NSG 533 ADVANCED PHARMACOLOGY
EXAM 3 PRACTICE QUESTIONS AND
ANSWERS
1. A patient with Type 2 Diabetes is prescribed Metformin. Which lab value is most critical to
monitor to prevent lactic acidosis?
A. Serum Potassium
B. Hemoglobin A1c
C. Alanine Aminotransferase (ALT)
D. Glomerular Filtration Rate (GFR)
Answer: D
Conceptual Explanation: Metformin is renally cleared; a GFR below 30 mL/min/1.73m² is
a contraindication because it increases the risk of metformin-associated lactic acidosis.
2. Which mechanism best describes the action of SGLT2 inhibitors like Empagliflozin?
A. Inhibition of glucose absorption in the small intestine
B. Stimulation of insulin release from pancreatic beta cells
C. Increasing insulin sensitivity in peripheral tissues
,D. Reduction of renal glucose reabsorption in the proximal tubule
Answer: D
Conceptual Explanation: SGLT2 inhibitors block the sodium-glucose cotransporter 2 in
the proximal convoluted tubule, leading to glucosuria and lowering blood glucose.
3. A patient on Warfarin has an INR of 7.5 and no active bleeding. According to standard
guidelines, what is the appropriate next step?
A. Administer Vitamin K 10mg IV push immediately
B. Hold Warfarin and monitor only
C. Hold Warfarin and administer oral Vitamin K
D. Administer Fresh Frozen Plasma (FFP)
Answer: C
Conceptual Explanation: For INRs between 4.5 and 10 without bleeding, the
recommendation is to hold Warfarin and consider a small dose of oral Vitamin K (1-2.5 mg)
to speed reduction.
4. What is the primary Black Box Warning associated with GLP-1 receptor agonists such as
Liraglutide?
A. Heart failure exacerbation
B. Acute renal failure
C. Severe hypersensitivity reactions
, D. Risk of thyroid C-cell tumors
Answer: D
Conceptual Explanation: GLP-1 agonists carry a warning regarding the risk of medullary
thyroid carcinoma, based on rodent studies; they are contraindicated in patients with a
history of MTC or MEN2.
5. Which medication is a long-acting insulin analogue that provides a basal rate of insulin with
no peak?
A. Insulin Lispro
B. NPH Insulin
C. Insulin Aspart
D. Insulin Glargine
Answer: D
Conceptual Explanation: Insulin Glargine (Lantus) is a long-acting insulin with a
relatively peakless action profile that lasts approximately 24 hours.
6. A patient is diagnosed with Heparin-Induced Thrombocytopenia (HIT). Which alternative
anticoagulant should be started?
A. Enoxaparin
B. Warfarin
C. Argatroban
EXAM 3 PRACTICE QUESTIONS AND
ANSWERS
1. A patient with Type 2 Diabetes is prescribed Metformin. Which lab value is most critical to
monitor to prevent lactic acidosis?
A. Serum Potassium
B. Hemoglobin A1c
C. Alanine Aminotransferase (ALT)
D. Glomerular Filtration Rate (GFR)
Answer: D
Conceptual Explanation: Metformin is renally cleared; a GFR below 30 mL/min/1.73m² is
a contraindication because it increases the risk of metformin-associated lactic acidosis.
2. Which mechanism best describes the action of SGLT2 inhibitors like Empagliflozin?
A. Inhibition of glucose absorption in the small intestine
B. Stimulation of insulin release from pancreatic beta cells
C. Increasing insulin sensitivity in peripheral tissues
,D. Reduction of renal glucose reabsorption in the proximal tubule
Answer: D
Conceptual Explanation: SGLT2 inhibitors block the sodium-glucose cotransporter 2 in
the proximal convoluted tubule, leading to glucosuria and lowering blood glucose.
3. A patient on Warfarin has an INR of 7.5 and no active bleeding. According to standard
guidelines, what is the appropriate next step?
A. Administer Vitamin K 10mg IV push immediately
B. Hold Warfarin and monitor only
C. Hold Warfarin and administer oral Vitamin K
D. Administer Fresh Frozen Plasma (FFP)
Answer: C
Conceptual Explanation: For INRs between 4.5 and 10 without bleeding, the
recommendation is to hold Warfarin and consider a small dose of oral Vitamin K (1-2.5 mg)
to speed reduction.
4. What is the primary Black Box Warning associated with GLP-1 receptor agonists such as
Liraglutide?
A. Heart failure exacerbation
B. Acute renal failure
C. Severe hypersensitivity reactions
, D. Risk of thyroid C-cell tumors
Answer: D
Conceptual Explanation: GLP-1 agonists carry a warning regarding the risk of medullary
thyroid carcinoma, based on rodent studies; they are contraindicated in patients with a
history of MTC or MEN2.
5. Which medication is a long-acting insulin analogue that provides a basal rate of insulin with
no peak?
A. Insulin Lispro
B. NPH Insulin
C. Insulin Aspart
D. Insulin Glargine
Answer: D
Conceptual Explanation: Insulin Glargine (Lantus) is a long-acting insulin with a
relatively peakless action profile that lasts approximately 24 hours.
6. A patient is diagnosed with Heparin-Induced Thrombocytopenia (HIT). Which alternative
anticoagulant should be started?
A. Enoxaparin
B. Warfarin
C. Argatroban
