NR 567 Exam 2 V3 | NR 567 Advanced
Pharmacology for the AGACNP | Actual
Q&A with Rationale (NR567 Exam 2) |
Chamberlain College of Nursing
1. Which of the following adverse effects are commonly associated with Angiotensin-
Converting Enzyme (ACE) inhibitors? Select all that apply.
A. Dry, non-productive cough
B. Hypokalemia
C. Hyperkalemia
D. Angioedema
E. Tachycardia
F. Teratogenicity
Correct Answer: A, C, D, F
ACE inhibitors frequently lead to a dry cough due to the accumulation of bradykinin in the
lungs. They can cause hyperkalemia by reducing aldosterone secretion, which is why
monitoring serum potassium is essential. Angioedema is a rare but life-threatening side effect,
and these drugs are strictly contraindicated in pregnancy due to known teratogenic risks.
,2. When transitioning a patient from an ACE inhibitor to Sacubitril/Valsartan (Entresto), what
is the mandatory washout period?
A. 12 hours
B. 24 hours
C. 48 hours
D. 36 hours
Correct Answer: D
A 36-hour washout period is required when switching from an ACE inhibitor to an ARNI to
minimize the risk of angioedema. This delay ensures that the ACE inhibitor is sufficiently
cleared from the system before starting the neprilysin inhibitor. Failure to observe this period
significantly increases the dual-mechanism accumulation of bradykinin.
3. A patient with HFrEF and an ejection fraction of 30% remains symptomatic on an ACE
inhibitor and a beta-blocker. Which medication is the most appropriate next step in according
to GDMT?
A. Amlodipine
B. Spironolactone
C. Diltiazem
D. Clonidine
Correct Answer: B
, Mineralocorticoid receptor antagonists (MRAs) like spironolactone are recommended for
patients with HFrEF (NYHA Class II-IV) who meet specific renal and potassium criteria. These
agents provide mortality benefits by blocking the fibrotic effects of aldosterone on the
myocardium. Calcium channel blockers like diltiazem should be avoided in patients with
reduced ejection fraction as they can worsen heart failure.
4. Which of the following is considered a high-intensity statin regimen?
A. Simvastatin 40 mg daily
B. Atorvastatin 80 mg daily
C. Pravastatin 40 mg daily
D. Rosuvastatin 10 mg daily
Correct Answer: B
High-intensity statins are defined as those that lower LDL-C by approximately 50% or more.
Currently, only Atorvastatin 40-80 mg and Rosuvastatin 20-40 mg meet this threshold. Lower
doses or other statins like Simvastatin are classified as moderate or low-intensity therapy.
5. A patient taking Warfarin presents with an INR of 8.0 and no active bleeding. According to
clinical guidelines, what is the appropriate management?
A. Administer 10 mg Vitamin K via IV push
B. Hold Warfarin and give 2.5 mg Vitamin K orally
C. Hold Warfarin and give 1 to 5 mg Vitamin K orally
Pharmacology for the AGACNP | Actual
Q&A with Rationale (NR567 Exam 2) |
Chamberlain College of Nursing
1. Which of the following adverse effects are commonly associated with Angiotensin-
Converting Enzyme (ACE) inhibitors? Select all that apply.
A. Dry, non-productive cough
B. Hypokalemia
C. Hyperkalemia
D. Angioedema
E. Tachycardia
F. Teratogenicity
Correct Answer: A, C, D, F
ACE inhibitors frequently lead to a dry cough due to the accumulation of bradykinin in the
lungs. They can cause hyperkalemia by reducing aldosterone secretion, which is why
monitoring serum potassium is essential. Angioedema is a rare but life-threatening side effect,
and these drugs are strictly contraindicated in pregnancy due to known teratogenic risks.
,2. When transitioning a patient from an ACE inhibitor to Sacubitril/Valsartan (Entresto), what
is the mandatory washout period?
A. 12 hours
B. 24 hours
C. 48 hours
D. 36 hours
Correct Answer: D
A 36-hour washout period is required when switching from an ACE inhibitor to an ARNI to
minimize the risk of angioedema. This delay ensures that the ACE inhibitor is sufficiently
cleared from the system before starting the neprilysin inhibitor. Failure to observe this period
significantly increases the dual-mechanism accumulation of bradykinin.
3. A patient with HFrEF and an ejection fraction of 30% remains symptomatic on an ACE
inhibitor and a beta-blocker. Which medication is the most appropriate next step in according
to GDMT?
A. Amlodipine
B. Spironolactone
C. Diltiazem
D. Clonidine
Correct Answer: B
, Mineralocorticoid receptor antagonists (MRAs) like spironolactone are recommended for
patients with HFrEF (NYHA Class II-IV) who meet specific renal and potassium criteria. These
agents provide mortality benefits by blocking the fibrotic effects of aldosterone on the
myocardium. Calcium channel blockers like diltiazem should be avoided in patients with
reduced ejection fraction as they can worsen heart failure.
4. Which of the following is considered a high-intensity statin regimen?
A. Simvastatin 40 mg daily
B. Atorvastatin 80 mg daily
C. Pravastatin 40 mg daily
D. Rosuvastatin 10 mg daily
Correct Answer: B
High-intensity statins are defined as those that lower LDL-C by approximately 50% or more.
Currently, only Atorvastatin 40-80 mg and Rosuvastatin 20-40 mg meet this threshold. Lower
doses or other statins like Simvastatin are classified as moderate or low-intensity therapy.
5. A patient taking Warfarin presents with an INR of 8.0 and no active bleeding. According to
clinical guidelines, what is the appropriate management?
A. Administer 10 mg Vitamin K via IV push
B. Hold Warfarin and give 2.5 mg Vitamin K orally
C. Hold Warfarin and give 1 to 5 mg Vitamin K orally
