NUR 6011/NUR6011 Exam 2 V2 | Advance
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient is prescribed Lisinopril for hypertension. Which mechanism best describes how
this medication works?
A. It blocks the binding of Angiotensin II to its receptors.
B. It blocks calcium channels in the vascular smooth muscle.
C. It promotes the excretion of sodium and water in the distal tubule.
D. It inhibits the enzyme that converts Angiotensin I to Angiotensin II.
Answer: D
Rationale: ACE inhibitors like Lisinopril function by inhibiting the Angiotensin-Converting
Enzyme. This action prevents the formation of Angiotensin II, which is a potent
vasoconstrictor. Consequently, it leads to vasodilation and decreased aldosterone
secretion, which helps lower blood pressure.
2. A nurse is teaching a patient with asthma about using a Propranolol for a non-cardiac
condition. Why is this drug often contraindicated in asthma patients?
A. It causes excessive dryness of the mucous membranes.
B. It may cause bronchoconstriction by blocking Beta-2 receptors.
C. It increases the heart rate too significantly for asthma patients.
,D. It interferes with the metabolism of inhaled steroids.
Answer: B
Rationale: Propranolol is a non-selective beta-blocker that affects both Beta-1 and Beta-2
receptors. Blocking Beta-2 receptors in the lungs can lead to bronchoconstriction, which
can trigger an asthma attack. For patients with respiratory issues, cardio-selective beta-
blockers are generally preferred.
3. Which sign is most indicative of early Digoxin toxicity in a clinical setting?
A. Tachycardia and hypertension
B. Visual disturbances, such as seeing yellow-green halos
C. Anorexia, nausea, and vomiting
D. Severe peripheral edema and weight gain
Answer: C
Rationale: Gastrointestinal symptoms like anorexia, nausea, and vomiting are typically the
earliest signs of Digoxin toxicity. While visual disturbances are a classic sign, they often
appear later as toxicity progresses. Monitoring for these early indicators is crucial for
preventing more severe cardiac dysrhythmias.
4. A patient on Warfarin therapy has an INR of 1.2. How should the provider interpret this
result for a patient with atrial fibrillation?
A. The INR is within the therapeutic range.
, B. The INR is too low, and the dose needs to be increased.
C. The INR is too high, and the dose should be decreased.
D. The patient is at immediate risk for major hemorrhage.
Answer: B
Rationale: For a patient with atrial fibrillation, the standard therapeutic INR range is
typically between 2.0 and 3.0. An INR of 1.2 indicates that the blood is not sufficiently
anticoagulated, increasing the risk of clot formation. The dosage of Warfarin likely needs to
be titrated upward to reach the target range.
5. Which lab value must be monitored closely for a patient starting Atorvastatin (Lipitor)?
A. Serum Creatinine and BUN
B. Complete Blood Count (CBC) with differential
C. Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST)
D. Serum Amylase and Lipase
Answer: C
Rationale: Statins like Atorvastatin can occasionally cause hepatotoxicity or elevation in
liver enzymes. It is standard practice to obtain baseline liver function tests before starting
therapy and monitor them if symptoms of liver injury occur. Patients should also be
advised to report any unexplained muscle pain or weakness.
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient is prescribed Lisinopril for hypertension. Which mechanism best describes how
this medication works?
A. It blocks the binding of Angiotensin II to its receptors.
B. It blocks calcium channels in the vascular smooth muscle.
C. It promotes the excretion of sodium and water in the distal tubule.
D. It inhibits the enzyme that converts Angiotensin I to Angiotensin II.
Answer: D
Rationale: ACE inhibitors like Lisinopril function by inhibiting the Angiotensin-Converting
Enzyme. This action prevents the formation of Angiotensin II, which is a potent
vasoconstrictor. Consequently, it leads to vasodilation and decreased aldosterone
secretion, which helps lower blood pressure.
2. A nurse is teaching a patient with asthma about using a Propranolol for a non-cardiac
condition. Why is this drug often contraindicated in asthma patients?
A. It causes excessive dryness of the mucous membranes.
B. It may cause bronchoconstriction by blocking Beta-2 receptors.
C. It increases the heart rate too significantly for asthma patients.
,D. It interferes with the metabolism of inhaled steroids.
Answer: B
Rationale: Propranolol is a non-selective beta-blocker that affects both Beta-1 and Beta-2
receptors. Blocking Beta-2 receptors in the lungs can lead to bronchoconstriction, which
can trigger an asthma attack. For patients with respiratory issues, cardio-selective beta-
blockers are generally preferred.
3. Which sign is most indicative of early Digoxin toxicity in a clinical setting?
A. Tachycardia and hypertension
B. Visual disturbances, such as seeing yellow-green halos
C. Anorexia, nausea, and vomiting
D. Severe peripheral edema and weight gain
Answer: C
Rationale: Gastrointestinal symptoms like anorexia, nausea, and vomiting are typically the
earliest signs of Digoxin toxicity. While visual disturbances are a classic sign, they often
appear later as toxicity progresses. Monitoring for these early indicators is crucial for
preventing more severe cardiac dysrhythmias.
4. A patient on Warfarin therapy has an INR of 1.2. How should the provider interpret this
result for a patient with atrial fibrillation?
A. The INR is within the therapeutic range.
, B. The INR is too low, and the dose needs to be increased.
C. The INR is too high, and the dose should be decreased.
D. The patient is at immediate risk for major hemorrhage.
Answer: B
Rationale: For a patient with atrial fibrillation, the standard therapeutic INR range is
typically between 2.0 and 3.0. An INR of 1.2 indicates that the blood is not sufficiently
anticoagulated, increasing the risk of clot formation. The dosage of Warfarin likely needs to
be titrated upward to reach the target range.
5. Which lab value must be monitored closely for a patient starting Atorvastatin (Lipitor)?
A. Serum Creatinine and BUN
B. Complete Blood Count (CBC) with differential
C. Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST)
D. Serum Amylase and Lipase
Answer: C
Rationale: Statins like Atorvastatin can occasionally cause hepatotoxicity or elevation in
liver enzymes. It is standard practice to obtain baseline liver function tests before starting
therapy and monitor them if symptoms of liver injury occur. Patients should also be
advised to report any unexplained muscle pain or weakness.
