NR565 Week 8 Final Exam Due 1st March 2026
Complete Actual Exam Questions 1- 100 NR565
Advanced Pharmacology Fundamentals NR 565
Midterm and Finals Examplify Online Proctored
Exam Questions and Answers | 100% Pass
Guaranteed | Graded A+
Section I: Endocrine Pharmacology – Diabetes Management (Questions 1-20)
Question 1: A 58-year-old male with newly diagnosed type 2 diabetes has an A1C
of 7.2%. His creatinine clearance is >60 mL/min. According to the ADA treatment
algorithm, what is the most appropriate initial pharmacotherapy?
A. Initiate basal insulin
B. Begin metformin 500 mg daily, titrating upward
C. Start a GLP-1 receptor agonist
D. Begin combination therapy with metformin and sitagliptin
,,,,answer,,,,,,,,: B. Begin metformin 500 mg daily, titrating upward
*Rationale: The American Diabetes Association (ADA) standards of care
recommend metformin as the first-line pharmacologic agent for type 2 diabetes at
diagnosis, in conjunction with lifestyle modifications. Metformin is effective, safe,
inexpensive, and has a low risk of hypoglycemia. It also does not cause weight
gain .*
,Question 2: A patient on metformin reports significant nausea and diarrhea after
taking her medication. What is the best initial recommendation?
A. Discontinue metformin and switch to a sulfonylurea
B. Take on an empty stomach to improve absorption
C. Take with the largest meal of the day
D. Split the dose to three times daily
,,,,answer,,,,,,,,: C. Take with the largest meal of the day
*Rationale: Gastrointestinal side effects are very common with metformin,
especially upon initiation. These effects are dose-dependent and can be minimized
by taking the medication with food. Starting with a low dose (500 mg) and titrating
slowly also helps. The medication should not be stopped abruptly .*
Question 3: Which mechanism of action is correct for GLP-1 receptor agonists?
A. Block SGLT-2 receptors in the kidney
B. Increase insulin production, inhibit postprandial glucagon, and increase satiety
C. Directly stimulate pancreatic beta cells to secrete insulin
D. Decrease hepatic glucose production
,,,,answer,,,,,,,,: B. Increase insulin production, inhibit postprandial glucagon, and
increase satiety
,*Rationale: GLP-1 receptor agonists (e.g., dulaglutide, semaglutide) are incretin
mimetics. They increase glucose-dependent insulin secretion, suppress elevated
glucagon levels, and slow gastric emptying, which promotes satiety .*
Question 4: Before prescribing a GLP-1 receptor agonist, it is most important to
screen for a personal or family history of which condition?
A. Pancreatitis
B. Medullary thyroid carcinoma
C. Bladder cancer
D. Heart failure
,,,,answer,,,,,,,,: B. Medullary thyroid carcinoma
*Rationale: GLP-1 receptor agonists carry a black box warning for the risk of
medullary thyroid carcinoma (MTC). They are contraindicated in patients with a
personal or family history of MTC or Multiple Endocrine Neoplasia syndrome type
2 (MEN-2) .*
Question 5: A patient with type 2 diabetes has an A1C of 9.5% despite being on
metformin and glipizide. Estimated GFR is >45 mL/min. What is the most
appropriate next step?
A. Discontinue glipizide due to risk of hypoglycemia
B. Add basal insulin (e.g., glargine)
C. Switch to a DPP-4 inhibitor
D. Triple the dose of metformin
, ,,,,answer,,,,,,,,: B. Add basal insulin (e.g., glargine)
*Rationale: When a patient is not at goal on two oral agents (especially with A1C
>9%), the next step is often to add basal insulin. Continuing oral agents (especially
metformin) is beneficial while adding insulin to overcome insulin deficiency.
Adding insulin earlier helps preserve beta-cell function .*
Question 6: What lab values are diagnostic for diabetes mellitus? (Select all that
apply)
A. Fasting plasma glucose greater than 126 mg/dL
B. Random plasma glucose greater than 200 mg/dL with symptoms
C. Oral glucose tolerance test greater than 200 mg/dL
D. Hemoglobin A1c at or greater than 6.5%
,,,,answer,,,,,,,,: A, B, C, D
*Rationale: All four criteria are diagnostic for diabetes. A fasting glucose ≥126
mg/dL, random glucose ≥200 mg/dL with symptoms, OGTT ≥200 mg/dL, or A1C
≥6.5% are all acceptable for diagnosis. Any combination of two tests may be used,
but both must be positive for confirmation .*
Question 7: A patient with type 2 diabetes has an A1C of 7.8% and a history of
heart failure. Which oral agent should be AVOIDED?
