NR 565
Advanced Pharmacology Fundamentals
Final Exam - Weeks 5, 6, 7, & 8
QUESTIONS AND VERIFIED ANSWERS
Chamberlain University - Graduate Nursing Program
Comprehensive 140-Question Final Exam with Verified Rationales
Prescriber-Level Pharmacology for Weeks 5-8 Course Content
Total Questions 140 MCQs (4 options, one correct)
Sections 9 advanced pharmacology content domains
Cognitive Mix 30% recall / 50% application / 20% analysis
Format 80% scenario-based / 20% direct recall
Rationale Depth 2-4 sentences with mechanism, monitoring, contraindications, and prescribe
Chamberlain University NR 565 | Advanced Pharmacology Fundamentals | Z.ai Academic Series
Confidential - Educational Use
,NR 565 Final Exam Weeks 5-8 - Advanced Pharmacology Fundamentals - Verified Answers Latest 2026/2027
Examination Overview
Purpose: This 140-question final exam is designed to assess graduate nursing students'
mastery of advanced pharmacology concepts covered in NR 565 Weeks 5-8 at Chamberlain
University. The questions cover nine core content domains: cardiovascular pharmacology;
endocrine pharmacology; respiratory pharmacology; anti-infective pharmacology; CNS and
psychopharmacology; GI/GU/musculoskeletal pharmacology; pharmacokinetics and
pharmacodynamics in prescribing; special populations and prescribing safety; and
prescriptive authority, controlled substances, and pharmacovigilance. Each question includes
a detailed rationale with mechanism of action, monitoring parameters, contraindications, and
prescriber-level clinical judgment to support NR 565 final exam preparation.
How to use this document: Attempt all 140 questions across the 9 sections. Verify each answer
against the rationale. Pay special attention to prescriber-focused "Which medication is the
BEST initial choice?" and "Which monitoring parameter is MOST important?" formats,
drug-drug and drug-disease interaction recognition, therapeutic drug monitoring and dose
adjustment scenarios, Beers Criteria and polypharmacy application, and DEA controlled
substance scheduling — these are highest-yield on the NR 565 final exam.
Section Title Q Range # Qs
Section 1 Cardiovascular Pharmacology Q1-Q24 24
Section 2 Endocrine Pharmacology Q25-Q42 18
Section 3 Respiratory Pharmacology Q43-Q56 14
Section 4 Anti-Infective Pharmacology Q57-Q74 18
Section 5 Central Nervous System and Psychopharmacology Q75-Q94 20
Section 6 Gastrointestinal, Genitourinary, and Musculoskeletal Pharmacology
Q95-Q108 14
Section 7 Pharmacokinetics and Pharmacodynamics in Prescribing Q109-Q122 14
Section 8 Special Populations and Prescribing Safety Q123-Q132 10
Section 9 Prescriptive Authority, Controlled Substances, and Pharmacovigilance
Q133-Q140 8
TOTAL 140
NR 565 Final Exam Page 2 140 Questions
, Section 1: Cardiovascular Pharmacology
Antihypertensives, Antiarrhythmics, Diuretics, Anticoagulants, & Lipid-Lowering Agents
Q1. A 62-year-old African American male with hypertension (BP 158/96) and type 2
diabetes initiates therapy. Based on current JNC 8 / ACC-AHA guidelines, which
antihypertensive is the BEST initial choice given his comorbidities?
A. Hydrochlorothiazide 25 mg daily
B. Amlodipine 5 mg daily
C. Losartan 50 mg daily
D. Lisinopril 10 mg daily [CORRECT]
Correct Answer: D
Rationale: An ACE inhibitor (lisinopril) is first-line for hypertensive patients with diabetes
because ACEIs slow progression of diabetic nephropathy by reducing intraglomerular
pressure. African American patients may have a less robust response to monotherapy ACEIs
(often requiring higher doses or addition of a thiazide/CCB); however, in the presence of
diabetes with renal protective benefits, ACEI is the recommended first-line agent regardless of
race. ARBs (losartan) are an alternative when ACEIs are not tolerated (e.g., cough). Thiazides
and CCBs are first-line for uncomplicated HTN in African Americans but lack the
renal-protective benefit in diabetes.
