NR 567 Final Exam V3 | NR 567 Advanced
Pharmacology for the AGACNP | Actual
Q&A with Rationale (NR567 Final Exam) |
Chamberlain College of Nursing
1. An AGACNP is treating a patient with suspected MRSA bacteremia. Which of the following
parenteral antibiotics provide reliable coverage against Methicillin-resistant Staphylococcus
aureus? Select all that apply.
A. Vancomycin
B. Linezolid
C. Daptomycin
D. Ceftaroline
E. Ceftriaxone
F. Piperacillin-tazobactam
Correct Answer: A, B, C, D
Vancomycin, linezolid, daptomycin, and ceftaroline are all clinically indicated for the
management of MRSA infections. Vancomycin remains a standard of care for bacteremia,
while daptomycin is an excellent alternative for skin and blood infections but cannot be
used for pneumonia. Ceftaroline is the only cephalosporin with activity against MRSA,
whereas ceftriaxone and Zosyn lack the necessary affinity for PBP2a.
,2. A patient on long-term Digoxin therapy for heart failure presents with nausea, vomiting,
and reports seeing yellow-green halos around lights. Which electrolyte abnormality is most
likely to exacerbate this toxicity?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hyponatremia
Correct Answer: C
Digoxin toxicity is frequently precipitated by electrolyte disturbances that influence the
sodium-potassium ATPase pump. Hypokalemia increases the risk of toxicity because
digoxin competes with potassium for binding sites on the pump. Clinical signs of toxicity
often include gastrointestinal upset and the classic visual disturbance known as
xanthopsia.
3. When initiating an ACE inhibitor for a patient with heart failure, which monitoring
parameter is most critical to evaluate within 1-2 weeks of starting therapy?
A. Serum glucose levels
B. Liver function tests
C. Complete blood count
D. Serum potassium and creatinine
,Correct Answer: D
ACE inhibitors interfere with the renin-angiotensin-aldosterone system, leading to a
reduction in aldosterone and a subsequent risk of hyperkalemia. They also alter renal
hemodynamics, which can result in a transient rise in serum creatinine levels. Early
monitoring is essential to prevent acute renal failure and life-threatening electrolyte
imbalances.
4. A 55-year-old patient with Type 2 Diabetes is scheduled for a CT scan with intravenous
contrast. Which medication must be withheld for 48 hours following the procedure to
prevent lactic acidosis?
A. Glipizide
B. Pioglitazone
C. Sitagliptin
D. Metformin
Correct Answer: D
Metformin is primarily excreted by the kidneys and can accumulate if renal function is
impaired by IV contrast, leading to potentially fatal lactic acidosis. Current guidelines
recommend withholding metformin at the time of or prior to the procedure and resuming
only after renal function is confirmed to be stable. This precaution is vital for patients with
a history of kidney disease or those receiving large doses of contrast.
, 5. Amiodarone is a potent antiarrhythmic used in acute care settings. Which of the following
monitoring requirements are necessary due to its potential for long-term toxicity? Select all
that apply.
A. Pulmonary function tests and chest X-ray
B. Thyroid function tests
C. Liver function tests
D. Serum calcium levels
E. Annual ophthalmic exam
Correct Answer: A, B, C, E
Amiodarone is associated with significant multi-organ toxicities, including pulmonary
fibrosis, hepatotoxicity, and thyroid dysfunction due to its high iodine content. Ophthalmic
exams are required to monitor for corneal micro-deposits and optic neuropathy. These
monitoring parameters are essential for early detection and prevention of permanent
organ damage in chronic users.
6. A patient receiving a continuous heparin infusion for a pulmonary embolism has a sudden
drop in platelet count by 50% from baseline. What is the most appropriate immediate action
for the AGACNP?
A. Discontinue all heparin products and start Argatroban
B. Order a repeat CBC to confirm the count
C. Decrease the heparin infusion rate by 20%
Pharmacology for the AGACNP | Actual
Q&A with Rationale (NR567 Final Exam) |
Chamberlain College of Nursing
1. An AGACNP is treating a patient with suspected MRSA bacteremia. Which of the following
parenteral antibiotics provide reliable coverage against Methicillin-resistant Staphylococcus
aureus? Select all that apply.
A. Vancomycin
B. Linezolid
C. Daptomycin
D. Ceftaroline
E. Ceftriaxone
F. Piperacillin-tazobactam
Correct Answer: A, B, C, D
Vancomycin, linezolid, daptomycin, and ceftaroline are all clinically indicated for the
management of MRSA infections. Vancomycin remains a standard of care for bacteremia,
while daptomycin is an excellent alternative for skin and blood infections but cannot be
used for pneumonia. Ceftaroline is the only cephalosporin with activity against MRSA,
whereas ceftriaxone and Zosyn lack the necessary affinity for PBP2a.
,2. A patient on long-term Digoxin therapy for heart failure presents with nausea, vomiting,
and reports seeing yellow-green halos around lights. Which electrolyte abnormality is most
likely to exacerbate this toxicity?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hyponatremia
Correct Answer: C
Digoxin toxicity is frequently precipitated by electrolyte disturbances that influence the
sodium-potassium ATPase pump. Hypokalemia increases the risk of toxicity because
digoxin competes with potassium for binding sites on the pump. Clinical signs of toxicity
often include gastrointestinal upset and the classic visual disturbance known as
xanthopsia.
3. When initiating an ACE inhibitor for a patient with heart failure, which monitoring
parameter is most critical to evaluate within 1-2 weeks of starting therapy?
A. Serum glucose levels
B. Liver function tests
C. Complete blood count
D. Serum potassium and creatinine
,Correct Answer: D
ACE inhibitors interfere with the renin-angiotensin-aldosterone system, leading to a
reduction in aldosterone and a subsequent risk of hyperkalemia. They also alter renal
hemodynamics, which can result in a transient rise in serum creatinine levels. Early
monitoring is essential to prevent acute renal failure and life-threatening electrolyte
imbalances.
4. A 55-year-old patient with Type 2 Diabetes is scheduled for a CT scan with intravenous
contrast. Which medication must be withheld for 48 hours following the procedure to
prevent lactic acidosis?
A. Glipizide
B. Pioglitazone
C. Sitagliptin
D. Metformin
Correct Answer: D
Metformin is primarily excreted by the kidneys and can accumulate if renal function is
impaired by IV contrast, leading to potentially fatal lactic acidosis. Current guidelines
recommend withholding metformin at the time of or prior to the procedure and resuming
only after renal function is confirmed to be stable. This precaution is vital for patients with
a history of kidney disease or those receiving large doses of contrast.
, 5. Amiodarone is a potent antiarrhythmic used in acute care settings. Which of the following
monitoring requirements are necessary due to its potential for long-term toxicity? Select all
that apply.
A. Pulmonary function tests and chest X-ray
B. Thyroid function tests
C. Liver function tests
D. Serum calcium levels
E. Annual ophthalmic exam
Correct Answer: A, B, C, E
Amiodarone is associated with significant multi-organ toxicities, including pulmonary
fibrosis, hepatotoxicity, and thyroid dysfunction due to its high iodine content. Ophthalmic
exams are required to monitor for corneal micro-deposits and optic neuropathy. These
monitoring parameters are essential for early detection and prevention of permanent
organ damage in chronic users.
6. A patient receiving a continuous heparin infusion for a pulmonary embolism has a sudden
drop in platelet count by 50% from baseline. What is the most appropriate immediate action
for the AGACNP?
A. Discontinue all heparin products and start Argatroban
B. Order a repeat CBC to confirm the count
C. Decrease the heparin infusion rate by 20%
