D027 Advanced Pathopharmacological
Foundations verified questions and answers
2026\2027 A+ Grade
A 23-year-old woman comes in for prenatal counseling. While completing her family history, she reports
her brother has cystic fibrosis. She does not know if she is a carrier. She asks if her children will be
affected by the disease.
What is an accurate way to determine the likelihood of this patient's children being affected?
A sweat test
A genetic or a carrier test
A history and a physical
A fertility test
- correct answer A genetic or carrier test
The disease occurs when an individual inherits the mutated gene from each parent. When only one
mutated gene is inherited, the individual is labeled a carrier.
chance of the disease.
A 31-year-old man comes into the office for an exam. He is 6' 5 " with a high-pitched voice, and he has a
moderate degree of mental impairment. It is discovered upon exam that his body hair is sparse, his
testes are small, and he has gynecomastia.
Which genetic disorder should this patient be tested for?
Klinefelter syndrome
Turner syndrome
Partial trisomy
,Sex chromosome aneuploidy
- correct answer Klinefelter syndrome: a hereditary disease also known as 47,XXY or XXY that manifests
as the series of symptoms described.
A six-month-old female infant with failure to thrive comes in to the office with her parents. It is noticed
upon exam that the patient has facial deformities and is jaundiced. A complete blood count (CBC) is
ordered, which reveals anemia. When that patient's blood is examined under a microscope, the red
blood cells appear small and abnormally shaped. A mutational analysis is ordered, and alpha thalassemia
is diagnosed.
What is the likelihood of incidence of these parent's future children having alpha thalassemia?
25%
100%
0%
50%
- correct answer 25% or 1/4 chance
A 64-year-old male truck driver comes in complaining of pain in his lower left calf. He states he drives
eight to ten hours per day. Upon exam, swelling and mottled coloring are noted in the patient's calf. A
D-dimer test is ordered and comes back positive.
Which additional test should be ordered to confirm a diagnosis in this patient?
A CT scan
A Doppler Ultrasound
The D-dimer test again
A clotting factors test
- correct answer A Doppler Ultrasound is the initial test of choice for patients who are not initially
stratified according to clinical pretest probability (PTP) as being low, moderate, or high risk for DVT.
A 54-year-old man comes into a clinic for a routine visit. His initial BP is 148/92. After a recheck 15
minutes later, his BP is 140/90. He states he suffers from "white coat hypertension." He states he has no
history of high blood pressure and no family history of high blood pressure.
Which nursing intervention would assist this patient in receiving a clinical diagnosis of hypertension?
,Ordering the patient a cholesterol level test
Checking the patient's blood pressure in three months
Completing a biochemical blood profile
Completing an ambulatory blood pressure assessment
- correct answer Completing an ambulatory BP assessment.
Assessing blood pressure in a location of comfort like the home environment when no professional is
present will enable the ability to determine his blood pressure under routine circumstances.
A 58-year-old woman comes in complaining of retrosternal chest pain, worsening with recumbent
position. She states she has had a low-grade fever for two days. Upon exam, the patient has a friction
rub. An EKG reveals sinus tachycardia with inflammatory changes. An ultrasound is performed, and she
is diagnosed with an acute pericarditis.
Which condition would make pericarditis more likely in this patient?
Stroke
Hypertension
Lupus
Asthma
- correct answer Lupus
Lupus is an autoimmune disorder that is often responsible for causing an inflammatory response in the
pericardial sac. Autoimmune disorders are known to cause chronic pericarditis.
A 54-year-old Caucasian man comes in for a lab review. His lipids reveal an LDL of 180, an HDL of 52, and
triglycerides of 326. He has no history of atherosclerotic cardiovascular disease (ASCVD) or diabetes. His
blood pressure is 118/64. He has a pulse rate of 64, and he weighs 320 lb. He smokes one pack of
cigarettes per day, and his ASCVD risk score is 12.8.
Which medication should this patient be started on?
