NR 566 FINAL EXAM PREP – ADVANCED PHARMACOLOGY – (2026) ACTUAL QUESTIONS AND ANSWERS
ALREADY GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
An APRN is considering prescribing a statin for a 55-year-old patient with type 2 diabetes, hypertension, and an
LDL of 140 mg/dL. The patient's 10-year ASCVD risk is 12%. Which of the following is the most appropriate
recommendation?
A. Recommend lifestyle modifications only
B. Initiate moderate-intensity statin therapy
C. Initiate high-intensity statin therapy
D. Initiate a PCSK9 inhibitor
🟢 Correct Answer: B. Initiate moderate-intensity statin therapy
🔴 RATIONALE: The patient has type 2 diabetes and an LDL ≥ 70 mg/dL, which qualifies for moderate-intensity
statin therapy. High-intensity statins are indicated for patients with clinical ASCVD or very high risk (multiple risk
factors). PCSK9 inhibitors are used as add-on therapy for patients with familial hypercholesterolemia or those
who cannot achieve goals on maximally tolerated statins.
Question 2
,A 72-year-old female with heart failure with reduced ejection fraction (HFrEF) is taking sacubitril/valsartan.
Which of the following laboratory findings requires immediate attention?
A. Serum potassium of 5.1 mEq/L
B. Serum creatinine of 1.2 mg/dL
C. Serum potassium of 5.9 mEq/L
D. Serum sodium of 135 mEq/L
🟢 Correct Answer: C. Serum potassium of 5.9 mEq/L
🔴 RATIONALE: Sacubitril/valsartan (an ARNI) can cause hyperkalemia. A potassium of 5.9 mEq/L is significantly
elevated and requires immediate intervention. Potassium levels should be monitored and management
adjusted for levels > 5.0 mEq/L. The other values are within acceptable ranges.
Question 3
A patient with type 2 diabetes is prescribed canagliflozin. Which of the following is a key monitoring parameter
specific to this medication?
A. Liver function tests
B. Serum creatinine
C. Genital mycotic infections
D. Complete blood count
🟢 Correct Answer: C. Genital mycotic infections
,🔴 RATIONALE: SGLT2 inhibitors, including canagliflozin, increase the risk of genital mycotic infections due to
the excretion of glucose in the urine. Patients should be counseled on signs and symptoms. Renal function
monitoring is also important, but genital infections are a specific side effect of this class.
Question 4
An APRN is starting a patient on empagliflozin for type 2 diabetes with known cardiovascular disease. Which of
the following is a significant benefit of this medication that may influence the prescribing decision?
A. Decreased risk of hypoglycemia
B. Reduced risk of cardiovascular death and hospitalization for heart failure
C. Improved glycemic control
D. Weight loss
🟢 Correct Answer: B. Reduced risk of cardiovascular death and hospitalization for heart failure
🔴 RATIONALE: Empagliflozin has been shown in EMPA-REG OUTCOME to reduce cardiovascular death and
hospitalization for heart failure. Weight loss and improved glycemic control are benefits, but the primary driver
for use in patients with cardiovascular disease is the cardiovascular mortality benefit.
Question 5
, A 45-year-old patient is prescribed levothyroxine for newly diagnosed hypothyroidism. Which of the following
patient statements indicates a correct understanding of the medication?
A. "I should take my medication with food to avoid stomach upset."
B. "I should take my medication in the morning on an empty stomach."
C. "I can stop taking my medication when my symptoms improve."
D. "I should take my medication with a calcium supplement for better absorption."
🟢 Correct Answer: B. "I should take my medication in the morning on an empty stomach."
🔴 RATIONALE: Levothyroxine should be taken on an empty stomach in the morning, at least 30-60 minutes
before eating, to maximize absorption. It should not be taken with food, calcium, or iron supplements.
Levothyroxine is typically a lifelong medication.
Question 6
A patient with asthma is prescribed a LABA (long-acting beta-agonist). Which of the following is a critical safety
consideration regarding LABA monotherapy?