Q2. A patient on lisinopril 20 mg daily develops a dry, hacking cough. The MOST
appropriate prescriber action is to:
A. Increase the lisinopril dose to 40 mg daily
B. Add a thiazide diuretic
C. Discontinue lisinopril and switch to an angiotensin receptor blocker (ARB) such as
losartan 50 mg daily [CORRECT]
D. Add an inhaled corticosteroid for the cough
Correct Answer: C
Rationale: ACE inhibitor-induced cough (occurring in 5-20% of patients) results from
accumulation of bradykinin and substance P in the lungs. It is non-dose-dependent and
typically appears within 1-2 weeks to months of therapy. The cough is dry, persistent, and not
relieved by antitussives. The treatment is to discontinue the ACE inhibitor and switch to an
ARB (which does not affect bradykinin breakdown). Increasing the ACEI dose, adding a
diuretic, or treating symptomatically does not address the underlying mechanism.
Q3. A 72-year-old patient with heart failure with reduced ejection fraction (HFrEF, EF
30%) is being discharged. Which combination of medications represents
guideline-directed medical therapy (GDMAT) that should be prescribed?
A. Amlodipine + hydrochlorothiazide + digoxin
B. Verapamil + lisinopril + furosemide
C. Hydralazine/isosorbide dinitrate + digoxin + spironolactone
, D. Sacubitril/valsartan (ARNI) + beta blocker (e.g., carvedilol) + SGLT2 inhibitor (e.g.,
dapagliflozin) + mineralocorticoid receptor antagonist (e.g., spironolactone) — the
'four pillars' of HFrEF therapy [CORRECT]
Correct Answer: D
Rationale: Current HFrEF guideline-directed therapy (the 'four pillars'): (1) ARNI
(sacubitril/valsartan) preferred over ACEI/ARB alone; (2) evidence-based beta blocker
(carvedilol, metoprolol succinate, or bisoprolol); (3) SGLT2 inhibitor (dapagliflozin or
empagliflozin); (4) mineralocorticoid receptor antagonist (spironolactone or eplerenone) for
patients with NYHA Class II-IV and EF ≤35%. These four foundational therapies reduce
mortality. Non-dihydropyridine CCBs (verapamil, diltiazem) are contraindicated in HFrEF.
Hydralazine/isosorbide is reserved for African American patients with persistent symptoms
despite optimal therapy.
Q4. A patient with atrial fibrillation is started on warfarin. The INR goal is 2.0-3.0.
The patient's INR comes back at 5.5 with no evidence of bleeding. The prescriber's
MOST appropriate action is to:
A. Hold the next 1-2 doses of warfarin and resume at a lower dose when INR is in
therapeutic range; consider oral vitamin K 1-2.5 mg if INR is significantly elevated or
bleeding risk is high [CORRECT]
B. Administer protamine sulfate IV
C. Administer fresh frozen plasma immediately
D. Continue the current dose and recheck INR in 1 week
Correct Answer: A
Rationale: Per ACC/AHA guidelines: INR 4.5-10 without bleeding — hold warfarin, decrease
dose, monitor closely; oral vitamin K 1-2.5 mg is optional for high-risk patients. INR >10
without bleeding — hold warfarin, give oral vitamin K 2.5-5 mg. With serious/life-threatening
bleeding — hold warfarin, give IV vitamin K 5-10 mg, plus fresh frozen plasma or 4-factor PCC.
Protamine is the antidote for heparin (not warfarin). Continuing the current dose would
worsen the supratherapeutic INR.
Q5. A 58-year-old patient with nonvalvular atrial fibrillation and CrCl 45 mL/min is
started on a DOAC for stroke prevention. Which DOAC requires dose adjustment
based on renal function (anti-Xa level NOT routinely monitored)?
