NR 565 Advanced Pharmacology Final Exam |
Complete Practice Test with Actual Exam Questions
and Verified Correct Answers with Rationales | Latest
Update - 2026/2027 Edition || Chamberlain University
Question 1
In which patient population is Metformin contraindicated in?
A. Diabetics with HA1c < 7.0%
B. Patients older than 50
C. Alcoholics
D. Women suffering from infertility
Answer: C
Rationale: Metformin is contraindicated in alcoholics due to increased risk of lactic acidosis.
Metformin is safe in patients with HA1c < 7%, older adults, and women with infertility.
Question 2
What lab value suggests metformin might be contraindicated?
A. eGFR <30
B. Crea 0.8
C. WBC 7.8
D. BUN 17
Answer: A
Rationale: eGFR <30 indicates severe renal impairment, which is a contraindication to
metformin due to risk of lactic acidosis. Creatinine 0.8, WBC 7.8, and BUN 17 are within
normal limits.
Question 3
What medication is contraindicated to treat diabetes if a patient already has a cardiac ejection
fraction rate of 40%?
A. Second Generation sulfonylureas
B. Thiazolidinediones
C. Dopamine Agonist
D. Glucosidase Inhibitor
Answer: B
pg. 1
,Rationale: Thiazolidinediones (TZDs) cause fluid retention and can exacerbate heart failure.
They are contraindicated in patients with NYHA Class III/IV heart failure or EF < 40%.
Question 4
Sabrina is a 35-year-old female who presents with complaints of fatigue, anxiety, and
palpitations. She has a long history of obesity and reports that she is happy that she has lost 23
pounds in the last 2 months. She also reports that she has trouble sleeping and her husband
complains that she is keeping the house too cold. Physical exam reveals slight tachycardia at 104
bpm and a slightly enlarged thyroid. Thyroid testing reveals hyperthyroidism or Grave's disease.
Which of the following agents is the first-line treatment for hyperthyroidism or Grave's disease?
A. Methimazole
B. Metoprolol
C. Allopurinol
D. Levothyroxine
Answer: A
Rationale: Methimazole is the first-line treatment for hyperthyroidism and Graves' disease. It
inhibits thyroid peroxidase, reducing thyroid hormone production. Metoprolol is used for
symptom management (tachycardia). Levothyroxine is for hypothyroidism.
Question 5
Which of the following medications would be considered the first line of treatment for a newly
diagnosed Diabetic patient with adequate renal and hepatic function?
A. NovoLog Sliding Scale Insulin
B. Liraglutide (Victoza)
C. Oral Metformin
D. Glipizide
Answer: C
Rationale: Metformin is the first-line pharmacologic therapy for type 2 diabetes according to
ADA guidelines. It is preferred due to efficacy, safety, low cost, and lack of weight
gain/hypoglycemia risk.
Question 6
Of the following medications, which is most likely to cause hypoglycemia?
A. Metformin
B. Insulin
C. Incretin mimetics
D. Thiazolidinediones
pg. 2
,Answer: B
Rationale: Insulin carries the highest risk of hypoglycemia. Metformin, incretin mimetics, and
TZDs have lower hypoglycemia risk when used as monotherapy.
Question 7
Which symptoms are most expected of a patient diagnosed with hypothyroidism?
A. shortness of breath, wheezing, fatigue
B. tachycardia, insomnia, weight loss, goiter
C. irritability, anxiety, dizziness, increased sweating
D. dry pale skin, brittle hair, fatigue, myxedema
Answer: D
Rationale: Hypothyroidism causes dry pale skin, brittle hair, fatigue, weight gain, cold
intolerance, constipation, and myxedema. The other options describe hyperthyroidism or other
conditions.
Question 8
Patients with an increased risk for UTIs and genital infections or an active diagnosis, should
avoid what drug class/es for treatment of Type II Diabetes?
A. Thiazolidinediones (Glitazones)
B. Biguanide
C. Sodium-Glucose Cotransporter 2 (SGLT-2) Inhibitors
D. All of the above
Answer: C
Rationale: SGLT-2 inhibitors increase glucose excretion in urine, raising the risk of UTIs and
genital fungal infections. They should be avoided in patients with active infections or high risk.
Question 9
A 45-year-old patient with a history of type 2 diabetes presents to the clinic for a follow-up
appointment. The healthcare provider has prescribed metformin as part of the treatment plan.
