NR508 Advanced Pharmacology FINAL EXAM
2026/2027 COMPLETE ACCURATE TEST EXAM
ACTUAL QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED
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A patient is prescribed lisinopril for hypertension. What is the primary mechanism of
action?
a. Blocks beta-1 receptors in the heart
b. Inhibits angiotensin-converting enzyme (ACE)
c. Blocks calcium channels in vascular smooth muscle
d. Increases aldosterone secretion
✔️ Correct Answer: B
Rationale:
Lisinopril is an ACE inhibitor that reduces conversion of angiotensin I to angiotensin II,
decreasing vasoconstriction and aldosterone-mediated fluid retention. By inhibiting
ACE, lisinopril lowers blood pressure through vasodilation and reduced sodium and
water retention. This mechanism also provides renal protection in patients with diabetes
and heart failure.
,Option A is incorrect because beta-1 receptor blockade is the mechanism of beta-
blockers like metoprolol. Option C is incorrect because calcium channel blockade is the
mechanism of drugs like amlodipine. Option D is incorrect because ACE inhibitors
decrease, not increase, aldosterone secretion.
A patient taking warfarin has an INR of 6.0. What is the priority action?
a. Administer vitamin K
b. Increase warfarin dose
c. Give heparin
d. Continue current dose
✔️ Correct Answer: A
Rationale:
Vitamin K reverses warfarin-induced anticoagulation in cases of supratherapeutic INR to
prevent bleeding. An INR of 6.0 indicates a significantly increased risk of hemorrhage.
Vitamin K can be administered orally or intravenously depending on the urgency. The
warfarin dose should be held, and the patient should be monitored for signs of
bleeding.
Option B is incorrect because increasing the dose would worsen the elevated INR.
Option C is incorrect because heparin would further anticoagulate the patient. Option D
is incorrect because continuing the current dose would maintain the elevated INR and
bleeding risk.
A patient is prescribed metoprolol. What should the nurse monitor for?
a. Hyperglycemia
b. Bradycardia
c. Hypertension
d. Hyperkalemia
✔️ Correct Answer: B
Rationale:
Metoprolol is a beta-blocker that can cause bradycardia by slowing heart rate and AV
,conduction. Beta-blockers competitively block beta-1 receptors in the heart, reducing
heart rate and contractility. Bradycardia is a common and potentially serious adverse
effect requiring dose adjustment or discontinuation.
Option A is incorrect because metoprolol does not typically cause hyperglycemia.
Option C is incorrect because metoprolol lowers, not increases, blood pressure. Option
D is incorrect because metoprolol does not affect potassium levels.
A patient takes furosemide. What electrolyte imbalance is most expected?
a. Hyperkalemia
b. Hypokalemia
c. Hypercalcemia
d. Hypernatremia
✔️ Correct Answer: B
Rationale:
Loop diuretics increase potassium excretion leading to hypokalemia. Furosemide
inhibits the Na-K-2Cl cotransporter in the thick ascending limb of the loop of Henle,
increasing distal delivery of sodium and promoting potassium loss. Hypokalemia can
cause muscle weakness, arrhythmias, and other complications.
Option A is incorrect because furosemide causes potassium loss, not retention. Option
C is incorrect because furosemide does not typically cause hypercalcemia. Option D is
incorrect because furosemide promotes sodium excretion, not retention.
A patient on heparin develops bleeding. What antidote is used?
a. Vitamin K
b. Protamine sulfate
c. Naloxone
d. Flumazenil
✔️ Correct Answer: B
Rationale:
Protamine sulfate reverses heparin anticoagulation. Protamine is a positively charged
, molecule that binds to negatively charged heparin, forming a stable complex that
neutralizes its anticoagulant effect. It is administered intravenously and is effective
against both unfractionated and low-molecular-weight heparin.
Option A is incorrect because vitamin K is the antidote for warfarin. Option C is incorrect
because naloxone is the antidote for opioids. Option D is incorrect because flumazenil is
the antidote for benzodiazepines.
A patient taking digoxin reports nausea and visual halos. What is the priority concern?
a. Therapeutic effect
b. Digoxin toxicity
c. Hypokalemia only
d. Hypertension
✔️ Correct Answer: B
Rationale:
Nausea, vomiting, and yellow-green vision are classic signs of digoxin toxicity. Digoxin
has a narrow therapeutic index, and toxicity can occur with relatively small increases in
serum levels. Risk factors include hypokalemia, renal impairment, and drug interactions.
The medication should be held, and a digoxin level should be drawn.
Option A is incorrect because these symptoms indicate toxicity, not therapeutic effect.
Option C is incorrect because while hypokalemia increases toxicity risk, the symptoms
themselves indicate toxicity. Option D is incorrect because digoxin does not cause
hypertension.
A patient is prescribed albuterol. What is the expected effect?
a. Bronchoconstriction
b. Bronchodilation
c. Mucus production decrease only
d. Sedation
✔️ Correct Answer: B
Rationale:
2026/2027 COMPLETE ACCURATE TEST EXAM
ACTUAL QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED
SOLUTIONS) |ALREADY GRADED
A+||NEWEST
VERSION |BEST DOCUMENT FOR EXAM
2026/2027 Frequently Most Tested Questions
and 100% Accurate From Past papers | Graded
A+ , Reviewed and Updated | 100% Guarantee
Pass | Latest Exam and Newest Version!!!
