NR565 EXAM 3: ADVANCED
CARDIOVASCULAR AND ENDOCRINE
PHARMACOLOGY QUESTIONS AND
VERIFIED ANSWERS |GRADE
A+|CHAMBERLAIN COLLEGE
1. A patient with Heart Failure with Reduced Ejection Fraction (HFrEF) is currently taking
Lisinopril and Carvedilol. Which medication class should be added next to improve survival
and reduce hospitalizations, according to current guidelines?
A. Mineralocorticoid Receptor Antagonists (MRAs)
B. Loop Diuretics
C. Digoxin
D. Calcium Channel Blockers
Answer: A
Conceptual Explanation: In HFrEF, MRAs like spironolactone provide mortality benefits
and are recommended for patients already on ACEI/ARB and Beta-blockers who still have
symptoms.
2. Which of the following laboratory parameters must be monitored most closely when
initiating Spironolactone?
A. Serum Sodium
,B. Serum Potassium
C. Serum Calcium
D. Hemoglobin A1c
Answer: B
Conceptual Explanation: Spironolactone is a potassium-sparing diuretic; monitoring for
hyperkalemia is critical, especially when combined with ACE inhibitors or ARBs.
3. A 55-year-old Black male patient has a blood pressure of 152/94 mmHg. According to JNC 8
and ACC/AHA guidelines, which is the most appropriate first-line therapy?
A. Lisinopril
B. Losartan
C. Metoprolol Succinate
D. Amlodipine
Answer: D
Conceptual Explanation: For the general Black population, including those with diabetes,
initial antihypertensive treatment should include a thiazide-type diuretic or Calcium
Channel Blocker (CCB).
4. What is the mechanism of action of Sacubitril in the combination drug Entresto?
A. Angiotensin II receptor blockade
B. Direct renin inhibition
, C. Neprilysin inhibition
D. Beta-1 adrenergic blockade
Answer: C
Conceptual Explanation: Sacubitril is a neprilysin inhibitor that prevents the breakdown
of natriuretic peptides, leading to vasodilation and natriuresis.
5. A patient taking Warfarin has an INR of 5.5 and no clinical signs of bleeding. What is the
appropriate management?
A. Administer IV Vitamin K
B. Administer Fresh Frozen Plasma (FFP)
C. Omit the next few doses and monitor closely
D. Increase the dose of Warfarin
Answer: C
Conceptual Explanation: For INR between 4.5 and 10 without bleeding, the
recommendation is usually to hold the dose and monitor, rather than administering
Vitamin K immediately unless there is a high bleeding risk.
6. Which class of diabetic medication is contraindicated in patients with a history of
Medullary Thyroid Carcinoma?
A. SGLT2 inhibitors
B. Sulfonylureas
CARDIOVASCULAR AND ENDOCRINE
PHARMACOLOGY QUESTIONS AND
VERIFIED ANSWERS |GRADE
A+|CHAMBERLAIN COLLEGE
1. A patient with Heart Failure with Reduced Ejection Fraction (HFrEF) is currently taking
Lisinopril and Carvedilol. Which medication class should be added next to improve survival
and reduce hospitalizations, according to current guidelines?
A. Mineralocorticoid Receptor Antagonists (MRAs)
B. Loop Diuretics
C. Digoxin
D. Calcium Channel Blockers
Answer: A
Conceptual Explanation: In HFrEF, MRAs like spironolactone provide mortality benefits
and are recommended for patients already on ACEI/ARB and Beta-blockers who still have
symptoms.
2. Which of the following laboratory parameters must be monitored most closely when
initiating Spironolactone?
A. Serum Sodium
,B. Serum Potassium
C. Serum Calcium
D. Hemoglobin A1c
Answer: B
Conceptual Explanation: Spironolactone is a potassium-sparing diuretic; monitoring for
hyperkalemia is critical, especially when combined with ACE inhibitors or ARBs.
3. A 55-year-old Black male patient has a blood pressure of 152/94 mmHg. According to JNC 8
and ACC/AHA guidelines, which is the most appropriate first-line therapy?
A. Lisinopril
B. Losartan
C. Metoprolol Succinate
D. Amlodipine
Answer: D
Conceptual Explanation: For the general Black population, including those with diabetes,
initial antihypertensive treatment should include a thiazide-type diuretic or Calcium
Channel Blocker (CCB).
4. What is the mechanism of action of Sacubitril in the combination drug Entresto?
A. Angiotensin II receptor blockade
B. Direct renin inhibition
, C. Neprilysin inhibition
D. Beta-1 adrenergic blockade
Answer: C
Conceptual Explanation: Sacubitril is a neprilysin inhibitor that prevents the breakdown
of natriuretic peptides, leading to vasodilation and natriuresis.
5. A patient taking Warfarin has an INR of 5.5 and no clinical signs of bleeding. What is the
appropriate management?
A. Administer IV Vitamin K
B. Administer Fresh Frozen Plasma (FFP)
C. Omit the next few doses and monitor closely
D. Increase the dose of Warfarin
Answer: C
Conceptual Explanation: For INR between 4.5 and 10 without bleeding, the
recommendation is usually to hold the dose and monitor, rather than administering
Vitamin K immediately unless there is a high bleeding risk.
6. Which class of diabetic medication is contraindicated in patients with a history of
Medullary Thyroid Carcinoma?
A. SGLT2 inhibitors
B. Sulfonylureas
