NR565 ADVANCED PHARMACOLOGY
FINAL EXAM COMPREHENSIVE
REVIEW QUESTIONS AND VERIFIED
ANSWERS |GRADE A+|CHAMBERLAIN
COLLEGE
1. A patient with a history of chronic heart failure is prescribed Digoxin. Which electrolyte
abnormality most significantly increases the risk of digoxin toxicity?
A. Hyperkalemia
B. Hyponatremia
C. Hypokalemia
D. Hypercalcemia
Answer: C
Conceptual Explanation: Hypokalemia increases the risk of digoxin toxicity because
digoxin competes with potassium for the same binding site on the Na+/K+-ATPase pump.
Low potassium levels allow more digoxin to bind, leading to toxic effects.
2. Which of the following classes of antihypertensives is strictly contraindicated in a pregnant
patient due to the risk of fetal renal damage and malformations?
A. ACE Inhibitors
,B. Beta-Blockers
C. Calcium Channel Blockers
D. Alpha-2 Agonists
Answer: A
Conceptual Explanation: ACE Inhibitors (and ARBs) are teratogenic, particularly in the
second and third trimesters, where they can cause fetal renal failure, oligohydramnios, and
skull hypoplasia.
3. A 65-year-old patient is taking Warfarin for atrial fibrillation. They are started on
Amiodarone for rhythm control. What adjustment should the provider anticipate?
A. Increase the Warfarin dose by 50%
B. Decrease the Warfarin dose by 25-50%
C. Discontinue Warfarin immediately
D. No adjustment is necessary
Answer: B
Conceptual Explanation: Amiodarone is a potent inhibitor of CYP2C9, which metabolizes
the more active S-isomer of warfarin. This leads to increased warfarin levels and a higher
INR, necessitating a dose reduction.
, 4. Which laboratory value must be monitored closely when initiating a patient on a HMG-CoA
reductase inhibitor (Statin) who also reports muscle tenderness?
A. Creatine Kinase (CK)
B. Thyroid Stimulating Hormone (TSH)
C. Serum Creatinine
D. Hemoglobin A1c
Answer: A
Conceptual Explanation: Creatine Kinase (CK) levels are monitored to assess for
myopathy or rhabdomyolysis, which are rare but serious side effects of statin therapy,
especially if the patient reports muscle pain or weakness.
5. In the treatment of Type 2 Diabetes, which drug class works primarily by inhibiting the
SGLT2 transporter in the proximal renal tubule?
A. GLP-1 Receptor Agonists
B. DPP-4 Inhibitors
C. Gliflozins
D. Sulfonylureas
Answer: C
FINAL EXAM COMPREHENSIVE
REVIEW QUESTIONS AND VERIFIED
ANSWERS |GRADE A+|CHAMBERLAIN
COLLEGE
1. A patient with a history of chronic heart failure is prescribed Digoxin. Which electrolyte
abnormality most significantly increases the risk of digoxin toxicity?
A. Hyperkalemia
B. Hyponatremia
C. Hypokalemia
D. Hypercalcemia
Answer: C
Conceptual Explanation: Hypokalemia increases the risk of digoxin toxicity because
digoxin competes with potassium for the same binding site on the Na+/K+-ATPase pump.
Low potassium levels allow more digoxin to bind, leading to toxic effects.
2. Which of the following classes of antihypertensives is strictly contraindicated in a pregnant
patient due to the risk of fetal renal damage and malformations?
A. ACE Inhibitors
,B. Beta-Blockers
C. Calcium Channel Blockers
D. Alpha-2 Agonists
Answer: A
Conceptual Explanation: ACE Inhibitors (and ARBs) are teratogenic, particularly in the
second and third trimesters, where they can cause fetal renal failure, oligohydramnios, and
skull hypoplasia.
3. A 65-year-old patient is taking Warfarin for atrial fibrillation. They are started on
Amiodarone for rhythm control. What adjustment should the provider anticipate?
A. Increase the Warfarin dose by 50%
B. Decrease the Warfarin dose by 25-50%
C. Discontinue Warfarin immediately
D. No adjustment is necessary
Answer: B
Conceptual Explanation: Amiodarone is a potent inhibitor of CYP2C9, which metabolizes
the more active S-isomer of warfarin. This leads to increased warfarin levels and a higher
INR, necessitating a dose reduction.
, 4. Which laboratory value must be monitored closely when initiating a patient on a HMG-CoA
reductase inhibitor (Statin) who also reports muscle tenderness?
A. Creatine Kinase (CK)
B. Thyroid Stimulating Hormone (TSH)
C. Serum Creatinine
D. Hemoglobin A1c
Answer: A
Conceptual Explanation: Creatine Kinase (CK) levels are monitored to assess for
myopathy or rhabdomyolysis, which are rare but serious side effects of statin therapy,
especially if the patient reports muscle pain or weakness.
5. In the treatment of Type 2 Diabetes, which drug class works primarily by inhibiting the
SGLT2 transporter in the proximal renal tubule?
A. GLP-1 Receptor Agonists
B. DPP-4 Inhibitors
C. Gliflozins
D. Sulfonylureas
Answer: C
