WILKES UNIVERSITY NSG 533
ADVANCED PHARMACOLOGY EXAM 3
2026/2027 Academic Year
50 QUESTIONS | VERIFIED QUESTIONS & ANSWERS | 100% CORRECT | GRADED A+
Introduction
This Wilkes NSG 533 Advanced Pharmacology Exam 3 format for 2026/2027 reflects the stan-
dardized competency assessment used to evaluate proficiency in advanced pharmacologic
principles for Nurse Practitioner students at Wilkes University. The exam measures knowl-
edge of cardiovascular, respiratory, endocrine, pain management, antimicrobial, and psychi-
atric pharmacotherapies; pharmacokinetic considerations in special populations; drug inter-
action recognition; and scenario-based clinical decision-making essential for safe, effective,
evidence-based prescribing practice as an Advanced Practice Registered Nurse.
1. An APRN is initiating therapy for a 55-year-old African American male with a BP of
152/94 mmHg and no history of CKD or DM. According to JNC-8 and ACC/AHA guide-
lines, which is the preferred initial agent?
A. Lisinopril
B. Amlodipine
C. Metoprolol Succinate
D. Losartan
Rationale: For the general African American population, including those with diabetes but
without CKD, initial antihypertensive treatment should include a thiazide-type diuretic or a
Calcium Channel Blocker (CCB) like Amlodipine, as these populations often show better BP
response to these agents compared to ACE-I/ARBs.
2. A client with Heart Failure with Reduced Ejection Fraction (HFrEF) is currently taking
Lisinopril. The APRN decides to switch the patient to an ARNI (Sacubitril/Valsartan).
What is the mandatory washout period?
A. 12 hours
B. 24 hours
C. 36 hours
D. 72 hours
Rationale: A 36-hour washout period is required when switching from an ACE inhibitor to
an ARNI to minimize the risk of angioedema due to the combined inhibition of neprilysin and
ACE on bradykinin metabolism.
3. Which laboratory value must be monitored closely within 1-2 weeks of initiating an
ACE Inhibitor or ARB in a patient with chronic hypertension?
A. Serum Calcium
B. Serum Potassium and Creatinine
C. ALT and AST
1
, D. Hemoglobin A1c
Rationale: ACE inhibitors and ARBs can cause hyperkalemia and a transient rise in serum
creatinine due to their effects on the efferent arteriole of the glomerulus.
4. A patient is diagnosed with Type 2 Diabetes and has established Atherosclerotic Car-
diovascular Disease (ASCVD). According to ADA guidelines, which class of medication
should be prioritized after Metformin?
A. Sulfonylureas
B. DPP-4 Inhibitors
C. GLP-1 Receptor Agonists (with proven CVD benefit)
D. Pioglitazone
Rationale: For patients with T2DM and established ASCVD, GLP-1 RAs with proven cardio-
vascular benefit or SGLT2 inhibitors are recommended to reduce the risk of major adverse
cardiovascular events (MACE).
5. A 68-year-old male is prescribed Amiodarone for refractory Atrial Fibrillation. Which
baseline and periodic screening is essential for this medication?
A. Pulmonary Function Tests (PFTs) and Thyroid Function Tests (TFTs)
B. Bone Mineral Density
C. Serum Uric Acid
D. Complete Blood Count (CBC) every month
Rationale: Amiodarone has a high iodine content and can cause thyroid dysfunction (hypo or
hyper). More critically, it can cause potentially fatal pulmonary fibrosis, requiring baseline
and periodic PFTs.
6. An APRN is managing a patient with Asthma who is currently using a SABA as needed
but continues to have symptoms more than twice a week. What is the next step in the
GINA stepwise management?
A. Add a LABA
B. Add a low-dose Inhaled Corticosteroid (ICS)
C. Add a Leukotriene Receptor Antagonist (LTRA)
D. Switch to a LAMA
Rationale: Low-dose ICS is the preferred Step 2 controller therapy to reduce airway inflam-
mation and prevent exacerbations in patients whose asthma is not controlled by SABA alone.
7. Which medication is considered the first-line treatment for a patient with newly di-
agnosed Hypothyroidism?
