NURS 5334 Advanced Pharmacology for Nurse
Practitioners – Real Exam 2 Questions with
verified Answers (2025 Edition)
Overview
This comprehensive Actual exam is designed for Advanced Pharmacology NP students
preparing for NURS 5334 Exam 2. The questions cover high-yield topics in cardiovascular,
endocrine, neurological, renal, gastrointestinal, and psychiatric pharmacology, with a focus
on:
Mechanisms of action of common and high-risk drugs
First-line therapies for common chronic and acute conditions
Adverse effects, contraindications, and drug interactions
Monitoring parameters and patient safety considerations
Clinical decision-making and evidence-based pharmacotherapy
Question 1
A 55-year-old patient with chronic heart failure is prescribed digoxin. Which of
the following symptoms would indicate digoxin toxicity?
A. Bradycardia, nausea, visual disturbances (yellow halos)
B. Tachycardia, hypertension, flushing
C. Hyperactivity, insomnia, tremors
D. Hypoglycemia, weight gain, dry mouth
Rationale:
Digoxin has a narrow therapeutic index.
Toxicity often presents as GI symptoms (nausea, vomiting), CNS
symptoms (fatigue, confusion), cardiac symptoms (bradycardia,
dysrhythmias), and visual disturbances such as yellow-green halos.
,Question 2
Which beta-blocker is most cardioselective and preferred in patients with asthma?
A. Propranolol
B. Metoprolol
C. Carvedilol
D. Labetalol
Rationale:
Cardioselective beta-1 blockers (e.g., metoprolol, atenolol) mainly affect
the heart and have minimal effect on the lungs.
Non-selective beta-blockers (propranolol) can cause bronchospasm in
patients with asthma.
Question 3
A patient on warfarin presents with an INR of 6.0 and minor bleeding. What is the
most appropriate immediate action?
A. Increase warfarin dose
B. Hold warfarin and administer vitamin K
C. Continue current dose and monitor
D. Administer aspirin
Rationale:
An INR >5 increases bleeding risk.
Vitamin K reverses warfarin anticoagulation.
Continuing warfarin or giving aspirin would worsen bleeding.
Question 4
Which antibiotic class can cause QT prolongation and should be used cautiously
in patients with cardiac arrhythmias?
,A. Macrolides (e.g., azithromycin)
B. Penicillins
C. Cephalosporins
D. Aminoglycosides
Rationale:
Macrolides can prolong the QT interval, increasing risk for torsades de
pointes.
Monitor ECG in patients with risk factors.
Question 5
A patient is prescribed metformin for type 2 diabetes. Which patient education
point is essential?
A. Avoid alcohol to reduce risk of lactic acidosis
B. Take with food to reduce risk of hypoglycemia
C. Monitor potassium levels closely
D. Take at bedtime to improve efficacy
Rationale:
Metformin rarely causes hypoglycemia.
The major risk is lactic acidosis, particularly in alcohol users or patients
with renal impairment.
Question 6
Which statin is preferred in patients with liver disease due to its lower
hepatotoxicity risk?
A. Atorvastatin
B. Rosuvastatin
C. Pravastatin
D. Simvastatin
, Rationale:
Pravastatin is hydrophilic and metabolized less by the liver compared to
lipophilic statins.
It has a lower risk of hepatotoxicity and is safer in patients with mild liver
disease.
Question 7
A patient is started on ACE inhibitors for hypertension. Which adverse effect
requires immediate discontinuation?
A. Dry cough
B. Hyperkalemia
C. Angioedema
D. Mild hypotension
Rationale:
ACE inhibitors can rarely cause angioedema, a potentially life-threatening
reaction.
Mild cough and hypotension can be monitored, hyperkalemia requires dose
adjustment, but angioedema requires stopping the drug immediately.
Question 8
Which anticoagulant is preferred in a patient with heparin-induced
thrombocytopenia (HIT)?
A. Warfarin
B. Low molecular weight heparin
C. Argatroban
D. Aspirin
Rationale:
HIT is an immune-mediated reaction to heparin.
