Pharm Quiz 2 Practice Questions
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A nurse is administering lisinopril to a patient with hypertension. Which mechanism of action explains how this medication lowers blood pressure
Prevents conversion of angiotensin I to angiotensin II
3 multiple choice options
A patient taking enalapril reports developing a persistent dry cough. Which action by the nurse is most appropriate?
Notify the provider because this is a common ACE inhibitor adverse effect.
3 multiple choice options
- Constipation
- Peripheral edema
- Bradycardia
- Flushing
Which findings are common adverse effects of calcium channel blockers? (Select all that apply.)
Which medication is classified as an angiotensin receptor blocker (ARB)?
Losartan
3 multiple choice options
- Decreased heart rate
- Decreased myocardial contractility
- Reduced tremors
The nurse is teaching a patient about beta blockers. Which effects should the nurse expect? (Select all that apply.)
Which adverse effect should the nurse monitor for in a patient receiving furosemide?
Hypokalemia
3 multiple choice options
- Hypokalemia
- Hyponatremia
- Hypomagnesemia
- Hypochloremia
Which electrolyte abnormalities are associated with loop diuretics? (Select all that apply.)
Which medication is considered a low-molecular-weight heparin?
Enoxaparin
3 multiple choice options
Which adverse effect is the priority concern for a patient receiving heparin therapy?
Bleeding
3 multiple choice options
- Heparin
- Enoxaparin
- Clopidogrel
- Alteplase
Which medications are classified as coagulation modifiers? (Select all that apply.)
Digoxin primarily improves cardiac output by:
Increasing myocardial contractility
3 multiple choice options
- Bradycardia
- Cardiac arrhythmias
- Cardiac arrest
- Hypokalemia
Which findings may indicate digoxin toxicity? (Select all that apply.)
Nitroglycerin relieves angina primarily by:
Producing nitric oxide that causes vasodilation
3 multiple choice options
- Headache
- Flushing
- Hypotension
- Dizziness
Which adverse effects are expected with nitroglycerin therapy? (Select all that apply.)
Which drug is classified as a calcium channel blocker?
Amlodipine
3 multiple choice options
Which statement best describes the mechanism of thiazide diuretics?
Block sodium-chloride reabsorption in the distal convoluted tubule
3 multiple choice options
- Hypokalemia
- Hyponatremia
- Hyperglycemia
- Hyperuricemia
- Hypercalcemia
Which adverse effects are associated with hydrochlorothiazide? (Select all that apply.)
Which medication is a selective beta-1 blocker?
Metoprolol
3 multiple choice options
- Muscle weakness
- Palpitations
- Arrhythmias
- Numbness
The nurse is teaching a patient about spironolactone. Which findings should be reported immediately? (Select all that apply.)
Which medication combination should the nurse question?
Valsartan/sacubitril and an ACE inhibitor taken 12 hours ago
( ARNIs should NOT be given within 36 hours of an ACE inhibitor due to the risk of angioedema
3 multiple choice options
A patient taking lisinopril develops a persistent cough. The provider switches the patient to losartan. What is the rationale for this change?
Losartan does not increase bradykinin levels.
3 multiple choice options
- Potassium 2.9
- Sodium 128
- Magnesium 1.2
- Chloride 94
A nurse is reviewing laboratory values for a patient taking furosemide. Which findings would concern the nurse? (Select all that apply.)
Which patient should the nurse question before administering valsartan/sacubitril (Entresto)?
Patient who took lisinopril 24 hours ago
3 multiple choice options
- Nitroglycerin
- Hydralazine/isosorbide dinitrate
- Amlodipine
- Losartan
Which medications lower blood pressure primarily through vasodilation? (Select all that apply.)
Which assessment finding requires immediate intervention in a patient receiving digoxin?
HR 52 bpm
3 multiple choice options
- Blocks beta-1 receptors
- Decreases heart rate
- Lowers blood pressure
The nurse is teaching a patient about metoprolol. Which statements are correct? (Select all that apply.)
Which adverse effect is most characteristic of verapamil?
Constipation
3 multiple choice options
- Decreased myocardial oxygen demand
- Vasodilation
- Decreased preload
- Improved coronary blood flow
A patient is receiving nitroglycerin. Which findings indicate expected effects of therapy? (Select all that apply.)
Which medication is a nonselective beta blocker?
Propranolol
3 multiple choice options
- Heparin
- Enoxaparin
- Clopidogrel
- Alteplase
Which medications increase the risk of bleeding? (Select all that apply.)
A patient is prescribed spironolactone. Which laboratory value requires the greatest concern?
