Page 1 of 171
NSG 533 ADVANCED PHARMACOLOGY
EXAM 3 COMPLETE PREMIUM
QUESTION BANK | 200+ VERIFIED
ACADEMIC YEAR | ALIGNED WITH
WILKES UNIVERSITY CURRICULUM |
TABLE OF CONTENTS
| Section | Content Area | Questions |
|---------|-------------|-----------|
| **I** | **Cardiovascular Pharmacology: Heart Failure & Coronary Artery Disease** | Q1–Q45 |
| **II** | **Hypertension & Dyslipidemia Management** | Q46–Q80 |
| **III** | **Anticoagulation & Antithrombotic Therapy** | Q81–Q105 |
| **IV** | **Respiratory Pharmacology: Asthma & COPD** | Q106–Q140 |
| **V** | **Anti-Infective & Antimicrobial Therapy** | Q141–Q170 |
| **VI** | **Endocrine & Metabolic Pharmacology** | Q171–Q195 |
| **VII** | **Gastrointestinal Pharmacology** | Q196–Q210 |
| **VIII** | **Clinical Case Studies & Prescribing Decisions** | Q211–Q230 |
,Page 2 of 171
SECTION I: CARDIOVASCULAR PHARMACOLOGY — HEART FAILURE &
CORONARY ARTERY DISEASE
## Questions 1–45
**Question 1**
A 68-year-old patient with heart failure with reduced ejection fraction (HFrEF) is prescribed
sacubitril/valsartan. The nurse practitioner understands that this medication works by:
A. Blocking beta-1 adrenergic receptors and reducing heart rate
B. Inhibiting neprilysin and blocking angiotensin II receptors, reducing preload and afterload
C. Inhibiting ACE and reducing aldosterone secretion
D. Blocking calcium channels in vascular smooth muscle
**Correct Answer: B**
**Rationale:** Sacubitril/valsartan (Entresto) is a combination drug that inhibits neprilysin
(which breaks down natriuretic peptides) and blocks angiotensin II receptors. This dual
mechanism reduces preload and afterload, improving cardiac function in HFrEF. It is superior to
enalapril in reducing mortality and hospitalizations.
**Clinical Judgment Focus:** Analyze cues → Pharmacodynamics
---
,Page 3 of 171
**Question 2**
A patient with HFrEF is initiated on carvedilol. Which statement by the patient indicates a need
for further education?
A. "I should take this medication with food."
B. "I need to monitor my blood pressure and heart rate."
C. "I can stop this medication once my heart failure improves."
D. "I should report any weight gain or increased shortness of breath."
**Correct Answer: C**
**Rationale:** Beta-blockers like carvedilol must not be stopped abruptly in heart failure
patients, as this can cause rebound tachycardia, hypertension, and worsening heart failure. The
medication should be taken with food (A) and the patient should monitor vital signs (B) and
report signs of worsening HF (D).
**Clinical Judgment Focus:** Evaluate outcomes → Patient education
---
**Question 3**
Which finding indicates that digoxin therapy is effective in a patient with heart failure?
A. Increased urine output and decreased edema
B. Increased heart rate and blood pressure
C. Decreased serum potassium level
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D. Increased jugular venous distention
**Correct Answer: A**
**Rationale:** Digoxin increases cardiac contractility and reduces heart rate, improving cardiac
output and renal perfusion. Increased urine output and decreased edema indicate improved
cardiac function and fluid mobilization.
**Clinical Judgment Focus:** Evaluate outcomes → Evaluation
---
**Question 4**
A patient with HFrEF is prescribed spironolactone. Which laboratory value requires
IMMEDIATE notification of the provider?
A. Serum potassium of 5.8 mEq/L
B. Serum sodium of 138 mEq/L
C. Serum creatinine of 1.1 mg/dL
D. Serum magnesium of 2.0 mg/dL
**Correct Answer: A**
**Rationale:** Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia. A
serum potassium of 5.8 mEq/L is dangerously elevated and can cause cardiac dysrhythmias. The
nurse should hold the medication and notify the provider immediately.
