NUR 6011/NUR6011 Exam 2 V3 | Advance
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient taking an ACE inhibitor for hypertension develops a persistent, dry cough. Which
mechanism is most likely responsible for this side effect?
A. Inhibition of the sympathetic nervous system
B. Increased production of aldosterone
C. Direct irritation of the bronchial mucosa
D. Accumulation of bradykinin in the lungs
Answer: D
Rationale: ACE inhibitors prevent the breakdown of bradykinin, leading to its
accumulation in the respiratory tract. This accumulation is the primary cause of the dry
cough often associated with this drug class. Switching the patient to an ARB is usually the
next step because ARBs do not affect bradykinin levels.
2. Which medication is contraindicated in a patient with a history of severe asthma due to the
risk of bronchospasm?
A. Metoprolol
B. Amlodipine
C. Propranolol
,D. Lisinopril
Answer: C
Rationale: Propranolol is a non-selective beta-blocker that inhibits both Beta-1 and Beta-2
receptors. Blocking Beta-2 receptors in the lungs can trigger significant
bronchoconstriction in susceptible patients. Cardioselective beta-blockers like metoprolol
are generally safer, though still used with caution in respiratory patients.
3. A patient is prescribed Warfarin for atrial fibrillation. Which laboratory test is the primary
indicator for monitoring this therapy?
A. aPTT
B. Platelet count
C. Serum creatinine
D. INR
Answer: D
Rationale: The International Normalized Ratio (INR) is the standard measurement used to
assess the effectiveness of Warfarin. It ensures that the results are consistent across
different laboratories regardless of the thromboplastin reagent used. Most patients on
Warfarin require a target INR between 2.0 and 3.0 to balance stroke prevention and
bleeding risk.
, 4. What is the primary mechanism of action of Metformin in the treatment of Type 2
Diabetes?
A. Stimulating insulin secretion from pancreatic beta cells
B. Slowing the absorption of carbohydrates in the gut
C. Increasing glucose excretion via the kidneys
D. Inhibiting hepatic glucose production
Answer: D
Rationale: Metformin works primarily by reducing the amount of glucose produced by the
liver (gluconeogenesis). It also improves insulin sensitivity by increasing peripheral
glucose uptake and use. Unlike sulfonylureas, Metformin does not stimulate insulin
secretion and therefore has a lower risk of causing hypoglycemia.
5. A patient with heart failure is taking Spironolactone. Which electrolyte abnormality should
the nurse monitor for most closely?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
Answer: B
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient taking an ACE inhibitor for hypertension develops a persistent, dry cough. Which
mechanism is most likely responsible for this side effect?
A. Inhibition of the sympathetic nervous system
B. Increased production of aldosterone
C. Direct irritation of the bronchial mucosa
D. Accumulation of bradykinin in the lungs
Answer: D
Rationale: ACE inhibitors prevent the breakdown of bradykinin, leading to its
accumulation in the respiratory tract. This accumulation is the primary cause of the dry
cough often associated with this drug class. Switching the patient to an ARB is usually the
next step because ARBs do not affect bradykinin levels.
2. Which medication is contraindicated in a patient with a history of severe asthma due to the
risk of bronchospasm?
A. Metoprolol
B. Amlodipine
C. Propranolol
,D. Lisinopril
Answer: C
Rationale: Propranolol is a non-selective beta-blocker that inhibits both Beta-1 and Beta-2
receptors. Blocking Beta-2 receptors in the lungs can trigger significant
bronchoconstriction in susceptible patients. Cardioselective beta-blockers like metoprolol
are generally safer, though still used with caution in respiratory patients.
3. A patient is prescribed Warfarin for atrial fibrillation. Which laboratory test is the primary
indicator for monitoring this therapy?
A. aPTT
B. Platelet count
C. Serum creatinine
D. INR
Answer: D
Rationale: The International Normalized Ratio (INR) is the standard measurement used to
assess the effectiveness of Warfarin. It ensures that the results are consistent across
different laboratories regardless of the thromboplastin reagent used. Most patients on
Warfarin require a target INR between 2.0 and 3.0 to balance stroke prevention and
bleeding risk.
, 4. What is the primary mechanism of action of Metformin in the treatment of Type 2
Diabetes?
A. Stimulating insulin secretion from pancreatic beta cells
B. Slowing the absorption of carbohydrates in the gut
C. Increasing glucose excretion via the kidneys
D. Inhibiting hepatic glucose production
Answer: D
Rationale: Metformin works primarily by reducing the amount of glucose produced by the
liver (gluconeogenesis). It also improves insulin sensitivity by increasing peripheral
glucose uptake and use. Unlike sulfonylureas, Metformin does not stimulate insulin
secretion and therefore has a lower risk of causing hypoglycemia.
5. A patient with heart failure is taking Spironolactone. Which electrolyte abnormality should
the nurse monitor for most closely?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
Answer: B
