NR 568 Advanced Pharmacology for AGPCNP Final
(Weeks 5–8) – Chamberlain University
Questions
Section 1: Cardiovascular Pharmacology
1. MC: A 68-year-old male with a history of HFrEF (EF 30%) is on optimal
medical therapy including sacubitril/valsartan. He presents with a serum
potassium of 5.8 mEq/L. What is the most appropriate initial action?
o A. Continue sacubitril/valsartan and add a potassium binder.
o B. Reduce the dose of sacubitril/valsartan by half.
o C. Discontinue sacubitril/valsartan.
o D. Add low-dose hydrochlorothiazide.
o Correct Answer: C
2. MC: A patient on a stable dose of warfarin for atrial fibrillation is started on
amiodarone for a ventricular arrhythmia. How should the nurse practitioner
manage this interaction?
o A. Monitor the INR frequently; amiodarone increases INR.
o B. Monitor the INR frequently; amiodarone decreases INR.
o C. No change in warfarin dose is needed.
o D. Hold warfarin until amiodarone is therapeutic.
o Correct Answer: A
3. MC: A patient is prescribed a statin for primary prevention of CVD. Which
of the following is the most important baseline laboratory assessment?
o A. Creatinine Kinase (CK)
o B. Aspartate Aminotransferase (AST)
o C. High-sensitivity C-reactive protein (hs-CRP)
, o D. Fasting lipid panel
o Correct Answer: D
4. SATA: Which of the following are characteristic adverse effects of
amiodarone? (Select all that apply)
o A. Pulmonary fibrosis
o B. Blue-gray skin discoloration
o C. Thyroid dysfunction (hyper or hypothyroidism)
o D. Correct Answer: A, B, C. (Corneal microdeposits are also
common but optic neuropathy is rare; the classic triad is pulmonary,
thyroid, skin).
5. MC: A 72-year-old female with angina is prescribed sublingual nitroglycerin.
What instruction should be prioritized?
o A. Store the bottle in the refrigerator.
o B. Take one tablet every 15 minutes for up to three doses.
o C. If pain persists after 5 minutes, call 911.
o D. Replace the bottle every 3-6 months after opening.
o Correct Answer: D
6. MC: Which of the following beta-blockers is considered the most
cardioselective (beta-1 selective)?
o A. Carvedilol
o B. Propranolol
o C. Metoprolol succinate
o D. Labetalol
o Correct Answer: C
7. MC: A patient with CKD stage 3 is started on an ACE inhibitor. You
anticipate the serum creatinine will:
, o A. Decrease as GFR improves.
o B. Increase up to 30% and stabilize.
o C. Double within the first week.
o D. Remain unchanged if renal function is stable.
o Correct Answer: B
8. MC: A patient on spironolactone 50 mg daily for HFrEF develops tender
gynecomastia. Which medication would be an appropriate alternative to
maintain potassium-sparing effects?
o A. Hydrochlorothiazide
o B. Furosemide
o C. Eplerenone
o D. Amiloride
o Correct Answer: C
9. SATA: A patient with AFib has a CHA2DS2-VASc score of 4. Which of the
following are appropriate anticoagulation options? (Select all that apply)
o A. Warfarin
o B. Apixaban
o C. Clopidogrel
o D. Dabigatran
o Correct Answer: A, B, D. Warfarin and DOACs (Apixaban,
Dabigatran, Rivaroxaban) are indicated. Clopidogrel is antiplatelet,
not appropriate as monotherapy in this setting.
10.MC: A patient reports muscle aches after initiating atorvastatin. The CK
level is 9,000 U/L (normal < 200). What is the appropriate management?
o A. Reduce the dose of atorvastatin by half.
o B. Switch to a low-intensity statin.
, o C. Discontinue atorvastatin immediately.
o D. Start Coenzyme Q10.
o Correct Answer: C (This is rhabdomyolysis. Statin should be
held).
11.MC: What is the mechanism of action of ranolazine?
o A. Beta-1 receptor blockade
o B. Inhibition of the late sodium current
o C. Calcium channel blockade
o D. Direct vasodilation of coronary arteries
o Correct Answer: B
12.MC: A patient with resistant hypertension (on lisinopril, HCTZ, and
amlodipine) has a BP of 148/90. Which class of medication would be most
appropriate to add?
o A. Beta-blocker (Metoprolol)
o B. Aldosterone antagonist (Spironolactone)
o C. Alpha-blocker (Doxazosin)
o D. Direct vasodilator (Hydralazine)
o Correct Answer: B
13.MC: A patient on digoxin is prescribed verapamil. What is the primary
concern?
o A. Increased risk of bleeding
o B. Decreased renal clearance of digoxin
o C. Increased risk of digoxin toxicity
o D. Risk of severe bradycardia
o Correct Answer: D (Both drugs depress AV node).
(Weeks 5–8) – Chamberlain University
Questions
Section 1: Cardiovascular Pharmacology
1. MC: A 68-year-old male with a history of HFrEF (EF 30%) is on optimal
medical therapy including sacubitril/valsartan. He presents with a serum
potassium of 5.8 mEq/L. What is the most appropriate initial action?
o A. Continue sacubitril/valsartan and add a potassium binder.
o B. Reduce the dose of sacubitril/valsartan by half.
o C. Discontinue sacubitril/valsartan.
o D. Add low-dose hydrochlorothiazide.
o Correct Answer: C
2. MC: A patient on a stable dose of warfarin for atrial fibrillation is started on
amiodarone for a ventricular arrhythmia. How should the nurse practitioner
manage this interaction?
o A. Monitor the INR frequently; amiodarone increases INR.
o B. Monitor the INR frequently; amiodarone decreases INR.
o C. No change in warfarin dose is needed.
o D. Hold warfarin until amiodarone is therapeutic.
o Correct Answer: A
3. MC: A patient is prescribed a statin for primary prevention of CVD. Which
of the following is the most important baseline laboratory assessment?
o A. Creatinine Kinase (CK)
o B. Aspartate Aminotransferase (AST)
o C. High-sensitivity C-reactive protein (hs-CRP)
, o D. Fasting lipid panel
o Correct Answer: D
4. SATA: Which of the following are characteristic adverse effects of
amiodarone? (Select all that apply)
o A. Pulmonary fibrosis
o B. Blue-gray skin discoloration
o C. Thyroid dysfunction (hyper or hypothyroidism)
o D. Correct Answer: A, B, C. (Corneal microdeposits are also
common but optic neuropathy is rare; the classic triad is pulmonary,
thyroid, skin).
5. MC: A 72-year-old female with angina is prescribed sublingual nitroglycerin.
What instruction should be prioritized?
o A. Store the bottle in the refrigerator.
o B. Take one tablet every 15 minutes for up to three doses.
o C. If pain persists after 5 minutes, call 911.
o D. Replace the bottle every 3-6 months after opening.
o Correct Answer: D
6. MC: Which of the following beta-blockers is considered the most
cardioselective (beta-1 selective)?
o A. Carvedilol
o B. Propranolol
o C. Metoprolol succinate
o D. Labetalol
o Correct Answer: C
7. MC: A patient with CKD stage 3 is started on an ACE inhibitor. You
anticipate the serum creatinine will:
, o A. Decrease as GFR improves.
o B. Increase up to 30% and stabilize.
o C. Double within the first week.
o D. Remain unchanged if renal function is stable.
o Correct Answer: B
8. MC: A patient on spironolactone 50 mg daily for HFrEF develops tender
gynecomastia. Which medication would be an appropriate alternative to
maintain potassium-sparing effects?
o A. Hydrochlorothiazide
o B. Furosemide
o C. Eplerenone
o D. Amiloride
o Correct Answer: C
9. SATA: A patient with AFib has a CHA2DS2-VASc score of 4. Which of the
following are appropriate anticoagulation options? (Select all that apply)
o A. Warfarin
o B. Apixaban
o C. Clopidogrel
o D. Dabigatran
o Correct Answer: A, B, D. Warfarin and DOACs (Apixaban,
Dabigatran, Rivaroxaban) are indicated. Clopidogrel is antiplatelet,
not appropriate as monotherapy in this setting.
10.MC: A patient reports muscle aches after initiating atorvastatin. The CK
level is 9,000 U/L (normal < 200). What is the appropriate management?
o A. Reduce the dose of atorvastatin by half.
o B. Switch to a low-intensity statin.
, o C. Discontinue atorvastatin immediately.
o D. Start Coenzyme Q10.
o Correct Answer: C (This is rhabdomyolysis. Statin should be
held).
11.MC: What is the mechanism of action of ranolazine?
o A. Beta-1 receptor blockade
o B. Inhibition of the late sodium current
o C. Calcium channel blockade
o D. Direct vasodilation of coronary arteries
o Correct Answer: B
12.MC: A patient with resistant hypertension (on lisinopril, HCTZ, and
amlodipine) has a BP of 148/90. Which class of medication would be most
appropriate to add?
o A. Beta-blocker (Metoprolol)
o B. Aldosterone antagonist (Spironolactone)
o C. Alpha-blocker (Doxazosin)
o D. Direct vasodilator (Hydralazine)
o Correct Answer: B
13.MC: A patient on digoxin is prescribed verapamil. What is the primary
concern?
o A. Increased risk of bleeding
o B. Decreased renal clearance of digoxin
o C. Increased risk of digoxin toxicity
o D. Risk of severe bradycardia
o Correct Answer: D (Both drugs depress AV node).
