Test Bank 2 for NUR 635 Final GCU
Questions and Correct Answers Review /
NUR 635 Advanced Pharmacology Final
Exam Latest Practice Questions with
Correct Answers
SECTION 1: Pharmacokinetics & Pharmacodynamics
1. A patient prescribed sildenafil (Viagra) should be instructed to avoid which of
the following due to a potentially life-threatening interaction?
A) Grapefruit juice
B) Nitroglycerin
C) Dairy products
D) High-fat meals
Rationale: Sildenafil and other PDE5 inhibitors are absolutely contraindicated with
nitrates (nitroglycerin) due to the risk of severe hypotension and cardiovascular collapse.
Both drugs cause vasodilation, and their combined effect can be synergistic and
dangerous.
2. Rapid-acting insulin formulations include:
A) NPH insulin
B) Lispro (Humalog), Aspart (Novolog), Glulisine (Apidra)
C) Regular insulin
D) Glargine (Lantus)
Rationale: Rapid-acting insulin analogs (lispro, aspart, glulisine) have an onset of
approximately 15 minutes, peak in 1-2 hours, and duration of 3-4 hours. They are
designed to be taken immediately before meals.
3. The drug of choice for first-line treatment of Type 2 Diabetes Mellitus is
metformin because it:
A) Stimulates insulin secretion from pancreatic beta cells
B) Decreases glycogenolysis (glucose production) in the liver
,C) Slows carbohydrate absorption from the GI tract
D) Increases insulin sensitivity only in adipose tissue
Rationale: Metformin is the first-line agent for type 2 diabetes because it reduces
hepatic glucose production (gluconeogenesis and glycogenolysis) and improves
peripheral insulin sensitivity. Unlike sulfonylureas, it does not cause hypoglycemia or
weight gain.
4. Beta-blockers prescribed to patients with diabetes can mask which symptom of
hypoglycemia?
A) Sweating
B) Confusion
C) Tachycardia
D) Hunger
Rationale: Beta-blockers block the sympathetic nervous system response to
hypoglycemia, particularly tachycardia and palpitations. Sweating is mediated by the
parasympathetic system and may still occur. Patients on beta-blockers need education
about recognizing hypoglycemia through other symptoms.
5. A patient with diabetes is being transitioned from NPH insulin to glargine
(Lantus). The APRN should:
A) Increase the glargine dose by 20%
B) Decrease the glargine dose by 20%
C) Maintain the same total daily dose
D) Double the glargine dose
Rationale: When switching from NPH to glargine, the dose should be reduced by
approximately 20% to avoid hypoglycemia due to the different pharmacokinetic profiles
of these insulins. Glargine provides a steady, peakless basal insulin level.
6. Before prescribing metformin, which laboratory value is most important to
assess?
A) Hemoglobin A1c
B) Liver function tests
C) Kidney function (eGFR/CrCl)
D) Serum potassium
Rationale: Metformin is contraindicated in patients with severe renal impairment (eGFR
< 30 mL/min) due to the risk of lactic acidosis. Baseline and periodic renal function
monitoring is essential. The drug should also be held before and after contrast dye
procedures.
7. DPP-4 inhibitors (gliptins) differ from other diabetes medications because they:
A) Directly stimulate insulin secretion independent of glucose
, B) Indirectly increase insulin production through the incretin system
C) Block glucose reabsorption in the kidney
D) Act as insulin sensitizers
Rationale: DPP-4 inhibitors such as sitagliptin work by preventing the breakdown of
GLP-1 and GIP, leading to increased glucose-dependent insulin secretion and decreased
glucagon release. They are weight-neutral and have a low risk of hypoglycemia.
8. GLP-1 receptor agonists work by:
A) Binding to receptors in the pancreas to stimulate insulin release through the
incretin system
B) Directly activating pancreatic beta cells to secrete insulin
C) Inhibiting glucose absorption from the gastrointestinal tract
D) Increasing hepatic glucose production
Rationale: GLP-1 receptor agonists (semaglutide, liraglutide) mimic endogenous GLP-1,
binding to GLP-1 receptors on pancreatic beta cells to stimulate glucose-dependent
insulin secretion. They also slow gastric emptying and promote satiety.
9. A patient prescribed high-dose aspirin should be counseled to monitor for
which adverse effect?
A) Hypertension
B) Tinnitus
C) Constipation
D) Hyperglycemia
Rationale: High-dose aspirin can cause salicylism, with tinnitus being a common early
sign of toxicity. Other symptoms include nausea, vomiting, dizziness, and
hyperventilation.
10. A patient is prescribed finasteride (Proscar) for benign prostatic hyperplasia
(BPH). The APRN explains that this medication:
A) Relaxes smooth muscle in the prostate
B) Decreases the size of the prostate gland
C) Increases urinary flow by reducing inflammation
D) Acts as a direct smooth muscle relaxant
Rationale: Finasteride is a 5-alpha-reductase inhibitor that prevents the conversion of
testosterone to dihydrotestosterone (DHT), thereby reducing prostate size. Alpha-
blockers (tamsulosin) relax smooth muscle but do not reduce prostate size.
