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NURS 711 EXAM 2
Advanced Pharmacotherapies Guide
Comprehensive Practice & Clinical Decision-Making Preparation Guide (2026
Academic Standards)
Total Practice Items: 200 Advanced Clinical Questions
This Study Guide Features:
✓ Complete coverage of Advanced Cardiovascular, Endocrine, Autonomic, and Renal
Pharmacotherapy.
✓ Strictly original scenario-based, decision-making, and priority application questions.
✓ Individualized item structure with dedicated red answer keys and green detailed
clinical rationales.
✓ Standardized formatting compliant with A4 print and responsive layout
requirements.
✓ Zero repetitive question stems—designed for high-yield board-style preparation.
Document ID: N711-EX2-2026-SG
Target Audience: Graduate Nursing & Advanced Practice Nursing Students
Notice: This document is an independent educational study aid created strictly for advanced practice
preparation and knowledge verification.
,NURS 711: Advanced Pharmacotherapies Exam 2 Preparation Guide
TABLE OF CONTENTS
Module / Topic
Focus Areas Questions
Section
Advanced Cardiovascular Pharmacotherapy &
Module 1 Q1 – Q50
Hemodynamics
Module 2 Endocrine & Metabolic Pharmacology Q51 – Q100
Q101 –
Module 3 Autonomic, Neuro-Pharmacology & Pain Management
Q150
Q151 –
Module 4 Renal, Pulmonary & Special Populations Pharmacology
Q200
MODULE 1: ADVANCED CARDIOVASCULAR
PHARMACOTHERAPY & HEMODYNAMICS
Antihypertensives, Heart Failure, Dysrhythmias, and Anticoagulation
,Question 1
A 62-year-old male with a history of heart failure with reduced ejection fraction (HFrEF) and
chronic kidney disease (Stage 3a) is prescribed sacubitril/valsartan. Which baseline lab value
requires the most immediate reassessment prior to initiating this therapy?
A. Serum Sodium
B. Serum Potassium
C. Serum Uric Acid
D. Serum Magnesium
Correct Answer: B
Rationale: Sacubitril/valsartan (an ARNI) inhibits the breakdown of natriuretic peptides and blocks
AT1 receptors, leading to reduced aldosterone secretion. This significantly increases the risk of
hyperkalemia, particularly in patients with baseline renal impairment. Baseline potassium must be
evaluated to prevent life-threatening dysrhythmias.
Question 2
A patient receiving an intravenous diltiazem infusion for atrial fibrillation with rapid
ventricular response develops a blood pressure drop from 128/82 mmHg to 84/52 mmHg
while remaining in rapid atrial fibrillation. What is the priority advanced nursing action?
A. Stop the diltiazem infusion and administer IV normal saline bolus.
B. Reduce the diltiazem infusion rate by 50%.
C. Administer IV digoxin immediately.
D. Place the patient in high-Fowler’s position.
Correct Answer: A
Rationale: Non-dihydropyridine calcium channel blockers like diltiazem cause negative inotropy
and vasodilation. Acute symptomatic hypotension requires immediate discontinuation of the
offending agent and intravascular volume expansion to restore organ perfusion.
, Question 3
A 58-year-old patient taking spironolactone for refractory hypertension presents with muscle
weakness and EKG findings showing peaked T waves. Which mechanism explains this clinical
presentation?
A. Antagonism of mineralocorticoid receptors in the distal convoluted tubule and collecting duct
leading to potassium retention.
B. Blockade of voltage-gated calcium channels in cardiac myocytes leading to intracellular
potassium loss.
C. Inhibition of the Na+/K+/2Cl- cotransporter in the loop of Henle.
D. Activation of epithelial sodium channels (ENaC) promoting sodium excretion and potassium
reabsorption.
Correct Answer: A
Rationale: Spironolactone competitively blocks aldosterone at mineralocorticoid receptors,
reducing expression of sodium channels and Na+/K+ ATPase in late distal tubules/collecting ducts.
This decreases urinary excretion of potassium, resulting in hyperkalemia, which alters cardiac
membrane action potentials.
Question 4
Which antiarrhythmic agent carries a black box warning for pulmonary toxicity,
hepatotoxicity, and proarrhythmic effects, necessitating baseline chest X-ray and pulmonary
function testing?
A. Flecainide
B. Sotalol
C. Amiodarone
D. Dofetilide
Correct Answer: C
Rationale: Amiodarone is an iodine-rich Class III antiarrhythmic with extensive tissue accumulation.
It causes pulmonary toxicity (e.g., interstitial pneumonitis) in up to 17% of patients, alongside risk
for fatal fatal hepatotoxicity and exacerbation of dysrhythmias. Baseline pulmonary and hepatic
monitoring is mandatory.
