NR566 ADVANCED PHARMACOLOGY
MIDTERM AND FINALS REVIEW EXAM
QUESTIONS WITH 100% CORRECT
ANSWERS
1. A 55-year-old patient with type 2 diabetes and chronic kidney disease (eGFR 25
mL/min/1.73m²) requires glucose management. Which medication is contraindicated in this
patient?
A. Glipizide
B. Liraglutide
C. Metformin
D. Pioglitazone
Answer: C
Conceptual Explanation: Metformin is contraindicated in patients with an eGFR less than
30 mL/min/1.73m² due to the increased risk of lactic acidosis.
2. Which education point is most critical for a patient starting a Long-Acting Beta2 Agonist
(LABA) for asthma management?
A. It should be used as a rescue inhaler for acute symptoms.
B. Rinse your mouth to prevent oral candidiasis.
,C. You should stop taking all other asthma medications immediately.
D. It should only be used in combination with an inhaled corticosteroid (ICS).
Answer: D
Conceptual Explanation: In asthma, LABA monotherapy is associated with an increased
risk of asthma-related death; it must be used with an ICS. ICS requires rinsing to prevent
thrush, not LABAs.
3. A patient taking Lisinopril for hypertension develops a dry, hacking cough. Which class of
medication is the most appropriate alternative that avoids this specific side effect?
A. Beta-Blockers
B. Calcium Channel Blockers
C. Angiotensin II Receptor Blockers (ARBs)
D. Thiazide Diuretics
Answer: C
Conceptual Explanation: ACE inhibitors cause a cough due to bradykinin accumulation.
ARBs do not affect bradykinin and are the standard alternative for ACEI-induced cough.
4. Which of the following is a Black Box Warning for Fluoroquinolones such as Ciprofloxacin?
A. Ototoxicity
B. Gingival hyperplasia
C. Tendon rupture and tendinitis
, D. Stevens-Johnson Syndrome
Answer: C
Conceptual Explanation: Fluoroquinolones carry a BBW for tendinitis and tendon
rupture, as well as peripheral neuropathy and CNS effects.
5. When initiating Statins, which laboratory parameter should be monitored if the patient
reports unexplained muscle pain or weakness?
A. Serum Potassium
B. Creatine Kinase (CK)
C. Blood Urea Nitrogen (BUN)
D. Thyroid Stimulating Hormone (TSH)
Answer: B
Conceptual Explanation: Statin-associated muscle symptoms require checking CK levels
to assess for myopathy or rhabdomyolysis.
6. Which medication is the first-line treatment for an acute gout flare in a patient with no
contraindications?
A. Allopurinol
B. Febuxostat
C. Probenecid
D. Naproxen
MIDTERM AND FINALS REVIEW EXAM
QUESTIONS WITH 100% CORRECT
ANSWERS
1. A 55-year-old patient with type 2 diabetes and chronic kidney disease (eGFR 25
mL/min/1.73m²) requires glucose management. Which medication is contraindicated in this
patient?
A. Glipizide
B. Liraglutide
C. Metformin
D. Pioglitazone
Answer: C
Conceptual Explanation: Metformin is contraindicated in patients with an eGFR less than
30 mL/min/1.73m² due to the increased risk of lactic acidosis.
2. Which education point is most critical for a patient starting a Long-Acting Beta2 Agonist
(LABA) for asthma management?
A. It should be used as a rescue inhaler for acute symptoms.
B. Rinse your mouth to prevent oral candidiasis.
,C. You should stop taking all other asthma medications immediately.
D. It should only be used in combination with an inhaled corticosteroid (ICS).
Answer: D
Conceptual Explanation: In asthma, LABA monotherapy is associated with an increased
risk of asthma-related death; it must be used with an ICS. ICS requires rinsing to prevent
thrush, not LABAs.
3. A patient taking Lisinopril for hypertension develops a dry, hacking cough. Which class of
medication is the most appropriate alternative that avoids this specific side effect?
A. Beta-Blockers
B. Calcium Channel Blockers
C. Angiotensin II Receptor Blockers (ARBs)
D. Thiazide Diuretics
Answer: C
Conceptual Explanation: ACE inhibitors cause a cough due to bradykinin accumulation.
ARBs do not affect bradykinin and are the standard alternative for ACEI-induced cough.
4. Which of the following is a Black Box Warning for Fluoroquinolones such as Ciprofloxacin?
A. Ototoxicity
B. Gingival hyperplasia
C. Tendon rupture and tendinitis
, D. Stevens-Johnson Syndrome
Answer: C
Conceptual Explanation: Fluoroquinolones carry a BBW for tendinitis and tendon
rupture, as well as peripheral neuropathy and CNS effects.
5. When initiating Statins, which laboratory parameter should be monitored if the patient
reports unexplained muscle pain or weakness?
A. Serum Potassium
B. Creatine Kinase (CK)
C. Blood Urea Nitrogen (BUN)
D. Thyroid Stimulating Hormone (TSH)
Answer: B
Conceptual Explanation: Statin-associated muscle symptoms require checking CK levels
to assess for myopathy or rhabdomyolysis.
6. Which medication is the first-line treatment for an acute gout flare in a patient with no
contraindications?
A. Allopurinol
B. Febuxostat
C. Probenecid
D. Naproxen
