NR 567 Final Exam V1 | NR 567 Advanced
Pharmacology for the AGACNP | Actual
Q&A with Rationale (NR567 Final Exam) |
Chamberlain College of Nursing
1. A patient in the ICU is being treated for septic shock. The AGACNP is considering the
initiation of vasopressor therapy. Which of the following statements are correct regarding the
use of Norepinephrine (Levophed) in this setting? Select all that apply.
A. It is considered the first-line vasopressor for septic shock.
B. It primarily acts as a potent Beta-2 agonist.
C. It increases Mean Arterial Pressure (MAP) through Alpha-1 adrenergic stimulation.
D. It should be administered through a peripheral IV for long-term therapy.
E. It may provide a modest increase in cardiac output due to mild Beta-1 activity.
F. Central venous access is required to minimize the risk of tissue necrosis from
extravasation.
Correct Answer: A, C, E, F
Norepinephrine is the primary vasopressor recommended by the Surviving Sepsis
Campaign for maintaining perfusion in septic shock. Its mechanism of action involves
strong Alpha-1 agonism for vasoconstriction and moderate Beta-1 agonism for inotropic
,support. Due to the high risk of severe tissue damage upon extravasation, central line
administration is the standard of care in the acute care environment.
2. An 82-year-old patient with a history of heart failure is prescribed Digoxin. Which of the
following factors would most significantly increase this patient’s risk for developing Digoxin
toxicity?
A. Hyperkalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypokalemia
Correct Answer: D
Hypokalemia increases the risk of digoxin toxicity because digoxin competes with
potassium for the Na+/K+ ATPase pump. When potassium levels are low, digoxin binds
more effectively, leading to excessive inhibition of the pump and subsequent toxicity. The
AGACNP must monitor electrolyte panels closely, especially when patients are also
receiving loop diuretics.
3. The AGACNP is managing a patient receiving a Propofol (Diprivan) infusion for sedation.
Which clinical finding would most likely indicate the development of Propofol Infusion
Syndrome (PRIS)?
A. Metabolic acidosis and rhabdomyolysis
B. Respiratory alkalosis and hypertension
,C. Hypocalcemia and bradycardia
D. Acute hepatic failure and hyperglycemia
Correct Answer: A
Propofol Infusion Syndrome is a rare but fatal complication characterized by severe
metabolic acidosis, hyperkalemia, and myocyte necrosis. It typically occurs with high doses
(greater than 50 mcg/kg/min) administered over a prolonged period (more than 48
hours). The AGACNP must monitor triglyceride levels and arterial blood gases to detect
early signs of this syndrome.
4. A patient with Chronic Obstructive Pulmonary Disease (COPD) is experiencing an acute
exacerbation. Which of the following medications is preferred for rapid bronchodilation in
the emergency setting?
A. Albuterol
B. Tiotropium
C. Salmeterol
D. Fluticasone
Correct Answer: A
Albuterol is a short-acting beta-agonist (SABA) that provides rapid relief of bronchospasm
by stimulating Beta-2 receptors in the lungs. Medications like Salmeterol and Tiotropium
are intended for long-term maintenance and have a slower onset of action. In an acute
exacerbation, immediate reversal of airway obstruction is the priority for the AGACNP.
, 5. Which of the following is the most appropriate reversal agent for a patient experiencing
life-threatening bleeding while on Warfarin (Coumadin)?
A. Prothrombin Complex Concentrate (PCC) and Vitamin K
B. Idarucizumab
C. Andexanet alfa
D. Protamine Sulfate
Correct Answer: A
For rapid reversal of warfarin in the presence of major bleeding, Prothrombin Complex
Concentrate (PCC) is preferred over Fresh Frozen Plasma due to its lower volume and
faster action. Vitamin K must also be administered to provide the substrate for the liver to
synthesize new clotting factors once the PCC effect wears off. Other agents like Protamine
are specific to heparin, while Idarucizumab is specific to Dabigatran.
6. A patient is admitted with an acute myocardial infarction and is scheduled for PCI. Which
antiplatelet agent is a thienopyridine that irreversibly inhibits the P2Y12 receptor?