Practitioners – Real Exam 2 Questions with
verified Answers (2025 Edition)
Overview
This comprehensive Actual exam is designed for Advanced Pharmacology NP students
preparing for NURS 5334 Exam 2. The questions cover high-yield topics in cardiovascular,
endocrine, neurological, renal, gastrointestinal, and psychiatric pharmacology, with a focus
on:
Mechanisms of action of common and high-risk drugs
First-line therapies for common chronic and acute conditions
Adverse effects, contraindications, and drug interactions
Monitoring parameters and patient safety considerations
Clinical decision-making and evidence-based pharmacotherapy
Question 1
A 55-year-old patient with chronic heart failure is prescribed digoxin. Which of
the following symptoms would indicate digoxin toxicity?
A. Bradycardia, nausea, visual disturbances (yellow halos)
B. Tachycardia, hypertension, flushing
C. Hyperactivity, insomnia, tremors
D. Hypoglycemia, weight gain, dry mouth
Rationale:
Digoxin has a narrow therapeutic index.
Toxicity often presents as GI symptoms (nausea, vomiting), CNS
symptoms (fatigue, confusion), cardiac symptoms (bradycardia,
dysrhythmias), and visual disturbances such as yellow-green halos.
,Question 2
Which beta-blocker is most cardioselective and preferred in patients with asthma?
A. Propranolol
B. Metoprolol
C. Carvedilol
D. Labetalol
Rationale:
Cardioselective beta-1 blockers (e.g., metoprolol, atenolol) mainly affect
the heart and have minimal effect on the lungs.
Non-selective beta-blockers (propranolol) can cause bronchospasm in
patients with asthma.
Question 3
A patient on warfarin presents with an INR of 6.0 and minor bleeding. What is the
most appropriate immediate action?
A. Increase warfarin dose
B. Hold warfarin and administer vitamin K
C. Continue current dose and monitor
D. Administer aspirin
Rationale:
An INR >5 increases bleeding risk.
Vitamin K reverses warfarin anticoagulation.
Continuing warfarin or giving aspirin would worsen bleeding.
Question 4
Which antibiotic class can cause QT prolongation and should be used cautiously
in patients with cardiac arrhythmias?
,A. Macrolides (e.g., azithromycin)
B. Penicillins
C. Cephalosporins
D. Aminoglycosides
Rationale:
Macrolides can prolong the QT interval, increasing risk for torsades de
pointes.
Monitor ECG in patients with risk factors.
Question 5
A patient is prescribed metformin for type 2 diabetes. Which patient education
point is essential?
A. Avoid alcohol to reduce risk of lactic acidosis
B. Take with food to reduce risk of hypoglycemia
C. Monitor potassium levels closely
D. Take at bedtime to improve efficacy
Rationale:
Metformin rarely causes hypoglycemia.
The major risk is lactic acidosis, particularly in alcohol users or patients
with renal impairment.
Question 6
Which statin is preferred in patients with liver disease due to its lower
hepatotoxicity risk?
A. Atorvastatin
B. Rosuvastatin
C. Pravastatin
D. Simvastatin
, Rationale:
Pravastatin is hydrophilic and metabolized less by the liver compared to
lipophilic statins.
It has a lower risk of hepatotoxicity and is safer in patients with mild liver
disease.
Question 7
A patient is started on ACE inhibitors for hypertension. Which adverse effect
requires immediate discontinuation?
A. Dry cough
B. Hyperkalemia
C. Angioedema
D. Mild hypotension
Rationale:
ACE inhibitors can rarely cause angioedema, a potentially life-threatening
reaction.
Mild cough and hypotension can be monitored, hyperkalemia requires dose
adjustment, but angioedema requires stopping the drug immediately.
Question 8
Which anticoagulant is preferred in a patient with heparin-induced
thrombocytopenia (HIT)?
A. Warfarin
B. Low molecular weight heparin
C. Argatroban
D. Aspirin
Rationale:
HIT is an immune-mediated reaction to heparin.