A. Liothyronine (T3)
B. Levothyroxine (T4)
C. Armour Thyroid
D. Methimazole
2
ADVANCED PHARMACOLOGY EXAM 3
2026/2027 Academic Year
50 QUESTIONS | VERIFIED QUESTIONS & ANSWERS | 100% CORRECT | GRADED A+
Introduction
This Wilkes NSG 533 Advanced Pharmacology Exam 3 format for 2026/2027 reflects the stan-
dardized competency assessment used to evaluate proficiency in advanced pharmacologic
principles for Nurse Practitioner students at Wilkes University. The exam measures knowl-
edge of cardiovascular, respiratory, endocrine, pain management, antimicrobial, and psychi-
atric pharmacotherapies; pharmacokinetic considerations in special populations; drug inter-
action recognition; and scenario-based clinical decision-making essential for safe, effective,
evidence-based prescribing practice as an Advanced Practice Registered Nurse.
1. An APRN is initiating therapy for a 55-year-old African American male with a BP of
152/94 mmHg and no history of CKD or DM. According to JNC-8 and ACC/AHA guide-
lines, which is the preferred initial agent?
A. Lisinopril
B. Amlodipine
C. Metoprolol Succinate
D. Losartan
Rationale: For the general African American population, including those with diabetes but
without CKD, initial antihypertensive treatment should include a thiazide-type diuretic or a
Calcium Channel Blocker (CCB) like Amlodipine, as these populations often show better BP
response to these agents compared to ACE-I/ARBs.
2. A client with Heart Failure with Reduced Ejection Fraction (HFrEF) is currently taking
Lisinopril. The APRN decides to switch the patient to an ARNI (Sacubitril/Valsartan).
What is the mandatory washout period?
A. 12 hours
B. 24 hours
C. 36 hours
D. 72 hours
Rationale: A 36-hour washout period is required when switching from an ACE inhibitor to
an ARNI to minimize the risk of angioedema due to the combined inhibition of neprilysin and
ACE on bradykinin metabolism.
3. Which laboratory value must be monitored closely within 1-2 weeks of initiating an
ACE Inhibitor or ARB in a patient with chronic hypertension?
A. Serum Calcium
B. Serum Potassium and Creatinine
C. ALT and AST
1
, D. Hemoglobin A1c
Rationale: ACE inhibitors and ARBs can cause hyperkalemia and a transient rise in serum
creatinine due to their effects on the efferent arteriole of the glomerulus.
4. A patient is diagnosed with Type 2 Diabetes and has established Atherosclerotic Car-
diovascular Disease (ASCVD). According to ADA guidelines, which class of medication
should be prioritized after Metformin?
A. Sulfonylureas
B. DPP-4 Inhibitors
C. GLP-1 Receptor Agonists (with proven CVD benefit)
D. Pioglitazone
Rationale: For patients with T2DM and established ASCVD, GLP-1 RAs with proven cardio-
vascular benefit or SGLT2 inhibitors are recommended to reduce the risk of major adverse
cardiovascular events (MACE).
5. A 68-year-old male is prescribed Amiodarone for refractory Atrial Fibrillation. Which
baseline and periodic screening is essential for this medication?
A. Pulmonary Function Tests (PFTs) and Thyroid Function Tests (TFTs)
B. Bone Mineral Density
C. Serum Uric Acid
D. Complete Blood Count (CBC) every month
Rationale: Amiodarone has a high iodine content and can cause thyroid dysfunction (hypo or
hyper). More critically, it can cause potentially fatal pulmonary fibrosis, requiring baseline
and periodic PFTs.
6. An APRN is managing a patient with Asthma who is currently using a SABA as needed
but continues to have symptoms more than twice a week. What is the next step in the
GINA stepwise management?
A. Add a LABA
B. Add a low-dose Inhaled Corticosteroid (ICS)
C. Add a Leukotriene Receptor Antagonist (LTRA)
D. Switch to a LAMA
Rationale: Low-dose ICS is the preferred Step 2 controller therapy to reduce airway inflam-
mation and prevent exacerbations in patients whose asthma is not controlled by SABA alone.
7. Which medication is considered the first-line treatment for a patient with newly di-
agnosed Hypothyroidism?
A. Liothyronine (T3)
B. Levothyroxine (T4)
C. Armour Thyroid
D. Methimazole
2
