NR 566 / NR566 Advanced Pharmacology Care of the
Family Midterm Exam Actual 2025/2026 with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+
Graded
SECTION 1: PHARMACOKINETICS & PHARMACODYNAMICS (12
Questions)
Q1: A patient with heart failure is started on digoxin. Which laboratory value should
the nurse monitor most closely to prevent toxicity?
● A. Serum sodium
● B. Serum potassium
● C. Serum calcium
● D. Serum magnesium
● Correct Answer: B
● Rationale: Correct because hypokalemia increases the risk of digoxin toxicity
by enhancing its binding to cardiac sodium-potassium ATPase pumps.
Q2: A 65-year-old female with type 2 diabetes has a GFR of 45 mL/min. Which oral
antidiabetic agent requires dose adjustment or avoidance?
● A. Metformin
● B. Glipizide
● C. Pioglitazone
● D. Sitagliptin
● Correct Answer: A
● Rationale: Correct because metformin is contraindicated with GFR <30 and
requires dose reduction at GFR 30-45 due to lactic acidosis risk.
Q3: A patient is prescribed warfarin for atrial fibrillation. Which herbal supplement
should the patient be warned to avoid due to increased bleeding risk?
, ● A. Garlic
● B. Echinacea
● C. St. John's Wort
● D. Valerian root
● Correct Answer: A
● Rationale: Correct because garlic has antiplatelet effects and potentiates
warfarin, increasing INR and bleeding risk.
Q4: A 28-year-old female with epilepsy is planning pregnancy. Which anticonvulsant
is considered the safest during pregnancy?
● A. Valproic acid
● B. Phenytoin
● C. Lamotrigine
● D. Carbamazepine
● Correct Answer: C
● Rationale: Correct because lamotrigine has the most favorable reproductive
safety profile among anticonvulsants with lower teratogenicity risk.
Q5: Which beta-blocker is preferred for heart failure with reduced ejection fraction?
● A. Atenolol
● B. Propranolol
● C. Metoprolol succinate
● D. Nadolol
● Correct Answer: C
● Rationale: Correct because metoprolol succinate (extended-release) is
FDA-approved for heart failure and has proven mortality benefit.
Q6: A patient on lisinopril develops a persistent dry cough. What is the most likely
cause?
● A. Bronchospasm
● B. Angioedema
● C. Bradykinin accumulation
● D. Histamine release
● Correct Answer: C
● Rationale: Correct because ACE inhibitors prevent bradykinin breakdown,
leading to accumulation and cough.
, Q7: A 55-year-old male with benign prostatic hyperplasia is prescribed tamsulosin.
Which side effect is most commonly associated?
● A. Orthostatic hypotension
● B. Gynecomastia
● C. Hyperkalemia
● D. Tachycardia
● Correct Answer: A
● Rationale: Correct because tamsulosin is an alpha-blocker causing
vasodilation and orthostatic hypotension.
Q8: A patient on lithium therapy has a serum level of 1.8 mEq/L. What symptoms
should the nurse anticipate?
● A. Hypothyroidism
● B. Tremor, confusion, nausea
● C. Polyuria and polydipsia
● D. Weight gain
● Correct Answer: B
● Rationale: Correct because levels above 1.5 mEq/L indicate lithium toxicity
with GI and neurologic symptoms.
Q9: Which statin has the greatest potency for LDL reduction?
● A. Pravastatin
● B. Rosuvastatin
● C. Atorvastatin
● D. Simvastatin
● Correct Answer: B
● Rationale: Correct because rosuvastatin is the most potent statin with highest
LDL reduction at equivalent doses.
Q10: A patient is started on sertraline for depression. How long should the nurse
advise the patient to wait for therapeutic effect?
● A. 1-3 days
● B. 1-2 weeks
● C. 4-6 weeks
● D. 8-10 weeks
● Correct Answer: C
Family Midterm Exam Actual 2025/2026 with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+
Graded
SECTION 1: PHARMACOKINETICS & PHARMACODYNAMICS (12
Questions)
Q1: A patient with heart failure is started on digoxin. Which laboratory value should
the nurse monitor most closely to prevent toxicity?
● A. Serum sodium
● B. Serum potassium
● C. Serum calcium
● D. Serum magnesium
● Correct Answer: B
● Rationale: Correct because hypokalemia increases the risk of digoxin toxicity
by enhancing its binding to cardiac sodium-potassium ATPase pumps.
Q2: A 65-year-old female with type 2 diabetes has a GFR of 45 mL/min. Which oral
antidiabetic agent requires dose adjustment or avoidance?
● A. Metformin
● B. Glipizide
● C. Pioglitazone
● D. Sitagliptin
● Correct Answer: A
● Rationale: Correct because metformin is contraindicated with GFR <30 and
requires dose reduction at GFR 30-45 due to lactic acidosis risk.
Q3: A patient is prescribed warfarin for atrial fibrillation. Which herbal supplement
should the patient be warned to avoid due to increased bleeding risk?
, ● A. Garlic
● B. Echinacea
● C. St. John's Wort
● D. Valerian root
● Correct Answer: A
● Rationale: Correct because garlic has antiplatelet effects and potentiates
warfarin, increasing INR and bleeding risk.
Q4: A 28-year-old female with epilepsy is planning pregnancy. Which anticonvulsant
is considered the safest during pregnancy?
● A. Valproic acid
● B. Phenytoin
● C. Lamotrigine
● D. Carbamazepine
● Correct Answer: C
● Rationale: Correct because lamotrigine has the most favorable reproductive
safety profile among anticonvulsants with lower teratogenicity risk.
Q5: Which beta-blocker is preferred for heart failure with reduced ejection fraction?
● A. Atenolol
● B. Propranolol
● C. Metoprolol succinate
● D. Nadolol
● Correct Answer: C
● Rationale: Correct because metoprolol succinate (extended-release) is
FDA-approved for heart failure and has proven mortality benefit.
Q6: A patient on lisinopril develops a persistent dry cough. What is the most likely
cause?
● A. Bronchospasm
● B. Angioedema
● C. Bradykinin accumulation
● D. Histamine release
● Correct Answer: C
● Rationale: Correct because ACE inhibitors prevent bradykinin breakdown,
leading to accumulation and cough.
, Q7: A 55-year-old male with benign prostatic hyperplasia is prescribed tamsulosin.
Which side effect is most commonly associated?
● A. Orthostatic hypotension
● B. Gynecomastia
● C. Hyperkalemia
● D. Tachycardia
● Correct Answer: A
● Rationale: Correct because tamsulosin is an alpha-blocker causing
vasodilation and orthostatic hypotension.
Q8: A patient on lithium therapy has a serum level of 1.8 mEq/L. What symptoms
should the nurse anticipate?
● A. Hypothyroidism
● B. Tremor, confusion, nausea
● C. Polyuria and polydipsia
● D. Weight gain
● Correct Answer: B
● Rationale: Correct because levels above 1.5 mEq/L indicate lithium toxicity
with GI and neurologic symptoms.
Q9: Which statin has the greatest potency for LDL reduction?
● A. Pravastatin
● B. Rosuvastatin
● C. Atorvastatin
● D. Simvastatin
● Correct Answer: B
● Rationale: Correct because rosuvastatin is the most potent statin with highest
LDL reduction at equivalent doses.
Q10: A patient is started on sertraline for depression. How long should the nurse
advise the patient to wait for therapeutic effect?
● A. 1-3 days
● B. 1-2 weeks
● C. 4-6 weeks
● D. 8-10 weeks
● Correct Answer: C
