NR565 ADVANCED PHARMACOLOGY
FINAL EXAM STUDY GUIDE
QUESTIONS AND VERIFIED ANSWERS
|GRADE A+|CHAMBERLAIN COLLEGE
1. Which of the following medication classes is contraindicated for a patient with a history of
angioedema while taking Lisinopril?
A. Calcium Channel Blockers
B. Thiazide Diuretics
C. Beta-Blockers
D. Angiotensin II Receptor Blockers (ARBs)
Answer: D
Conceptual Explanation: While the risk is lower than with ACE inhibitors, ARBs carry a
potential risk of cross-reactivity for angioedema and should be used with extreme caution
or avoided in patients with a history of ACEI-induced angioedema.
2. A patient with Heart Failure with Reduced Ejection Fraction (HFrEF) is currently taking a
stable dose of Enalapril. The provider decides to switch to Sacubitril/Valsartan (Entresto).
What is the mandatory washout period?
A. 36 hours
,B. 24 hours
C. 12 hours
D. 72 hours
Answer: A
Conceptual Explanation: A 36-hour washout period is required when switching from an
ACE inhibitor to an ARNI to minimize the risk of angioedema due to dual inhibition of
neprilysin and ACE.
3. Which mechanism of action best describes SGLT2 inhibitors like Empagliflozin?
A. Stimulating insulin secretion from pancreatic beta cells
B. Reducing glucose reabsorption in the proximal convoluted tubule of the kidney
C. Inhibiting the breakdown of GLP-1
D. Increasing peripheral insulin sensitivity in muscle tissue
Answer: B
Conceptual Explanation: SGLT2 inhibitors lower blood glucose by inhibiting the sodium-
glucose cotransporter 2 in the kidneys, leading to increased glycosuria.
4. A 65-year-old male with atrial fibrillation is prescribed Warfarin. What is the mechanism by
which Warfarin acts as an anticoagulant?
A. Direct inhibition of Factor Xa
B. Irreversible inhibition of Cyclooxygenase-1
, C. Direct inhibition of Thrombin (Factor IIa)
D. Inhibition of Vitamin K Epoxide Reductase
Answer: D
Conceptual Explanation: Warfarin inhibits the enzyme vitamin K epoxide reductase,
which is necessary for recycling vitamin K, thereby preventing the synthesis of Factors II,
VII, IX, and X.
5. When monitoring a patient on Amiodarone, which of the following baseline and periodic
tests is essential due to the drug’s high iodine content?
A. Renal Function Tests (BUN/Cr)
B. Thyroid Function Tests (TSH/T4)
C. Complete Blood Count (CBC)
D. Hemoglobin A1c
Answer: B
Conceptual Explanation: Amiodarone contains iodine and can cause both hypo- and
hyperthyroidism; therefore, TSH and T4 levels must be monitored regularly.
6. A patient is prescribed Levothyroxine for hypothyroidism. The patient also takes Ferrous
Sulfate for anemia. How should the provider instruct the patient to take these medications?
A. Take both together on an empty stomach
B. Take Levothyroxine with food and Iron at bedtime
FINAL EXAM STUDY GUIDE
QUESTIONS AND VERIFIED ANSWERS
|GRADE A+|CHAMBERLAIN COLLEGE
1. Which of the following medication classes is contraindicated for a patient with a history of
angioedema while taking Lisinopril?
A. Calcium Channel Blockers
B. Thiazide Diuretics
C. Beta-Blockers
D. Angiotensin II Receptor Blockers (ARBs)
Answer: D
Conceptual Explanation: While the risk is lower than with ACE inhibitors, ARBs carry a
potential risk of cross-reactivity for angioedema and should be used with extreme caution
or avoided in patients with a history of ACEI-induced angioedema.
2. A patient with Heart Failure with Reduced Ejection Fraction (HFrEF) is currently taking a
stable dose of Enalapril. The provider decides to switch to Sacubitril/Valsartan (Entresto).
What is the mandatory washout period?
A. 36 hours
,B. 24 hours
C. 12 hours
D. 72 hours
Answer: A
Conceptual Explanation: A 36-hour washout period is required when switching from an
ACE inhibitor to an ARNI to minimize the risk of angioedema due to dual inhibition of
neprilysin and ACE.
3. Which mechanism of action best describes SGLT2 inhibitors like Empagliflozin?
A. Stimulating insulin secretion from pancreatic beta cells
B. Reducing glucose reabsorption in the proximal convoluted tubule of the kidney
C. Inhibiting the breakdown of GLP-1
D. Increasing peripheral insulin sensitivity in muscle tissue
Answer: B
Conceptual Explanation: SGLT2 inhibitors lower blood glucose by inhibiting the sodium-
glucose cotransporter 2 in the kidneys, leading to increased glycosuria.
4. A 65-year-old male with atrial fibrillation is prescribed Warfarin. What is the mechanism by
which Warfarin acts as an anticoagulant?
A. Direct inhibition of Factor Xa
B. Irreversible inhibition of Cyclooxygenase-1
, C. Direct inhibition of Thrombin (Factor IIa)
D. Inhibition of Vitamin K Epoxide Reductase
Answer: D
Conceptual Explanation: Warfarin inhibits the enzyme vitamin K epoxide reductase,
which is necessary for recycling vitamin K, thereby preventing the synthesis of Factors II,
VII, IX, and X.
5. When monitoring a patient on Amiodarone, which of the following baseline and periodic
tests is essential due to the drug’s high iodine content?
A. Renal Function Tests (BUN/Cr)
B. Thyroid Function Tests (TSH/T4)
C. Complete Blood Count (CBC)
D. Hemoglobin A1c
Answer: B
Conceptual Explanation: Amiodarone contains iodine and can cause both hypo- and
hyperthyroidism; therefore, TSH and T4 levels must be monitored regularly.
6. A patient is prescribed Levothyroxine for hypothyroidism. The patient also takes Ferrous
Sulfate for anemia. How should the provider instruct the patient to take these medications?
A. Take both together on an empty stomach
B. Take Levothyroxine with food and Iron at bedtime
