NSG 533 EXAM 2 – WILKES
PHARMACOLOGY (2026/2027) ACTUAL
QUESTIONS AND ANSWERS
1. A patient with a history of heart failure and a reduced ejection fraction (HFrEF) is currently
taking an ACE inhibitor and a beta-blocker. Which medication should be added to improve
mortality according to current guidelines?
A. Amlodipine
B. Spironolactone
C. Furosemide
D. Digoxin
Answer: B
Conceptual Explanation: Mineralocorticoid receptor antagonists (MRAs) like
spironolactone have been shown to reduce mortality and hospitalizations in patients with
HFrEF.
,2. Which of the following describes the primary mechanism of action of Sodium-glucose
cotransporter 2 (SGLT2) inhibitors?
A. Inhibiting the breakdown of GLP-1 hormones
B. Preventing glucose reabsorption in the proximal convoluted tubule of the kidney
C. Increasing insulin sensitivity in peripheral tissues
D. Stimulating the release of insulin from pancreatic beta cells
Answer: B
Conceptual Explanation: SGLT2 inhibitors lower blood glucose by promoting the
excretion of glucose in the urine by blocking reabsorption in the proximal tubule.
3. A 65-year-old male with atrial fibrillation is prescribed Warfarin. Which of the following lab
values represents the standard therapeutic target for this patient?
A. aPTT 60-80 seconds
B. Prothrombin time 15-20 seconds
C. INR 2.0-3.0
D. INR 1.0-1.5
Answer: C
Conceptual Explanation: For most patients with atrial fibrillation on Warfarin, the target
International Normalized Ratio (INR) is between 2.0 and 3.0.
, 4. A patient complains of a dry, hacking cough after starting Lisinopril. This adverse effect is
primarily attributed to the accumulation of which substance?
A. Renin
B. Bradykinin
C. Angiotensin II
D. Aldosterone
Answer: B
Conceptual Explanation: ACE inhibitors prevent the breakdown of bradykinin in the
lungs, which can lead to a dry, non-productive cough in some patients.
5. Which class of anti-arrhythmics is associated with a risk of pulmonary toxicity and thyroid
dysfunction?
A. Class III (Amiodarone)
B. Class II (Metoprolol)
C. Class I (Procainamide)
D. Class IV (Verapamil)
E. N/A
Answer: A
PHARMACOLOGY (2026/2027) ACTUAL
QUESTIONS AND ANSWERS
1. A patient with a history of heart failure and a reduced ejection fraction (HFrEF) is currently
taking an ACE inhibitor and a beta-blocker. Which medication should be added to improve
mortality according to current guidelines?
A. Amlodipine
B. Spironolactone
C. Furosemide
D. Digoxin
Answer: B
Conceptual Explanation: Mineralocorticoid receptor antagonists (MRAs) like
spironolactone have been shown to reduce mortality and hospitalizations in patients with
HFrEF.
,2. Which of the following describes the primary mechanism of action of Sodium-glucose
cotransporter 2 (SGLT2) inhibitors?
A. Inhibiting the breakdown of GLP-1 hormones
B. Preventing glucose reabsorption in the proximal convoluted tubule of the kidney
C. Increasing insulin sensitivity in peripheral tissues
D. Stimulating the release of insulin from pancreatic beta cells
Answer: B
Conceptual Explanation: SGLT2 inhibitors lower blood glucose by promoting the
excretion of glucose in the urine by blocking reabsorption in the proximal tubule.
3. A 65-year-old male with atrial fibrillation is prescribed Warfarin. Which of the following lab
values represents the standard therapeutic target for this patient?
A. aPTT 60-80 seconds
B. Prothrombin time 15-20 seconds
C. INR 2.0-3.0
D. INR 1.0-1.5
Answer: C
Conceptual Explanation: For most patients with atrial fibrillation on Warfarin, the target
International Normalized Ratio (INR) is between 2.0 and 3.0.
, 4. A patient complains of a dry, hacking cough after starting Lisinopril. This adverse effect is
primarily attributed to the accumulation of which substance?
A. Renin
B. Bradykinin
C. Angiotensin II
D. Aldosterone
Answer: B
Conceptual Explanation: ACE inhibitors prevent the breakdown of bradykinin in the
lungs, which can lead to a dry, non-productive cough in some patients.
5. Which class of anti-arrhythmics is associated with a risk of pulmonary toxicity and thyroid
dysfunction?
A. Class III (Amiodarone)
B. Class II (Metoprolol)
C. Class I (Procainamide)
D. Class IV (Verapamil)
E. N/A
Answer: A
