NURS 6521 ADVANCED
PHARMACOLOGY FINAL EXAM
(VERIFIED ANSWERS) QUESTIONS
WITH ANSWERS: WALDEN
UNIVERSITY
1. Which mechanism is responsible for the dry cough frequently associated with ACE
inhibitors?
A. Accumulation of bradykinin in the lungs
B. Inhibition of prostaglandins
C. Direct stimulation of the cough reflex center
D. Bronchoconstriction via muscarinic receptors
Answer: A
Conceptual Explanation: ACE inhibitors prevent the breakdown of bradykinin and
substance P, leading to their accumulation in the respiratory tract, which triggers a dry,
non-productive cough.
2. A patient is prescribed Amiodarone for ventricular arrhythmias. Which monitoring
parameter is most critical due to potential long-term organ toxicity?
A. Daily weights and intake/output
,B. Serial serum potassium levels
C. Thyroid function tests and chest X-rays
D. Serum creatinine and BUN
Answer: C
Conceptual Explanation: Amiodarone contains iodine and is associated with thyroid
dysfunction (both hyper- and hypo-), and its most serious side effect is pulmonary toxicity,
necessitating regular chest X-rays.
3. A patient taking Warfarin is started on Trimethoprim-Sulfamethoxazole (Bactrim). What is
the expected pharmacological interaction?
A. Decreased anticoagulant effect of Warfarin
B. Increased metabolism of Sulfamethoxazole
C. Increased INR and risk of bleeding
D. Decreased absorption of the antibiotic
Answer: C
Conceptual Explanation: Bactrim is a potent inhibitor of the CYP2C9 enzyme, which is
responsible for metabolizing the more potent S-isomer of Warfarin, leading to increased
drug levels and elevated INR.
, 4. Which teaching point is essential for a patient starting Bisphosphonate therapy for
osteoporosis?
A. Remain upright for at least 30 minutes after taking the drug
B. Take the medication with a glass of milk to enhance calcium absorption
C. Take the medication immediately before bedtime
D. Discontinue use if muscle aches occur
Answer: A
Conceptual Explanation: Bisphosphonates can cause severe esophageal irritation and
ulceration; staying upright helps ensure the drug enters the stomach quickly.
5. In the management of Type 2 Diabetes, which drug class carries the highest risk for causing
euglycemic ketoacidosis?
A. GLP-1 receptor agonists
B. SGLT2 inhibitors
C. DPP-4 inhibitors
D. Sulfonylureas
Answer: B
Conceptual Explanation: SGLT2 inhibitors (like canagliflozin) promote glucose excretion
in urine, but in some cases, can lead to ketoacidosis even when blood glucose levels are
relatively normal (euglycemic).
PHARMACOLOGY FINAL EXAM
(VERIFIED ANSWERS) QUESTIONS
WITH ANSWERS: WALDEN
UNIVERSITY
1. Which mechanism is responsible for the dry cough frequently associated with ACE
inhibitors?
A. Accumulation of bradykinin in the lungs
B. Inhibition of prostaglandins
C. Direct stimulation of the cough reflex center
D. Bronchoconstriction via muscarinic receptors
Answer: A
Conceptual Explanation: ACE inhibitors prevent the breakdown of bradykinin and
substance P, leading to their accumulation in the respiratory tract, which triggers a dry,
non-productive cough.
2. A patient is prescribed Amiodarone for ventricular arrhythmias. Which monitoring
parameter is most critical due to potential long-term organ toxicity?
A. Daily weights and intake/output
,B. Serial serum potassium levels
C. Thyroid function tests and chest X-rays
D. Serum creatinine and BUN
Answer: C
Conceptual Explanation: Amiodarone contains iodine and is associated with thyroid
dysfunction (both hyper- and hypo-), and its most serious side effect is pulmonary toxicity,
necessitating regular chest X-rays.
3. A patient taking Warfarin is started on Trimethoprim-Sulfamethoxazole (Bactrim). What is
the expected pharmacological interaction?
A. Decreased anticoagulant effect of Warfarin
B. Increased metabolism of Sulfamethoxazole
C. Increased INR and risk of bleeding
D. Decreased absorption of the antibiotic
Answer: C
Conceptual Explanation: Bactrim is a potent inhibitor of the CYP2C9 enzyme, which is
responsible for metabolizing the more potent S-isomer of Warfarin, leading to increased
drug levels and elevated INR.
, 4. Which teaching point is essential for a patient starting Bisphosphonate therapy for
osteoporosis?
A. Remain upright for at least 30 minutes after taking the drug
B. Take the medication with a glass of milk to enhance calcium absorption
C. Take the medication immediately before bedtime
D. Discontinue use if muscle aches occur
Answer: A
Conceptual Explanation: Bisphosphonates can cause severe esophageal irritation and
ulceration; staying upright helps ensure the drug enters the stomach quickly.
5. In the management of Type 2 Diabetes, which drug class carries the highest risk for causing
euglycemic ketoacidosis?
A. GLP-1 receptor agonists
B. SGLT2 inhibitors
C. DPP-4 inhibitors
D. Sulfonylureas
Answer: B
Conceptual Explanation: SGLT2 inhibitors (like canagliflozin) promote glucose excretion
in urine, but in some cases, can lead to ketoacidosis even when blood glucose levels are
relatively normal (euglycemic).
