FULL TEST BANK Pharmacotherapeutics for
Advanced Nursing Questions and Correct
Answers (Verified Answers) Plus Rationale
2027 Q&A| Instant Download Pdf
1. A patient with hypertension is prescribed lisinopril. Which
mechanism best describes how this medication lowers blood
pressure?
A. Blocks beta-1 adrenergic receptors
B. Blocks calcium channels in vascular smooth muscle
C. Inhibits angiotensin-converting enzyme
D. Increases sodium reabsorption in the kidneys
Answer: C. Inhibits angiotensin-converting enzyme
Rationale: Lisinopril is an angiotensin-converting enzyme (ACE)
inhibitor. It decreases the conversion of angiotensin I to angiotensin II,
resulting in reduced vasoconstriction and decreased aldosterone
,secretion. This lowers blood pressure and reduces sodium and water
retention.
2. Which laboratory value is particularly important to monitor in a
patient taking an ACE inhibitor?
A. Serum amylase
B. Serum potassium
C. Hemoglobin A1c only
D. Platelet count
Answer: B. Serum potassium
Rationale: ACE inhibitors can decrease aldosterone production, which
may reduce potassium excretion and cause hyperkalemia. Renal
function, particularly serum creatinine, should also be monitored.
3. A patient taking warfarin has an international normalized ratio
(INR) of 5.8 without active bleeding. What is the most appropriate
general consideration?
A. Increase the warfarin dose
B. Continue the same dose without reassessment
C. Hold or adjust warfarin according to the clinical protocol and
reassess INR
D. Administer an additional anticoagulant
,Answer: C. Hold or adjust warfarin according to the clinical protocol
and reassess INR
Rationale: An INR substantially above the therapeutic range increases
bleeding risk. Management depends on the degree of elevation,
bleeding status, indication for anticoagulation, and current guidelines.
The medication should not simply be increased or continued without
evaluation.
4. Which medication is classified as a direct oral anticoagulant
(DOAC)?
A. Warfarin
B. Apixaban
C. Heparin
D. Alteplase
Answer: B. Apixaban
Rationale: Apixaban is a direct factor Xa inhibitor and belongs to the
DOAC class. Warfarin is a vitamin K antagonist, unfractionated heparin
works through antithrombin, and alteplase is a thrombolytic agent.
5. A patient taking a statin reports unexplained muscle pain and
weakness. Which laboratory test may be appropriate when
significant statin-associated muscle symptoms are suspected?
, A. Creatine kinase
B. Serum sodium
C. INR
D. Serum bilirubin only
Answer: A. Creatine kinase
Rationale: Creatine kinase (CK) may be evaluated when clinically
significant muscle injury is suspected in a patient receiving a statin.
Severe muscle injury can lead to rhabdomyolysis, although routine CK
monitoring is not required for every patient taking a statin.
6. Which medication is a beta-1 selective adrenergic blocker
commonly used for hypertension and certain cardiac conditions?
A. Metoprolol
B. Amlodipine
C. Losartan
D. Hydrochlorothiazide
Answer: A. Metoprolol
Rationale: Metoprolol primarily blocks beta-1 adrenergic receptors at
usual therapeutic doses, reducing heart rate, myocardial contractility,
and cardiac workload. Amlodipine is a calcium-channel blocker, losartan
Advanced Nursing Questions and Correct
Answers (Verified Answers) Plus Rationale
2027 Q&A| Instant Download Pdf
1. A patient with hypertension is prescribed lisinopril. Which
mechanism best describes how this medication lowers blood
pressure?
A. Blocks beta-1 adrenergic receptors
B. Blocks calcium channels in vascular smooth muscle
C. Inhibits angiotensin-converting enzyme
D. Increases sodium reabsorption in the kidneys
Answer: C. Inhibits angiotensin-converting enzyme
Rationale: Lisinopril is an angiotensin-converting enzyme (ACE)
inhibitor. It decreases the conversion of angiotensin I to angiotensin II,
resulting in reduced vasoconstriction and decreased aldosterone
,secretion. This lowers blood pressure and reduces sodium and water
retention.
2. Which laboratory value is particularly important to monitor in a
patient taking an ACE inhibitor?
A. Serum amylase
B. Serum potassium
C. Hemoglobin A1c only
D. Platelet count
Answer: B. Serum potassium
Rationale: ACE inhibitors can decrease aldosterone production, which
may reduce potassium excretion and cause hyperkalemia. Renal
function, particularly serum creatinine, should also be monitored.
3. A patient taking warfarin has an international normalized ratio
(INR) of 5.8 without active bleeding. What is the most appropriate
general consideration?
A. Increase the warfarin dose
B. Continue the same dose without reassessment
C. Hold or adjust warfarin according to the clinical protocol and
reassess INR
D. Administer an additional anticoagulant
,Answer: C. Hold or adjust warfarin according to the clinical protocol
and reassess INR
Rationale: An INR substantially above the therapeutic range increases
bleeding risk. Management depends on the degree of elevation,
bleeding status, indication for anticoagulation, and current guidelines.
The medication should not simply be increased or continued without
evaluation.
4. Which medication is classified as a direct oral anticoagulant
(DOAC)?
A. Warfarin
B. Apixaban
C. Heparin
D. Alteplase
Answer: B. Apixaban
Rationale: Apixaban is a direct factor Xa inhibitor and belongs to the
DOAC class. Warfarin is a vitamin K antagonist, unfractionated heparin
works through antithrombin, and alteplase is a thrombolytic agent.
5. A patient taking a statin reports unexplained muscle pain and
weakness. Which laboratory test may be appropriate when
significant statin-associated muscle symptoms are suspected?
, A. Creatine kinase
B. Serum sodium
C. INR
D. Serum bilirubin only
Answer: A. Creatine kinase
Rationale: Creatine kinase (CK) may be evaluated when clinically
significant muscle injury is suspected in a patient receiving a statin.
Severe muscle injury can lead to rhabdomyolysis, although routine CK
monitoring is not required for every patient taking a statin.
6. Which medication is a beta-1 selective adrenergic blocker
commonly used for hypertension and certain cardiac conditions?
A. Metoprolol
B. Amlodipine
C. Losartan
D. Hydrochlorothiazide
Answer: A. Metoprolol
Rationale: Metoprolol primarily blocks beta-1 adrenergic receptors at
usual therapeutic doses, reducing heart rate, myocardial contractility,
and cardiac workload. Amlodipine is a calcium-channel blocker, losartan
