NUR 5461 ADVANCED
PHARMACOLOGY PRACTICE EXAM
QUESTIONS AND CORRECT ANSWERS
2026/2027
1. Which pharmacokinetic process is primarily affected in a patient with significant
hypoalbuminemia when administering highly protein-bound drugs?
A. Distribution
B. Absorption
C. Metabolism
D. Excretion
Answer: A
Conceptual Explanation: Hypoalbuminemia leads to a higher fraction of free (unbound)
drug in the plasma, which directly affects the volume of distribution and the
pharmacological activity of highly protein-bound medications.
2. A patient is prescribed Lisinopril for hypertension. Which electrolyte abnormality should
the provider monitor for most closely?
A. Hypokalemia
B. Hypercalcemia
,C. Hyponatremia
D. Hyperkalemia
Answer: D
Conceptual Explanation: ACE inhibitors like Lisinopril reduce aldosterone secretion,
which can lead to potassium retention, resulting in hyperkalemia.
3. When prescribing an SSRI for depression, which symptom is most suggestive of Serotonin
Syndrome?
A. Bradycardia and hypotension
B. Hyperreflexia and autonomic instability
C. Respiratory depression and miosis
D. Constipation and urinary retention
Answer: B
Conceptual Explanation: Serotonin Syndrome is characterized by a triad of cognitive
effects, autonomic hyperactivity (instability), and somatic effects like hyperreflexia and
tremors.
4. A patient on Warfarin therapy has an INR of 7.0 but no evidence of bleeding. What is the
recommended management according to current guidelines?
A. Administer IV Vitamin K immediately
B. Hold Warfarin and monitor closely
, C. Hold Warfarin and administer oral Vitamin K
D. Continue Warfarin at a lower dose
Answer: C
Conceptual Explanation: For an INR between 4.5 and 10 with no bleeding, holding
Warfarin and potentially giving low-dose oral Vitamin K is recommended to prevent
hemorrhage.
5. What is the primary mechanism of action of Metformin in the treatment of Type 2
Diabetes?
A. Decreasing hepatic glucose production
B. Stimulating insulin secretion from pancreatic beta cells
C. Increasing glucose excretion via the kidneys
D. Delaying carbohydrate absorption in the gut
Answer: A
Conceptual Explanation: Metformin works primarily by inhibiting hepatic
gluconeogenesis and increasing peripheral insulin sensitivity; it does not stimulate insulin
secretion.
6. Which drug class is considered the first-line treatment for a patient with HFrEF (Heart
Failure with reduced Ejection Fraction) to reduce mortality?
A. Loop Diuretics
PHARMACOLOGY PRACTICE EXAM
QUESTIONS AND CORRECT ANSWERS
2026/2027
1. Which pharmacokinetic process is primarily affected in a patient with significant
hypoalbuminemia when administering highly protein-bound drugs?
A. Distribution
B. Absorption
C. Metabolism
D. Excretion
Answer: A
Conceptual Explanation: Hypoalbuminemia leads to a higher fraction of free (unbound)
drug in the plasma, which directly affects the volume of distribution and the
pharmacological activity of highly protein-bound medications.
2. A patient is prescribed Lisinopril for hypertension. Which electrolyte abnormality should
the provider monitor for most closely?
A. Hypokalemia
B. Hypercalcemia
,C. Hyponatremia
D. Hyperkalemia
Answer: D
Conceptual Explanation: ACE inhibitors like Lisinopril reduce aldosterone secretion,
which can lead to potassium retention, resulting in hyperkalemia.
3. When prescribing an SSRI for depression, which symptom is most suggestive of Serotonin
Syndrome?
A. Bradycardia and hypotension
B. Hyperreflexia and autonomic instability
C. Respiratory depression and miosis
D. Constipation and urinary retention
Answer: B
Conceptual Explanation: Serotonin Syndrome is characterized by a triad of cognitive
effects, autonomic hyperactivity (instability), and somatic effects like hyperreflexia and
tremors.
4. A patient on Warfarin therapy has an INR of 7.0 but no evidence of bleeding. What is the
recommended management according to current guidelines?
A. Administer IV Vitamin K immediately
B. Hold Warfarin and monitor closely
, C. Hold Warfarin and administer oral Vitamin K
D. Continue Warfarin at a lower dose
Answer: C
Conceptual Explanation: For an INR between 4.5 and 10 with no bleeding, holding
Warfarin and potentially giving low-dose oral Vitamin K is recommended to prevent
hemorrhage.
5. What is the primary mechanism of action of Metformin in the treatment of Type 2
Diabetes?
A. Decreasing hepatic glucose production
B. Stimulating insulin secretion from pancreatic beta cells
C. Increasing glucose excretion via the kidneys
D. Delaying carbohydrate absorption in the gut
Answer: A
Conceptual Explanation: Metformin works primarily by inhibiting hepatic
gluconeogenesis and increasing peripheral insulin sensitivity; it does not stimulate insulin
secretion.
6. Which drug class is considered the first-line treatment for a patient with HFrEF (Heart
Failure with reduced Ejection Fraction) to reduce mortality?
A. Loop Diuretics