Which of the following statements regarding metformin is correct?
A. Metformin primarily stimulates insulin production from the pancreas.
B. Metformin reduces glucose levels primarily by decreasing insulin resistance.
C. Metformin is associated with a risk of hypoglycemia.
D. Metformin improves insulin sensitivity and reduces hepatic glucose production.
Answer: D
Rationale: Metformin improves insulin sensitivity and reduces hepatic glucose production
(gluconeogenesis). It does not stimulate insulin secretion and has low hypoglycemia risk.
pg. 3
, Question 10
In what part of the body are SGLT-2 (sodium-glucose cotransporter 2) inhibitors active?
A. Small intestine
B. Pancreas
C. Renal tubules
D. Stomach
Answer: C
Rationale: SGLT-2 inhibitors act on the renal tubules (proximal convoluted tubule) to block
glucose reabsorption, increasing urinary glucose excretion.
Question 11
Which of the following statements is not true regarding sulfonylureas?
A. Sulfonylureas are safe to prescribe to pregnant and/or breast-feeding women.
B. Patients should be educated about signs and symptoms of hypoglycemia.
C. Sulfonylureas cause a dose-dependent reduction in blood glucose.
D. Sulfonylureas are indicated for only patients diagnosed with type 2 diabetes.
Answer: A
Rationale: Sulfonylureas are not safe in pregnancy (category C/D). They cross the placenta and
can cause neonatal hypoglycemia. They are not recommended during breastfeeding.
Question 12
A 33 year old woman previously diagnosed with hyperthyroidism noted have tachycardia. Which
medication should the NP add to the patient's regimen?
A. Atenolol
B. Levothyroxine
C. Lithium
D. Semaglutide
Answer: A
Rationale: Atenolol (beta-blocker) is added to manage tachycardia and other sympathomimetic
symptoms in hyperthyroidism. Levothyroxine is for hypothyroidism. Lithium can cause
hypothyroidism.
Question 13
Once a patient's thyroid is euthyroid and their dose can be maintained at the prescription, at what
interval should their TSH be re-checked?
A. every 18 months
pg. 4
Complete Practice Test with Actual Exam Questions
and Verified Correct Answers with Rationales | Latest
Update - 2026/2027 Edition || Chamberlain University
Question 1
In which patient population is Metformin contraindicated in?
A. Diabetics with HA1c < 7.0%
B. Patients older than 50
C. Alcoholics
D. Women suffering from infertility
Answer: C
Rationale: Metformin is contraindicated in alcoholics due to increased risk of lactic acidosis.
Metformin is safe in patients with HA1c < 7%, older adults, and women with infertility.
Question 2
What lab value suggests metformin might be contraindicated?
A. eGFR <30
B. Crea 0.8
C. WBC 7.8
D. BUN 17
Answer: A
Rationale: eGFR <30 indicates severe renal impairment, which is a contraindication to
metformin due to risk of lactic acidosis. Creatinine 0.8, WBC 7.8, and BUN 17 are within
normal limits.
Question 3
What medication is contraindicated to treat diabetes if a patient already has a cardiac ejection
fraction rate of 40%?
A. Second Generation sulfonylureas
B. Thiazolidinediones
C. Dopamine Agonist
D. Glucosidase Inhibitor
Answer: B
pg. 1
,Rationale: Thiazolidinediones (TZDs) cause fluid retention and can exacerbate heart failure.
They are contraindicated in patients with NYHA Class III/IV heart failure or EF < 40%.
Question 4
Sabrina is a 35-year-old female who presents with complaints of fatigue, anxiety, and
palpitations. She has a long history of obesity and reports that she is happy that she has lost 23
pounds in the last 2 months. She also reports that she has trouble sleeping and her husband
complains that she is keeping the house too cold. Physical exam reveals slight tachycardia at 104
bpm and a slightly enlarged thyroid. Thyroid testing reveals hyperthyroidism or Grave's disease.
Which of the following agents is the first-line treatment for hyperthyroidism or Grave's disease?
A. Methimazole
B. Metoprolol
C. Allopurinol
D. Levothyroxine
Answer: A
Rationale: Methimazole is the first-line treatment for hyperthyroidism and Graves' disease. It
inhibits thyroid peroxidase, reducing thyroid hormone production. Metoprolol is used for
symptom management (tachycardia). Levothyroxine is for hypothyroidism.
