NR565 Final Exam Question Bank (Latest
2026/2027) Advanced Pharmacology
Fundamentals – Chamberlain University Verified
Questions with Correct Answers & Rationales |
100% Correct | Pass Guaranteed
Q1 A 62-year-old male with hypertension and type 2 diabetes is prescribed lisinopril. Which of
the following laboratory values should the nurse practitioner monitor most closely after
initiation?
Answer: Serum potassium and serum creatinine
Rationale: ACE inhibitors (lisinopril) can cause hyperkalemia (due to reduced aldosterone) and
acute kidney injury (especially in patients with diabetes or renal artery stenosis). Potassium and
creatinine should be checked within 1–2 weeks of starting therapy.
Q2 A 45-year-old female with newly diagnosed hypertension is started on hydrochlorothiazide.
Which electrolyte abnormality is most likely to occur?
Answer: Hypokalemia
Rationale: Thiazide diuretics inhibit sodium reabsorption in the distal convoluted tubule, leading
to increased potassium excretion and hypokalemia (most common electrolyte disturbance).
Q3 A patient with heart failure with reduced ejection fraction (HFrEF) is already on carvedilol,
sacubitril/valsartan, and spironolactone. Which additional medication has the strongest evidence
for reducing hospitalization and mortality?
Answer: Dapagliflozin or empagliflozin (SGLT2 inhibitor)
Rationale: SGLT2 inhibitors (dapagliflozin – DAPA-HF, empagliflozin – EMPEROR-Reduced)
have Class I recommendation in HFrEF, independent of diabetes status, for reducing HF
hospitalization and CV death.
Q4 A 58-year-old male with type 2 diabetes and established ASCVD has an A1C of 8.4% on
metformin. Which agent class has the strongest evidence for reducing major adverse
cardiovascular events (MACE)?
Answer: GLP-1 receptor agonist with proven CV benefit (e.g., semaglutide, dulaglutide)
, Rationale: ADA 2025 guidelines give A-level recommendation to GLP-1 RA or SGLT2i with
demonstrated CV benefit in T2DM + ASCVD/high-risk patients.
Q5 A 52-year-old female with T2DM, eGFR 42 mL/min/1.73 m², and persistent albuminuria
despite maximal ACE inhibitor. Which medication has the strongest evidence for slowing CKD
progression?
Answer: Finerenone
Rationale: FIDELIO-DKD and FIGARO-DKD trials demonstrated finerenone significantly
reduces CKD progression and CV events in diabetic kidney disease.
Q6 A 34-year-old female with Graves disease is started on methimazole. Which serious adverse
effect requires monitoring of the CBC?
Answer: Agranulocytosis
Rationale: Methimazole (and PTU) carry a rare but potentially fatal risk of agranulocytosis;
CBC monitoring is recommended, especially in the first 3 months.
Q7 A 55-year-old male presents with fatigue, erectile dysfunction, and decreased libido.
Morning total testosterone is 220 ng/dL. What is the next step?
Answer: Repeat morning total testosterone and obtain LH and FSH
Rationale: Confirm hypogonadism with repeat morning level and assess the hypothalamic–
pituitary–gonadal axis to differentiate primary vs secondary hypogonadism.
Q8 A 35-year-old female with heavy menstrual bleeding, fatigue, and pica for ice has
hemoglobin 8.0 g/dL, MCV 65 fL, ferritin 4 ng/mL. Diagnosis?
Answer: Iron deficiency anemia
Rationale: Microcytic anemia with very low ferritin is diagnostic of iron deficiency; heavy
menses are the most common cause in premenopausal women.
Q9 A 68-year-old male with BPH has nocturia, weak stream, and post-void dribbling. First-line
pharmacologic therapy?
Answer: Tamsulosin (alpha-1 blocker)
Rationale: Alpha-1 blockers are first-line for moderate-to-severe lower urinary tract symptoms
(LUTS) due to BPH.
Q10 A 71-year-old male with BPH is started on finasteride. Which lab should be monitored
long-term?
