WGU D116 ADVANCED PHARMACOLOGY FINAL
EXAM OBJECTIVE ASSEMENT Questions and
Correct Answers (Verified Answers) Plus Rationale
2027 Q&A| Instant Download Pdf
Question 1
A patient with hypertension is prescribed lisinopril. Which mechanism
best describes how this medication lowers blood pressure?
A. Blocks beta-1 adrenergic receptors in the heart
B. Blocks calcium channels in vascular smooth muscle
C. Inhibits conversion of angiotensin I to angiotensin II
D. Promotes direct sodium excretion by the kidneys
Answer: C. Inhibits conversion of angiotensin I to angiotensin II
Rationale: Lisinopril is an angiotensin-converting enzyme (ACE)
inhibitor. It decreases the conversion of angiotensin I to angiotensin II,
reducing vasoconstriction and aldosterone secretion. This lowers
systemic vascular resistance and sodium and water retention. ACE
inhibitors can also increase bradykinin, contributing to the
characteristic dry cough.
,Question 2
A patient taking an ACE inhibitor develops swelling of the lips and
tongue. What is the nurse's priority action?
A. Administer the next scheduled dose with food
B. Document the finding as an expected adverse effect
C. Assess the airway and obtain emergency assistance
D. Encourage increased oral fluid intake
Answer: C. Assess the airway and obtain emergency assistance
Rationale: Facial, lip, and tongue swelling can indicate angioedema, a
potentially life-threatening reaction to ACE inhibitors. Airway
compromise can develop rapidly, so airway assessment and
emergency intervention take priority. The medication should not be
continued without evaluation.
Question 3
Which patient would require the greatest caution before receiving a
nonselective beta blocker?
,A. Patient with controlled hypothyroidism
B. Patient with asthma and recurrent bronchospasm
C. Patient with mild seasonal allergies
D. Patient with iron-deficiency anemia
Answer: B. Patient with asthma and recurrent bronchospasm
Rationale: Nonselective beta blockers block both beta-1 and beta-2
receptors. Blocking beta-2 receptors in bronchial smooth muscle can
cause bronchoconstriction and worsen asthma. Cardioselective beta-1
blockers may sometimes be considered when clinically appropriate,
but caution is still required.
Question 4
A patient taking metoprolol should be monitored most closely for
which adverse effect?
A. Tachycardia
B. Bradycardia
C. Severe hyperglycemia
D. Increased salivation
Answer: B. Bradycardia
, Rationale: Metoprolol is a beta-1 selective adrenergic blocker that
decreases heart rate, myocardial contractility, and conduction.
Bradycardia and hypotension are important adverse effects. Beta
blockers may also mask some manifestations of hypoglycemia,
particularly tachycardia.
Question 5
A patient taking warfarin asks which laboratory test is routinely used to
monitor therapeutic effect. Which response is correct?
A. aPTT
B. INR
C. Serum creatinine
D. Platelet count only
Answer: B. INR
Rationale: Warfarin therapy is monitored using the international
normalized ratio (INR), which standardizes prothrombin-time
measurements. The therapeutic INR target depends on the indication.
Excessive anticoagulation increases bleeding risk, while inadequate
anticoagulation increases thromboembolic risk.
EXAM OBJECTIVE ASSEMENT Questions and
Correct Answers (Verified Answers) Plus Rationale
2027 Q&A| Instant Download Pdf
Question 1
A patient with hypertension is prescribed lisinopril. Which mechanism
best describes how this medication lowers blood pressure?
A. Blocks beta-1 adrenergic receptors in the heart
B. Blocks calcium channels in vascular smooth muscle
C. Inhibits conversion of angiotensin I to angiotensin II
D. Promotes direct sodium excretion by the kidneys
Answer: C. Inhibits conversion of angiotensin I to angiotensin II
Rationale: Lisinopril is an angiotensin-converting enzyme (ACE)
inhibitor. It decreases the conversion of angiotensin I to angiotensin II,
reducing vasoconstriction and aldosterone secretion. This lowers
systemic vascular resistance and sodium and water retention. ACE
inhibitors can also increase bradykinin, contributing to the
characteristic dry cough.
,Question 2
A patient taking an ACE inhibitor develops swelling of the lips and
tongue. What is the nurse's priority action?
A. Administer the next scheduled dose with food
B. Document the finding as an expected adverse effect
C. Assess the airway and obtain emergency assistance
D. Encourage increased oral fluid intake
Answer: C. Assess the airway and obtain emergency assistance
Rationale: Facial, lip, and tongue swelling can indicate angioedema, a
potentially life-threatening reaction to ACE inhibitors. Airway
compromise can develop rapidly, so airway assessment and
emergency intervention take priority. The medication should not be
continued without evaluation.
Question 3
Which patient would require the greatest caution before receiving a
nonselective beta blocker?
,A. Patient with controlled hypothyroidism
B. Patient with asthma and recurrent bronchospasm
C. Patient with mild seasonal allergies
D. Patient with iron-deficiency anemia
Answer: B. Patient with asthma and recurrent bronchospasm
Rationale: Nonselective beta blockers block both beta-1 and beta-2
receptors. Blocking beta-2 receptors in bronchial smooth muscle can
cause bronchoconstriction and worsen asthma. Cardioselective beta-1
blockers may sometimes be considered when clinically appropriate,
but caution is still required.
Question 4
A patient taking metoprolol should be monitored most closely for
which adverse effect?
A. Tachycardia
B. Bradycardia
C. Severe hyperglycemia
D. Increased salivation
Answer: B. Bradycardia
, Rationale: Metoprolol is a beta-1 selective adrenergic blocker that
decreases heart rate, myocardial contractility, and conduction.
Bradycardia and hypotension are important adverse effects. Beta
blockers may also mask some manifestations of hypoglycemia,
particularly tachycardia.
Question 5
A patient taking warfarin asks which laboratory test is routinely used to
monitor therapeutic effect. Which response is correct?
A. aPTT
B. INR
C. Serum creatinine
D. Platelet count only
Answer: B. INR
Rationale: Warfarin therapy is monitored using the international
normalized ratio (INR), which standardizes prothrombin-time
measurements. The therapeutic INR target depends on the indication.
Excessive anticoagulation increases bleeding risk, while inadequate
anticoagulation increases thromboembolic risk.