NSG 533 ADVANCED PHARMACOLOGY
EXAM 3 COMPLETE PREMIUM
QUESTION BANK | 200+ VERIFIED
ACADEMIC YEAR | ALIGNED WITH
WILKES UNIVERSITY CURRICULUM |
TABLE OF CONTENTS
| Section | Content Area | Questions |
|---------|-------------|-----------|
| **I** | **Cardiovascular Pharmacology: Heart Failure & Coronary Artery Disease** | Q1–Q45 |
| **II** | **Hypertension & Dyslipidemia Management** | Q46–Q80 |
| **III** | **Anticoagulation & Antithrombotic Therapy** | Q81–Q105 |
| **IV** | **Respiratory Pharmacology: Asthma & COPD** | Q106–Q140 |
| **V** | **Anti-Infective & Antimicrobial Therapy** | Q141–Q170 |
| **VI** | **Endocrine & Metabolic Pharmacology** | Q171–Q195 |
| **VII** | **Gastrointestinal Pharmacology** | Q196–Q210 |
| **VIII** | **Clinical Case Studies & Prescribing Decisions** | Q211–Q230 |
,Page 2 of 171
SECTION I: CARDIOVASCULAR PHARMACOLOGY — HEART FAILURE &
CORONARY ARTERY DISEASE
## Questions 1–45
**Question 1**
A 68-year-old patient with heart failure with reduced ejection fraction (HFrEF) is prescribed
sacubitril/valsartan. The nurse practitioner understands that this medication works by:
A. Blocking beta-1 adrenergic receptors and reducing heart rate
B. Inhibiting neprilysin and blocking angiotensin II receptors, reducing preload and afterload
C. Inhibiting ACE and reducing aldosterone secretion
D. Blocking calcium channels in vascular smooth muscle
**Correct Answer: B**
**Rationale:** Sacubitril/valsartan (Entresto) is a combination drug that inhibits neprilysin
(which breaks down natriuretic peptides) and blocks angiotensin II receptors. This dual
mechanism reduces preload and afterload, improving cardiac function in HFrEF. It is superior to
enalapril in reducing mortality and hospitalizations.
**Clinical Judgment Focus:** Analyze cues → Pharmacodynamics
---
,Page 3 of 171
**Question 2**
A patient with HFrEF is initiated on carvedilol. Which statement by the patient indicates a need
for further education?
A. "I should take this medication with food."
B. "I need to monitor my blood pressure and heart rate."
C. "I can stop this medication once my heart failure improves."
D. "I should report any weight gain or increased shortness of breath."
**Correct Answer: C**
**Rationale:** Beta-blockers like carvedilol must not be stopped abruptly in heart failure
patients, as this can cause rebound tachycardia, hypertension, and worsening heart failure. The
medication should be taken with food (A) and the patient should monitor vital signs (B) and
report signs of worsening HF (D).
**Clinical Judgment Focus:** Evaluate outcomes → Patient education
---
**Question 3**
Which finding indicates that digoxin therapy is effective in a patient with heart failure?
A. Increased urine output and decreased edema
B. Increased heart rate and blood pressure
C. Decreased serum potassium level
, Page 4 of 171
D. Increased jugular venous distention
**Correct Answer: A**
**Rationale:** Digoxin increases cardiac contractility and reduces heart rate, improving cardiac
output and renal perfusion. Increased urine output and decreased edema indicate improved
cardiac function and fluid mobilization.
**Clinical Judgment Focus:** Evaluate outcomes → Evaluation
---
**Question 4**
A patient with HFrEF is prescribed spironolactone. Which laboratory value requires
IMMEDIATE notification of the provider?
A. Serum potassium of 5.8 mEq/L
B. Serum sodium of 138 mEq/L
C. Serum creatinine of 1.1 mg/dL
D. Serum magnesium of 2.0 mg/dL
**Correct Answer: A**
**Rationale:** Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia. A
serum potassium of 5.8 mEq/L is dangerously elevated and can cause cardiac dysrhythmias. The
nurse should hold the medication and notify the provider immediately.
