NR 508 ADVANCED PHARMACOLOGY
COMPREHENSIVE EXAM BANK
QUESTIONS AND ANSWERS
1. A 64-year-old male with a history of heart failure with reduced ejection fraction (HFrEF) is
currently taking an ACE inhibitor and a loop diuretic. Which medication, if added, requires the
closest monitoring of serum potassium levels due to the risk of life-threatening
hyperkalemia?
A. Metoprolol succinate
B. Spironolactone
C. Amlodipine
D. Hydralazine
Answer: B
Conceptual Explanation: Spironolactone is a potassium-sparing diuretic (aldosterone
antagonist). When combined with ACE inhibitors, which also increase potassium by
inhibiting aldosterone, the risk of severe hyperkalemia is significantly elevated.
,2. Which of the following medications is considered the first-line treatment for a pregnant
patient diagnosed with gestational diabetes who has failed nutritional therapy?
A. Insulin
B. Glyburide
C. Metformin
D. Sitagliptin
Answer: A
Conceptual Explanation: Insulin is the gold standard for gestational diabetes
management because it does not cross the placenta and has a well-established safety
profile compared to oral hypoglycemics.
3. A patient is prescribed Amiodarone for the management of atrial fibrillation. Which
baseline and periodic monitoring is essential due to the drug’s potential for organ toxicity?
A. Complete blood count and Renal profile
B. Pulmonary function tests and Thyroid function tests
C. Serum glucose and Lipid panel
D. Bone density scan and Audiometry
Answer: B
, Conceptual Explanation: Amiodarone contains iodine and can cause both hypo- and
hyperthyroidism. It is also associated with potentially fatal pulmonary fibrosis,
necessitating PFTs and TFTs.
4. Which mechanism best describes the action of Sodium-Glucose Cotransporter 2 (SGLT2)
inhibitors like Empagliflozin?
A. Increasing insulin sensitivity in peripheral tissues
B. Stimulating the release of insulin from pancreatic beta cells
C. Slowing gastric emptying and suppressing glucagon release
D. Inhibiting glucose reabsorption in the proximal convoluted tubule of the kidney
Answer: D
Conceptual Explanation: SGLT2 inhibitors lower blood glucose by promoting glucosuria
through the inhibition of the SGLT2 protein in the kidneys, which is responsible for
reabsorbing most of the filtered glucose.
5. When prescribing a Fluoroquinolone, such as Levofloxacin, for a 75-year-old patient, the
nurse practitioner must warn the patient about which Black Box Warning?
A. Severe hepatotoxicity
B. Stevens-Johnson Syndrome
C. Aplastic anemia
D. Tendon rupture and tendonitis
COMPREHENSIVE EXAM BANK
QUESTIONS AND ANSWERS
1. A 64-year-old male with a history of heart failure with reduced ejection fraction (HFrEF) is
currently taking an ACE inhibitor and a loop diuretic. Which medication, if added, requires the
closest monitoring of serum potassium levels due to the risk of life-threatening
hyperkalemia?
A. Metoprolol succinate
B. Spironolactone
C. Amlodipine
D. Hydralazine
Answer: B
Conceptual Explanation: Spironolactone is a potassium-sparing diuretic (aldosterone
antagonist). When combined with ACE inhibitors, which also increase potassium by
inhibiting aldosterone, the risk of severe hyperkalemia is significantly elevated.
,2. Which of the following medications is considered the first-line treatment for a pregnant
patient diagnosed with gestational diabetes who has failed nutritional therapy?
A. Insulin
B. Glyburide
C. Metformin
D. Sitagliptin
Answer: A
Conceptual Explanation: Insulin is the gold standard for gestational diabetes
management because it does not cross the placenta and has a well-established safety
profile compared to oral hypoglycemics.
3. A patient is prescribed Amiodarone for the management of atrial fibrillation. Which
baseline and periodic monitoring is essential due to the drug’s potential for organ toxicity?
A. Complete blood count and Renal profile
B. Pulmonary function tests and Thyroid function tests
C. Serum glucose and Lipid panel
D. Bone density scan and Audiometry
Answer: B
, Conceptual Explanation: Amiodarone contains iodine and can cause both hypo- and
hyperthyroidism. It is also associated with potentially fatal pulmonary fibrosis,
necessitating PFTs and TFTs.
4. Which mechanism best describes the action of Sodium-Glucose Cotransporter 2 (SGLT2)
inhibitors like Empagliflozin?
A. Increasing insulin sensitivity in peripheral tissues
B. Stimulating the release of insulin from pancreatic beta cells
C. Slowing gastric emptying and suppressing glucagon release
D. Inhibiting glucose reabsorption in the proximal convoluted tubule of the kidney
Answer: D
Conceptual Explanation: SGLT2 inhibitors lower blood glucose by promoting glucosuria
through the inhibition of the SGLT2 protein in the kidneys, which is responsible for
reabsorbing most of the filtered glucose.
5. When prescribing a Fluoroquinolone, such as Levofloxacin, for a 75-year-old patient, the
nurse practitioner must warn the patient about which Black Box Warning?
A. Severe hepatotoxicity
B. Stevens-Johnson Syndrome
C. Aplastic anemia
D. Tendon rupture and tendonitis
