WGU D116 Advanced Pharmacology OA & ACTUAL EXAM
2026/2027 | Verified Questions and Correct Detailed
Answers | Pass Guaranteed - A+ Graded
Question 1. A patient is prescribed a drug that is a potent inhibitor of CYP3A4.
Which of the following drugs would most likely have increased plasma levels when
co-administered?
A. Warfarin
B. Simvastatin
C. Metformin
D. Lisinopril
Correct Answer: B
Rationale:
Simvastatin is metabolized primarily by CYP3A4. Inhibiting CYP3A4 increases simvastatin
levels, raising the risk of myopathy and rhabdomyolysis. Warfarin (A) is metabolized by
CYP2C9, CYP1A2, and CYP3A4, but the primary interaction is with CYP2C9. Metformin
(C) is renally eliminated. Lisinopril (D) is renally eliminated.
Question 2. A patient with heart failure is started on sacubitril/valsartan. Which of
the following is a critical nursing consideration?
A. Monitor for hyperkalemia
B. Avoid concurrent use with ACE inhibitors
C. Monitor for hypoglycemia
D. Administer with grapefruit juice
Correct Answer: B
Rationale:
Sacubitril/valsartan (Entresto) should not be used concomitantly with ACE inhibitors due
to increased risk of angioedema. A 36-hour washout period is required. Hyperkalemia
(A) can occur but is not the critical consideration. Hypoglycemia (C) is not typical.
Grapefruit juice (D) is not a major interaction.
Question 3. Which of the following drugs is a direct oral anticoagulant (DOAC)
that specifically inhibits factor Xa?
,A. Dabigatran
B. Rivaroxaban
C. Warfarin
D. Heparin
Correct Answer: B
Rationale:
Rivaroxaban is a direct factor Xa inhibitor. Dabigatran (A) is a direct thrombin inhibitor.
Warfarin (C) inhibits vitamin K-dependent clotting factors. Heparin (D) enhances
antithrombin III activity.
Question 4. A patient is taking levothyroxine. Which of the following medications
would most likely decrease its absorption?
A. Calcium carbonate
B. Lisinopril
C. Metformin
D. Atorvastatin
Correct Answer: A
Rationale:
Calcium carbonate binds to levothyroxine in the GI tract, decreasing its absorption.
Levothyroxine should be taken on an empty stomach, 4 hours apart from calcium.
Lisinopril (B), metformin (C), and atorvastatin (D) do not significantly affect levothyroxine
absorption.
Question 5. Which of the following is a common adverse effect of amiodarone?
A. Pulmonary fibrosis
B. Hypothyroidism
C. Corneal microdeposits
D. All of the above
Correct Answer: D
Rationale:
Amiodarone can cause pulmonary fibrosis, thyroid dysfunction (hypo- or
hyperthyroidism), corneal microdeposits, hepatotoxicity, and photosensitivity. Therefore,
all of the above are correct.
,Question 6. A patient is prescribed metformin. Which laboratory test should be
monitored to assess for a rare but serious adverse effect?
A. Serum creatinine
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: A
Rationale:
Metformin can cause lactic acidosis, especially in patients with renal impairment. Serum
creatinine should be monitored to assess renal function. Potassium (B), calcium (C), and
magnesium (D) are not directly related to metformin toxicity.
Question 7. Which of the following drugs is a beta-2 agonist used for acute asthma
exacerbations?
A. Salmeterol
B. Albuterol
C. Montelukast
D. Fluticasone
Correct Answer: B
Rationale:
Albuterol is a short-acting beta-2 agonist (SABA) for acute relief. Salmeterol (A) is a
long-acting beta-2 agonist (LABA) for maintenance. Montelukast (C) is a leukotriene
modifier. Fluticasone (D) is an inhaled corticosteroid.
Question 8. A patient is taking warfarin. Which of the following dietary
instructions is most important?
A. Maintain consistent intake of vitamin K-rich foods
B. Avoid all green leafy vegetables
C. Increase intake of grapefruit juice
D. Take with aspirin for pain
Correct Answer: A
Rationale:
Consistent vitamin K intake is essential to maintain stable INR. Avoiding all greens (B) is
, unnecessary and can lead to vitamin K deficiency. Grapefruit juice (C) can interact with
many drugs but not warfarin significantly. Aspirin (D) increases bleeding risk.
Question 9. Which of the following is the primary mechanism of action of statins?
A. Inhibition of HMG-CoA reductase
B. Activation of lipoprotein lipase
C. Inhibition of cholesterol absorption
D. Increased bile acid excretion
Correct Answer: A
Rationale:
Statins inhibit HMG-CoA reductase, the rate-limiting enzyme in cholesterol synthesis.
Activation of lipoprotein lipase (B) is the mechanism of fibrates. Inhibition of cholesterol
absorption (C) is ezetimibe. Increased bile acid excretion (D) is bile acid sequestrants.
Question 10. A patient is prescribed an ACE inhibitor. Which of the following
adverse effects is most common?
A. Dry cough
B. Hyperkalemia
C. Angioedema
D. Renal failure
Correct Answer: A
Rationale:
A dry, persistent cough is the most common adverse effect of ACE inhibitors, occurring
in up to 20% of patients. Hyperkalemia (B) and angioedema (C) are less common but
serious. Renal failure (D) can occur but is not the most common.
Question 11. Which of the following drugs is a potassium-sparing diuretic?
