NURS 6521N WEEK 6 ADVANCED
PHARMACOLOGY EXAM QUESTIONS
WITH COMPLETE AND VERIFIED
SOLUTIONS: WALDEN UNIVERSITY
1. A patient with bilateral renal artery stenosis is prescribed Lisinopril for hypertension. What
is the most significant risk associated with this treatment in this specific patient population?
A. Acute liver failure due to drug-induced hepatitis
B. Reflex tachycardia leading to myocardial infarction
C. Acute renal failure due to a decrease in efferent arteriolar resistance
D. Severe hypokalemia necessitating emergency replacement
Answer: C
Conceptual Explanation: In patients with bilateral renal artery stenosis, the glomerular
filtration pressure is maintained by Angiotensin II-mediated vasoconstriction of the
efferent arteriole. ACE inhibitors block this, leading to a sudden drop in GFR and potentially
acute renal failure.
2. Which of the following describes the primary mechanism by which Digoxin increases
cardiac contractility?
A. Activation of beta-1 adrenergic receptors
,B. Direct inhibition of phosphodiesterase III
C. Opening of L-type calcium channels during depolarization
D. Inhibition of the Na+/K+-ATPase pump, increasing intracellular sodium and subsequent
calcium
Answer: D
Conceptual Explanation: Digoxin inhibits the Na+/K+-ATPase pump, which increases
intracellular sodium. This reduces the activity of the sodium-calcium exchanger, leading to
higher intracellular calcium levels and increased contractility.
3. A patient on Warfarin therapy has a consistent INR of 1.2 despite dosage increases. Which
genetic polymorphism should the provider consider?
A. CYP3A4 deficiency
B. CYP2C9 increased activity or VKORC1 resistance
C. G6PD deficiency
D. HLA-B*1502 polymorphism
Answer: B
Conceptual Explanation: Warfarin sensitivity is highly influenced by the CYP2C9 enzyme
and the VKORC1 gene. Resistance or high metabolism (low INR) can be linked to specific
variants in these genetic markers.
, 4. What is the most appropriate management for a patient who develops Heparin-Induced
Thrombocytopenia (HIT) Type II?
A. Switching immediately to Enoxaparin
B. Administering a platelet transfusion
C. Increasing the Heparin dose to overcome resistance
D. Stopping all heparin and starting a direct thrombin inhibitor like Argatroban
Answer: D
Conceptual Explanation: HIT Type II is an immune-mediated reaction. All heparin
(including LMWH) must be stopped immediately. Non-heparin anticoagulants, such as
direct thrombin inhibitors, are required to prevent thrombosis.
5. Which calcium channel blocker is most likely to cause significant peripheral edema through
preferential dilation of precapillary arterioles?
A. Diltiazem
B. Verapamil
C. Amlodipine
D. Metoprolol
Answer: C
PHARMACOLOGY EXAM QUESTIONS
WITH COMPLETE AND VERIFIED
SOLUTIONS: WALDEN UNIVERSITY
1. A patient with bilateral renal artery stenosis is prescribed Lisinopril for hypertension. What
is the most significant risk associated with this treatment in this specific patient population?
A. Acute liver failure due to drug-induced hepatitis
B. Reflex tachycardia leading to myocardial infarction
C. Acute renal failure due to a decrease in efferent arteriolar resistance
D. Severe hypokalemia necessitating emergency replacement
Answer: C
Conceptual Explanation: In patients with bilateral renal artery stenosis, the glomerular
filtration pressure is maintained by Angiotensin II-mediated vasoconstriction of the
efferent arteriole. ACE inhibitors block this, leading to a sudden drop in GFR and potentially
acute renal failure.
2. Which of the following describes the primary mechanism by which Digoxin increases
cardiac contractility?
A. Activation of beta-1 adrenergic receptors
,B. Direct inhibition of phosphodiesterase III
C. Opening of L-type calcium channels during depolarization
D. Inhibition of the Na+/K+-ATPase pump, increasing intracellular sodium and subsequent
calcium
Answer: D
Conceptual Explanation: Digoxin inhibits the Na+/K+-ATPase pump, which increases
intracellular sodium. This reduces the activity of the sodium-calcium exchanger, leading to
higher intracellular calcium levels and increased contractility.
3. A patient on Warfarin therapy has a consistent INR of 1.2 despite dosage increases. Which
genetic polymorphism should the provider consider?
A. CYP3A4 deficiency
B. CYP2C9 increased activity or VKORC1 resistance
C. G6PD deficiency
D. HLA-B*1502 polymorphism
Answer: B
Conceptual Explanation: Warfarin sensitivity is highly influenced by the CYP2C9 enzyme
and the VKORC1 gene. Resistance or high metabolism (low INR) can be linked to specific
variants in these genetic markers.
, 4. What is the most appropriate management for a patient who develops Heparin-Induced
Thrombocytopenia (HIT) Type II?
A. Switching immediately to Enoxaparin
B. Administering a platelet transfusion
C. Increasing the Heparin dose to overcome resistance
D. Stopping all heparin and starting a direct thrombin inhibitor like Argatroban
Answer: D
Conceptual Explanation: HIT Type II is an immune-mediated reaction. All heparin
(including LMWH) must be stopped immediately. Non-heparin anticoagulants, such as
direct thrombin inhibitors, are required to prevent thrombosis.
5. Which calcium channel blocker is most likely to cause significant peripheral edema through
preferential dilation of precapillary arterioles?
A. Diltiazem
B. Verapamil
C. Amlodipine
D. Metoprolol
Answer: C