A. It should be used as rescue therapy for acute symptoms
B. It should never be used as monotherapy without an inhaled corticosteroid
C. It should be taken before exercise to prevent exercise-induced bronchospasm
D. It should be taken at bedtime to prevent nocturnal symptoms
🟢 Correct Answer: B. It should never be used as monotherapy without an inhaled corticosteroid
ALREADY GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
An APRN is considering prescribing a statin for a 55-year-old patient with type 2 diabetes, hypertension, and an
LDL of 140 mg/dL. The patient's 10-year ASCVD risk is 12%. Which of the following is the most appropriate
recommendation?
A. Recommend lifestyle modifications only
B. Initiate moderate-intensity statin therapy
C. Initiate high-intensity statin therapy
D. Initiate a PCSK9 inhibitor
🟢 Correct Answer: B. Initiate moderate-intensity statin therapy
🔴 RATIONALE: The patient has type 2 diabetes and an LDL ≥ 70 mg/dL, which qualifies for moderate-intensity
statin therapy. High-intensity statins are indicated for patients with clinical ASCVD or very high risk (multiple risk
factors). PCSK9 inhibitors are used as add-on therapy for patients with familial hypercholesterolemia or those
who cannot achieve goals on maximally tolerated statins.
Question 2
,A 72-year-old female with heart failure with reduced ejection fraction (HFrEF) is taking sacubitril/valsartan.
Which of the following laboratory findings requires immediate attention?
A. Serum potassium of 5.1 mEq/L
B. Serum creatinine of 1.2 mg/dL
C. Serum potassium of 5.9 mEq/L
D. Serum sodium of 135 mEq/L
🟢 Correct Answer: C. Serum potassium of 5.9 mEq/L
🔴 RATIONALE: Sacubitril/valsartan (an ARNI) can cause hyperkalemia. A potassium of 5.9 mEq/L is significantly
elevated and requires immediate intervention. Potassium levels should be monitored and management
adjusted for levels > 5.0 mEq/L. The other values are within acceptable ranges.
Question 3
A patient with type 2 diabetes is prescribed canagliflozin. Which of the following is a key monitoring parameter
specific to this medication?
A. Liver function tests
B. Serum creatinine
C. Genital mycotic infections
D. Complete blood count
🟢 Correct Answer: C. Genital mycotic infections
,🔴 RATIONALE: SGLT2 inhibitors, including canagliflozin, increase the risk of genital mycotic infections due to
the excretion of glucose in the urine. Patients should be counseled on signs and symptoms. Renal function
monitoring is also important, but genital infections are a specific side effect of this class.
Question 4
An APRN is starting a patient on empagliflozin for type 2 diabetes with known cardiovascular disease. Which of
the following is a significant benefit of this medication that may influence the prescribing decision?
A. Decreased risk of hypoglycemia
B. Reduced risk of cardiovascular death and hospitalization for heart failure
C. Improved glycemic control
D. Weight loss
🟢 Correct Answer: B. Reduced risk of cardiovascular death and hospitalization for heart failure
🔴 RATIONALE: Empagliflozin has been shown in EMPA-REG OUTCOME to reduce cardiovascular death and
hospitalization for heart failure. Weight loss and improved glycemic control are benefits, but the primary driver
for use in patients with cardiovascular disease is the cardiovascular mortality benefit.
Question 5
, A 45-year-old patient is prescribed levothyroxine for newly diagnosed hypothyroidism. Which of the following
patient statements indicates a correct understanding of the medication?
A. "I should take my medication with food to avoid stomach upset."
B. "I should take my medication in the morning on an empty stomach."
C. "I can stop taking my medication when my symptoms improve."
D. "I should take my medication with a calcium supplement for better absorption."
🟢 Correct Answer: B. "I should take my medication in the morning on an empty stomach."
🔴 RATIONALE: Levothyroxine should be taken on an empty stomach in the morning, at least 30-60 minutes
before eating, to maximize absorption. It should not be taken with food, calcium, or iron supplements.
Levothyroxine is typically a lifelong medication.
Question 6
A patient with asthma is prescribed a LABA (long-acting beta-agonist). Which of the following is a critical safety
consideration regarding LABA monotherapy?
A. It should be used as rescue therapy for acute symptoms
B. It should never be used as monotherapy without an inhaled corticosteroid
C. It should be taken before exercise to prevent exercise-induced bronchospasm
D. It should be taken at bedtime to prevent nocturnal symptoms
🟢 Correct Answer: B. It should never be used as monotherapy without an inhaled corticosteroid