A patient is prescribed lisinopril for hypertension. What is the primary mechanism of
action?
a. Blocks beta-1 receptors in the heart
b. Inhibits angiotensin-converting enzyme (ACE)
c. Blocks calcium channels in vascular smooth muscle
d. Increases aldosterone secretion
✔️ Correct Answer: B
Rationale:
Lisinopril is an ACE inhibitor that reduces conversion of angiotensin I to angiotensin II,
decreasing vasoconstriction and aldosterone-mediated fluid retention. By inhibiting
ACE, lisinopril lowers blood pressure through vasodilation and reduced sodium and
water retention. This mechanism also provides renal protection in patients with diabetes
and heart failure.
,Option A is incorrect because beta-1 receptor blockade is the mechanism of beta-
blockers like metoprolol. Option C is incorrect because calcium channel blockade is the
mechanism of drugs like amlodipine. Option D is incorrect because ACE inhibitors
decrease, not increase, aldosterone secretion.
A patient taking warfarin has an INR of 6.0. What is the priority action?
a. Administer vitamin K
b. Increase warfarin dose
c. Give heparin
d. Continue current dose
✔️ Correct Answer: A
Rationale:
Vitamin K reverses warfarin-induced anticoagulation in cases of supratherapeutic INR to
prevent bleeding. An INR of 6.0 indicates a significantly increased risk of hemorrhage.
Vitamin K can be administered orally or intravenously depending on the urgency. The
warfarin dose should be held, and the patient should be monitored for signs of
bleeding.
Option B is incorrect because increasing the dose would worsen the elevated INR.
Option C is incorrect because heparin would further anticoagulate the patient. Option D
is incorrect because continuing the current dose would maintain the elevated INR and
bleeding risk.
A patient is prescribed metoprolol. What should the nurse monitor for?
a. Hyperglycemia
b. Bradycardia
c. Hypertension
d. Hyperkalemia
✔️ Correct Answer: B
Rationale:
Metoprolol is a beta-blocker that can cause bradycardia by slowing heart rate and AV
,conduction. Beta-blockers competitively block beta-1 receptors in the heart, reducing
heart rate and contractility. Bradycardia is a common and potentially serious adverse
effect requiring dose adjustment or discontinuation.
Option A is incorrect because metoprolol does not typically cause hyperglycemia.
Option C is incorrect because metoprolol lowers, not increases, blood pressure. Option
D is incorrect because metoprolol does not affect potassium levels.
A patient takes furosemide. What electrolyte imbalance is most expected?
a. Hyperkalemia
b. Hypokalemia
c. Hypercalcemia
d. Hypernatremia
✔️ Correct Answer: B
Rationale:
Loop diuretics increase potassium excretion leading to hypokalemia. Furosemide
inhibits the Na-K-2Cl cotransporter in the thick ascending limb of the loop of Henle,
increasing distal delivery of sodium and promoting potassium loss. Hypokalemia can
cause muscle weakness, arrhythmias, and other complications.
Option A is incorrect because furosemide causes potassium loss, not retention. Option
C is incorrect because furosemide does not typically cause hypercalcemia. Option D is
incorrect because furosemide promotes sodium excretion, not retention.
A patient on heparin develops bleeding. What antidote is used?
a. Vitamin K
b. Protamine sulfate
c. Naloxone
d. Flumazenil
✔️ Correct Answer: B
Rationale:
Protamine sulfate reverses heparin anticoagulation. Protamine is a positively charged
, molecule that binds to negatively charged heparin, forming a stable complex that
neutralizes its anticoagulant effect. It is administered intravenously and is effective
against both unfractionated and low-molecular-weight heparin.
Option A is incorrect because vitamin K is the antidote for warfarin. Option C is incorrect
because naloxone is the antidote for opioids. Option D is incorrect because flumazenil is
the antidote for benzodiazepines.
A patient taking digoxin reports nausea and visual halos. What is the priority concern?
a. Therapeutic effect
b. Digoxin toxicity
c. Hypokalemia only
d. Hypertension
✔️ Correct Answer: B
Rationale:
Nausea, vomiting, and yellow-green vision are classic signs of digoxin toxicity. Digoxin
has a narrow therapeutic index, and toxicity can occur with relatively small increases in
serum levels. Risk factors include hypokalemia, renal impairment, and drug interactions.
The medication should be held, and a digoxin level should be drawn.
Option A is incorrect because these symptoms indicate toxicity, not therapeutic effect.
Option C is incorrect because while hypokalemia increases toxicity risk, the symptoms
themselves indicate toxicity. Option D is incorrect because digoxin does not cause
hypertension.
A patient is prescribed albuterol. What is the expected effect?
a. Bronchoconstriction
b. Bronchodilation
c. Mucus production decrease only
d. Sedation
✔️ Correct Answer: B
Rationale:
