NR566 ADVANCED PHARMACOLOGY
MIDTERM PRACTICE EXAM
QUESTIONS WITH 100% CORRECT
ANSWERS
1. Which mechanism best describes how ACE inhibitors, such as Lisinopril, lower blood
pressure?
A. Inhibiting the release of renin from the kidneys
B. Directly antagonizing Angiotensin II receptors
C. Blocking the conversion of Angiotensin I to Angiotensin II
D. Increasing the breakdown of bradykinin
Answer: C
Conceptual Explanation: ACE inhibitors block the Angiotensin-Converting Enzyme,
preventing the conversion of Angiotensin I to Angiotensin II, a potent vasoconstrictor. This
also leads to increased levels of bradykinin, which contributes to vasodilation but also the
characteristic dry cough.
2. A patient taking Lisinopril develops a persistent, non-productive cough. Which medication
class is the most appropriate alternative that avoids this side effect?
A. Beta-Blockers
,B. Angiotensin II Receptor Blockers (ARBs)
C. Calcium Channel Blockers
D. Loop Diuretics
Answer: B
Conceptual Explanation: ARBs do not inhibit the breakdown of bradykinin, thus they do
not typically cause the dry cough associated with ACE inhibitors while providing similar
cardiovascular benefits.
3. Which of the following is a significant side effect specifically associated with the use of
Dihydropyridine Calcium Channel Blockers like Amlodipine?
A. Peripheral edema
B. Hyperkalemia
C. Dry mouth
D. Tachycardia
Answer: A
Conceptual Explanation: Dihydropyridines commonly cause peripheral edema due to
preferential arterial vasodilation, which increases capillary hydrostatic pressure.
4. Which beta-blocker is considered cardioselective, primarily targeting Beta-1 receptors?
A. Propranolol
B. Nadolol
, C. Carvedilol
D. Metoprolol
Answer: D
Conceptual Explanation: Metoprolol and Atenolol are cardioselective (Beta-1).
Propranolol and Nadolol are non-selective, and Carvedilol blocks both Alpha and Beta
receptors.
5. A patient with a history of asthma requires a beta-blocker for hypertension. Which agent
would be the most dangerous to prescribe due to potential bronchospasm?
A. Atenolol
B. Metoprolol succinate
C. Propranolol
D. Bisoprolol
Answer: C
Conceptual Explanation: Propranolol is a non-selective beta-blocker that antagonizes
Beta-2 receptors in the lungs, potentially triggering bronchospasm in asthmatic patients.
6. Which electrolyte abnormality is most commonly associated with the use of Thiazide
diuretics like Hydrochlorothiazide (HCTZ)?
A. Hyperkalemia
B. Hypernatremia
MIDTERM PRACTICE EXAM
QUESTIONS WITH 100% CORRECT
ANSWERS
1. Which mechanism best describes how ACE inhibitors, such as Lisinopril, lower blood
pressure?
A. Inhibiting the release of renin from the kidneys
B. Directly antagonizing Angiotensin II receptors
C. Blocking the conversion of Angiotensin I to Angiotensin II
D. Increasing the breakdown of bradykinin
Answer: C
Conceptual Explanation: ACE inhibitors block the Angiotensin-Converting Enzyme,
preventing the conversion of Angiotensin I to Angiotensin II, a potent vasoconstrictor. This
also leads to increased levels of bradykinin, which contributes to vasodilation but also the
characteristic dry cough.
2. A patient taking Lisinopril develops a persistent, non-productive cough. Which medication
class is the most appropriate alternative that avoids this side effect?
A. Beta-Blockers
,B. Angiotensin II Receptor Blockers (ARBs)
C. Calcium Channel Blockers
D. Loop Diuretics
Answer: B
Conceptual Explanation: ARBs do not inhibit the breakdown of bradykinin, thus they do
not typically cause the dry cough associated with ACE inhibitors while providing similar
cardiovascular benefits.
3. Which of the following is a significant side effect specifically associated with the use of
Dihydropyridine Calcium Channel Blockers like Amlodipine?
A. Peripheral edema
B. Hyperkalemia
C. Dry mouth
D. Tachycardia
Answer: A
Conceptual Explanation: Dihydropyridines commonly cause peripheral edema due to
preferential arterial vasodilation, which increases capillary hydrostatic pressure.
4. Which beta-blocker is considered cardioselective, primarily targeting Beta-1 receptors?
A. Propranolol
B. Nadolol
, C. Carvedilol
D. Metoprolol
Answer: D
Conceptual Explanation: Metoprolol and Atenolol are cardioselective (Beta-1).
Propranolol and Nadolol are non-selective, and Carvedilol blocks both Alpha and Beta
receptors.
5. A patient with a history of asthma requires a beta-blocker for hypertension. Which agent
would be the most dangerous to prescribe due to potential bronchospasm?
A. Atenolol
B. Metoprolol succinate
C. Propranolol
D. Bisoprolol
Answer: C
Conceptual Explanation: Propranolol is a non-selective beta-blocker that antagonizes
Beta-2 receptors in the lungs, potentially triggering bronchospasm in asthmatic patients.
6. Which electrolyte abnormality is most commonly associated with the use of Thiazide
diuretics like Hydrochlorothiazide (HCTZ)?
A. Hyperkalemia
B. Hypernatremia