Fenofibrate (Tricor) 145mg
Ezetimibe (Zetia) 10mg
Atorvastatin (Lipitor) 20mg
, Ibuprofen (Motrin) 200mg
- correct answer Atorvastatin (Lipitor) 20mg
Atorvastatin is more effective in reducing total cholesterol having a greater impact on lowering LDL
cholesterol. The American College of Cardiology guidelines on blood cholesterol management
emphasize that the greater the reduction in the LDL-C on statin therapy, the greater the subsequent risk
reduction.
A 73-year-old man with Systolic congestive heart failure (CHF) with reduced ejection fraction (HFrEF)
comes to a clinic complaining of shortness of breath. He is currently taking 6.25 mg carvedilol (Coreg)
twice a day and 50 mg losartan (Cozaar) and 20 mg furosemide (Lasix) daily. His oxygen saturation is
95%, and he has a pulse of 64. His BP is 138/82, and his BNP is 1150.
Using the 2017 heart failure guidelines, which medication change should be recommended for this
patient?
Add amlodipine (Norvasc)
Stop ARB and add lisinopril (Zestril)
Stop angiotensin receptor blockers (ARB) and add sacubitril/valsartan (Entresto)
Add nifedipine (Procardia)
- correct answer Stop angiotensin receptor blockers (ARB) and add sacubitril/valsartan (Entresto)
The elevated BNP indicates significant heart failure. Guidelines recommend replacing an ARB or ACE
inhibitor with an ARNI such as Entresto, especially in those with HFrEF.
A 78-year-old man comes in with stable angina. He reports he has been having more angina recently. He
is currently taking the following medications: lisinopril (Zestril), atorvastatin (Lipitor), aspirin, and
Nitrostat PRN for chest pain. He has a history of COPD with bronchospasm. His blood pressure is 145/88,
and he has a pulse of 74.
Which class of medications should be avoided for this patient?
Diuretics
Beta blockers
Long-acting nitrates
Calcium channel blockers
- correct answer Beta Blockers
Foundations verified questions and answers
2026\2027 A+ Grade
A 23-year-old woman comes in for prenatal counseling. While completing her family history, she reports
her brother has cystic fibrosis. She does not know if she is a carrier. She asks if her children will be
affected by the disease.
What is an accurate way to determine the likelihood of this patient's children being affected?
A sweat test
A genetic or a carrier test
A history and a physical
A fertility test
- correct answer A genetic or carrier test
The disease occurs when an individual inherits the mutated gene from each parent. When only one
mutated gene is inherited, the individual is labeled a carrier.
chance of the disease.
A 31-year-old man comes into the office for an exam. He is 6' 5 " with a high-pitched voice, and he has a
moderate degree of mental impairment. It is discovered upon exam that his body hair is sparse, his
testes are small, and he has gynecomastia.
Which genetic disorder should this patient be tested for?
Klinefelter syndrome
Turner syndrome
Partial trisomy
,Sex chromosome aneuploidy
- correct answer Klinefelter syndrome: a hereditary disease also known as 47,XXY or XXY that manifests
as the series of symptoms described.
A six-month-old female infant with failure to thrive comes in to the office with her parents. It is noticed
upon exam that the patient has facial deformities and is jaundiced. A complete blood count (CBC) is
ordered, which reveals anemia. When that patient's blood is examined under a microscope, the red
blood cells appear small and abnormally shaped. A mutational analysis is ordered, and alpha thalassemia
is diagnosed.
What is the likelihood of incidence of these parent's future children having alpha thalassemia?
25%
100%
0%
50%
- correct answer 25% or 1/4 chance
A 64-year-old male truck driver comes in complaining of pain in his lower left calf. He states he drives
eight to ten hours per day. Upon exam, swelling and mottled coloring are noted in the patient's calf. A
D-dimer test is ordered and comes back positive.
Which additional test should be ordered to confirm a diagnosis in this patient?