A. Metformin
Complete Actual Exam Questions 1- 100 NR565
Advanced Pharmacology Fundamentals NR 565
Midterm and Finals Examplify Online Proctored
Exam Questions and Answers | 100% Pass
Guaranteed | Graded A+
Section I: Endocrine Pharmacology – Diabetes Management (Questions 1-20)
Question 1: A 58-year-old male with newly diagnosed type 2 diabetes has an A1C
of 7.2%. His creatinine clearance is >60 mL/min. According to the ADA treatment
algorithm, what is the most appropriate initial pharmacotherapy?
A. Initiate basal insulin
B. Begin metformin 500 mg daily, titrating upward
C. Start a GLP-1 receptor agonist
D. Begin combination therapy with metformin and sitagliptin
,,,,answer,,,,,,,,: B. Begin metformin 500 mg daily, titrating upward
*Rationale: The American Diabetes Association (ADA) standards of care
recommend metformin as the first-line pharmacologic agent for type 2 diabetes at
diagnosis, in conjunction with lifestyle modifications. Metformin is effective, safe,
inexpensive, and has a low risk of hypoglycemia. It also does not cause weight
gain .*
,Question 2: A patient on metformin reports significant nausea and diarrhea after
taking her medication. What is the best initial recommendation?
A. Discontinue metformin and switch to a sulfonylurea
B. Take on an empty stomach to improve absorption
C. Take with the largest meal of the day
D. Split the dose to three times daily
,,,,answer,,,,,,,,: C. Take with the largest meal of the day
*Rationale: Gastrointestinal side effects are very common with metformin,
especially upon initiation. These effects are dose-dependent and can be minimized
by taking the medication with food. Starting with a low dose (500 mg) and titrating
slowly also helps. The medication should not be stopped abruptly .*
Question 3: Which mechanism of action is correct for GLP-1 receptor agonists?
A. Block SGLT-2 receptors in the kidney
B. Increase insulin production, inhibit postprandial glucagon, and increase satiety
C. Directly stimulate pancreatic beta cells to secrete insulin
D. Decrease hepatic glucose production
,,,,answer,,,,,,,,: B. Increase insulin production, inhibit postprandial glucagon, and
increase satiety
,*Rationale: GLP-1 receptor agonists (e.g., dulaglutide, semaglutide) are incretin
mimetics. They increase glucose-dependent insulin secretion, suppress elevated
glucagon levels, and slow gastric emptying, which promotes satiety .*
Question 4: Before prescribing a GLP-1 receptor agonist, it is most important to
screen for a personal or family history of which condition?
A. Pancreatitis
B. Medullary thyroid carcinoma
C. Bladder cancer
D. Heart failure
,,,,answer,,,,,,,,: B. Medullary thyroid carcinoma
*Rationale: GLP-1 receptor agonists carry a black box warning for the risk of
medullary thyroid carcinoma (MTC). They are contraindicated in patients with a
personal or family history of MTC or Multiple Endocrine Neoplasia syndrome type
2 (MEN-2) .*
Question 5: A patient with type 2 diabetes has an A1C of 9.5% despite being on
metformin and glipizide. Estimated GFR is >45 mL/min. What is the most
appropriate next step?
A. Discontinue glipizide due to risk of hypoglycemia
B. Add basal insulin (e.g., glargine)
C. Switch to a DPP-4 inhibitor
D. Triple the dose of metformin
, ,,,,answer,,,,,,,,: B. Add basal insulin (e.g., glargine)
*Rationale: When a patient is not at goal on two oral agents (especially with A1C
>9%), the next step is often to add basal insulin. Continuing oral agents (especially
metformin) is beneficial while adding insulin to overcome insulin deficiency.
Adding insulin earlier helps preserve beta-cell function .*
Question 6: What lab values are diagnostic for diabetes mellitus? (Select all that
apply)
A. Fasting plasma glucose greater than 126 mg/dL
B. Random plasma glucose greater than 200 mg/dL with symptoms
C. Oral glucose tolerance test greater than 200 mg/dL
D. Hemoglobin A1c at or greater than 6.5%
,,,,answer,,,,,,,,: A, B, C, D
*Rationale: All four criteria are diagnostic for diabetes. A fasting glucose ≥126
mg/dL, random glucose ≥200 mg/dL with symptoms, OGTT ≥200 mg/dL, or A1C
≥6.5% are all acceptable for diagnosis. Any combination of two tests may be used,
but both must be positive for confirmation .*
Question 7: A patient with type 2 diabetes has an A1C of 7.8% and a history of
heart failure. Which oral agent should be AVOIDED?
A. Metformin
