NR566 Final Exam Practice Questions &
[Verified Answers], Plus Explained
Rationales|2027 Latest Update| Instant
Download PDF
1. A nurse practitioner is evaluating a patient who is taking warfarin
for prevention of thromboembolic events. Which laboratory test
is most important for monitoring the therapeutic effect of
warfarin?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. International normalized ratio (INR)
D. Serum creatinine
Rationale: The INR is used to monitor the anticoagulant effect of
warfarin. For many indications, the usual therapeutic range is
approximately 2.0–3.0, although the target varies according to the
clinical indication.
2. A patient taking an ACE inhibitor develops a persistent dry cough.
Which medication-related mechanism most directly explains this
adverse effect?
A. Increased aldosterone production
B. Increased histamine release
C. Accumulation of bradykinin
D. Increased acetylcholine activity
1|Page
,Rationale: ACE normally contributes to the breakdown of bradykinin.
ACE inhibition increases bradykinin concentrations, which can cause
the characteristic persistent dry cough associated with ACE inhibitors.
3. Which medication is generally considered a first-line
pharmacologic treatment for uncomplicated essential
hypertension?
A. Digoxin
B. Thiazide-type diuretic
C. Warfarin
D. Amiodarone
Rationale: Thiazide-type diuretics are among the recommended first-
line antihypertensive classes for uncomplicated hypertension. Other
first-line options include ACE inhibitors, ARBs, and calcium channel
blockers, depending on patient-specific factors.
4. A patient with type 2 diabetes is prescribed metformin. Which
instruction is most appropriate?
A. Take the medication only when blood glucose exceeds 200 mg/dL
B. Stop the medication whenever appetite decreases
C. Take it with meals to reduce gastrointestinal adverse effects
D. Double the next dose if one dose is missed
Rationale: Metformin is commonly taken with meals to minimize
gastrointestinal adverse effects such as nausea and diarrhea. Patients
should not routinely double doses after a missed dose.
5. A patient taking a statin reports severe unexplained muscle pain
and weakness. Which laboratory evaluation may be appropriate
when significant statin-associated muscle symptoms are
suspected?
2|Page
,A. INR
B. Troponin
C. Creatine kinase (CK)
D. Amylase
Rationale: Creatine kinase may be measured when clinically
significant muscle injury is suspected in a patient receiving a statin.
Severe muscle symptoms accompanied by markedly elevated CK can
indicate myopathy or rhabdomyolysis.
6. Which adverse effect is particularly associated with
spironolactone?
A. Hypokalemia
B. Ototoxicity
C. Hyperkalemia
D. Severe hypoglycemia
Rationale: Spironolactone is a potassium-sparing aldosterone
antagonist. It can increase serum potassium, particularly in patients
with kidney impairment or those taking other medications that
increase potassium.
7. A patient receiving an aminoglycoside requires monitoring for
which major toxicities?
A. Hepatotoxicity and constipation
B. Nephrotoxicity and ototoxicity
C. Hyperglycemia and hypertension
D. Photosensitivity and diarrhea
Rationale: Aminoglycosides such as gentamicin and amikacin can
cause kidney injury and damage to the auditory or vestibular system.
Renal function and, when appropriate, drug concentrations should be
monitored.
3|Page
, 8. Which antibiotic class is associated with an increased risk of
tendon injury?
A. Penicillins
B. Macrolides
C. Fluoroquinolones
D. Tetracyclines
Rationale: Fluoroquinolones have been associated with tendinitis and
tendon rupture, particularly involving the Achilles tendon. Risk is
increased in certain populations, including older adults and patients
receiving corticosteroids.
9. A patient prescribed doxycycline asks how to take the medication.
Which instruction is most appropriate?
A. Take it immediately before lying down
B. Take it with an iron supplement
C. Take it with adequate water and avoid lying down immediately
afterward
D. Crush all delayed-release formulations
Rationale: Doxycycline can cause esophageal irritation. Taking it with
adequate fluid and remaining upright after administration reduces
this risk. Doxycycline can also interact with minerals such as calcium
and iron, reducing absorption.
10. A patient taking an SSRI begins using St. John’s wort. Why
should the nurse practitioner be concerned?
