NR 565 ADVANCED PHARMACOLOGY
FINAL EXAM REVIEW QUESTIONS AND
ANSWERS
1. A patient taking an ACE inhibitor for hypertension develops a dry, persistent cough. Which
biochemical mechanism is responsible for this side effect?
A. Inhibition of angiotensin II receptors
B. Increase in systemic prostaglandin levels
C. Direct irritation of the bronchial mucosa
D. Accumulation of bradykinin in the lungs
Answer: D
Conceptual Explanation: ACE inhibitors block the breakdown of bradykinin. The
accumulation of bradykinin in the respiratory tract is what triggers the characteristic dry
cough.
2. Which of the following beta-blockers is considered cardioselective and would be safer for a
patient with well-controlled asthma?
A. Propranolol
,B. Nadolol
C. Metoprolol
D. Timolol
Answer: C
Conceptual Explanation: Metoprolol is a cardioselective beta-1 blocker, meaning it has a
higher affinity for cardiac tissue than bronchial tissue, making it safer for patients with
asthma compared to non-selective blockers like Propranolol.
3. What is the most critical contraindication for starting a patient on Metformin?
A. Estimated Glomerular Filtration Rate (eGFR) less than 30 mL/min/1.73m²
B. Chronic Obstructive Pulmonary Disease (COPD)
C. Body Mass Index (BMI) greater than 35
D. History of hypertension
Answer: A
Conceptual Explanation: Metformin is contraindicated in patients with severe renal
impairment (eGFR < 30) due to the significantly increased risk of lactic acidosis.
4. A patient is prescribed Warfarin. Which of the following lab values is used to monitor the
therapeutic effectiveness of this medication?
A. aPTT
B. INR
, C. Serum Creatinine
D. Platelet count
Answer: B
Conceptual Explanation: The International Normalized Ratio (INR) is the standard
measurement used to monitor the anticoagulant effect of Warfarin.
5. A patient on Atorvastatin (Lipitor) reports new-onset muscle pain and weakness. Which
laboratory test is most appropriate to order first?
A. Alanine Aminotransferase (ALT)
B. Creatine Kinase (CK)
C. C-Reactive Protein (CRP)
D. Serum Electrolytes
Answer: B
Conceptual Explanation: Muscle pain in a patient taking a statin suggests myopathy or
rhabdomyolysis; a Creatine Kinase (CK) level is required to assess for muscle damage.
6. Amiodarone is a highly effective antiarrhythmic but requires frequent monitoring due to its
side effect profile. Which organ systems should be monitored periodically?
A. Renal and Hepatic
B. Gastrointestinal and Musculoskeletal
C. Integumentary and Auditory
FINAL EXAM REVIEW QUESTIONS AND
ANSWERS
1. A patient taking an ACE inhibitor for hypertension develops a dry, persistent cough. Which
biochemical mechanism is responsible for this side effect?
A. Inhibition of angiotensin II receptors
B. Increase in systemic prostaglandin levels
C. Direct irritation of the bronchial mucosa
D. Accumulation of bradykinin in the lungs
Answer: D
Conceptual Explanation: ACE inhibitors block the breakdown of bradykinin. The
accumulation of bradykinin in the respiratory tract is what triggers the characteristic dry
cough.
2. Which of the following beta-blockers is considered cardioselective and would be safer for a
patient with well-controlled asthma?
A. Propranolol
,B. Nadolol
C. Metoprolol
D. Timolol
Answer: C
Conceptual Explanation: Metoprolol is a cardioselective beta-1 blocker, meaning it has a
higher affinity for cardiac tissue than bronchial tissue, making it safer for patients with
asthma compared to non-selective blockers like Propranolol.
3. What is the most critical contraindication for starting a patient on Metformin?
A. Estimated Glomerular Filtration Rate (eGFR) less than 30 mL/min/1.73m²
B. Chronic Obstructive Pulmonary Disease (COPD)
C. Body Mass Index (BMI) greater than 35
D. History of hypertension
Answer: A
Conceptual Explanation: Metformin is contraindicated in patients with severe renal
impairment (eGFR < 30) due to the significantly increased risk of lactic acidosis.
4. A patient is prescribed Warfarin. Which of the following lab values is used to monitor the
therapeutic effectiveness of this medication?
A. aPTT
B. INR
, C. Serum Creatinine
D. Platelet count
Answer: B
Conceptual Explanation: The International Normalized Ratio (INR) is the standard
measurement used to monitor the anticoagulant effect of Warfarin.
5. A patient on Atorvastatin (Lipitor) reports new-onset muscle pain and weakness. Which
laboratory test is most appropriate to order first?
A. Alanine Aminotransferase (ALT)
B. Creatine Kinase (CK)
C. C-Reactive Protein (CRP)
D. Serum Electrolytes
Answer: B
Conceptual Explanation: Muscle pain in a patient taking a statin suggests myopathy or
rhabdomyolysis; a Creatine Kinase (CK) level is required to assess for muscle damage.
6. Amiodarone is a highly effective antiarrhythmic but requires frequent monitoring due to its
side effect profile. Which organ systems should be monitored periodically?
A. Renal and Hepatic
B. Gastrointestinal and Musculoskeletal
C. Integumentary and Auditory
