NR 565
Advanced Pharmacology Final | Chamberlain
Practice Exam | Questions, Answers & Detailed
Rationales
Resource Features
➢ NR 565 Final practice questions
➢ Answers for self-assessment
➢ Detailed rationales
➢ Advanced pharmacology review
➢ Patient-education questions
➢ Safe-prescribing concepts
➢ Exam-focused review
, NR 565 Advanced Pharmacology Final | Chamberlain
Practice Exam | Questions, Answers & Detailed
Rationales
1. In which patient population is Metformin contraindicated?
A. Diabetics with HA1c < 7.0%
B. Patients older than 50
C. Alcoholics
D. Women suffering from infertility
Answer: C
Rationale: Metformin is contraindicated in patients with chronic alcoholism due to the
increased risk of lactic acidosis. Alcohol consumption can precipitate lactic acidosis in
patients taking metformin, especially in those with hepatic dysfunction or other risk
factors.
2. What lab value suggests metformin might be contraindicated?
A. eGFR < 30
B. Crea 0.8
C. WBC 7.8
D. Bun 17
Answer: A
Rationale: Metformin is contraindicated in patients with an eGFR < 30 mL/min/1.73m²
due to the risk of lactic acidosis. The drug is excreted renally, and impaired kidney
function leads to accumulation. It should be used with caution when eGFR is between
30-45 and is not recommended when < 30.
,3. What medication is contraindicated to treat diabetes if a
patient already has a cardiac ejection fraction rate of 40%?
A. Second Generation sulfonylureas
B. Thiazolidinediones
C. Dopamine Agonist
D. Glucosidase Inhibitor
Answer: B
Rationale: Thiazolidinediones (TZDs) such as pioglitazone and rosiglitazone are
contraindicated in patients with heart failure (NYHA Class III or IV) or an ejection fraction
< 40%. TZDs cause fluid retention and can worsen heart failure.
4. A 35-year-old female presents with fatigue, anxiety,
palpitations, weight loss, trouble sleeping, and cold intolerance.
Physical exam reveals tachycardia at 104 bpm and slightly
enlarged thyroid. Testing reveals hyperthyroidism/Grave's
disease. Which agent is first-line treatment?
A. Methimazole
B. Metoprolol
Answer: A
Rationale: Methimazole is the first-line antithyroid medication for
hyperthyroidism/Grave's disease. It inhibits thyroid peroxidase, blocking the synthesis of
thyroid hormones. Beta-blockers like metoprolol are used for symptomatic relief of
tachycardia but do not treat the underlying hyperthyroidism.
, 5. Which medication would be considered first-line treatment for
a newly diagnosed diabetic patient with adequate renal and
hepatic function?
A. NovoLog Sliding Scale Insulin
B. Liraglutide (Victoza)
C. Oral Metformin
D. Glipizide
Answer: C
Rationale: Metformin is the first-line pharmacologic treatment for type 2 diabetes in
patients with adequate renal and hepatic function, according to the American Diabetes
Association guidelines. It is effective, safe, inexpensive, and has beneficial cardiovascular
effects.
6. Of the following medications, which is most likely to cause
hypoglycemia?
A. Metformin
B. Insulin
C. Incretin mimetics
D. Thiazolidinediones
Answer: B
Rationale: Insulin has the highest risk of causing hypoglycemia among all diabetes
medications. While sulfonylureas also cause hypoglycemia, insulin therapy carries the
greatest risk due to its mechanism of directly lowering blood glucose.
7. Which symptoms are most expected of a patient diagnosed
with hypothyroidism?
Advanced Pharmacology Final | Chamberlain
Practice Exam | Questions, Answers & Detailed
Rationales
Resource Features
➢ NR 565 Final practice questions
➢ Answers for self-assessment
➢ Detailed rationales
➢ Advanced pharmacology review
➢ Patient-education questions
➢ Safe-prescribing concepts
➢ Exam-focused review
, NR 565 Advanced Pharmacology Final | Chamberlain
Practice Exam | Questions, Answers & Detailed
Rationales
1. In which patient population is Metformin contraindicated?
A. Diabetics with HA1c < 7.0%
B. Patients older than 50
C. Alcoholics
D. Women suffering from infertility
Answer: C
Rationale: Metformin is contraindicated in patients with chronic alcoholism due to the
increased risk of lactic acidosis. Alcohol consumption can precipitate lactic acidosis in
patients taking metformin, especially in those with hepatic dysfunction or other risk
factors.
2. What lab value suggests metformin might be contraindicated?
A. eGFR < 30
B. Crea 0.8
C. WBC 7.8
D. Bun 17
Answer: A
Rationale: Metformin is contraindicated in patients with an eGFR < 30 mL/min/1.73m²
due to the risk of lactic acidosis. The drug is excreted renally, and impaired kidney
function leads to accumulation. It should be used with caution when eGFR is between
30-45 and is not recommended when < 30.
,3. What medication is contraindicated to treat diabetes if a
patient already has a cardiac ejection fraction rate of 40%?
A. Second Generation sulfonylureas
B. Thiazolidinediones
C. Dopamine Agonist
D. Glucosidase Inhibitor
Answer: B
Rationale: Thiazolidinediones (TZDs) such as pioglitazone and rosiglitazone are
contraindicated in patients with heart failure (NYHA Class III or IV) or an ejection fraction
< 40%. TZDs cause fluid retention and can worsen heart failure.
4. A 35-year-old female presents with fatigue, anxiety,
palpitations, weight loss, trouble sleeping, and cold intolerance.
Physical exam reveals tachycardia at 104 bpm and slightly
enlarged thyroid. Testing reveals hyperthyroidism/Grave's
disease. Which agent is first-line treatment?
A. Methimazole
B. Metoprolol
Answer: A
Rationale: Methimazole is the first-line antithyroid medication for
hyperthyroidism/Grave's disease. It inhibits thyroid peroxidase, blocking the synthesis of
thyroid hormones. Beta-blockers like metoprolol are used for symptomatic relief of
tachycardia but do not treat the underlying hyperthyroidism.
, 5. Which medication would be considered first-line treatment for
a newly diagnosed diabetic patient with adequate renal and
hepatic function?
A. NovoLog Sliding Scale Insulin
B. Liraglutide (Victoza)
C. Oral Metformin
D. Glipizide
Answer: C
Rationale: Metformin is the first-line pharmacologic treatment for type 2 diabetes in
patients with adequate renal and hepatic function, according to the American Diabetes
Association guidelines. It is effective, safe, inexpensive, and has beneficial cardiovascular
effects.
6. Of the following medications, which is most likely to cause
hypoglycemia?
A. Metformin
B. Insulin
C. Incretin mimetics
D. Thiazolidinediones
Answer: B
Rationale: Insulin has the highest risk of causing hypoglycemia among all diabetes
medications. While sulfonylureas also cause hypoglycemia, insulin therapy carries the
greatest risk due to its mechanism of directly lowering blood glucose.
7. Which symptoms are most expected of a patient diagnosed
with hypothyroidism?
