NR 565 ADVANCED PHARMACOLOGY
FINAL EXAM REVIEW QUESTIONS AND
ANSWERS
1. A 65-year-old patient with heart failure and a reduced ejection fraction (HFrEF) is being
started on an ACE inhibitor. Which laboratory parameter is most critical to monitor within the
first week of therapy?
A. Serum sodium
B. Serum creatinine and potassium
C. Liver function tests
D. White blood cell count
Answer: B
Conceptual Explanation: ACE inhibitors can cause hyperkalemia and a decrease in renal
function (increased creatinine) due to their effect on the efferent arteriole in the
glomerulus.
,2. Which of the following medications is considered the first-line treatment for a patient
newly diagnosed with Type 2 Diabetes Mellitus, assuming no contraindications?
A. Glyburide
B. Sitagliptin
C. Metformin
D. Liraglutide
Answer: C
Conceptual Explanation: Metformin is the first-line agent for Type 2 DM due to its
efficacy, safety profile, weight neutrality, and low risk of hypoglycemia.
3. A patient is prescribed Amiodarone for atrial fibrillation. Which baseline and periodic
monitoring is essential due to the drug’s potential for systemic toxicity?
A. Complete blood count every 3 months
B. Serial echocardiograms
C. Pulmonary function tests and Thyroid function tests
D. Bone density scans
Answer: C
Conceptual Explanation: Amiodarone contains iodine and is associated with pulmonary
fibrosis and thyroid dysfunction (hypothyroidism or hyperthyroidism).
, 4. A pregnant patient in her third trimester requires treatment for a urinary tract infection.
Which of the following antibiotics should be avoided due to the risk of kernicterus in the
newborn?
A. Sulfamethoxazole/Trimethoprim
B. Cephalexin
C. Nitrofurantoin
D. Amoxicillin
Answer: A
Conceptual Explanation: Sulfonamides can displace bilirubin from albumin, increasing
the risk of kernicterus when administered near term.
5. When prescribing a HMG-CoA reductase inhibitor (Statin), what is the primary mechanism
of action that leads to lowered LDL levels?
A. Inhibition of cholesterol absorption in the small intestine
B. Activation of PPAR-alpha receptors
C. Binding of bile acids in the gut
D. Upregulation of LDL receptors in the liver
Answer: D
FINAL EXAM REVIEW QUESTIONS AND
ANSWERS
1. A 65-year-old patient with heart failure and a reduced ejection fraction (HFrEF) is being
started on an ACE inhibitor. Which laboratory parameter is most critical to monitor within the
first week of therapy?
A. Serum sodium
B. Serum creatinine and potassium
C. Liver function tests
D. White blood cell count
Answer: B
Conceptual Explanation: ACE inhibitors can cause hyperkalemia and a decrease in renal
function (increased creatinine) due to their effect on the efferent arteriole in the
glomerulus.
,2. Which of the following medications is considered the first-line treatment for a patient
newly diagnosed with Type 2 Diabetes Mellitus, assuming no contraindications?
A. Glyburide
B. Sitagliptin
C. Metformin
D. Liraglutide
Answer: C
Conceptual Explanation: Metformin is the first-line agent for Type 2 DM due to its
efficacy, safety profile, weight neutrality, and low risk of hypoglycemia.
3. A patient is prescribed Amiodarone for atrial fibrillation. Which baseline and periodic
monitoring is essential due to the drug’s potential for systemic toxicity?
A. Complete blood count every 3 months
B. Serial echocardiograms
C. Pulmonary function tests and Thyroid function tests
D. Bone density scans
Answer: C
Conceptual Explanation: Amiodarone contains iodine and is associated with pulmonary
fibrosis and thyroid dysfunction (hypothyroidism or hyperthyroidism).
, 4. A pregnant patient in her third trimester requires treatment for a urinary tract infection.
Which of the following antibiotics should be avoided due to the risk of kernicterus in the
newborn?
A. Sulfamethoxazole/Trimethoprim
B. Cephalexin
C. Nitrofurantoin
D. Amoxicillin
Answer: A
Conceptual Explanation: Sulfonamides can displace bilirubin from albumin, increasing
the risk of kernicterus when administered near term.
5. When prescribing a HMG-CoA reductase inhibitor (Statin), what is the primary mechanism
of action that leads to lowered LDL levels?
A. Inhibition of cholesterol absorption in the small intestine
B. Activation of PPAR-alpha receptors
C. Binding of bile acids in the gut
D. Upregulation of LDL receptors in the liver
Answer: D