2026/2027) Advanced Pharmacology
Fundamentals – Chamberlain University Verified
Questions with Correct Answers & Rationales |
100% Correct | Pass Guaranteed
Q1 A 62-year-old male with hypertension and type 2 diabetes is prescribed lisinopril. Which of
the following laboratory values should the nurse practitioner monitor most closely after
initiation?
Answer: Serum potassium and serum creatinine
Rationale: ACE inhibitors (lisinopril) can cause hyperkalemia (due to reduced aldosterone) and
acute kidney injury (especially in patients with diabetes or renal artery stenosis). Potassium and
creatinine should be checked within 1–2 weeks of starting therapy.
Q2 A 45-year-old female with newly diagnosed hypertension is started on hydrochlorothiazide.
Which electrolyte abnormality is most likely to occur?
Answer: Hypokalemia
Rationale: Thiazide diuretics inhibit sodium reabsorption in the distal convoluted tubule, leading
to increased potassium excretion and hypokalemia (most common electrolyte disturbance).
Q3 A patient with heart failure with reduced ejection fraction (HFrEF) is already on carvedilol,
sacubitril/valsartan, and spironolactone. Which additional medication has the strongest evidence
for reducing hospitalization and mortality?
Answer: Dapagliflozin or empagliflozin (SGLT2 inhibitor)
Rationale: SGLT2 inhibitors (dapagliflozin – DAPA-HF, empagliflozin – EMPEROR-Reduced)
have Class I recommendation in HFrEF, independent of diabetes status, for reducing HF
hospitalization and CV death.
Q4 A 58-year-old male with type 2 diabetes and established ASCVD has an A1C of 8.4% on
metformin. Which agent class has the strongest evidence for reducing major adverse
cardiovascular events (MACE)?
Answer: GLP-1 receptor agonist with proven CV benefit (e.g., semaglutide, dulaglutide)
, Rationale: ADA 2025 guidelines give A-level recommendation to GLP-1 RA or SGLT2i with
demonstrated CV benefit in T2DM + ASCVD/high-risk patients.
Q5 A 52-year-old female with T2DM, eGFR 42 mL/min/1.73 m², and persistent albuminuria
despite maximal ACE inhibitor. Which medication has the strongest evidence for slowing CKD
progression?
Answer: Finerenone
Rationale: FIDELIO-DKD and FIGARO-DKD trials demonstrated finerenone significantly
reduces CKD progression and CV events in diabetic kidney disease.
Q6 A 34-year-old female with Graves disease is started on methimazole. Which serious adverse
effect requires monitoring of the CBC?
Answer: Agranulocytosis
Rationale: Methimazole (and PTU) carry a rare but potentially fatal risk of agranulocytosis;
CBC monitoring is recommended, especially in the first 3 months.
Q7 A 55-year-old male presents with fatigue, erectile dysfunction, and decreased libido.
Morning total testosterone is 220 ng/dL. What is the next step?
Answer: Repeat morning total testosterone and obtain LH and FSH
Rationale: Confirm hypogonadism with repeat morning level and assess the hypothalamic–
pituitary–gonadal axis to differentiate primary vs secondary hypogonadism.
Q8 A 35-year-old female with heavy menstrual bleeding, fatigue, and pica for ice has
hemoglobin 8.0 g/dL, MCV 65 fL, ferritin 4 ng/mL. Diagnosis?
Answer: Iron deficiency anemia
Rationale: Microcytic anemia with very low ferritin is diagnostic of iron deficiency; heavy
menses are the most common cause in premenopausal women.
Q9 A 68-year-old male with BPH has nocturia, weak stream, and post-void dribbling. First-line
pharmacologic therapy?
Answer: Tamsulosin (alpha-1 blocker)
Rationale: Alpha-1 blockers are first-line for moderate-to-severe lower urinary tract symptoms
(LUTS) due to BPH.
Q10 A 71-year-old male with BPH is started on finasteride. Which lab should be monitored
long-term?
