NR566 Exam Questions with 100% Correct
Answers and Detailed Explanations Latest
Version
Question 1
A 58-year-old patient with hypertension and type 2 diabetes has
persistent albuminuria. Which medication is the best initial choice to
reduce blood pressure while also protecting kidney function?
A. Amlodipine
B. Hydrochlorothiazide
C. Lisinopril
D. Metoprolol
Answer: C. Lisinopril
Rationale:
ACE inhibitors, such as lisinopril, are recommended for patients with
diabetes and albuminuria because they lower blood pressure and help
slow the progression of diabetic kidney disease. Amlodipine lowers
blood pressure but does not provide the same renal protection.
Hydrochlorothiazide is effective for hypertension but is not first-line for
diabetic nephropathy. Metoprolol is useful in certain cardiovascular
conditions but is not the preferred initial agent for renal protection.
Question 2
,A patient taking warfarin begins therapy with trimethoprim-
sulfamethoxazole for a urinary tract infection. What is the most
appropriate action?
A. Increase the warfarin dose
B. Discontinue warfarin permanently
C. Monitor the INR closely because the antibiotic may increase the
anticoagulant effect
D. No change is needed
Answer: C. Monitor the INR closely because the antibiotic may increase
the anticoagulant effect.
Rationale:
Trimethoprim-sulfamethoxazole inhibits warfarin metabolism and can
significantly increase the INR, raising the risk of bleeding. Close
monitoring and possible dose adjustment are appropriate.
Question 3
Which adverse effect is most commonly associated with ACE
inhibitors?
A. Bradycardia
B. Dry cough
C. Weight gain
D. Hypoglycemia
Answer: B. Dry cough
,Rationale:
ACE inhibitors increase bradykinin levels, which can cause a persistent
dry cough. Other important adverse effects include hyperkalemia,
angioedema, and increases in serum creatinine in some patients.
Question 4
A patient with asthma reports using an albuterol inhaler six times each
day. What is the best next step?
A. Continue the current regimen
B. Increase albuterol use
C. Assess asthma control and initiate or adjust inhaled corticosteroid
therapy
D. Stop all inhalers
Answer: C. Assess asthma control and initiate or adjust inhaled
corticosteroid therapy.
Rationale:
Frequent use of a short-acting beta₂-agonist indicates poor asthma
control. Current asthma management emphasizes controller therapy,
typically with an inhaled corticosteroid, rather than increasing rescue
medication alone.
Question 5
Metformin is contraindicated in which situation?
A. Well-controlled hypertension
, B. Severe renal impairment
C. Seasonal allergies
D. Hyperlipidemia
Answer: B. Severe renal impairment
Rationale:
Metformin is generally avoided in patients with significantly reduced
kidney function because impaired clearance increases the risk of lactic
acidosis.
Question 6
A patient taking levothyroxine should be instructed to:
A. Take it with calcium supplements
B. Take it on an empty stomach 30–60 minutes before breakfast
C. Take it only at bedtime with food
D. Skip doses if feeling well
Answer: B. Take it on an empty stomach 30–60 minutes before
breakfast.
Rationale:
Food, calcium, iron, and certain other medications reduce levothyroxine
absorption. Consistent administration on an empty stomach helps
maintain stable thyroid hormone levels.
Question 7
Answers and Detailed Explanations Latest
Version
Question 1
A 58-year-old patient with hypertension and type 2 diabetes has
persistent albuminuria. Which medication is the best initial choice to
reduce blood pressure while also protecting kidney function?
A. Amlodipine
B. Hydrochlorothiazide
C. Lisinopril
D. Metoprolol
Answer: C. Lisinopril
Rationale:
ACE inhibitors, such as lisinopril, are recommended for patients with
diabetes and albuminuria because they lower blood pressure and help
slow the progression of diabetic kidney disease. Amlodipine lowers
blood pressure but does not provide the same renal protection.
Hydrochlorothiazide is effective for hypertension but is not first-line for
diabetic nephropathy. Metoprolol is useful in certain cardiovascular
conditions but is not the preferred initial agent for renal protection.
Question 2
,A patient taking warfarin begins therapy with trimethoprim-
sulfamethoxazole for a urinary tract infection. What is the most
appropriate action?
A. Increase the warfarin dose
B. Discontinue warfarin permanently
C. Monitor the INR closely because the antibiotic may increase the
anticoagulant effect
D. No change is needed
Answer: C. Monitor the INR closely because the antibiotic may increase
the anticoagulant effect.
Rationale:
Trimethoprim-sulfamethoxazole inhibits warfarin metabolism and can
significantly increase the INR, raising the risk of bleeding. Close
monitoring and possible dose adjustment are appropriate.
Question 3
Which adverse effect is most commonly associated with ACE
inhibitors?
A. Bradycardia
B. Dry cough
C. Weight gain
D. Hypoglycemia
Answer: B. Dry cough
,Rationale:
ACE inhibitors increase bradykinin levels, which can cause a persistent
dry cough. Other important adverse effects include hyperkalemia,
angioedema, and increases in serum creatinine in some patients.
Question 4
A patient with asthma reports using an albuterol inhaler six times each
day. What is the best next step?
A. Continue the current regimen
B. Increase albuterol use
C. Assess asthma control and initiate or adjust inhaled corticosteroid
therapy
D. Stop all inhalers
Answer: C. Assess asthma control and initiate or adjust inhaled
corticosteroid therapy.
Rationale:
Frequent use of a short-acting beta₂-agonist indicates poor asthma
control. Current asthma management emphasizes controller therapy,
typically with an inhaled corticosteroid, rather than increasing rescue
medication alone.
Question 5
Metformin is contraindicated in which situation?
A. Well-controlled hypertension
, B. Severe renal impairment
C. Seasonal allergies
D. Hyperlipidemia
Answer: B. Severe renal impairment
Rationale:
Metformin is generally avoided in patients with significantly reduced
kidney function because impaired clearance increases the risk of lactic
acidosis.
Question 6
A patient taking levothyroxine should be instructed to:
A. Take it with calcium supplements
B. Take it on an empty stomach 30–60 minutes before breakfast
C. Take it only at bedtime with food
D. Skip doses if feeling well
Answer: B. Take it on an empty stomach 30–60 minutes before
breakfast.
Rationale:
Food, calcium, iron, and certain other medications reduce levothyroxine
absorption. Consistent administration on an empty stomach helps
maintain stable thyroid hormone levels.
Question 7