A CT scan
A Doppler Ultrasound
The D-dimer test again
A clotting factors test
- correct answer A Doppler Ultrasound is the initial test of choice for patients who are not initially
stratified according to clinical pretest probability (PTP) as being low, moderate, or high risk for DVT.
A 54-year-old man comes into a clinic for a routine visit. His initial BP is 148/92. After a recheck 15
minutes later, his BP is 140/90. He states he suffers from "white coat hypertension." He states he has no
history of high blood pressure and no family history of high blood pressure.
Which nursing intervention would assist this patient in receiving a clinical diagnosis of hypertension?
,Ordering the patient a cholesterol level test
Checking the patient's blood pressure in three months
Completing a biochemical blood profile
Completing an ambulatory blood pressure assessment
- correct answer Completing an ambulatory BP assessment.
Assessing blood pressure in a location of comfort like the home environment when no professional is
present will enable the ability to determine his blood pressure under routine circumstances.
A 58-year-old woman comes in complaining of retrosternal chest pain, worsening with recumbent
position. She states she has had a low-grade fever for two days. Upon exam, the patient has a friction
rub. An EKG reveals sinus tachycardia with inflammatory changes. An ultrasound is performed, and she
is diagnosed with an acute pericarditis.
Which condition would make pericarditis more likely in this patient?
Stroke
Hypertension
Lupus
Asthma
- correct answer Lupus
Lupus is an autoimmune disorder that is often responsible for causing an inflammatory response in the
pericardial sac. Autoimmune disorders are known to cause chronic pericarditis.
A 54-year-old Caucasian man comes in for a lab review. His lipids reveal an LDL of 180, an HDL of 52, and
triglycerides of 326. He has no history of atherosclerotic cardiovascular disease (ASCVD) or diabetes. His
blood pressure is 118/64. He has a pulse rate of 64, and he weighs 320 lb. He smokes one pack of
cigarettes per day, and his ASCVD risk score is 12.8.
Which medication should this patient be started on?
Fenofibrate (Tricor) 145mg
Ezetimibe (Zetia) 10mg
Atorvastatin (Lipitor) 20mg
, Ibuprofen (Motrin) 200mg
- correct answer Atorvastatin (Lipitor) 20mg
Atorvastatin is more effective in reducing total cholesterol having a greater impact on lowering LDL
cholesterol. The American College of Cardiology guidelines on blood cholesterol management
emphasize that the greater the reduction in the LDL-C on statin therapy, the greater the subsequent risk
reduction.
A 73-year-old man with Systolic congestive heart failure (CHF) with reduced ejection fraction (HFrEF)
comes to a clinic complaining of shortness of breath. He is currently taking 6.25 mg carvedilol (Coreg)
twice a day and 50 mg losartan (Cozaar) and 20 mg furosemide (Lasix) daily. His oxygen saturation is
95%, and he has a pulse of 64. His BP is 138/82, and his BNP is 1150.
Using the 2017 heart failure guidelines, which medication change should be recommended for this
patient?
Add amlodipine (Norvasc)
Stop ARB and add lisinopril (Zestril)
Stop angiotensin receptor blockers (ARB) and add sacubitril/valsartan (Entresto)
Add nifedipine (Procardia)
- correct answer Stop angiotensin receptor blockers (ARB) and add sacubitril/valsartan (Entresto)
The elevated BNP indicates significant heart failure. Guidelines recommend replacing an ARB or ACE
inhibitor with an ARNI such as Entresto, especially in those with HFrEF.
A 78-year-old man comes in with stable angina. He reports he has been having more angina recently. He
is currently taking the following medications: lisinopril (Zestril), atorvastatin (Lipitor), aspirin, and
Nitrostat PRN for chest pain. He has a history of COPD with bronchospasm. His blood pressure is 145/88,
and he has a pulse of 74.
Which class of medications should be avoided for this patient?
Diuretics
Beta blockers
Long-acting nitrates
Calcium channel blockers
- correct answer Beta Blockers
