apical pulse rate is less than 60 beats per minute, the dose should be withheld
and the health care provider notified. The remaining options are incorrect actions
and would harm the client (administer one half the prescribed amount to avoid
digoxin toxicity.) or delay needed intervention (check the client's temperature,
radial pulse rate, and respiratory rate. and
2|Page
,offer to bring back the digoxin to the client when his appetite improves.).
Additionally, a radial pulse is not as accurate as an apical pulse and should not be
used to determine the possibility of digoxin toxicity.
A 1-year-old child has been prescribed digoxin to treat heart failure (HF). When
should the nurse plan on withholding the prescribed dose of the medication?
The child's pulse is less than 80 beats per minute.
Rationale: The normal pulse rate for a 1-year-old child is about 100 beats per
minute. A missed dose is withheld if 4 hours have elapsed. Fever is not a
contraindication to giving the medication. Knowing that a sign of digoxin toxicity
is a decreased heart rate, the most likely choice is pulse less than 80 bpm, which
indicates a relative bradycardia.
Thrombolytic therapy was administered to a client following an acute inferior
myocardial infarction. The nurse giving discharge instructions to the client
evaluates a need for further teaching when the client makes which statement?
"I will apply pressure for 10 minutes for minor bleeding."
Rationale: Thrombolytic medication causes lysis of blood clots. Client teaching
includes reporting a temperature over 104° F (40° C), which can be an indicator of
internal bleeding. Other instructions include avoiding venous or arterial
punctures and rectal temperatures. Fevers can be treated with acetaminophen or
aspirin. Pressure should be applied for 30 seconds to a minor bleeding site.
Inform the primary health care provider if this does not attain hemostasis.
The nurse is caring for a client who is receiving hydralazine. The nurse
evaluates the effectiveness of the medication by monitoring which client
parameters?
Blood pressure
3|Page
, Rationale: Hydralazine is an antihypertensive medication used in the management
of moderate to severe hypertension. It is a vasodilator medication that decreases
afterload, so it is important that the blood pressure be monitored. The remaining
options are not specifically related to determining the effectiveness of this
medication.
A client has received atropine sulfate intravenously during a surgical procedure.
The nurse monitors the client for which side effect of the atropine sulfate in the
postoperative period?
Urinary retention
Rationale: Atropine sulfate is an anticholinergic medication that causes
tachycardia, drowsiness, blurred vision, dry mouth, constipation, and urinary
retention. The nurse monitors the client for any of these effects in the
postoperative period.
A client receiving total parenteral nutrition (PN) has a history of heart failure. The
health care provider has prescribed furosemide 40 mg orally daily to prevent fluid
overload.
The nurse is giving instructions about taking furosemide in relation to the client's
health plan. Which statement by the client indicates a need for further teaching?
"I need to talk to my doctor about increasing my digoxin."
Rationale: Furosemide is a potassium-losing diuretic. Instructions include a need
for a high-potassium diet or potassium replacement, rising slowly from a lying or
sitting position because orthostatic hypotension may occur, and taking the
medication early in the day to prevent sleeplessness and nocturia. Furosemide can
increase the risk of toxicity of lithium, nondepolarizing skeletal muscle relaxants,
digoxin, salicylates, aminoglycosides, and cisplatin.
A client is receiving heparin sodium by continuous intravenous (IV) infusion. The
licensed practical nurse (LPN) is concerned that the client received a bolus of
medication
4|Page
Accurate Real Exam Questions and Verified
Correct Answers
The nurse has completed client teaching about heart failure and prescribed
medications that include digoxin and furosemide. The nurse documents that the
teaching goals have been met if the client states knowing to report which
symptom?
Weight gain of 2 to 3 pounds in a few days
Rationale: Clients with heart failure should immediately report weight gain, loss of
appetite, shortness of breath with activity, edema, persistent cough, and nocturia.
A high urine output is expected with these medications. A cough that
accompanies a cold is normal. A sudden increase in appetite is insignificant.
The nurse is preparing to administer digoxin to an adult client. The nurse checks
which important item before administering the medication?
Apical pulse rate
Rationale:Digoxin is a cardiac glycoside that is used to manage and treat heart
failure and to control ventricular rates in clients with atrial fibrillation. Before
administering the medication, the nurse needs to assess the apical heart rate for
60 seconds. If the pulse rate is less than 60 beats per minute in an adult client,
the nurse would withhold the medication and contact the health care provider
because a low pulse rate may be an indication of toxicity. Blood pressure,
Neurological signs, and level of consciousness may be a component of the
assessment depending on the client's diagnosis. However, these assessments are
not specifically associated with the use of digoxin.
Vasopressin is prescribed for the client with diabetes insipidus. During data
collection, the nurse is particularly cautious in checking the client for which
preexisting condition?
