NR 567 Advanced Pharmacology for the
AGACNP Midterm Exam Review |
Chamberlain College | Latest 2026–2027
Update | Questions and Verified
Answers | Grade A | 100% Correct
Instructions: This midterm exam contains 50 multiple-choice questions covering advanced
pharmacology for the Adult-Gerontology Acute Care Nurse Practitioner (AGACNP), focusing on
acute care pharmacology, drug mechanisms, interactions, adverse effects, and evidence-based
prescribing in critical care settings. Select the best answer (A–D) for each question. Each
question is worth 2 points (total 100 points). Use this for study and review. Good luck!
Question 1
A 65-year-old patient in septic shock is prescribed norepinephrine. What is its primary
mechanism of action?
A. Alpha-1 agonism causing vasoconstriction
B. Beta-1 agonism for inotropy
C. Vasodilation via nitric oxide
D. Dopamine receptor stimulation
Correct Answer: A
Rationale: Norepinephrine primarily stimulates alpha-1 receptors to increase systemic vascular
resistance in septic shock, per Surviving Sepsis Campaign guidelines. Why correct: Addresses
vasodilatory hypotension. Why others are incorrect: Beta-1 (B) is dobutamine; vasodilation (C)
is nitroglycerin; dopamine (D) is a separate agent.
Question 2
What is the primary indication for epinephrine in cardiac arrest?
A. Restore circulation via alpha and beta agonism
,B. Reduce intracranial pressure
C. Prevent arrhythmias
D. Improve renal perfusion
Correct Answer: A
Rationale: Epinephrine stimulates alpha and beta receptors to increase perfusion and
contractility, per AHA ACLS guidelines. Why correct: Enhances ROSC. Why others are
incorrect: ICP (B) is mannitol; arrhythmias (C) is amiodarone; renal (D) is secondary.
Question 3
A patient with acute decompensated heart failure is prescribed furosemide. What is a key
adverse effect?
A. Hypokalemia
B. Hyperkalemia
C. Hyperglycemia
D. Seizures
Correct Answer: A
Rationale: Furosemide, a loop diuretic, promotes potassium excretion, risking hypokalemia, per
ACC/AHA. Why correct: Can cause arrhythmias. Why others are incorrect: Hyperkalemia (B)
is spironolactone; hyperglycemia (C) is corticosteroids; seizures (D) are unrelated.
Question 4
Which antibiotic is first-line for community-acquired bacterial meningitis in adults?
A. Ceftriaxone
B. Vancomycin
C. Azithromycin
D. Doxycycline
Correct Answer: A
Rationale: Ceftriaxone covers common pathogens (S. pneumoniae, N. meningitidis) in
meningitis, per IDSA. Why correct: High CNS penetration. Why others are incorrect:
Vancomycin (B) for MRSA; azithromycin (C) and doxycycline (D) for atypical infections.
Question 5
A 70-year-old with acute gout flare is prescribed colchicine. What is a key precaution?
A. Reduce dose in renal impairment
, B. Take with high-fat meals
C. Monitor blood glucose
D. Avoid in hypertension
Correct Answer: A
Rationale: Colchicine requires dose adjustment in renal impairment to avoid toxicity, per ACR.
Why correct: Prevents myopathy. Why others are incorrect: Meals (B) increase toxicity;
glucose (C) is unrelated; hypertension (D) is not a contraindication.
Question 6
What is the mechanism of action of propofol in ICU sedation?
A. GABA-A receptor agonism
B. NMDA receptor antagonism
C. Alpha-2 agonism
D. Opioid mu-receptor agonism
Correct Answer: A
Rationale: Propofol enhances GABA activity for rapid sedation, per SCCM. Why correct: Fast
onset and offset. Why others are incorrect: NMDA (B) is ketamine; alpha-2 (C) is
dexmedetomidine; opioid (D) is fentanyl.
Question 7
In acute ischemic stroke, what is the therapeutic dose of alteplase (tPA)?
A. 0.9 mg/kg IV (max 90 mg)
B. 1.5 mg/kg IV (max 100 mg)
C. 0.5 mg/kg IV (max 50 mg)
D. 2.0 mg/kg IV (max 120 mg)
Correct Answer: A
Rationale: Alteplase is dosed at 0.9 mg/kg (max 90 mg) for stroke, per AHA. Why correct:
Balances efficacy and bleeding risk. Why others are incorrect: Higher (B, D) or lower (C)
doses increase complications or inefficacy.
Question 8
A patient with acute pancreatitis is prescribed pantoprazole. What is its primary purpose?
