NR 566 MIDTERM EXAM PREP – ADVANCED PHARMACOLOGY – (2026) ACTUAL QUESTIONS AND ANSWERS
ALREADY GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | (CHAMBERLAIN)|
GRADED A+
Question 1
An APRN is prescribing a statin for a 60-year-old patient with a history of coronary artery disease. The patient's
LDL is 160 mg/dL. Which of the following is the most appropriate recommendation?
A. Moderate-intensity statin therapy
B. High-intensity statin therapy
C. Low-intensity statin therapy
D. PCSK9 inhibitor alone
🟢 Correct Answer: B. High-intensity statin therapy
🔴 RATIONALE: High-intensity statin therapy is recommended for secondary prevention in patients with clinical
ASCVD (including coronary artery disease) with an LDL ≥ 70 mg/dL. The goal is to reduce LDL by at least 50%.
Moderate-intensity is for primary prevention or lower risk. PCSK9 inhibitors are used as add-on therapy.
Question 2
,A patient is prescribed a calcium channel blocker for hypertension. Which of the following side effects is most
commonly associated with dihydropyridine calcium channel blockers?
A. Constipation
B. Peripheral edema
C. Bradycardia
D. Heart block
🟢 Correct Answer: B. Peripheral edema
🔴 RATIONALE: Dihydropyridine calcium channel blockers (e.g., amlodipine, nifedipine) commonly cause
peripheral edema due to vasodilation. Constipation, bradycardia, and heart block are more associated with non-
dihydropyridines (e.g., verapamil, diltiazem).
Question 3
A patient with type 2 diabetes is prescribed metformin. Which of the following is the mechanism of action of
metformin?
A. Stimulates insulin secretion
B. Decreases hepatic glucose production and increases insulin sensitivity
C. Delays carbohydrate absorption
D. Increases glucagon-like peptide-1 levels
🟢 Correct Answer: B. Decreases hepatic glucose production and increases insulin sensitivity
,🔴 RATIONALE: Metformin works by decreasing hepatic glucose production (gluconeogenesis) and increasing
peripheral insulin sensitivity. It does not stimulate insulin secretion (sulfonylureas do), delay carbohydrate
absorption (acarbose does), or increase GLP-1 (GLP-1 agonists do).
Question 4
A patient with heart failure is prescribed furosemide. Which of the following electrolyte imbalances is most likely
to occur?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
🟢 Correct Answer: B. Hypokalemia
🔴 RATIONALE: Furosemide is a loop diuretic that inhibits sodium-potassium-chloride cotransport in the loop
of Henle, leading to increased potassium excretion and hypokalemia. Hyperkalemia is associated with
potassium-sparing diuretics.
Question 5
, A patient with a history of peptic ulcer disease is prescribed a PPI and is also on clopidogrel. Which of the
following PPIs should be avoided due to a drug interaction?
A. Omeprazole
B. Pantoprazole
C. Rabeprazole
D. Esomeprazole
🟢 Correct Answer: A. Omeprazole
🔴 RATIONALE: Omeprazole is a CYP2C19 inhibitor and reduces the activation of clopidogrel, decreasing its
antiplatelet effect. Pantoprazole is preferred as it has less effect on CYP2C19. Rabeprazole and esomeprazole
also have some interaction, but omeprazole is most commonly cited.
Question 6
A patient with asthma is prescribed an inhaled corticosteroid and a LABA combination. Which of the following is
the correct use of this combination?
A. Use as needed for acute symptoms
B. Use daily for maintenance therapy
C. Use only before exercise
D. Use only during allergy season
🟢 Correct Answer: B. Use daily for maintenance therapy
ALREADY GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | (CHAMBERLAIN)|
GRADED A+
Question 1
An APRN is prescribing a statin for a 60-year-old patient with a history of coronary artery disease. The patient's
LDL is 160 mg/dL. Which of the following is the most appropriate recommendation?
A. Moderate-intensity statin therapy
B. High-intensity statin therapy
C. Low-intensity statin therapy
D. PCSK9 inhibitor alone
🟢 Correct Answer: B. High-intensity statin therapy
🔴 RATIONALE: High-intensity statin therapy is recommended for secondary prevention in patients with clinical
ASCVD (including coronary artery disease) with an LDL ≥ 70 mg/dL. The goal is to reduce LDL by at least 50%.
Moderate-intensity is for primary prevention or lower risk. PCSK9 inhibitors are used as add-on therapy.
Question 2
,A patient is prescribed a calcium channel blocker for hypertension. Which of the following side effects is most
commonly associated with dihydropyridine calcium channel blockers?
A. Constipation
B. Peripheral edema
C. Bradycardia
D. Heart block
🟢 Correct Answer: B. Peripheral edema
🔴 RATIONALE: Dihydropyridine calcium channel blockers (e.g., amlodipine, nifedipine) commonly cause
peripheral edema due to vasodilation. Constipation, bradycardia, and heart block are more associated with non-
dihydropyridines (e.g., verapamil, diltiazem).
Question 3
A patient with type 2 diabetes is prescribed metformin. Which of the following is the mechanism of action of
metformin?
A. Stimulates insulin secretion
B. Decreases hepatic glucose production and increases insulin sensitivity
C. Delays carbohydrate absorption
D. Increases glucagon-like peptide-1 levels
🟢 Correct Answer: B. Decreases hepatic glucose production and increases insulin sensitivity
,🔴 RATIONALE: Metformin works by decreasing hepatic glucose production (gluconeogenesis) and increasing
peripheral insulin sensitivity. It does not stimulate insulin secretion (sulfonylureas do), delay carbohydrate
absorption (acarbose does), or increase GLP-1 (GLP-1 agonists do).
Question 4
A patient with heart failure is prescribed furosemide. Which of the following electrolyte imbalances is most likely
to occur?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
🟢 Correct Answer: B. Hypokalemia
🔴 RATIONALE: Furosemide is a loop diuretic that inhibits sodium-potassium-chloride cotransport in the loop
of Henle, leading to increased potassium excretion and hypokalemia. Hyperkalemia is associated with
potassium-sparing diuretics.
Question 5
, A patient with a history of peptic ulcer disease is prescribed a PPI and is also on clopidogrel. Which of the
following PPIs should be avoided due to a drug interaction?
A. Omeprazole
B. Pantoprazole
C. Rabeprazole
D. Esomeprazole
🟢 Correct Answer: A. Omeprazole
🔴 RATIONALE: Omeprazole is a CYP2C19 inhibitor and reduces the activation of clopidogrel, decreasing its
antiplatelet effect. Pantoprazole is preferred as it has less effect on CYP2C19. Rabeprazole and esomeprazole
also have some interaction, but omeprazole is most commonly cited.
Question 6
A patient with asthma is prescribed an inhaled corticosteroid and a LABA combination. Which of the following is
the correct use of this combination?
A. Use as needed for acute symptoms
B. Use daily for maintenance therapy
C. Use only before exercise
D. Use only during allergy season
🟢 Correct Answer: B. Use daily for maintenance therapy
