NR565 ADVANCED PHARMACOLOGY
PRACTICE EXAM QUESTIONS AND
VERIFIED ANSWERS (2026/ 2027
UPDATE)- CHAMBERLAIN
1. A patient with a history of heart failure and chronic kidney disease is being started on an
ACE inhibitor. Which electrolyte imbalance is most likely to occur?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B
Conceptual Explanation: ACE inhibitors block the conversion of angiotensin I to
angiotensin II, leading to decreased aldosterone secretion. Aldosterone normally promotes
potassium excretion; therefore, inhibiting it can lead to potassium retention
(hyperkalemia), especially in patients with renal impairment.
2. When prescribing Amiodarone, the nurse practitioner knows that this drug has a very long
half-life. Approximately how long does it take to reach a steady state?
A. 3 to 5 days
,B. 2 to 3 weeks
C. Several months
D. 24 hours
Answer: C
Conceptual Explanation: Amiodarone has an exceptionally long half-life (ranging from 15
to 142 days). It typically takes 4 to 5 half-lives to reach steady state, which translates to
several months for this specific medication.
3. Which of the following is a Black Box Warning for all Fluoroquinolones?
A. Ototoxicity
B. Nephrotoxicity
C. Tendon rupture and tendonitis
D. Stevens-Johnson Syndrome
Answer: C
Conceptual Explanation: The FDA has issued a Black Box Warning for fluoroquinolones
due to the increased risk of tendonitis and tendon rupture, most commonly affecting the
Achilles tendon.
4. A 65-year-old patient is taking Warfarin for atrial fibrillation. They are prescribed
Trimethoprim/Sulfamethoxazole for a UTI. What is the expected interaction?
A. Decreased INR and increased clot risk
, B. Decreased absorption of the antibiotic
C. No interaction between these drugs
D. Increased INR and increased bleeding risk
Answer: D
Conceptual Explanation: Bactrim (TMP/SMZ) inhibits the metabolism of Warfarin and
displaces it from albumin, significantly increasing the INR and the risk of bleeding.
5. Metformin should be temporarily discontinued before which of the following procedures?
A. CT scan with intravenous contrast dye
B. Routine dental cleaning
C. Physical therapy session
D. Colonoscopy without sedation
Answer: A
Conceptual Explanation: Metformin must be held 48 hours before and after procedures
involving IV contrast dye to prevent acute renal failure and the subsequent risk of lactic
acidosis.
6. Which medication is considered first-line for a patient newly diagnosed with Type 2
Diabetes and a high risk for heart failure?
A. Sulfonylureas
B. SGLT2 inhibitors
PRACTICE EXAM QUESTIONS AND
VERIFIED ANSWERS (2026/ 2027
UPDATE)- CHAMBERLAIN
1. A patient with a history of heart failure and chronic kidney disease is being started on an
ACE inhibitor. Which electrolyte imbalance is most likely to occur?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B
Conceptual Explanation: ACE inhibitors block the conversion of angiotensin I to
angiotensin II, leading to decreased aldosterone secretion. Aldosterone normally promotes
potassium excretion; therefore, inhibiting it can lead to potassium retention
(hyperkalemia), especially in patients with renal impairment.
2. When prescribing Amiodarone, the nurse practitioner knows that this drug has a very long
half-life. Approximately how long does it take to reach a steady state?
A. 3 to 5 days
,B. 2 to 3 weeks
C. Several months
D. 24 hours
Answer: C
Conceptual Explanation: Amiodarone has an exceptionally long half-life (ranging from 15
to 142 days). It typically takes 4 to 5 half-lives to reach steady state, which translates to
several months for this specific medication.
3. Which of the following is a Black Box Warning for all Fluoroquinolones?
A. Ototoxicity
B. Nephrotoxicity
C. Tendon rupture and tendonitis
D. Stevens-Johnson Syndrome
Answer: C
Conceptual Explanation: The FDA has issued a Black Box Warning for fluoroquinolones
due to the increased risk of tendonitis and tendon rupture, most commonly affecting the
Achilles tendon.
4. A 65-year-old patient is taking Warfarin for atrial fibrillation. They are prescribed
Trimethoprim/Sulfamethoxazole for a UTI. What is the expected interaction?
A. Decreased INR and increased clot risk
, B. Decreased absorption of the antibiotic
C. No interaction between these drugs
D. Increased INR and increased bleeding risk
Answer: D
Conceptual Explanation: Bactrim (TMP/SMZ) inhibits the metabolism of Warfarin and
displaces it from albumin, significantly increasing the INR and the risk of bleeding.
5. Metformin should be temporarily discontinued before which of the following procedures?
A. CT scan with intravenous contrast dye
B. Routine dental cleaning
C. Physical therapy session
D. Colonoscopy without sedation
Answer: A
Conceptual Explanation: Metformin must be held 48 hours before and after procedures
involving IV contrast dye to prevent acute renal failure and the subsequent risk of lactic
acidosis.
6. Which medication is considered first-line for a patient newly diagnosed with Type 2
Diabetes and a high risk for heart failure?
A. Sulfonylureas
B. SGLT2 inhibitors