11. When prescribing iron for iron deficiency anemia, the APRN should instruct the
patient to take it:
A) With meals to reduce GI upset
B) On an empty stomach with orange juice (vitamin C)
Questions and Correct Answers Review /
NUR 635 Advanced Pharmacology Final
Exam Latest Practice Questions with
Correct Answers
SECTION 1: Pharmacokinetics & Pharmacodynamics
1. A patient prescribed sildenafil (Viagra) should be instructed to avoid which of
the following due to a potentially life-threatening interaction?
A) Grapefruit juice
B) Nitroglycerin
C) Dairy products
D) High-fat meals
Rationale: Sildenafil and other PDE5 inhibitors are absolutely contraindicated with
nitrates (nitroglycerin) due to the risk of severe hypotension and cardiovascular collapse.
Both drugs cause vasodilation, and their combined effect can be synergistic and
dangerous.
2. Rapid-acting insulin formulations include:
A) NPH insulin
B) Lispro (Humalog), Aspart (Novolog), Glulisine (Apidra)
C) Regular insulin
D) Glargine (Lantus)
Rationale: Rapid-acting insulin analogs (lispro, aspart, glulisine) have an onset of
approximately 15 minutes, peak in 1-2 hours, and duration of 3-4 hours. They are
designed to be taken immediately before meals.
3. The drug of choice for first-line treatment of Type 2 Diabetes Mellitus is
metformin because it:
A) Stimulates insulin secretion from pancreatic beta cells
B) Decreases glycogenolysis (glucose production) in the liver
,C) Slows carbohydrate absorption from the GI tract
D) Increases insulin sensitivity only in adipose tissue
Rationale: Metformin is the first-line agent for type 2 diabetes because it reduces
hepatic glucose production (gluconeogenesis and glycogenolysis) and improves
peripheral insulin sensitivity. Unlike sulfonylureas, it does not cause hypoglycemia or
weight gain.
4. Beta-blockers prescribed to patients with diabetes can mask which symptom of
hypoglycemia?
A) Sweating
B) Confusion
C) Tachycardia
D) Hunger
Rationale: Beta-blockers block the sympathetic nervous system response to
hypoglycemia, particularly tachycardia and palpitations. Sweating is mediated by the
parasympathetic system and may still occur. Patients on beta-blockers need education
about recognizing hypoglycemia through other symptoms.
5. A patient with diabetes is being transitioned from NPH insulin to glargine
(Lantus). The APRN should:
A) Increase the glargine dose by 20%
B) Decrease the glargine dose by 20%
C) Maintain the same total daily dose
D) Double the glargine dose
Rationale: When switching from NPH to glargine, the dose should be reduced by
approximately 20% to avoid hypoglycemia due to the different pharmacokinetic profiles
of these insulins. Glargine provides a steady, peakless basal insulin level.
6. Before prescribing metformin, which laboratory value is most important to
assess?
A) Hemoglobin A1c
B) Liver function tests
C) Kidney function (eGFR/CrCl)
D) Serum potassium
Rationale: Metformin is contraindicated in patients with severe renal impairment (eGFR
< 30 mL/min) due to the risk of lactic acidosis. Baseline and periodic renal function
monitoring is essential. The drug should also be held before and after contrast dye
procedures.
7. DPP-4 inhibitors (gliptins) differ from other diabetes medications because they:
A) Directly stimulate insulin secretion independent of glucose
, B) Indirectly increase insulin production through the incretin system
C) Block glucose reabsorption in the kidney
D) Act as insulin sensitizers
Rationale: DPP-4 inhibitors such as sitagliptin work by preventing the breakdown of
GLP-1 and GIP, leading to increased glucose-dependent insulin secretion and decreased
glucagon release. They are weight-neutral and have a low risk of hypoglycemia.
8. GLP-1 receptor agonists work by:
A) Binding to receptors in the pancreas to stimulate insulin release through the
incretin system
B) Directly activating pancreatic beta cells to secrete insulin
C) Inhibiting glucose absorption from the gastrointestinal tract
D) Increasing hepatic glucose production
Rationale: GLP-1 receptor agonists (semaglutide, liraglutide) mimic endogenous GLP-1,
binding to GLP-1 receptors on pancreatic beta cells to stimulate glucose-dependent
insulin secretion. They also slow gastric emptying and promote satiety.
9. A patient prescribed high-dose aspirin should be counseled to monitor for
which adverse effect?
A) Hypertension
B) Tinnitus
C) Constipation
D) Hyperglycemia
Rationale: High-dose aspirin can cause salicylism, with tinnitus being a common early
sign of toxicity. Other symptoms include nausea, vomiting, dizziness, and
hyperventilation.
10. A patient is prescribed finasteride (Proscar) for benign prostatic hyperplasia
(BPH). The APRN explains that this medication:
A) Relaxes smooth muscle in the prostate
B) Decreases the size of the prostate gland
C) Increases urinary flow by reducing inflammation
D) Acts as a direct smooth muscle relaxant
Rationale: Finasteride is a 5-alpha-reductase inhibitor that prevents the conversion of
testosterone to dihydrotestosterone (DHT), thereby reducing prostate size. Alpha-
blockers (tamsulosin) relax smooth muscle but do not reduce prostate size.
11. When prescribing iron for iron deficiency anemia, the APRN should instruct the
patient to take it:
A) With meals to reduce GI upset
B) On an empty stomach with orange juice (vitamin C)