Potassium 5.9 mEq/L
3 multiple choice options
- ACE inhibitors
- ARBs
- Beta blockers
Which drugs support cardiac function by decreasing afterload? (Select all that apply.)
A patient taking hydrochlorothiazide is most likely to develop which electrolyte imbalance?
Hypokalemia
3 multiple choice options
- Lisinopril
- Losartan
- Metoprolol
- Amlodipine
Which medications belong to the antihypertensive class? (Select all that apply.)
The nurse knows the primary mechanism of nitrates is:
Producing nitric oxide-mediated vasodilation
3 multiple choice options
- Bradycardia
- Hypotension
- Fatigue
- Dizziness
Which adverse effects should the nurse monitor for in a patient taking propranolol? (Select all that apply.)
Which medication is correctly paired with its drug class?
Enoxaparin — Low-molecular-weight heparin
3 multiple choice options
- Reduced heart rate
- Vasodilation
- Reduced oxygen demand
- Lower blood pressure
The nurse understands that calcium channel blockers produce which therapeutic effects? (Select all that apply.)
Which medication would the nurse expect to cause a persistent dry cough?
Enalapril
3 multiple choice options
- Enalapril
- Metoprolol
- Digoxin
- Valsartan/sacubitril
- Hydralazine/isosorbide dinitrate
The nurse is reviewing medication orders for a patient with heart failure. Which medications support cardiac function by reducing the workload of the heart or improving cardiac output? (Select all that apply.)
What drug class is valsartan?
ARB (angiotensin II receptor blocker)
What are the major adverse effects of valsartan?
dizziness, headache, fatigue, diarrhea, and hyperkalemia
a nurse is monitoring a patient on valsartan for adverse effects, which lab value is most concering?
elevated potassium (hyperkalemia)
Why does valsartan not cause a cough like ACE inhibitors do?
It blocks angiotensin II receptors directly rather than inhibiting ACE, so bradykinin levels don't rise
Which drug is the selective aldosterone receptor antagonist (SARA)?
Eplerenone (Inspra)
Why is spironolactone considered non-selective compared to eplerenone?
It also interacts with other hormone receptors (androgen and progesterone), causing extra side effects like gynecomastia
What are the major adverse effects of eplerenone?
Dizziness, insomnia, headache, cough, nausea/vomiting
A patient asks why their provider chose eplerenone instead of spironolactone. What's the best explanation?
Eplerenone selectively blocks aldosterone receptors only, lowering the risk of hormone-related side effects that spironolactone can cause
What is the major adverse effect to monitor for with any aldosterone blocker (spironolactone or eplerenone)?
Hyperkalemia
Which two drugs are classified as combination alpha-1/beta blockers?
Carvedilol and labetalol
How do combination alpha/beta blockers lower blood pressure?
By blocking alpha-1 receptors (vasodilation) and beta receptors (decreased heart rate and contractility) at the same time
A nurse is reviewing a medication list and needs to identify a combined alpha- and beta-blocker. Which drug fits?
Carvedilol (or labetalol)
What are sodium's primary functions in the body?
Fluid balance and nerve function
What are potassium's primary functions in the body?
Heart rhythm and muscle contraction
What are calcium's primary functions in the body?
Bone health and blood clotting
A patient on furosemide has a sodium level of 128 and potassium of 2.9. Which electrolyte imbalance affects nerve function, and which affects heart rhythm?
Sodium (hyponatremia) affects nerve function; potassium (hypokalemia) affects heart rhythm
What is the mechanism of action of statins?
Inhibit cholesterol (LDL) production in the liver
Name two examples of statins.
Atorvastatin (Lipitor) and rosuvastatin (Crestor) (also acceptable: fluvastatin, lovastatin, pravastatin)
What are the major adverse effects of statins?
Muscle pain, liver damage, digestive issues
A patient on atorvastatin asks if they can drink grapefruit juice. What should the nurse explain?
Grapefruit can interfere with how the body processes certain statins (atorvastatin, simvastatin, lovastatin), so it should be avoided or limited
What is the mechanism of action of bile acid sequestrants?
Bind to bile acids in the intestine, indirectly lowering cholesterol levels
Name an example of a bile acid sequestrant and its major adverse effects.
Cholestyramine (Questran); GI issues such as constipation, bloating, and gas
What is the mechanism of action of fibrates, and what do they primarily treat?
They primarily lower triglycerides and modestly raise HDL; used for mixed dyslipidemia
Name an example of a fibrate and its major adverse effects.
Gemfibrozil (Lopid); liver and muscle problems, GI issues, skin reactions
What electrolyte imbalance increases the risk of digoxin toxicity?
Hypokalemia (low potassium increases digoxin's effect and toxicity risk)