A. Apixaban (Eliquis) — no renal dose adjustment typically needed
B. Rivaroxaban (Xarelto) — requires dose reduction (15 mg daily instead of 20 mg daily)
when CrCl ≤50 mL/min [CORRECT]
C. Dabigatran (Pradaxa) — does not require renal adjustment
D. Warfarin — preferred over all DOACs in this case
Correct Answer: B
Rationale: Rivaroxaban dose is reduced from 20 mg daily to 15 mg daily when CrCl is ≤50
mL/min. Apixaban dosing is based on age ≥80, weight ≤60 kg, or serum creatinine ≥1.5
mg/dL (two of three criteria → 2.5 mg BID). Dabigatran is contraindicated when CrCl <30
mL/min and dose-reduced when 30-50 mL/min. DOACs do not require routine INR monitoring
(unlike warfarin), and dabigatran is the only DOAC dialyzable in overdose. For nonvalvular
Advanced Pharmacology Fundamentals
Final Exam - Weeks 5, 6, 7, & 8
QUESTIONS AND VERIFIED ANSWERS
Chamberlain University - Graduate Nursing Program
Comprehensive 140-Question Final Exam with Verified Rationales
Prescriber-Level Pharmacology for Weeks 5-8 Course Content
Total Questions 140 MCQs (4 options, one correct)
Sections 9 advanced pharmacology content domains
Cognitive Mix 30% recall / 50% application / 20% analysis
Format 80% scenario-based / 20% direct recall
Rationale Depth 2-4 sentences with mechanism, monitoring, contraindications, and prescribe
Chamberlain University NR 565 | Advanced Pharmacology Fundamentals | Z.ai Academic Series
Confidential - Educational Use
,NR 565 Final Exam Weeks 5-8 - Advanced Pharmacology Fundamentals - Verified Answers Latest 2026/2027
Examination Overview
Purpose: This 140-question final exam is designed to assess graduate nursing students'
mastery of advanced pharmacology concepts covered in NR 565 Weeks 5-8 at Chamberlain
University. The questions cover nine core content domains: cardiovascular pharmacology;
endocrine pharmacology; respiratory pharmacology; anti-infective pharmacology; CNS and
psychopharmacology; GI/GU/musculoskeletal pharmacology; pharmacokinetics and
pharmacodynamics in prescribing; special populations and prescribing safety; and
prescriptive authority, controlled substances, and pharmacovigilance. Each question includes
a detailed rationale with mechanism of action, monitoring parameters, contraindications, and
prescriber-level clinical judgment to support NR 565 final exam preparation.
How to use this document: Attempt all 140 questions across the 9 sections. Verify each answer
against the rationale. Pay special attention to prescriber-focused "Which medication is the
BEST initial choice?" and "Which monitoring parameter is MOST important?" formats,
drug-drug and drug-disease interaction recognition, therapeutic drug monitoring and dose
adjustment scenarios, Beers Criteria and polypharmacy application, and DEA controlled
substance scheduling — these are highest-yield on the NR 565 final exam.
Section Title Q Range # Qs
Section 1 Cardiovascular Pharmacology Q1-Q24 24
Section 2 Endocrine Pharmacology Q25-Q42 18
Section 3 Respiratory Pharmacology Q43-Q56 14
Section 4 Anti-Infective Pharmacology Q57-Q74 18
Section 5 Central Nervous System and Psychopharmacology Q75-Q94 20
Section 6 Gastrointestinal, Genitourinary, and Musculoskeletal Pharmacology
Q95-Q108 14
Section 7 Pharmacokinetics and Pharmacodynamics in Prescribing Q109-Q122 14
Section 8 Special Populations and Prescribing Safety Q123-Q132 10
Section 9 Prescriptive Authority, Controlled Substances, and Pharmacovigilance
Q133-Q140 8
TOTAL 140
NR 565 Final Exam Page 2 140 Questions
, Section 1: Cardiovascular Pharmacology
Antihypertensives, Antiarrhythmics, Diuretics, Anticoagulants, & Lipid-Lowering Agents
Q1. A 62-year-old African American male with hypertension (BP 158/96) and type 2
diabetes initiates therapy. Based on current JNC 8 / ACC-AHA guidelines, which
antihypertensive is the BEST initial choice given his comorbidities?
A. Hydrochlorothiazide 25 mg daily
B. Amlodipine 5 mg daily
C. Losartan 50 mg daily
D. Lisinopril 10 mg daily [CORRECT]
Correct Answer: D
Rationale: An ACE inhibitor (lisinopril) is first-line for hypertensive patients with diabetes
because ACEIs slow progression of diabetic nephropathy by reducing intraglomerular
pressure. African American patients may have a less robust response to monotherapy ACEIs
(often requiring higher doses or addition of a thiazide/CCB); however, in the presence of
diabetes with renal protective benefits, ACEI is the recommended first-line agent regardless of
race. ARBs (losartan) are an alternative when ACEIs are not tolerated (e.g., cough). Thiazides
and CCBs are first-line for uncomplicated HTN in African Americans but lack the
renal-protective benefit in diabetes.
