NURS 5663 ADVANCED
PHARMACOLOGY - WEEK 3
ASSESSMENT QUESTIONS AND
ANSWERS
1. A patient with heart failure is prescribed Digoxin. Which of the following electrolyte
imbalances most significantly increases the risk of Digoxin toxicity?
A. Hyperkalemia
B. Hyponatremia
C. Hypercalcemia
D. Hypokalemia
Answer: D
Conceptual Explanation: Hypokalemia increases the affinity of Digoxin for the Na+/K+
ATPase pump, thereby increasing the risk of toxicity even if serum digoxin levels are within
a normal therapeutic range.
,2. When administering Aliskiren (Tekturna), the nurse knows that this drug belongs to which
class of antihypertensives?
A. ACE Inhibitor
B. Angiotensin II Receptor Blocker (ARB)
C. Beta-Adrenergic Blocker
D. Direct Renin Inhibitor (DRI)
Answer: D
Conceptual Explanation: Aliskiren is the first-in-class direct renin inhibitor, which acts
earlier in the Renin-Angiotensin-Aldosterone System (RAAS) than ACE inhibitors or ARBs.
3. A patient is started on Amiodarone for refractory ventricular tachycardia. Which diagnostic
test is critical for long-term monitoring due to potential adverse effects?
A. Serial bone density scans
B. Annual hearing exams
C. Pulmonary function tests
D. Monthly CBC with differential
Answer: C
Conceptual Explanation: Amiodarone is associated with serious pulmonary toxicity
(interstitial pneumonitis). Baseline and periodic pulmonary function tests and chest X-rays
are required.
, 4. Which of the following describes the mechanism of action of Clopidogrel (Plavix)?
A. Direct inhibition of thrombin
B. Irreversible blockade of P2Y12 ADP receptors on platelets
C. Inhibition of Vitamin K-dependent clotting factors
D. Activation of antithrombin III
Answer: B
Conceptual Explanation: Clopidogrel is an ADP receptor antagonist that irreversibly
blocks P2Y12 receptors, preventing platelet aggregation for the life of the platelet.
5. A nurse is reviewing the lab results of a patient on Heparin therapy. The Activated Partial
Thromboplastin Time (aPTT) is 110 seconds (Control 30). What is the priority action?
A. Continue the infusion as ordered
B. Increase the infusion rate
C. Stop the infusion and prepare Protamine Sulfate
D. Administer Vitamin K intramuscularly
Answer: C
Conceptual Explanation: An aPTT of 110 seconds is significantly above the therapeutic
range (typically 1.5-2.5 times the control). The priority is to stop the infusion; Protamine
Sulfate is the antidote for Heparin overdose.
PHARMACOLOGY - WEEK 3
ASSESSMENT QUESTIONS AND
ANSWERS
1. A patient with heart failure is prescribed Digoxin. Which of the following electrolyte
imbalances most significantly increases the risk of Digoxin toxicity?
A. Hyperkalemia
B. Hyponatremia
C. Hypercalcemia
D. Hypokalemia
Answer: D
Conceptual Explanation: Hypokalemia increases the affinity of Digoxin for the Na+/K+
ATPase pump, thereby increasing the risk of toxicity even if serum digoxin levels are within
a normal therapeutic range.
,2. When administering Aliskiren (Tekturna), the nurse knows that this drug belongs to which
class of antihypertensives?
A. ACE Inhibitor
B. Angiotensin II Receptor Blocker (ARB)
C. Beta-Adrenergic Blocker
D. Direct Renin Inhibitor (DRI)
Answer: D
Conceptual Explanation: Aliskiren is the first-in-class direct renin inhibitor, which acts
earlier in the Renin-Angiotensin-Aldosterone System (RAAS) than ACE inhibitors or ARBs.
3. A patient is started on Amiodarone for refractory ventricular tachycardia. Which diagnostic
test is critical for long-term monitoring due to potential adverse effects?
A. Serial bone density scans
B. Annual hearing exams
C. Pulmonary function tests
D. Monthly CBC with differential
Answer: C
Conceptual Explanation: Amiodarone is associated with serious pulmonary toxicity
(interstitial pneumonitis). Baseline and periodic pulmonary function tests and chest X-rays
are required.
, 4. Which of the following describes the mechanism of action of Clopidogrel (Plavix)?
A. Direct inhibition of thrombin
B. Irreversible blockade of P2Y12 ADP receptors on platelets
C. Inhibition of Vitamin K-dependent clotting factors
D. Activation of antithrombin III
Answer: B
Conceptual Explanation: Clopidogrel is an ADP receptor antagonist that irreversibly
blocks P2Y12 receptors, preventing platelet aggregation for the life of the platelet.
5. A nurse is reviewing the lab results of a patient on Heparin therapy. The Activated Partial
Thromboplastin Time (aPTT) is 110 seconds (Control 30). What is the priority action?
A. Continue the infusion as ordered
B. Increase the infusion rate
C. Stop the infusion and prepare Protamine Sulfate
D. Administer Vitamin K intramuscularly
Answer: C
Conceptual Explanation: An aPTT of 110 seconds is significantly above the therapeutic
range (typically 1.5-2.5 times the control). The priority is to stop the infusion; Protamine
Sulfate is the antidote for Heparin overdose.
