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NCLEX-RN · 8 Essential Terms
High-yield NCLEX cardiovascular medications: ACE inhibitors, ARBs, beta blockers, loop diuretics, digoxin, nitroglycerin, warfarin, and heparin. These are licensure cues, not orders.
These are licensure study notes, not orders for patient care. Follow your program, your facility policy, and the current test plan.
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An ACE inhibitor used for hypertension and heart failure. It blocks the enzyme that converts angiotensin I to angiotensin II, which lowers blood pressure and reduces aldosterone effects.
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An ACE inhibitor used for hypertension and heart failure. It blocks the enzyme that converts angiotensin I to angiotensin II, which lowers blood pressure and reduces aldosterone effects.
Mnemonic. PRIL lowers Pressure. Remember the dry ACE cough and the pregnancy stop sign.
Exam trap. ACE inhibitors are contraindicated in pregnancy. The exam cluster is a dry cough, hyperkalemia, and angioedema. Angioedema is the one that stops the drug and gets emergency help.
An angiotensin II receptor blocker, or ARB, used for hypertension and heart failure. It blocks the receptor instead of the converting enzyme, so the classic dry ACE cough is less expected.
Mnemonic. SARTAN blocks the receptor. The cough is less typical; potassium and pregnancy still matter.
Exam trap. Students treat ARBs as consequence-free ACE inhibitors. They still raise potassium and are still avoided in pregnancy. The difference the exam wants is the cough, not a free pass on potassium.
A cardioselective beta blocker that reduces heart rate, blood pressure, and the heart's workload. It is used for hypertension, angina, heart failure, and rate control.
Mnemonic. LOL means lower the rate. Feel the pulse before you give it.
Exam trap. Hold and clarify when the apical pulse is below the parameter, classically under 60. Beta blockers can mask the tachycardia of hypoglycemia, so a diabetic client needs a different warning sign.
A loop diuretic that blocks sodium and water reabsorption in the loop of Henle. It relieves fluid overload and wastes potassium.
Mnemonic. Loops lose potassium and, pushed too fast, threaten hearing.
Exam trap. The IV-push exam harm is ototoxicity, including tinnitus, when the drug is pushed too fast. The lab story is low potassium, not high potassium. Daily weight is the volume trend.
A cardiac glycoside that strengthens contraction and slows the heart rate. Many references still quote a narrow serum window around 0.5 to 2.0 ng/mL.
Mnemonic. Digoxin digs a stronger squeeze and a slower beat. Low potassium makes toxicity easier.
Exam trap. Hypokalemia invites toxicity. The cluster is nausea, bradycardia, and visual changes such as yellow or green halos. It is not a blood-pressure drug, and an apical pulse under the hold parameter means you do not give it.
A nitrate vasodilator used for angina. The classic sublingual teaching is to sit, take one tablet, and repeat on a short interval up to three doses while emergency help is called if pain persists.
Mnemonic. Nitro drops the pressure and the preload. Sit down before the tablet, and never mix it with a PDE-5 inhibitor.
Exam trap. A headache and a drop in blood pressure are expected, not proof the tablet is fake. The dangerous combination is a PDE-5 inhibitor such as sildenafil. The client should be sitting, because syncope is part of the story.
An oral anticoagulant that interferes with vitamin K-dependent clotting factors. Therapy is followed with the INR. The classic reversal story is vitamin K.
Mnemonic. Warfarin is the INR drug. Vitamin K is the antidote story, and the diet stays consistent rather than banned.
Exam trap. The trap is telling the client to avoid every green vegetable forever. The exam wants a consistent vitamin K intake so the INR stays interpretable. Bleeding precautions are required, and the drug is not a same-day anticoagulant.
A fast anticoagulant that increases antithrombin's effect. Continuous IV therapy is monitored with aPTT. The classic reversal agent is protamine sulfate.
Mnemonic. Heparin is the aPTT drug with the protamine story. It works now; warfarin works later.
Exam trap. Bleeding is the obvious risk. Heparin-induced thrombocytopenia is the trap that turns a platelet drop into a clotting emergency, not a reason to push more heparin. Do not massage a subcutaneous dose.