1|Page
,Coronary artery disease
Rationale: Because of its powerful vasoconstrictive actions, vasopressin can cause
adverse cardiovascular effects. By constricting arteries of the heart, vasopressin
can cause angina pectoris and even myocardial infarction, especially if
administered to clients with coronary artery disease. In addition, vasopressin may
cause gangrene by decreasing blood flow in the periphery.
A client has taken his first dose of lisinopril about 2 hours ago and begins to
develop fullness in his face and hoarseness. Which action should the nurse take
first?
Determine the client's ability to breathe effectively.
Rationale: The client is experiencing angioedema, an adverse effect of the
medication, which involves facial swelling and hoarseness. Assessing the ability to
breathe effectively takes priority over assessing the blood pressure, preventing
dizziness, or determining how long the client has been hoarse.
A client takes digoxin 0.25 mg by prescription every day. When the nurse enters
the client's room with the medication, the client's meal tray is untouched and the
client says he has no appetite. Which action is the most appropriate?
Listen to the client's apical pulse. If it is less than 60 beats per minute, withhold
the medication.
Rationale: Anorexia is a common early sign of digoxin toxicity. Another sign of
digoxin toxicity is an apical pulse rate of less than 60 beats per minute. If the
apical pulse rate is less than 60 beats per minute, the dose should be withheld
and the health care provider notified. The remaining options are incorrect actions
and would harm the client (administer one half the prescribed amount to avoid
digoxin toxicity.) or delay needed intervention (check the client's temperature,
radial pulse rate, and respiratory rate. and
2|Page
,offer to bring back the digoxin to the client when his appetite improves.).
Additionally, a radial pulse is not as accurate as an apical pulse and should not be
used to determine the possibility of digoxin toxicity.
A 1-year-old child has been prescribed digoxin to treat heart failure (HF). When
should the nurse plan on withholding the prescribed dose of the medication?
The child's pulse is less than 80 beats per minute.
Rationale: The normal pulse rate for a 1-year-old child is about 100 beats per
minute. A missed dose is withheld if 4 hours have elapsed. Fever is not a
contraindication to giving the medication. Knowing that a sign of digoxin toxicity
is a decreased heart rate, the most likely choice is pulse less than 80 bpm, which
indicates a relative bradycardia.
Thrombolytic therapy was administered to a client following an acute inferior
myocardial infarction. The nurse giving discharge instructions to the client
evaluates a need for further teaching when the client makes which statement?
"I will apply pressure for 10 minutes for minor bleeding."
Rationale: Thrombolytic medication causes lysis of blood clots. Client teaching
includes reporting a temperature over 104° F (40° C), which can be an indicator of
internal bleeding. Other instructions include avoiding venous or arterial
punctures and rectal temperatures. Fevers can be treated with acetaminophen or
aspirin. Pressure should be applied for 30 seconds to a minor bleeding site.
Inform the primary health care provider if this does not attain hemostasis.
The nurse is caring for a client who is receiving hydralazine. The nurse
evaluates the effectiveness of the medication by monitoring which client
parameters?
Blood pressure
3|Page
, Rationale: Hydralazine is an antihypertensive medication used in the management
of moderate to severe hypertension. It is a vasodilator medication that decreases
afterload, so it is important that the blood pressure be monitored. The remaining
options are not specifically related to determining the effectiveness of this
medication.
A client has received atropine sulfate intravenously during a surgical procedure.
The nurse monitors the client for which side effect of the atropine sulfate in the
postoperative period?
Urinary retention
Rationale: Atropine sulfate is an anticholinergic medication that causes
tachycardia, drowsiness, blurred vision, dry mouth, constipation, and urinary
retention. The nurse monitors the client for any of these effects in the
postoperative period.
A client receiving total parenteral nutrition (PN) has a history of heart failure. The
health care provider has prescribed furosemide 40 mg orally daily to prevent fluid
overload.
The nurse is giving instructions about taking furosemide in relation to the client's
health plan. Which statement by the client indicates a need for further teaching?
"I need to talk to my doctor about increasing my digoxin."
Rationale: Furosemide is a potassium-losing diuretic. Instructions include a need
for a high-potassium diet or potassium replacement, rising slowly from a lying or
sitting position because orthostatic hypotension may occur, and taking the
medication early in the day to prevent sleeplessness and nocturia. Furosemide can
increase the risk of toxicity of lithium, nondepolarizing skeletal muscle relaxants,
digoxin, salicylates, aminoglycosides, and cisplatin.
A client is receiving heparin sodium by continuous intravenous (IV) infusion. The
licensed practical nurse (LPN) is concerned that the client received a bolus of
medication
4|Page
