RN NCLEX EXAM CARDIOVASCULAR DRUGS EXAM 2024/2025
QUESTIONS WITH ANSWERS
,RN NCLEX EXAM CARDIOVASCULAR DRUGS EXAM 2024/2025
QUESTIONS WITH ANSWERS
1. Following A. Electrolyte status. No repinephrine (Levophed) administration, it is essential
to the nurse to assess:
A. Electrolyte status.
B. Color and temperature of toes and fingers.
C. Capillary refill.
D. Ventricular arrhythmias.
Correct Answer: B. Color and temperature of toes and fingers.
Because decreased perfusion is a side effect of norepinephrine (Levophed), the nurse must check
circulation frequently. Vasoconstriction secondary to alpha1 stimulation can result in reflex bradycardia
via the baroreceptor reflex, which is generally not compensated for by the beta1 activity. The overall
result is that cardiac output may decrease, or at most stay the same, despite beta1 agonism. Electrolytes
and ventricular arrhytmias are not specific for norepinephrine.
Option A: Blood pressure requires close monitoring whenever vasopressors such as
norepinephrine are in use; this is possible via invasive or non-invasive measurement techniques.
If following non-invasive measurements, then it is recommended to obtain values every 2 to 3
minutes during initial titration and then at least every 5 minutes following the determination of
the appropriate maintenance dose.
Option C: Capillary refill is not a reliable indication of perfusion in a shocking state.
Option D: At the same time, the increase in systemic vascular resistance increases the work of
the heart by increasing afterload, thereby increasing myocardial oxygen demand. Because of
these phenomena, the benefits of norepinephrine for cardiogenic shock are still unclear but
merit consideration under certain conditions.
2. ACEs participate in the renin-angiotensin-aldosterone system to have which of the
following physiologic effects?
A. Inhibit conversion of angiotensin II to angiotensin I.
B. Vasoconstriction and sodium depletion.
C. Promote sodium and water retention.
D. Stimulate vasodilation and inhibit sodium depletion.
Answer: C. Promote sodium and water retention.
,Angiotensin is a potent vasoconstrictor that stimulates the release of aldosterone. Aldosterone release
promotes sodium and water retention. The renin–angiotensin–aldosterone system (RAAS) is a critical
regulator of blood volume and systemic vascular resistance. While the baroreceptor reflex responds in
a short-term manner to decreased arterial pressure, the RAAS is responsible for more chronic
alterations. It is composed of three major compounds: renin, angiotensin II, and aldosterone.
Option A: The conversion of angiotensin I to II is not inhibited. The conversion of angiotensin I
to angiotensin II is catalyzed by an enzyme called angiotensin-converting enzyme (ACE). ACE
is found primarily in the vascular endothelium of the lungs and kidneys. After angiotensin I is
converted to angiotensin II, it has effects on the kidney, adrenal cortex, arterioles, and brain
by binding to angiotensin II type I (AT) and type II (AT) receptors.
Option B: Aldosterone promotes sodium retention, not depletion. Aldosterone is a steroid
hormone that causes an increase in sodium reabsorption and potassium excretion at the distal
tubule and collecting duct of the nephron. Aldosterone works by stimulating the insertion of
luminal Na channels and basolateral Na-K ATPase proteins. The net effect is an increased level of
sodium reabsorption.
Option D: The effect of angiotensin II on vasoconstriction takes place in systemic arterioles.
Here, angiotensin II binds to G protein-coupled receptors, leading to a secondary messenger
cascade that results in potent arteriolar vasoconstriction. This acts to increase total peripheral
resistance, causing an increase in blood pressure.
3. Which of the following vitamins may not be absorbed properly when giving bile
acid sequestrants?
A. Vitamin B
B. Vitamin C
C. Vitamin B12
D. Vitamin
K Answer: D. Vitamin K
Vitamin K absorption may be reduced when giving these drugs. The only fat-soluble vitamin here is
vitamin K, which is synthesized in the liver. Bile acid sequestrants may prevent absorption of folic acid
and the fat-soluble vitamins A, D, E, and K. Other medications and vitamin supplements should be taken
one hour before or four to six hours after bile acid sequestrants for optimal absorption.
Option A: B vitamins play a vital role in maintaining good health and well-being. As the building
blocks of a healthy body, B vitamins have a direct impact on your energy levels, brain function,
and cell metabolism. Vitamin B complex helps prevent infections and helps support or promote
cell health.
Option B: Vitamin C is a water-soluble vitamin, antioxidant, and essential cofactor for collagen
biosynthesis, carnitine and catecholamine metabolism, and dietary iron absorption. Humans are
unable to synthesize vitamin C, so they can only obtain it through dietary intake of fruits and
, vegetables. Citrus fruits, berries, tomatoes, potatoes, and green leafy vegetables are excellent
sources of vitamin C.
Option C: Vitamin B12 (Cobalamin) is a water-soluble vitamin that is derived from animal
products such as red meat, dairy, and eggs. Intrinsic factor is a glycoprotein that is produced by
parietal cells in the stomach and necessary for the absorption of B12 in the terminal ileum.
Once absorbed, B12 is used as a cofactor for enzymes that are involved in the synthesis of DNA,
fatty acids, and myelin.
4. A nurse is monitoring a client who is taking carvedilol (Coreg CR). Which of the
following assessment made by the nurse would warrant a possible complication
with the use of this medication?
A. Baseline blood pressure of 160/100 mm hg followed by a blood pressure of 120/70
mm hg after 3 doses.
B. Baseline heart rate of 97 bpm followed by a heart rate of 62 bpm after 3 doses.
C. Complaints of nightmares and insomnia.
D. Complaints of
dyspnea. Answer: D. Complaints of
dyspnea.
A complaint of dyspnea is a sign of bronchospasm which is one of the serious complications of beta-
blockers.
Options A & B: The following show a decrease in blood pressure and heart rate which are
expected in this therapy.
Option C: Complaints of nightmares and insomnia is a side effect of this medication.
5. Epinephrine is used to treat cardiac arrest and status asthmaticus because of which of
the following actions?
A. Increased speed of conduction and gluconeogenesis.
B. Bronchodilation and increased heart rate, contractility, and conduction.
C. Increased vasodilation and enhanced myocardial contractility.
D. Bronchoconstriction and increased heart rate.
Answer: B. Bronchodilation and increased heart rate, contractility, and conduction.
Bronchodilation results from stimulated beta receptors, and cardiac effects result from the stimulation of
ß1 receptors. Epinephrine is a sympathomimetic catecholamine that exerts its pharmacologic effects on
both alpha and beta-adrenergic receptors using a G protein-linked second messenger system. It has a
greater affinity for beta receptors in small doses.
