NR565 ADVANCED PHARMACOLOGY
FINAL EXAM PREP QUESTIONS AND
VERIFIED ANSWERS (2026/ 2027
UPDATE)- CHAMBERLAIN
1. Which of the following is a primary clinical reason for choosing an ARB (Angiotensin II
Receptor Blocker) over an ACE inhibitor?
A. Better blood pressure control in diabetic patients
B. Reduced risk of renal failure in geriatric patients
C. Lower risk of hyperkalemia
D. Prevention of persistent dry cough due to bradykinin accumulation
Answer: D
Conceptual Explanation: ACE inhibitors prevent the breakdown of bradykinin, which can
lead to a dry, hacking cough; ARBs do not affect bradykinin, thus avoiding this side effect.
2. When prescribing Metformin, which creatinine clearance (CrCl) level represents a
contraindication for starting the drug?
A. CrCl < 60 mL/min
B. CrCl < 45 mL/min
C. CrCl < 15 mL/min
,D. CrCl < 30 mL/min
Answer: D
Conceptual Explanation: Metformin is contraindicated in patients with a GFR or CrCl less
than 30 mL/min due to the high risk of lactic acidosis.
3. A patient taking Warfarin presents with an INR of 7.0 but no active bleeding. According to
standard guidelines, what is the most appropriate action?
A. Administer 10mg Vitamin K intramuscularly immediately
B. Hold Warfarin and administer oral Vitamin K
C. Administer Fresh Frozen Plasma (FFP)
D. Continue current dose and recheck in 24 hours
Answer: B
Conceptual Explanation: For an INR between 4.5 and 10 with no bleeding, it is
recommended to hold Warfarin and consider low-dose oral Vitamin K.
4. Which pharmacokinetic process is most significantly affected by a patient having severe
hepatic cirrhosis?
A. Metabolism
B. Distribution
C. Absorption
D. Excretion
, Answer: A
Conceptual Explanation: The liver is the primary site of drug metabolism; cirrhosis
reduces enzyme activity and blood flow, significantly slowing metabolic processes.
5. A patient is prescribed Amiodarone for atrial fibrillation. Which baseline and periodic
monitoring is essential due to the drug’s side effect profile?
A. Hearing tests and CBC
B. Pulmonary function tests and Thyroid function tests
C. Renal ultrasound and Uric acid levels
D. Bone density scans and Vitamin D levels
Answer: B
Conceptual Explanation: Amiodarone is associated with pulmonary toxicity (interstitial
pneumonitis) and thyroid dysfunction (both hypo- and hyperthyroidism).
6. Which of the following describes the mechanism of action of SGLT2 inhibitors like
Empagliflozin?
A. Increased insulin secretion from pancreatic beta cells
B. Decreased hepatic glucose production
C. Inhibition of glucose reabsorption in the proximal renal tubule
D. Delaying carbohydrate absorption in the GI tract
Answer: C
FINAL EXAM PREP QUESTIONS AND
VERIFIED ANSWERS (2026/ 2027
UPDATE)- CHAMBERLAIN
1. Which of the following is a primary clinical reason for choosing an ARB (Angiotensin II
Receptor Blocker) over an ACE inhibitor?
A. Better blood pressure control in diabetic patients
B. Reduced risk of renal failure in geriatric patients
C. Lower risk of hyperkalemia
D. Prevention of persistent dry cough due to bradykinin accumulation
Answer: D
Conceptual Explanation: ACE inhibitors prevent the breakdown of bradykinin, which can
lead to a dry, hacking cough; ARBs do not affect bradykinin, thus avoiding this side effect.
2. When prescribing Metformin, which creatinine clearance (CrCl) level represents a
contraindication for starting the drug?
A. CrCl < 60 mL/min
B. CrCl < 45 mL/min
C. CrCl < 15 mL/min
,D. CrCl < 30 mL/min
Answer: D
Conceptual Explanation: Metformin is contraindicated in patients with a GFR or CrCl less
than 30 mL/min due to the high risk of lactic acidosis.
3. A patient taking Warfarin presents with an INR of 7.0 but no active bleeding. According to
standard guidelines, what is the most appropriate action?
A. Administer 10mg Vitamin K intramuscularly immediately
B. Hold Warfarin and administer oral Vitamin K
C. Administer Fresh Frozen Plasma (FFP)
D. Continue current dose and recheck in 24 hours
Answer: B
Conceptual Explanation: For an INR between 4.5 and 10 with no bleeding, it is
recommended to hold Warfarin and consider low-dose oral Vitamin K.
4. Which pharmacokinetic process is most significantly affected by a patient having severe
hepatic cirrhosis?
A. Metabolism
B. Distribution
C. Absorption
D. Excretion
, Answer: A
Conceptual Explanation: The liver is the primary site of drug metabolism; cirrhosis
reduces enzyme activity and blood flow, significantly slowing metabolic processes.
5. A patient is prescribed Amiodarone for atrial fibrillation. Which baseline and periodic
monitoring is essential due to the drug’s side effect profile?
A. Hearing tests and CBC
B. Pulmonary function tests and Thyroid function tests
C. Renal ultrasound and Uric acid levels
D. Bone density scans and Vitamin D levels
Answer: B
Conceptual Explanation: Amiodarone is associated with pulmonary toxicity (interstitial
pneumonitis) and thyroid dysfunction (both hypo- and hyperthyroidism).
6. Which of the following describes the mechanism of action of SGLT2 inhibitors like
Empagliflozin?
A. Increased insulin secretion from pancreatic beta cells
B. Decreased hepatic glucose production
C. Inhibition of glucose reabsorption in the proximal renal tubule
D. Delaying carbohydrate absorption in the GI tract
Answer: C