A. Furosemide
B. Hydrochlorothiazide
C. Spironolactone
D. Acetazolamide
Correct Answer: C
Rationale:
Spironolactone is a potassium-sparing diuretic (aldosterone antagonist). Furosemide (A)
2026/2027 | Verified Questions and Correct Detailed
Answers | Pass Guaranteed - A+ Graded
Question 1. A patient is prescribed a drug that is a potent inhibitor of CYP3A4.
Which of the following drugs would most likely have increased plasma levels when
co-administered?
A. Warfarin
B. Simvastatin
C. Metformin
D. Lisinopril
Correct Answer: B
Rationale:
Simvastatin is metabolized primarily by CYP3A4. Inhibiting CYP3A4 increases simvastatin
levels, raising the risk of myopathy and rhabdomyolysis. Warfarin (A) is metabolized by
CYP2C9, CYP1A2, and CYP3A4, but the primary interaction is with CYP2C9. Metformin
(C) is renally eliminated. Lisinopril (D) is renally eliminated.
Question 2. A patient with heart failure is started on sacubitril/valsartan. Which of
the following is a critical nursing consideration?
A. Monitor for hyperkalemia
B. Avoid concurrent use with ACE inhibitors
C. Monitor for hypoglycemia
D. Administer with grapefruit juice
Correct Answer: B
Rationale:
Sacubitril/valsartan (Entresto) should not be used concomitantly with ACE inhibitors due
to increased risk of angioedema. A 36-hour washout period is required. Hyperkalemia
(A) can occur but is not the critical consideration. Hypoglycemia (C) is not typical.
Grapefruit juice (D) is not a major interaction.
Question 3. Which of the following drugs is a direct oral anticoagulant (DOAC)
that specifically inhibits factor Xa?
,A. Dabigatran
B. Rivaroxaban
C. Warfarin
D. Heparin
Correct Answer: B
Rationale:
Rivaroxaban is a direct factor Xa inhibitor. Dabigatran (A) is a direct thrombin inhibitor.
Warfarin (C) inhibits vitamin K-dependent clotting factors. Heparin (D) enhances
antithrombin III activity.
Question 4. A patient is taking levothyroxine. Which of the following medications
would most likely decrease its absorption?
A. Calcium carbonate
B. Lisinopril
C. Metformin
D. Atorvastatin
Correct Answer: A
Rationale:
Calcium carbonate binds to levothyroxine in the GI tract, decreasing its absorption.
Levothyroxine should be taken on an empty stomach, 4 hours apart from calcium.
Lisinopril (B), metformin (C), and atorvastatin (D) do not significantly affect levothyroxine
absorption.
Question 5. Which of the following is a common adverse effect of amiodarone?
A. Pulmonary fibrosis
B. Hypothyroidism
C. Corneal microdeposits
D. All of the above
Correct Answer: D
Rationale:
Amiodarone can cause pulmonary fibrosis, thyroid dysfunction (hypo- or
hyperthyroidism), corneal microdeposits, hepatotoxicity, and photosensitivity. Therefore,
all of the above are correct.
,Question 6. A patient is prescribed metformin. Which laboratory test should be
monitored to assess for a rare but serious adverse effect?
A. Serum creatinine
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: A
Rationale:
Metformin can cause lactic acidosis, especially in patients with renal impairment. Serum
creatinine should be monitored to assess renal function. Potassium (B), calcium (C), and
magnesium (D) are not directly related to metformin toxicity.
Question 7. Which of the following drugs is a beta-2 agonist used for acute asthma
exacerbations?
A. Salmeterol
B. Albuterol
C. Montelukast
D. Fluticasone
Correct Answer: B
Rationale:
Albuterol is a short-acting beta-2 agonist (SABA) for acute relief. Salmeterol (A) is a
long-acting beta-2 agonist (LABA) for maintenance. Montelukast (C) is a leukotriene
modifier. Fluticasone (D) is an inhaled corticosteroid.
Question 8. A patient is taking warfarin. Which of the following dietary
instructions is most important?
A. Maintain consistent intake of vitamin K-rich foods
B. Avoid all green leafy vegetables
C. Increase intake of grapefruit juice
D. Take with aspirin for pain
Correct Answer: A
Rationale:
Consistent vitamin K intake is essential to maintain stable INR. Avoiding all greens (B) is
, unnecessary and can lead to vitamin K deficiency. Grapefruit juice (C) can interact with
many drugs but not warfarin significantly. Aspirin (D) increases bleeding risk.
Question 9. Which of the following is the primary mechanism of action of statins?
A. Inhibition of HMG-CoA reductase
B. Activation of lipoprotein lipase
C. Inhibition of cholesterol absorption
D. Increased bile acid excretion
Correct Answer: A
Rationale:
Statins inhibit HMG-CoA reductase, the rate-limiting enzyme in cholesterol synthesis.
Activation of lipoprotein lipase (B) is the mechanism of fibrates. Inhibition of cholesterol
absorption (C) is ezetimibe. Increased bile acid excretion (D) is bile acid sequestrants.
Question 10. A patient is prescribed an ACE inhibitor. Which of the following
adverse effects is most common?
A. Dry cough
B. Hyperkalemia
C. Angioedema
D. Renal failure
Correct Answer: A
Rationale:
A dry, persistent cough is the most common adverse effect of ACE inhibitors, occurring
in up to 20% of patients. Hyperkalemia (B) and angioedema (C) are less common but
serious. Renal failure (D) can occur but is not the most common.
Question 11. Which of the following drugs is a potassium-sparing diuretic?
A. Furosemide
B. Hydrochlorothiazide
C. Spironolactone
D. Acetazolamide
Correct Answer: C
Rationale:
Spironolactone is a potassium-sparing diuretic (aldosterone antagonist). Furosemide (A)