Question 5
Which of the following medications would be considered the first line of treatment for a newly
diagnosed Diabetic patient with adequate renal and hepatic function?
A. NovoLog Sliding Scale Insulin
B. Liraglutide (Victoza)
C. Oral Metformin
D. Glipizide
Answer: C
Rationale: Metformin is the first-line pharmacologic therapy for type 2 diabetes according to
ADA guidelines. It is preferred due to efficacy, safety, low cost, and lack of weight
gain/hypoglycemia risk.
Question 6
Of the following medications, which is most likely to cause hypoglycemia?
A. Metformin
B. Insulin
C. Incretin mimetics
D. Thiazolidinediones
pg. 2
,Answer: B
Rationale: Insulin carries the highest risk of hypoglycemia. Metformin, incretin mimetics, and
TZDs have lower hypoglycemia risk when used as monotherapy.
Question 7
Which symptoms are most expected of a patient diagnosed with hypothyroidism?
A. shortness of breath, wheezing, fatigue
B. tachycardia, insomnia, weight loss, goiter
C. irritability, anxiety, dizziness, increased sweating
D. dry pale skin, brittle hair, fatigue, myxedema
Answer: D
Rationale: Hypothyroidism causes dry pale skin, brittle hair, fatigue, weight gain, cold
intolerance, constipation, and myxedema. The other options describe hyperthyroidism or other
conditions.
Question 8
Patients with an increased risk for UTIs and genital infections or an active diagnosis, should
avoid what drug class/es for treatment of Type II Diabetes?
A. Thiazolidinediones (Glitazones)
B. Biguanide
C. Sodium-Glucose Cotransporter 2 (SGLT-2) Inhibitors
D. All of the above
Answer: C
Rationale: SGLT-2 inhibitors increase glucose excretion in urine, raising the risk of UTIs and
genital fungal infections. They should be avoided in patients with active infections or high risk.
Question 9
A 45-year-old patient with a history of type 2 diabetes presents to the clinic for a follow-up
appointment. The healthcare provider has prescribed metformin as part of the treatment plan.
Which of the following statements regarding metformin is correct?
A. Metformin primarily stimulates insulin production from the pancreas.
B. Metformin reduces glucose levels primarily by decreasing insulin resistance.
C. Metformin is associated with a risk of hypoglycemia.
D. Metformin improves insulin sensitivity and reduces hepatic glucose production.
Answer: D
Rationale: Metformin improves insulin sensitivity and reduces hepatic glucose production
(gluconeogenesis). It does not stimulate insulin secretion and has low hypoglycemia risk.
pg. 3
, Question 10
In what part of the body are SGLT-2 (sodium-glucose cotransporter 2) inhibitors active?
A. Small intestine
B. Pancreas
C. Renal tubules
D. Stomach
Answer: C
Rationale: SGLT-2 inhibitors act on the renal tubules (proximal convoluted tubule) to block
glucose reabsorption, increasing urinary glucose excretion.
Question 11
Which of the following statements is not true regarding sulfonylureas?
A. Sulfonylureas are safe to prescribe to pregnant and/or breast-feeding women.
B. Patients should be educated about signs and symptoms of hypoglycemia.
C. Sulfonylureas cause a dose-dependent reduction in blood glucose.
D. Sulfonylureas are indicated for only patients diagnosed with type 2 diabetes.
Answer: A
Rationale: Sulfonylureas are not safe in pregnancy (category C/D). They cross the placenta and
can cause neonatal hypoglycemia. They are not recommended during breastfeeding.
Question 12
A 33 year old woman previously diagnosed with hyperthyroidism noted have tachycardia. Which
medication should the NP add to the patient's regimen?
A. Atenolol
B. Levothyroxine
C. Lithium
D. Semaglutide
Answer: A
Rationale: Atenolol (beta-blocker) is added to manage tachycardia and other sympathomimetic
symptoms in hyperthyroidism. Levothyroxine is for hypothyroidism. Lithium can cause
hypothyroidism.
Question 13
Once a patient's thyroid is euthyroid and their dose can be maintained at the prescription, at what
interval should their TSH be re-checked?
A. every 18 months
pg. 4