Q2. A patient on lisinopril 20 mg daily develops a dry, hacking cough. The MOST
appropriate prescriber action is to:
A. Increase the lisinopril dose to 40 mg daily
B. Add a thiazide diuretic
C. Discontinue lisinopril and switch to an angiotensin receptor blocker (ARB) such as
losartan 50 mg daily [CORRECT]
D. Add an inhaled corticosteroid for the cough
Correct Answer: C
Rationale: ACE inhibitor-induced cough (occurring in 5-20% of patients) results from
accumulation of bradykinin and substance P in the lungs. It is non-dose-dependent and
typically appears within 1-2 weeks to months of therapy. The cough is dry, persistent, and not
relieved by antitussives. The treatment is to discontinue the ACE inhibitor and switch to an
ARB (which does not affect bradykinin breakdown). Increasing the ACEI dose, adding a
diuretic, or treating symptomatically does not address the underlying mechanism.
Q3. A 72-year-old patient with heart failure with reduced ejection fraction (HFrEF, EF
30%) is being discharged. Which combination of medications represents
guideline-directed medical therapy (GDMAT) that should be prescribed?
A. Amlodipine + hydrochlorothiazide + digoxin
B. Verapamil + lisinopril + furosemide
C. Hydralazine/isosorbide dinitrate + digoxin + spironolactone
, D. Sacubitril/valsartan (ARNI) + beta blocker (e.g., carvedilol) + SGLT2 inhibitor (e.g.,
dapagliflozin) + mineralocorticoid receptor antagonist (e.g., spironolactone) — the
'four pillars' of HFrEF therapy [CORRECT]
Correct Answer: D
Rationale: Current HFrEF guideline-directed therapy (the 'four pillars'): (1) ARNI
(sacubitril/valsartan) preferred over ACEI/ARB alone; (2) evidence-based beta blocker
(carvedilol, metoprolol succinate, or bisoprolol); (3) SGLT2 inhibitor (dapagliflozin or
empagliflozin); (4) mineralocorticoid receptor antagonist (spironolactone or eplerenone) for
patients with NYHA Class II-IV and EF ≤35%. These four foundational therapies reduce
mortality. Non-dihydropyridine CCBs (verapamil, diltiazem) are contraindicated in HFrEF.
Hydralazine/isosorbide is reserved for African American patients with persistent symptoms
despite optimal therapy.
Q4. A patient with atrial fibrillation is started on warfarin. The INR goal is 2.0-3.0.
The patient's INR comes back at 5.5 with no evidence of bleeding. The prescriber's
MOST appropriate action is to:
A. Hold the next 1-2 doses of warfarin and resume at a lower dose when INR is in
therapeutic range; consider oral vitamin K 1-2.5 mg if INR is significantly elevated or
bleeding risk is high [CORRECT]
B. Administer protamine sulfate IV
C. Administer fresh frozen plasma immediately
D. Continue the current dose and recheck INR in 1 week
Correct Answer: A
Rationale: Per ACC/AHA guidelines: INR 4.5-10 without bleeding — hold warfarin, decrease
dose, monitor closely; oral vitamin K 1-2.5 mg is optional for high-risk patients. INR >10
without bleeding — hold warfarin, give oral vitamin K 2.5-5 mg. With serious/life-threatening
bleeding — hold warfarin, give IV vitamin K 5-10 mg, plus fresh frozen plasma or 4-factor PCC.
Protamine is the antidote for heparin (not warfarin). Continuing the current dose would
worsen the supratherapeutic INR.
Q5. A 58-year-old patient with nonvalvular atrial fibrillation and CrCl 45 mL/min is
started on a DOAC for stroke prevention. Which DOAC requires dose adjustment
based on renal function (anti-Xa level NOT routinely monitored)?
A. Apixaban (Eliquis) — no renal dose adjustment typically needed
B. Rivaroxaban (Xarelto) — requires dose reduction (15 mg daily instead of 20 mg daily)
when CrCl ≤50 mL/min [CORRECT]
C. Dabigatran (Pradaxa) — does not require renal adjustment
D. Warfarin — preferred over all DOACs in this case
Correct Answer: B
Rationale: Rivaroxaban dose is reduced from 20 mg daily to 15 mg daily when CrCl is ≤50
mL/min. Apixaban dosing is based on age ≥80, weight ≤60 kg, or serum creatinine ≥1.5
mg/dL (two of three criteria → 2.5 mg BID). Dabigatran is contraindicated when CrCl <30
mL/min and dose-reduced when 30-50 mL/min. DOACs do not require routine INR monitoring
(unlike warfarin), and dabigatran is the only DOAC dialyzable in overdose. For nonvalvular