A. Ticagrelor
B. Abciximab
C. Aspirin
D. Clopidogrel
Correct Answer: D
Pharmacology for the AGACNP | Actual
Q&A with Rationale (NR567 Final Exam) |
Chamberlain College of Nursing
1. A patient in the ICU is being treated for septic shock. The AGACNP is considering the
initiation of vasopressor therapy. Which of the following statements are correct regarding the
use of Norepinephrine (Levophed) in this setting? Select all that apply.
A. It is considered the first-line vasopressor for septic shock.
B. It primarily acts as a potent Beta-2 agonist.
C. It increases Mean Arterial Pressure (MAP) through Alpha-1 adrenergic stimulation.
D. It should be administered through a peripheral IV for long-term therapy.
E. It may provide a modest increase in cardiac output due to mild Beta-1 activity.
F. Central venous access is required to minimize the risk of tissue necrosis from
extravasation.
Correct Answer: A, C, E, F
Norepinephrine is the primary vasopressor recommended by the Surviving Sepsis
Campaign for maintaining perfusion in septic shock. Its mechanism of action involves
strong Alpha-1 agonism for vasoconstriction and moderate Beta-1 agonism for inotropic
,support. Due to the high risk of severe tissue damage upon extravasation, central line
administration is the standard of care in the acute care environment.
2. An 82-year-old patient with a history of heart failure is prescribed Digoxin. Which of the
following factors would most significantly increase this patient’s risk for developing Digoxin
toxicity?
A. Hyperkalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypokalemia
Correct Answer: D
Hypokalemia increases the risk of digoxin toxicity because digoxin competes with
potassium for the Na+/K+ ATPase pump. When potassium levels are low, digoxin binds
more effectively, leading to excessive inhibition of the pump and subsequent toxicity. The
AGACNP must monitor electrolyte panels closely, especially when patients are also
receiving loop diuretics.
3. The AGACNP is managing a patient receiving a Propofol (Diprivan) infusion for sedation.
Which clinical finding would most likely indicate the development of Propofol Infusion
Syndrome (PRIS)?
A. Metabolic acidosis and rhabdomyolysis
B. Respiratory alkalosis and hypertension
,C. Hypocalcemia and bradycardia
D. Acute hepatic failure and hyperglycemia
Correct Answer: A
Propofol Infusion Syndrome is a rare but fatal complication characterized by severe
metabolic acidosis, hyperkalemia, and myocyte necrosis. It typically occurs with high doses
(greater than 50 mcg/kg/min) administered over a prolonged period (more than 48
hours). The AGACNP must monitor triglyceride levels and arterial blood gases to detect
early signs of this syndrome.
4. A patient with Chronic Obstructive Pulmonary Disease (COPD) is experiencing an acute
exacerbation. Which of the following medications is preferred for rapid bronchodilation in
the emergency setting?
A. Albuterol
B. Tiotropium
C. Salmeterol
D. Fluticasone
Correct Answer: A
Albuterol is a short-acting beta-agonist (SABA) that provides rapid relief of bronchospasm
by stimulating Beta-2 receptors in the lungs. Medications like Salmeterol and Tiotropium
are intended for long-term maintenance and have a slower onset of action. In an acute
exacerbation, immediate reversal of airway obstruction is the priority for the AGACNP.
, 5. Which of the following is the most appropriate reversal agent for a patient experiencing
life-threatening bleeding while on Warfarin (Coumadin)?
A. Prothrombin Complex Concentrate (PCC) and Vitamin K
B. Idarucizumab
C. Andexanet alfa
D. Protamine Sulfate
Correct Answer: A
For rapid reversal of warfarin in the presence of major bleeding, Prothrombin Complex
Concentrate (PCC) is preferred over Fresh Frozen Plasma due to its lower volume and
faster action. Vitamin K must also be administered to provide the substrate for the liver to
synthesize new clotting factors once the PCC effect wears off. Other agents like Protamine
are specific to heparin, while Idarucizumab is specific to Dabigatran.
6. A patient is admitted with an acute myocardial infarction and is scheduled for PCI. Which
antiplatelet agent is a thienopyridine that irreversibly inhibits the P2Y12 receptor?
A. Ticagrelor
B. Abciximab
C. Aspirin
D. Clopidogrel
Correct Answer: D
