NR566 ADVANCED PHARMACOLOGY
MIDTERM EXAM QUESTIONS WITH
100% CORRECT ANSWERS
1. Which of the following describes the primary mechanism of action of ACE inhibitors in
treating hypertension?
A. Increasing the secretion of aldosterone
B. Directly antagonizing Angiotensin II receptors
C. Inhibiting the release of renin from the kidneys
D. Blocking the conversion of Angiotensin I to Angiotensin II
Answer: D
Conceptual Explanation: ACE inhibitors work by inhibiting the angiotensin-converting
enzyme, which prevents the conversion of Angiotensin I to the potent vasoconstrictor
Angiotensin II.
,2. When prescribing Metformin for a patient with Type 2 Diabetes, which laboratory value is
most critical to monitor due to the risk of lactic acidosis?
A. Serum Potassium
B. Hemoglobin A1c
C. Liver Enzymes (ALT/AST)
D. Glomerular Filtration Rate (eGFR)
Answer: D
Conceptual Explanation: Metformin is renally cleared and is contraindicated in patients
with an eGFR below 30 mL/min/1.73m2 due to the high risk of lactic acidosis.
3. A patient is started on Warfarin (Coumadin). Which of the following statements regarding
the International Normalized Ratio (INR) is correct?
A. The target INR for most patients with atrial fibrillation is 1.0-2.0
B. The standard therapeutic target INR for atrial fibrillation is 2.0-3.0
C. Vitamin K intake should be drastically increased to stabilize the INR
D. INR should be checked every 6 months once stabilized
Answer: B
Conceptual Explanation: For common indications like atrial fibrillation, the standard
therapeutic range for INR is 2.0 to 3.0. Consistency in Vitamin K intake is key, rather than
total avoidance or drastic increase.
, 4. A patient with a history of severe asthma is diagnosed with hypertension. Which class of
antihypertensives should be used with extreme caution or avoided?
A. Calcium Channel Blockers
B. Non-selective Beta-Blockers
C. Thiazide Diuretics
D. ACE Inhibitors
Answer: B
Conceptual Explanation: Non-selective beta-blockers (like Propranolol) block Beta-2
receptors in the lungs, potentially causing bronchoconstriction and exacerbating asthma
symptoms.
5. Which antibiotic is associated with a black box warning regarding the risk of tendon
rupture and tendonitis?
A. Amoxicillin
B. Azithromycin
C. Ciprofloxacin
D. Doxycycline
Answer: C
Conceptual Explanation: Fluoroquinolones, such as Ciprofloxacin and Levofloxacin, carry
a FDA black box warning for tendon rupture, peripheral neuropathy, and CNS effects.
MIDTERM EXAM QUESTIONS WITH
100% CORRECT ANSWERS
1. Which of the following describes the primary mechanism of action of ACE inhibitors in
treating hypertension?
A. Increasing the secretion of aldosterone
B. Directly antagonizing Angiotensin II receptors
C. Inhibiting the release of renin from the kidneys
D. Blocking the conversion of Angiotensin I to Angiotensin II
Answer: D
Conceptual Explanation: ACE inhibitors work by inhibiting the angiotensin-converting
enzyme, which prevents the conversion of Angiotensin I to the potent vasoconstrictor
Angiotensin II.
,2. When prescribing Metformin for a patient with Type 2 Diabetes, which laboratory value is
most critical to monitor due to the risk of lactic acidosis?
A. Serum Potassium
B. Hemoglobin A1c
C. Liver Enzymes (ALT/AST)
D. Glomerular Filtration Rate (eGFR)
Answer: D
Conceptual Explanation: Metformin is renally cleared and is contraindicated in patients
with an eGFR below 30 mL/min/1.73m2 due to the high risk of lactic acidosis.
3. A patient is started on Warfarin (Coumadin). Which of the following statements regarding
the International Normalized Ratio (INR) is correct?
A. The target INR for most patients with atrial fibrillation is 1.0-2.0
B. The standard therapeutic target INR for atrial fibrillation is 2.0-3.0
C. Vitamin K intake should be drastically increased to stabilize the INR
D. INR should be checked every 6 months once stabilized
Answer: B
Conceptual Explanation: For common indications like atrial fibrillation, the standard
therapeutic range for INR is 2.0 to 3.0. Consistency in Vitamin K intake is key, rather than
total avoidance or drastic increase.
, 4. A patient with a history of severe asthma is diagnosed with hypertension. Which class of
antihypertensives should be used with extreme caution or avoided?
A. Calcium Channel Blockers
B. Non-selective Beta-Blockers
C. Thiazide Diuretics
D. ACE Inhibitors
Answer: B
Conceptual Explanation: Non-selective beta-blockers (like Propranolol) block Beta-2
receptors in the lungs, potentially causing bronchoconstriction and exacerbating asthma
symptoms.
5. Which antibiotic is associated with a black box warning regarding the risk of tendon
rupture and tendonitis?
A. Amoxicillin
B. Azithromycin
C. Ciprofloxacin
D. Doxycycline
Answer: C
Conceptual Explanation: Fluoroquinolones, such as Ciprofloxacin and Levofloxacin, carry
a FDA black box warning for tendon rupture, peripheral neuropathy, and CNS effects.