NURS 711 EXAM 2
Advanced Pharmacotherapies Guide
Comprehensive Practice & Clinical Decision-Making Preparation Guide (2026
Academic Standards)
Total Practice Items: 200 Advanced Clinical Questions
This Study Guide Features:
✓ Complete coverage of Advanced Cardiovascular, Endocrine, Autonomic, and Renal
Pharmacotherapy.
✓ Strictly original scenario-based, decision-making, and priority application questions.
✓ Individualized item structure with dedicated red answer keys and green detailed
clinical rationales.
✓ Standardized formatting compliant with A4 print and responsive layout
requirements.
✓ Zero repetitive question stems—designed for high-yield board-style preparation.
Document ID: N711-EX2-2026-SG
Target Audience: Graduate Nursing & Advanced Practice Nursing Students
Notice: This document is an independent educational study aid created strictly for advanced practice
preparation and knowledge verification.
,NURS 711: Advanced Pharmacotherapies Exam 2 Preparation Guide
TABLE OF CONTENTS
Module / Topic
Focus Areas Questions
Section
Advanced Cardiovascular Pharmacotherapy &
Module 1 Q1 – Q50
Hemodynamics
Module 2 Endocrine & Metabolic Pharmacology Q51 – Q100
Q101 –
Module 3 Autonomic, Neuro-Pharmacology & Pain Management
Q150
Q151 –
Module 4 Renal, Pulmonary & Special Populations Pharmacology
Q200
MODULE 1: ADVANCED CARDIOVASCULAR
PHARMACOTHERAPY & HEMODYNAMICS
Antihypertensives, Heart Failure, Dysrhythmias, and Anticoagulation
,Question 1
A 62-year-old male with a history of heart failure with reduced ejection fraction (HFrEF) and
chronic kidney disease (Stage 3a) is prescribed sacubitril/valsartan. Which baseline lab value
requires the most immediate reassessment prior to initiating this therapy?
A. Serum Sodium
B. Serum Potassium
C. Serum Uric Acid
D. Serum Magnesium
Correct Answer: B
Rationale: Sacubitril/valsartan (an ARNI) inhibits the breakdown of natriuretic peptides and blocks
AT1 receptors, leading to reduced aldosterone secretion. This significantly increases the risk of
hyperkalemia, particularly in patients with baseline renal impairment. Baseline potassium must be
evaluated to prevent life-threatening dysrhythmias.
Question 2
A patient receiving an intravenous diltiazem infusion for atrial fibrillation with rapid
ventricular response develops a blood pressure drop from 128/82 mmHg to 84/52 mmHg
while remaining in rapid atrial fibrillation. What is the priority advanced nursing action?
A. Stop the diltiazem infusion and administer IV normal saline bolus.
B. Reduce the diltiazem infusion rate by 50%.
C. Administer IV digoxin immediately.
D. Place the patient in high-Fowler’s position.
Correct Answer: A
Rationale: Non-dihydropyridine calcium channel blockers like diltiazem cause negative inotropy
and vasodilation. Acute symptomatic hypotension requires immediate discontinuation of the
offending agent and intravascular volume expansion to restore organ perfusion.
, Question 3
A 58-year-old patient taking spironolactone for refractory hypertension presents with muscle
weakness and EKG findings showing peaked T waves. Which mechanism explains this clinical
presentation?
A. Antagonism of mineralocorticoid receptors in the distal convoluted tubule and collecting duct
leading to potassium retention.
B. Blockade of voltage-gated calcium channels in cardiac myocytes leading to intracellular
potassium loss.
C. Inhibition of the Na+/K+/2Cl- cotransporter in the loop of Henle.
D. Activation of epithelial sodium channels (ENaC) promoting sodium excretion and potassium
reabsorption.
Correct Answer: A
Rationale: Spironolactone competitively blocks aldosterone at mineralocorticoid receptors,
reducing expression of sodium channels and Na+/K+ ATPase in late distal tubules/collecting ducts.
This decreases urinary excretion of potassium, resulting in hyperkalemia, which alters cardiac
membrane action potentials.
Question 4
Which antiarrhythmic agent carries a black box warning for pulmonary toxicity,
hepatotoxicity, and proarrhythmic effects, necessitating baseline chest X-ray and pulmonary
function testing?
A. Flecainide
B. Sotalol
C. Amiodarone
D. Dofetilide
Correct Answer: C
Rationale: Amiodarone is an iodine-rich Class III antiarrhythmic with extensive tissue accumulation.
It causes pulmonary toxicity (e.g., interstitial pneumonitis) in up to 17% of patients, alongside risk
for fatal fatal hepatotoxicity and exacerbation of dysrhythmias. Baseline pulmonary and hepatic
monitoring is mandatory.