A. Increased risk of hypokalemia
B. Potential for serotonin toxicity and drug interactions
C. Increased risk of renal stones
D. Complete loss of SSRI absorption
4|Page
[Verified Answers], Plus Explained
Rationales|2027 Latest Update| Instant
Download PDF
1. A nurse practitioner is evaluating a patient who is taking warfarin
for prevention of thromboembolic events. Which laboratory test
is most important for monitoring the therapeutic effect of
warfarin?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. International normalized ratio (INR)
D. Serum creatinine
Rationale: The INR is used to monitor the anticoagulant effect of
warfarin. For many indications, the usual therapeutic range is
approximately 2.0–3.0, although the target varies according to the
clinical indication.
2. A patient taking an ACE inhibitor develops a persistent dry cough.
Which medication-related mechanism most directly explains this
adverse effect?
A. Increased aldosterone production
B. Increased histamine release
C. Accumulation of bradykinin
D. Increased acetylcholine activity
1|Page
,Rationale: ACE normally contributes to the breakdown of bradykinin.
ACE inhibition increases bradykinin concentrations, which can cause
the characteristic persistent dry cough associated with ACE inhibitors.
3. Which medication is generally considered a first-line
pharmacologic treatment for uncomplicated essential
hypertension?
A. Digoxin
B. Thiazide-type diuretic
C. Warfarin
D. Amiodarone
Rationale: Thiazide-type diuretics are among the recommended first-
line antihypertensive classes for uncomplicated hypertension. Other
first-line options include ACE inhibitors, ARBs, and calcium channel
blockers, depending on patient-specific factors.
4. A patient with type 2 diabetes is prescribed metformin. Which
instruction is most appropriate?
A. Take the medication only when blood glucose exceeds 200 mg/dL
B. Stop the medication whenever appetite decreases
C. Take it with meals to reduce gastrointestinal adverse effects
D. Double the next dose if one dose is missed
Rationale: Metformin is commonly taken with meals to minimize
gastrointestinal adverse effects such as nausea and diarrhea. Patients
should not routinely double doses after a missed dose.
5. A patient taking a statin reports severe unexplained muscle pain
and weakness. Which laboratory evaluation may be appropriate
when significant statin-associated muscle symptoms are
suspected?
2|Page
,A. INR
B. Troponin
C. Creatine kinase (CK)
D. Amylase
Rationale: Creatine kinase may be measured when clinically
significant muscle injury is suspected in a patient receiving a statin.
Severe muscle symptoms accompanied by markedly elevated CK can
indicate myopathy or rhabdomyolysis.
6. Which adverse effect is particularly associated with
spironolactone?
A. Hypokalemia
B. Ototoxicity
C. Hyperkalemia
D. Severe hypoglycemia
Rationale: Spironolactone is a potassium-sparing aldosterone
antagonist. It can increase serum potassium, particularly in patients
with kidney impairment or those taking other medications that
increase potassium.
7. A patient receiving an aminoglycoside requires monitoring for
which major toxicities?
A. Hepatotoxicity and constipation
B. Nephrotoxicity and ototoxicity
C. Hyperglycemia and hypertension
D. Photosensitivity and diarrhea
Rationale: Aminoglycosides such as gentamicin and amikacin can
cause kidney injury and damage to the auditory or vestibular system.
Renal function and, when appropriate, drug concentrations should be
monitored.
3|Page
, 8. Which antibiotic class is associated with an increased risk of
tendon injury?
A. Penicillins
B. Macrolides
C. Fluoroquinolones
D. Tetracyclines
Rationale: Fluoroquinolones have been associated with tendinitis and
tendon rupture, particularly involving the Achilles tendon. Risk is
increased in certain populations, including older adults and patients
receiving corticosteroids.
9. A patient prescribed doxycycline asks how to take the medication.
Which instruction is most appropriate?
A. Take it immediately before lying down
B. Take it with an iron supplement
C. Take it with adequate water and avoid lying down immediately
afterward
D. Crush all delayed-release formulations
Rationale: Doxycycline can cause esophageal irritation. Taking it with
adequate fluid and remaining upright after administration reduces
this risk. Doxycycline can also interact with minerals such as calcium
and iron, reducing absorption.
10. A patient taking an SSRI begins using St. John’s wort. Why
should the nurse practitioner be concerned?
A. Increased risk of hypokalemia
B. Potential for serotonin toxicity and drug interactions
C. Increased risk of renal stones
D. Complete loss of SSRI absorption
4|Page
