NR 508 Advanced Pharmacology Week 4 Midterm
Exam 2025| Chamberlain University| Actual Exam
Questions and Correct Answers
Which of the following has been shown to prolong life in patients with chronic congestive heart
failure despite having a negative inotropic effect on cardiac contractility?
A) Digoxin
B) Carvedilol
C) Furosemide
D) Spironolactone
Correct Answer: B) Carvedilol
Explanation: Beta-blockers like carvedilol prolong life in chronic heart failure by reducing
myocardial workload and improving left ventricular function, despite their negative inotropic
effect, as supported by clinical trials.
Which of the following statements gives the best explanation for the use of beta-blockers in
congestive heart failure?
A) They increase cardiac contractility
B) They reduce sympathetic activation and myocardial stress
C) They directly increase coronary blood flow
D) They prevent fluid retention
Correct Answer: B) They reduce sympathetic activation and myocardial stress
Explanation: Beta-blockers reduce sympathetic overactivity, lowering heart rate and myocardial
oxygen demand, which decreases stress on the heart and improves outcomes in heart failure.
What is the molecular mechanism of action of digoxin (Lanoxin, Cardoxin) used in the
management of congestive heart failure?
A) Inhibits sodium-potassium ATPase
B) Blocks beta-adrenergic receptors
C) Inhibits angiotensin-converting enzyme
D) Increases chloride channel conductance
Correct Answer: A) Inhibits sodium-potassium ATPase
Explanation: Digoxin inhibits sodium-potassium ATPase, increasing intracellular calcium in
cardiac myocytes, which enhances contractility (positive inotropic effect) in heart failure.
, Which of the following is an aldosterone antagonist and is useful in the management of
hypertensive patients with hypokalemia?
A) Hydrochlorothiazide
B) Furosemide
C) Spironolactone
D) Amiloride
Correct Answer: C) Spironolactone
Explanation: Spironolactone, an aldosterone antagonist, is potassium-sparing and effective for
hypertension with hypokalemia, as it reduces sodium reabsorption and potassium excretion in the
distal tubule.
Which of the following agents is the most appropriate choice as a diuretic in patients with
hypertension, heart failure, and renal failure?
A) Hydrochlorothiazide
B) Furosemide
C) Spironolactone
D) Mannitol
Correct Answer: B) Furosemide
Explanation: Furosemide, a loop diuretic, is effective in hypertension, heart failure, and renal
failure, as it works in low renal function to reduce fluid overload and manage symptoms.
Which is the atypical antidepressant known to block the reuptake of dopamine and
norepinephrine (NDRI) and is used to treat depression and nicotine addiction?
A) Fluoxetine
B) Bupropion
C) Mirtazapine
D) Venlafaxine
Correct Answer: B) Bupropion
Explanation: Bupropion, an NDRI, blocks dopamine and norepinephrine reuptake, making it
effective for depression and as an aid for smoking cessation.
Which drug increases GABA activity and chloride conductance in neuronal cells, inhibiting
action potentials, and is known to treat anxiety, convulsions, and could cause marked sedation?
A) Diazepam
B) Buspirone
Exam 2025| Chamberlain University| Actual Exam
Questions and Correct Answers
Which of the following has been shown to prolong life in patients with chronic congestive heart
failure despite having a negative inotropic effect on cardiac contractility?
A) Digoxin
B) Carvedilol
C) Furosemide
D) Spironolactone
Correct Answer: B) Carvedilol
Explanation: Beta-blockers like carvedilol prolong life in chronic heart failure by reducing
myocardial workload and improving left ventricular function, despite their negative inotropic
effect, as supported by clinical trials.
Which of the following statements gives the best explanation for the use of beta-blockers in
congestive heart failure?
A) They increase cardiac contractility
B) They reduce sympathetic activation and myocardial stress
C) They directly increase coronary blood flow
D) They prevent fluid retention
Correct Answer: B) They reduce sympathetic activation and myocardial stress
Explanation: Beta-blockers reduce sympathetic overactivity, lowering heart rate and myocardial
oxygen demand, which decreases stress on the heart and improves outcomes in heart failure.
What is the molecular mechanism of action of digoxin (Lanoxin, Cardoxin) used in the
management of congestive heart failure?
A) Inhibits sodium-potassium ATPase
B) Blocks beta-adrenergic receptors
C) Inhibits angiotensin-converting enzyme
D) Increases chloride channel conductance
Correct Answer: A) Inhibits sodium-potassium ATPase
Explanation: Digoxin inhibits sodium-potassium ATPase, increasing intracellular calcium in
cardiac myocytes, which enhances contractility (positive inotropic effect) in heart failure.
, Which of the following is an aldosterone antagonist and is useful in the management of
hypertensive patients with hypokalemia?
A) Hydrochlorothiazide
B) Furosemide
C) Spironolactone
D) Amiloride
Correct Answer: C) Spironolactone
Explanation: Spironolactone, an aldosterone antagonist, is potassium-sparing and effective for
hypertension with hypokalemia, as it reduces sodium reabsorption and potassium excretion in the
distal tubule.
Which of the following agents is the most appropriate choice as a diuretic in patients with
hypertension, heart failure, and renal failure?
A) Hydrochlorothiazide
B) Furosemide
C) Spironolactone
D) Mannitol
Correct Answer: B) Furosemide
Explanation: Furosemide, a loop diuretic, is effective in hypertension, heart failure, and renal
failure, as it works in low renal function to reduce fluid overload and manage symptoms.
Which is the atypical antidepressant known to block the reuptake of dopamine and
norepinephrine (NDRI) and is used to treat depression and nicotine addiction?
A) Fluoxetine
B) Bupropion
C) Mirtazapine
D) Venlafaxine
Correct Answer: B) Bupropion
Explanation: Bupropion, an NDRI, blocks dopamine and norepinephrine reuptake, making it
effective for depression and as an aid for smoking cessation.
Which drug increases GABA activity and chloride conductance in neuronal cells, inhibiting
action potentials, and is known to treat anxiety, convulsions, and could cause marked sedation?
A) Diazepam
B) Buspirone
