WGU D116 Advanced Pharmacology OA Exam
2026/2027 Actual Exam - 450 Questions with
Detailed Rationales | 100% Verified Answers Pass
Guaranteed - A+ Graded
1. An elderly patient with a history of heart failure and chronic kidney disease is prescribed metformin for newly
diagnosed type 2 diabetes. The nurse should be most concerned about which potential complication?
A) Hypoglycemia
B) Lactic acidosis
C) Hyperkalemia
D) Weight gain
Answer: B
Rationale: Metformin is contraindicated in patients with renal impairment due to the risk of lactic acidosis, a rare but
life-threatening complication; the patient's CKD increases this risk significantly, and the medication should be used
with extreme caution or avoided.
2. A patient receiving warfarin therapy has an INR of 5.2 and reports bleeding gums. Which of the following
interventions should the nurse anticipate?
A) Administer vitamin K orally
B) Administer protamine sulfate
pg. 1
,C) Increase the warfarin dose
D) Administer fresh frozen plasma
Answer: A
Rationale: An INR of 5.2 with bleeding indicates excessive anticoagulation; oral vitamin K is the appropriate
reversal agent for warfarin when the INR is elevated but there is no life-threatening bleeding; protamine sulfate is
used for heparin reversal.
3. A patient is prescribed a selective serotonin reuptake inhibitor (SSRI) for depression. The nurse should educate
the patient that therapeutic effects typically require how long to manifest?
A) 24-48 hours
B) 3-5 days
C) 2-4 weeks
D) 6-8 weeks
Answer: C
Rationale: SSRIs typically require 2-4 weeks of consistent dosing before therapeutic effects are seen; this delayed
onset is due to the time required for adaptive changes in serotonin receptors; patients should be instructed not to
discontinue the medication prematurely due to lack of immediate effect.
4. A patient with angina is prescribed sublingual nitroglycerin. Which instruction regarding storage and
administration is most important?
pg. 2
,A) Store the tablets in a light-resistant container
B) Replace the tablets every 12 months
C) Take the medication with a full glass of water
D) Chew the tablet for faster absorption
Answer: A
Rationale: Nitroglycerin is light-sensitive and should be stored in its original light-resistant container; it should be
replaced every 6 months, and administered sublingually (dissolved under the tongue) without swallowing or
chewing.
5. A patient receiving vancomycin therapy is at risk for which of the following adverse effects that requires
therapeutic drug monitoring?
A) Hepatotoxicity
B) Nephrotoxicity and ototoxicity
C) Cardiotoxicity
D) Bone marrow suppression
Answer: B
pg. 3
, Rationale: Vancomycin is associated with nephrotoxicity and ototoxicity, especially when serum levels exceed
therapeutic range; peak and trough levels should be monitored to ensure efficacy and minimize toxicity; trough
levels are typically maintained at 10-20 mcg/mL.
6. A patient with asthma uses an albuterol inhaler. The nurse should explain that albuterol primarily works by which
mechanism?
A) Blocking muscarinic receptors
B) Stimulating beta-2 adrenergic receptors
C) Inhibiting phosphodiesterase
D) Stabilizing mast cells
Answer: B
Rationale: Albuterol is a short-acting beta-2 agonist that stimulates beta-2 receptors in the bronchial smooth muscle,
leading to bronchodilation; it is the first-line rescue medication for acute asthma symptoms due to its rapid onset of
action.
7. A patient is prescribed digoxin for heart failure. The nurse should monitor for signs of digoxin toxicity, which
include which of the following?
A) Tachycardia and hypertension
B) Nausea, vomiting, and visual disturbances
C) Hypokalemia and hyperglycemia
pg. 4
2026/2027 Actual Exam - 450 Questions with
Detailed Rationales | 100% Verified Answers Pass
Guaranteed - A+ Graded
1. An elderly patient with a history of heart failure and chronic kidney disease is prescribed metformin for newly
diagnosed type 2 diabetes. The nurse should be most concerned about which potential complication?
A) Hypoglycemia
B) Lactic acidosis
C) Hyperkalemia
D) Weight gain
Answer: B
Rationale: Metformin is contraindicated in patients with renal impairment due to the risk of lactic acidosis, a rare but
life-threatening complication; the patient's CKD increases this risk significantly, and the medication should be used
with extreme caution or avoided.
2. A patient receiving warfarin therapy has an INR of 5.2 and reports bleeding gums. Which of the following
interventions should the nurse anticipate?
A) Administer vitamin K orally
B) Administer protamine sulfate
pg. 1
,C) Increase the warfarin dose
D) Administer fresh frozen plasma
Answer: A
Rationale: An INR of 5.2 with bleeding indicates excessive anticoagulation; oral vitamin K is the appropriate
reversal agent for warfarin when the INR is elevated but there is no life-threatening bleeding; protamine sulfate is
used for heparin reversal.
3. A patient is prescribed a selective serotonin reuptake inhibitor (SSRI) for depression. The nurse should educate
the patient that therapeutic effects typically require how long to manifest?
A) 24-48 hours
B) 3-5 days
C) 2-4 weeks
D) 6-8 weeks
Answer: C
Rationale: SSRIs typically require 2-4 weeks of consistent dosing before therapeutic effects are seen; this delayed
onset is due to the time required for adaptive changes in serotonin receptors; patients should be instructed not to
discontinue the medication prematurely due to lack of immediate effect.
4. A patient with angina is prescribed sublingual nitroglycerin. Which instruction regarding storage and
administration is most important?
pg. 2
,A) Store the tablets in a light-resistant container
B) Replace the tablets every 12 months
C) Take the medication with a full glass of water
D) Chew the tablet for faster absorption
Answer: A
Rationale: Nitroglycerin is light-sensitive and should be stored in its original light-resistant container; it should be
replaced every 6 months, and administered sublingually (dissolved under the tongue) without swallowing or
chewing.
5. A patient receiving vancomycin therapy is at risk for which of the following adverse effects that requires
therapeutic drug monitoring?
A) Hepatotoxicity
B) Nephrotoxicity and ototoxicity
C) Cardiotoxicity
D) Bone marrow suppression
Answer: B
pg. 3
, Rationale: Vancomycin is associated with nephrotoxicity and ototoxicity, especially when serum levels exceed
therapeutic range; peak and trough levels should be monitored to ensure efficacy and minimize toxicity; trough
levels are typically maintained at 10-20 mcg/mL.
6. A patient with asthma uses an albuterol inhaler. The nurse should explain that albuterol primarily works by which
mechanism?
A) Blocking muscarinic receptors
B) Stimulating beta-2 adrenergic receptors
C) Inhibiting phosphodiesterase
D) Stabilizing mast cells
Answer: B
Rationale: Albuterol is a short-acting beta-2 agonist that stimulates beta-2 receptors in the bronchial smooth muscle,
leading to bronchodilation; it is the first-line rescue medication for acute asthma symptoms due to its rapid onset of
action.
7. A patient is prescribed digoxin for heart failure. The nurse should monitor for signs of digoxin toxicity, which
include which of the following?
A) Tachycardia and hypertension
B) Nausea, vomiting, and visual disturbances
C) Hypokalemia and hyperglycemia
pg. 4