A. Prevent stress-induced GI bleeding
B. Reduce pancreatic enzyme activity
AGACNP Midterm Exam Review |
Chamberlain College | Latest 2026–2027
Update | Questions and Verified
Answers | Grade A | 100% Correct
Instructions: This midterm exam contains 50 multiple-choice questions covering advanced
pharmacology for the Adult-Gerontology Acute Care Nurse Practitioner (AGACNP), focusing on
acute care pharmacology, drug mechanisms, interactions, adverse effects, and evidence-based
prescribing in critical care settings. Select the best answer (A–D) for each question. Each
question is worth 2 points (total 100 points). Use this for study and review. Good luck!
Question 1
A 65-year-old patient in septic shock is prescribed norepinephrine. What is its primary
mechanism of action?
A. Alpha-1 agonism causing vasoconstriction
B. Beta-1 agonism for inotropy
C. Vasodilation via nitric oxide
D. Dopamine receptor stimulation
Correct Answer: A
Rationale: Norepinephrine primarily stimulates alpha-1 receptors to increase systemic vascular
resistance in septic shock, per Surviving Sepsis Campaign guidelines. Why correct: Addresses
vasodilatory hypotension. Why others are incorrect: Beta-1 (B) is dobutamine; vasodilation (C)
is nitroglycerin; dopamine (D) is a separate agent.
Question 2
What is the primary indication for epinephrine in cardiac arrest?
A. Restore circulation via alpha and beta agonism
,B. Reduce intracranial pressure
C. Prevent arrhythmias
D. Improve renal perfusion
Correct Answer: A
Rationale: Epinephrine stimulates alpha and beta receptors to increase perfusion and
contractility, per AHA ACLS guidelines. Why correct: Enhances ROSC. Why others are
incorrect: ICP (B) is mannitol; arrhythmias (C) is amiodarone; renal (D) is secondary.
Question 3
A patient with acute decompensated heart failure is prescribed furosemide. What is a key
adverse effect?
A. Hypokalemia
B. Hyperkalemia
C. Hyperglycemia
D. Seizures
Correct Answer: A
Rationale: Furosemide, a loop diuretic, promotes potassium excretion, risking hypokalemia, per
ACC/AHA. Why correct: Can cause arrhythmias. Why others are incorrect: Hyperkalemia (B)
is spironolactone; hyperglycemia (C) is corticosteroids; seizures (D) are unrelated.
Question 4
Which antibiotic is first-line for community-acquired bacterial meningitis in adults?
A. Ceftriaxone
B. Vancomycin
C. Azithromycin
D. Doxycycline
Correct Answer: A
Rationale: Ceftriaxone covers common pathogens (S. pneumoniae, N. meningitidis) in
meningitis, per IDSA. Why correct: High CNS penetration. Why others are incorrect:
Vancomycin (B) for MRSA; azithromycin (C) and doxycycline (D) for atypical infections.
Question 5
A 70-year-old with acute gout flare is prescribed colchicine. What is a key precaution?
A. Reduce dose in renal impairment
, B. Take with high-fat meals
C. Monitor blood glucose
D. Avoid in hypertension
Correct Answer: A
Rationale: Colchicine requires dose adjustment in renal impairment to avoid toxicity, per ACR.
Why correct: Prevents myopathy. Why others are incorrect: Meals (B) increase toxicity;
glucose (C) is unrelated; hypertension (D) is not a contraindication.
Question 6
What is the mechanism of action of propofol in ICU sedation?
A. GABA-A receptor agonism
B. NMDA receptor antagonism
C. Alpha-2 agonism
D. Opioid mu-receptor agonism
Correct Answer: A
Rationale: Propofol enhances GABA activity for rapid sedation, per SCCM. Why correct: Fast
onset and offset. Why others are incorrect: NMDA (B) is ketamine; alpha-2 (C) is
dexmedetomidine; opioid (D) is fentanyl.
Question 7
In acute ischemic stroke, what is the therapeutic dose of alteplase (tPA)?
A. 0.9 mg/kg IV (max 90 mg)
B. 1.5 mg/kg IV (max 100 mg)
C. 0.5 mg/kg IV (max 50 mg)
D. 2.0 mg/kg IV (max 120 mg)
Correct Answer: A
Rationale: Alteplase is dosed at 0.9 mg/kg (max 90 mg) for stroke, per AHA. Why correct:
Balances efficacy and bleeding risk. Why others are incorrect: Higher (B, D) or lower (C)
doses increase complications or inefficacy.
Question 8
A patient with acute pancreatitis is prescribed pantoprazole. What is its primary purpose?
A. Prevent stress-induced GI bleeding
B. Reduce pancreatic enzyme activity
